Thursday, May 26, 2011

Ask Naughty Nurse Kimpy

Ask Naughty Nurse Kimpy is an advice column that addresses reader’s most burning questions on sexual health/relationships. STDs, birth control, is it real or is it fic, sexual positions--you name it. There are no stupid questions, only ones that are too embarrassing to ask someone you know. If Naughty Nurse Kimpy doesn’t know the answer, she’ll find an expert who does!

The information and advice from Ask Naughty Nurse Kimpy is for entertainment/educational purposes only and is not intended to be used as expert medical advice. It is not meant to replace the advice of your physician. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.

As a follow up to one of last week's question, a Canadian reader left this tip for reporting pedophilic porn if you live in the Great White North:
This site: Cybertips is very very good for Canadians as well as anyone interested in helping again the exploitation of children. They recently ran a very powerful ad campaign all across my province. I have in the past met, through a professional development conference, one of the detectives. I can tell you these people are committed, determined and are my heros. He talked to us about their work stress and how they deal with it. It made me appreciate each moment of my job quite a bit more.
Now, for today's questions:
This is less of a question and more of a word of caution. A few months ago I went in to the doctor because I had bad pain in my right calf. They did an altrasound and it turned out to be a blood clot. I was 21 years old at the time, so I wondered why I got a blood clot. I thought it was for older people, or people who have been hospitalized for a while, of which I was neither. The doctor told me the main contributing factor of my clot was my oral contraceptive (The Pill.) I had heard that there was a risk of blood clot when taking the pill, but no doctor or health teacher talked about it being a possibility for a young adult like me.
I had to immediately stop taking The Pill, start taking blood thinner pills (for up to 6 months, and I am still taking them now), and give myself injections of blood thinning medication for two weeks! I needed a new form of birth control, so I got an IUD placed, even though I have never had a child. It was so painful that I was on the verge of passing out for over 30 minutes while a team of nurses pumped me full of fluids and oxygen and checked my vitals.
Even after all of that, I am glad that I got the blood clot and the IUD. I am glad I learned that I have a blood clot risk now, rather than when I was pregnant or hospitalized. (I also learned that when I become pregnant, I will need to see a high risk pregnancy OBGYN and give myself daily shots of blood thinner medication.) I am glad that I got the IUD because it is so easy and cheaper in the long run than The Pill. An IUD (when placed correctly) is 99% effective at preventing pregnancy!
I just wanted to ask why IUDs and blood clot risks aren't talked about with young women? I am certain that there are other young women out there like me who don't know they are at risk for blood clots, and I wish they could know the risks before it is too late.
You bring up an excellent point, and thank you for the word of caution based upon your own experience. Using a birth control method that contains synthetic hormones to alter your natural cycle always carries a risk; blood clots is a big one. There are possible side effects in using almost any form of birth control, some more serious than others. That being said, it is any gynecologist's or general practitioner's responsibility to cover any/all risks and possible side effects with you when they prescribe a method of birth control. If you're using the pill, the ring, the patch, or other methods that use synthetic hormones to control your cycle, you should have a drug information sheet in every package you open. While it is lengthy and hard to read, it's there for a reason--so that users are amply informed about risks and side effects. If it's too hard to understand the information, ask your pharmacist about the risks. Planned Parenthood is also a great educational resource: What are the disadvantages of birth control pills?.

The risks birth control methods that use synthetic hormones increase significantly if you're over 35, you're very overweight, or if you smoke, have diabetes, high cholesterol, or high blood pressure. Please be sure to make an informed decision when you select a method of birth control. Do your research ahead of time. Weigh all the options. Find the method that is right for you, and use it every time you are supposed to. Approximately half of all pregnancies in the United States are unintended, meaning they are either unwanted or mis-timed. Using your chosen method of birth control consistently and carefully can help to minimize some of the risks and unintended outcomes.

I'm glad you were able to find an alternate method of birth control that works for you, but a word of caution about IUDs--there are some brands that have hormones fused into the device, so it carries the same kinds of risks and side effects as do birth control pills, rings, patches, etc. I'm sure that your gynecologist gave you an IUD that was hormone-free, but I encourage you to make 100% certain that that is the case, because mistakes can happen. With your past experience, it's important to have assurances that you are not at increased risk with the type of IUD that you use.
I have a question about doggy style. When my boyfriend and I have sex in this position, it sometimes really hurts for me. It feels like he's hitting something in there with the head of his cock that doesn't want to be hit. If I had to guess, I'd say he's hitting my cervix, but I'm not at all sure. It feels like a bruising pain.
It doesn't happen all of the time, and it doesn't happen in other positions where he's behind me. It has been happening more lately, where we've had to stop because of it. Do you know what this is, and if there's any way to prevent it? Like, is there a way to un-clench things up in there, to make more room? Is this a normal thing to happen? I'd hate to take doggy-style off the roster completely, but I will have to if it keeps hurting.
Dang, I hate to take doggy-style off your roster too, because it is a damn good position! That being said, one of the best things about it is how deeply your partner can thrust into you, and therein lies your problem. There are a number of possibilities as to what might be going on here. It is entirely possible that your partner is hitting your cervix with his thrusts. Even more likely, he's probably bumping into your ovaries; depending upon where you are in your cycle, the ovaries can be more sensitive around the time you ovulate.
There are two suggestions I have for you:

1. Ask your partner to thrust a little bit less aggressively when you try doggy style, and see if that helps. Sometimes, it's just a matter of easing back a bit.

2. You state that, "It has been happening more lately." Now, that either means that you guys are getting more zealous in your doggy style thrusts, or there has been an increased sensitvity for you. If you have changed birth control methods recently, that could be a factor. For example, switching to a method that involves synthetic hormones (like the pill, the ring, the patch, or an IUD with a hormonal component) could make your ovaries and uterus more sensitive. It could mean that you have an ovarian cyst or some other kind of swelling in your reproductive tract. It is also possible that your uterus is tipped or inverted, which could cause more pain when using this position. I urge you to see your gynecologist for a check up, just to make sure that there aren't any structural/internal issues involved.

Once you get the feedback from your gynecologist, assuming there are no other issues at play, try doggy style again , but start out slowly and not as deep as your partner typically goes. Gradually, your partner can increase the depth of his thrusts, until you reach a point where it becomes uncomfortable. That will be your cue as to how deep he can go. It might not be as deep as he used to go, but at least the position will still be a viable option for you both.

My husband and I are in our late thirties and have a very active and healthy sex life. Recently (roughly the past two years), he has had times where he orgasms without ejaculating. I've assured him that this is normal and most men would kill to have that experience, but it's totally freaking him out. He thinks he's broken and is extremely embarrassed and frustrated when it happens. It doesn't happen every time but when he least expects it, so it's not like he's in control of it. What can I tell him to reassure him that he's not broken?
It breaks Naughty Nurse Kimpy's heart to know there are so many people out there--women and men--who feel broken or abnormal. Remember, there is a huge range of normal in humans, and it is not very likely that anyone is truly broken. People come in all shapes, sizes, and experiences, and that is what makes life so interesting.

There are men who sometimes orgasm without ejaculating. It truly does happen. Your assurances that he is perfectly normal were caring, loving, and spot-on, so good for you. You are also absolutely correct that there are men who would kill to have that experience. Really, truly, I know a number of them personally!! Remind him that there are some medications that have a side effect of orgasm without ejaculation, so that is a possibility.
The biggest problem your husband truly faces? His own brain. The more a man fixates on his performance, the more likely he is to be affected by performance issues. It's the same way for men who have occasional problems getting it up. The more they worry, the more they experience a self-fulfilling prophecy.

So what can you do to help convince him that he is anything but broken?

1. Have said husband sit in front of the computer while you locate the ANNK post on PPSS;

2. Force said husband to read my lips (well, not literally--just make him read item #3);

3. "You are completely normal and not broken. You experience something that other guys would DIE to be able to do. Think of it as a tool in your sexual arsenal, rather than something to be embarrassed about. Dude, you are the equivalent of a female who can squirt when she comes. Really, truly, this is something special to be proud of, not something to feel shamed about. You are the man."

4. Repeat steps 1-3 until the message sinks in;

5. Sex up said husband as quickly as possible, and as often as possible. Enjoy. Repeat. Ad infinitum.
Good luck to you both--you sexual dynamos, you! *wink*

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