Remote Contr-aception

Implantable contraceptive devices have been discussed on this blog here. One problem with these devices is that for women who want to come off the devices they must be surgically removed.

A new device created by MicroCHIPS hopes to change that. This device, currently in pre-market saftey and efficacy trials, is theoretically able to have the same contraceptive efficacy as conventional implants. What makes it exciting is it can last for 16 years (most current implants have a 5 year turn around) and most importantly it can be turned on and off using radio waves.

This small device (20x20x7mm) is implanted in the armpit, abdomen or buttock. From here it is able to secrete levonorgestrel, at 30mg/day (a drug currently used in contraceptive devices to prevent pregnancy). It holds the levonorgestrel in small reservoirs surrounded by thin membranes. These membranes are melted by electrical currents resulting in the release of the dose of levonorgrestel into the body.

By turning this signal on and off through a remote control the drug can be stopped or started whenever the woman sees fit, assumedly by her GP.

This would allow women more control over their sexual health. Specifically it would make the decision to become (or not become) pregnant easier, they would not have to visit an outpatient clinic to start trying.

Obviously it's early days but this is another development we will keep our eye on. 

Sex, Squats and Pelvic Floor Control

It's no real surprise to anyone that uses social media that exercise is the flavour of the month. In the modern age there has been massive shift in attitudes surrounding exercise and being fit, it's not just for athletes anymore. This change in attitude is doubly true for females.

To put on my feminist hat, it's bloody great (mostly). I recall a friend of mine from high school, a middle distance runner who struggled through high school with her identity as a woman. She was strong, muscly and flat chested. Kids are cruel. I remember class mates teasing her for looking like a man.

Now the aesthetic and the discourse is changing. Fit women not only have a place but are lorded and accepted for being strong.

Of course this new fit, strong and sexy aesthetic can put some pressure on other women who don't fit that mold. Thankfully however, there are multiple different societally accepted roles in which women can establish their femininity (the same cannot be said for men, but that's a whole other topic).

Whilst fit is very faddy at the moment, with people getting into fitness for aesthetics rather than health, I don't mind. Does the vessel matter if the outcome is the same?

So I'm gonna go there. I'm gonna bust out the hashtag.

What's your #fitspiration?

Is it aesthetics, health or functional ability (sport, flexibility etc)? If they don't motivate, sorry #fitspirate, you into picking up a dumbbell (and activating your long lost instagram account) why not exercise for sex?

Firstly sex is (or should i say can be?) a workout in and of itself. It involves coordinated activation of the cardio-respiratory and musculoskeletal systems for short to long periods. So just like sprinting the 100ms or running a marathon, sex has demands on the body.

The fitter sexual participant will be able to cope with the change in cardio-respiratory homeostasis better and thus may have longer lasting sex. The stronger participant will also be less muscularly sore after sex and able to experiment with more different positions, potentially increasing both partners enjoyment.

From a more medical angle physical activity is also known to: increase libido, decrease the risk of developing erectile dysfunction, decrease rates of prostatic disease and improve the quality of sperm in men. In women it improves libido, menstrual cyclcity, ovulation and fertility.

That said it is not all roses. Constant bouts of "extreme" exercise (running a daily marathon etc) can result in negative energy balance leading to detrimental effects on the reproductive system (especially in women read: amenarchy and infertility). It is best to do a moderate amount of exercise (30-60minutes/day).

So are there are any particular exercises you should be doing?

Yes and no. Any exercise is better than none but there are a few things you should be focusing on.

Guys
Think abdominals (crunches), hip flexors (lunges, squats, deadlifts) and glutes (squats, deadlifts). Extra flexibility isn't going to hurt either so keep up your stretches and maybe think about a yoga class (could be something you do together).

Girls
Think hamstrings (lunges, hamstring curls), glutes (squats, deadlifts) also you want to have some pretty loose hip flexors to get those legs up and out of the way (yoga, pilates). Also probably an idea to think about your pelvic floor. The muscle of interest here is the the pubococcygeus muscle (PC to it's friends). PC runs on each side of the vagina and contracts on orgasm. Strengthening this may make the vaginal canal appear tighter and increase sensation for both you and your partner.

If you type "pelvic floor exercises" into Google you will get all manner of results, plenty to play with. One easy way to work the PC muscle is to stop urination midstream, hold it for 3-10seconds and repeat.

So what are you waiting for? Jump on the fitness bandwagon (remember it only works if you use hashtags). Reinforce your bed and get to the gym!

Sex, Butter and Sausage Rolls

"Let's do it again Rick,
for old times sake." 

As discussed previously  being sexually healthy is far more than being absent of infection and pregnant/not pregnant (dependent on your wants). Sex is a natural part of life and safe, consensual, practice of it can help to make us happier and more fulfilled. To understand its pervasiveness just look at how much sex and love are referred to in the pop culture of both the present and past.

However many people, even those who are active sexually, report poor sexual satisfaction. The reason may be as simple as us buttering up too much.

According to ABS data in 2011-12, 62.8% of Australians were overweight (35.3%) or obese (27.5%). The pervasiveness of obesity presents problems on many fronts, one of which may be sexual dissatisfaction.

Sexy ButtHer
(http://edibleblog.com/wp-content/uploads/2010/08/Butter-Scupted-by-Jim-Victor.jpg)

According to a 2006 publication in the journal of Obesity people with higher BMIs reported lower sexual quality of life. Obesity is associated with less enjoyment of sexual intercourse, less 'sex drive' (desire to have sex), more problems with sexual performance leading to avoidance of sexual encounters. This loss of sexual quality of life was found to be greater in women than in men.

A 2014 publication in JAMA Surgery discusses this further. In this prospective cohort study women were assessed for sexual quality of life and functionality before, 1 year and 2 years after bariatric surgery. Most women responded well to the surgeries and lost weight. These women also reported improvements in sex specific functionality and sexual (as well as general) quality of life at both 1 and 2 years after post surgery. Women who didn't respond well to the surgery (who didn't loose weight) saw no significant improvement in sexual variables.

What is not clear from this paper is why the women who improved improved. The reason may be hormonal, psychological (i.e the thinner women felt more attractive) or something different altogether. Hopefully this question will be answered in further research.

From a practical viewpoint if you are experiencing loss of sexual quality of life, some weight loss is not going to hurt. Though before you rush to the specialist's office and ask for a gastric band I'd suggest good old fashioned diet and exercise.

Sexual Health: More Than Just Bugs and Babies

From a scientific perspective, sexual health is if often discussed in the contexts of procreation and disease. However to focus on these aspects alone gives a false representation of sex and the role it has in our lives.

The question stands:
Bees do it, trees do it, we do it, but, why do it? 

The answer may seem to be obvious to some (pleasure) but a more detailed answer isn't clear.

Evolutionary speaking having sex for pleasure is quite a new phenomenon yet sexual reproduction itself is not. So why did were our single-celled ancestors having sex if there was no pleasure?

A commonly touted argument is that sexual reproduction allows natural selection to act leading to increased variation and more viable offspring. The full discussion of these assertions is beyond the scope of this post but is discussed well in this article in Nature Education. Interestingly, according to models, sexual reproduction actually decreases variation and leads to less viable offspring. So no luck getting an answer from evolutionary biologists.

What have the psychologists got to add?

A lot.

I'm scared to type 'psychology' and 'sex' into Google. I don't want to break the internet.

Instead of going down the psychological rabbit hole (where the only way out is to wake up and admit you're in love with your mother/have penis envy) I'll keep this discussion brief and talk about Maslow's Hierarchy of Needs (pictorially depicted to the right). I'm sure many of you are familiar with this model but I will describe it in brief anyway.

Maslow's Heirachy of Needs - Depicted as a triangle
with the more basic needs at the bottom.

Maslow was a psychologist who postulated the theory that certain needs that must be met for people to live, and live well. There are different types of needs, some more fundamental to life itself and some essential to a 'good' life.

The lower the level the needs are on the triangle the more fundamental they are to life. For instance for the person who cannot breathe or eat (physical/phsyiological needs) having a sense of self-esteem (esteem need) is inconsequential. It is only when all needs in each category are met that people ascend the pyramid to self actualisation. (live their life to it's full potential).

Ok. So let's have a look at the physiological needs.
Sex is there.
As essential to life as eating, drinking and breathing.

Whilst this contention may not hold too much weight in biological circles its inclusion highlights the importance that sex has for all of us. A lot of behaviour can be drawn back to sex either doing it or trying to do it.

So the psychologists tell us we have sex because it is a natural as inhaling and exhaling, but (as the 4 year old product of our nature may ask) why?

Is it purely for the pleasure of orgasm? the pleasure of the experience? Because it brings us closer to others? Because it makes little versions of us? Because there was nothing good on T.V that night?

Who knows.

The fact of the matter is we do it. Sexual health is much more than just the absence of something (disease or foetus). Sex is part of what makes us who we are and thus a well taken sexual history should be a part of the holistic doctors practice.

The New Condom?

We have talked about the efficacy of condoms in preventing STIs and unintended pregnancy on this site previously. They are are 98% effective when used correctly (though they are often used incorrectly). It may sound simplistic but they are also only effective when they are used, which isn't such a sure thing.

Whilst many people know the benefits of condom use, they are often not used as they are thought to reduce the perceived sensation of sex. Many people instead take the risk (of pregnancy or STIs) and don't use a condom favoring sensual sex over safety.

Another issue with traditional condoms is that they are made of latex and are therefore unusable by people with latex allergies.

In order to make condoms more consistently used, in 2014 the Bill and Melinda Gates Foundation gave 11 grants to different researchers or companies to make the next generation of condoms. An Australian research team based at the University of Woolongong, NSW was a recipient of one of these grants.

Essentially they are trying to see if condoms made from hydrogels (a jelly like substance made of hydrogen) are able to prevent STIs and unintended pregnancies. These hydrogels have a few advantages over the traditional condom, one of which is that they reportedly feel like skin. Theoretically this property may reduce the loss of sensation felt with normal latex condoms.

More information is contained in the video embedded below.

It's early days and though the idea is promising we don't know how this will pan out in the long term. It is however, something we will be keeping a close eye on.