A great thing about the internet is how quickly we can find new information, and how we are easily able to share information with others. An equally not-so-great thing about the internet is that anyone can share anything as if it’s fact and a bunch of people can see it. Recently I’ve seen a lot of stuff online and on social media about using boric acid suppositories to balance your vaginal pH and treat vaginal infections. Although I think sharing knowledge about vaginal health is super important and is a conversation that should happen more often, telling people on the internet to put medicine inside their vagina without consulting their doctor is not a good idea. 

What are boric acid suppositories?

Boric acid is a weak acid that has traditionally been used as an antiseptic to treat cuts and burns. Because it is acidic, it can also be used to help maintain a healthy vaginal pH. Your vagina has a natural pH balance between 3.8 and 4.5 and is naturally acidic. This pH can be thrown off pretty easily, however. Your menstrual cycle, a new sexual partner, unprotected sex, condoms, and scented soap or laundry detergent can all throw off your vaginal pH. Most of the time, our vaginas are able to adjust back to homeostasis, but if things get thrown off too much, that’s when an infection occurs. 

Boric acid suppositories can be used to treat yeast infections, bacterial vaginosis, and trichomoniasis (an STD). Yeast infections are usually treated with antifungal medication that can be taken orally or inserted into the vagina. Bacterial vaginosis or BV is usually treated with an oral antibiotic. Trichomoniasis is also treated with an oral antibiotic. Basically, boric acid suppositories have worked for some people as additional or alternative treatments for these infections, however, the evidence is not strong enough to say that this is a great treatment for anyone. 

When to ask your doctor about treatment

If you have lingering symptoms of a vaginal infection even after your initial treatment plan has been executed, ask your doctor before using boric acid suppositories! Putting a foreign substance into your vagina can be risky, so it is imperative you consult with your doctor to make sure it is safe for you to do so. Boric acid is available over the counter, whereas these other treatment options are not, so I assume that’s why it has gained popularity online. If your body responds positively to the suppositories, it can help alleviate symptoms of your infection and restore your pH. Side effects include burning at the vaginal opening, watery discharge, and redness around the labia and vagina. You cannot use boric acid suppositories if you are pregnant, as it is fatal for the fetus. It will also irritate any tears or wounds in the skin around or in the vagina. Finally, boric acid should never be ingested orally, as it is poisonous. 

If you want to try boric acid suppositories as an over-the-counter treatment for yeast infections, bacterial vaginosis, or trichomoniasis, please, please consult your doctor first. Do not put any medication into your vagina without talking it through with your doctor.

Ever heard of mycoplasma genitalium? I had never heard of it either! That is, until a few weeks ago when I was scrolling through Instagram and a sex education account I follow posted about it. Mycoplasma genitalium, also known as MG, is a sexually transmitted infection that can be spread through oral, vaginal, or anal sex, as well as rubbing up on someone that is infected. It is spread through sex fluids, so it is not just spread through penetration alone. 

What are the symptoms of mycoplasma genitalium?

Similar to many other sexually transmitted infections, MG can oftentimes be present with no symptoms at all. In mild cases, it can clear up on its own. It is also not included in the standard STD screening provided at sexual health clinics or doctor’s offices. It is often only tested for if you present symptoms or specifically ask to be tested for it. If you have a penis, symptoms include watery discharge from the penis and burning, stinging, or pain while you pee. If you have a vagina, symptoms include abnormal discharge from your vagina, pain during sex, bleeding after sex or between periods, and pain in your pelvic floor or lower abdominals. There is not a test specifically for MG that is approved by the FDA, but it can be tested through a urine sample or via a swab test, swabbing the vagina, cervix, or urethra.

If left untreated, MG can cause urethritis, which is an irritated, swollen, and itchy urethra. It can also cause pelvic inflammatory disease in people with vaginas. It can lead to an inflamed cervix as well. Because it is a bacterial infection, it is treated with antibiotics, however, it is often tricky to treat in one round. Traditionally, antibiotics treat bacterial infections by damaging the walls of a cell, but pesky ‘ole MG doesn’t have cell walls, so it often takes a few rounds of different antibiotics to completely get rid of it. 

How can we prevent mycoplasma genitalium?

Safer sex practices such as condoms, gloves, and dental dams can decrease the chance of spreading MG, but since it can also be spread through sex fluids being rubbed on someone else during sexual activity, it’s possible it can still be spread even if someone is practicing safer sex. Since MG is not tested for unless specifically asked about, it’s important to stay in tune with your body and changing symptoms. A doctor would likely test for the standard STDs like gonorrhea, chlamydia, trichomoniasis, HPV, and HIV first, and if those came back negative and symptoms persisted, an MG test would likely be the next step. You can also specifically ask your doctor for an MG test if you suspect you might have it.

Treatments for mycoplasma genitalium

As with all STDs, if you find out you have it, you need to inform your sexual partners so they can also get tested, even if you use barrier methods for safer sex. Having an STD is not a big deal, and can be treated. In this case, MG is treated with antibiotics, just like infections in other parts of the body would be treated. Practice safer sex with condoms and barrier methods every time, stay in tune with changes you notice in your body, and get tested regularly to stay on top of your sexual health. If you do not have one monogamous partner, it is recommended to get tested after each new sexual partner, or once every six to 12 months. You can even get tested at home, so stay safe and have fun!

As of January 21, 2022, the first-ever injectable HIV treatment has been approved. This injectable drug called Cabenuva is a revolutionary breakthrough for HIV treatment. 

What is HIV?

Human Immunodeficiency Virus (HIV) is a virus that takes over cells in the body of an infected person and weakens the immune system, making it impossible for the virus to get cleared out. HIV can be spread through certain bodily fluids such as blood, semen, pre-seminal fluid or pre-cum, rectal fluids, vaginal fluids and breast milk. People can become infected with HIV by sharing a needle or having unprotected sex with someone who is infected with HIV. Although HIV is a virus that will stay in your body indefinitely, there have been great strides made for the treatment of HIV over the last several decades. 

What is the traditional HIV treatment?

People who are HIV positive typically take a daily pill to keep the level of HIV in their blood low enough that it can no longer be detected on a lab test. Once the blood levels are this low and stay that way for at least six months, the person can no longer spread HIV. This phase of HIV is typically called “U=U,” meaning undetectable=untransmittable. If the virus is untransmittable, that means you can’t spread it to someone else. Yay! Although you can get to a point in treatment where the virus is U=U, you still have to take meds for HIV every day if you have the virus. 

How does the injectable HIV treatment work?

This new injection works similarly to the daily pills, but it is a once-a-month injectable treatment administered by a doctor, rather than something taken every day. Patients who are eligible for the injection should consult with their doctor first, of course, then will take once-a-day “starter pills” for the first month of treatment and can start getting the shot shortly after. 

Patients will schedule what Cabenuva calls a “Target Treatment Date,” which is the same date each month to come into the office and receive the shot. If something comes up and that Target Treatment Day has to be missed, patients are still covered within their “Flexible Treatment Window,” which is seven days before the treatment date, and up to seven days after. This once-a-month injection is just as effective as the daily pills patients are used to taking, as long as it’s taken within this treatment window.

Why is an injectable HIV treatment a big deal?

The daily pill first came onto the scene in 2006 and has been a great option to keep patients undetectable, but now with this monthly injection, there are more options. A once-a-month injection is a great option for someone who doesn’t want to have to worry about taking a pill every day or someone who doesn’t have a schedule or lifestyle that allows that to be accessible. Since the injection has to be administered by a doctor, this is also a great option for someone who would enjoy having a monthly check-in with their provider each time they get their shot. 

Are there any side effects?

Similar to the daily pill, the injection does come with some possible side effects: fever, tiredness, muscle aches, trouble breathing, blisters or sores in the mouth, swelling of eyes, swelling of the mouth, face, lips, or tongue. The Cabenuva website also notes that you should contact your doctor immediately if you develop a rash after the shot.

This is a wonderful development for HIV treatment and helps make living with HIV easier and more manageable. I also want to be clear that people living with HIV have healthy, fulfilling lives. They have great sex lives, loved ones and careers. Treatment options like the daily pill and now this injection help make living U=U easier than ever. Visit Cabenuva’s website for more info, and contact your doctor if you think the once-a-month shot is for you.

Over 50% of Americans have oral herpes, and one in every six people has genital herpes. Herpes is incredibly common, so why aren’t we talking about it like it’s normal? There is a huge stigma that comes with herpes and other sexually transmitted infections in general. The truth is herpes is fairly common, and it’s also not a big deal. It’s just a skin condition.

What is herpes?

Herpes is a viral infection that once you get it, it stays in your body forever, although there are ways to manage it. There are two types of herpes, HSV-1 and HSV-2. HSV-1 is also known as oral herpes or cold sores, and this can spread from any sort of contact with someone. It doesn’t have to be spread sexually. Oral herpes presents itself as cold sores, and these can be spread from person to person quite easily. You could even get oral herpes as a child from a relative giving you a peck on the lips. 

HSV-2, or genital herpes, is spread through sexual contact. Genital herpes is spread through oral, vaginal, or anal sex. It is possible to get HSV-1 on your genitals and HSV-2 on your mouth, but generally speaking, they thrive in their designated area of the body. If you have a cold sore and give someone oral sex, you could spread oral herpes to their genitals, for example. 

How do you test for herpes?

You can be infected with herpes and show no symptoms for years, so it’s really hard to know when exactly you got infected. The only true way to know if you have herpes is to get tested once you already have symptoms. If you’ve ever gotten regular STD testing done, you might notice that they don’t test for herpes as part of the regular screening. This is because herpes testing is incredibly inaccurate if you don’t have symptoms. 

Herpes can be tested for without symptoms through a blood test, but false positives are incredibly common. When I first learned this, it seemed bonkers to me! I should be able to get tested and know if I have it or not, right? Why is testing for herpes so complicated but I can get a clear answer for a test for other STDs even without symptoms? Part of the reason false positives are so common is that the herpes blood test just tests for HSV in your body. It doesn’t distinguish if you have HSV-1 or HSV-2. Because oral herpes or cold sores are so incredibly common, most people have been exposed to HSV-1, even if they’ve never shown symptoms. 

So if you got a blood test and tested positive, it’s quite possible it just shows you’ve been exposed to cold sores before, but there’s no way to know for sure if the test is detecting HSV-1 or 2. Ugh! Because herpes is so stigmatized and the possibility of having an STD is very anxiety-inducing for most people, doctors don’t recommend testing for herpes unless you have symptoms. You also cannot complete at-home testing for herpes as you can with some other STDs.

What are the common herpes symptoms?

Symptoms of genital herpes include blisters around your genital area or your inner thighs. These blisters are often itchy and painful and turn into sores. You can also experience flu-like symptoms like aches, pains and fever if you have HSV-2. If you have sores, go to your doctor and they’ll swab one of the sores and test that for an accurate reading. If you don’t have symptoms, there is nothing to treat anyhow because even if you have the virus, it will be in your body forever.

How is herpes spread?

Herpes is a little tricky though because you could be asymptomatic and still spread the virus to someone else. This is called asymptomatic shedding. You could have herpes, but not know it because you have no symptoms, and have oral, vaginal, or anal sex with someone and spread the virus to them without even knowing. Using condoms and dental dams can help prevent this from spreading, but this is why herpes is so common. I wonder though if you don’t have symptoms, and your partner never has symptoms, then does it even matter that much? Again, there’s nothing to treat if you don’t have symptoms.

What is a herpes outbreak?

If you do have symptoms and test positive for genital herpes, there are some things you can do. Most people that have genital herpes experience only several outbreaks throughout their life. Although the virus isn’t curable, you won’t have constant symptoms and it’s not detrimental to your health or sex life in any way. An outbreak is when the sores and other symptoms show up. 

For most people, this first outbreak occurs 2-20 days after your first exposure, but you might not show symptoms for years so it’s hard to know. The first outbreak is the worst and lasts from 2-4 weeks. You can take anti-viral medication and use home remedies to treat the discomfort. The anti-viral medication can make your outbreak shorter and also can be taken regularly to severely lower your chances of spreading herpes to a partner. You should wait until your outbreak clears, however, to engage in sexual activity. 

How can we end the stigma of herpes?

When you break it down, herpes is just a skin condition. Yes, it can be spread sexually, but oral herpes isn’t spread that way. Genital herpes gets such a stigma attached to it because it is a sexually transmitted infection, but it is incredibly common and won’t affect your overall health or wellbeing. People that have herpes have completely normal, unaffected sex lives. Just refrain from sex during an outbreak, talk to your doctor about anti-viral meds to prevent it from shedding when you’re asymptomatic and be open with your partners so they can fully consent to sexual activity with you.

It’s important to keep up with your sexual well-being and get tested after each new sexual partner, or every 6 to 12 months but you don’t need to worry about herpes until and unless you show symptoms. You’ll make yourself sick with worry wondering if you have it. Since it truly is just a skin condition, you don’t need to worry too much about it until you have something on your skin to treat. The blood tests are so inaccurate that it isn’t recommended to get those done anyway. There are plenty of other STDs you can get blood tests for, so focus on those as part of your sexual well-being and get tested for herpes only if you show symptoms. 

Picture it: You’ve been having a lot of sex recently (yay you!), and are loving it. After a week or so of fun with your sex partner, you feel a little discomfort when you pee. Could it be? No, it couldn’t be … but wait, it is! It’s a UTI! You realize you forgot to pee after sex every time, and all the sex recently has caused a urinary tract infection. You’ve had many UTIs before, so you recognize the telltale symptoms and know you need meds ASAP, but don’t want to wait to schedule an appointment with your doctor. You know what it is, you just need some meds to feel better. Enter Wisp telehealth.

What is Wisp telehealth?

Wisp is a website where you can meet with a doctor, get a prescription, and get treated for your sexual wellness needs from the comfort of your own home. Wisp has several doctors partnering with the site, and you would have a telehealth consultation with one of them via webcam to describe your symptoms and receive treatment. 

What treatments can I receive?

Wisp offers birth control, emergency contraception, cold sore treatment, herpes treatment, treatment for bacterial vaginosis, yeast infections, UTIs, and medication to delay your period. Although it is a little unclear from their website, it seems you purchase unlimited consultations with “Wispcare,” which is a subscription for $10 a month, or pay a one-time fee of $39 for a single consultation. After choosing the best option for your needs, you then consult with the doctor and get prescribed a treatment. It says that they accept HSA (Health Spending Account) and FSA (Flexible Savings Account) for payment, but it’s unclear without making an order if they accept insurance. 

I looked at the treatments for UTIs, and Wisp telehealth has several options for recurring meds like probiotics to be shipped to you each month, or one-time treatments like antibiotics. You can order your medication to your home, or pick it up later that day at a pharmacy. Although this seems like a great option for getting medication if you already know your symptoms well, I am still a little skeptical. 

What is the cost for Wisp treatments?

When looking to check out for antibiotics for a UTI, there were three or four prompts offering me other medications or products to buy, unrelated to what I needed meds for. It also is $65 for an antibiotic for a UTI, which is pricey. If you were to go to your doctor on insurance, the cost of the medication could be mostly covered with insurance. Again, perhaps they accept insurance, but it’s unclear without making an actual purchase, and there’s no information on their website about payment options other than accepting HSA and FSA. 

This could be a great option if you just want treatment for a condition you’ve had before (like a recurring UTI) without going to the doctor. They also offer a Symptoms Quiz if you are unsure what exactly is bothering you down there. Wisp could be a cheaper option if you don’t have insurance and pay out-of-pocket, as doctor’s visits without insurance can get expensive. I think it could work in a pinch, but I’m not sure if it’s worth it if you have the time and insurance coverage to go to your doctor IRL. 

Every winter many people experience Seasonal Affective Disorder or seasonal depression. It’s fairly common for people to experience low mood or depressive symptoms for the winter months. Decreased sunlight, fewer opportunities to be active outside and an overall desire to stay cozy and inside can contribute to this. Seasonal affective disorder can be treated with a SAD lamp, among other things. This is a lamp that provides light therapy, similar to the positive effects of sunlight which can improve mood a bit. Besides a SAD lamp, maintaining an active lifestyle and taking a vitamin D supplement can help as well.

Staying active in the winter

We all know it’s important to stay active all year round, but it’s especially important to keep this up during the winter months. During the winter we naturally want to make like animals and hibernate. It’s cold, the sun doesn’t shine, and we want to stay cozied up inside. Although allowing your body to rest is important, too much hibernation can lead to seasonal affective disorder, fatigue, trouble sleeping and low energy in general. 

During the colder months, your heart rate generally doesn’t get as high as it does during exercise in the warmer months. Because of this, you generally sweat less and use less energy, increasing your endurance. You can also get creative with how to stay active. You don’t have to exercise outside if it’s too cold, and if you don’t have a gym membership you can exercise at home. Any sort of physical activity in the winter is good for us. Look up workout videos online and do them in your living room. Stretch. Do yoga. Walk around the mall. In general, 30 minutes of mild activity per day is recommended, but even just a ten-minute burst of activity will serve you well in the colder months.

Dressing for cold weather

If you are working out outside, be sure to dress in layers so you can allow your body to cool and sweat as you work out. Also, keep your head covered with a hat or earmuffs. We lose most of our body heat through our heads. Regular exercise will help improve your mood, give you more energy, and help you sleep better.

Getting regular vitamin D

Additionally, it’s important to maintain healthy levels of vitamin D in the winter. About 40% of people are vitamin D deficient year-round, and that number increases in the winter. The main way we get vitamin D is from the sun, and if the sun isn’t shining or it’s too cold to go outside, obviously we can be lacking. Taking a vitamin D supplement can help maintain healthy amounts of vitamin D in your diet. Speak with your doctor first to make sure you’re taking the correct amount. You can also increase your vitamin D with a handy dandy SAD lamp. And finally, eating foods rich in vitamin D such as pork, mushrooms and fish can help increase your levels as well. 

The winter can be a tough time for a lot of people. Seasonal affective disorder rears its ugly head, we feel cold and tired and we’re missing out on some important vitamins. Getting regular exercise, using a SAD lamp and taking vitamin D supplements can all help improve your mood and overall physical health in the winter months. 

From the beginning of time, people with uteruses have experienced menopause. Menopause occurs when a person’s estrogen and progesterone levels decrease and their period permanently stops. This decrease in hormone levels typically starts between the ages of 45 and 55 in people with uteruses, but it can sometimes start earlier or later. Once you have gone without a period for a whole year, you are officially menopausal. Congrats! If you want to start preventing symptoms now, you may be able to thanks to the connection between exercise and menopause. 

What to expect in menopause

The time leading up to menopause where you experience symptoms like hot flashes, mood swings, and decreased muscle mass is called perimenopause. This begins during the ages of 45-55 (sometimes sooner, as I mentioned), and symptoms from this period can last for up to 14 years after menopause is done. That seems unfair to me!! During this time, your baby-making hormones are decreasing, and your body is no longer able to make a baby. That’s why it causes someone’s period to stop. Similar to puberty when all of your sex hormones are gearing up, menopause can come with a lot of symptoms. In addition to hot flashes and mood swings which we are typically aware of, menopause can also cause a decrease in bone density and a decrease in muscle mass. 

Estrogen levels are linked to healthy bones and muscles in women and people with uteruses, so when these levels decrease, bone mass and muscles decrease as well. Many studies have shown that people who practice some form of exercise, particularly weight-bearing exercise, experience some milder symptoms related to this decrease during menopause. 

How exercise can help symptoms

Lifting weights and doing strength training helps increase bone density. It’s recommended that women in the early 40s start exercising intentionally to lessen the symptoms of menopause even before they begin. If you lift weights, even light ones, and build up that bone density and muscle mass for years before your menopausal symptoms even begin, your body will be in an even healthier state to make up for some of those losses once those hormones start to fluctuate. 

Cardio exercise is also recommended for menopausal women. Dancing, going for walks, light jogging, and yoga are all great for relieving stress and mood swings that accompany changing hormones, but they also ensure the body is fit and healthy, creating as pleasant of a menopausal experience as possible.

Start to exercise and menopause may be milder

If you begin weight training now, when perimenopause beings, hopefully, some of the physical changes in the body will be less noticeable or less painful. Although a great stress reliever, unfortunately, weight training won’t stop hot flashes from happening. Some women will treat this with hormone replacement therapy, or HRT. During this treatment, patients take either estrogen, progesterone, or both to help alleviate menopause symptoms. By adding in some hormones through treatment, the decline in these hormones in the body will hopefully be milder. 

Although I am decades away from experiencing menopause myself, it’s something I’ve become increasingly fascinated with. Despite learning about my period and birth control very thoroughly, no one has ever talked to me about what to expect in menopause. It seems like a scary adventure no one is talking about. 

Resources such as The Menopause Manifesto by Dr. Jen Gunter talk in-depth about this time of life and ways to handle the changes and live a wonderful life after menopause. This, in addition to exercising and talking with your doctor can make menopause a less scary thing to navigate.

If you had any sort of sexual education growing up, you were probably taught about using condoms for birth control. Condoms are a fairly inexpensive and effective way to help prevent unwanted pregnancy and the spread of STDs. When used effectively (aka perfectly every time you have sex), condoms can be up to 98% successful at preventing pregnancy. Condoms are known as a barrier method of birth control, meaning they act as a barrier between sperm getting inside the vagina; it should all stay in the condom. Some barrier methods, like condoms, can act as birth control, but a number of other barrier methods are also a great way to prevent STDs.

Condoms themselves are a great and inexpensive barrier method of birth control, offering different sizes and thicknesses to provide different sensations. Condoms are typically made of latex, and some people can’t use them due to allergies. There are non-latex condoms available, but there are also other barrier methods to rely on when it comes to preventing the spread of sexually transmitted infections.

1. Internal or vaginal condom

Internal condoms work by being inserted into the vagina or anus to protect you from unwanted pregnancy and STDs. Vaginal condoms are bigger than penile condoms and are up to 79% effective at preventing pregnancy. Internal condoms look a little strange, but trust that they’ll work just fine. Essentially, they look like a clear tube with a ring on the end.

These condoms are bigger than traditional condoms, but if inserted correctly, they won’t cause any discomfort. If you’re wearing one in your vagina, squeeze the ring and insert it so the open end of the tube is near your vaginal opening. If inserting into the anus, remove the ring on the end so it’s easier to insert. Just make sure to hold the condom open when something is being inserted to make sure you’re protected the whole time. Planned Parenthood has a great step-by-step guide for how to properly insert one.

Internal condoms aren’t always available at drug stores like penile condoms, so they can be a little harder to find. They are available at health clinics and some university health centers give them away for free. You can also find them online. The only brand approved by the FDA is called FC2, so make sure this is the brand you purchase if you get any. These condoms are also made out of synthetic rubber, making them a great option if you or your partner has a latex allergy. Additionally, these condoms can put wearers in a great position of control over their safe sex practices if their partner doesn’t want to wear a condom. Additionally, since they fit differently than traditional condoms and go inside of the body, they could provide fun new sensations for you and your partner. Yay!

2. Dental dam barrier methods

I know for a fact that I was never taught about dental dams in sex ed. I learned what this was from the feminist group I was involved with in college. Thanks, college feminists! Dental dams act as a barrier method for safe oral sex.

Dental dams are a thin, square sheet of latex that is placed over the vulva or the anus before oral sex to prevent the spread of STDs. Fun fact, types of dental dams are even used by orthodontists or dentists during oral care. MIND BLOWN!

Dental dams create a barrier so STDs cannot spread. These are not used for the prevention of pregnancy—they should only be used for oral sex. Dental dams can be bought at a drug store or you can even make them from a rubber glove or condom. To make them from a condom, cut off the tip of the condom and cut open one of the sides, forming a rectangle, and voila! A dental dam, baby! If you or your partner is allergic to latex, make one by cutting up a rubber glove.

Dental dams can provide easy STD protection during oral sex for anyone that uses them.

3. Finger cot

Finger cots are basically little gloves for your individual fingers. You may have seen a doctor use a finger cot before, or even put one over a medical instrument, and they can also be used for safe manual sex! Finger cots are made of rubber and typically used for inserting fingers into the vagina or anus, providing protection against STDs. Finger cots can be bought at a drug store or made by cutting up a rubber or latex glove, and are great if anyone involved is allergic to latex. In addition to preventing STDs from spreading, they are also a great option for anyone extra concerned about cleanliness when fingers are inserted into the body.

4. Gloves as barrier methods

Gloves work similarly to finger cots but provide more protection because they cover a larger surface area. Gloves can be used as a barrier method for manual stimulation, using the fingers or fist, in the mouth, vagina, or anus. Gloves protect all people involved from getting any germs from under the fingernails inside the body, and from spreading STDs from sexual fluids. Again, since they are typically rubber, these are great for anyone with latex allergies.

All of these barrier methods are fairly inexpensive and easy to access. If you are in a monogamous relationship where you and your partner have both been tested for STDs, you don’t need to use these barrier methods unless you are also wanting to prevent pregnancy, then in that case use condoms, penile or internal. If you have multiple sexual partners or you and your partner haven’t been tested, these barrier methods act as a great way to prevent the spread of STDs. 

Asking your partner about their STD status

Additionally, asking your partner about their STD status before having sex is a great way to create open communication and care in your relationship, whether that is a one-time experience with someone or a long-term relationship. Make normalizing talking about STD status and getting regularly tested part of your safe sex practice in addition to these great barrier methods.

Some people complain about a slight loss of sensation when using barrier methods,  but being worried about unwanted pregnancy or contracting an STD during sex will kill the mood even more. Stay protected and have safe and consensual sex!

Although not described in detail, this article on arousal non-concordance mentions sexual assault.

Are you sitting down? Because I’m about to drop some knowledge on you that will change your life! I’m here to tell you about something called arousal non-concordance. Arousal non-concordance is basically when your sexual arousal physically (in your genitals) doesn’t match up with your subjective arousal (how turned on you feel). You probably have never heard this term before, but I can almost guarantee you’ve experienced these differing levels of arousal before because it’s incredibly common. 

The origins of arousal non-concordance

I first learned about arousal non-concordance while reading Emily Nagoski’s book, Come as You Are: The Surprising New Science That Will Transform Your Sex Life. Nagoski has written extensively on this topic and even gave a Ted Talk about it last year. Her Ted Talk is fantastic and I recommend watching it right after you finish reading this. 

Your genitals can respond to something that is sexually relevant without it being sexually appealing. If you witness something that is sexual, your body can process it as sexually relevant, regardless of if you enjoy it or not. Your brain is what helps you decide if you like and want that thing. Nagoski gives the example of reading a news article about a sexual assault and noticing her genitals feeling aroused at the same time she felt horrified by what she was reading. This doesn’t mean she is turned on by reading about assault; she had this physical response because her body is responding to something that is sexually relevant, but her mind knows that she obviously does not find this appealing. 

Another example she gives is that victims of sexual assault can sometimes orgasm during a rape or assault. In some court cases, unfortunately, people have interpreted this as consent. Because of the research backing up arousal non-concordance, we know that the survivor’s body processed this as something that was sexually relevant, which would be why they had an orgasm, but that does not at all mean they wanted or liked what was happening. 

How it helps us understand relationships

Arousal non-concordance can help us understand our own sexual relationships better as well. You may have experienced times when you are intimate with a partner and you are ready to have sex, but your genitals might not seem ready. Similarly, you might have experienced when your genitals seem ready, but you are not ready yet. It is important that your partner listens to your words and not your body. Even though your genitals might be hard or wet or whatever else, you decide if and when you are ready to engage with someone sexually. You should never second guess yourself or have your partner convince you you’re ready because of what your genitals are saying. Your genitals respond if something is sexually relevant, but you respond if you like or want that sexually relevant thing!

The overlap between genital and subjective arousal

Based on the research behind arousal non-concordance, there is a 50% overlap between genital arousal and subjective arousal for someone with a penis. For someone with a clitoris and vagina, there is only a 10% overlap between genital arousal and subjective arousal. That means that for someone with a penis, about 50% of the time their genitals and mind will be equally aroused, but for someone with a clitoris, this perfect overlap only occurs 10% of the time!!! That’s why it is so important to have your partner trust your words and not your genital’s response in a sexual situation. That’s also why your genitals can respond sexually to something that is not appealing to you.

Now that you know about arousal non-concordance, what can you do with this enlightening information? As Nagoski suggests in her book and Ted Talk, tell someone about it. Spread this exciting news and know that you are not sexually twisted or broken. Tell your partner to trust your words and not your genitals. Finally, if you’re someone who experiences only the 10% overlap, pay attention to your subjective arousal (how mentally turned on you are) and buy some lube to help with the rest. 

The Sexual Response Cycle was developed by sex researchers Masters and Johnson in 1966 after observing patients during various sexual activities. Although this model was developed so long ago, it is still widely taught as the way our bodies respond to sexual activity. In general, this model can help us understand what’s happening in our bodies when we experience sexual arousal and desire, but human sexuality is nuanced and varies widely, so this model isn’t perfect. I do think it does a great job of helping us understand generally what’s happening in our bodies when we experience sexual arousal. It is important to note that people of all genders experience the cycle, but in different ways and at different times. You and your partner likely won’t experience the exact same phases at the exact same time, and that’s okay. 

Excitement Phase

The first phase of the cycle is excitement. The excitement phase can last anywhere from several minutes to several hours and includes experiencing muscle tension, a faster heart rate and faster breathing, blood starting to flow to the genitals. This cycle can start even before you physically see or touch your partner, which I think is so cool! 

For example, if you’re dating someone and every time you’ve seen one another so far you’ve had sex, simply seeing their name pop up on your phone on the day of a date together can start this cycle because your brain associates them with sex. How wild is that!? As I mentioned, this phase can last anywhere from a few minutes to hours, and of course, can vary in levels of intensity. Sometimes your mind can feel desire, but perhaps your body doesn’t yet, or vice versa. 

Plateau Phase

The second phase is plateau. During the plateau phase, all of the experiences from the excitement phase continue but slowly increase with intensity. Perhaps the feelings you initially feel thinking about seeing your partner later increase when you actually see them or when they kiss you hello. This phase could also occur when you and your partner(s) actually start being physically intimate with one another. 

All of the things in the excitement phase are continuing, and the genitals get more filled with blood. Your breathing and heart rate increase even more, as well as your muscle tension. Some people also experience muscle spasms during this phase in other parts of their body besides their genitals. Even though this phase is called “plateau,” the arousal and sensations in the body are still increasing here little by little. 

Orgasm Phase

The third phase is orgasm. A very important note to make here is that not everyone experiences orgasm every time or even most of the time they have sex with a partner. Orgasm shouldn’t be the only goal of sexual interaction, pleasure should be! Although this is included in the response cycle, I want to acknowledge that this is not accurate for a lot of people. 

During orgasm, people can reach the climax of their sexual experience. This climax can include orgasm or involuntary contraction of the muscles and genitals. Blood pressure heart rate and breathing are all at a high, and a great release of sexual tension can occur. The vagina and uterus involuntarily contract here, and the penis can ejaculate. Some people also experience a flush of color on their face or body in this phase. 

Resolution Phase

The final phase of the cycle is resolution. During resolution, the body slowly returns back to its natural resting state. The heart rate slows, the muscles relax, and the increased blood flow to the genitals returns to its resting state. During this phase, people may feel relaxed, more connected to their partner, or even snuggly and tired. This phase is a great opportunity for partners to discuss aftercare, or ways to feel safe and comfortable after sex. People with vaginas should always pee right after sex during this period. 

What if I experience the sexual response cycle differently?

Generally speaking, this is the cycle our bodies go through during a sexual encounter with someone else or ourselves. As I mentioned, this model isn’t totally accurate to how people experience sexual arousal, but generally speaking, it can give us an idea. This model presents the sexual response in a very straightforward, linear way, and that is not always accurate. For example, orgasm might not be part of everyone’s sexual response, and that is normal. 

Perhaps there are some encounters where you experience the excitement and then resolution, never experience a plateau or a climax. That is normal. It is also normal to not experience these phases at the same time, in the same way, or at the same level of intensity as your partner or partners. For example, it is not likely that everyone involved in a sexual encounter will experience orgasm at the same time. One partner might naturally spend more time in the excitement or plateau phase before reaching a climax. One partner might feel more energized during the resolution, while the other might feel sleepy. All experiences are normal!

My favorite thing I’ve learned in studying the sexual response cycle is learning more about the excitement phase. I love knowing that this phase can start by even just seeing your partner without physically touching yet. That is so cool! 

Are there other models of sexual response?

Since this cycle was first established in 1966, other researchers have written and observed more accurate ways to describe the sexual response that accounts for all of the variations in sexual experience and desire people have. These different models can be found with a little extra reading, but the Masters and Johnson model still remains the most widely taught, despite its shortcomings. Other models developed in the years after Masters and Johnson account for acknowledging desire, pleasure, and satisfaction as part of the sexual response and someone’s interest in seeking out sexual activity with a certain partner again. 

Next time you experience the sexual response cycle, it might be interesting to tune into your body and see how you’re really feeling. Notice if the excitement phase starts by simply knowing you’ll see your partner later that day, for example. Think about what makes you feel totally cared for a safe during the resolution phase. Once you reflect, share that information with your partner for a more connected sexual experience.