Science of Sex: Paps Vs HPV Testing for Cervical Cancer Screening

August 1st, 2019

Pap Smears Vs HPV Testing for Cervical Cancer Screening

This month’s Science of Sex was inspired by research I was doing myself based on my own health, so this post will be a bit more anecdotal/personal than usual.

I’ve been getting Pap smears since I was 18. If I had to get, I’ve had about a dozen or so — one every year until a positive HPV result when the exams became twice yearly. After things returned to normal, I went back to annual paps. Seven years ago, the American Cancer Society changed recommendations official to three years, so my visits became less frequent. As an American, I went according to the suggested schedule because I thought it was helpful; although, I realize other countries have different recommendations. I imagine that many women, trans men, and nonbinary folks have followed a similar schedule.

I don’t know if the HPV test has always accompanied my paps, but it has a good portion of them. Combination testing is recommended for anyone over 30 as it’s believed that people in their 20s may have transitory strains of HPV that will be suppressed by the younger person’s immune system. The HPV test can now detect the very strain of HPV (13 of the highest-risk strains), which is helpful to prevent cervical cancer and benefits treating HPV itself.

Read more about HPV and the vaccine.

Imagine my surprise several months ago when my pap came back clear, but I was positive for HPV 16. For those who may not be familiar, the pap smear is a collection of cells using a swab. The swab can miss areas of the cervix where cells may be abnormal, so false negatives are possible. On top of that, false positives are also possible. Because samples are sent away to a lab where a person must identify if cells are abnormal are not, there’s a pretty high margin of error.

According to one 1996 article,

Pap smears, which can detect cancer of the cervix, are now said to have a false negative rate of 20 to 40 percent.

Things may be looking up; however. Modern paps experience false negatives been 10% and 20% of the time.

A false negative could allow abnormal cells to spread and potentially turn pre-cancerous or cancerous. However, a false positive can result in unnecessary, invasive procedures. My HPV results have led to biopsies colposcopies, which enabled doctors to examins the cells of my cervix to locate and sample abnormal cells. After finding moderately abnormal cells this time around, I was referred for a procedure known as a LEEP that involves cauterization of the cervix.

Considering that abnormal cervical cells are not uncommon and not always caused by HPV and can clear up by themselves, which could make any followup procedure unnecessary.

This leads me to the crux of this post: HPV tests alone are more accurate and better predictors of cervical cancer than paps. In fact, people have questioned how useful paps are as a tool for over two decades. Clearly, co-testing (combining both HPV testing and pap smears) is effective, but it may be effective enough to simply perform HPV testing.

However, for those people who may not routinely undergo STI screenings, the recommendation that paps should be performed less frequently may mean less frequent HPV testing as well. Because HPV testing can indicate when a person’s immune system is no longer suppressing the virus in addition to new viruses, it might be helpful to increase the recommendation for HPV testing even as paps become less frequent especially considering that the CDC now states virtually everyone who is sexually active will have HPV, and it may have gone unnoticed because of a faulty pap, or may reappear during times of a weakened immune system.

Further Reading

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Coochy Plus Intimate Shaving Cream

July 17th, 2019

There are at least three brands that use some variation of “Coochy” for their “intimate” shaving creams. Classic Erotica makes the products I typically use, Pure Romance also uses the same name. The third I found on Amazon under the moniker Coochy Plus made by IntiMD.

The company actually has a review program that will reimburse you for their product, even if you don’t write a review. I guess it’s risk-free for users. I’d also hazard a guess that’s why there are so many positive reviews.

So I browsed the scents. IntiMD does have detailed descriptions, which are described similar to perfumes. That should have given me an idea what this might smell like in person, but I overlooked that. I went with Citrus Elixir, described as:

 

Citrus Elixir is all about rejuvenation and healing. Natural exotic mandarin and orange can’t fail to stimulate your senses and revive your mind as you pamper your body with this restorative intimate shaving cream.

At the heart of Citrus Elixir is a fruity accord of plum, pear and summer melon, along with a spray of fresh ocean marine muguet to refresh you like a sea breeze. Dry, Citrus Elixir delivers evocative scents of warm amber, sandalwood, and vanilla for an all over shave that leaves you feeling invigorated and brand new.

I like sweet and fruity scents, and this one seemed the best fit. All of the scents are reviewed highly, however.

Thanks to Prime, the shaving cream showed up quickly. I was a little surprised by the size of the bottle. I had focused on photos and not the specs. A squat bottle is usually larger. 8-ounce bottles tend to be taller and more narrow. If you make that mistake, you might not be happy with paying $13 for the product. That’s about what I’m used to, however.

I do have issues with the bottle, though. The pump never worked. I’ve spent almost half an hour turning it, and it never sprung up. This meant I just had to dump product in my hand from the bottle, which negates having a pump at all. Had I read reviews, I would have seen this is a common problem.

It also makes the scent different. There’s something about the pump that seems to aerate the cream and help diffuse the scent. Without the pump, all I could smell was this horrendous perfume smell. This shaving cream just reminded me of old ladies and, man, was it overpowering!

Others have complimented this line for not smelling like typical shave cream but if perfume is a plus, it’s not for me. Fortunately, the smell fades fast.

I have since transferred some of the product to an empty pump bottle, which makes it easier to use and makes the scent a little less hard on the nose. I still don’t detect any of the “notes” – no orange, no mandarin, no plum, no pear, and definitely no melon. It’s just a little less.. offensive.

It’s palatable enough that a good shave would make it worthwhile. But is it?

Eh, kinda. It’s not the worst shaving cream I’ve ever used. But it’s not the best, either. The formula is.. different from what I expected, less slick. I feel like I need either slickness or lather to get a shave as close as I’d like. This means the hair is a little longer by the end of the day that I prefer. It’s doable but not preferable.

My skin doesn’t feel dry or sensitive after using it; although, I haven’t used it where I tend to get razor bumps to test if it helps with those.

I also feel as though I need to use more of this shaving cream than others. Considering that it’s more expensive than what I typically use, I am not inclined to buy it again.

But, like I said, you can try it for free if you join the Care Insider Community, so it may be worth the risk to try. Just beware that your pump will likely come broken, and the scent may not be what you’re looking for.

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June 2019 Media Recommendations

July 1st, 2019

June flew right past in a flurry of red tape, phone calls, and health concerns, so this post is later than it typically would be. However, this gave me a chance to binge a few podcasts and watch a few episodes so I can recommend more to my readers!

Listen

I was enthralled with the very first episode of Unladylike that I listened to once I came across it.  Cristen and Caroline, who formerly hosted Stuff Mom Never Told You, have been working on their podcast that tackles a variety of issues from a feminist POV since early last year. They’re all about smashing the patriarchy and encouraging women to do whatever the hell they want. It’s not a podcast I’d listen to every episode of, but I haven’t regretted any I’ve listened to. Of note are episodes titled How to Get a Rape Kit and How to Find a Lesbian Bar.

Note that none of these episodes are “how-tos.’ The naming mechanic is annoying.

The episode of Sex Out Loud with Yin Q introduced me to Mercy Mistress on Youtube but also her other projects including Red Canary, a sex worker organization that focuses on Chinese migrants who work at massage parlors. Yin Q describes to Tristan how selling sex work under the guise of licensed massage is actually a felony and describes the danger of being detained by ICE.

Just recently, Sluts and Scholars was removed from iTunes podcast list, and Shameless Sex had their IG account removed. I made a point to listen to both.

S&S had two great episodes with Amber Heard, with whom I was only really familiar because of her marriage to Johnny Depp. I loved learning more about her. Amber seems to be a strong, feminist who is very aware of her privilege.

I tuned in to the bonus Shameless Sex episode title Sex For Curvy Folks With Laura Delarato because I only had a little time. Laura discusses body positivity and practical sex advice for anyone who is curvy or having sex with a curvy partner.

Honestly, I listened to most of these tonight because I’ve been obsessively listening to Hello From the Magic Tavern for the last three weeks or so. It’s a nerdy, improv podcast that has successfully distracted me from the current stress of my life.

Watch

The Cut presents Sex Probz, a web series featuring sex educators Dirty Lola and Francisco who help people improve their sex lives. If you ever wanted to see someone’s sex life get a makeover, here you go! The pair provide simple solutions to issues such as long-distance relationships, having sex with a disability, exploring kink, and reclaiming your sexuality after having kids. Although the episodes are too short to go super in-depth, viewers can implement these practical changes in their own lives.

Samantha Bee’s Sex Ed for Senators is a hilarious, cutting, and enraging look at the misconceptions some politicians have about pregnancy and abortion. It’s probably old news for many of my readers but still entertaining.

I discovered Mercy Mistress when creator Yin Q was on Sex Out Loud. It’s a sexy series on YouTube. Each episode is short (under 4 minutes) and steamy without sacrificing reality (a huge criticism of Bonding on Netflix) as it takes a look at various aspects of a professional Domme. The music and visuals are both so well done. I love seeing kinky POC getting screen time! There are also bonus videos that introduce viewers to the different tools used.

Read

I focused on reading things unrelated to sex during the month of June, namely A People’s History of the United States and Grunt: The Curious Science of Humans at War, both of which I recommend. I also read a few comics/graphic novels. After thoroughly enjoying Good Omens on Amazon, I picked up the graphic novel adaptation of American Gods.

I also enjoyed the first two volumes of Man-Eater, a story about how cis girls who reach the age of menstruation become werecats that eat people. It highlights the mistrust and mistreatment of women in society. However, right around the time I discovered this series, author Chelsea Cain backed herself into a corner in response to critique that the comic ignores trans people. She’s since deleted her Twitter account and the future of Man-Eaters is unknown. I think the premise is interesting but agree that the comic is limited because Cain’s white feminism isn’t inclusive or intersectional. The experimental format also leaves each book feeling a little light. Perhaps we’ll see some less problematic feminist comics in the future.

I’m still reading A People’s History, so sex may take a backseat, but I welcome any of your suggestions.

What media did you consume related to sex last month?

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Science of Sex: Using Drugs to Raise Women’s Libido

June 29th, 2019

Raising Women's Sex Drive with Medication

This month’s Science of Sex post comes on the heels of an announcement that the FDA has approved the second drug that intended’s to treat women with low libido, also known as hypoactive sexual desire disorder and which you might remember is one of several types of female sexual dysfunction.  The new medication, called Vyleesi, works differently than the previously-released Addyi. In both cases, however, the efficacy and methods of the drugs leave us with more questions than answers.

Vyleesi binds to melanocortin receptors in the brain. Although researchers aren’t sure why that would lead to increased libido because those receptors deal with pain and food intake among other functions. The current theory is that this helps to increase dopamine. Dopamine is a chemical that functions as a hormone in the body and a neurotransmitter in the brain, sending signals to other cells. Of the dopamine pathways in the brain, one is associated with the reward center. The association with pleasure is why dopamine plays a role in addition. It also helps to regular attention, emotional response, movement, and learning.

This drug may force the brain to process erotic stimulation as rewarding, which boosts libido. Because this happens immediately, Vyleesi only needs to be taken before sexual activity and not every day like Addyi, which has been around for several years but hasn’t performed well commercially.

Furthermore, Addyi works on another brain receptor to block serotonin, a neurotransmitter that contributes to feelings of happiness among many other functions. Serotonin plays a role in reward systems and too much can dampen libido as well as curb dopamine. Taken daily, Addyi can reduce serotonin

Both drugs have their risks. Because low serotonin levels are associated with depression, Addyi may be a poor fit with women who struggle from depression. It may be negated by SSRIs, which mitigate depression by boosting serotonin levels in the body but often reduce sex drive. The drug also comes with side effects such as dizziness and “sedation.” It shouldn’t be used with alcohol.

While Vyleesi isn’t taken daily and can be used with alcohol, which might mitigate some risks, users will face a tighter schedule. The drug can be used once daily, up to eight times a month. Boosting libido twice a week is better than the one additional sack session prompted by Addyi over placebo during clinical trials, but Vyleesi comes as an injection while Addyi is a pill. Furthermore, Vyleesi’s side effects include nausea, which affected 40% of women who took it, mostly after the first injection. A small number of participants experienced changes in skin color that remained even after they stopped the drug. Consider that 90% of participants remained in the trial, however.

Before Addyi was even approved, some sex educators were wary of the drug. I imagine Vyleesi will receive some of the same critiques. Vyleesi appears to be a better deal than Addyi in some ways, but neither drug increased the number of sexually satisfying events n a statistically significant way. The FDA no longer requires companies making these drugs to count sexual sessions, and critics point out that women may simply be having more sex that they don’t enjoy. 

And this leads us to one of the main complaints. Is it really beneficial to boost a woman’s sex drive just so it’ll be closer to her partner’s? Should we make women to feel bad for having less desire than men (apparently)? It is a win to force women to sit through more bad sex? Certainly there are women who would feel just fine having less sex if society allowed them to.

The CEO of the drug company has stated “It’s not just about low sexual desire, but about how it impacts patients’ relationships and quality of life. These women are really suffering.” However, this drug doesn’t examine why women are suffering. Dr. Adriane Fugh-Berman, a professor in the department of pharmacology and physiology at Georgetown University Medical Center who studies pharmaceutical marketing has.

I think it’s worth noting what’s an acceptable level of libido is socially influenced. Making women care less about the bad sex that they’re having is a dubious goal.

And for those women who want to want more sex? There are non-drug options that are more effective than both of these options and present fewer risks. Mindfulness can increase libido and sexual satisfaction. Sex education can ensure that women know and ask for what they want in bed, that their partners are better lovers, and that people understand that responsive desire does not necessarily mean low desire. On top of this, education explains concepts such as the dual-control model, which helps explain how external factors play into libido and enables people to ditch the shackles placed on them by society in the form of (useless) sexual scripts.

Can we even diagnose low libido before tackling those issues?

Reading a book or experimenting doesn’t require a prescription, abstinence from alcohol, or perfect health to produce results that are more statistically significant than Addyi and Vyleesi have shown.

Further Reading

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Bijoux Indiscrets cosmetics for better sex

Revolting Prostitutes: The Fight For Sex Workers Rights

June 6th, 2019

Not two days ago I had an elegant summary for Revolting Prostitutes bouncing around my head. It was the perfect segue into a review, and I’ve gone and lost it. That’s what I get, I suppose, for waiting to write it down. And I really waited far too long to even start writing this review because my memory is not hazy. Good thing Revolting Prostitutes leaves an impact.

Just what impact is it?

This book makes the argument that sex workers’ rights are women’ rights are sex workers’ rights and human rights by extension, and because of this should not be excluded as feminists or members of society. Juno Mac and Molly Smith do this by taking a hard look at the reality of sex work: why people do it, how it can be done safely, whether it’s feminist, how sex work and sex trafficking differ, and how society can protect some of its most at-risk members. Mac and Smith examine laws about sex work around the world to make their ultimate argument that in a world where some people must resort to sex work to make money, decriminalizing and not legalizing sex work is the only way to protect those people. Furthermore, they illustrate how pivotal sex workers have been when it comes to the fight for women’s rights and why excluding them from feminist arguments is not just unethical but grossly ignorant.

Revolting Prostitutes takes us through Nevada where just a few brothels operate legally toward Sweden where it examines the Scandinavian model of criminalization to the UK and, finally, to New Zealand. It is here where sex work has been decriminalized, and sex workers have a voice when it comes to laws that would affect them.

The feminism promoted in Revolting Prostitutes is not white feminism. Even though the authors admit to their own privilege (being cisgender, white and middle class), they examine the issues surrounding sex workers, many of whom are working class or people of color, through and intersectional lens. Among the topics addressed in these pages is immigration, which makes Revolting Prostitutes seem especially timely to this American.

Aside from teaching the reader what they don’t know about sex work, the authors smash longheld myths about sex work, including the idea that legalization is the best route. I once viewed sex work similar to marijuana and fell into the camp of “legalize sex work so it can be taxed.” But this book thoughtfully points out that legalization offers no protections for sex workers when one of the main dangers they face is from the police. In a world where that wasn’t the case, they argue, legalization may be an option. But for now, it remains out of reach.

It is far from the only myth torn apart in these pages. While so many people who argue for sex worker’s rights paint the picture of the “Happy Hooker,” you will not see that imagery in Revolting Prostitutes. This book is more frank than that. The authors would not paint with such broad strokes. Instead, they write honestly about how sex is neither good nor bad by definition, and neither is sex work or people, for that matter. These things can be positive or negative, health or otherwise. And when it comes to people, they are people who deserve our care faults and all. This is why the authors write candidly about the damage done to sex workers by so-called carceral feminists who want brothels shut down, and sex workers deported even if doing so will result in the greater abuse and potentially death of those sex workers.

When disproving these ideologies, Juno and Moll never take the easy way out by simply claiming them false. time after time they are prepared to say it’s more complicated than that and explain why. For example, when they touch on whether sex work is a bad thing because some sex works do not enjoy their jobs or because sex workers sell their bodies, the authors are quick to point out that there are many grueling jobs that do not bring joy to those who perform them. Those workers simply need the money. They trade their time and, yes, their bodies, to jobs that take a toll day in and day out. Revolting Prostitutes breaks down the issues one by one into palatable bites like that, and more.

Those people who have a strict anti-sex work stance would likely not enjoy or agree with Revolting Prostitutes. I’d hope that some people who are on the fence or who have not thought deeply about these issues might find themselves swayed by the book, however. Furthermore, the authors are clearly proponents of socialized elements of society. In this way, Revolting Prostitutes look as society as a whole using sex workers as a litmus test. A society that lacks support will surely fail this marginalized group of people. Readers who disagree with a government supporting its people through socialized healthcare and similar programs will surely balk at statements within the pages.

As for me, I am neither of those types of people. I found the arguments thoughtful and eye-opening. With the words they’ve written, Mac and Smith do an excellent job bringing sex workers, and they work they do from the other. They humanize people that are all too often written off, ignored, and otherwise erased. I am all too happy to recommend Revolting Prostitutes as long as society overlooks sex workers. I am angered that this book needs to exist but glad that it does. I hope that people and governments can learn from words like these and the people who are willing to write and speak them. Perhaps reality could be not quite so harsh for sex workers and women as a whole.

Until then, I can only lend my support to the revolt.

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May 2019 Media Recommendations

May 28th, 2019

I’ve got lots of suggestions this month, so I’ll jump right into them.

Listen

Several podcasts touched on abortion in recent episodes. This includes Science Vs, which took a different stance with their episode called The Abortion Underground, in which host Wendy interviews women who required abortions when they were illegal and absolutely terrifying as well as women who provided abortion services. I wasn’t very familiar with how this worked, and this episode was eye-opening and timely.

Sunny Megatron also tackles the topic with a focus on how criminalizing abortion disproportionately affects marginalized groups such as people of color and those who are impoverished on American Sex.

A previous episode of Science Vs looks into the fertility cliff, whether it’s real, and why so many people

Outward hosts talked about sex ed this month. They discuss how many LGBTQ+ issues should be included in sex ed (and whether sex ed should just take that slant to begin with because straight people have so much to learn), how porn fails as sex ed, and why everyone should use lube.

My final recommendation is another Slate podcast: The Waves. Introducing Hi-Phi Nation: For Women Only is a brief history of trans women as feminist activists, the TERFs who exclude them, and how events in the 70s affect us all today.

Lovehoney also has a new podcast that you can give a listen.

Read

I’ve got to catch up on my reviews, including two book reviews. In Turned On: Science, Sex and Robots, Kate Devlin really breaks down the state of sex robots, who uses them, and the implications for human and does it all with a side of British humor. One of my favorite books all year!

Watch

I wasn’t previously familiar with Philosophy Tube before this video about sex work came across my screen. It seems like a lot of the topics covered were also addressed in the book Revolting Prostitutes (yes, a review is still coming!) including decriminalizing, marginalized people, and various models the world over, among others. I haven’t watched every second of the video, but it seems like a good intro if you can’t dedicate yourself to an entire book and especially if you listen to it on double time.

Terri Conley discusses myths about sex and specifically casual sex in her TEDx talk at U of M. She draws from her research that flips much of what we believe about sex and a person based on their sexual preferences and activities on its head.

Let me know what you thought of anything on this list or if you have suggestions for me!

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Fun Factory Laya II – Revamped

May 17th, 2019

Betrayal.

There is no other word to describe how I felt after trying the Laya II Black Line.

The shape was similar and the material was upgraded, but the motor was disappointing. Devastatingly so.

While the original Laya Spot wasn’t the most powerful, its medium vibrations were dependable. Deep enough to do the job consistently. The Laya II presented me with high-pitched vibrations that were ineffective.

So I was happy to hear that Fun Factory was doing something about it; although, I almost missed the announcement. I heard it first when Epiphora blogged about the new model and how they it was more acceptable than the last. I also emailed the company to ask about the changes and received the response that they were 30% stronger.

What’s the difference?

For a while, you could find both the Black Line and newer Laya IIs. You still may be able to, which could lead to confusion. The new ones are colorful (purple, pink, or blue) unlike the Black Line, which is black as the name suggests.

Both styles are rechargeable via Fun Factory’s magnetic chargers whereas the very first Laya Spot was powered by 2 AAAs. hard to believe I was such a fan, eh?

Regardless of color, the Laya IIs are the same size and shape, which is a bit difficult to measure. However, they’re not exactly the same as the original. It’s close, to be sure, but Fun Factory states they’ve “tweaked the shape to make it hug your body even better.” The newer Layas are a bit longer, for one. They’re heavier, too, because of the internal motor, and the valley on top where I would have rested my finger isn’t as defined. As you can see in my photo, the original Laya Spot (green and pink) is flatter along the bottom sides while the new ones are rounder.

These things aren’t necessarily bad. The differences aren’t that noticeable aside from the buttons. The three buttons on Laya II are closer to the end of the toy… exactly where I want to press down to achieve pressure. The original only needed space for two buttons so I could place my fingers there. Furthermore, the bubbly buttons of the Laya II are incredibly easy to find and press, perhaps too easy. I would prefer something between the recessed buttons of the original and Fun Factory’s current buttons.

Other than that, you might assume the toys are the same shape if you’re only viewing images online or not staring intently at them in person. Regardless, any Laya is much taller than similar clitoral stimulators — the Lilys and Siris of the world. And the “nose” of the toy is always what’s worked for me. It can penetrate thick labial folds with ease.

It’s firm enough for pressure (but less firm than the original, which was made mostly of hard plastic while the newer versions are coated in a softer silicone), and the bent shape of the Laya Spot sits more comfortably in my hand. It doesn’t leave my hand as cramped as smaller toys, something that’s increasingly become a concern as my pain progresses.

The shape was always my favorite aspect of this toy, and it still delivers. There were times when I’d used my original Laya to achieve pressure without any vibrations at all. I’ll get back to that.

But what about the new Laya II? Compared to the Black Line, the vibrations are noticeably stronger and deeper. It’s not the rumbliest or strongest clitoral vibrator. If you need Hitachi-level vibes, then you should pass on this. The Laya II is absolutely weaker and buzzier than FF’s full-size toys, too, so keep that in mind. Still, it’s an improvement. It’s workable. No, better.

Those vibrations can get me off; although, I usually just skip to the highest steady setting. The new Laya II isn’t as frustrating as the Black Line. Perhaps the biggest sign is that even when the vibrator died, I continued to use the shape to get off.

The Laya II has become a toy that I actually crave using, at least every once in a while. That doesn’t happen much anymore.

It gives me hope because I’ve gone through two original Laya Spots and don’t have one that still works. At least I have something to fall back on that I won’t hate. I call this a win.

I am not quite as much a proponent of the Laya II, partly because there are many more quality clitoral vibes out there, including the Mimi Soft with its deep vibrations. This wasn’t the case over a decade ago when the Laya Spot was one of few. So, while I am glad that Fun Factory has updated my favorite clitoral vibe so that I can use it for a few more years and another generation of users can discover it, I know it’s not for everyone. And that’s okay.

Update: Fun Factory has now released the Laya III.

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