Pregnancy

Getting More Information

October 19-22, 2012

I headed off to North Carolina to relax with several girlfriends at lake house. I didn’t think much about being pregnant while I was away since I assumed that the odds of the doctors letting me try to carry to term were so miniscule.

When I returned to DC from the lake, I couldn’t avoid reality for any longer. As I spoke with my gynecologist, she indicated that I didn’t seem 100% comfortable with terminating the pregnancy.

“I guess that’s because I’m not,” I responded. “There are so many health concerns that I bring to the table! But…there’s this part of me that feels as though this is a miracle…that so many odds had to be beaten for me to even get pregnant…what if this is part of God’s plan?”

“Well, what do your oncologist and neurologist say about this?” the doctor inquired.

“I haven’t called them,” I admitted. “I just didn’t want to hear that this wasn’t possible from all these doctors since that would make this even tougher.”

“I think you need to get more information so you truly know what your options are.”

“You’re right. Thanks!”

On Monday, October 22nd, I spoke with six of my doctors.

I wish that I had video of their reactions at the news that I was pregnant at the age of 39 after chemotherapy-induced menopause. One of them cursed. One started to stutter. One of them was silent. And, not surprisingly, all of them were shocked!

It was my turn to be shocked, though, as my entire medical team ranged between neutral and excited about me trying to have a baby.

My oncologist informed me that previous research had discouraged breast cancer survivors from getting pregnant within several years of finishing treatment. However, a recent study indicated that pregnancy would slightly reduce my risk of recurrence.

“The researchers couldn’t say why that was the case in the women who were studied,” my oncologist continued. “It might be psychological, but no one really knows.”

My neurologist said that even though my migraines weren’t hormonal, pregnant women typically experience fewer migraines than when they’re not pregnant.

“Pregnancy could actually be good for you!” she surmised.

My internist has known me longer than any other doctor. He explained, "I think you could safely carry to term, but I’m more worried about how your health will be after you give birth. You would need a lot of extra support to ensure that your other conditions don’t get worse or that if they do, your baby would be well taken care of."

“I had figured that much. We know how my health is when I don’t get enough sleep, and newborns are the antithesis of a good night’s sleep!”

I hung up with my internist and felt both positive and pensive. The medical obstacles that I had thought would impede me from trying to carry to term were no longer.

Could this actually be possible? And, if it was, did I want this to be possible?

I had always planned to adopt because I never envisioned myself pregnant or parenting a newborn. The expression, “If you want to make God laugh, make a plan,” kept going through my head.

I had an appointment with a high-risk obstetrician in two days.  I had some time to formulate my thoughts, and I knew that I needed to hear hers.

To be continued…

As a PS, I won’t be exclusively writing about my pregnancy from hereon forward. I’m just trying to catch everyone up to the present day so that you know how I’m doing and how the pregnancy is going.

Six Weeks and Six Days

Wednesday, October 17, 2012 – Thursday, October 18, 2012

I woke up the morning after finding out that I was pregnant to call my gynecologist. When the receptionist answered, I introduced myself and asked if she could relay a message to my doctor.

“What’s the message?” the receptionist inquired.

“Would you mind telling her that ‘I’m no longer in chemo menopause because I’m pregnant?’”

The receptionist was silent for several seconds so I interjected before it became uncomfortable.

“I bet you’ve never typed that message down before!”

We both laughed awkwardly before she replied, “No…I haven’t.”

When my gynecologist returned the call 30 minutes later, she expressed her shock and then said, “To be honest, no doctor is going to be able to tell you that you can or can’t carry safely to term. There’s not enough research about pregnancy and one of your health conditions, let alone any research that looks at pregnancy and all of your conditions.”

“I know. No one unfortunately has a crystal ball,” I responded.

“If you decide you’ll try to carry, you need to stop your migraine medicine immediately. That drug is highly toxic to a fetus.”

I knew that, but it was easier said than done. I’ve suffered from migraines since I was a teenager. The medicine I’ve taken since 2003 has been the only medicine that has worked and kept my migraines at a manageable two a week.

The rest of the day was spent preparing for my Health Activism and Social Media class that evening. The topic for the two-and-a-half hour class? Abortion.

I broke down several times as I worked on my Power Point for the lecture. During the class itself, I had to fight back the urge to tear up. There was a video that I showed from an anti-choice organization that included a sonogram photograph of an embryo at six weeks and six days. I was exactly six weeks and six days pregnant.

The following day, I headed to my gynecologist’s office for an ultrasound. I knew the technician because I had gone there the previous month for a sonogram because of menopausal pelvic pain. (Oh, the irony!)

As one would hope, the technician was extremely compassionate during the ultrasound. At that stage of development, the embryo just looked like a tadpole on the monitor. I exhaled when she informed me that the size looked good so far, but I started sobbing when I heard a noise and she commented, “Strong heartbeat.”

I looked up toward the ceiling and silently prayed. I didn’t think there was a chance that my doctors would let me try to carry to term, but I wondered what message God was trying to tell me.

To be continued…

Taking the Test

Tuesday, October 16, 2012

I left my friend at Starbucks with one thing on my mind:

Chicken Wings from TGI Friday’s.

I couldn’t remember the last time I ate chicken wings or went to Friday's. As I walked to 2000 Pennsylvania Avenue, I realized that I had been craving a lot of different foods over the past few weeks. I couldn’t get enough tofu, egg salad and chickpeas, and yet, I was passing on the beef dishes that I normally loved.

I wondered for a moment if I could be pregnant and reviewed the miniscule chances of that in my head:

  • The average 39-year-old woman has approximately a 7% chance of getting pregnant in a given month.
  • I was in full chemotherapy menopause for over a year. Even though my periods had returned, I was still experiencing some menopausal symptoms.
  • Chemotherapy increases the risk of infertility and damages eggs, especially in women who are in their 30s and had high doses of chemotherapy.

I ordered my chicken wings from the carryout counter and went across the street to CVS.  It was easy enough to pick up a pregnancy test for the peace of mind.

Fifteen minutes later, I headed home with my chicken wing sampler and the test.

After eating two wings, I went into the bathroom. I began to count the requisite seconds and before I had even reached, "Five Mississippi," the test was positive.

I stared at the test and started to scream and sob hysterically.

“Noooooooo! Are you kidding me? What are you doing to me, Lord?!?” I looked up at the ceiling and yelled. “”Why are the odds of this? What kind of cruel lesson am I meant to learn here?”

Why, given my desire to be a mom, did I react this way?

Well, between my chronic migraines and highly toxic migraine medicine, the fact that I wasn’t even two years out of treatment for breast cancer, and my genetic health conditions, I couldn’t imagine that my doctors would give the green light for me to even try to carry to term.

As sad as I was, I did my best to dry my tears. I’d call my gynecologist first thing in the morning. I couldn’t do anything else at this late hour so I just tried to relax and get some sleep.

To be continued with a thankfully much happier tone…

Planned Parenthood and Komen

What are my views on the recent controversy between Planned Parenthood and Susan G. Komen?

Claim: Planned Parenthood doesn’t offer mammograms so it shouldn't receive funds from Komen.

My Thoughts: It's true that Planned Parenthood Centers don't have mammography equipment. However, health care practitioners at Planned Parenthood provide clinical breast exams and instruction in how patients can perform self-exams.

Self-exams and clinical breast exams are critical to breast health and early detection. They are the first line of defense in the fight against breast cancer. In addition, if a patient or practitioner finds a lump, Planned Parenthood provides necessary referrals for biopsies and follow-up care.

Claim: Susan G. Komen isn’t fiscally responsible.

My Thoughts: According to public financial records, 82.5% of the funds that Susan G. Komen receives go to program expenses. I view that as fiscally responsible, as does Charity Navigator and the American Institute of Philanthropy. Komen gave $72 million in one year in aid and grants to programs and research in the United States. Given the organization's overall impact on the cause, I don't have a problem if Executive Director Nancy Brinker makes $417,000 a year and flies first class.

Claim: The board at Susan G. Komen can give money to whichever programs and organizations it chooses.

My Thoughts: I agree with that. However, the reason why Komen discontinued its grant to Planned Parenthood wasn’t supported by evidence. Specifically, Komen continued to fund programs that were under investigation, including the medical center at Pennsylvania State University.

Other actions and inactions by the organization also raised some red flags for me.

  • Why didn’t Komen executives agree to sit down in person with Planned Parenthood executives and discuss the end of a long-time annual grant?
  • Why didn’t Komen utilize its marketing, public relations and social media resources to control the story and messaging?
  • Why did Komen delete many of the comments it received on Facebook, rather than engaging in a two-way conversation?
  • Why did Komen claim that its decision wasn’t politically motivated, and yet, its then Vice-President Tweeted differently?
  • Why didn't Komen reinstate its grant to Planned Parenthood, rather than just allowing the organization to apply for grants with the disclaimer that Komen wishes to fund clinics that offer mammograms?

Over the past year, my students and I have talked about Planned Parenthood’s use of social media during the debt ceiling debate and Komen controversy. For Alex Lugovina’s final project in our Sexuality and Social Media class, she chose the following topic:

What has been the impact of social media on the current climate surrounding contraception in the United States? More specifically, how has Planned Parenthood used social media to deliver its message and services, and how has this impacted the organization? I chose this topic because I think it is critically important for all women to have access to healthcare in general and especially access to contraception. Planned Parenthood was reluctant to enter the social media world because of client confidentiality issues. They were able to work around that, and the recent controversy between the Komen Foundation and Planned Parenthood will show the importance of social media to Planned Parenthood.

In a recent post about the history of contraception and the economics behind birth control, Alex wrote:

“The typical American woman, who wants two children, spends about five years pregnant, postpartum or trying to become pregnant, and three decades–more than three-quarters of her reproductive life–trying to avoid pregnancy (Guttmacher).” Wow, 30 years trying to avoid pregnancy!

Almost half of all pregnancies annually are unintended and 3 of 10 pregnancies will end in abortion. More than 36 million women of reproductive age are in need of contraceptives.

So how do women — 36 million women — find and pay for contraceptives?

71% of these women can only afford contraceptives through publicly funded programs because they have an income below 250% of the federal poverty level, and 29% are under the age of 20 (Guttmacher).

I look forward to seeing how Alex’s project evolves and her examination of Planned Parenthood’s use of new media. Follow her posts and Tweets.

Now that the dust has settled a bit, what are your thoughts on the Planned Parenthood and Komen controversy? Will either organization receive your donations or time?

Scared of Getting Pregnant?

Thursday is the day to answer a reader’s relationship or sex question from Formspring so without further ado:

My boyfriend and I have been together for almost two years, but he doesn't want to have sex with me because of the fear of getting me pregnant. We always practice safe sex, but he still worries. How can I reassure him we will be fine?

Answer: Thanks for sharing what you’re going through in your relationship. A few other questions come to mind:

1. Has your boyfriend been this way for the past two years?
2. Has birth control ever failed your boyfriend or an ex-girlfriend of his and caused an unintended pregnancy?
3. Even though you’ve always practiced safe sex together, was there a pregnancy scare or a time when your period was late?
4. Is there something else going on here?

It’s important for couples to practice safe sex to prevent unintended pregnancies and protect against Sexually Transmitted Infections. If you’ve used birth control the entire two years, it gives me cause to pause that your boyfriend would become fearful at a later time.

If he has been consistently worried about getting pregnant throughout your relationship, would you consider using two forms of birth control? He could wear a condom, and you could use another method to be doubly protected. (There might have been a certain attorney-turned-blogger who used three methods of birth control with her first boyfriend because she so feared getting pregnant.)

I never like belittling someone else’s feelings or speculating where a person is coming from, but I feel like there’s more to the story. This level of anxiety about getting pregnant doesn’t typically present itself without a precipitating event. Did his parents have him when they were very young? Did a close friend get pregnant unexpectedly? Did you or an ex-girlfriend have a scare? Is he religious or fearful about what would happen if you did get pregnant?

I recommend talking to him about his concerns when you’re not in the bedroom and there’s no expectation of sex. Don’t assume what he’s feeling and leave your questions open-ended. Let him know that you love him and want to work through this as a couple. Offer to schedule an appointment for you both at a health clinic or gynecologist’s office to discuss birth control methods and their effectiveness. You can also ask for information about Plan B.

If this concern is a newer one for him, there might be more going on than just pregnancy fears. Has his interest in having sex with you changed over the past two years? If so, you might need to ask him why that is and confirm that you both are on the same page in your relationship.

I hope that this is just a small obstacle that you will overcome together. Please keep me posted.

Anything to add, readers? Two – or fifty – cents welcome! xoxo
 

My thoughts on People Magazine’s cover story

My heart goes out to Giuliana Rancic. I admire her strength in dealing with fertility issues and now breast cancer in a very public eye. I join her millions of supporters in keeping her health, recovery and hopes in my thoughts and prayers.

When I saw Giuliana on the cover of People Magazine, I felt her pain through her words and photographs. I also felt thankful that we now live in a society in which we can talk about breast cancer openly. There was a time not so long ago when that wasn't the case.

With those disclaimers, I had some problems with the medical information included in the article:

“That recovery [from a double mastectomy with immediate reconstruction] is expected to take two weeks.”

Two weeks?!? Two weeks? I’ve fought a cold longer than two weeks!

People Magazine, I realize that you’re not known for investigative journalism, but I still hoped for more accurate information from your publication!

Following a double mastectomy with immediate reconstruction, a woman is likely to be hospitalized for several days to a week. She may be sent home with drains coming out of her breasts. Depending on where the extra tissue came from (her back, underarms and stomach are all possibilities), she may also feel a significant amount of pain in other areas.

The recovery time for reconstructive surgery alone is six to eight weeks. That estimate is increased when mastectomies and reconstruction are done simultaneously because that’s a more traumatic procedure on a female’s body.

The surgical recovery time also fails to factor in the need that many women have for physical therapy once they are recouped. Mastectomies and reconstruction make it difficult for women to move their arms, stretch their chest and rotate their shoulders. Physical therapy might be required to assist with increasing strength and mobility.

And, what about the emotional recovery piece? We live in a culture that reveres breasts as symbols of femininity. Battling cancer and frequent hospital visits and surgeries can also take their toll on a woman’s peace of mind. An estimated 30% of women beat breast cancer and experience depression. Another 20% suffer from body image issues.

I also cringed when I read the statement in the article from oncologist Dr. Guiliano that “in some conditions…it [attempting IVF after surgery for breast cancer] is quite safe.”

I’m not a doctor, but it doesn’t take a medical degree to put the pieces of this puzzle together.

If a woman has breast cancer that tested positive for estrogen receptors, the cancer fed on estrogen and hormonal imbalances. About 75% of breast cancers are estrogen positive. IVF, pregnancy and childbirth cause dramatic fluctuations in the hormones in a woman’s body.

The decision to try IVF or get pregnant after battling certain types of cancers should not be a precipitous one. Women understandably look up to and identify with a public figure like Giuliana Rancic. People Magazine, it was worth throwing in a disclaimer that each woman’s experience with the disease and fertility is unique and that each woman should consult with her doctor to determine what is in her best interest.

Giuliana, I pray that your recovery is as quick and painless as possible.

People Magazine, I hope you recognize that you can empower women to be better health advocates and be more informed through your publication.

Readers, the year is almost over! What can you do to take care of your health more in 2012? Are there medical appointments that you need to be making?
 

Facebook and Relationships

If your relationship isn’t “Facebook official,” is it real in this day and age of social media? Read on to learn about my thoughts on several different types of relationship modes on Facebook:

1. The Play-by-Play: They’re on. They’re off. Oh, wait, they’re back on. Friend this person so you can find out when they’re “in a relationship” or she’s “single” again. Tune in for the occasional status update in which all the specifics about what’s not working are shared with every friend she has! Also note related status updates in which a guy checks in with the boys at a sporting event or locations in Vegas, Miami or New York, or a female writes about how much she loves her girlfriends and that she’s in desperate need of a spa day or Girls’ Night Out!

2. The Photo Barometer: Are they on or off? They don’t include their relationship status in their Facebook profiles, but a simple glance at which profile picture they’re using should tell you all you want to know. A couple’s shot means that they’re on, but a photograph without the other person speaks a thousand words.

3. Peeing on the Wall: You didn’t even know that those two people knew each other, and yet, he’s writing on her wall, checking in at places with her, and commenting on her photos as though he’s getting paid to do so! It’s like The Animal Kingdom, Facebook Edition. The man wants to mark his turf and let you know that he’s staking his claim to this woman and her…I’ll go with heart. Just click “like” to encourage this behavior.

For those of you who notice a lot of comments on your wall after only one date, view this as a bright yellow flag! If you're in a relationship and don’t write on your girlfriend’s wall, while she writes a lot on yours, realize that she still feels the need to proclaim that you’re her man.

4. The Masquerade: A couple hasn’t indicated that they’re in a relationship. The two people don’t write on each others' walls. They don’t post their own pictures of themselves, and yet, they’re tagged together in photos at every event. Are they together? Yes. Are they doing their best to keep their relationship off of social media? Yes. Tag sparingly if you’re a good friend of either party.

5. The Passive-Aggressive: He doesn’t confront his significant other about a problem directly, but he’ll start a conversation about the issue on Facebook. Parenting, money, shopping, PMS and pregnancy are often the prime topics to be highlighted. Maybe relationship therapy from the Facebook peanut gallery can help smooth things over? [Insert eye roll here.] Isn’t it easier to keep certain matters private and off relatively public forums like Facebook and blogs?

6. The Glory of Love: She can’t describe her partner in a status update without the use of a minimum of three adjectives. And, there are numerous status updates a season, espousing her undying love and appreciation for her wonderful, fabulous, amazingly sweet husband. I’m all for letting others know that you love and appreciate them. And, there's nothing wrong with the occasional loving status update or wall comment. But, unless you're in the beginning stages of a relationship, me thinks thou doth praise too much.

So, readers, what did I miss? What have you seen on Facebook with respect to relationships that's worth noting? What modes do you personally use?

Keepin’ It Wrapped

In an earlier post, I wrote about how to broach condom use without ruining the mood.  Now, let’s get to the nuts and bolts (pun intended) of shopping for condoms!

What should you consider when buying condoms?

A latex rubber condom provides protection against pregnancy, HIV/AIDS and STDs.  Choose latex, unless you have a rubber allergy.  A lubricated condom is often preferable to heighten the experience.  If you pick an unlubricated condom for a tighter fit and need to add your own lubricant over the condom, steer clear of oil-based liquids since oil weakens the effectiveness of condoms.

For those of you with latex allergies, there are polyurethane and animal skin condoms.  (No, lambskin condoms are not actually made with animal skin.)  Those types of condoms are thinner and allow for more warmth and sensation than latex condoms, but they do NOT prevent against HIV/AIDS and STDs.  As a result, it’s not recommended to use these condoms unless you’re in a monogamous relationship.

What condoms should you purchase?

If you’re making your first condom purchase, you might care to try a Variety Pack from Trojan to sample several different types.  For those of you who are able to visit Lotus Blooms or order condoms online, it’s worth picking up one of the store's bestsellers: RFSU and One.

RFSU condoms are made by the Swedish Association for Sexuality Education and are found throughout Europe.  RFSU is about more than just condoms, though, as the organization focuses on sex information, advocacy and education on an international scale.  RFSU’s condoms are made of soft and silky, yet durable, latex with silicone lubricant.  The condoms come in a rectangular package that’s about half the size of a traditional square condom.  

Next, we broke out the Classic Select condom from One.  One products are manufactured by Global Protection Corporation, a company committed to outreach and making condom use socially accepted.  One condoms combine high-quality latex with innovative packaging (the wrappers are round, not square).  In addition, a portion of all of the company’s condom sales goes to HIV prevention and treatment in Africa.    

The Classic Select condom provided a fit that was rather snug for my man.  Average-sized cocks should find the tight fit beneficial, but if you’re larger than average, choose One’s The Legend or Pleasure Dome brands.  (The former is larger in all regards, while the latter is larger around the top of the shaft.)  

Despite the snug fit, the Classic Select is thin.  The condom is also purer and has been safely treated so it doesn’t contain any of that unpleasant latex odor.  My man enjoyed the experience, even commenting that he could feel how wet and warm my pussy was while wearing the condom.  I wasn’t as fond of the Classic Select, though, since I wasn’t able to orgasm without clitoral stimulation.  
 
If it’s easier for you to purchase condoms at your local drugstore than online or at Lotus Blooms, I also recommend the Trojan Ecstasy.  I received samples of the Ultra-Ribbed Ecstasy at a conference for sex educators earlier this summer.  I loved the condom so much that I gave several to a friend. 
 
What’s so great about the Ecstasy?  The amazing G-Spot stimulating ridges on the outside!  I have never cum so much with a condom and without clitoral stimulation than when my man has worn the Ecstasy.  The latex feels sheer and smooth in a way that’s not the norm for condoms.  The condom is also shaped with a rounder head (rather than the tapered tip) and tighter base.  Since it’s looser on the shaft, it provides a less constricting experience for the man.

I don’t feel right ranking condoms because I would hate for a reader to refuse to use a condom because of my review of a particular brand.  So, I’ll give out my Condom Superlatives instead.

Best for G-Spot Stimulation: The Trojan Ecstasy

Best for a Natural Fit: The Trojan Ecstasy

Best for Feeling Heat and Wetness: One Classic Select

Thinnest: RFSU’s Birds and Bees

Try one.  Try all.  Just be safe.

What's your favorite condom and why?

 

* Pursuant to FTC Guidelines, I received the products free of charge in exchange for my honest reviews.

Very Smart Balls

While I was at the AASECT conference last weekend, I was thrilled to see that Fun Factory had a representative in the exhibition hall.

"What's Fun Factory?" you might be asking.

Fun Factory is a German sex toy company known for its aesthetically pleasing and top performing products! If you purchase a Fun Factory toy, you can also take comfort in the fact that the item is high quality, and free of toxic ingredients and allergens.

The Fun Factory representative provided me with the Smart Balls Teneo Duo. I looked at the two weighted balls and envisioned a lot of anal pleasure to be had. So, imagine my dismay, when the representative indicated that the balls are only for vaginal use. (Where's the fun in that?)

When I got up to my hotel room, I opened the box containing the Smart Balls. The two soft silicone balls are attached by a small piece of material. The end of the toy has a cord to assist with removal. The balls are ridged, and the two balls together feel about as heavy as a single golf ball. The weighted balls inside the silicone shell allow for some vibration, but you have to listen carefully to hear any noise emanating from the toy.

The box indicates that the toy helps strengthen vaginal muscles. Midwives recommend Smart Balls to women after pregnancy, and they are also used as a substitute or conduit for Kegel exercises. The goal here is to tighten the pelvic floor muscles, which in turn, increases pleasure during sex.

As I read about the toy in my hotel room, I rolled my eyes. I really wasn't in the market for a toy to tighten my pussy. I figured that the Smart Balls would get used once for the sake of the review and then tossed in the back of the toy drawer. Boy, was I mistaken!

The Smart Balls can significantly enhance oral and anal sex, if you leave them in during those sexcapades. Significantly.

The fact that the toy is ridged and weighted led me to believe that the cord would need to be pulled to move the balls and cause the vibrations. However, that's not the case. The toy works phenomenally well if it's just inside you. Or, you can get a lot of enjoyment from subtle movements of the cord.

Imagine that you are just teasing the cord and tap it gently from one side to the other. Or guide it slowly up and down. You don't need repeated movements here since the vibrations respond to light, sporadic touches. And, no pulling or tugging of the string is required.

If you need to use a lubricant to insert the Smart Balls, use a water-based lubricant, rather than a silicone-based product. Since the Smart Balls are silicone, silicone lube might cause the product to melt. (Maybe that won't happen, but why risk it?) The Smart Balls can be cleaned with mild soap and water or a Toy Cleaner.

Once the Smart Balls are comfortably inside you, have your partner focus on your clitoris with his tongue and occasionally touch the cord of the toy. During anal sex, the thrusting motion will allow the Smart Balls to vibrate enough to provide added G-spot stimulation. The vibrations are subtle, effective and not distracting at all. Oral and anal can be much more intense and orgasmic with the toy than without it.

The Smart Balls allow for heightened G-Spot sensitivity and awareness. For those of you who are still trying to harness the power of your G-spot or clitoral legs, you might find this toy to be very useful.

Smart Balls can be used without stimulation to strengthen the pelvic floor muscles and help with Kegel exercises. The toy is highly recommended for postpartum women, although you should check with your doctor before inserting a toy into your vagina after delivery.

For straight women looking to bring something new into the bedroom, your man shouldn't find anything intimidating about the Smart Balls. There's also the advantage that the toy requires very little effort. No batteries, charging, or operation required. You can insert the Smart Balls inside and neither you nor your man need to do much else.

The Smart Balls will be a great addition to your normal sexual mix. Bullets or small sex toys rarely stay in place. And, traditional vibrators are often too big to feel comfortable – let alone erotic – when inside your pussy during anal sex. The Smart Balls are just right.

Some sex toy websites indicate that the balls can be used anally. Please don't do that, though! Shanna Katz, a Sex Educator, explains why the balls aren't medically safe for anal use here.

Smart Balls retail for $29.90. Given how versatile the toy is, I found that price to be reasonable. This toy will be a regular part of your sexual routine. Thanks Fun Factory!

Note: Pursuant to FTC regulations, I received this product free of charge in exchange for my participation in a survey at the AASECT conference.

Wrapping it up

I recently received the following question on Formspring:

I have had unprotected sex a couple of times, and I know it's a bad idea for the future. How do you bring it up without ruining the mood? Also, who should carry the condoms: the man or the woman? (I don't know how to pick them out since each guy is different.)

To state the obvious, few people enjoy using condoms. But, there is a key difference between wanting to use a condom and needing to use a condom. Unless you and your boyfriend are in a monogamous relationship and have both been tested for HIV and STDs, he should be wearing a condom each and every time you have sex. (I'm sure I'm not telling you anything that you don't know, but it can't hurt to be reminded again.)

Since you have had unprotected sex, have you made an appointment to get tested yet? If not, I recommend doing so in the near future. Most major health insurance companies cover an HIV test as part of your annual physical, and you can be tested for STDs at your annual OB/GYN appointment. If you are attending college, confirm that you can get tested at your school's health center. If your school doesn't offer those services, then check online to find out where the nearest Planned Parenthood or women's center is.

Since you don't care to have unprotected sex in the future, how can you bring up the topic without ruining the mood? Well, that depends on the nature of the relationship:

1. A one-night stand or more casual relationship. You aren't seriously dating anyone and are meeting your girlfriends for drinks. You're open to wherever the evening takes you if you meet a fine guy or receive a text from Mr. Right Now.

Be prepared before you leave the house. Buy a cute condom compact and a box of condoms. Keep the box at your house and before you go out for the evening, place a few condoms in the compact. Throw the compact in your purse along with your keys, phone and lip gloss, and you're ready to go!

Prior to having sex, I imagine that the guy will reach for a condom. If he doesn't say or do anything, put your hands on his face and look into his eyes as you say:

I want you inside me. Do you have a condom?

(If you like to talk dirty, feel free to substitute the first line with any variation of "I want to fuck you.")

If he has a condom, then let him use whatever condom he prefers. If he doesn't have one, then you can reach over and grab a condom out of your purse. It doesn't need to ruin the mood since using a condom is a means to a hopefully enjoyable end! If the mention of the word, "condom," makes the guy less excited (as in, less hard), then take a few minutes to get him just how you want him before he puts on the condom.

Most guys in this day and age should realize that it's dangerous to have unprotected sex. But, there are still those guys who will break out a line to try to convince you otherwise. Be prepared with your responses. For example:

Guy: I'll just put the tip in.
Girl: We both know where that will lead.

Guy: I can't feel anything with a condom.
Girl: I bet you will. I'm very wet.

Guy: I don't want to use a condom.
Girl: We can just mess around without having sex, but wouldn't sex be more fun?

Guy: Aren't you on the pill?
Girl: That's not the point. We don't know each other well enough to go raw.

You can use whatever words you wish to get the point across. Just know your limits and stick to them.

With respect to ruining the mood, I would try to reframe your thoughts on that. Using a condom when you have sex should be viewed as Standard Operating Procedure, not a buzz kill. Unless you and the guy are in a monogamous relationship and have both been tested, then the risks of not using a condom FAR outweigh the 60 seconds it takes to bring it up and put one on. (Please realize how much of an understatement this is and that I could go on and on about how testing positive for HIV or dealing with an unplanned pregnancy could really ruin the mood.) Just view using a condom as a normal part of the routine of having sex.

What condoms should you buy? You could buy a Variety Pack from Durex or Trojan or pick a lubricated, latex condom that you like. Choose latex over lambskin since lambskin does not prevent again STDs.

If you want to cover all your bases, you can also pick up a box of Trojan Magnums for larger men and throw one of those condoms in the compact. Trojan's bestseller is the lubricated, ultra-thin ENZ condom, but the company recently came out with an ultra-ribbed Ecstasy condom. (The Ecstasy claims to let you feel all of the pleasure without feeling the condom. Has anyone tried one of these condoms? What was your experience? Please comment – anonymously if need be – and let us know.)

2. If you're in a relationship, then the topic of condoms becomes part of a larger discussion of past sexual history and birth control. I think it's easier to have those discussions out of the bedroom so that there's less pressure. But, if you prefer to have that conversation in the bedroom, that's fine, too. (It's more important that you talk about it than where you talk about it.)

If you care about this person, then it's worth communicating about the following things:

Are you using condoms for birth control and STD/HIV prevention or just the latter?

What condom does he like best? Will he be providing them or do you need to stock up, too?

Will you be using condoms in the early stage of your relationship with the intent to get tested later on?

Are you both monogamous?

Can you orgasm with condoms or will you need additional clitoral stimulation?

You might address all these issues in one fell swoop or discuss these matters over time. If you are in a relationship with someone, then it's appropriate and necessary to broach all of these topics. Just remember that communication and honesty are keys to a healthy relationship in all senses of the word!

Have fun and be safe! xoxo

How have you broached condom use with a partner? What's your brand of choice and why?