Pearly Penile What???

Hi Shawna,

I just started having sex with my new boyfriend and I noticed he had some small bumps around the head of his penis. I asked him about it and he said that his doctor told him it was normal. He said it was called pearly pimples or something like that. What is that and is it something I should worry about it?

Thanks!
______________________________________________________________________

Great Question! Does it look something like this???

pearly-penile-papules

This is called Pearly Penile Papules, often abbreviated to PPP. They are tiny bumps that form a ring around the head of the penis. PPP is fairly common; about 20%-30% of the male population has them. We don’t know what causes them but we do know that PPP is nothing to worry about. PPP is not a sexually transmitted infection, it is not contagious, and poses no health risks. Although normal and totally not harmful, some men may choose to have them removed for aesthetic reasons (meaning, they don’t know like the way they look).

While PPP are harmless, other lumps or bumps in the genital area may not be. It’s always a good idea to be checked out by a clinician whenever in doubt.

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

To bleed or not to bleed?? How to control your period using the NuvaRing!

Hi Shawna,

I am going on vacation soon and really don’t want to be on my period. I am using the NuvaRing and my best friend told me that if I kept it in, I would skip my period. Is that true?

-Anonymous

Swim-when-You-Are-on-Your-Period-Step-5

Hi,

Great question! Your friend is right!

Although I have written about the ring before, I have not written about how to use it to skip periods (which is totally safe). For those who have never heard of the NuvaRing or still a bit confused about it, check out my previous blog post by clicking here.

NuvaRing 1

It’s actually pretty simple to skip a period using the ring. Instead of taking the ring out after 3 weeks and going ring free for a week, simply leave the ring in for 4 weeks and immediately replace it with a new ring when the 4 weeks is up. This means there will not be a time in which you aren’t wearing a ring. Don’t worry; your ring is still protecting you against pregnancy during the 4th week, just don’t forget to remove it and replace it when the 4th week is up. You can do this just once or continually. And remember, it’s totally safe not to have a period, so using your ring in this way is a great option for people who hate having their periods.

grace-period-300x199
Let me know if you have any other questions!

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

Get the Skinny on Weight Gain & Birth Control

Many women are worried about gaining wight on birth control. In fact, it’s something women ask us about nearly every day here at New Gen. Fortunately, it’s not necessarily true. Check out this article written for Bedsider by Jessica Morse, MD, MPH. Some of you might even remember Dr. Morse, she was a clinician here at New Gen a few years ago and she is most definitely missed!

BCM & Weight Gain

What myths have you heard about birth control??? First 3 people who leave a comment about a birth control myth they’ve heard will win a $5 gift card to Starbucks or Jamba Juice.

Gaining weight: Is it the birth control?
If those skinny jeans are feeling a bit too skinny, don’t assume your birth control is the cause.

It’s a common story. A woman starts using hormonal birth control, finds herself gaining weight, and assumes the birth control is to blame. The tricky thing is that lots of research about hormonal birth control shows that, with one important exception, it’s probably not the birth control.

A note on personal experiences vs. the big picture:
Before we lay out the evidence, we want to acknowledge the difference between looking at lots of women on average versus an individual woman. Research tells us about women on average, but not about specific women’s experiences. When we describe what happens for women on average, we are not dissing personal stories. (Bedsider has big love for personal stories!)

Here’s why the big picture is important: it sets our expectations. Being influenced by our expectations is a basic part of human nature. That’s why the placebo effect exists, and it’s why this hatpin trick is gross even though we know it’s fake.
The big picture

Researchers have looked at whether hormonal birth control makes it more likely to get bloated or hungry. They’ve also looked at women’s weight changes over time when using specific birth control methods and compared them with women using methods with no hormones. With one exception, they’ve found no direct link between using hormonal birth control and gaining weight. Here are the details.

IUDs: There are two kinds of IUDs. One kind releases a low dose of progestin hormone (Mirena and Skyla) and the other kind has no hormones (ParaGard). Both kinds of IUDs mainly work inside the uterus, so there are minimal effects on the rest of the body. Studies show no difference in weight changes between women using hormonal IUDs and women using birth control without hormones.

The implant: The implant also releases a low dose of progestin hormone. Because the implant is relatively new, there are fewer studies about it. Early studies showed that about 5% of women using the implant got them removed due to concerns about weight gain. However, the weight changes don’t appear to be different between women using the implant and women using birth control without hormones.

The pill, the patch, and the ring: Birth control pills contain both an estrogen and progestin hormone, and are probably one of the most studied medicines on Earth. Many studies show that the pill does not cause weight gain, yet concern about weight gain is the main reason why women quit taking it. The ring and the patch are similar to the pill in terms of their ingredients and dose, so are not likely to cause weight gain, either.

That important exception

The shot: Most women don’t gain weight because of the shot, but some do. Interestingly, weight gain on the shot seems to be more common in young women who are already considered overweight. Additionally, the women prone to gaining weight because of the shot will usually notice a change within the first six months. If weight gain is absolutely not okay for you, the shot may not be the best choice.

The takeaway:

Understanding all of the details that can affect weight—like diet, exercise, and genetics—can feel overwhelming. The tendency is for people to gain weight throughout their lives, so being a year older is more likely to cause weight gain than birth control. But like we said—this is on average and doesn’t take into account women’s personal experiences. If you think your birth control is affecting your weight in a way you don’t like, talk to your health care provider to find another effective method that works for you.

No matter what birth control you’re using, it’s important to get a daily cardiovascular workout. And no one says you have to leave the bedroom for that.

Jessica Morse, MD, MPH

Exercise & Eating

Thank you Bedsider and Dr. Morse for busting this common myth!

In happiness & health,

Shawna

Don’t forget to leave a comment about birth control myths you’ve heard to win a $5 gift card to Starbucks of Jamba Juice!

Dare to Bare? Shaving tips for pubic hair removal!

Pubic hair (hair around the penis, vulva, or anus) is a totally normal part of becoming an adult. However, some people (and it’s not just the ladies) would rather not have it, so they choose to shorten it or remove it all together (but if you aren’t one of them, don’t worry! Pubic hair is totally normal). The most common way of removing pubic hair is by shaving. Although shaving is meant to leave the area smooth and hairless, it can instead leave the area irritated! Razor burn and ingrown hairs are common concerns for those just starting to shave their pubic area so New Gen has come up with a few tips to help ya out.

Pubic Hair

1. If you have long hairs (usually those who have never shaved or haven’t shaved in a long time), trim the hairs with clippers or scissors first. Electric clippers are best for this purpose.

Trimming

2. The softer the hairs, the easier it will be for you to shave. Try taking a long, warm bath before shaving, or choose to shave at the end of your shower.

3. Apply shaving gel a few minutes before shaving to soften hairs. If you have sensitive skin, you might want to try a hypoallergenic or fragrance-free brand.

4. Use a sharp and or new razor. The sharper the razor blade, the better it will work and less irritation it will cause to your skin.

New razor

5. When shaving, don’t move the razor over the same area more than twice. This will help reduce skin irritation.

         On the first stroke, go with the direction of hair growth to remove most of the hair.

         On the second stroke, go against the direction of hair growth for a smooth, close shave. If going against the direction of the hair growth tends to irritate you (and for many it does, especially when they are new to shaving), then skip that and do both strokes going the same direction of hair growth.

shaving_directions

6. Clean the area after shaving with mild soap and water to reduce the risk of infection. Continue to practice clean hygiene, washing the area at least once a day to reduce sweat and oil build-up.

7. Go as long as possible between shavings to reduce skin irritation.

A few extra tips:

1. The skin around your genitals is extra sensitive. Some people can be allergic to some types of shave gel. If you have sensitive skin, you might want to try a hypoallergenic or fragrance-free brand of shave gel.

2. To reduce the risk of ingrown hairs and razor bumps after shaving, use an exfoliating brush or loofah sponge when washing the area daily.

ingrownhair razor bump

3. When the hair starts growing back, it can be uncomfortable and itchy. Chaffing is nearly unavoidable, but exfoliating the area regularly can help. Exfoliating means removing the outer most layer of dead skin cells. This can be done with a loofah or wash cloth.

Towels with Bath Spa Kit and Gladiolus

4. If you have tried shaving and you don’t like it for whatever reason but still want a sleeker look, consider closely trimming your hair instead of shaving. It provides many of the benefits of shaving without all the risks!

street_art_big_size_17

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

Does the URGE to Go Leave You BURNING to Know? The Dreadful Urinary Tract Infection!

Hi Shawna,

I feel like I have to pee all the time and when I go nothing happens except for a lot of pain and burning. What’s wrong?

-Anonymous

Hi,

Before I begin to answer your question you need to know that I cannot diagnose your problem via email (meaning I can’t tell you exactly what’s wrong). Only an in-person visit with a clinician can tell you what is going on. If you live in the Bay Area, give us a call at 415.502.8336 to schedule an appointment.

That being said, I can tell you that these symptoms are commonly associated with a urinary tract infection.What is a urinary tract infection?

A urinary tract infection, often referred to as a UTI, is an infection in any part of your urinary system (the part of your body that makes pee) — your kidneys, ureters, bladder and urethra. Most infections happen in the lower urinary tract system — the bladder and the urethra. The bladder is where urine is stored before leaving the body. The urethra is the tube that connects the bladder to the outside of the body.Check out the diagram below.

UTIAlthough men can get UTI’s, it isn’t very common. That’s because the urethra, the tube that connects the bladder to the outside of the body, is shorter in women then it is in men making it much easier for bacteria (the germs that cause the infection) to travel from the outside of the body into the inside.

Most UTI symptoms include

  • A frequent and strong urge to pee
  • Despite the frequent and strong urge to pee, there may actually be little to no pee when trying to go
  • A burning sensation when peeing
  • Pee that appears cloudy
  • Pee that appears red, bright pink or cola-colored — a sign that blood may be present in your pee (not a good thing)
  • Strong-smelling pee
  • Pelvic pain in women (lower abdominal/stomach area pain)
  • Rectal pain in men (pain in the butt, literally)

It’s important to see a clinician right away if you are experiencing any of these symptoms because an untreated UTI can lead to more serious complications, like a kidney infection. Once a clinician diagnoses a UTI, antibiotics are given to clear the infection.

There are a few things you can do to prevent UTI’s and that includes wiping from front to back after using the bathroom. That will help prevent bacteria from the anus (butt-hole) finding their way into the urethra and into the bladder. Also, drinking plenty of water and peeing when you feel the need will flush bacteria from the bladder often and prevent them from multiplying and causing a problem. Lastly, for women, emptying your bladder right before and right after sex can really help reduce your risk of getting a UTI!

As always, let me know if you have any questions.

In happiness & health,

Shawna

Reviewed by Koher Der Simonian, MD

Period pain? Birth control can help!

This week we have an awesome article written by New Gen’s very own clinician, Meredith Warden!!! The article was originally published on Bedsider but it’s a concern we hear at NGHC all the time so we thought it was worth sharing!

WARDEN_small

Meredith Warden MD, MPH is a Family Planning Clinical Fellow and an Ob/Gyn at the University of California, San Francisco. She lives in San Francisco with her fantastic skateboarding husband and their little mini dachshund named Stretch. She loves being outside doing anything, and reading anywhere, anytime.

 

Hormonal birth control is one of the best ways to manage painful periods.

Having a painful period can mess up your day, or week—or weeks! Every woman’s period is different and the same woman’s periods are often different over time. So how do you know if the pain you have with your period is normal? And what can you do to make your periods  less painful?

For more information on periods, check out some previous blogs!

Aunt Flow’s Monthly Visit

When Aunt Flow DOESN’T Visit

My periods are really painful. Am I normal?

It’s normal for women to have some cramping, bloating, nausea, or diarrhea before their period starts each month. These symptoms can continue for a few days after the period starts, and they can be annoying—but they shouldn’t interfere with going to school or work, or with otherwise living life.

Here’s what’s not normal:

  • Moderate to severe cramps or lower belly pain with every period.
  • Periods so bad that they interfere with work, school, or life in general

crampsSo what’s the problem, exactly?

Periods like this may be dysmenorrhea—a fancy medical term for pain with menstruation. There are several possible causes of severe period pain, some of which have special treatment options.

  • The cells from the lining of the uterus may be growing into the muscles of the uterus (adenomyosis) or on other organs in the body (endometriosis).
  • The muscle of the uterus may be growing fibroids.
  • The uterus may be releasing too much of a substance called prostaglandins, causing its muscles to contract irregularly and leading to big-time pain.

The good news is that you don’t have to put up with this pain! If you’re having abnormally bad periods, talk to your health care provider about what might be causing the pain and how to treat it. There are a few things you can do to make your periods less painful, shorter, or go away altogether.

And what are the solutions?

1. Make your periods less painful. You can buy pain killers like ibuprofen (Advil or Motrin) at the drug store. Start taking them right when you first start feeling symptoms, or if your cycle is really regular, take them just before you expect your period.

3-02-11-ibuprofen2. Make your periods lighter. All types of hormonal birth control are even better at reducing pain than over-the-counter meds. The hormonal IUD, the implant, the shot, the pill, the patch, and the ring will all make periods lighter. This is because these methods of birth control make the lining of the uterus thinner. There’s less tissue in the uterus to shed, so periods are lighter. One special note on the implant and the shot: for some women, these methods cause more days of spotting or bleeding, but periods become lighter and less painful overall.

3. Have fewer periods. The ultimate solution may be to have as few periods as possible. Several methods of birth control can make periods go away for months or even years at a time:

  • One of the best ways to treat painful periods is to get the hormonal IUD Mirena. This IUD makes periods lighter and shorter for nearly all women, and many stop getting periods even after one year of use. The chance that you’ll stop getting your period increases the longer you use it. Periods should be light or nonexistent as long as you use a Mirena—up to 5 years. (Of course you don’t have to use it for all 5 years—you can have it removed anytime you want to. Your ability to get pregnant returns right after it’s removed.)

Mirena-In-Uterus

  • You can use the pill or the ring continuously. Some brands of the pill are packaged for 3 months of continuous use (e.g. Seasonale or Seasonique). But you don’t need a fancy brand: with a monophasic pill, instead of having a few days of placebo pills when you’d normally get your period, you can just start a new pack of active pills. Here are more details on how to use the pill this way. (However, this may not be an option for those using Family Pact, the little green card we give you at New Gen, to pay for their pills because Family Pact will only give 3 packs of pills every 3 months – ask NGHC for more information about this.) For the ring, instead of having the ring out for a few days when you’d normally get your period, you can just change your ring once a month and skip the week without one. After 3-6 months, you may have break-through bleeding.

endo_cont_horm_instructions

  • You can try the shot, which causes about half of women to stop getting periods after a year of use.

DMPAWhen hormonal birth control stops your period, it’s because the lining of the uterus gets so thin that there’s nothing to shed. It’s totally safe to skip periods this way, so if you suffer from serious period pain, talk to your provider about what you can do about it.

If you have questions or you are experiencing period pain, come see us at New Gen! We would love to help put an end to your period pain!

Thank you for reading,

Meredith Warden, MD

Happy Pride Everyone!!!

New Gen joins in on celebrating LGBTQI Pride!

We are not claiming to be experts on this subject. Like all kinds of people, many LGBTQI people have their own way of explaining what their identity means to them or what their experience may be . This blog is just a brief view into what is a huge and active conversation around the world. If you find yourself wanting to learn more, or want to join in on that conversation, we include some sites to check out at the end of this blog.

This past weekend, June 29-30, was Pride Weekend in San Francisco—a weekend when people from across the country and throughout the Bay Area come together to celebrate the LGBTQI community. According to the SFPride website, this event is “the largest LGBT gathering in the nation.” This is something for all San Franciscans to be proud of!

Identifying with one or more of these terms is totally personal. It is 100% OK if you don’t identify with any of these terms or don’t know which of these you consider yourself right now. It’s also totally normal if how you identify changes over a lifetime. While the identities represented by all these letters may be separate, many of the people in these groups have come together to support each other and work for a common cause of acceptance, equal rights and access to services. Even if we don’t personally identify with any of these letters, many of us have loved ones, friends, coworkers, and neighbors who do. As a clinic, we welcome LGBTQI patients and do our best to make every person comfortable!

 So what do all these letters stand for exactly? They represent different kinds of

Sexualities—Based on sexual attraction and romantic love: homosexual, heterosexual, bisexual, queer.

Gender Expression—Based on how a person wants the world to see them: feminine, masculine, transgender*, androgynous*,   or genderqueer*.

*Some transgender people may identify simply as female or male, while others may identify as trans.

*Androgynous: some people desire to look neither masculine nor feminine.

*Genderqueer: some people desire to look sometimes feminine, sometimes masculine, sometimes both or neither, and not stick to one gender at all times.

Biological sexesBased on sexual anatomy: male, female, intersex.

All three of these identities can and do include more than just appearance — identity is never that simple. As you read on, you’ll see there is a lot of grey in between.

Gingerbread

http://itspronouncedmetrosexual.com/2011/11/breaking-through-the-binary-gender-explained-using-continuums/

L: Lesbian. Women who are attracted to other women.

G: Gay. Someone who is attracted to other people of the same sex. A man who is attracted to other men OR a woman who is attracted to other women.

B: Bisexual. A person who is attracted to people of both sexes.

T: Transgender. A person who identifies as a different gender than the biological sex they were assigned at birth based on their sexual organs. The gender with which someone identifies does not necessarily have to do with their sexual orientation (heterosexual, homosexual, bisexual, queer).

Q: Queer. Some people prefer to call themselves “queer” instead of “gay” or “bisexual” because they feel it is less confining (they may feel attracted to people regardless of gender or not want to think about attraction in terms of two genders or sexes).

I: Intersex. A person who is biologically both sexes. This can mean they have the hormones, genes, and/or anatomy of both a male and female.

It can be a huge leap for someone to open up to friends, family, health care providers, employers or coworkers about any one of these identities. That’s what make events like Pride Weekend so awesome!

Happy Pride Everyone! This past weekend and everyday!

Barbara Haupt

For more information check out:

San Francisco LGBT Community Center – Resources for LGBTQI people an queer education.

LyricActivities, tutoring, recreation, health and sex ed. for GLBTQ youth

SFQueer A Calendar for Queer events and activities in the Bay Area

The Trevor Project 24 hr. suicide prevention and crisis hotline

Transgendered San Francisco Support and social group for the Transgender community.

Intersex Society for North America

National Center for Lesbian Rights