Sunday, November 30, 2008

Let's Talk About Sex

What men need to know about women's sexual health.

By Sally Wadyka for MSN Health & Fitness
Let's Talk About Sex// Frustrated man and sleeping woman (© Getty Images/Image Source)

If you're like most guys, you probably think you already know everything there is to know about sex. But it's what you don't know—or don't bother to ask—that could hurt you. We're not talking about satisfying your partner (although that's important too!), but about issues that impact both her as well as your own sexual health. Read on to learn valuable lessons about birth control, menstrual cycles, and when you're most likely to get your partner pregnant. Anything else you don't know? Well, don't be afraid to ask!

Why she's just not in the mood

You could blame her lack of interest in sex on a variety of factors—from fatigue to stress to emotional issues. But there's another libido-killer you may not be considering. "Many commonly used anti-depressant drugs can have a negative impact both on libido and on ability to achieve orgasm," says Nanette Santoro, M.D., professor of obstetrics and gynecology at Albert Einstein College of Medicine. If you're in a new relationship—and she hasn't yet revealed to you that she's even taking antidepressants—you might be left frustrated and wondering if you've suddenly lost your touch. For some women, being on the Pill can also diminish their interest in sex—probably because the Pill works by suppressing various hormones, including testosterone (the hormone that usually fires the sex drive).

PMS: It's not all in her head

"That time of the month" may be the topic of countless jokes, but if your partner is suffering from premenstrual symptoms, it's no joke to her. "About 80 percent of women suffer from some type of PMS symptoms—from physical complaints like bloating and breast tenderness to emotional ones like mood swings and irritability," says Santoro. Throughout a woman's monthly cycle, hormone levels fluctuate. And right before her period arrives, there's a huge drop in estrogen, and the brain respond to the lack of estrogen by also dropping serotonin production. Serotonin—known as the "feel-good hormone"—is what gives you a sense of well being. Not surprisingly, when it drops, your girl will get cranky, and may also crave the sort of high-carb comfort foods that boost serotonin levels. So be sensitive to her PMS symptoms, and consider yourself lucky that your hormones don't wreak this kind of havoc on you!

Her sexual history is now yours

"You are now sleeping with [whomever] she has slept with in her past, and you are subjecting yourself to any sexually transmitted diseases she may have gotten from previous partners," says Santoro. And while it's not necessarily important to divulge exact numbers and all the intimate details of your previous sexual partners, it is important to know how she has protected herself in the past and when was the last time she was tested for sexually transmitted diseases.

What she can do if the condom breaks

If you've had unprotected sex—because the condom broke, because you thought she was on the Pill, or because neither of you bothered to bring up the subject of birth control in the heat of the moment—there is an option for helping to prevent an unwanted pregnancy. The so-called "morning-after pill" is available without a prescription under the brand name Plan B (you need to request it at the pharmacy counter, but need not get a prescription from your doctor). "There are many theories as to how it works," says Santoro. "It might prevent a pregnancy from implanting in the uterus or it may interfere with the fertilization of the egg." It needs to be taken within 72 hours of unprotected sex, and involves two doses, so if an accident happens, talk to you partner about her willingness to take it and urge her to do it quickly.

Sex may make her suffer

Blame it on anatomy, but women are more prone to suffer from yeast infections, vaginal infections, and urinary tract infections as a result of having intercourse. "Semen is much more likely to disrupt a woman's normal vaginal pH and aggravate or precipitate an infection," says Santoro. "It's pretty unlikely for a man to get a yeast or other infection from a woman." So when she pops out of bed to pee immediately after sex (which doctors recommend to prevent bladder infections)—or won't have sex with you because she's got a burning infection down below—have pity on her and be glad your anatomy keeps you safer from such insults.

Know what she's doing to prevent pregnancy

"Any man who sleeps with a woman without intending to sign on for life as the father of her baby—and leaves the contraception totally up to her without thinking about it—deserves the paternity suit he is risking!" warns Santoro. Seriously, this is a conversation you simply have to have before you get busy. When in doubt (even if she says she's on the Pill or using a diaphragm), wear a condom. "If you don't know her well enough to know exactly how careful she is about taking the Pill or using other protection, then don't take the risk," says Santoro.

Find out her most fertile days

If your goal isn't to become a father right now—and your partner is not using hormonal birth control (like the Pill or Depo-Provera)—it pays to know a little about her cycle. It's a commonly held belief that all women have a 28-day cycle, and ovulate midway through—around day 14. Even if that is the case with your partner, there is still a several-day window surrounding ovulation during which she can get pregnant. Since sperm can live in the fallopian tubes for up to 72 hours, she can get pregnant if you have unprotected sex at any time during the three days before she actually ovulates, as well as the day after. And more importantly, cycles can vary from woman to woman, and even from month to month. "Just because she says that her period comes every 28 days like clockwork, you should still assume there's room for error in that number," says Santoro. And yes, a woman can even get pregnant during her period. "If her menstrual cycle is short (like 25 days or so) and she bleeds for several days, she could potentially still be bleeding but also be ovulating," Santoro explains.

STDs—the one thing you don't want to share

While it is easier for a man to pass most sexually transmitted diseases to a woman (as opposed to vice versa), you both need to be concerned about protecting yourselves and each other. And don't make any assumptions about how safe you are. "It is important to remember that STDs cut through every social stratum, so ask your partner about any known STDs she has and talk about when you were both last tested," says Santoro. And while they don't offer absolutely foolproof protection, condoms are still your best defense against sharing infections. Some of the most common STDs include chlamydia (which afflicts about 28 million people each year) and HPV, the human papilloma virus, which affects about 20 million. HPV is so easily spread that the Centers for Disease Control and Prevention estimates that a sexually active woman has about an 80 percent chance of contracting it in her lifetime. And be very careful of herpes. If she has a cold sore (oral herpes), it can be passed to you via oral sex and manifest as genital herpes—and you could do the same to her. If the relationship seems like it might have legs, it's a good opportunity to go get tested for the full range of STDs. "Going together and getting screened for STDs can be a very romantic gesture," says Santoro.

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