Sexual Health FAQs 3

Sexual FAQs - III



Q. What do I do when a condom tears?

A. Good question. This is a very scary thing. First, don't panic. The condom with which you've entrusted your life has torn. Here's what to do to help avoid sexually transmitted diseases and an unwanted pregnancy.

1. Wash immediately. Share the news and hit the shower. "Wash yourself with soap and water," says James Trussell, Ph.D., an expert in emergency contraception at Princeton University. No studies have shown that soap destroys STDs, "but it won't do any harm, and it might do some good."

2. Show concern. Gently ask your partner to (a) inspect herself for condom bits, (b) refrain from douching, as that can push in microbes, and (c) use emergency contraception pills. If taken fewer than 72 hours after intercourse, they can prevent pregnancy. She can get them from her doctor or call Planned Parenthood at (800) 230-PLAN.

3. Talk about history. Before you even consider having sex with a anyone, you should talk about history--not the "World War II" kind of history, but how many sexual partners she has been with, etc. If she is infected, and the condom breaks, your risk of getting a sexually transmitted disease ranges from 50 percent for gonorrhea to 0.2 percent for HIV. Should your condom break, have another chat with her about previous sex partners and diseases. "If you're concerned about STDs, see your doctor and get tested within a few days," says Jonathan Zenilman, M.D., of the Johns Hopkins University STD Research Group. If you know you were exposed to HIV, ask your doctor about a combination anti-HIV drug treatment. This measure is expensive, controversial and unproven, but it may be your only recourse.

4. Troubleshoot. Did you use an expired condom or an oil-based lubricant? Maybe you nicked the condom with a fingernail while putting it on. Whatever the cause, eliminate it.

A study published in the American Journal of Public Health showed that men who experienced a condom break or slip were twice as likely to do so again. So be careful with condoms; breakage is not common, but it does happen!

See "Plan B® - The Morning After Pill" for information about this FDA-approved drug that prevents unwanted pregnancy in case of an emergency. You must be 18 years old or older to buy this drug without a prescription in the United States. This drug is not meant to be used as a form of birth control.

Q. I heard about a pill that is for breast enlargement. Have you ever heard of this, and can a pill work? If so, can you say anything about its safety? It is being used in Europe for cosmetic breast enlargement. I haven't a clue as to its name.

A. I did a search in the U.S. Pharmacopoeia (USP) and could not find any pill that has been approved for use in the United States for cosmetic breast enlargement. There are tons of drugs that include breast enlargement as a side effect, and a class of androgens that are prescribed for men undergoing sex-change operations.

This means that there is no product that has been approved for use for cosmetic breast enlargement in the U.S., and it would be illegal for any drug company to market a drug using this claim. That does not mean some physician somewhere would not prescribe these medications to a person for this purpose. Doctors have prescribed oral contraceptives to control acne for years, even though only one brand has been approved by the Food and Drug Administration for this use. And that's only been in the last couple of years.

My guess is that this product is some version of the Pill, or another hormone therapy. Drug companies are probably beginning the process of applying to the FDA for approval to market these products for this use. If this is the case, the final product will probably be relatively safe (I'm just guessing here--don't take this to mean you can call on me for any future litigation you might pursue). There has been a lot of research on the effects of the Pill, and for most women who do not smoke, it is very safe.

There are also many "natural" or herbal products on the market that claim to enlarge or enhance the bustline. These products usually use some form of phytoestrogen, which is a nutrient found in foods like soy or yams that mimics female hormones in the body.

Natural breast enlargers may also be some form of human hormone. There are a number of growth hormones that claim to have breast enhancement as a benefit. But here's the kicker: Just because you can go to the store and buy these products does not mean they are actually safe for you to use. These products are considered dietary supplements because their formulas include ingredients that occur naturally. This means they can be sold over the counter and the manufacturer does not have to prove they are safe. The FDA is responsible for proving these products are unsafe, and they do not have the resources to conduct the same types of trials the pharmaceutical companies have to conduct before drugs are sold. So the only thing the FDA has to go on are reports when something goes wrong with one of the products.

There is a great deal of speculation about whether phytoestrogens and growth hormones are safe. The manufacturers do some testing--but it is usually eyed suspiciously. There are also some independent evaluations going on, but they are a long way from determining whether the products are safe, and if they are, whether they have any effect. The issue with phytoestogens and growth hormones is that long-term or excessive use could possibly cause nasty things like cancer and heart disease.

So I don't have an answer to your question. When considering the use of any of these products, be they prescription or supplement, it comes down the individual making a decision about how much risk she is willing to accept for the supposed benefits and the real money she will spend. You have to look for good, quality, unbiased research, ask a lot of questions, and be careful.

Q. Why does it hurt so much when I get kicked in the groin?

A. Testicles are super-sensitive because they're rich in nerve endings. Testes take shape in the abdomen, near the stomach and kidneys, and the nerves and blood vessels remain attached there even after the gonads hit "dangle mode." That's why, after a poke to the groin, you feel the pain in the very pit of your stomach. That pain is so bad that men can actually experience it simply by seeing someone else receive the blow.