Roundups Sexual Health

This Week in Sex: RIP Virginia Johnson, HPV Rates Stall, and Smoking During Pregnancy Worse Than Thought

Martha Kempner

This week, Virginia Johnson, half of the pioneering sex research team Masters and Johnson, died; it was reported that HPV vaccination rates have stalled; and new research said smoking during pregnancy causes behavioral issues in kids.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Sex Researcher Virginia Johnson Dies

Virginia Johnson, best known as half of the sex research team Masters and Johnson, died Thursday at the age of 88. Johnson became a household name in 1966 when she and her partner, gynecologist William Masters, published Human Sexual Response. The book, considered groundbreaking in the field of sex research, presented the results of laboratory studies of men and women actively engaging in sexual behavior either together or alone. Using their observations, the authors described the sexual response cycle in both genders as having four stages: excitement (in which the penis and clitoris become erect and the vagina lubricates), plateau (in which individuals maintain a stable level of arousal), orgasm (in which individuals experience a rush of pleasurable sensations), and resolution (in which the body returns to its unexcited state). They also argued that Freud’s theory of vaginal orgasms being superior to clitoral orgasms was false, saying, essentially, “An orgasm is an orgasm.”

Though she became a researcher and sex therapist in her own right, Johnson joined Masters in 1957 as his administrative assistant after having been a country singer and a newspaper writer. At the time, Johnson had also been married and divorced three times and was the mother of two small children.

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Masters and Johnson went on to work together for over 35 years, during which they ran the Reproductive Biology Research Foundation in St. Louis (which was later named after them) and wrote more than five additional books. Though they are pioneers in the field of sex research, they have received a fair share of criticism over the years. Some researchers have argued that what they observed in a laboratory setting was not necessarily what happens in bedrooms across the United States. Moreover, their 1988 book about AIDS, Crisis: Heterosexual Behavior in the Age of AIDS, which was not peer reviewed, included some glaring inaccuracies about the disease, such as the assertion that it could be transmitted by eating food prepared by an infected restaurant worker.

The pair married in 1971 and divorced amicably in 1993. Their relationship and work was the subject of a 2010 book, Thomas Maier’s Masters of Sex, which has been turned into a series for Showtime, premiering this fall.

HPV Vaccination Rates Stall

Earlier this week, Rewire reported on two new studies representing good news and bad news about human papillomavirus (HPV). First, researchers concluded that certain strains of HPV cause about one-third of cancers of the neck and throat. On the flip side, another study found that one of the available vaccines designed to prevent HPV infection and cervical cancer can also prevent these cancers of the neck and throat. Unfortunately, now news has come out that there was a slowdown in the number of vaccines given in 2012.

The Centers for Disease Control and Prevention (CDC) released an article this week showing that HPV vaccination had increased over the first five years the vaccine was available, and that by 2011, 53 percent of girls had gotten at least one dose. In 2012, however, that number barely budged, with only 53.8 percent of girls having received the shot. According to USA Today, CDC Director Tom Frieden told reporters in a telephone briefing on Thursday that this is very disappointing news. “Coverage for girls getting this anti-cancer vaccine has not increased at all from one year to the next. Zero,” said Frieden. “We’re dropping the ball. We’re missing opportunities to give the HPV vaccine. That needs to change to protect girls from cervical cancer.”

The CDC recommends that girls receive the three-dose vaccination as part of their regular preventative care beginning at age 11. The goal is to make sure that all young women are protected from HPV before they become sexually active. This is clearly not happening. According to the paper, if every girl 11 and up who saw a health-care worker since 2007 had been encouraged to get the HPV vaccine, coverage could have reached 92 percent.

A study earlier this year suggested that some parents still fear that the HPV vaccine will encourage sexual activity in young people. Frieden pointed out that this is not the case, saying simply, “HPV vaccine does not open the door to sex. HPV vaccine closes the door to cancer.”

Parents also have been swayed by false reports of the vaccine being unsafe. The truth is that the vaccine is quite safe. More than 56 million doses of the HPV vaccine have been distributed since 2006, and only 21,194 adverse events have been reported. Most of these are limited to pain at the site of the shot, redness, and swelling. As Frieden put it, “We’ve been doing a systematic review of medical records in managed care systems for any adverse events that occur after vaccination with the HPV vaccine and we haven’t seen anything other than fainting.”

Fainting is not uncommon after any vaccine, especially for adolescents.

HPV is very common, with about 79 million Americans becoming infected each year. Moreover, about 17,400 women in the United States get cancer caused by the virus—cervical cancer being the most common type. And about 8,800 men get cancers of the neck, throat, and penis from HPV.

Smoking During Pregnancy May Lead to “Conduct Disorders” in Kids

There is a picture in one of the old photo albums on my parents’ bookshelf of my mother visibly pregnant with my sister unabashedly smoking a cigarette at a party. It was 1970; no one had told her or anyone else that it was a bad idea. By the time she got pregnant with me two years later, doctors were recommending that women quit smoking at least for those all-important nine months. In the decades since, it has become clear that smoking during pregnancy can lead to a host of problems, including miscarriage, placental abruption (when the placenta separates from the uterus too early), premature babies, babies with low birth weight, sudden infant death syndrome, and certain birth defects, such as cleft palates. New research, published in JAMA Psychiatry, now adds behavior problems to the list of health issues smoking during pregnancy can cause.

Researchers looked at data from three studies of parents and children: one that includes biological and adopted children, one that includes children adopted at birth, and a third that includes children who are “adopted at conception” and are raised either by parents who are genetically related to them or ones who are not.

Mothers were asked if they smoked during pregnancy and how many cigarettes they smoked per day. The researchers then asked both parents and teachers about any behavioral problems the children displayed between the ages of 4 and 10. Children were given a behavior score based on these reports with 100 being the average. The researchers determined that children born to biological mothers who did not smoke scored 99 on average, while those born to mothers who smoked ten or more cigarettes per day scored 104 on average. These results did not change based on whether a child was raised by the birth mother or not, suggesting the issues are biological rather than social.

Theodore A. Slotkin, a professor of pharmacology and cancer biology at the Duke University School of Medicine in Durham, North Carolina, published an editorial that accompanied the study. He writes, “Thus, the conclusion is incontrovertible: Prenatal tobacco smoke exposure contributes significantly to subsequent conduct disorder in the offspring.”

Of course, if I try to hold this over my sister in any way, she will undoubtedly point out that mom’s doctors ordered her to have a glass of vodka every day to “quiet the baby” during the last six weeks of her pregnancy with me. But that’s for another article.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

Roundups Sexuality

This Week in Sex: Why Men Fake Orgasms and How Real Ones May Help Them Avoid Prostate Cancer

Martha Kempner

Many men pretend to have orgasms to make their partners feel better—and report higher levels of sexual satisfaction, at the same time. Another study suggests that the more ejaculation, the better if men want to reduce their prostate cancer risk. And there may be more help for women with sexual arousal problems.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

When Men “Fake It,” Their Motives Are Often Altruistic 

In the pilot episode of the TV show Masters of Sex, Dr. William Masters seems shocked to learn that women might fake orgasms. When he asks his new assistant, Virginia Johnson (who becomes his research partner and later his wife), why women might do such a thing, she replies: “To get a man to climax quickly. Usually so the woman can get back to whatever it is she’d rather be doing.”

Masters and Johnson, whose real-life work and relationship was fictionalized in that Showtime series, were pioneers of sex research in the 1950s and 1960s. Those who follow in their footsteps today are still trying to answer some of the same questions.

A new study from two Canadian researchers looks not at why women fake orgasms, but why men do—and what, if any, correlation there is between faking it and relationship satisfaction.

Researchers surveyed 230 young men between ages 18 and 29 who had admitted to faking an orgasm at least once in their current relationship. Using an online survey, they asked these men at what point in their relationship they began to fake orgasms, how often they did so, and why. They also measured sexual desire and relationship satisfaction.

On average, the men began faking orgasms 14 months into the relationship. On average, the men said they faked an orgasm in about 30 percent of their sexual encounters; 71 percent of participants reported having faked an orgasm during penile-vaginal intercourse; 27 percent during oral sex; 22 percent during anal intercourse; 18 percent during manual stimulation by a partner; and 5 percent while being stimulated with a sex toy by a partner.

Many of the reasons the men gave for faking orgasm revolved around making their partners feel better—including giving their partner an ego boost, feigning simultaneous orgasms, or avoiding upsetting their partner.

Interestingly, men who faked it for these relationship reasons tended to report higher levels of sexual desire. The authors theorize, “It is possible that men feel good when giving a partner pleasure, either out of love and generosity, or because it provides indirect reassurance of their own sexual adequacy, leading them to associate this reward with sexual activity, further leading them to seek more sex (i.e., experience higher levels of sexual desire).”

Men who faked orgasms also had higher levels of relationship satisfaction, though the authors point out that pretending might not lead to relationship satisfaction; those who are already satisfied may be more likely to fake orgasms for the sake of their partner’s feelings.

While it’s reassuring to know that some men fake orgasms for altruistic reasons, we here at This Week in Sex are not big fans of the fake orgasm, regardless of the gender or the reason. Once in a while is understandable “to get back to whatever it is [you’d] rather be doing,” as Johnson said. But, for the most part, we think it’s better to talk to partners about why you didn’t have a real one this time and what could be different next time.

Is Frequent Ejaculation a Cancer Prevention Method? 

Another new study found that men who ejaculated more frequently were less likely to be diagnosed with prostate cancer. Researchers followed about 32,000 men for almost 20 years, using the national Health Professionals Follow-up Study  at the Harvard School of Public Health. The men were all in their 20s when the study started in 1992 and therefore their 40s (or close to it) when it ended in 2010. They filled out questionnaires that asked about their sexual behavior (including masturbation), and researchers also looked at the men’s medical records.

During the course of the study, about 4,000 of the men were diagnosed with prostate cancer. The researchers’ analysis showed that men who ejaculated at least 21 times a month in their 20s were 19 percent less likely to be diagnosed with prostate cancer than men who ejaculated no more than seven times a month at that age. Similarly, men who ejaculated more often in their 40s were 22 percent less likely to be diagnosed with prostate cancer diagnosis.

There are some limitations of the study, including the possible inaccuracy of self-reported data on ejaculation and the lack of diversity among participants. In addition, one urologist who spoke to Reuters questioned the fact that the relationship between ejaculation and prostate cancer applied mostly to less invasive forms of the disease. Dr. Behfar Ehdaie of the Memorial Sloan Kettering Cancer Center in New York, who was not part of the study, noted: “If ejaculation frequency was truly a causal factor for prostate cancer development, we would expect to find the association across all prostate cancer risk categories.”

And, of course, correlation does not equal causation. There could be other reasons that men who ejaculate less often are more likely to get prostate cancer. Specifically, as study co-author Dr. Jennifer Rider points out, men who ejaculate less than three times a month may be suffering from other health issues.

Still, there could be a prevention strategy in the findings. Rider told Reuters in an email: “The results of our study suggest that ejaculation and safe sexual activity throughout adulthood could be a beneficial strategy for reducing the risk of prostate cancer.”

Given that ejaculation tends to be enjoyable, it seems like a pretty good idea to try even while more research into the correlation is being conducted.

Emerging Options for Women With Sexual Arousal Issues

When the drug Addyi was under development, people referred to it as “female Viagra” because it was intended to address women’s sexual dysfunction. But the two treatments actually work very differently. While Viagra causes an erection by increasing blood flow to the penis, Addyi (or flibanserin) works on chemicals in the brain to increase sexual desire.

Now, researchers are developing a new treatment for women that is actually much more similar to Viagra. A company called Creative Medical Technologies filed a patent last week for a treatment that uses regenerative stem cells to increase blood flow to the vagina. Unlike Addyi, this treatment is designed for women who desire sex but are having trouble becoming aroused. Increasing blood flow to the vagina can cause the clitoris to become erect and the vagina to lubricate, both of which are important parts of the arousal stage of sexual response.

The treatment still needs more research and, of course, FDA approval, which was a very controversial process for Addyi’s maker. Moreover, it’s not clear how big the market is for female sexual dysfunction treatment, as prescriptions for Addyi have been low since its market release last October.