What can one do about premature ejaculation? by James Leslie McCary.From "Human Sexuality" a brief edition by James Leslie McCary. D. Van Nostrand Company, Copyright 1973, ISBN 0-442-25236-6 The Treatment of Premature Ejaculation Given the cooperation of his lover, a man can train himself (except when the cause is purely physical) to withhold orgasm until both want it to happen. The main enemy is the fear and anxiety engendered in the man by previous failures. Once he gains confidence in his "staying power" and accepts the fact that all men face the problem at one time or another, the battle is half won. To assist him toward confidence in his abilities, several routes can be taken. Some counsellors recommend that a local anesthetic (for example, Nupercainal) be applied to the penile glans--care being taken not to smear any of the ointment on the woman's vulva--a few minutes before the beginning of intercourse. The assumption is that the deadening effect will decrease the sensitivity of the penis and delay ejaculation. Others prescribe the wearing of one or more condoms to reduce the stimulation generated by the friction of intercourse and the warmth and moisture within the vagina. Since muscular tension is a notorious catalyst in ejaculation, premature ejaculation my be prevented by the man's lying beneath the woman and thus taking a more passive role in coitus. (Sexual intercourse in the cramped confines of an automobile is unsatisfactory for many reasons, one of which is that it often creates muscular tension that terminates in early ejaculation.) Some men also find that taking a drink just before coitus helps, since alcohol is a deterrent in all physiological functioning. Other men claim similar success through concentrating on singularly unsexy thoughts, such as their income tax payments. (It is suggested, however, that these men take care not to let their partners know of their diversionary thoughts, lest they be dumped from the bed before ejaculation, premature or otherwise!) Having an orgasm and, after a short rest, attaining another erection often permit a man to experience a more prolonged act of coitus the second time. Some men masturbate shortly before they expect to have sexual intercourse; because their sex drive will thereby be decreased, they can then prolong intercourse later. The technique of delaying the man's orgasm can be learned, and probably the best method is one requiring the cooperation of both the man and his sex partner. The best chance of success lies in both partners' consulting a psychotherapist who will, first of all, assure the couple that premature or early ejaculation is a reversible phenomenon. The couple will then be instructed in the somewhat complicated technique of bringing about the reversal of premature ejaculation. The technique requires that the woman manually stimulate her partners' genitals until the point that he feels the very earliest signs of "ejaculatory inevitability." (This is the stage of a man's orgasmic experience at which he feels ejaculation of seminal fluid coming, and can no longer control it.) At that moment he signal the woman with such a pre-agreed word as "now", and she immediately ceases her massage of the penis. She then quickly squeezes its glans, or head, by placing her thumb on the frenulum (on the lower surface of the glans) and two fingers on the top of the glans, applying rather strong pressure for 3 or 4 seconds. The pressure will be uncomfortable enough to cause the man to lose the urge to ejaculate. Such "training sessions" should continue for 15 to 20 minutes, with alternating periods of sexual stimulation and squeezing. In later sessions, the man inserts his penis in the woman's vagina as she sits astride him until he senses impending orgasm, at which point he withdraws and she once more squeezes the penis to stop ejaculation. Use of these techniques is continued un further sexual encounters until, progressively, the man is capable of prolonged sexual intercourse, in any position, without ejaculating sooner than he wishes. Two notes of caution should be sounded to those using this technique. First, the technique will be unavailing if the man himself applies the pressure to his penis; and, second, the couple must not treat this new- found sexual skill as a game and overdo it. If the technique is overused, the man may eventually find that he has become insensitive to the stimulation and unable to respond to it. He may then develop new fears, this time about his potency, and risk developing secondary impotence. The guidance of a therapist is strongly recommended in the treatment of premature ejaculation to prevent such secondary problems. Masters and Johnson report a 97.8% success rate in the treatment of premature ejaculation. In any discussion of premature ejaculation, a word of caution must be injected. It is important to understand that at any one time or another almost every man has experienced ejaculation more swiftly than he or his partner would have liked. The essential thing is that the man not became anxious over possible future failures. Otherwise what is a normal, situational occurrence may become a chronic problem. --------------------------------------- c3-16. Is it possible for men to be multi-orgasmic? From: sawyer@hubble..westford.ccur.com (George Sawyer) Keywords: NEMO, Taoist Yoga, Sexual techniques Message-ID: <62486@masscomp.westford.ccur.com> Date: 4 Nov 91 16:49:14 GMT The following is a modified repost of my answer to "Postie's query" I study and teach Taoist esoteric yoga, and among the practices are sexual techniques which are VERY EFFECTIVE. There are solo techniques, and partner techniques. They require ongoing practice and, for men, realistically speaking, the partner techniques require a practising partner. A basic concept is that you can have an orgasm without ejaculating. Since ejaculation takes you through the refractory period & etc. cycle as well as emptying your fluid level, it tends to limit activity. Remove this constraint and you can go on as long as you want. (Have as many orgasms as you want). When you get close to the point of ejaculatory inevitability, you perform the techniques, which pull the sexual energy out of your testes / prostate up to your brain & compress the prostate causing partial loss of erection & subsiding of prostate. When the energy moves upward, you have an non-ejaculatory orgasm. The only way I can describe the orgasm experience is to compare it to to some types of psychedelic drug experiences - except that you are in control and can stop immediately if you want. The more you practice, the longer and stronger the effects are. An orgasm of 5 to 10 minutes is "quite easy" and you can become able to have one of more than an hour with "determined practice". About an hour twenty minutes is my personal best (from solo practice at that) and I made it stop because I was getting too high. You tend to rest for a few or several minutes after each orgasm, being with your partner, and then optionally doing it again. Use lots of lubricant. There are different levels of orgasm, the initial one being a "senses" orgasm, in which you experience amplified pleasure from all your senses simultaneously. Since this includes touch, it is a bodywide experience. An "unexpected" benefit for men is that you will always have more energy after sex than before, thus dramatically reducing the "roll off and snore" syndrome. Also, after sex you will feel much closer to your partner and much more connected than prior. Many people have intense experiences of total connection and submersion into each other. It is also a First Class system for being celibate. Completely eliminates wet dreams, and gives you a fair amount of choice about whether to allow yourself to become aroused or not. Over the long term you develop some degree of control over your sexual desire in general. Feels great (even the non-aroused solo practice), and doesn't require "struggle and effort". The non-aroused solo practices are being done by individuals in many Christian monasteries & nunneries in Europe. Downsides. NOT TO BE IGNORED For men, it only really works if your partner practices too. Otherwise they get BORED watching you have extended orgasms while they wait. Initially, it is QUITE DIFFICULT not to ejaculate, and you will need cooperation from your partner at the WORST possible times - "I need to stop NOW!". It does not work well with promiscuity. It takes time to learn - I'll say an average of 6 months to beginning of competence and control, and requires 15min to 30min per day of various meditative practices. Realistically, most people don't stick to it long enough to be able to do it. Success rate among persistent people is very high, and the practices are not difficult. Some women find it really weird if you don't ejaculate, and you can really fuck up your relationship/marriage if you don't take care of your significant other first and foremost. That is far more important than mastery of sex techniques. These techniques are not part of a religion, no Deities to believe in, no statues, none of that. The techniques are described quite clearly in: "Taoist Secrets of Love: Cultivating Male sexual energy" (men's) "Healing Love thru the Tao: Cultivating Female sexual energy" (women's) Both are written by Mantak and Manewan Chia, and widely available at New Age bookstores. The pre-requisite is: "Awakening Healing Energy Thru the Tao" Most people find these reference books a bit much, and take one day courses. There are about 70 instructors in the USA, you can find the nearest one by calling the Healing Tao center @ (516) 367-2701. Classes are about $85, and there is a pre-requisite course "The Microcosmic Orbit" which is also about $85. DO NOT IGNORE THE SAFETY POINTS IN THE BOOKS Happy practice! --------------------------------------- c3-17. What are some good positions to try out? The Teachings of Kama Sutra: (See Appendix 3. The list is long enough to warrant it's own section.) From the net (* indicates beginning of a new post): * Both are variations of the missionary position and can be done with either person on top: 1) Instead of the usual man's legs inside the woman's legs, have the man place one leg _outside_ the woman's legs. The allows a "sideways" penetration which makes my SO happy. 2) Place _both_ man's legs outside the woman's legs. This causes inward pressure on the vagina and clitoris and tightens the vagina. We both like this very much :) Note: If the woman is on top you must be careful not to crush the man's testicles :( * Have her lay on her side, bottom leg straight and top leg bent at the knee, which is in the air. You approach her, sitting up, straddling her bottom leg and enter her this way. This allows for *deep* entry which your SO may or may not like. * Penile thrusting from the right angle can pull the labia enough to give amazing clitoral stimulation. I usually find this happens most with rear-entry positions. * The first is with the woman on top, her legs straight and directly over the man's, pushing her weight backwards and forwards with her arms (above the man's shoulders); The other is basically the same thing with the man on top, sliding forward and backward. We also occasionally use a position with her legs inside mine, but on top. We both have to be pretty energetic for this, though. It seems to produce intense sensation, increased tightness and friction, etc., but we've never been able to make it lead to an orgasm for my partner. * Have the guy lie on his back legs spread wide. Have her mount with her back towards you. Now, with your thigh between her legs bend your knee slightly, this way she can bounce her clit on your thigh with each stroke. With your leg you can control how much she gets... straighten out your leg and she has to go down further to get the same stimulation. Guess it works well for me 'cause of my 18" thighs. ;) * A recent x-SO of mine had a favorite position, and I was wondering if other women enjoy this also. I would enter her from behind (just like doggy style), then while I was fully inserted she would lie down with me on top of her. We would both place our hands underneath her (just above were I was inserted. Then she would wiggle almost methodically. I assume this put great pressure on the clitoris. However after a short time she would orgasm and even sometimes multiple. * My ex-SO much preferred doggy style. She indicated that that was the right level of penetration. What is the position called that has man on top, woman with legs up so far that her knees are practically at her ears? My ex-SO did not like that, she said penetration was too deep. Same thing with her on top, but sitting up, making her body at right angles to mine. Also, she says that doggy style caused some stimulation of the clitoral and pudendal region that wasn't there in other positions, presumably because of the movement of tissues around the outside of the vagina during intercourse. Upside-down position: * That question on the purity test refers to (I believe) the people being opposite - ie one standing upright and one standing on their hands or head. This is a fun one, but you have to be careful that you don't stand up too quickly afterwards if you have been upside down or you could possibly pass out. OR * Have her sitting on the edge of the bed, facing away from the edge, on your lap. Lean over forwards, holding on to a handy dresser. She does a handstand, and you hold yourself up with one hand and hold both of you together with the other. Good for some giggles. * We prefer it with the man on his back, with lots of pillows under his rear end, propping him up.. I then mount directly on top, one leg between his and the other between his leg and arm, i.e. I am at a 90 angle with him, sort of squatting, at least initially :-) If I then lean forward and move up and down and around, the combination of deep penetration and frontal rubbing of my clitoris on his leg makes for a very interesting combination. * standing up...my girlfriend's hanging on to my shoulders, and her legs definitely don't touch the ground. * My SO likes really deep penetration. She likes "doggie-style" but she prefers variations of "in the buck" (legs over the man's shoulders to provide deeper penetration.) Actually, as long as you get your arms under her knees it provides the same effect -- some women, my SO included, find it extremely uncomfortable to have their knees pressed all the way up to their chest during intercourse and just putting your arms under her knees or legs will lift her rear up and arch her back, giving you a better angle to penetrate at. Also, since your arms are under her legs, you are supporting some of her weight, so she doesn't have to hold her own rear up for you. When we get into this position, I've found that she prefers a sort of rocking motion as opposed to a straight in-and-out thrusting (try bending your own legs so that your knees come up about even with her hips, then you'll be almost cradling her in your lap and if you rock back and forth you will stay inside and alternate between plunging deep and not-so-deep--this has been the easiest way for me to bring her to orgasm). Another thing she likes is to get on top and face away from me. I'm living in a college apartment and I've got the bottom bunk and the bed above has bars under it. I can grab one of these bars and pull myself up into her, and if I go fast and hard enough, we can get the bed bouncing pretty good and she actually bounces up off of my penis and plunges back down onto it. She really enjoys this but it's tough for me to do it for very long. --------------------------------------- c3-18. What is the M-spot? From: (unknown) I don't know if the spot I'm talking about is really the "M-spot," or not. There's actually a *pair* of these "spots." You stimulate them from outside the body, unlike the G-spot, which you get at from inside the vagina. These "M-spots" are on both men and women! They're not easy to find, and you've got to already be somewhat sexually aroused, I think, or it won't feel like anything. I think you probably also have to be ticklish, but maybe not. Stand up. Take your shirt and pants off. Put your hands on your hips. Now, feel how your hands are resting on a big "shelf" of bone? That's your pelvic bone. Grip that bone, and get a feel for the shape of it in that area. Now, concentrate on where the tips of your fingers are. Feel around that area. Relax your stomach muscles completely. (Try sitting down if it helps you relax that area.) If you have big hands, or a small waist, your fingertips are probably already on "the spots." Otherwise, move your hands forward, around towards the front of you a little bit, until you find the edge of that bone, on both sides. Now reach around that ridge of bone, pressing in on the sides of your tummy. Dig in with your fingertips. That's it! They're *right* on the edge of that bone, off the insides of it, not off the top of it. Your fingertips should be somewhere just below and to the sides of your belly-button. I can't describe it any better than that. It's probably easier to find if your partner does the searching, instead. If you look for the spots yourself, you could be pressing right in them and not know it, because it's like trying to tickle yourself -- it just doesn't work. Get naked with your partner, do some normal foreplay for a while, and get to where you're really ready for sex. Then have your partner stand behind you, and have him/her put their hands on your hips, as if you were, then proceed as given above. If they push and poke around in that area long enough, they're bound to find the spots. They might end up just tickling you to death, though. :-) (If it tickles, they're not pressing hard enough.) When they do find your M-spots, you will KNOW IT. You will feel a fire light up inside you. Within moments, you will want to turn around and kiss your partner so hard they suffocate. It is VERY intense. It's kind of uncomfortable, at first, and you can't take it for very long. If you're SO is "moving too slow" during foreplay, go for these spots. Things will speed up REAL fast. Good luck ... Sorc Re: M-spot I've experienced something like this, although she (my girlfriend at the time, not a prostitute :-) touched a spot to either side of the navel, not directly below it. 1 - 2 inches down is about right, but then 2 - 3 inches over. It's right on the inside of the pelvic bone. If you're wearing jeans, and you casually hang your thumbs over those first two belt loops, the tips of your thumbs are right there. This wasn't just a "male" thing -- it worked on her, too. It's just ticklish if you do it too lightly, but press a little more firmly, and it's *very* intense. It's not really orgasm-inducing, but it turns light arousal into high arousal *really* fast. Get ready for your partner to *tackle* you if you do this right. Use several fingers and kind of "push in" on it, like you're kneading dough with your fingers. So, I don't know if this is the "M-spot," but it's definitely some kind of spot. :-) And it was great for warming up, but I don't know what it'd be like having it stimulated during actual intercourse. If she was on top, so the guy was relatively stationary, and she did that "kneading" while "riding" ... hm ... I'll put that on my list of things to try. :-) --------------------------------------- c3-19. What are Kegel exercises?/How can one increase the force of ejaculation? From: sesharp@happy.colorado.edu Message-ID: <1991Oct5.231811.1@happy.colorado.edu> Date: 6 Oct 91 05:18:11 GMT Kegel exercises (pronounced "Kay-gill", in case you ever actually have a conversation about them) were invented to give women better bladder control. They have a number of useful advantages in sex. In women, they can help tighten the vagina, particularly after childbirth. The muscles can also be used deliberately during intercourse to stimulate her partner. They have a variety of uses for men. As I already mentioned, they strengthen the muscles used in seminal retention, making that technique more effective. They can make ejaculation more powerful. This may increase male enjoyment somewhat and female enjoyment if she is sensitive to it. Deliberate twitches during intercourse are also useful for males. Knowing how to force relaxation of the muscles can help maintain control and prevent premature ejaculation, as well as relieving the muscle cramps that can occur from too many ejaculations in succession. For females: My recollection of the exercise regimen taken from the older ESO book is as follows. First you have to identify the PC muscles and get them under conscious control. Starting and stopping urination is one method. Inserting a finger into the vagina to feel the contractions or watching the movement of the erect penis is another. Once it is under control, there are three kinds of exercises. The first is to clench the muscle and hold it for two seconds before releasing it. The second is to bear down as though constipated, using the abdominal muscles to force the PC muscles to relax. I find that alternating reps of these two works well. The third exercise is a fast twitch of the muscle, with repetitions as close together as possible, similar to orgasmic contractions. An initial set of exercises consists of 10 repetitions of each exercise. Five sets should be performed in a day. As strength improves, the number of repetitions in a set is increased. Around 30 repetitions in a set is suggested as a good number for retaining good muscle tone. The exercises are unobtrusive and can be performed almost anywhere. For males: Kegel exercises might indeed help with [increasing the force of ejaculation]. Here is how they are performed by males. First you have to learn to consciously control the muscles. One way of doing this is to use them to stop and start urination repeatedly. When you have an erection, contracting them causes it to move, making them easy to identify. Once you have the muscles identified, there are three types of exercises to do: 1) try contracting the muscles and holding them that way for a slow count of ten. You may not be able to last that long at first, but that is why you are exercising. 2) force them to relax by bearing down as though you were constipated and trying to force a bowel movement. 3) twitch (contract and release) the muscles as fast as you can ten times in a row. I find that it works well to alternate each of the first type with one of the second type. I don't recall how many of these are recommended. Something like ten of each to start, eventually working up to a hundred. In addition to the possibility of increasing the force of ejaculation, these may increase the number of contractions and the total enjoyment. The same muscles can also be used to reduce the amount of semen in an ejaculation by contracting them as hard as possible during it. This leaves a less than satisfied feeling, usually accompanied by an urgent desire for another orgasm 10 to 20 minutes later. This can be useful if your partner wants more sex than you do. Supposedly, increasing the strength of the muscles can increase this effect to allow quite a few orgasms in a row. --------------------------------------- c3-20. What are blue balls? From: markley@grad1.cis.upenn.edu (Jim Markley) Blue Balls is a real condition! The "correct" term for blue balls is epididymitis, which is an inflammation of the epididymis. So what is an epididymis, you ask? Well from the library dictionary -- an elongated mass at the back of the testis composed chiefly of the greatly convoluted efferent tubes of that organ. In simple terms blue balls most commonly occurs when the epididymis get blocked up when the sperm leave the testis but not the penis. The "efferent tubes" are the conduit for the sperm from the testis to the urethra. When they get blocked you get pain. Why blue balls and not "swollen balls," well maybe the connotation is that you balls have the "blues", or maybe its because with all that swelling some of the blood flow is restricted enough to cause some blueing of the area because of pooling blood. ---------------------------------------------------------------------- c3-21. Is spanish fly dangerous? From: japlady@casbah.acns.nwu.edu (Rebecca Radnor) Subject: Re: Aphrodisiacs??? does really work??? In article Ochoa) writes: >I was wondering about all the aphrodisiacs that are announced on some >magazines, and wanted to know if they really work.. like the famous >spanish fly that i know the use it's illegal??? in their various >presentations like liquid or capsules, or the pheromones >lotion that claims to attract and seduce women in 3 out of 4... is that >really true??? anyone have tested yet???.. > There is this great show on CNBC called steals and deals that recently did a week on sex related stuff. They said that most of the spanish fly stuff that is sold is basically sugar water. The real machoy is illegal, and an over dose can be lethal. (I think they said it will give you a permanent hard-on that can develop gangrene and need to be surgically amputated, but I'm not sure.) There are some places that are selling it, but on the show they said that the risks are far to high compared to the benefits. On the other subjects, they said that most of the really good stuff is the kind of thing that you can get at any reputable sex shop (like the treasure chest in Chicago, or is it the Pleasure chest?). Just about everything else is a rip off. ======================================================================== Category 4. SEXUALLY TRANSMITTED DISEASES A quick table of current treatment effectiveness: Gonorrhea: curable Syphilis: curable in early stages Herpes: incurable, but effective treatment available. HPV: incurable, but treatment available. Chlamydia: curable Lice: curable AIDS: incurable, but some treatment available. Hepatitis B: incurable, but possible vaccine available. c4-1. How is the AIDS virus transmitted? and what does a HIV test show? (From: Travis Lee Winfrey "AIDS is caused by the Human Immuno-deficiency Virus (HIV). In a person infected with HIV, the virus can be present in the body's semen, blood, and breast milk. It can also be present, in much smaller quantities, in vaginal secretion, saliva, and tears. The AIDS virus can be transmitted via any of these fluids, but only the first two -- semen and blood -- are likely to be involved. Anal sex is the most commonly _perceived_ method of transfer, but vaginal sex has been repeatedly shown to transmit HIV. Men are less likely than women to be infected through vaginal sex, but they have, in fact, been infected this way. Cunnilingus and fellatio have also been established as capable of transmitting the virus. Sexual activities, not sexual orientation, transmit the virus. HIV cannot be passed on through casual contact, hugging, hand-shaking, touching the sweat of an infected person, or mosquito bites. HIV can pass through non-latex or "natural" condoms, such as Fourex Lambskin condoms. HIV transmission has nothing whatever to do with the presence of feces in anal sex. The HIV test shows the presence of antibodies to HIV. It does not show the presence of the virus: the body first has to develop antibodies, which normally takes about six weeks. Hence, a positive result means that someone has antibodies and could possibly develop AIDS in the future. A negative result means that someone does not have antibodies _at the moment_. If there is a reason to think that exposure was more recent than six weeks, then a test taken immediately can only serve as a baseline to compare against a test taken later. Within six months of HIV infection, 99% of the population will test positive. No one should be tested for HIV without first obtaining counselling and ensuring _beforehand_ support from his or her family or friends. The following numbers may be of use. AIDS Hotline (800) 342-2437 AIDS Information Clearing House (800) 458-5231 9-7 EST CDC AIDS Ethnicity, Age recording (404) 330-3020 CDC AIDS Transmission mode recording (404) 330-3021 CDC AIDS Top 10, Projections recording (404) 330-3022 --------------------------------------- c4-2. What is HPV (human papilloma virus)? Treatment? *** The writer raises several good questions, which are still *** *** unanswered. Any help will be greatly appreciated. *** From: loredich@miavx3.mid.muohio.edu (Loredich) Subject: HPV and genital warts: a dossier Message-ID: <427.294a72cb@miavx3.mid.muohio.edu> Date: 15 Dec 91 02:08:27 GMT HPV (human papilloma virus) is, like any virus, resistant to antibiotic therapy. Once a human is infected with the virus, there is no known treatment. HPV can cause warts to appear on the genitals, on the head of the penis in men, and both internally and externally in women. These warts have been inconclusively linked to cervical cancer in women. There is no reliable examination or culture that will reveal the presence of the virus unless warts have already developed, as far as I understand it. Is there anyone with differing information? Is it possible to diagnose HPV without the actual appearance of warts? The diagnostic procedure for women is called a colposcopy, which involves an examination of the cervix with a microscope-like device. The procedure for men involves an application of a solution to the penis which turns the warts white, making them easily visible. A similar examination for women involves the application of white vinegar, which makes the woman smell like a salad for several days afterward. The virus is transmissible through sexual contact. However, there seems to be some disagreement over the likelihood of transmission when no warts are present. The gurus at Planned Parenthood swear that the virus is transmissible at any time, with or without warts. But several letters I received declared that transmission is highly unlikely unless warts are present: apparently, the virus is not close enough to the surface of the skin to cause damage if no warts are visible. The jury is still out on this one. Anyone know for sure? Once the warts appear, they are removed either by freezing, burning, or laser surgery (which sounds like the least unpleasant option). Now, the virus itself does not go away, I was told, but the warts do once they are removed. Do they reappear? The consensus seems to be that they generally do not. One woman who wrote to me declared that she had seen no warts in seven years. Has anyone had recurring warts? No real word on whether oral sex is a bad idea. When the warts are present, I can't imagine that it would be too terribly pleasant, but wartlessly, is there a high risk of transmission? Again, Planned Parenthood shrieked in dismay and issued a stern "NO!" when I asked, but I am not quite sure how reliable their information has been. Does anyone know about this? Plenty of readers have suggested that oral sex be performed with a condom, but I am also concerned with being the receptive partner in this. Can oral sex be safely performed WITHOUT a condom or dental dam? Response from (anonymous) The serotypes of this virus that commonly cause venereal warts are associated with cervical cancer. Other serotypes of the virus have been linked to other malignancies. As to transmission of HPV in the absence of visible warts, even if no microscopic warts are present, the mechanical trauma of sex is known to cause at least microscopic damage to the skin/mucosa of the genitals that may provide a means of transmission of this virus. The presence of visible warts only increases the likelihood of such a transmission occurring in the absence of adequate barriers to transmission. HPV can be detected in a PAP smear as cellular atypia, but I believe that a PAP smear has a low sensitivity for detecting HPV. --------------------------------------- c4-3. The major sexually transmitted disease (STDs) and their symptoms (Gonorrhea, Syphilis, Genital Herpes, AIDS, Pubic Lice (Crabs), Nonspecific Urethritis (NSU), Hepatitis B are covered.) From: mf2x+@andrew.cmu.edu (Michael Raymond Feely) Date: 13 Oct 91 01:35:57 GMT All information is courtesy of "On Sex and Human Loving", Masters and Johnson Copyright 1985. All typos are mine, but sadly, this newsreader doesn't have a spell checker on it. Further info on the development times and the percentage of asymptomatic cases of AIDS would be appreciated... Gonorrhea --------- Transmission: Intercourse, fellatio, anal sex, cunnilingus, kissing (infrequently) Women run a roughly 50% chance of contracting the disease after one session of inter- course, men 20-25%. MALE Symptoms: Yellowish discharge from the penis. Painful, frequent urination. Symptoms develop from two to thirty days after infection. Roughly 10% of men have no symptoms. Later stages of the infection may move into the prostate, seminal vesicles, and epididymis, causing severe pain and fever. Untreated, gonorrhea can lead to sterility in a small minority of cases. UPDATE: Traditionally, gonorrhea in the male was thought to be a symptomatic disease as described above. More recently it has been recognized that a significant number of males have asymptomatic gonorrhea. As asymptomatic infections can lead to the same complications as symptomatic infections and can be transmitted in the same way, it is important for men to realize that an exposure needs to be investigated whether or not there are symptoms. Also, a complication of gonorrhea not mentioned above is septic arthritis (infected joint). While the infection itself is easy to treat, this can severely damage the involved joint (often the knee) leading to a permanent disability. FEMALE Symptoms: Under half of women with gonorrhea show no symptoms, or symptoms so mild they are commonly ignored. Early symptoms include increased vaginal discharge, irritation of the ex- ternal genitals, pain or burning on urination and abnormal menstrual bleeding. Women who are untreated may develop severe complications. The infection will usually spread to the uterus, Fallopian tubes, and ovaries, causing Pelvic Inflammatory Disease (PID). PID, though not only caused by gonorrhea, is the most common cause of female infer- tility. Early symptoms of PID are lower abdominal pain, fever, nausea, vomiting, and pain during intercourse. Syphilis -------- Transmission: Nominally sexual contact, but can be transmitted by blood transfusion or from an infected pregnant woman to her fetus. Symptoms: PRIMARY STAGE A chancre sore develops at the site of infection from two to four weeks after infection has occurred. The chancre is painless 75% of the time. The chancre starts as a dull red spot, turns into a pimple, which ulcerates, forming a round or oval sore with a red rim. The sore heals in 4-6 weeks - however, the infection is still present. The chancre is usually found on the genitals or anus, but can appear on any part of the skin. SECOND STAGE One week to six months after the chancre heals. Pale red or pinkish rash appears (often on palms or soles) fever, sore throat, headaches, joint pains, poor appetite, weight loss, hair loss. Moist sores may appear around the genitals or anus and are highly infectious. Symptoms usually last three to six months, but can come and go. LATENT STAGE No apparent symptoms, and the carrier is no longer contagious. However, the organism is insinuating itself into the host's tissues. 50 to 70 percent of carriers pass the rest of their lives without the disease leaving this stage. The reminder pass into Third Stage syphilis THIRD STAGE Serious heart problems, eye problems, brain and spinal cord damage, with a high probability of paralysis, insanity, blindness or death. From: (anonymous) While all of the symptoms mentioned are possible (as well as others), it usually manifests with a limited number of these symptoms at any one time (often just one). In the past, syphilis was known as the great imitator because it could resemble almost any known illness (It was said that "To know syphilis was to know medicine.") Modern diagnostic techniques now make this a much simpler disease to diagnose, especially in the early stages. The statement in the FAQ that later stages of syphilis are not curable is IMHO wrong. There is some controversy on this point in treating advanced neurosyphilis, but I believe this represents difficulties in evaluating the effectiveness of treatment in the short term in these patients. I believe patients who are not successfully treated represent treatment failures not incurable disease. Having said this, let me point out that damage by the disease prior to treatment is not reversible, although it is often treatable. Genital Herpes -------------- Transmission: Generally by sexual contact. Direct contact with infected genitals can cause transmission via intercourse, rubbing genitals together, oral genital contact, anal sex, or oral anal contact. In addition, normally protected areas of skin can become infected if there is a cut, rash, sore. Herpes viruses can be spread in some instances by kissing, if one participant has the infection sited in or near the mouth. Symptoms: Herpes is marked by clusters of small, painful blisters on the genitals. After a few days, the blisters burst, leaving small ulcers. In men, the blisters usually appear on the penis, but can appear in the urethra or rectum. In women, they usually appear on the labia, but can appear on the cervix and anal area. First outbreaks are accompanied by fever, headache, and muscle soreness for two or more consecutive days in 39% of men and 68% of women. Other relatively common symptoms include painful urination discharge from the urethra or vagina, and tender, swollen lymph nodes in the groin. These symptoms tend to disappear within two weeks. Aseptic meningitis occurs in 8 percent of cases, eye infections in 1% of cases, and infection of the cervix in 88% of infected women. Skin lesions last on average 16.5 days in men, 19.7 in women. Secondary symptoms are most prominent in the first four days and then gradually diminish. Recurrence: None in 10% of cases. Frequency for the remaining population is from once a month to once every few years. The majority of sufferers do not have repeat attacks after a few years. Most repeat attacks are less severe than the initial attack. AIDS (Acquired Immune Deficiency Syndrome) ----------------------------------------- Transmission: Sexual contact, sharing IV needles, blood transfusion (Note that blood is now routinely screened for HIV) Note also that the HIV virus is significantly less likely to be transmitted than the gonorrhea or syphilis bacteria. Symptoms: No single pattern exists. Most common symptoms are progressive, inexplicable weight loss, persistent fever, swollen lymph nodes, and reddish purple coin sized spots on the skin (These spots are Kaposi's sarcoma, a form of cancer) When symptoms appear, they may remain unchanged for months, of may be followed by any one of a number of op- portunistic infections. Typically these include pneumocystis carinii, an unusual form of pneumonia, fungal infections, tuberculosis, and various herpes forms. Treatment may fend off these infections, however the typical course is for one overwhelming infection to follow another until the victim succumbs due to the immune system's failure to return to a normal state, and hence, the opportunistic infection's relative freedom to wreak havoc on the victim's systems. It is possible for AIDS to be asymptomatic for prolonged periods of time while still being contagious. On the significance of symptoms of HIV separate from infections: While most AIDS patients do eventually die of/with various opportunistic infections, the significance of the chronic wasting can not be ignored. In the early days of AIDS, there were patients that by current definitions clearly had AIDS, but were never classified as such since they died of the "dwindles" before acquiring an opportunistic infection that would have made that diagnosis. Also, there has been much discussion of the minimal time until HIV seroconversion. It should be noted that patients with advanced HIV disease can become "HIV negative" as they lose the ability to make antibodies to HIV (this does not represent an improvement in the condition). A final comment on HIV: the opportunistic infections encountered in HIV infection are generally acquired common environmental pathogens or acquired from the host themselves. This is why HIV wards do not serve to infect all occupants with all diseases present. Pubic Lice (Crabs) ------------------ Transmission: Nominally through sexual contact, however they may be picked up through use of sheets, towels or clothing used by an infected person. Symptoms: Intense itching, usually felt mostly at night. Some victims have no symptoms, others may develop an allergic rash. Nonspecific Urethritis (NSU) ---------------------------- (Most commonly - Chlamydia trachomatous and T. mycoplasma) Transmission: Some cases are allergic or chemical reactions, and are not transmitted per se. Others are through sexual contact. Symptoms: Similar to gonorrhea but usually milder. Urethral discharge is generally thin and clear. Some cases are asymptomatic. Also: This can also precipitate a condition called Reiter's syndrome in susceptible persons. This is most commonly characterized by The Facts on Hepatitis B ------------------------ What is Hepatitis B? Hepatitis B, a potentially deadly, sexually transmitted disease, is not selective about who it infects: anyone can get hepatitis B. Yet, even though it affects the lives of hundreds of thousands in the United States, most people know very little about this serious disease. The hepatitis B virus has been spreading rapidly in the United States, with 14 Americans dying each day from hepatitis B-related illnesses. Chances are you know at least one person with hepatitis B because one in 20 Americans has been infected with the virus. Why is Hepatitis B Called a Sexually Transmitted Disease? Hepatitis B is not commonly thought of as a sexually transmitted disease. The fact is that it is commonly spread through sex, just like AIDS, syphilis, herpes and gonorrhea. The number of Americans who have contracted hepatitis B through sex has almost doubled in the last decade. Who Can get Hepatitis B? Because it is extremely contagious--100 times more contagious than AIDS--anyone can get hepatitis B. But you are in even greater danger if: o you have had more than one sexual partner in the last six months o you have had unprotected sex (without a condom) o you or your partner have ever been diagnosed with a sexually transmitted disease (such as herpes, gonorrhea, syphilis, chlamydia, genital warts or AIDS) o you or your partner have had sexual contact with someone who has had hepatitis B, or someone who is in one of the categories listed above What Are the Symptoms? About half of those who get hepatitis B will suffer from an inflammation of the liver, called acute hepatitis. Many people with hepatitis B mistake the symptoms for other illnesses, such as the flu, while others are more seriously affected and may miss school or work for months. Some of the symptoms caused by hepatitis B are: o mild, flu-like illness o skin rashes and arthritis o nausea o vomiting o loss of appetite o malaise o abdominal pain o jaundice (yellowing of the eyes and skin) What Happens if I Get Hepatitis B? Those who become chronically infected with hepatitis B have substantially higher risk of developing liver cancer than the general population. But even if you don't get liver cancer, the effects of hepatitis B infection can be so severe that you may not be able to go to school or work for several months. Then there are those who don't even know they have hepatitis B. We call them the "silent carriers". This group of symptomless carriers can pass the disease on to countless others unknowingly (and may eventually get very ill themselves). NOTE: THERE IS NO KNOWN CURE FOR HEPATITIS B although there is a possible vaccine. Ask a physician for more information. After May 1, you can call 1-800-HEP-B-873 for referral to a physician near you who can answer questions. Because the transmission of different STDs are not independent, persons who acquire _any_ STD are at considerably greater risk (epidemiologically) of acquiring other STDs. Persons diagnosed with one STD should be examined for other STDs at that time (Multiple infections are possible!!!). Persons who have ever had a STD (except lice, "crabs") should be aware of whatever was done that led them to acquire that STD. ======================================================================== Category 5. CONTRACEPTION c5-1. What are the various methods of contraception? and their effectiveness rates? and their associated risks if any? From: c31002wb@jezebel.wustl.edu (William Burris) Message-ID: <1992Mar10.215138.11142@wuecl.wustl.edu> Date: Tue, 10 Mar 1992 21:51:38 GMT % of women experiencing an accidental pregnancy in the first year of use ---------------------------------------------------- Lowest Lowest Method Expected Typical Reported ------------------------------------------------------------------------------ Chance 85 85 43.1 Spermicides 3 21 0.0 Periodic abstinence 20 Calender 9 14.4 Ovulation Method 3 10.5 Symptothermal 2 12.6 Postovulation 1 2.0 Withdrawal 4 18 6.7 Cervical Cap 6 18 8.0 Sponge Parous women 9 28 27.7 Nulliparous women 6 18 13.9 Diaphragm 6 18 2.1 Condom 2 12 4.2 IUD Progestasert 2.0 3 1.9 Copper T 380A 0.8 3 0.5 Pill Combined 0.1 3 0.0 Progestogen only 0.5 3 1.1 Injectable progestogen DMPA 0.3 0.3 0.0 NET 0.4 0.4 0.0 Implants NORPLANT (6 capsules) 0.04 0.04 0.0 NORPLANT (2 rods) 0.03 0.03 0.0 Female sterilization 0.2 0.4 0.0 Male sterilization 0.1 0.15 0.0 Associated Risk statistics Activity Chance of Death in a Year ------------------------------------------------------------------------------ Risks for men and women of all ages who participate in: Motorcycling 1 in 1,000 Automobile driving 1 in 6,000 Power boating 1 in 6,000 Rock climbing 1 in 7,500 Playing football 1 in 25,000 Canoeing 1 in 100,000 Risks for women aged 15 to 44 years: Using Tampons 1 in 350,000 Having sexual intercourse (PID) 1 in 50,000 Preventing pregnancy: Using birth control pills nonsmoker 1 in 63,000 smoker 1 in 16,000 Using IUDs 1 in 100,000 Using diaphragm, condom or spermicide NONE Using fertility awareness methods NONE Undergoing sterilization: Laparoscopic tubal ligation 1 in 67,000 Hysterectomy 1 in 1,600 Vasectomy 1 in 300,000 Continuing pregnancy 1 in 14,300 Terminating Pregnancy: Illegal abortion 1 in 3,000 Legal abortion Before 9 weeks 1 in 500,000 Between 9-12 weeks 1 in 67,000 Between 13-15 weeks 1 in 23,000 After 15 weeks 1 in 8,700 ------------------------------------------------------------------------------ The source is the 1990-1992, 15th Revised Edition of Contraceptive Technology. Authored by too many doctors to cite. However, this book is used by millions of doctors around the world as an authority on contraception. It's authors gather their sources from data published by several different statistic gathering organizations (such as the Centers for Disease Control) and then compile and interpret it in their book. Happy Reading. ----- From: mf2x+@andrew.cmu.edu (Michael Raymond Feely) Date: 1 Oct 91 20:52:32 GMT Nominally, the failure rates for contraceptive methods are expressed as "number of pregnancies per one hundred user couples per year" Thus of one hundred couples who used condoms as a birth control method, two experienced unwanted pregnancies in one year. Below are reproduced the failure rates for typical contraceptive methods. My source for this is the tome "Sex A User's Manual" published by The Diagram Group. (Berkeley Publishing Group, New York c 1981) The list of credited contributors includes Toni Bellefield, Medical Information Officer, Family Planning Information Service, and D.B. Garrioch, MD, MRCOG, Senior Registrar in Gynecology, St. Thomas' Hospital, London. Actual failure rate - number of pregnancies per 100 couples per year of use, includes conception do to user's failing to use the method properly, as well as through method failures. Theoretical failure rate - number of pregnancies expected per 100 couples per year of use, allowing only for failure of the method to function when used properly. Condoms breaking for no apparent reason, etc, are method failures. I = less than 1 X = expected failure rate, one X per pregnancy x = actual failure rate minus expected rate, one x per pregnancy I Tubal Ligation (E 0.04/A 0.04) I Vasectomy (E 0.15/A 0.15) XXXxx IUD (E 1-3/A 5) Ixxxxxxxxxx Combined Pill (E 1-1.5/A 5-10) Ixxxxxxxxxx Minipill (E 1-1.5/A5-10) XXXxxxxxxx Condoms (E 3/A 10) XXXxxxxxxxxxxxxxx Cap & Spermicide (E 3/A17) (Rates for diaphragm are probably somewhat lower) XXXXXXXxxxxxxxxxxxxx Rhythm (temp) (E 7/A 20) XXXXXXXXXXXXXxxxxxxxx Rhythm (calendar) (E 13 /A 21) XXxxxxxxxxxxxxxxxxxxxxxxx Rhythm (mucous) (E 2/A25) XXXxxxxxxxxxxxxxxxxxxxxxx Spermicides (E 3/A 20-25) XXXXXXXXXxxxxxxxxxxxxxxxx Withdrawal (E 9/A20-25) It is to be noted that this data is rather old, and therefore omits one crucial form of birth control currently available - the low dose pill. Low dose birth control pills are a more sophisticated development of the combined pill, and function in essentially the same way, but do not require as high an overall dose of hormones per month, thus reducing side effects considerably. Low dose pills may also be taken right up til menopause, whereas it is recommended that the combined or mini pills be discontinued around age 40-45. The rate I remember for "No birth control" was somewhere on the order of 80%, however, that is for a statistical sample over time, not for "one fuck". >I believe some women also have strong allergic reactions to spermicides. I >would (personally) say they are a poor choice. Independently, they are, but bear in mind that spermicides are absolutely necessary to the functioning of some forms of birth control - even a well fitted diaphragm is pretty much useless without spermicidal jelly. DIAPHRAGM --------- (from: elf@halcyon.com) Has a failure rate of 2% (i.e. out of 100 women who primarily use the diaphragm, two become pregnant). Always use spermicide; both partners _must_ learn how to place it properly. It has few associated risks; it cannot become 'lost' because the vagina is only a few inches long. Can 'slip' and press against the rectum; this can be uncomfortable. Also, some men can feel the diaphragm during intercourse. Some women have recurrent yeast infections when using the diaphragm. The average diaphragm costs about 20-30 dollars, but it must first be sized and fitted by a gynecologist, so there is the cost of a doctors' fee. Must be replaced every two years to ensure correct fit and product lifespan. A tube of Gynol II costs around 11 dollars and is good for 24 doses of spermicide. The major disadvantage to the diaphragm is that it must be used one of two ways; either it is inserted before any sort of sexual play, in which case the taste of spermicide can become an issue if the couple wishes to engage in oral sex, or is inserted after oral sex but before intercourse, which can be considered a major interruption of play and may lead to not using it all. (SOURCE: "The New Our Bodies, Ourselves" The Boston Women's Health Book Collective, 1984. Pgs 225-228.) A personal observation: Omaha and I rely on the diaphragm as our primary birth control. As mentioned, she does have recurrent yeast infection, but we both agree this is a minimal compared to the intense, suicidal depression that came when she mixed birth control pills and her epilepsy medication. We are both fond of oral sex, so we use the diaphragm in the latter way described in paragraph three. We have never failed to used it; insertion of the diaphragm has become a major part of our play, a way of saying "I love you, I care about you, I _will_ be responsible with your body" during lovemaking. The diaphragm, it _must_ be remembered, is _not_ an effective method of STD control; only a condom can do that. The diaphragm is a reproduction control method for primary partners only! c5-2. What kinds of condoms are there? (from: Steven Sharp, sesharp@happy.colorado.edu) This is a posting of information about types of condoms which are significantly larger or smaller than average. I got it out of a book called "The Condom Book" or something similarly imaginative. One thing that was apparent from reading through the descriptions was that advertising on size (or for that matter thickness or ribbing or whatever) is often misleading. A brand which is claimed to be smaller than average frequently isn't outside the normal variation. There may also be differences in size based on variations in manufacturing and these figures were probably based on single samples. Different size measurements for different styles of the same brand may indicate such variations or be an attempt to provide some size variation, in which case getting the precise style named is important. All measurements are flat and don't take into account elasticity, which might influence comfort when worn. Typical condom flat widths range from 2" to 2-1/8" (meaning two and one eighth, not two minus an eight). All the condoms listed here are both lubricated and reservoir ended. Company names are listed in parentheses. Extra words which may appear in the name on some packages are listed in square brackets. It is possible I've copied some numbers wrong (and other disclaimer noises). Slimmer condoms --------------- Bikini (Barnetts) : slightly less than 2" by 7-1/4", packaged in that frustrating plastic wrapper [Sheik] Fetherlite (Schmid) : 1-7/8" by 7-1/2" Hugger (Circle) : 1-7/8" by 7-1/8" Slims (Circle) : 1-7/8 by 7-3/4 Mentor (Mentor) : 2" by 8", not smaller, but has adhesive inside to prevent slippage, rather expensive though Wider condoms ------------- Excita (Schmid) : 2-1/4" by 8-1/4", Excita Extra has spermicide [Lifestyle] [Horizon] Nuda (Ansel) : 2-5/8" head, 2-1/8" shaft, by 8-1/8" [Ramses] NuForm (Schmid) : 2-1/2" upper, 2+" lower, by 8-1/4, has benzocaine anaesthetic Rough Rider (Ansel) : 2-1/2" by 8" thick but doesn't block sensations, raised studs Sheik Ribbed (Schmid) : 2-1/4", forgot to note length (Note wide variation in Sheik. Elite with spermicide and Lubricated (with benzocaine?) are both 2-1/8". Fetherlite is 1-7/8".) Trojan-Enz Lubricated (Carter-Wallace) : 2-1/4" by 8" Longer condoms -------------- Man-form Lubricated (Protex) : 2" by 8-3/4" long packaged in that frustrating plastic wrapper [Trojan] Naturalube (Carter-Wallace) : 2" by 8-5/8" |