Teaching pelvic skills

The City of London skyline summer 2014

The Photo: The London financial district “The City” skyline in August 2014, including Tower 42 (left), the Leadenhall Building (centre) and 20 Fenchurch Street, the “walkie-talkie”, (right) with the Thames in the foreground.

Pelvic training for elite Personal Assistant candidates: Returning readers may recall Taryn, one my former wards, who lives on an estate (that her partying friends call Cunt Castle) north east of Cambridge who has just received her MD and PhD in psychiatry. She is currently interning in a Cambridge hospital before starting her practice as a psychiatrist. In addition to her porn empire which she inherited from her parents she has recently started another business to care for a currently underserved niche market. She has identified a need - especially in the financial industry where money is no object and beautiful and talented women are rare - for an elite class of Personal Assistants for executives in the UK and U.S. business world; PAs who can provide intimate services to relieve their bosses’ stress as well as keeping an executive’s business day flowing smoothly.

The seven initial candidates all of whom are Cambridge graduates were first chosen for being sexually adventuresome. Additionally, they have been extensively screened for intelligence, beauty, personality, ballet training, and have degrees in accounting or business administration. The women who passed this initial winnowing were given extensive training in how to please even the most obsessive-compulsive and obstinate of men, which is where my skills as a ballet mistress and pelvic trainer come in.  While with me the women are still PA candidates and won’t be fully qualified until satisfactorily completing my pelvic training course.     

Pompoir training at Blackthorn Castle: I was pleased to receive Taryn’s call asking me to be ballet and pelvic training mistress for the few women who have successfully passed the screening process as I was wondering how to constructively occupy my time at the castle since with no men present I was missing the myriad of activity choices available in London and considering returning to Eaton Square. Since I was assured that all the girls who would come to me have at least six years of pointework, which I think is the minimum needed for an Elite escort, I settled on an accelerated eight week course in Pompoir and ancillary training (ballet-sex and dive-sex) and the ability to easily switch between Domme and submissive depending on what the man they work for needs at any given time.

Taryn thought the course should take only six weeks, but she was never fully trained in Pompoir and even at an accelerated pace six weeks is rarely enough time for even someone with superior pelvic muscle control because the first several weeks are consumed in identifying and slowly strengthening the proper groups w/o causing severe cramps from over working muscles. I intend to fully train the women under my tutelage and think eight weeks of intensive training should be enough for the trainees to be able to confidently and successfully perform Pompoir on even the most difficult man if they apply themselves. Of course these women will be far more than arm candy as they will be in charge of their executives’ day. Still they need the skills and wiles of an elite escort in order to keep their executive relaxed as only exquisite penile-vaginal intercourse can do so that he can be as effective in the board room as she is in the bedroom.

I had Taryn send along an experienced, uncut and very well endowed cocksman (a male escort not a porn actor) for each trainee and an additional one for Anya and another for me as I will need a partner to help demonstrate pelvic techniques and skills, and to sleep with at night since none of my current boyfriends are here. The uncut and well endowed men are better to work with since some women have never seen an uncut penis and a large penis is better for training purposes as the trainee needs to learn how to avoid injury if her partner isn’t gentle while thrusting.

The women all have current and negative full STI panels and have standard (six bead) GyneFix frameless copper IUDs implanted (with the strings trimmed off so cervical barriers can be used for ‘flood insurance’) four months ago so they are over any adjustment side effects. None have discomfort from menses that can’t be handled with 800 mg of ibuprofen while cycling naturally so they can comfortably provide menstrual sex if asked. All have been vaccinated against the full range of diseases as well as having the three shot regimen of Gardasil the HPV virus vaccine. All the men have negative STI panels and had their Gardasil shots as well.

I sent The Dragon down to London to pick up the six trainees and their partners and the other men for Anya and me. They arrived yesterday and a convoy of Land Rovers picked them up at Caersws and brought them up to the castle. The weather is forecast to be very wet with heavy rains and gusty winds for the next week with temperatures from the mid 30s to the mid 40s (F) so there should be little interest in anything but training, the care of sore muscles and sleep.

Since the training will be heavily centered on pelvic activity Chris, my male Gyn from the Barony’s London clinic, as well as his current girlfriend, a Physician’s Assistant and cervical barrier fitter, will be here as well for the entire eight week course.  So we now have seven women trainees and nine well endowed men in residence in addition to Chris and his girlfriend and Anya and me. Having seven trainees and an eight week course means that after the first week the men can swap partners each week so the candidates can train with seven different men.  I love having sexually active guests and being able to train young women in very impressive but relatively unknown pelvic skills.

Menstrual protection and fellatio

A Diva menstrual cup showing fill levels and removal stem

The Photo: Showing the smaller (size 1) silicone Diva menstrual cup. The Diva Cup holds one full ounce of menstrual flow (30 ml) when filled to the four tiny air holes below the rim). As the average woman only flows approximately 1 to 2 ounces (30-60 ml) per cycle the wearing interval can be up to be 12 hours or longer w/o emptying it. However, with copper IUDs implanted my wards periods can be a bit heavier so on heavy days they may need to empty sooner.

Kassi gets her first Diva Cup: Kassi had been using tampons and panty liners. I introduced her to the Diva Cup menstrual cup (size 1) which is the brand my other wards and I use. A Diva Cup’s total length, including the stem, is 70mm and the cup length is 57mm. for both size 1 and 2 while the rim diameter is 41mm for the smaller size and 45mm for the larger so one or the other should fit most women. And the cup softens with body heat so it forms to the wearer’s body improving its comfort and seal.

My cup switch: Several months ago, I switched to a Diva 2 since the manufacturer recommends cup wearers older than 30 or who have given birth would have less likelihood of leakage if she used a Diva 2. I tried a Diva 2 and found I didn’t care for the larger size. My vagina is tighter than most nulliparous 20 y/os and I’ve had no problems with leakage and I don’t need the additional capacity as I can go more than 12 hours w/o emptying on almost all days with the smaller size so I’m back to a size one again. 

The Diva Cup at St Lucy’s: While St Lucy’s girls should already have the three shot regimen of Gardasil inoculations required for maximum protection from HPV viruses that cause cervical cancers as well as some genital warts – they can start the series of injections as early as age 9 - students aren’t fitted for menstrual cups and contraceptive cervical protection until menarche. The cervical barriers as returning readers of this blog know are primarily for flood insurance to protect the upper reproductive tract  in case the vagina floods during underwater intercourse since nearly all St Lucy’s girls reaching menarche now have stringless mini GyneFix copper IUDs inserted for contraception as part of a clinical study. Thus leaving only a need for effective menstrual protection during high impact activities, on heavy days and while traveling where long intervals between emptying are necessary. An Ideal product for all women of reproductive age is the Diva cup.

So this week I’ve been teaching a group of three girls who just reached menarche how to correctly insert a Diva Cup so it doesn’t leak and how to tell by feel and experience when the cup needs emptying by how heavy it feels, and the interval difference between light and heavy days. With just a little practice they became proficient at insertion and removal and now they love their Diva Cups!

Insertion is a several step process. First before preparing any vaginal device for insertion wash your hands. Then it’s a matter of folding the cup for insertion, spreading the labia, pushing it partly in horizontally toward the tailbone then letting it spring open. Once it’s in the ringed bottom of the cup is grasped and rotated one full turn to ensure it is fully open and seals properly. During the full turn it should rotate smoothly an indication that the cup is fully open. Then push it further in until the stem is just inside the vagina where it can be easily grasped for removal.

The Cup should sit low in the vagina away from the cervix. Placed higher it might leak and it could interfere with the strings of an IUD. Once they are confident that the cup fits properly and they can insert it correctly so it doesn’t leak they can do away with their tampons and panty liners and not have to worry about using a Milex diaphragm for flow control that was tricky to empty w/o spilling the contents… unless they want to use the diaphragm for flow control during menstrual sex. The students are so excited to have reached menarche and get their first diaphragms and menstrual cups as now they are biologically adult and their reproductive years have begun.

For removal the ringed bottom of the cup can be gently pulled to break the seal. If that isn’t successful then insert a finger between the vaginal wall and the cup to break the seal and then gently pull it out grasping the ringed portion of the lower dome while sitting on the toilet. Then it should be washed in a mild unscented soap in warm water dried and reinserted. The cup can darken with use and may be boiled for 10 – 15 minutes if it develops an odor.

Forcing Kassi’s period, an update: On Tuesday Oct 7 she took her first 5mg Norethindrone tablet. She will continue for nine more days stopping on Oct 16th when I will be CD27. That should cause her to spot on the 17th and start bleeding (her new CD1) on Saturday the 18th when we all should be CD1.

Kassi and fellatio:  Even though she has had her Gardasil shots there is still a chance of an HPV strain causing throat cancer a few years in the future so unless the men are screened the safest thing to do is to suck a man off while he is wearing a condom. The bar-condom brand we offer at our clubs is the latex LifeStyles ultra sensitive non-lubricated. That way the fellator just gets the scent and taste of the latex.

I’m teaching Kassi a trick that men love when it happens to them.  It’s part of my course in Contemporary Sexual Health that I teach at St. Lucy’s. If I’m with an uncut man who is known to have a safe sexual history when he’s just about ready to cum it’s always fun to bite through the reservoir tip and force his glans through the hole in the ruined sheath. Then skin-on-skin I manipulate his frenulum with my tongue with his glans forced tight against the roof of my mouth so that just before he comes he’s gasping and trying to shove his shaft down my throat.  But – and this is important or you can start gagging with your air cut off - I have my hand around the base of his shaft so no matter how hard he thrusts he can only spew in my mouth where I can taste his semen and easily swallow it as a nutritional supplement.

Next of kin

A 40 foot Bristol sloop

The arrival: The authorities in Spanish Town contacted us by radio and told that Sailor Girl’s  older sister, Miranda, and her partner would be arriving in the cove aboard her 40’ Bristol Sloop, the Sell Short. Then Miranda radioed that they should be expected on Wednesday after a stop in Spanish Town to identify the body of her sister, Veronica and get it released to the family by the authorities. The Sell Short didn’t appear in the cove until very early Friday just in time for breakfast as they had to re-stock provisions after arriving from Bermuda and take care of funeral arrangements. They had begun the leisurely sail several weeks ago intending to meet Veronica in Spanish Town for several weeks of diving when they were contacted by radio to notify them of her death.

The family: Veronica (Roni) was 26 and working on her masters in marine biology at Florida State.  She had been working for the summer as crew on a large rental yacht out of Spanish Town. Miranda is 31, has a PhD in finance from the Wharton School and is a vice president in a small but highly regarded Wall Street Merchant Bank. Her partner, Ralph, is a 32 y/o bond trader for J.P Morgan; both are avid sailors and excellent swimmers. Miranda is a petite blond with a lovely figure (isn’t that always the way) and Ralph is a rugged 6’2” with magnificent shoulders a gloriously hairy chest, superbly proportioned thighs and buns and washboard abs. An absolute hunk he stirred my carnal interest immediately.

A change in plan: From Miranda’s superior attitude during our radio conversation I had taken an immediate dislike to her.  So when I saw Ralph I decided I would seduce him taking him from her temporarily while she was in her bereavement when I thought she would need him the most. I needn’t have bothered. He fell into my lap!

From the way Miranda acted she and Roni hadn’t been close at all and her death was a mere inconvenience.  Given the circumstances I was amazed that both Miranda and Ralph had roving eyes which I spotted immediately since Ralph didn’t try to hide that he was staring hungrily at me and Miranda seemed fascinated by Chris, the Brit Gyn who always accompanies us on vacations. Perhaps on a long sea voyage Ralph and Miranda had gotten bored with one another or were both looking for a little variety in partners. Whatever the reason Ralph definitely wanted me. And Miranda who sat next to Chris at breakfast couldn’t keep her hands off him. Given that Miranda was supposed to be bereaved she hid it extremely well.

With seduction in mind I had dressed for our meeting wearing a bright yellow swimsuit intended to offset the sadness of the occasion and accent my dancer’s body as I showed the bereaved couple around my villa before breakfast which was when I told them how Cyndi and I had found Roni. I wore a custom made canary thong bikini by Gottex and for Ralph’s benefit took off my pareo to display my legs while showing the villa intentionally preceded them up a long flight of stairs on pointe in yellow satin Grishko 2007 toe-shoes, an ability which I use to test an interesting man’s concentration. He tried to hide his interest as he struggled for control, but I turned as I reached the top and immediately spotted the change in the drape of his shorts. I smiled at him and he returned my smile. Miranda was looking off the stairway at the chandelier hanging from the three story high ceiling so she missed our visual exchange.

Or perhaps she was intentionally looking away as my tight buns and contracted calves (far better than hers) were swaying in front of her lover as we climbed the two long flights of stone steps and she recognized the effect I was having on Ralph. By the time breakfast was over he was in thrall to me and she was talking primarily to Chris while occasionally stroking his hand or putting her hand on his thigh as she hung spellbound on his every word in answer to her questions about his medical  training in the UK. Watching him seduce her was like watching a mongoose hypnotize a cobra. Not that she was at all dangerous.

Roni’s cause of death: Miranda and Ralph had brought along a few of Roni’s things off the sloop she sailed into the bay as well as the personal items off her body as Miranda said she had questions about some of them. Veronica’s rings and All-Flex were there, but not the inserted tampon which I suppose the police kept for DNA analysis and possible match. The doctor acting as coroner said she wasn’t pregnant. He said that, as I guessed from the blood in her throat when we got her aboard, she had a rare pulmonary aneurism which burst. He thought it probable that the strain her body had been under from a very tiring series of recent long deep dives (recorded on her dive computer) contributed to the aneurism rupturing. She bled to death or drowned in her own blood either of which would take only a short time to kill her. Apparently she had had the aneurism for some time though Miranda said she never heard her complain about chest pain in any of their conversations.  

Personal effects and plan comes together: Miranda asked wistfully about the kinky rimmed All-Flex, asking why it was bent like that and why there was no spermicide in Roni’s slit kit if she was using a diaphragm. The answers to her questions are that the All-Flex was kinked from water pressure and was the wrong rim style to use for dive-sex because the rim would distort below 10 meters. There was no spermicide because she was on the pill and was using the diaphragm only for flood insurance. Miranda mentioned several times while handling the bent All-Flex that Roni had been going to teach her how to protect her upper reproductive tract during underwater sex and she and Ralph had been so looking forward to the dive-sex experience.

That gave me the opportunity I was looking for to explain about the proper equipment to provide upper reproductive tract protection at depth and to offer to teach them myself with Chris’ help. Doing that would solve two problems simultaneously; letting me fuck Ralph’s brains out under the guise of training, while giving Miranda an excuse to be with Chris who would teach her the fine points of dive-sex while fucking her brains out which she so obviously and desperately wanted, perhaps as bereavement release if not just for the pure carnal pleasure of it. 

The business of pleasure: I explained that Chris could fit her with the correct type and size diaphragm then act as her trainer for a dive-sex lesson and she was all smiles as she agreed. What woman hasn’t wanted to fuck her male Gyn, right? Which, afterward she confided to me had been her fantasy since her first pelvic. But first we needed to take care of checking everyone’s sexual health. I accessed Chris and my health records at our Vegas clinic and printed out copies of our current negative full STI panel results. I also printed out copies of Cyndi and Bea’s Full STI panels just in case they had an opportunity to be with Ralph. Then Miranda and Ralph accessed their medical records held by their primary care physicians and printed copies of their most recent full STI panel results. That’s at least one good thing to come from digitalizing medical records. I was interested to see that both of them had all three of the Gardasil, HPV vaccine, shots just as I and my circle of men as well as women friends have even though both are outside the target population, girls and boys from ages 9 to 26. But with oral sex now being the cause of so much throat and rectal cancer I think it is beneficial for older adults to minimize their chances of HPV related infections. And Miranda was so pleased about having Chris all to herself that she didn’t ask why I was showing Cyndi and Bea’s STI panel results to Ralph.

Once everyone was assured that we were all STI free it was a simple matter for Chris to fit Miranda with a 70 mm Reflexions and show her how to insert and remove it correctly in the exam room I have set up for his use in my villa. She is using the single rod etonogestrel implant Nexplanon for contraception so assuming she watches her meds the progestin should suppress her ovulation and she can use the Reflexions w/o spermicide, but with a good quality silicone lube strictly for flood insurance unless Fred likes the feel of the stretchy dome as his thrusts force it into her anterior fornix and wants her to wear it all the time.   

Training dives: Miranda and Ralph’s used their own SCUBA gear except tanks which I provided.  Their training went very well after we got them to concentrate on taking full breaths and exhaling completely before taking the next breath. Hyperventilating is a common problem when divers are nervous or concentrating on a task and don’t empty their lungs before taking the next breath. It’s a very common problem when new to dive-sex. I thought they should have already known about how to avoid hyperventilating, but since they were both into new partners and a new sexual experience perhaps they forgot.

After 45 minute session in the villa’s swimming pool we found that Chris could massage Miranda’s G-spot and thrust into her anterior fornix giving her massive orgasms. She was sucking so much air that I decided to give her an 80 cu ft. tank rather than the 60 when we went into the cove. Also in the pool I found that Ralph’s pelvic equipment was marvelously thick while being just long enough to reach into my anterior fornix when I was aroused and he was about to ejaculate. If I have to choose between thick or long I’d much prefer thick and so I was very pleased with his equipment, but not initially with his performance. It was as though he hadn’t had much experience pleasing a woman with his penis so I adjusted my hips and tightened my legs around him to direct his thrusts where they would do me the most good and after a few minutes he caught on. Then he was magnificent with his pile-driving butt pounding away and his recovery time was very short. I actually had to stop him in the pool so he would save his ardor for sex at depth in the cove.  

Dive-sex in the cove: We took the Zodiac out in the cove and showed Miranda and Fred the spot where we found Roni’s body. The girls wore bikinis and the guys slingshots and dove briefly to the bottom (60 feet) there for them to look around before moving out of the lava tube to tether pointes elsewhere in the cove where the water was shallower (25 feet) and much warmer so the men could perform w/o having performance anxiety. I went over tethering again as I had in the villa swimming pool, showing them how the women use the ankle leashes on each ankle to tether ourselves to the anchors then inflate our BCs to hold us with our legs spread wide and the leashes tight because of our positive buoyancy so our partners have a relatively stable target.  I showed Miranda how to apply a 10 ml disposable applicator of DiveGel+ while tethered. With dive sex, especially in the salty water of the ocean there is no such thing as having too much silicone lube. Because once your delicate vaginal lining becomes raw the salt water burns like fire and you have to surface and rinse out with a water/vinegar douche and are out of action for a few days until you heal.

Burial at sea: Miranda invited us aboard the Sell Short and Ralph raised the anchor and took us out into North Sound. She prepared a cold lunch of lobster and shrimp after which she invited us to walk aft and there presented each of us with an orchid blossom. On the afterdeck on a small teak table sat a small cardboard box containing Roni’s ashes. Miranda read parts of the funeral service from the Episcopal Book Of Common Prayer and then with the breeze off the starboard quarter opened the box and poured the ashes into the sea and threw her orchid blossom after them and we all tossed our orchids after hers. Miranda said she was returning her sister to the ocean she had loved so much. Once the burial was completed Ralph took us back into the cove and anchored again. I had no idea that the authorities would release a body that quickly. One assumes they kept enough evidence to open an investigation if questions should arise, but with a burst aneurism the cause of death was undeniable. 

Afterward: Miranda stayed on board the Sell Short with Chris for rest of the afternoon while Ralph came ashore with me to meet and have dive-sex in the pool with Cyndi and Bea. They both enjoyed taking a new man who was so well hung and who they could impress with the strength of their pelvic muscles. Cyndi had wanted to wear Roni’s black rubber swim-skin, but fortunately she mentioned the idea to me first and I nixed it. No one had asked why it was missing or they may not have known, but there was no reason to flaunt a souvenir in front of the donor’s relatives lest someone remember. That evening I tool Ralph back to the Sell Short and an hour later Cyndi, Bea and I were still draining his semen while we watched the Sell Short's navigation lights disappear as it sailed for St John in the USVIs.

The temporary swap of partners for training was an ideal solution letting us girls burn off a lot of estrogenic lust with a new man w/o adding him to my circle while Miranda got to enjoy Chris before going back to being submissive enough to eventually capture Ralph as her husband if she wants him. After all he is the eldest son of an extremely rich industrialist and superb marriage material, which may help explain why Miranda didn’t keep him on a much tighter leash.

Gardasil moves closer to approval for boys

Proposed HPV vaccine for boys

CDC Panel Votes to Extend HPV Vaccine to Young Boys
By LARA SALAHI and JANE E. ALLEN
October 25, 2011 Good Morning America

“All males starting at age 11 should receive the HPV vaccine Gardasil to protect themselves against sexually transmitted forms of human papillomavirus, the cause of most cervical and anal cancers as well as most mouth and throat cancers, a Centers for Disease Control and Prevention advisory committee voted today.

Thirteen members of the committee voted in favor of extending the HPV vaccine recommendation to young boys, and one member abstained. The recommendation now goes to the director of the CDC and the secretary of the U.S. Department of Health and Human Services for final approval.

The CDC already recommends routinely immunizing girls with a three-dose vaccine beginning at age 11 or 12, before they become sexually active, although they can be vaccinated as young as age 9. The agency previously issued a so-called permissive recommendation giving boys and young men from ages 9 through 26 the option of receiving the vaccine.

The prospect of requiring that preteen boys and girls get vaccinated against a sexually transmitted infection has drawn the sharpest outcry from some parents, who fear that vaccinating preteens might encourage promiscuous behavior. Vaccination policies also have become an issue in the 2012 presidential campaign, with several GOP candidates objecting to mandates for HPV vaccination.

Many infectious disease specialists welcome universal vaccination as a key tool in reducing the toll of preventable diseases.

"Vaccination is perhaps the greatest invention of medicine," said Dr. John Sinnott, director of the Division of Infectious Disease at the University of South Florida. "It is a tragedy that this vaccine has become politicized." But Dr. Lawrence Stanberry, chief pediatrician at New York Presbyterian Morgan Stanley Children's Hospital, said parents support universal recommendations more recommendations targeting groups at higher risk.

"Recommending universal immunization for girls and making the recommendation for boys permissive sends parents mixed messages," Stanberry said. He offered a fairness argument for recommending vaccinations for both sexes. "Girls acquire the infection from boys and it seems appropriate, even fair, for boys to share responsibility for maximizing community [herd] immunity," he said.

Nearly a dozen experts contacted by ABC News cited "herd protection" from HPV-associated diseases in both women and men as a main reason they supported universal immunization.

William Muraskin, an urban studies professor at Queens College in New York, said it's hard to determine which men and women will benefit directly from vaccination. "The HPV vaccine if given before males become sexually active will also protect those who will become homosexual or bisexual," Muraskin said. Routine vaccination of all young men protects "an important subgroup that otherwise will be at significant risk but cannot be identified until it is too late."

The panel is expected to issue a policy statement on the importance of vaccinating men who have sex with men, because of the risk they could develop anal cancer from HPV.

Two HPV Vaccines on The Market Protect Against Multiple Strains

There are two HPV vaccines currently available, both of which protect against the two principal cancer-causing types of HPV, HPV 16 and HPV 18. By CDC estimates, the two strains cause 15,000 malignancies in women and 7,000 in men every year. The two strains account for an estimated 70 percent of cervical cancers, about 70 percent of vaginal cancers and most vulvar cancers. HPV 16 by itself causes 85 percent of anal cancers.

In addition to protecting against HPV 16 and HPV 18, Merck's Gardasil protects against two other disease-causing strains, HPV 6 and HPV 11, responsible for 90 percent of genital warts as well as cervical cell changes. GlaxoSmithKline's Cervarix protects against HPV 16 and HPV 18, but also has been found to confer some protection against three other cancer-causing strains, HPV 31, HPV 33 and HPV 45.

Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research Group at the University of Missouri-Kansas City called it "misguided to think that all boys will gain any health benefit from HPV vaccination."

She contended that "mass vaccination for the prevention of the other HPV-associated cancers puts large numbers of people at risk for harms from vaccination compared to both the personal and public health risk of anal, penile, and oropharyngeal cancers."

In a background memo leading up to the vote, the CDC estimated that routinely vaccinating 11- and 12-year-old boys would likely be cost-effective. If 1 million 12-year-old boys were vaccinated, over the course of a lifetime, they would prevent 2,381 cases of mouth and throat cancer; 633 cases of anal cancer and 169 cases of penile cancer, assuming the vaccine was 75 percent effective against those conditions.”

Personal Comment: I’m so pleased that the CDC will probably recommend Gardasil for boys! All the men in our casino’s escort training program are required to have completed the entire three injection series of Gardasil vaccine before completing the course. And male escorts used as lab instructors for St Lucy’s students (in AST as well as the more vanilla Contemporary Sexual Health) must have completed the full injection series before they can become a trainer at St Lucy’s.

The pill and sexual satisfaction

A combined birth control pill dial-pack


The Pill decreases Sexual satisfaction, but Boosts Relationship Happiness

Popping a birth-control pill could significantly impact your long-term relationship choices, new research suggests.

Comparing the relationships of women who were on the pill when they met their partner with those who weren't, researchers found that pill users were less sexually satisfied, but happier overall with their relationships than women not taking birth control when they first met their mate.

"These results are in line with what we and other groups have seen in the lab," study researcher Lisa DeBruine, of the University of Aberdeen, told LiveScience in an e-mail. "Although they're less sexually satisfied, they are MORE satisfied with nonsexual aspects of their relationship, including a partner’s financial provision and support."

Polling the pill

The study, performed by lead author Craig Roberts, of the University of Stirling in the U.K., polled about 2,000 women from all over the world, including the U.S., U.K. and the Czech Republic. The average age of the women was around 37, and to make sure the levels of relationship commitment were comparable, they were asked about their relationships with the fathers of their first children.

The women filled out surveys about their relationships and sex lives. Oddly, these couples who met while the woman was on hormonal birth control were also more emotionally satisfied and were more likely to stay together, on average about two years longer. If those couples did separate, the break-up was more likely to be initiated by the woman.

While the nonsexual parts of their relationship were satisfying, these women showed increasing sexual dissatisfaction during their relationships, while there was no change in nonusers. This increasing sexual dissatisfaction could lead to a tipping point between emotional and financial satisfaction and a desire to be sexually satisfied, the researchers suggest.

Pill use and attraction

Though the biology behind this phenomenon is unknown, DeBruine believes it's most likely related to the hormones found in the pill used to control fertility. "The biological mechanisms are almost certainly linked to hormones," she said. "Hormones influence our bodies and behavior in many ways, so we're still researching exactly how hormones affect mating behavior."

These hormones influence what characteristics women are attracted to in a mate. Studies have shown that a main component of attraction is a desire to find a genetically dissimilar partner, specifically in genes called the major histocompatibility complex (or MHC) that are involved in the body’s immune system. Having a large selection in these genes improves the immune system and can make for healthier offspring in the long run.

When women are on the pill, however, they are in an "eternally pregnant state," meaning they aren’t ovulating and may be wired to instead to seek out genetically similar men — essentially, the genetic equivalent of a relative — because evolutionarily, family would help raise the baby. This desire for genetically similar men was found in a study published in the journal Proceedings of the Royal Society B: Biological Sciences. That same 2008 study found that women not taking hormonal birth control prefer genetically dissimilar men and those with higher testosterone levels and more masculine features.

And supporting the lower sexual satisfaction in birth-control couples, previous research has indicated that females with genetically similar partners express lower sexual satisfaction and have a higher interest in having sex with someone who isn't their partner; essentially, they think about cheating.

Though the new study didn't test genetic similarity, they found that women who had been on a progesterone birth-control pill when their relationship started expressed sexual dissatisfaction and desire to cheat.

Complex relationships

Jonathan Schaffir, a doctor at Ohio State University Medical Center who has studied the link between hormonal contraception and sexual desire but who wasn't involved in this study, suggested that trying to tease out the effect of hormonal birth control on something as complex as mate choice can be misleading.

"It's not likely that a small change in a single biological parameter will make a big difference," noting that the differences the study found, while statistically significant, were small. He said a forward-looking study, or an investigation of possible biological effects of the hormone treatment would have been more convincing. [The History and Future of Birth Control]

"This type of retrospective study cannot fully explain all of the complex processes that shape relationships," DeBruine told LiveScience. "Our findings do suggest that these processes play out slightly differently in women who were and were not using the pill when they met their partner."

Schaffir worries about how women might interpret these findings. "Sometimes people give good forms of birth control a bad name by suggesting that they might have [these kinds of] effects," Schaffir told LiveScience. "I don't want women to have the impression that they shouldn’t use reliable birth control because of dubious psychosocial effects."

The study was published today (Oct. 11) in the journal Proceedings of the Royal Society B: Biological Sciences.

Personal comment: Students at St Lucy’s have always been counseled to use effective methods of non-hormonal of contraception where possible as we feel young women should be able to experience the full range of their femininity available only though the ebb and flow of their natural hormonal cycles. Hormonal contraceptives are only used to treat heavy or painful periods, acne or other conditions where appropriate.

HPV-Related Throat Cancers Increasing, Study Finds

The percentage of throat cancers caused by the human papillomavirus has increased significantly in the U.S. since the 1980s, according to a study in the Journal of Clinical Oncology, the New York Times http://www.nytimes.com/2011/10/04/health/research/04hpv.html?_r=2&ref=health reports. HPV type 16, which also causes many cases of cervical cancer, is sexually transmitted, including during oral sex.

For the study -- which was funded by the National Cancer Institute, Ohio State University and the Oral Cancer Foundation -- researchers tested tumor samples from 271 patients diagnosed with throat cancers between 1984 and 2004. About 16% of samples from the 1980s found strains of HPV, compared with nearly 72% of cases found after 2000. Overall, throat cancers caused by HPV increased from 0.8 cases per 100,000 people in 1988 to 2.6 per 100,000 people in 2004, the study found.

According to the Times, there are fewer than 10,000 cases of throat cancer annually, and most people with HPV do not develop cancer. HPV-related throat cancers are more treatable than those not caused by the virus. People with throat cancers caused by HPV have a median survival of 131 months, compared with 20 months for people whose cancers are not related to the virus (Grady, New York Times, 10/3).

Risk Highest Among Men

The study found that the risk of HPV-related throat cancer was greatest among men, though the researchers did not determine why. According to the AP/Washington Post http://www.washingtonpost.com/national/health-science/healthbeat-study-finds-cervical-cancer-virus-is-fueling-rise-in-type-of-oral-cancer-too/2011/10/04/gIQAZXL5JL_story.html?wprss=rss_national , the incidence of oropharyngeal cancer has risen 28% since 1988, even though the incidence of other types of head-and-neck cancers has been decreasing.

An HPV vaccine is approved to protect against cervical cancer in girls and women and to protect against genital warts and anal cancer in both sexes. Maura Gillison, a head-and-neck cancer specialist at Ohio State University and senior author of the study, said protection against oral HPV has not been studied in either gender. A spokesperson for Merck, which makes the HPV vaccine, said the company does not plan to conduct an oral cancer study.

She said that oral cancer always has been a bigger threat to men than women and that women's incidence is steady while men's is rising. Women account for about 25% of oral cancers, which could suggest that gender differences in sexual behavior play a role or that the virus stays in men's bodies longer (Neergaard, AP/Washington Post, 10/4).

Personal comment: All of the casino’s escort trainees (both male and female) and St Lucy’s students are required to have had the full series of Gardasil injections and for the women routine pelvic exams including pap tests are scheduled in addition to full STI panels for the sexually active St Lucy’s students. This well-woman care has virtually eliminated most health risks associated with their assertiveness training.

Pointes, pain, gas masks and Gardasil

The US Army M40 Gas Mask

Pointes, pain and eroticism: I was chatting with a friend this morning while I was doing pointe maintenance. He has a new master at work who requires him to do a lot of physical training and he was just back from a session that worked his arms until he could hardly use them for much other than keyboarding.

I was telling him about a ballet teacher in school who was like that. In her pointe classes she kept us on our toes forever until most of us were bleeding regardless of how well our toes were taped or what padding we used in our shoes. The good news was that those of us who survived Miss Willoughby’s classes were much better and stronger dancers and some few of us found we enjoyed the pain. I think pain caused by standing en pointe is erotic! Of course you have to come off pointe occasionally or your toes go numb and you lose sensation. Toes going numb can be a blessing if you are trying to get through a long and difficult piece of choreography w/o mistakes, especially toward the end where your leg muscles are burning. But if you are into pain for pleasure as I sometimes am (usually at the end of my cycle when I’m nearing my period) I find it's best to come off pointe every 8 to 10 minutes to keep the pain going during the entire sexual encounter, class or rehearsal where I’m using pain for pleasure or as a performance tool.

Men in gas masks: My friend is into gas masks and his fave is the M40 currently used by the US Army. [The M40 is pictured in the image accompanying this entry.] Most of my circle both men and women wear Mestel SGE 400 gas masks for fetish-sex so I’ve been penetrated by a lot of men in Mestel gas masks, but I’ve had sex with guys who were wearing Israeli or Russian masks they got from surplus stores or on-line and a few in the Czech M10 with cheek filters. The men say they enjoy wearing a gasmask for sex because it makes them look scary and conceals their identity while causing dread in their partner. I like guys in gas masks because it makes it harder for them to breathe when they are fucking me and I love to see the man sweat and the lenses of his mash fog up as he begins to thrust more urgently when he nears orgasm.

HPV Vaccines in Canada: “Gardasil, a vaccine against human papilloma virus (HPV), has been approved as a treatment to prevent genital warts in males aged nine to 26 in Canada, the vaccine's manufacturer said Tuesday.

Health Canada approved Gardasil to prevent infection caused by human papilloma virus Types six, 11, 16, and 18 and genital warts caused by HPV types six and 11.

HPV is the most common sexually transmitted infection in Canada, said Merck, the vaccine's manufacturer.

In 2006, Health Canada approved Gardasil to prevent cervical cancer and genital warts in females aged nine to 26. All provinces and territories now offer school-based programs using Gardasil, which works best if given to females before they become sexually active.

Two weeks ago, GlaxoSmithKline announced that Health Canada has approved its HPV vaccine, Cervarix, in girls and women. Cervarix protects against three other cancer-causing strains, HPV 31, 33 and 45.

In most people who develop genital warts, the infection clears up on its own. For some women, the infection persists and can lead to cervical cancer.

A study published last year in the Journal of the American Medical Association concluded that Gardasil in females has a safety record on par with other vaccines.

In January, researchers in Montreal published a study in the journal Sexually Transmitted Diseases showing 56 per cent of young people in a new sexual relationship were infected with at least one type of HPV.

The federal government announced in its March 2007 budget that $300 million over three years will be available to the provinces and territories in support of a national HPV vaccination program for girls and women.

It is up to provinces and territories to recommend vaccines for use within their jurisdiction. Doctors may also prescribe any approved vaccine.

An estimated 40,000 new cases of ano-genital warts are diagnosed each year in Canadian men and women”.

Our Holidays hospital tour

Sensational! When only the best will do

Our Christmas: For the last few days Anya, Taryn, Peter and now Robin and I have been traveling. We are visiting military hospitals entertaining the wounded men, and women. With the sort of entertainment we provide we have to be low-key about publicity so we don’t get the hospital administrators in trouble. I may write about it when it’s over. Security is much tighter since the Fort Hood incident. We will have a quiet Christmas at home and then go to a few more locations before ending our 2009 tour. Of course there isn’t much chance for screening our partners so we are going through a lot of Trojan Naturalamb condoms. They are expensive but in the quantity we buy them we get a nice discount and they give our partners the most natural experience possible while still being protected. We special order them unlubed so we can roll a latex condom on over it to protect ourselves (and our partners - but the concern is mainly with the unknown sexual history and health of our military partners) against HIV while giving our male wounded warriors the most intimate experience possible. For the women, Peter and Robin roll on a latex condom first then the Naturalamb is slipped on so the women also get the most natural sensation from the lamb skin. Unlike double bagging with latex the Naturalamb/latex combination does not have a higher burst rate. Usually, with civilians, there is some whining on the part of guys about not being able to perform while wearing a condom. Perhaps it’s the circumstances they find themselves in but all the military men who have been our partners (there is a lottery) have been able to perform very well while wearing the lambskin/latex combination. We don’t do anything kinky, it’s just good plain vanilla sex with the girls in pointe shoes (Freeds or Gaynors) or ballet boots. For the guys who can’t get out of bed we will ride astride and that has worked very well. In a few instances we will also give head since all of us have been vaccinated for HPV (with Gardasil) so there is very little chance of getting HPV related throat cancer.

Some of the female wounded have asked Robin and Peter to take them bareback as they want to get pregnant, but as much as our guys would love to honor a wounded partner’s request, for safety reasons they really can’t. Of course we phrase it so it’s the woman’s safety we are concerned about. Plus, there would be a huge stink if DNA testing showed one of our guys was the father and counting back – and you know how people love to count - it was found that conception occurred during our entertainment tour visit. The fact that pregnancy is a get-out-of-the-service-free ticket for a woman is another reason we don’t want any of our guys getting active duty women preggers. The military has enough retention problems as it is w/o us contributing the losses.

Misuse of cervical barriers: For women who are not trained in their use or seriously committed to avoiding pregnancy there continues to be a high rate of unintended pregnancies while using a diaphragm or cervical cap. I don’t really think of the barrier as being any less effective, it’s that the user is noncompliant in their use and reproductive biology is intolerant of cutting corners and just-this-once risk taking, especially by young fertile women.. This sort of behavior seems to be especially prevalent in women into the vaginal rubber aspect of a latex fetish lifestyle. My classes for newbie vaginal rubber-girls is helping reduce the failure rate, but there are some women who wanted to get off hormones who were happy to start using a cervical barrier but who aren’t interested in using it correctly and then are upset when they get preggers. Go figure! I expect some of that in teens, but it’s even true with rubber-chicks in their 20s and older who should know better. In my classes we first steer the girls to a knowledgeable and supportive fitter. If the device doesn’t fit correctly its effectiveness is greatly reduced. You would think that would be obvious but you would be surprised at the number of women who want to use a friend, room mate or sisters diaphragm or cap rather than being properly fitted with one of their own. Then we try to emphasize the importance of establishing a wearing regimen as a habit so the wearer isn’t caught unprotected whether for contraception or using the device as a gas guard to protect against embolism during dive-sex or when playing with compressed gasses. And, we try to get them to involve their partner’s in the use of the barrier, learning how to insert it and to check that is positioned correctly to protect the wearer’s cervix. We’ve found a partner showing interest in his girl’s cervical barrier is a major help in keeping the woman compliant.

Wishing all my readers a very Merry Christmas!

HPV vaccine for men

Boy getting his shot

CDC Advisory Committee To Weigh Whether To Recommend Vaccinating Boys Against HPV

“October 21, 2009 — The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices on Wednesday is scheduled to consider whether to recommend vaccination of boys with Merck's human papillomavirus vaccine Gardasil, NPR's "All Things Considered" reports. Both men and women can be infected by HPV, which can lead to genital warts, cervical cancer in women and other genital cancers in both sexes (Wilson, "All Things Considered," NPR, 10/20).

Since 2006, Gardasil has been approved for use in girls and women to prevent two strains of HPV -- types 16 and 18 -- that cause about 70% of cervical cancer. Gardasil also protects against two other strains of HPV that cause 90% of genital warts. Last week, FDA approved GlaxoSmithKline's Cervarix for use in girls and women ages 10 through 25 to prevent cervical cancer, and it expanded approval of Gardasil to include boys and men ages nine through 26 for protection against genital warts. Cervarix does not protect against genital warts, though there is evidence showing it protects against another HPV strain closely related to types 16 and 18 (Women's Health Policy Report, 10/19).

On Wednesday, the advisory panel will focus on whether it is cost effective to vaccinate boys against HPV. Neal Halsey, a professor at the Johns Hopkins Bloomberg School of Public Health, said the best way to control transmission of HPV "would be to immunize both men and women, boys and girls." He added that the "right thing to do -- from a scientific standpoint, ethical standpoint, in terms of shared responsibility -- is to immunize all boys, all girls."

However, a recent Harvard University study found that vaccinating boys is not cost effective if most women are vaccinated. The cost savings associated with vaccination of boys and men are affected by how many girls receive all three doses of Gardasil, which is priced at about $130 per dose. Vaccinating boys would do more to help curb the spread of HPV if very few girls are vaccinated. CDC surveys show that 37% of U.S. girls ages 12 through 17 have received one dose of Gardasil. In comparison, nearly 80% of girls in the United Kingdom have received the HPV vaccine, and there is no intent to immunize boys.

Merck's Erik Dasbach said that vaccinating boys would be cost effective based on current vaccination rates among U.S. girls. However, the figure used to determine the vaccine's cost effectiveness in the U.S. also "accounts for the vaccine, and for screening cervical cancer, compared to all the cost that would be avoided by preventing HPV diseases," Dasbach said, adding that vaccinating boys would not be cost effective when examined through that model.

"All Things Considered" reports that many analysts had wanted Merck to delay seeking approval for Gardasil for girls in 2006 because it was still being tested in boys. This would have allowed Merck to offer the vaccine universally for boys and girls at a lower price, which analysts say would have been cost effective ("All Things Considered," NPR, 10/20).”

Personal comment: For the last two years our clinic has been vaccinating all young men screened for STIs as candidates for Escort training and as partners for St Lucy’s girls. There are no exceptions. Men applying for drilling rights through our screening program are required to have all their shots in minimum time. I think the cost effectiveness question for boys will resolve itself when Glaxo Smith Kline’s competing vaccine, Cervarix, comes on the market in a few months. It doesn’t make sense to pinch pennies when we are responsible for the sexual health of young socially prominent women.

Gardasil Vaccine Safety 8-20-2009

Gardasil Vaccine Safety 8-20-2009
Information from FDA And CDC on the Safety of Gardasil Vaccine

On August 20, 2009 the FDA published information on the safety of Gardasil vaccine. The full text of that publication is at:
http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/ucm179549.htm

Summary

Based on the review of available information by FDA and CDC, Gardasil continues to be safe and effective, and its benefits continue to outweigh its risks.

CDC has not changed its recommendations for use of Gardasil. FDA has not made any changes to the prescribing information for how the vaccine is used. In addition, FDA routinely reviews manufacturing information, and has not identified any issues affecting the safety, purity and potency of Gardasil.

Public health and safety are priorities for FDA and CDC. As with all licensed vaccines, we will continue to closely monitor the safety of Gardasil. FDA and CDC continue to find that Gardasil is a safe and effective vaccine that will potentially benefit the health of millions of women by providing protection against the types of HPV in the vaccine that cause cervical, vulvar and vaginal cancer, genital warts, and other HPV-related genital diseases in females.

Gardasil in the news, again

Merck's Gardasil Has Higher Rates of Fainting, Clots

The Wall Street Journal - Health
AUGUST 18, 2009, 4:15 P.M. ET
By PETER LOFTUS

“Recipients of Merck & Co.'s Gardasil cervical-cancer vaccine had higher rates of fainting and blood clots than those receiving other vaccines, but it doesn't appear to raise the risk of certain severe adverse events, according to a new safety analysis.

A separate article accompanying the safety study, published Tuesday in the Journal of the American Medical Association, criticized Merck's marketing of Gardasil, including the company's funding of education campaigns by professional medical associations, which the authors said didn't provide a balanced view of the vaccine.

The two articles add to questions about the safety, effectiveness and marketing of Gardasil, which have dogged the vaccine since its 2006 introduction.

Doctors have questioned how effectively the vaccine prevents cervical cancer, given that its regulatory approval was for protecting against two strains of human papilloma virus, or HPV, that can cause cancer, but not all cancer-causing strains. Also, the vaccine was tested in only a few hundred 11- and 12-year-old girls, which some doctors said was too small a number to declare it safe for that age group. Critics assailed Merck's efforts to get states to require HPV vaccination, a push Merck backed away from in 2007.

Gardasil sales have stalled over the past year after brisk growth initially. U.S. Gardasil sales for the first six months of 2009 declined 34% to $363 million. Merck has had a particularly tough time persuading women ages 18 to 26 to get the shot--which costs nearly $400 for the full three-dose regimen.

The shot is designed to prevent infection by some types of HPV, a sexually transmitted virus that can cause cervical cancer, rarer forms of cancer and genital warts. Merck is seeking regulatory approval to market its use in males.

The U.S. health authorities who led the safety review say the vaccine is safe, despite the higher rates of fainting and blood clots they identified. The vaccine's benefits and potential to prevent cervical cancer outweigh the risks, said Barbara Slade, the study's lead author and a medical officer in the immunization safety office of the U.S. Centers for Disease Control and Prevention.

But others urge greater caution among doctors and patients in deciding on Gardasil vaccination. Cervical cancer takes decades to develop, and there are established methods for detecting and treating it, said Charlotte Haug, editor in chief of the Journal of the Norwegian Medical Association. Ms. Haug, who wrote an accompanying editorial in this week's JAMA, called Merck's marketing for Gardasil "pushy" and "disturbing."

Researchers at the CDC and U.S. Food and Drug Administration analyzed more than 12,400 reports of adverse events following Gardasil vaccination that were filed between June 2006 through December. During this time, more than 23 million doses of Gardasil were distributed in the U.S.

About 6% of the reported events resulted in hospitalization, permanent disability or death, Dr. Slade said. This was a smaller percentage than other vaccines, and the 32 deaths weren't higher than would be expected among the vaccine's target population--females ages nine to 26. Plus, nothing suggested that Gardasil caused the deaths, Dr. Slade said.

Of nearly 1,900 reports of fainting, 200 resulted in falls that caused head injuries including fractures and dental injuries. Anxiety and pain from the shot may be causing the fainting spells, Dr. Slade said. The study's authors recommended health-care professionals keep recipients in the office for about 15 minutes after vaccination to mitigate fainting.

Blood clots were less common, occurring 56 times, according to the study. They included four deaths due to pulmonary embolisms. But the authors say the clot data should be viewed with caution because 90% of those with clots had other risk factors, such as being smokers or using oral contraceptives.

Rick Haupt, program lead for HPV vaccines at Merck's research arm, said the study supports Merck's view that Gardasil has "high efficacy" and a "favorable safety profile."

In the marketing critique, researchers from Columbia University wrote that Merck's strategy maximized the threat of cervical cancer to adolescents, minimized the sexual transmission of HPV, and "practically ignored" the sub-populations most at risk, including African Americans in the South, Latinos along the Texas-Mexico border and whites in Appalachia.

Merck, of Whitehouse Station, N.J., funded professional medical associations to help spread the word about Gardasil, including groups of gynecologists and doctors working at colleges. These groups developed lecture programs and other educational materials that, according to the Columbia researchers, "did not address the full complexity of the issues surrounding the vaccine and did not provide balanced recommendations on risks and benefits."

Spokespeople for the groups say their educational campaigns were developed with no oversight from Merck, and that the information used was consistent with recommendations by health authorities.

Merck said it provided about $750,000 to the three groups highlighted in the JAMA article to help improve understanding of HPV. Also, Mr. Haupt said, Merck's marketing focused on cervical cancer because two HPV types targeted by the vaccine are believed to cause about 70% of all cervical-cancer cases, and health authorities believe routine vaccination of adolescent girls will prevent many cases.”

Personal comment: There is no evidence in this research to suggest that Gardasil is more dangerous or less effective than the initial studies suggested. I think the most criticism is coming from religious conservative individuals or groups who are uncomfortable with anything that might protect women from the danger caused by some forms of HPV. Are there effective alternatives? In some cases there are, but not from genital warts if a partner is shedding cells. Do many women still die each year from cervical cancer? Yes, because they aren’t getting routine PAPs that will pick it up in time. Gardasil has a place as an effective vaccine for young women. As I’ve posted before all the students at St Lucy’s get the Gardasil vaccine as do all my female casino performers and escorts.

Start of cycle routine and HPV protection

A Milex Omniflex silicone contraceptive diaphragm

My start-of-cycle routine: It’s Thursday June 4, 2009 today and I’m CD28. Tomorrow is a pamper me day. I’ll have my menstrual extraction at the clinic first thing after class then I’ll go to Body Buffers for my Brazilian wax. I have an ME at the first of each menstrual cycle to shorten my periods from about five days to just a bit over two. That way I can wear an Oves cap for about 26 of the 28 days of my menstrual cycle and have deep dive-sex as much as I want. I’ve been calling the proceedure that sucks out my old endometrium a ME but I think it is closer to what is thought of as a electric vacuum aspiration (EVA) because of the special equipment that’s used and since it’s performed by my Gyn. I always take 800 mg of Ibuprofen an hour before my appointment and a pregnancy test is standard before we start so everyone knows where we are. It’s never been positive and I’m certain it won’t be tomorrow because my Oves is screwed so tight onto my cervix!

Even though it’s technically an EVA a small cannula is used so I don’t have to have my cervix dilated. An electric vacuum pump is used and my cervix fits in a cup that locks behind my pubic bone to keep the cervix stable. My cervix isn’t clamped. which could hurt but worse the clamp might cause a tear in the side of the cervix which would affect my ability to wear an Oves cap so I absolutely must avoid that! The proccdure isn’t really uncomfortable - though there is some pressure occasionally - and it’s worth the bother because, as I’ve mentioned, it gives me an additional three days of deep dive-sex.

The whole EVA process takes about 30 minutes and I gossip with my Gyn while she’s working so the time passes quickly. When she’s through I insert one of my Milex Omniflex (the Milex name for a coil spring rim) diaphragms to catch the greatly reduced menstrual flow for the next two days at the end of which I’ve stopped bleeding for that cycle. Then I can go back to wearing Oves again. While wearing my Milex I can have sex, even dive-sex but only down to 10m below which the rim of a D can start to distort due to water pressure.

GARDASIL HPV VACCINE


Merck & Co: Gardasil shows promise in older women

“Jun 03, 2009 A Colombian study has revealed that Merck & Co's cervical cancer vaccine Gardasil has a beneficial effect in women aged 24 to 45. However, following a ruling against the vaccine in June 2008, Merck & Co will first have to present 48 months of continuous study data to the FDA before it can be reconsidered for approval for use within this potentially lucrative market.

Gardasil protects against infection with human papillomavirus (HPV) types 6, 11, 16 and 18. While HPV6 and 11 are associated with genital warts, HPV16 and 18 cause approximately 70% of cervical cancer cases. The peak incidence of HPV generally occurs within five to 10 years of first sexual experience; Gardasil has been approved since 2006 for girls aged nine to 26 years, however, the vaccine does not protect those who have already been infected.

Gardasil is currently the market leader in the cervical cancer vaccine field, with global sales of $2.3 billion in 2008, although growth has slowed after strong initial sales in 2006-07 due to a less-than-expected uptake in the catch-up population. Aiming to extend the vaccine's market potential to additional age groups, Merck is seeking to expand its use to women aged 24 to 45 years. However, the FDA rejected a previous filing for this age group in June 2008, and has requested 48-month efficacy data, which are expected later this year.

Researchers at the National Institute of Cancer in Bogotá, Colombia have now reported data from a study investigating Gardasil in over 3,800 women aged 24 to 45 years. Study results indicate that women aged 24 to 45 years with no history of cancer-causing genital warts or cervical disease were significantly less likely to become infected with HPV if they received Gardasil than women who received placebo injections. After a mean follow-up time of 2.2 years, the efficacy of Gardasil in preventing disease or infection related to the vaccine serotypes was more than 90% in this age group.

Even if this study shows that Gardasil is of medical benefit to older women, full 48-month data will be required for the FDA to reconsider approval for the vaccine in this age group. In addition, more data is needed regarding the cost-efficacy of Gardasil in this population, particularly since screening of patients.

for existing HPV infection may be required, which would further increase the already substantial costs of the vaccine. In light of this, Datamonitor believes that while a future widespread recommendation of HPV vaccination for older women is questionable; this age group may become a promising private sector opportunity.”

Comment: Our clinic has been using Gardasil off label for the last year to protect women between the ages of 26 and 50. Once it has been established that the patient hasn’t been exposed to HPV then the three injection vaccine is very effective in reducing the likelihood of her becoming infected. Of course we have been using Gardasil since its introduction in 2006 for all our entertainers and St Lucy’s students and for male entertainers since last year. Our clinic will also provided it for both female and male UNLV students if they ask for it.