Fundamentals of Dive-Sex class, latex-grab

His condom burst! I’m fertile! I am SO fucked!

Casino dive-moms: Several women working in our casinos came to me asking that I teach a ‘Fundamentals of Dive-Sex’ course during spring break because they have daughters who will be taking courses at the University of Hawaii in Honolulu this summer and want to ensure they know how to protect themselves during an underwater sexual encounter. West coast girls have been taking summer courses at UH almost forever, but until recently there didn’t appear to be a need for gas-guards as underwater intercourse was fairly rare and if there were serious injuries none seemed to make the headlines. The students I taught will be at the University of Hawaii Manoa campus on the north side of H1 inland from Waikiki, but can easily get to the outer islands on weekend trips.

The Fundamentals of Dive-Sex course I taught included: Being fitted for FemCaps or Reflections flat spring latex diaphragms for use as gas-guards or as one student called her FemCap ‘Flood Insurance’, since its needed to prevent water being forced into the uterus if the vagina floods which, as returning readers know, is very common during underwater penetrative sex. I taught how to correctly insert their gas-guards, what lubricants to use and how to apply them and the use of Ben Wa balls for pelvic muscle toning. All the girls were on Yaz or Beyaz so I didn’t stress the normal need to use a spermicide with their cervical barriers, but they will be using DiveGel+ as their lube which has the O9 spermicide Semécide in it so that was covered. I also taught how to use the FC2 female condom – correct insertion technique and to make sure he reenters inside the sheath if he slips out - if for some reason they couldn’t use their cervical barriers for an underwater encounter.

Latex-Grab: Lastly I taught the girls about latex-grab. That’s where, if both partners are wearing barriers, a lot of their natural lubricant is trapped within each barrier and that is especially true for diaphragms since they cover almost the entire anterior wall of the vagina. An additional complication is if the woman is also on hormonal contraceptives. The progestin in hormonal birth control can dry up the normal vaginal lubricant for some women so that even when aroused they are relatively dry. In addition to the pain involved in having sex while not sufficiently lubricated, a potentially more serious problem is that the friction of the condom tip on the dome of the diaphragm can cause the condom to burst or pull the diaphragm off the cervix leaving her unprotected, or both. Latex-grab is particularly common when a couple is using both a latex condom and latex diaphragm though it can also occur with silicone diaphragms and polyurethane condoms.

The supplies: I provided each student with the necessary supplies for the course as well as what each should need for summer school. They were: a primary cervical barrier either the Reflexions latex flat spring diaphragm (because it is especially difficult to under-thrust) or a FemCap; two 25 count boxes of prefilled 10ml DiveGel+ disposable applicators; two doses of Plan B One-Step in case she forgets to take her pills. Plan B is better in their case since they will need to continue taking their regular birth control pills; a package of 10 FC2 female condoms, which are about $.90 each through our clinic. And since the students are dependents of casino employees they are covered under the casino’s reproductive health care insurance so they could be enrolled in the clinical trial to use DiveGel+.; and finally for the class each student was provided a set of (two individual) one inch diameter .6 oz Pyrex glass vaginal training balls.

Several needed to be SCUBA certified first and the five that ended up in the class I taught were very highly motivated and worked hard to get the technique down correctly so that if necessary they could teach their partners what they needed to get the most from the experience. It’s so nice when I’m working with highly motivated young women. The First summer session at UH Manoa is May 21 – June 29, and the second session July 2 – Aug 10, 2012 and my Vegas girls will stay for both sessions.

Label change for birth control pills containing Drospirenone: Birth Control Pills Containing Drospirenone: Label Change-Products may be associated with a higher risk for blood clots

“FDA has completed its review of recent observational (epidemiologic) studies regarding the risk of blood clots in women taking drospirenone-containing birth control pills. Based on this review, FDA has concluded that drospirenone-containing birth control pills may be associated with a higher risk for blood clots than other progestin-containing pills.” The full Safety Alert can be found HERE

The FDA Approved Oral Contraceptives containing Drospirenone are:

Drospirenone and ethinyl estradiol: Drospirenone 3 mg and ethinyl estradiol 0.03 mg
Ocella: Drospirenone 3 mg and ethinyl estradiol 0.03 mg
Safyral: Drospirenone 3 mg, ethinyl estradiol 0.03 mg, and levomefolate calcium 0.451 mg
Syeda: Drospirenone 3 mg and ethinyl estradiol 0.03 mg
Yasmin: Drospirenone 3 mg and ethinyl estradiol 0.03 mg
Zarah: Drospirenone 3 mg and ethinyl estradiol 0.03 mg
Beyaz: Drospirenone 3 mg, ethinyl estradiol 0.02 mg and levomefolate calcium 0.451 mg
Drospirenone and ethinyl estradiol: Drospirenone 3 mg and ethinyl estradiol 0.02 mg
Gianvi: Drospirenone 3 mg and ethinyl estradiol 0.02 mg
Loryna: Drospirenone 3 mg and ethinyl estradiol 0.02 mg
Yaz: Drospirenone 3 mg and ethinyl estradiol 0.02 mg

Increased clot risk for some hormonal birth control

Yaz birth control pills

FDA Details Clot Risk for Birth Control Products
By John Gever, Senior Editor, MedPage Today
Published: October 27, 2011

“Worrisome increases in thrombotic risk associated with hormonal contraceptives are not limited to those containing drospirenone, according to an FDA report issued Thursday.
Compared with hormonal contraceptives with relatively low estrogen doses, norelgestromin/ethinyl estradiol transdermal patch and etonogestrel/estradiol vaginal ring products were both associated with increased risk for venous thromboembolism (VTE), as were birth control pills containing drospirenone, according to the retrospective database analysis.

FDA researchers ran the analysis on records maintained by Kaiser Permanente for members in California and state Medicaid programs in Tennessee and Washington, covering a total of more than 835,000 women who received contraceptive prescriptions from 2001 to 2007.

After adjusting for demographic and other factors, the analysis indicated the following relative risks, with low-estrogen hormonal contraceptives as the reference:

• Drospirenone products: 1.74 (95% CI 1.42 to 2.14)

• Norelgestromin/ethinyl estradiol transdermal patch: 1.55 (95% CI 1.17 to 2.07)

• Etonogestrel/estradiol vaginal ring: 1.56 (95% CI 1.02 to 2.37)

Younger women (those up to age 34) appeared to be at higher risk for VTE for all three product types, the study showed.

And the clotting risk was not limited to VTE -- arterial thromboembolism was significantly increased among women 35 and older taking drospirenone products for the first time.

Thrombosis has long been a concern for hormonal contraceptives of all types and doses. But a number of studies have suggested that the risk differs among the multitude of product types now available.

Drospirenone came into the FDA's crosshairs earlier this year when two studies found that the VTE risk was doubled or tripled relative to levonorgestrel-containing pills.
Previous studies had also identified possible increases in risk associated with the patch and vaginal ring products, although the FDA had not formally announced a safety review, as it had done for the drospirenone products.

All of the previous studies were relatively small and fell short of the quality needed to form the basis for regulatory action, the FDA indicated.

Late last month, after reviewing the preliminary data from the Kaiser/Medicaid analysis, the agency said it still had not reached a conclusion about the degree of risk. That remains the case, according to the FDA this week.

It plans to present all the data to its Reproductive Health Drugs and Drug Safety and Risk Management advisory committees at a joint meeting on Dec. 8.”

Personal comment: Birth-control pills that contain drospirenone include Bayer's Yaz, Yasmin, Beyaz, Safyral; Sandoz's Syeda and Loryna; as well as Barr Laboratories' Ocella, Watson Pharmaceuticals' Zarah and Teva Pharmaceuticals' Loryna. Etonogestrel is also used in the single rod implant Implanon.

It will be interesting to see what the FDA decides because they have known about the problems with Ortho Evra (the patch) – because of the much higher average estrogen dose - for years and have done nothing more than require warning labels for the product.