Un-Memorizing the “Silence is Sexy” Date Script

Submission: IUD Review

Age: 20
Children: 0
Total Cost of Procedure: 70 cents (thanks to a wonderful healthcare system and great medical benefits, all prescriptions only cost me 35 cents each, and the insertion process was free).

I am writing this for all the ladies who, like me, research and review every little detail about their medical procedures. Do not be misinformed. There are worse things in life than getting an IUD inserted. So about 3 weeks ago, I was super excited to be approved to get an IUD.

For those of you who don’t know, an IUD is an Intrauterine Device used for birth control. The particular device I chose, is called Mirena. This will protect me against unwanted pregnancy for the next 5 years. For more information about Mirena, you can visit: http://www.mirena-us.com/index.php

I did myself a horrible ‘favor’ by researching and reading all sorts of reviews about the insertion of this ‘T’ shaped contraceptive, with complete disregard to the fact that the most popular reviews were, of course, horror stories. I’m not saying they were made up or over exaggerated, because I understand everyone has a different pain threshold, but I was prepared for agonizing pain, when in reality I left with uncomfortable, but very bearable cramps. 

I vaginally inserted 2 Misoprostol tablets the night prior to my insertion to soften my cervix. An hour before my appointment, I orally took 600mg of ibuprofen. I then went to my family doctor, who first performed a pregnancy test (just to be sure) and an internal examination to figure out which way my uterus was facing. He told me mine was backwards, but that it wouldn’t make the insertion process anymore difficult. He then sterilized all equipment, my vagina, cervix and uterus (this felt the same as any pap-smear). He then had to measure the depth of my uterus. In order to do this he had to clamp my cervix (the slightest pinch, it was more discomfort than pain), then insert a thin metal rod. Think of a very bad period cramp, this is how that felt. Next came the actual insertion of the IUD, which felt exactly the same as the measuring process. I had pretty bad cramps for all of two minutes, and next thing you know, he’s trimming the strings, removing the instruments, and leaving me feeling relieved. 

I am writing this not even an hour after having it inserted, and I feel just fine. Again, slight period-like cramps and some very minor bleeding, but nothing like the horrid, agonizing reviews I read just yesterday. For me, this was the perfect choice and I am at complete peace of mind, enough so that I will be heading to work in 3 hours!

All in all, prepare for a crampy day, but do not let all these painful experience reviews scare you away from a perfectly safe contraception form. It is well worth it!

Phobias

A phobia is a type of anxiety disorder where there is an irrational and excessive fear of something. In a previous post we talked about Social Anxiety Disorder which is considered a Social Phobia as it is an irrational fear to social situations. There are many different kinds of phobias out there but they all have similar symptoms and similar treatments. Symptoms usually are the same as any other anxiety or panic disorder, rapid heartbeat, trembling, shortness of breath, dizziness, nausea, sense of unreality, feeling of dying, and inability to function. These symptoms may be triggered by either being in the presence of whatever you’re afraid of or even thinking about it. This can cause people to avoid their fear and avoid anything that may remind them of their fear. Everyone has fears that they have to deal with, it isn’t considered an actual phobia until it greatly disrupts your day-to-day life and keeps you from functioning in society. At this point you should see a therapist to get a diagnoses and treatment. It’s important to first try talk therapy. Talk about your fear and look at possible reasons why you have that fear and confront your feelings about that fear. Also learning about techniques to control anxiety. After a while your therapist will probably try desensitization techniques. They may start with just slowly introducing you to situations with your phobia and have you work with the coping techniques you’ve learned and slowly build you up to situations that you may have a higher level of anxiety for. There is also the flooding technique where you’re forced to be in a situation with your phobia and you can’t leave. There’s also counter-conditioning, where when you’re met with the phobia you try and replace your anxious behavior with relaxation techniques. Some antidepressants and anti-anxiety medications have also been shown to help.

Fears in general have a huge impact on relationships and sex. Any fears or insecurities you have need to be addressed and it’s important to talk to your parter about what you’re going through and where your boundaries lie, especially when it comes to common fears like fear of intimacy, commitment, or displays of affection. Likewise, Phobias can affect every aspect of your life including relationships and sex. There’s countless numbers of recognized phobias and all could have an impact on sex and relationships, but there are some that in particular need to be addressed. For instance, Genophobia is the fear of sex, Coitophobia is the fear of intercourse, Eurotophobia is the fear of love, Primeisodophobia is the fear of first time sex, Aphenphosmphobia is the fear of being touched, Philemaphobia is the fear of kissing, Nudophobia is the fear of nudity, Eurotophobia is the fear of vulvas, Phallophobia is the fear of penises, Medorthophobia is the fear of erect penises, Medomalacuphobia is the fear of losing an erection, and Tokophobia is the fear of pregnancy. With any of these phobias treatment is similar. First, talking with a therapist about your phobia. Explain what it is, what feelings and automatic thoughts arise. Make a list of all your triggers related to this phobia. Then, you’re going to learn some stress management techniques. I go through the common Behavioral Therapy process of understanding automatic thoughts when it comes to anxiety and depression and how to change those thoughts in this post. This may help quite a bit. Once you learn how to cope with your anxiety and not let those thoughts spiral you down into depression and anxiety, you can start desensitizing yourself. Together with your therapist look back at your list of triggers. Come up with another list based on that that is a hierarchy of related things that scare you the least to the most. What I suggest the first step being is doing research into that subject. Understanding it can make it easier to not be so afraid. With tokophobia in particular doing your research into pregnancy prevention can help. Once you do that, go up the list one step at a time. Here’s a relatively easy list for Phallophobia, fear of penises; first look at drawings of penises, then pictures, then gifs, then watch videos, then find a relatively unrealistic dildo to touch and look at, then a realistic one.  If things get too much, that’s okay don’t push yourself too far. Talk to your therapist some more and look at the progress you made and why you were afraid to take that next step. There are other techniques that your therapist may suggest as well. It can also help to go to support groups. Things will get better, but take your time and don’t rush yourself. It’s important that you have a supportive partner that will work with you and that you can talk to.

Peyronie’s Disease

Peyronie’s Disease is a condition in which a bend in the penis and pain occurs during an erection because of fibrous scar tissue. Injury to the penis, surgery, or radiation can up your chances of getting this condition. Bends in the penis are common, they come in all shapes and sizes, however if the bend is significant and causes pain it could be Peyronie’s Disease and you should consult a doctor. A doctor will diagnose you based on physical examination. This condition can make sex difficult and cause difficulties maintaining or achieving erection. It can also make the penis narrower or shorter. The condition can cause depression and anxiety. The pain can decrease over time, but the bend usually remains and can still cause problems. Sometimes the condition will resolve itself and no problems will remain. Every case is different and vary in severity. Sometimes symptoms get worse over time, and can cause impotence. When you continue to have problems and your symptoms don’t decrease over time treatment can include  Corticosteroid injections, certain proteins to help break down the tissue, vitamin E therapy, medication to treat high blood pressure, radiation therapy, and other medications. Usually medication isn’t as successful as surgery, although this isn’t recommended unless until after medical treatment and time causes the curvature of the penis to stop increasing erections have been pain-free for at least six months.

This condition can definitely cause issues with sex and relationships. It’s important to talk to your partner about the condition and how you’re feeling both physically and emotionally. It can put a lot of emotional stress on you, but you don’t have to go through it alone. There is nothing to be embarrassed or ashamed about. Your body and your sexuality is not defined by this condition. It’s important to remain affectionate to partners with PD, even when they pull away. Encourage them and show them how much you care and are attracted to them. Spend time being intimate, even if you can’t always be sexual. Spend more time on foreplay and non intercourse forms of sex. You can try taking anti-inflammatory medication before sexual play if you have pain with erection. You can use the curve to your advantage, curved penises can hit the g-spot in the vagina or prostate in the anus better. Just play around with positions and communicate what feels good and what doesn’t. Different positions can also help decrease pressure on the penis, which decreases chance of pain during sex. Every body is different, so just experiment. If you have problems achieving or maintaining erection, watching porn together, using viagra, or penis pumps may help. Talk to a doctor before using any kind of medication. If you’re still having problems talk to your doctor about your options.

For my next mental health post I’d like to do a post on common phobias involving sex and relationships. I’m making a list of applicable phobias so PLEASE chime in on other phobias that should be included. Here’s what I have so far:

• Tokophobia (fear of pregnancy)
• Genophobia (fear of sex)
• Erotophobia (fear of love)
• Eurotophobia (fear of vulvas/vaginas)
• Medorthophobia (fear of erect penises)
• Medomalacuphobia (fear of losing an erection)
• Nudophobia (fear of nudity)
• Phallophobia (fear of penises)
• Spermatophobia (fear of semen)
• Coitophobia (fear of intercourse)
• Primeisodophobia (fear of first time sex)
• Aphenphosmphobia (fear of being touched)
• Philemaphobia (fear of kissing)
• fear of intimacy

Avoidant Personality Disorder

Avoidant Personality Disorder is characterized by extreme social inhibition, inadequacy, and sensitivity to criticism and rejection. It’s more than just being “shy” or “socially awkward”. it causes extreme discomfort and limits function in every-day life. Common symptoms include obsessive thinking about perceived flaws, hold back too much in relationships, reluctant to become involved with people, avoid activities that involve people, makes potential difficulties bigger than they are, low self-esteem, isolation, fear of speaking in public, feelings of inferiority, viewing themselves as socially inept, and having very few close friends. This commonly comes with other depression or anxiety related conditions and may involve feelings of self-harm or suicide. After diagnoses by a therapist treatment can include therapy and medication. Therapy is the main thing found to help, medication usually treats symptoms of depression (anti-depressants) or anxiety (anti-anxiety medication)

This can definitely complicate relationships. It’s important if you’re with someone with APD to not pressure them into social situations or criticize them. Encourage them to talk to you. Ask them what’s wrong when they start to isolate themselves. Encourage them to seek treatment and to talk to you instead of withdrawal. They may isolate themselves from you as well, try not to take it personally. It’s important for the person with APD to be honest with their partners about what they’re feeling and what they’re going through and when they are having the urge to isolate. It’s important to realize that everyone has flaws and every relationship has problems. People with APD take any little problem too seriously and view it as proof that they are a problem. That’s not true, and it’s important to remind yourself and your partner of this. Always be honest about your fears and insecurities so you can work together to make things better.

Hemorrhoids

Hemorrhoids are painful and swollen veins in the lower portion of the rectum or anus. They can occur both inside the body and outside of the body. They are incredibly common and are usually caused by increased pressure in the veins of the anus. Events that can cause this include pregnancy and child birth, bowel issues, anal infections, sitting for long amounts of time, and certain diseases. Symptoms include itching, ache or pain especially when sitting or having a bowel movement or anal sex, bright blood during bowel movements, and one or more tender lumps around the anus. If you have any of these symptoms it’s best to see a doctor. They can usually diagnose with a basic examination of the rectal area. Treatment is usually for the symptoms while waiting for the hemorrhoids themselves to heal. This can include creams to reduce swelling or pain, witch hazel to reduce itching, sitz baths, and stool softeners to make bowel movements easier and reduce irritation. Keeping the area clean can help, but don’t use soap as that could irritate it. It’s also a good idea to use moist towlettes to wipe after a bowel movement, and apply a cold pack when there is pain. I would caution against having anal sex with a current hemorrhoid as this can cause pain and take it longer to heal. If you have frequent bowel issues, especially constipation, drink more water, eat more fruits and veggies high in fiber, and exercise. Talk to a doctor about other treatments for bowel issues if you continue to have problems. Always go to the bathroom as soon as you feel the urge to go. Avoid sitting too long, especially on the toilet, and avoid standing for long periods of time as that increases your risk. If the hemorrhoids don’t get better,  infrared coagulation may be used to shrink hemorrhoids. If you still don’t get any better and especially if there continues to be pain or bleeding surgery may be needed. If clots occur surgery may also be used so the surrounding tissue does not die.

The main way that Hemorrhoids may affect your sex life is if you enjoy anal sex. Now, anal sex shouldn’t cause hemorrhoids if you do it correctly. Any time anal sex hurts, stop. Anal sex should not hurt. If you properly prepare the anus, use condoms, use lube, and you’re relaxed it should be fairly easy. The main thing is to relax all your muscles, and don’t push. I’d suggest not having sex while you have a hemorrhoid, especially if it hurts. If your hemorrhoids are very painful they may make you not want to have any sex, or it may cause other forms of sex to be painful. Talk to your partner about what you feel up to and when you’re in pain. Explain what you’re going through so that they know and can support you.

Chronic Prostatis

Prostatis is basically the swelling and inflammation of the prostate. The prostate is a walnut sized gland that produces semen that the body then mixes with sperm and it is then ejaculated through the penis. The prostate itself is located directly below the bladder and can be felt through the anal canal. Prostatis causes painful or difficulty with urination, pain in the pelvic area, and sometimes flu like symptoms. Usually it’s caused by bacterial infections and is easy to treat and cure. However, sometimes it can become chronic. There are two different kinds of chronic prostatis, those cases caused by bacteria and those not caused by bacteria. Chronic Bacterial Prostatis is the result of recurrent (especially untreated) urinary tract infections that enter the prostate. Usually with this the symptoms are less severe but can fluctuate and change. Treatment is usually longterm antibiotic use and treatment for pain. Chronic Non-bacterial Prostatis is also called Chronic Pelvic Pain Syndrome. Urinary and Genital pain need to last for at least three of the past six months for diagnoses and there must be no bacteria present in the urine. For both there may be blood in semen or urine, pain with ejaculation, lower back pain, testicular pain, and pain with bowel movements. Treatment usually involves antibiotics at first to make sure that there is no bacteria as it can be difficult to find bacteria in urine from prostatis. If that doesn’t work they switch to  alpha-adrenergic blockers that helps relax the prostate. Pain medication may also be used. If none of this works part or all of the prostate may be removed with surgery. There is more research being done on how to treat this, many people think that doing pelvic floor exercises, prostate massage, and providing biofeedback may help. There is a type of Chronic Prostatis that is asymptomatic and may be found on accident. It also can be important to drain the bladder with a catheter to help reduce symptoms and to reduce chance of damage to the kidneys as it can be difficult to urinate with chronic prostatitis. It’s a good idea to avoid drinks like alcohol, citrus juice, and caffeinated beverages and foods that are spicy to reduce irritation to the bladder.       

 As with anything that causes pain, this can affect relationships. It can also cause sexual dysfunction or pain with sex. A lot of times there is a decrease in libido and difficulties holding an erection. Treatment can definitely help, as most of this is due to the pain. It’s also a good idea to see a therapist to help cope with the pain and the medical system. Always talk with your partners about what you’re going through and what your symptoms are so they are aware. It may be a good idea to take an anti inflammatory before sexual activity to reduce chance of pain and other problems. Unprotected sex can cause a flair up in pain so always use condoms. It can also help to soak in a warm bath beforehand. Learning relaxation techniques and pelvic floor exercises also tends to help. The main thing is to listen to your body. If you’re hurting too much, don’t have sex. Talk to your partner and make sure your partner is supportive and understanding.

Separation Anxiety

A lot of people tend to think of separation anxiety as just a young child not wanting to leave their parents, but separation anxiety is much more than that and it can extend into the teens and adulthood. It generally begins before age eighteen, but not always. It can come with other conditions like other anxiety disorders, depression, developmental disorders or schizophrenia. It is expressed as excessive anxiety when a person is separated from their home or from those that the person is attached (not necessarily parents). Many children especially have some anxiety when away from their home or family, I know I did, but separation anxiety is a lot more serious than that. A lot of times the person will be afraid that the people they are attached to will come to harm, or even die when the child is away from them. They may have major fears of getting lost or being kidnapped. They may refuse to go to school or social events when they are younger which can lead to learning disorders or cognitive problems being overlooked. Their anxiety may keep them from focusing or performing well which can continue to affect them later on in life. Many people with separation anxiety drop out of school or don’t continue to college and may have trouble working. They may have anxiety even being alone in the house or in other buildings, they may have the feeling of people peering into the room or scary creatures reaching out to them. This may cause trouble sleeping and they may refuse to sleep without the person they are attached to. They may have many nightmares involving separation especially. They may feel no body loves them when they are left alone or that others wish they were dead. Especially as they get older this can lead to self harm or suicidal behavior. They may get extremely upset and cry or even lash out and hit someone that they perceive is causing the separation. They may also have physical symptoms like headaches, stomachaches, nausea, or vomiting.  They usually suffer from low self esteem. Symptoms may change or get worse with time if left untreated. Treatment usually involves therapy, medication, and techniques to reduce stress. It can be helpful to have therapy sessions both one on one and with the person they are attached to. Medications include antidepressants and in older people anti anxiety medication. Medication should be only used as a last resort with children and teens as they are more likely to have a bad reaction to the medication. It’s important for the person they are attached to to become educated on Separation Anxiety and what they can do to help. It’s important they listen to the other’s feelings, reassure them of their love, keep calm during high anxiety times, anticipate what events may cause anxiety, remind them that they survived the last separation, planning enjoyable activities they can do alone and reminding them that they can remain in contact, set firm limits, support participation in social activities, and teach relaxation techniques.  In adults and teens it’s common for attachment to involve a spouse or partner, but it can also be with a friend, family member, a child, or even a place.

This can be uncomfortable for partners, either them being the center for attachment or someone else being the center for attachment. It can make relationships very difficult. It’s important to encourage them to go through treatment and to use techniques discussed earlier. Support groups may also exist in your area that can help both the partner and the person with separation anxiety. People with Separation Anxiety may become very jealous if their partner is around other people. It’s important for the partner to talk about boundaries and reassure them of their affection, and it’s important for the patient to realize that trust is the most important part of the relationship. It’s also important for people with separation anxiety to learn what a healthy and unhealthy relationship is. They may become stuck in an unhealthy relationship with a partner, friend, or family member because they are attached to them. It’s important for others to point out when a relationship is harmful and to help them deal with separation. It’s also important to be supportive and understanding, otherwise the person with separation anxiety may blame themselves for everything and beat themselves up and become very depressed.

Panic Disorder

Panic Disorder is a type of anxiety disorder in which you have a period of intense fear, called a panic attack. As someone with anxiety disorders I personally distinguish between anxiety attacks and panic attacks. When I’m doing something that tends to trigger my anxiety I’ll have an anxiety attack. This is usually a period of rapid heartbeat, trouble breathing, and trouble concentrating while my mind is stuck on whatever is causing me anxiety. With panic attacks there usually is no trigger. Suddenly you’re gripped with fear, a lot of times that something that you know isn’t going to happen will happen. You may literally not be able to breath or be gasping for breath, you may be having spasms or not be able to move or stand (or both), you may not be able to speak, have chest pain, and you can’t think of anything but the fear. Your heart will beat incredibly fast and it feels like you’re dying. Other symptoms include nausea, numbness, feeling that your life isn’t real, sweating, chills, detaching from reality, and choking. Eventually it will go away but there’s no functioning during a panic attack. With Panic disorders you tend to avoid any stimulus that has caused a panic attack in the past, which can decrease your ability to live your life. It’s common for panic attacks to occur with other anxiety disorders, especially specific phobias or fears. Many people think that they’re having a heart attack the first time they have a panic attack. Sometimes it gets misdiagnosed, I was diagnosed with asthma when I started getting mild anxiety attacks (not panic attacks) which is apparently rather common as the main symptom is shortness of breath. Once you see a therapist and you talk to them about your symptoms treatment will usually include therapy to help you learn to deal with anxiety and treat any phobias you have, and medication. Medication can include antidepressants as well as benzodiazipines, tranquilizers, and in extreme cases antiseizure drugs. It also helps to live a healthy lifestyle. Panic disorders can be difficult to treat, but you do have to just keep at it. Panic Disorder can definitely effect many aspects of your life, including relationships. Many people with Panic disorders tend to isolate themselves to reduce the chance of panic attack. It’s important to get treatment and to learn how to cope with the attacks as well as learn how to slowly acclimate yourself to the things that can trigger an attack.

It’s important to have a partner that you can talk to and who will understand your panic attack. A really important thing to go over is what you need your partner to do when you have a panic attack and they are there. Would you like physical contact or would it make it worse? Would you like words of comfort or would that just make you more anxious. Panic attacks can definitely resemble seizures so it can be scary to see one happen. Explain what happens to you during an attack and what they can do to help and what they definitely shouldn’t do. The main thing that people with any mental condition needs is support. It’s important for partners to give them the space they need but it can help to also have someone to help you test your boundaries. It’s easier to go out of your comfort zone if you have someone there with you who can support you, knows what you’re going through, and if they see you start to get too anxious or you tell them you need to leave they will respect that and get you out of the situation. As far as sex goes, we’ll talk more about sex specific phobias later, but definitely discuss boundaries and sex activities that may trigger your anxiety so that your partner knows what they should not do during sex and they can better respect your boundaries and negotiate consent to make sure that you’re not being put through something you’re not comfortable with.