Sexual Conditions

Stephanie Watson

Women often fear sex after a heart attack

A heart attack can be a frightening wake-up call with long-lasting aftereffects. It’s no surprise that women often tread gently after having a heart attack—and many don’t tread back into the bedroom for sex. Up to 60% of women are less sexually active after a heart attack, often due to worries that sex could trigger a repeat heart attack. A new study suggests that although women believe sex is important for resuming a sense of normalcy and intimacy with their partners, many are fearful that it would be too much for their hearts to take. Reassurance from a doctor is sometimes all that’s needed to ease those fears. How does a woman know if she’s physically ready for sex after a heart attack? It’s safe to have sex if you can work up a light sweat without triggering symptoms like chest pain or shortness of breath.

Howard LeWine, M.D.

HPV transmission during oral sex a growing cause of mouth and throat cancer

Actress Angelina Jolie recently went public with her double mastectomy to prevent breast cancer. Governor Chris Christie told us his reasons for gastric bypass surgery. And now actor Michael Douglas is shining the spotlight on the human papilloma virus (HPV)—the number one cause of mouth and throat cancer. In an interview published in The Guardian newspaper in London, Douglas mentioned that his own throat cancer could have been brought on by oral sex, a common way to become infected with HPV. HPV transmitted by sexual contact often doesn’t become active enough to cause symptoms. When it does become active, it tends to invade mucous membranes, such as those covering the lining of the vagina, cervix, anus, mouth, tongue, and throat. An HPV infection can cause warts in and around these tissues. Most people sexually exposed to HPV never develop symptoms or health problems, and most HPV infections go away by themselves within two years. But the infection can persist and cause long-term problems. These include cervical cancer in women, penis cancer in men, and in both sexes some cancers of the anus and oropharyngeal cancer (cancer in the back of throat, including the base of the tongue and tonsils).

Patrick J. Skerrett

Puberty starts earlier in many American boys

Two years ago, new research showed that American girls were hitting puberty at younger ages than ever. The same thing is happening with boys: they are starting puberty almost two years earlier than they did 30 to 40 years ago. Why this is happening isn’t clear, but it could affect social and sexual behaviors. A new study shows that the average age of puberty is now 10 years for white boys (about one-and-a-half years earlier than what has long been considered “normal”), 9 years for African-American boys (about two years earlier than expected), and 10 years for Hispanic boys, which is unchanged from before. Although early puberty is increasingly common, it can be a signal of a tumor in the brain, pituitary glands, or elsewhere; an underactive thyroid gland; or other medical problems.

Harvey B. Simon, M.D.

Biking and sex—avoid the vicious cycle

Bicycling is a terrific way to get from one place to another. It’s also an excellent form of exercise. Some men and women avoid bicycling, though, because they worry that it may damage their reproductive organs and harm their sexual function. This mainly happens to people who cycle a lot. And it isn’t inevitable. One problem is the design of many bicycle seats, which put pressure on the perineum, a region of the body that runs from the anus to the sex organs. It contains the nerves and arteries that supply the penis in men and the clitoris and labia in women. You don’t have to give up biking to preserve your sexual function. Take a few simple precautions, like picking a wider seat, and shifting your position and taking breaks during long rides. These precautions will ensure that your passion for exercise doesn’t interfere with your passion in the bedroom.

Howard LeWine, M.D.

New guidelines urge immediate treatment after HIV infection

New guidelines now urge adults who have been infected with HIV to start taking HIV-fighting drugs as soon as possible, ideally within two weeks of being diagnosed with the infection, rather than waiting to see what happens with white blood cell counts. By preventing the virus from multiplying in the body, this strategy can maintain health and slow—or even stop—the progression to AIDS. Equally important, taking anti-HIV drugs early can decrease the odds that a person will spread HIV to someone else as much as 96%. The new guidelines, from the International Antiviral Society—USA Panel, were presented at the 19th International AIDS Conference, now going on in Washington DC. The new guidelines aren’t without their challenges. Patients must be “ready and willing” to stick with drug therapy, which can be complicated. Another hurdle is cost. An effective anti-HIV drug strategy costs more than $1,000 a month.

Daniel Pendick

A new option for orgasm problems in men

One sex-related problem that men are sometimes reluctant to talk about—and doctors are unlikely to ask about—is called anorgasmia. It’s the inability to reach a climax during usual sexual activity. Until now, there hasn’t been much in the way of medication that can help. Researchers from Baylor College of Medicine are reporting that a drug called cabergoline (Dostinex, generic) restored half of men with anorgasmia to normal orgasm. Cabergoline raises the amount of prolactin in the bloodstream. In the Baylor study, 50 of 72 men with anorgasmia said their orgasms improved after taking 0.5 milligrams of cabergoline twice a week for an average of 10 months.

Howard LeWine, M.D.

New York City pushes earlier treatment for AIDS

In an effort to halt the spread of AIDS, health officials in New York City recommended yesterday that treatment with anti-AIDS drugs should begin as soon as an individual is diagnosed with the human immunodeficiency virus (HIV), the virus that causes AIDS, rather than waiting for it to begin harming the immune system. Early treatment also lessens the likelihood of passing HIV to someone else.

Peter Wehrwein

World AIDS Day 2011: Is the HIV/AIDS glass finally half full?

On the 13th annual World AIDS Day, there’s cause for hope. The epidemic seems to have peaked. Drug therapy has turned HIV/AIDS into a manageable chronic disease. Drug therapy appears to prevent transmission of HIV from infected to uninfected individuals. And HIV cures are under investigation. Yet there is also cause for continued alarm. The AIDS epidemic is far from over, and the downward trends in infection rates could plateau or head up if prevention and treatment efforts slack off. The overalI trends don’t apply to everybody. In the United States, new HIV infections are still increasing among young black men, both gay and bisexual. And despite all the research into HIV and over two dozen ongoing trials of candidate agents, there’s still no HIV/AIDS vaccine.

Patrick J. Skerrett

CDC panel says boys should get HPV vaccine, too

For the past five years, the Centers for Disease Control and Prevention (CDC) has recommended that all girls and young women be vaccinated against the human papillomavirus (HPV), a sexually transmitted virus that is a key cause of cervical cancer. Members of a CDC advisory panel have now voted unanimously that boys and young men should also get the vaccine. Vaccinating boys and young men against the virus will help prevent its transmission to women, and will also help prevent some of the 7,000 HPV-related cancers that occur in men each year, including cancers of the penis, anus, head, neck, and throat. HPV also causes genital warts in both men and women. The vaccine works best when a child gets it before he or she becomes sexually active.

Patrick J. Skerrett

Erectile dysfunction often a warning sign of heart disease

For many men, trouble getting or keeping an erection, formally known as erectile dysfunction, is often an early warning sign of heart disease or other circulatory problems. Atherosclerosis, the same disease process that clogs coronary arteries with cholesterol-filled plaque, does the same thing to the arteries that supply blood to the penis. Since an erection depends on extra blood flow to the penis, any obstructions can prevent an erection from occurring. According to Erectile Dysfunction, a Special Health Report from Harvard Medical School, blood vessel problems are the leading cause of erectile dysfunction and serve as an early warning sign of trouble in the heart or elsewhere in the circulatory system. Simple lifestyle changes like losing weight, exercising more, or stopping smoking can improve erections, as can Viagra and other erectile dysfunction drugs, devices, and sex therapy.