Pointe shoe quiz December 27, 2011

Who is the maker of these shoes?

There are several obvious clues so this one should be easy

Merry Christmas 2011

Repetto dance Shop Paris, Christmas 2011

Wishing all my friends and readers the Merriest of Christmases and good health and Happiness in the New Year!

Breeding diaphragms and ‘death rubber’

A Milex Wide Seal Omniflex often used as a gas-guard

A ‘Death Rubber’ Omniflex & Chi: Chi: the bodies vital life force a portion of which is left contained in objects the owner was wearing when s/he died. I’m CD3 and bleeding heavily today so I have a diaphragm inserted for flow control and contraceptive protection, though with my 28 day cycles it is very unlikely that I would become fertile during my menses. Recently a German reader has been searching this blog with the term ‘death rubber’ which is the reason I mention that the Omniflex I’m wearing I got when I pulled it out of an escort trainee who died during training encounter in Adolph’s deep water training facility, ‘the well’. She was a 23 y/o Dutch escort and friend of a French Dom who had sent her to Adolph’s facility for proficiency training in underwater intercourse below 30 meters. She apparently had an adverse event of some sort, possibly a blood clot or a nitrogen bubble to her brain during her second extended 30 meter dive of the day. She was over her nitrogen loading limit and was also on Yaz and was a smoker. She was dead by the time she reached the surface. I was at Adolph’s for dinner with him and her as well as another student in the same course and Adolph, knowing my interest in rubber clothing and equipment women were wearing when they died during sex, hence the term ‘death rubber’, suggested I remove and keep her gas-guard, which he knew was my size, for my collection and personal use. I love wearing a diaphragm another woman died while wearing! I can feel her Chi still trapped in the rubber which I feel enhances my strength, confidence and eroticism. Additionally, when I wear a death rubber diaphragm during my period I think I have less cramping and am in a better mood.

Cyndi’s first death rubber: When Cyndi accompanies me on cleanup projects she has second pick (I have first) of any clothing and equipment the dead women are wearing. She had taken pointe shoes one girl had been wearing and a dildo that another had inserted when she was drowned during a solo underwater masturbation session, but until this past week she had never found a death rubber diaphragm/gas-guard that was her size. What she imagined would be a triumphal moment pulling a dead woman’s most intimate possession out of the body and inserting it in her own vagina, turned out to be bittersweet because the dead woman had been one of her best friends.

It happened at Splash, Adolph’s private swim club, where Cyndi has an after-school job as a Red Door qualified Towel-Girl. Her mentor, a 28 y/o blond Swede who has been at Splash since it opened and had guided Cyndi through the intricacies of Towel-Girl competitiveness for advancement and the best clients was with a client in an encounter suite where they were having dry-SCUBA sex. That’s where the couples is both in latex fetish dive gear and wear regulation OTS FFM dive gear and breathe compressed gas from regular scuba tanks mounted on a tank trolley next to the bed.

What happened was that a nearly empty tank was left on or exchanged for a tank on the trolley and Inga connected her mask to that tank. Since the Towel Girls are responsible for ensuring that they and their clients are breathing the correct gas mix and from full tanks at the start of the encounter it’s hard to understand how Inga with her years of experience could have made such a serious mistake. She was on her hands and knees, her client opened her relief zipper and entered her from the rear, taking her doggie style, and the security videos don’t show her making any attempt to stop the encounter or remove her mask. Since they were not underwater there was no tell-tale bubble stream to watch so that security could tell she was still breathing. She just quivered and moaned as though she was enjoying his getting to her G-spot so the first time anyone knew she was in trouble was when the client came in her and withdrew taking his hands off her hips and she toppled over. There was an ambient breathing valve on her mask so if she was having a problem breathing off the tank she could have opened the valve and been fine. So it seems to me she must have been mentally incapacitated in some way otherwise she would have opened her ABV. I suppose the good news is that a client didn’t die.

The tragedy of Inga’s death had at least one small bright spot in that while Cyndi was helping strip her mentor’s body of the fetish dive gear and breathing equipment she also pulled out Inga’s Omniflex and swapped diaphragms. Since the Towel-Girl uniform is thong bikinis she quickly removed her own diaphragm and inserted Inga’s then stuffed her own back in Inga’s body. Since the diaphragms at Splash don’t have RFID chips in them there is no way to tell the swap was made other than by DNA. The switch was accomplished while everyone else was distracted righting the tank trolley that had tipped over when someone tripped on a hose. Inga had given Cyndi one of her old discolored Omniflex Ds so she knew it would be the right size. She told me that to have an Omniflex she pulled from her friend who died while wearing it during sex and while her body was still warm and with the client’s seed dripping from it was just awesome, in a really sad way!

Cyndi is so pleased that she can feel her mentor’s Chi coursing through her 17 y/o body while she has her death rubber protecting her cervix. Since she has a GyneFix IUD implanted Cyndi has no need of a diaphragm for birth control, but does use it for sex when she is menstrual and as a gas-guard when she is likely to have dive-sex, which means it is continuously worn when she is at Splash. And of course she will wear it for dive-sex in the cove when we go to Virgin Gorda.

Breeding diaphragms: Since there has been an increase in the number of men asking for breeding encounters with our escorts I’ve started training the girls to use a ‘breeding diaphragm’. For rape fantasies I take a different approach when providing contraceptive protection that ‘accidentally’ fails. Rather than sabotage my partner’s condoms which they hate wearing anyway I wear what I call a breeding diaphragm. A breeding diaphragm is one that is two sizes smaller than the size the woman should wear for it to be effectively used for contraception. And it is worn ‘dry’, that is w/o spermicide in the dome. I’ve found the type diaphragms that work best are an Ortho All-Flex (arcing spring) or a Milex Omniflex (coil spring) rim styles

When a woman has a diaphragm inserted that is considerably smaller than her correct size it is much easier for her partner/attacker/fantasist to under-thrust the rim with his penis and plant his seed under or in the dome so that when he withdraws the rim will reseal on the anterior wall of her vagina trapping almost all of his semen inside the dome where the tip of her cervix is submerged in a pool of semen while she sleeps. Or if the couple is into bondage and the woman is tied down and gagged during the encounter an additional advantage of using a diaphragm during a rape/breeding encounter is that it can be pulled out by her attacker and shoved in her mouth as a gag.

Ideally an Ortho All-Flex is the best breeder because the rim is the easiest to under-thrust. However, the smallest size All-Flex is a 65mm and some adult women might take a 60mm in a breeder so they would need an Omniflex which makes a 60mm in a coil spring rim.

Someone unfamiliar with cervical barriers might ask why not use a cervical cap, such as FemCap for breeding? The answer is that while an improperly sized FemCap can be displaced off the cervix with a thrusting penis it may fill with semen, but it is very unlikely to reseat itself on the cervix after withdrawal. And a diaphragm rather than a FemCap is far safer for the woman since a FemCap if pulled out and used as a gag can easily be lodged in the woman’s throat and her partner, with his mind elsewhere, may think she is squirming in ecstasy when in fact she is being asphyxiated, especially if she has been penetrated from the rear, taken doggie style, where he can’t see her face.

Personal protection during breeding/rape fantasy encounters: Of course our escorts have IUDs inserted or are on long acting hormonal birth control, but for me during a rape fantasy I 'double bag' and wear an Oves cap screwed down tight on my cervix under my diaphragm so when my ‘attacker’ under-thrusts the rim and shoots his wad or pulls my D out and stuffs it in my mouth I’m still well protected. Of course, when I’m having my period (as I am now) I can’t safely do rape fantasies and so if I’m with a man I know to be mischievous I wear a Reflexions flat spring so it’s nearly impossible for a him to under-thrust the rim.

Pointe Shoe Quiz December 17, 2011

Who is the maker of these shoes?

The Ringlets, NuvaRing and dive-sex

The vaginal ring, NuvaRing, and its packaging

The Ringlets: A group of UNLV women graduate students in their mid 20s calling themselves the Ringlets because they all use NuvaRing have recently become interested in dive-sex. Having heard about me from Taryn’s friend they asked me for guidance in becoming sexually active underwater. Along with their boyfriends they have rented a live-aboard dive boat in Cancun for the holidays and needed basic contraceptive barrier (gas-guard) skills and necessary supplies. I’ve been talking to them about getting copper IUDs, but at this point it’s too late to change contraceptive methods before their trip. That’s because unless there is a serious problem with her current birth control it’s not a good idea to change methods just before a woman expects to have a high level of sexual activity. So since they all have been on NuvaRing for several years and none is experiencing any problem with it they should be ok.

NuvaRing description: NuvaRing (etonogestrel/ethinyl estradiol vaginal ring) is a nonbiodegradable, flexible, transparent, colorless to almost colorless, combination contraceptive vaginal ring containing two active components, a progestin, etonogestrel and an estrogen, ethinyl estradiol. When placed in the vagina, each ring releases on average 0.120 mg/day of etonogestrel and 0.015 mg/day of ethinyl estradiol over a three-week period of use. NuvaRing® is made of ethylene vinylacetate copolymers (28% and 9% vinylacetate) and magnesium stearate and contains 11.7 mg etonogestrel and 2.7mg ethinyl estradiol. NuvaRing is latex-free. NuvaRing® has an outer diameter of 54 mm and a cross-sectional diameter of 4 mm. [From the NuvaRing prescribing information at: http://www.spfiles.com/pinuvaring.pdf ]

Fitting the Ringlets: In addition to needing a gas-guard for upper reproductive tract protection - in case the vagina floods during submerged penetrative sex – a NuvaRing user needs something to prevent her ring from being hooked and pulled out by a partner’s penis as he withdraws after ejaculation while she is in the water. Having a ring pulled out is not uncommon especially if the man is well endowed and it is easily found in the bed clothes or in the car after vanilla sex. However having a ring pulled out while the woman is swimming is a different matter entirely. Submerged couples minds are often on air consumption and other things after the ecstasy of an underwater orgasm so a missing ring is easy to overlook and if noticed at all difficult to find afterward on the bottom of a pool and impossible in open water. So a diaphragm is a form of ring insurance for those women who don’t want to remove NuvaRing before a dive. There is a three hour maximum interval that the ring can be out w/o decreasing the effectiveness of the wearer’s protection. However there is very little privacy on a live-aboard for women to remove and insert their rings before and after dives, so wearing their rings under an Omniflex is becoming a popular alternative.

The diaphragm make and rim style I fitted the girls with was the Cooper Surgical Milex wide seal Omniflex (coil spring) rim. That was because they are all young with good vaginal muscle tone and all wear 70mm or 75mm diameter diaphragms which are large enough that the ring can safely and comfortably fit in the dome and the wide lip or flange around the inner edge of the rim helps hold the ring inside the dome. In addition I recommended that the Ringlets each take a spare ring and got them all two 12 applicator boxes of 10 ml DiveGel prefilled disposable applicators as well as a box each of FC2 condoms. A very good article (below) from Marie Claire earlier this year discusses NuvaRing and the possible adverse side effects of etonogestrel, a metabolite of desogestrel, used in it. The tips at the end of the article about clot control for women on the pill are particularly valuable.

Marie Claire
May 24, 2011
http://www.marieclaire.com/health-fitness/news/birth-control-safety
By Laura Beil

Is Your Birth Control as Safe as You Think?

Since NuvaRing hit the market, more than 700 women have filed lawsuits, claiming it has caused potentially life-threatening blood clots. The battle may change the way millions of women prevent pregnancy.

Christen Childs woke up on September 12, 2009, in the pitch dark of early morning with what she thought was a pulled muscle in her leg. She reached down to massage the cramp, trying to fathom how her left calf could be so achingly sore when she hadn't made it to the gym in weeks. This was a Saturday — by Monday, her leg was swollen and hot, and when she tried to stand, jolts of pain shot up to her spine. She consulted her brother-in-law, a doctor, and he told her to go to the ER immediately. He suspected what an ultrasound would confirm: Childs, 26, had a blood clot in her leg — left untreated, it could kill her. "When the doctor diagnosed me, I started crying," she says. "I was stunned by how close I had come to dying."

Death would come closer still. Later that day, the clot broke apart and traveled to her lungs. Straining to breathe, she remained bedridden in the intensive-care unit as blood thinners were injected into her stomach four times a day for six days. By the following weekend, she was released, instructed to return weekly for hematology checks to make sure new clots hadn't formed. Meanwhile, her doctors ran a battery of tests to figure out what exactly went wrong. After all, Childs didn't have any of the risk factors associated with blood clots: She didn't smoke, wasn't overweight, and had no family history of clots. After six months on blood thinners, Childs was finally back to her old self, with one exception: Her doctors wouldn't let her go back on NuvaRing, her birth control, which they determined was the likely culprit behind her near-fatal illness.

NuvaRing is one of the world's most popular forms of non-pill birth control, and recent data indicates that more than 5.5 million prescriptions were written in the U.S. in 2010, according to IMS Health, a health-care information company. But in recent years, serious questions have arisen concerning its safety. To date, almost 1,000 cases of possible NuvaRing-related blood clots have been reported to the FDA, and more than 700 women in the U.S. are currently suing Merck, NuvaRing's manufacturer, for downplaying its health risks. Most of those lawsuits have been consolidated into a massive, multidistrict federal case that's expected to go to trial in Missouri next year. The NuvaRing case is being closely watched by physicians and the pharm industry. If the litigants persuade a jury that Merck undersold the device's risk for blood clots — a big if, to be sure — it could have far-reaching consequences for several contraceptives on the market.

• When it was approved by the FDA in 2001, NuvaRing became the world's first vaginal birth-control ring. Inserted just once a month, it dispenses hormones directly into the bloodstream. Unlike oral contraceptives, which require taking a pill the same time every day, NuvaRing is marketed as a pill-free, no-muss/no-fuss alternative. Just pop it in and forget about it (the ring remains in for three weeks and comes out for a week during your period). That pitch clearly resonated with women. Last year, NuvaRing generated $559 million in international sales for Merck.

It's worth noting that all hormonal birth control with added estrogen carries a risk of blood clots. In the 1960s, the estrogen used in the earliest pills raised the risk of clots more than nine fold. A decade later, a second generation of pills containing a much gentler dose of the hormone, coupled with the synthetic hormone progestin, had been developed. Though these second-generation pills are effective and safe, drugmakers have sought new forms to market as better able to control conditions like facial hair and acne. NuvaRing contains a version of the third-generation progestin desogestrel. There's even a fourth-generation progestin, said to alleviate symptoms of PMS; it's the essential component of Yaz and Yasmin, two top-selling oral contraceptives.

The problem? Some researchers say third- and fourth-generation contraceptives — including those containing desogestrel — raise the risk of blood clots without adding any benefit. In 2007, the consumer watchdog group Public Citizen petitioned the FDA to ban oral contraceptives containing desogestrel. Although NuvaRing wasn't named in that petition because it was still fairly new, the director of Public Citizen's Health Resource Group, Dr. Sidney Wolfe, reached an unequivocal conclusion: "We've told people not to use these drugs and have advised women that the safest contraceptives are the older, second-generation ones." The FDA didn't act on Public Citizen's claims, even though during its own review process, the agency concluded that NuvaRing's label should "clearly reflect safety concerns about an increased risk" for blood clots.

In 2009, the British Medical Journal published two investigations of desogestrel and fourth-generation progestins that seemed to bolster critics' concerns. Both studies found that women taking third- and fourth-generation pills were almost twice as likely to get a blood clot than those who took second-generation contraceptives. Frits Rosendaal, Ph.D., an epidemiologist at Leiden University Medical Center in the Netherlands who has contributed to more than a dozen scientific papers on desogestrel, coauthored one of the studies that found a higher risk for clots in NuvaRing than in second-generation birth control. "To me, it's incredible that [Merck] used desogestrel and not a second-generation progestin. Why not go for the one with the lowest risk?" says Rosendaal.

But Merck and other scientists dispute claims that NuvaRing poses a higher risk than other contraceptives. In NuvaRing's product information pamphlet, Merck acknowledges the findings, but adds, "Data from additional studies have not shown this twofold increase in risk. It is unknown if NuvaRing has a different risk of [blood clots] than second-generation oral contraceptives." That position infuriates NuvaRing's critics. "Nine years after the product was put on the market, they still say the risk is unknown. To say, 'We just don't know' is not sufficient," says Thomas Lamb, a North Carolina — based attorney whose firm represents more than 50 women around the country who have filed suit against NuvaRing, Yaz, and other third- and fourth-generation contraceptives.

Among those wanting answers is Robert Bozicev, 37, of Tom's River, New Jersey. His 32-year-old wife, Jackie, had begun using NuvaRing shortly after the birth of their daughter in 2007. One Friday morning, as he stood in the kitchen making breakfast for their two kids, he heard her puttering about in their second-floor bathroom. As she was about to step into the shower, she called his name. He answered her, preoccupied with their son, 2, who was demanding another waffle. After she cried for him a second time, barely able to get out his name, he dashed upstairs and found her on the floor, unable to breathe. "She was in a lot of pain, rolling around, trying to get onto her stomach," he says. "My son was there, watching the whole thing." To his horror, Jackie started turning blue.

When an ambulance arrived, emergency techs tried to restart her breathing. Bozicev was gripped with terror. Doctors continued to try to revive her in the hospital but eventually had to give up. She died that day. The cause of death: massive pulmonary thromboemboli due to deep vein thrombosis. In other words, she died from a blood clot. Anxious to learn more about what had happened, Bozicev searched online and came upon reports linking NuvaRing to an increased risk of clots. Knowing Jackie had been healthy before she started using the device (she wasn't overweight and didn't smoke), Bozicev concluded that NuvaRing was to blame, and filed a wrongful-death suit against Merck in March 2008. "Even to this day — and this is three and a half years later — I still can't believe it happened," he says. Jackie's clothes remain in her closet. He is too heartbroken to take them out.

NuvaRing isn't the only pill-free contraceptive beset by litigation. When Ortho Evra hit pharmacy shelves in 2002, it was the first birth-control patch of its kind. Its selling point: Simply slap a Band-Aid-like adhesive on your arm, stomach, or back each week. Within two years, sales had swelled to nearly $400 million. But soon after, studies emerged indicating that the blood concentrations of estrogen in Ortho Evra users might be much higher than previously thought, resulting in a greater risk of clots. That's when the lawsuits piled up. In November 2005, Ortho Evra, under an agreement with the FDA, added a black-box warning to its packages stating that patch users are exposed to roughly 60 percent more estrogen than the typical pill user, resulting in a potential "approximate doubling of risk of serious blood clots." The warning also stated that the risk might not increase at all, but it was still enough to scare off doctors. By year-end 2010, Ortho Evra's sales had fallen 69 percent to $124 million.

Merck, hoping to avoid a similar fallout, is standing by its product. "The decision was made to use this particular form of progestin [in Nuva Ring] because of the long history of safety and efficacy," says Dr. Michelle Vichnin, one of Merck's medical directors. When contacted by Marie Claire regarding the pending lawsuits, a Merck spokesperson stated: "The company intends to defend itself against these lawsuits." Possibly helping their case: In March 2010, researchers from the Cochrane Collaboration, a respected international organization that reviews published scientific data, analyzed 10 randomized studies of NuvaRing involving 3,000 women. They found that only two women in the study group developed clots, and one was later found to have a genetic risk.

Often lost in the discussion is just how unlikely the average healthy woman's chances of getting a blood clot are, whether she takes a second- or third-generation birth control. The risk of blood clots for women on a desogestrel-based contraceptive is about 30 out of 100,000, according to some studies — still less than half a percent. You're more likely to get struck by lightning over the course of your lifetime. And that risk is still several fold less than that of a woman who is pregnant or postpartum. Another issue undermining the claims against Merck is the scope of prior studies, which didn't look at a large enough pool of NuvaRing users, according to Dr. Andrew Kaunitz, a professor at the Department of Obstetrics & Gynecology at the University of Florida in Jacksonville. (Kaunitz consults for several pharmaceutical companies, including Merck.) To investigate the effect of something so marginal, he says, scientists need to conduct much bigger studies on women who do not have any known risk factors for clots. "When you're looking at rare events, even small biases can throw off your findings," says Kaunitz.

Larger studies are on the way. Merck is currently underwriting a massive trial of some 30,000 NuvaRing and pill users — the largest, most comprehensive study of the contraceptive to date.

The company says it expects to publicize results next year. "The study was started because we wanted to answer questions that were being discussed in the medical community," says Merck's Vichnin. Meanwhile, all eyes are on the impending litigation against fourth-generation pills like Yaz and Yasmin, also under fire for their potential blood clot risks and set to go to trial in September.

So what should NuvaRing users do in the meantime? Don't be afraid to ask your doctor questions about which birth control is right for you, given your medical history and lifestyle. There are close to 100 oral and pill-free contraceptives on the market today, yet many women take whatever their gynecologist recommends, no questions asked. Says epidemiologist Rosendaal, "It's not like there aren't options."

Clot Control

A healthy woman's risk of a blood clot increases dramatically if she takes birth control with estrogen. Here's what you need to know to diagnose and prevent a clot:

• What is a blood clot? A tiny buildup of platelets and blood plasma proteins caused by decreased blood flow to the lower extremities. Pregnancy, obesity, or being squashed like a sardine on a flight to Hong Kong all allow blood to pool, which can lead to a clot. On top of that, estrogen from oral contraceptives increases the levels of four of the blood's 12 clotting factors, making clots more likely, says Barbara Dehn, a nurse practitioner with the Women Physicians OB/GYN Medical Group in Mountain View, California.

• Telltale symptoms: Cramplike leg pain and red, swollen, or warm skin. Chest pain, shortness of breath, and heart palpitations may signal a pulmonary embolism (meaning a piece of the clot has broken off and traveled to the lungs). If you have any of these symptoms, get to the emergency room. Doctors will give you blood-thinning drugs; in an extreme emergency, you'll get an injection of a "clot-busting" drug like TPA (tissue plasminogen activator).

• Preventive measures: Drinking 8 ounces of water every two hours when on a plane will make a clot less likely. And do five minutes of toe raises or calf flexes every hour while traveling, says Dr. Mark Melrose, an emergency room physician and cofounder of Urgent Care Manhattan, a walk-in medical practice in New York. If you're pregnant or have had a clot before, wear support stockings (thick, tight panty hose that encourages circulation). And don't smoke — it increases the risk by a factor of nine, according to one study.

• Genes count. Get a "clotting workup," a blood test to detect inherited clotting disorders like factor V Leiden or a protein C or S deficiency. The conditions are rare, but if a family member has had a clot, get tested. (It costs about $200 if your insurance doesn't cover it.) Dehn recently told a patient whose sister had had a clot-related stroke to take the test before starting birth-control pills with estrogen. It turned out she had factor V Leiden, an inherited clotting disorder found in, on average, 5 percent of Caucasians; 2 percent of Latinos; and 1 percent or fewer of African-Americans, Native Americans, and Asians. She chose a different birth control, totally "blown away she could've put her life at risk," says Dehn. — Sophia Banay Moura”

No Christmas tour, FDA activity and BVI vacation

The Ortho Evra birth control patch

There will be no hospital tours this year: I’m sorry to say that changes in hospital administration have made it impossible for me to take a few of my dancers to give intimate performances at military hospitals for wounded service personnel this year. We were fortunate to have been able to tour hospitals for the last few years to add a little spicy holiday cheer to the recuperating veteran’s lives. I was hoping our tour would become a holiday tradition, but I guess not.

Christmas on Virgin Gorda: Anya, Cyndi and I along with our boyfriends are going to my place on Virgin Gorda for the holidays. But first there will be a quick trip to see Taryn in Cambridge and go to Stonehenge for the Winter Solstice on Thursday December 22nd. Cyndi has never been to a Winter Solstice celebration at Stonehenge and she is looking forward to that as well as seeing the Duchess, her grandmother, again and we are all looking forward to swimming with the dolphins if a pod is in the cove this year. My ballet company is well into our Christmas performances and since St Lucy’s is on holiday for several weeks it’s given me the flexibility to take some time off. Having penetrative sex at Stonehenge during the Winter Solstice isn’t for sissies, especially if the weather is bad, but it is a huge thrill to be that much in tune with the Druid Gods if things go well.

Recent FDA activity: Recommendations have been made concerning Ortho Evra and BCPs containing Drospirenone. Neither of which is a surprise. While the risk of serious side effects is greater when using these hormonal methods it isn’t at a level that would cause them to be banned. The decision to deny off-the-shelf availability of Plan B to teens under the age of 17 is not surprising either. While making Plan B available to younger girls has merit I think HHS is picking its battles giving first priority to getting Catholic institutions to provide employees with birth control in their health insurance policies. HHS/FDA can always come back later and approve sale of Plan B to girls younger than 17.

FDA Panel Says Ortho Evra (the patch) Benefits Outweigh Risks: 12/10/2011 RTTNews – “Reports in the media Friday said Johnson & Johnson (JNJ)'s Ortho Evra birth control patch was determined by an FDA Advisory panel to provide benefits that outweighed the risk of blood clotting. The advice is not binding on the FDA. The Reproductive and drug safety advisory panel voted 19-5 in favor of the benefits of the patch. Panelists voted 20-3 with one abstention that the drug label is inadequate.” The complete article can be found at:
http://www.rttnews.com/Content/BiotechStory.aspx?Id=1778819&Category=FDAPanel

FDA advisors recommend increasing warning label info on Yaz, Yasmin: (Reuters) Thu Dec 8, 2011 - U.S. health advisers recommended a revision of labels for the widely used new generation of birth control pills, based on data showing they may put women at a higher risk of dangerous blood clots. .” The full article can be seen at: http://www.reuters.com/article/2011/12/09/us-fda-birthcontrol-idUSTRE7B72KX20111209

HHS blocks sale of Plan B to teens 16 and younger w/o an Rx: Bloomberg - Dec 7, 2011 “Teva Pharmaceutical Industries Ltd. (TEVA) failed to win U.S. clearance for the first over-the-counter emergency contraceptive after an Obama Cabinet member overruled the head of the Food and Drug Administration on the issue.

Secretary of Health and Human Services Kathleen Sebelius ordered Margaret Hamburg, the FDA chief, to reject the application by Petach Tikva, Israel-based Teva, citing potential sales to girls under age 17. Hamburg, in a statement, said she was ready to approve over-the-counter sales based on “well- supported” and “science-based evidence.” The FDA said it’s the first time the HHS has reversed one of its decisions.

The product, called Plan B One-Step, reduces pregnancy risk if taken within three days of sex. As a result of Sebelius’s order, it will continue to be kept behind pharmacy counters and sold without prescription only to women 17 and older. Younger girls may obtain the drug with a doctor’s order.” The full article can be seen at:
http://www.bloomberg.com/news/2011-12-07/fda-rejects-over-the-counter-plan-b-birth-control-pill-for-girls-under-17.html

U.S. focus on birth control may raise new concerns: WASHINGTON Sun Dec 11, 2011 (Reuters) – “A ruling last week on the morning-after pill, as well as government recommendations on new forms of birth control, could have long-lasting effects on women's perceptions of its safety, health experts say. Last Wednesday, the health secretary for the first time overruled government scientists, refusing to make the morning--after pill available to users of all ages without a prescription.

In the days that followed, advisers to the Food and Drug Administration recommended revised labels on the best-selling class of birth control pills, as well as for a contraceptive patch, to better convey their higher risk of blood clots. Some women's advocacy groups worried the negative attention on the blood clot risk of a new generation of pills that contain drospirenone -- including Bayer AG's popular Yaz and Yasmin -- would create concerns about birth control in general.” The full article can be read at: http://www.reuters.com/article/2011/12/11/us-fda-birth-idUSTRE7BA0P820111211

Personal comment: I’m not sure that this sort of publicity will substantially affect the sale of combined drospirenone oral contraceptives. In Europe it’s been known that there was a higher incidence of blood clots for years and sales continue strong. Knowing that drospirenone pills cause 10 adverse events in 10,000 women Vs 6 adverse events in 10,000 for pills made with other progestins doesn’t seem to be that serious, unless you are one of the additional four.

On the other hand, the sale of Ortho Evra has declined considerably since it was determined several years ago that there was an average of 60% more estrogen in an Ortho Evra patient than if they were taking an oral contraceptive with 35mcg of estrogen per pill. From what Ex-patch users tell me it is the high average level of estrogen which cause swollen painful breasts and heavier periods that have caused women to come off or avoid Ortho Evra since there are so many combined pills now available that have 20mcg of estrogen or less per pill.

Too much information? Birth control choices abound

By LAURAN NEERGAARD
Monday - 12/12/2011
AP Medical Writer

“WASHINGTON (AP) - Worried about birth control in light of headlines about side effects from Yaz and the patch? Women have a lot of options that are safe and effective, including some that are even more reliable.

You can choose a contraceptive that's used daily, weekly, monthly, once every three months, once every three years, even once a decade.

Yet almost half of U.S. pregnancies are unintended _ and experts say confusion and uncertainty despite all the options is a big reason.

"We have a whole generation now of young adults, the vast majority of whom are sexually active, who are in a fog about modern contraception," says Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "They don't know enough to make a reasonable choice."

Indeed, in a recent survey, the campaign found 42 percent of unmarried 18- to 29-year-olds said they knew little about birth control pills and two-thirds knew little about even more effective long-lasting contraceptives. A third said they believe there's a good contraceptive for their personal needs but they don't know which one.

To help, her center just opened a novel website www.bedsider.org to offer frank answers for all those questions you might be embarrassed to ask.”

The complete article can be found at: http://www.wtop.com/?nid=267&sid=2667081&pid=0&page=2

Porn and the Prentif cap

A pair of 22mm (ID) latex Prentif cavity rim cervical caps

A rubberist’s delight: One of my fave stallions is a well endowed rubberist who delights in being able to thrust into my cervix, even when he penetrates me from behind. What really lights his fuse though is if I wear a Prentif cap sucking on my cervix so he can thrust into the soft latex dome. I wear a 25mm Prentif so the top of the dome dimples, collapses a bit, under vacuum, so that if he hits the dimple he knows he is right on target and thrusting into the soft stretchy latex and him ‘double tapping’ the dome and then the tip of my cervix under it gets him off very quickly.

The Prentif and the porn industry: Our clinic is one of the very few that still fits Prentif caps. That’s because Lamberts (Dalston) Ltd stopped making them at least four years ago and our clinic having a large Prentif user base bought up all the Prentif stock they could, much of it at a deep discount. Recently porn producers have discovered cervical barriers as a “new” fetish to be exploited. Since very few men younger that 60 have heard of diaphragms or cervical caps a Prentif used as protection by a porn actress in a video has become a ‘HOT’ retro scene guaranteed to increase demand for any vid in which one is used. Any producer who has his actress take fifteen minutes to languidly insert her Prentif as foreplay while her boyfriend/client is watching or has it pulled out by her attacker during her rape or has her lover eat her cervical mucus out of the dome is guaranteed a best seller.

Then too here is the ‘Geezer factor’ in niche-market porn especially in Europe where the Prentif was far more popular in the 50s than diaphragms and I’m told by the marketers that men of a certain age and style remember it fondly even though they now need performance enhancing meds to participate. Another advantage of a cap or diaphragm being used in porn is that unlike birth control hormones it is a physical object that can be inserted during a tender moment for protection or roughly pulled from the heroine or victim’s vagina during a rape and shoved into her mouth to emphasize the danger she is in. And for those into asphyxia a Prentif can be shoved down the woman’s throat as a very dangerous form of breath play because she can easily suffocate while her attacker is concentrating on planting his seed in her belly. With the increased interest in cervical barriers for use in porn – a lot of the resurgence has been because of the ‘Mad Men’ effect of retro TV shows that got the country longing for what seems a simpler time – our clinic is seeing a substantial increase in requests to fit Prentif caps.

Porn and poor cervical barrier technique: Porn actresses don’t rely on the effectiveness of a diaphragm or cap for contraceptive protection. Many of them have been sterilized or have had IUDs inserted so that an unplanned pregnancy from on-cam intercourse is very unlikely. That makes it far less important that most porn actresses be correctly fitted with a barrier that will remain securely in place through multiple acts of intercourse and for at least six hours afterward. All they need is one that won’t give them a UTI and won’t fall out while they are on-cam. Nor do they need to adhere to correct barrier insertion technique during a video production and that can leave the men and women watching the video with the wrong impression as to how to properly protect a woman using a cervical barrier.

The problem comes from the way the porn actresses are playing with their barriers and appear to become aroused long before insertion. As returning readers know a woman needs to insert her cervical barrier BEFORE she becomes aroused! That’s because during arousal the vagina lengthens (tents) as the uterus and thus the cervix is drawn up and out of the way of a thrusting penis. A vagina that is fully tented can make it very difficult or impossible to place a cervical barrier correctly over the cervix and therefore makes an unplanned pregnancy far more likely.

I’ve tried talking to several of the major producers of cervical barrier porn and they just laugh and say they are interested in getting their audience as hot as fast as possible and a porn-princess moaning and rubbing her barrier over her engorged labia wet with natural lube while she moans and writhes in ecstasy as she plays with herself is a critical part of the production and there won’t be any changes to correctly depict proper insertion technique. I suspected that was the answer I was going to get, but it was worth a try. It does make it more difficult to get vanilla women wanting to portray Magna Cum Loudly or other porn princesses to use their barriers correctly if they will need them for contraception and not just as a sex toy.

I’m trying to steer the porn actresses and their costumers toward diaphragms or FemCap and away from Prentif because the porn industry is not interested in contraception and as I mentioned above Prentif is now a device in short supply and the remaining caps should be used for women who intend to use them correctly for contraception and as gas-guards for upper reproductive tract protection during dive-sex.

Christmas break barrier fittings: At St Lucy’s it’s the end of Fall semester and we are finishing the fit checks – and replacements where necessary - of the cervical barriers the students wear before they go home or travel on Christmas break. While many of the upper form students were sexually active before arriving at St Lucy’s none had enough experience to have caused their vagina’s to stretch appreciably. While they have grown in the months they have been immersed in a strict ballet and pelvic training regimen the pelvic floor muscles have toned considerably making the vagina deeper and tighter. Fit checks are important before the increased use of cervical protection while away from the school’s sexual health support system. It’s also time for an ultrasound to verify the proper placement of students IUDs and for full STI panels to make certain the students are all healthy before sending them back to their families

The students in my Advanced Sexual Techniques class use their barriers as gas-guards for dive-sex while others on hormones use them for flow control for vanilla sex during their pill-periods or if they have a stringless IUD inserted. Stringless GyneFix IUD implants have become much more popular this year because they allow GyneFix users to safely wear a diaphragm or FemCap as a gas-guard during dive-sex. For anyone wondering the smallest Prentif, with an inner diameter of 22 mm, is too large for most teens to wear but they can wear a 22 mm FemCap because the FemCap seals against the walls of the vagina and not the cervix. So Prentif caps are left for the use of experienced adult women.

UNLV’s Fall semester also ends on December 17th and many of the sorority girls I know have had our clinic check the fit of their diaphragms and will be leaving mid week rather than on that Saturday so there has been a surge in barrier fit checks and some requests for STI panels for them as well. The students come to us to avoid having these items show up on their UNLV Student Health statements that are sent to their parents.

Checking Slit-kits: Before traveling for the holidays is also the time to check and restock everyone’s skit kits to ensure condoms, spermicide, antibiotics and emergency contraception pills are all fully stocked and in-date. There are two effective EC specific pills:

Plan B One-Step (a single pill containing 1.5 mg of the progestin levonorgestrel) which is effective for up to 72 hours, three days, after unprotected sex or a contraceptive failure. Plan Bs effectiveness decreases the longer after the event it’s taken so it should be taken as soon after the event of concern as possible. Women on oral contraceptives may continue taking them on their normal schedule after taking Plan B. In the U.S Plan B is available to women 17 years of age or older behind the counter w/o a prescription.

The second and newer pill is available in the U.S. as ella and in Europe as ellaOne (a single pill containing 30 mg of ulipristal acetate, a progesterone receptor modulator) which is effective for up to five days after the event of concern. Women on hormonal contraceptives should not rely on the effectiveness of their pills, but use a reliable barrier method of contraception after using ella, for any subsequent acts of intercourse that occur in that same menstrual cycle.

For EC our clinic now recommends ella, because of its longer effectiveness interval and at St Lucy’s its cost is covered by the student’s Student Health policy.

Pointe Shoe quiz December 7, 2011

Name two pointe-shoe makers shoes shown in this video.

This video is on the Australian Ballet’s website. The direct link is: http://www.australianballet.com.au/watch_listen/video/en_pointe! However, I’ve not been able to get that link to open for me. [link corrected 12-10-2011. Thanks Paul S!]

What I had to do was go to: http://www.australianballet.com.au/ Then highlight ‘watch&listen’, and scroll down to and click on ‘video’, then click on ‘en pointe’.

The video is well worth watching and with real dancers talking about and showing how they prepare their shoes it puts to rest the complaint about pointe shoe preparation shown in the film Black Swan where it was said shoe prep was ‘over dramatized’.

Ankle ribbons, dive-sex and mystery meat

Trolling for men in ballet-wrap stilettos

Ankle ribbons are in for Spring 2012: From Alice+Olivia’s Spring/Summer 2012 line. A ballet look for wannabes in 4 in stilettos that accent the ankles and legs. Even the most bookish women can give her ballet-girl alter ego a romp in these lovely shoes that scream “take me” to any man with a ballet fetish.

Why I like dive sex: I keep getting reader’s comments asking why I love dive-sex. I’ve answered this question before, but for new readers I’ll answer it again. My interest in dive-sex developed because being weightless in water shows off my toned body to its best advantage while providing a hostile environment in which to enjoy the physical delights a man can provide as well as an opportunity to savor the affects of asphyxia during weightless sex. I discovered that facet of breath play when I accidentally ran out of air during an orgasm at the bottom of a friend’s swimming pool. It was amazing, an epiphany for me, and has provided an entirely new more intense level of carnal pleasure! Surviving a breathplay encounter during dive-sex is such an adrenaline rush that when I surface immediately afterward I need to be taken by my lover again. I understand that side effect, needing sex, is common for men after combat and is also what I have experienced after a KP-boot fight where the mind is so glad to be alive that it needs to experience sexual pleasure to relieve the tension.

Adolph’s Thanksgiving gift of mystery meat: I’m sorry to say that Adolph’s contribution to the gravy served during our Thanksgiving dinner proved to be a disappointment. As I wrote in an earlier post I didn’t tell any of the guests about its supposed aphrodisiac effects. I just observed the behavior of the women (it is supposed to significantly increase only the female libido) who consumed it. As far as I could tell there was no increase in libido of any of my female guests and I’ve been around them (even Adèle) enough under intimate circumstances to have a pretty good idea of how randy they are at different points in their cycle from menstruation to fertility and ovulation. While they enjoyed themselves by sampling the different men available none of the women were over the top in erotic behavior. I’m wondering now if the tales told about the aphrodisiacal power of the organ meat were apocryphal as there is nothing I could find in medical texts of the period. Perhaps he was scammed and was provided with boar’s testes.

Thanksgiving weekend side effects: It’s now been a week since I had my Thanksgiving smorgasbord of studly men for the women in my circle to enjoy in safe and comfortable surroundings. None or us has come down with yeast or other normal infections that typically occur from being sexually intimate with so many different men in such a short interval of time and that’s as expected since we all used DiveGel+. There is no reason to suppose our contraceptive protection was any less effective, but no method is 100% effective so we should know for sure in another week or so.

I played Aphrodite to make sure all the woman got to experience all the men. I even managed to get Cyndi taken by her Mom’s boyfriend while Fiona was off shopping at Hermès with Anya. Anya took her to both Hermès stores - the Crystals and at Wynn’s Encore - and then lunch so Colin had plenty of time to be gentle with Cyndi since it was his first time with her. Cyndi’s experience with Colin seemed to help reassure her that he can meet Fiona’s considerable physical needs from a lover (they both like well hung men with plenty of stamina) and Cyndi came away from the weekend thinking far more favorably of Colin than that he was just the latest set of male genitals in her mother’s life.


I want to thank my good friend and regular reader Eric for bringing the article below to my attention.

“Stiletto Self-Defense
NBC LA
By Lolita Lopez Saturday, Nov 19, 2011

"I wanted women to just know enough ... to be able to tap into their inner power and ward off a predator"

Stiletto heels aren't just fashionable, they also serve a purpose.

Local self-defense expert Jennifer Cassetta has created the Stiletto Self Defense program that demonstrates how women can protect themselves.

She developed the techniques after she was attacked several years ago while walking on the street late at night.

"He grabbed me from behind and in that half a sec, like, I knew in my head from my training that I had an instant to choose whether to be a victim or a victor and I turned into what I liked to call a 'she beast,' basically went crazy like I was going to attack him," Cassetta said.

According to RAINN, the Rape, Abuse, & Incest National Network, someone in the U.S. is sexually assaulted every two minutes.

The 5 foot 1 inch third degree black belt in HapKido, a Korean martial art, was able to chase off her attacker while wearing high heels. She began teaching the program in 2006 using her 12 years of experience.

"I wanted women to just know enough of the basics to be able to tap into their inner power and ward off a predator," Cassetta said.

Cassetta explained her ABC's of self-defense: Awareness, Boundaries, and being Centered and Calm in the face of adversity.

"We have on our bodies five different weapons, pretty much, and they start with the hands, elbows, knees, feet and your head," Cassetta said.

As for those heels, Cassetta suggested wearing comfortable ones that you can run in if necessary.

"The first thing you do with those sexy stilettos is stomp your heel right down on the foot," Cassetta said. "Hopefully it will go right through the foot. You can also take the foot and go up the groin with that stiletto, as well."

Cassetta said, remember to let out your inner "she beast" and be loud, calling attention to your situation.

"It all starts in the mind and it's a mind body spirit class ... if you think you are powerful enough to get away in a situation like that, most likely you can," Cassetta said.

Another tip: think like a predator.

"How can you avoid being a target? You want to stand up straight make sure you are looking around, shoulders back,” she said. “You see girls texting and headphones. None of that.”

Two 20-something's taking her class were inspired by what they learned.

"I walk around with my headphones and disappear into my music, and I never thought I am very vulnerable at that moment," Stephanie McCall said.

Tina Pareedes said the class challenged her habits, as well.

"I usually avoid looking at people in the eye walking around the street but once you get that in your head to just go after someone in the face, yea," Pareedes said.

Cassetta holds local workshops once a month but is also available by appointment for special classes. She recently held a class in one part of Los Angeles where there was a spike in sexual assaults.

"I have mothers, a lot of mothers, who have girls going off to college that will call me and schedule a class" Cassetta said.

For the video see: http://www.nbclosangeles.com/news/local/Stilletto-Self-Defense-134180263.html

Her techniques are also available on DVDs. For more information check out www.jennifercassetta.com”

Personal Comment: I’ve always liked the idea of fighting back and using whatever is at hand as weapons and punching a 3 or 4 inch stiletto heel through an attacker’s foot can be pretty effective. Of course if you miss you lose the advantage of surprise that you are actually fighting back. Another tactic I like if I’m in flats or sneakers is to kick back into an attacker’s knees. If you break the knee he’s down and not going very far then you can safely run. Of course too there is the Wal-Mart Black Friday weapon of choice, pepper spray, if you have it where you can get at it, like in your hand as you walk to your car.