STD Awareness Month

Earlier in the month, we noted that April is Sexual Assault Awareness Month. But we also really need to note that April is STD Awareness Month!

Last month, evidence emerged that one in four teenage girls has an STD. It also turns out that this is true for the population overall -- one in four Americans has an STD. The United States Centers for Disease Control and Prevention estimates that there are 19 million new STD cases each year, and almost half of them are among those aged 15-24! Also, more than half of us will contract an STD at some point in our lives.

How can you stay safer? Planned Parenthood Federation of America's website offers a lot of great tips that you should check out. Here are some of the basics:

1. Get yourself tested. All STDs are treatable, and testing will help to prevent medical problems for you down the line. It will also help you prevent passing the infection to your sexual partner(s). Some STDs are passed through skin-to-skin contact, not body fluids, so even if you use a barrier method, it's a good idea to get checked out. You can also encourage your sexual partner(s) to do the same. PPRSR and other Planned Parenthood health centers offer STD testing.



2. Be comfortable talking about safer sex with your sexual partner(s). If your partner does not want to have a discussion about condoms, sexual history and/or STDs, you may want to reconsider that sexual encounter. People who are comfortable with their sexuality are likelier to engage in safer sex, and to enjoy safer sex more. Make sure to have these conversations in advance, not the heat of the moment.



3. If you are going to have vaginal, anal or oral sex, use a condom, female condom or dental dam. Though transmission of STDs like herpes and HPV is still possible, using a barrier method greatly reduces your risk.



4. There are lots of ways to get sexual satisfaction without engaging in riskier activities. Check out the PPFA tips for more!



5. Always be honest with your partner(s) and don't depend on anyone else to protect you from STDs -- protect yourself.

You can find out more about STDs, symptoms and treatment from our website.

If you are a sexually active man or person who has sex with men, you should know how to put on a condom! Safer sex is the responsibility of both partners. If you don't know how to use a condom properly, or aren't sure, don't be embarrassed -- but do check out this instructional video.



Enjoy and stay safe!

Check-Up Down Below

This is a guest post by KaeLyn that originally appeared in the Empty Closet. Thanks KaeLyn!

May is here and it’s time to open the windows, plant the vegetable garden, and store winter clothes away. May is about checking up, cleaning up, and preparing for the future, so it is the perfect time to celebrate National Women’s Check-Up Day on May 12th. On Check-Up Day, women are encouraged to get annual check-ups and preventative screenings. Today, let's focus on one of the most important routine check-ups for women, the gynecological exam.

There is a lot of fear surrounding the pelvic exam itself—the stirrups, the cold hands, the specula—it sounds like a really, really bad date! So here’s the truth: getting a gynecological exam is one of the easiest, shortest medical appointments you’ll ever have. No needles, no drills, no eye drops, no recovery time—just some questions and an exam that takes a few minutes. We’re going to go through a typical exam step-by-step so you can be empowered and prepared to make that appointment!

You should do a little homework before you get your exam. Call around and get recommendations from friends to find a gynecologist that is sensitive to your gender identity and/or sexual orientation. You may also want to consider if you have a preference about the gender of your gynecologist. Think of any problems or questions you might have for your doctor and write them down. If birth control is a need for you, ask your practitioner about options.

At the beginning of the appointment, your doctor will conduct a medical history. You will be asked questions about your last period, sexual activity, medications you are on, your smoking/drinking/drug use, and your family’s medical history. It’s important to answer honestly. In New York, all people have the right to confidential sexual health care, including teens. Everything you say will be private.

The exam itself is quick and simple. You will be asked to undress, change into a gown, and cover with a drape sheet. After talking with the doctor, you will lie back on the table and the exam will begin. The clinician will check your breasts for lumps, thickening, or irregularities. You may be shown how to do a breast self-exam. If you don’t know how, this is a great time to ask about it.

Next, the pelvic exam will start. You will be asked to put your feet in the footrests and spread your knees for the exam. If it is your first time, it can feel really weird. So take a deep breath and relax. Nobody really likes having a bright light shined onto their private parts while a stranger pokes around their vagina, but the exam will be more comfortable – both mentally and physically – if you are calm. You can ask the gynecologist to explain to you what they’re doing before or while the exam is going on. If your gyno is a man and that makes you feel a little uncomfortable, you can ask a woman to stay with you in the room during your exam.

The entire pelvic exam will only last a few minutes. Your clinician will visually check out your vaginal area for signs of irritation or irregularities. Next, the clinician will insert a speculum to hold your vagina open to see your cervix. Now before you panic, you should know the vagina is really stretchy so this won’t hurt, but you will feel a slight pressure. The clinician will look to see if the cervix is healthy. A Pap test will be done to collect cervical cells to test for pre-cancerous growths or abnormalities. If you and your doctor feel you are at risk for certain sexually transmitted infections, a culture may be taken for testing. A small spatula or tiny brush is used to collect cells for the tests. The speculum will then be removed.

Wearing gloves, the gynecologist will put one or two lubricated fingers in your vagina and use the other hand to press lightly on your abdomen. This is to check for enlarged ovaries, cysts, or tenderness. You'll feel some pressure during this part of the exam, but if you feel tenderness or pain, say something — it could indicate infection. Finally, your clinician may insert a finger into your rectum to test the condition of your muscles and check for tumors in this area. Again, it's normal to feel a bit of discomfort and pressure, but it should only last a few seconds.

So now you know exactly what to expect when you go in for your check-up “down there”! To be honest, the exam is uncomfortable, but a few minutes of discomfort once a year could save your life by preventing cervical, uterine, ovarian, and breast cancer, or an untreated STI infection. I hope you will celebrate National Women’s Check-Up Day on May 12th by making an appointment for your annual gyno exam, whether you’re a first-timer or an old pro! And tell your friends and family to “check-up down below,” too!

Contraceptive Options Expand For Women Over Forty

As the Associated Press recently reported, contraceptive options for women over the age of 40 are expanding. This is great news not only because more options always leads to more informed decisions, but because -- surprising though it may be -- women over 40 have traditionally been the least likely to use birth control!

Birth control choices are wider these days for women 40 and older — a group that once viewed its options as pretty much limited to tube-tying surgery and condoms. For them, the pill is back. So is the IUD. Both are safer than they used to be. There's even a nonsurgical method of tube-tying.

This variety of methods has long been needed, experts say, because 40- and 50-somethings are a complex group. Some have had several children and are willing to have sterilization surgery. Others may want children, but not right now.

Traditionally, women 40 and older are the least likely to use birth control. Along with adolescents, they have the highest rates of abortion. At the same time, these women are more experienced at using contraception and follow instructions better.

So, why the change? Mostly because medical advancements are giving all women more options, and making older methods of contraception safer.

A review of the current science of contraception and women 40 and older was published recently in the New England Journal of Medicine. The author, University of Florida gynecologist Dr. Andrew Kaunitz, noted that the risk of dangerous blood clots rises sharply at age 40 for women who take birth control pills containing estrogen.

The risk is even greater for overweight women, who also are more likely to have high blood pressure and diabetes.

But the dosage of estrogen in current birth control pills has been dramatically reduced. The pill is now considered a safe alternative for lean, healthy, older women Kaunitz and other experts said.

"It may not be well known that the current low-dose formulations are a reasonable option for healthy women in their 40s," said Dr. JoAnn Manson, a Harvard endocrinologist who wrote a book on menopausal hormone therapy.

The pill may be preferable for some women, because it can help control irregular menstrual bleeding and hot flashes and has been shown to reduce hip fractures and ovarian cancer, wrote Kaunitz. He has received fees or grants from several companies that make oral contraceptives.

Most women who smoke or have medical conditions that make taking the pill risky aren't left out, though. Newer options for women over 40 also include IUDs (a small device inserted into the uterus), a progestin-only "mini pill" and Implanon (a small device inserted into a woman's upper arm).

The most common method of contraception for women over 40 is still sterilization, either by tubal ligation (for women) or vasectomy (for men). This method is permanent and extremely effective. It's therefore most popular among women over 40, who may have decided that they don't want to bear children, or who have decided that their families are complete. The good news is that even these options are expanding; in recent years, a non-surgical method of female sterilization has become available.

Increasingly, gynecologists are offering a newer type of tubal ligation that is nonsurgical. The procedure, called Essure, was approved by the government in 2002. Instead of cutting through the abdomen to cut and tie the fallopian tubes, a doctor works through the cervix, using a thin tube to thread small devices into each fallopian tube. These cause scarring, which in about three months plugs the tubes, stopping eggs from the ovaries from reaching the uterus.

Among women aged 15-44 who have ever had sexual intercourse, 98% have used at least one contraceptive method, and 62% of American women in this age group are currently using a contraceptive method. Furthermore, a woman who wants two children will need to use contraception (or practice abstinence) for about 30 years (if course, the number of years is higher for women who want no children, and lower for those who want more). And since 80% of women will use the pill at some point in their lives, the popularity of other methods tells us that many women will use more than one form of contraception during their fertile years.

And that makes this good news for all women -- whether over 40-years-old now, or younger and looking to the future.

Sexual Assault Awareness Month

April is Sexual Assault Awareness Month. Sexual violence is a huge and unspoken problem. According to RAINN, over 270,000 sexual assault occurred in 2006 (the most recent year for which statistics are available). With this number, they've determined that a rape was committed every eight minutes, and a sexual assault was committed every two minutes. It is estimated that one in six women will be sexually assaulted in her life time (other studies and organizations argue even higher estimations). Most sexual assaults are never reported to police, and most victims know their assailants. In fact, only about 6% of rapists will ever spend a day in jail.

Sexual violence will be the theme all month at PPRSR's MySpace blog. We'll be will be updating with more information about rape and sexual assault and promoting our own community Rape Crisis Services, so check it out for more.

Also, yesterday was Blog Against Sexual Violence Day. We made it in a little late on that one, but it's better late than never. If you have your own blog, it's not too late for you to participate, either! Follow the link for more information and dozens of great posts that raise awareness and call for an end to sexual violence.

Anti-Choicers Try to Revive the South Dakota Abortion Ban

In 2006, the South Dakota legislature passed a ban on abortion in all cases except to save the life of the pregnant woman. The ban was not only devastating for the women of South Dakota; it was a direct challenge to Roe v. Wade. Planned Parenthood and other family planning organizations challenged the measure through a referendum and allowed voters to decide. They resoundingly rejected the ban by with 56% of the vote.

Since then, anti-choice groups have repeatedly tried to revive the initiative, this time allowing exceptions for rape, incest and physical health of the pregnant woman. All other abortions would be illegal, and if passed the law would still be a direct challenge to Roe. Common sense legislators, realizing that the citizens of the state had spoken and wanted their lawmakers to drop the bitter ideological battles, shot the measure down. But that didn't stop the anti-choice groups; they started a petition to send the abortion ban back to the 2008 ballot.

On Monday, they claimed to have turned in three times the number of signatures required to add the measure to the November ballot.

The new language was drafted by South Dakota Attorney General Larry Long, state Rep. Roger W. Hunt (R) and 20 other lawyers. As with the 2006 initiative, passage would probably trigger a lawsuit that could end up before the U.S. Supreme Court and provide an opportunity to reconsider its 1973 Roe v. Wade ruling.

"My job is to protect the women of South Dakota," said Leslee Unruh, VoteYesForLife.com executive director. If abortion rights advocates "follow what they've done in the past, suing, they'll probably sue on this one, as well. We're prepared for that; we've done due diligence in the preparation for this law."

The sponsors said their polls show that a majority of South Dakotans support the initiative with the exceptions.

The Campaign for Healthy Families, formed by Planned Parenthood and other groups to fight the 2006 initiative, said the new proposal is still too restrictive.

A woman would have to report rape or incest to police before seeking an abortion to qualify for that exception. "A woman who is the victim of incest and is 13, being raped by her father, is highly unlikely to report that," said Sarah Stoesz, president and chief executive of Planned Parenthood Minnesota, North Dakota, South Dakota.

Opponents also said the definition of a health risk to the woman is too narrow because the language implies a doctor would have to be certain the woman's health was threatened and excludes mental and emotional issues as health exceptions.

Stoesz is absolutely right. Sexual assault is grossly under reported, and the legislation requires that a report of rape or incest be made with law enforcement in order for an abortion to be authorized on those grounds. The full text of the bill can be read here (pdf). In it, you will find language requiring women to file reports with full personal information, as well as full information about their rapists. It would also require DNA samples from the woman and aborted fetus to be sent to authorities. And as one final deterrent, all of the documentation would become a part of the woman's official medical records, including the police report with all of the rapist's information.

Forcing a woman who has already made the decision to not report a rape to reopen wounds by reporting the assault, submitting to DNA tests and having the information exist as a part of all permanent records is cruel and unnecessary. It's particularly disturbing because the women have already suffered the additional trauma of having become pregnant by their rapists. Worst of all, these requirements could put many women in danger.

A woman who cannot handle the process of having to report her rape could potentially resort to drastic measures to end the pregnancy herself. Furthermore, the health exception does not include exceptions for mental or emotional health reasons. A woman too distressed to report her rape would not receive a reprieve. Neither would a woman who feels that she will attempt suicide if forced to continue her pregnancy. And this is to say nothing of the women who lack any recourse at all. Women who have not been raped and do not have a mental health condition may still be driven to self-harm, or unsafe and illegal abortion procedures. Unsafe abortion can cause irreparable harm to a woman's reproductive system and even her death (and regularly does in countries where abortion is illegal).

These are not pleasant circumstances to discuss. They are disturbing, difficult and distressing. Sadly, they are also reality. And if this ban were to pass, far too many women would be placed in this danger.

A Rapid City Journal blogger says of the previously defeated initiative that "Forcing women to give birth to their rapist’s child was indeed over the line for many women, and men, too, I suspect." Sadly, this version of the bill would carry exactly the same risks. While some women would be able to obtain an exception, it would not be without great distress. The rest would be forced "to give birth to their rapist's child," incur the expense of traveling out of state, or attempt to induce an abortion by illegal and unsafe measures. Women seeking abortions who did not become pregnant through rape would face similarly limited and distressing choices. Are these the kind of options that South Dakota citizens would really want for women living in their state?

We can certainly hope not, but just like in 2006, the initiative will not go down without a fight. This bill will likely enjoy higher popularity, receive a ton of misleading promotion from anti-choice groups, and cost women's health groups a small fortune to set the record straight.

You can donate to the South Dakota Campaign for Healthy Families, a non-partisan group comprised of Planned Parenthood and other local family planning organizations for the purpose of defeating any South Dakota abortion ban legislation. You can also stay in the know by signing up to receive email updates from the group.