Vegas vaginas and the contraceptive sponge

A Today vaginal contraceptive sponge

The photo: The Today vaginal contraceptive sponge hanging from an orchid by its ribbon removal loop. Today is a soft, disposable polyurethane foam sponge containing 1000 mg of the spermicide Nonoxynol 9 (N9) and is slightly less than two inches in diameter. The Today sponge while recommended for only 24 hours of continuous wear was originally approved for a 48 hour continuous wearing interval. However, wearing a sponge continuously makes it more likely that the wearer may become allergic to the N9 spermicide and that the sponge will develop an odor. The concave side fits over the cervix and the manufacture says it is effective protection for an unlimited number of acts of intercourse during the approved wearing interval making it ideal for a teen get-away weekend with a spongeworthy man..

Sponge pregnancies: For women who have given birth the contraceptive sponge failure rate is very high (20%) even when used perfectly so is not a good alternative. However, for a young woman who hasn’t been pregnant and has the willpower to use it consistently and correctly the Today vaginal contraceptive sponge can be an attractive birth control alternative if hormonal contraceptives; diaphragms and caps or a LARC method do not suit in her circumstances.  Walmart currently has a three count box advertised for less than eleven USD or about $3.33 each for 48 continuous hours of protection which is pretty good if you are going on a very spontaneous weekend with a new love interest. Of course it provides no STI protection, but does offer some thrust buffering if the man is large and frequently hits the cervix and it is readily available in most pharmacies w/o an Rx.

Bea has had some St Lucy’s girls to our home for weekend sleepovers with escort trainees for entertainment as an ice breaker for new girls entering the prep school during the spring semester. I was surprised to learn that several of the new girls, all Bea’s age, were using the sponge for protection.  There is no danger of contracting STIs on the sleepovers as the escorts and students have all been screened, but the likelihood of them using the sponge correctly at that age isn’t very good. So I made sure they all took the EC pill ella before they left for school the following Monday.  There is some risk but it was a major bonding experience for everyone involved. And I talked with their sexual health counselor at school to see if the girls can’t be convinced to switch to IUDs.

The sponge’s effectiveness: Source: Trussell J. Contraceptive efficacy. In Hatcher RA, Trussell J, Stewart F, Nelson A, Cates W, Guest F, Kowal D. Contraceptive Technology: Eighteenth Revised Edition. New York NY: Ardent Media, 2004.

Failures (unplanned pregnancies) per 100 women during the first year of use.

Parous women     Typical use (not always consistently or correctly) 32%         

      Perfect use (Always used consistently and correctly) 20%

Nulliparous women    Typical use (not always consistently or correctly) 16%         

 Perfect use (Always used consistently and correctly) 9%

Proper use means thoroughly wetting the Today Sponge with tap water before insertion, leaving it in place for six hours after the last act of intercourse, and having it in place every time intercourse occurs. The Today contraceptive sponge does not protect against STIs and should not be used during the woman’s menstrual period or for contraceptive protection during underwater sex. However, it is said to be safe to wear during bathing and while swimming.

Vegas vaginas and the contraceptive sponge: We are seeing a spike in sponge pregnancies coming in to our clinic for blood tests and terminations. That seems to be related to holiday (three day) weekends where the users are trying to stretch a single sponge to a continuous wearing interval of three days, 72 hours. Assuming that all other requirements had been met that leaves them in uncharted territory (as far as the sponges efficacy goes) for the last 24 hours and they are far more likely to have an allergic reaction to the continuous N9 released against delicate vaginal tissue. The scent of a sponge left inserted for three days is pretty ripe, but that is just from the interaction of the polyurethane foam with the wearer’s natural secretions and her partner(s) semen a reaction that occurs with diaphragms and cervical caps left inserted for too long as well.

Birth control hormones, copper IUDs and divorce: Our clinic is beginning to see a pattern in some patients who were recently married (in the past three years), who had been on hormonal contraceptives since their teens and who had come off hormones to get pregnant. The pattern is that the women are coming in for a ParaGard copper IUD before conceiving and having the strings removed so their husbands can’t tell they have An IUD inserted.

I’ve spoken to several of them and they have a common story; that when they came of contraceptive hormones each found they had married the wrong man, meaning that he wasn’t masculine enough for her. All are preparing themselves to divorce their husbands and while hormone free are searching for a more masculine and ruggedly compatible man. I’m not saying this is common, but it does fit with a study that was published last year which found that women who met their partners while they were on hormonal contraceptives chose less masculine men than those who were cycling naturally.    

 

 

Odette and Odile at the Boot Bar

Commercial lace-up boots too large for the wearer

The photo: A pair of calf length eyelet and hook lace-ups that is too large for the wearer. The eyelet lacing over the instep has no room to be tightened more as the wearer’s foot changes shape. As a work-around she could wear heavy sox to give her feet more volume to get the eyelet laces tighter across her instep. The toe of her boot has also been damaged giving some indication that the toe-box will probably collapse if the wearer tries standing in them for very long.

The twins go clubbing: With defensive lessons from Yardley well learned Cyndi, Yardley and I took the twins boot clubbing for their first time. I had intended to start at Naughty’s Boot Bar, but Yardley suggested we try another boot club first as it was supposed to cater to newbies initially strutting their stuff. Since it was supposed to have a Goody-Two-Shoes reputation I thought that was going to be a bit tame given the twins background even though they were new to ballet heels, but we could give it a try and move on. There is a sort of uniform for women frequenting boot clubs here, not that there are many of us, but there are a lot of wannabes most of whom make fools of themselves or show a flash of talent and then disappear. The uniform is no panties, black fishnet tights with an absorbent crotch gusset, black ballet boots and a black sports bra under a fitted black leather jacket. I wear a front closure Champion so I can breast feed while I’m clubbing. Most of us wear toe pads under sheer nylon anklets over our fishnets to make the boots easier to get on. Platform and flexed forefoot boots aren’t considered ballet boots (true BB must have the foot and toes pointed in the boot) and if they are worn to boot clubs the wearer is ridiculed unmercifully so she leaves soon after arriving.

We intentionally avoided the bikers clubs where some of the female members are ballet heel enthusiasts and brawlers.  We were just looking for some conventional ballet boot sex for the twins to get their boot cherries harvested. Taking a tight wet neophyte in her new boots is something males at boot clubs dream of; shoving their dripping erections in a ballet boot chick’s tight pussy and inseminating her so his semen drains into her boots. The club had recently changed ownership and it had been redecorated, but its atmosphere and clientele were still as benign as I remembered when I first took Cyndi and Bea there. It’s a sort of up-scale almost Hanna Montana wholesome sort of place for young High school ballet boot enthusiasts and their dates to gather. Almost all the girls there take ballet have moms who were or are dancers and married well or have good jobs so they can afford a six or seven hundred dollar pair of well made leather ballet boots for their daughters. The boots aren’t nearly as good as Gepettos, but at a fifth of his price they are good enough to strut around in to impress boys and stand in while having sex.

There were no 4WD pickups and Harleys in the parking lot just Suburban and Tahoe SUVs and minivans indicating Ballet heels moms were lending their children their rides their for “boot lessons” and cokes. Actually I was surprised that they were as busy as they were and it was sort of a high school crowd with Hitachi Magic Wands as the fave toys which could be rented by the half-hour. There was no obvious penetrative sex but couples went into the back from time to time and in the Ladies rest room two very young boot-chicks were trying to insert contraceptive sponges so there almost certainly was somewhere on the premises.

The Today Sponge: I asked the girls why they were using sponges and they said wearing one their partner didn’t need to wear a condom, they could wear one for the entire weekend, it offered some protection for the cervix from direct thrust injury from a well endowed partner and it absorbed a lot of a partner’s semen. Actually, the literature that comes with the sponge says it should be replaced every 24 hours, but the tests run for FDA approval showed it was effective for at least 48 hours. The failure rate for the sponge is: for Parous women: typical use 24% Perfect use 20% and for Nulliparous women: typical use 12% Perfect use 9%, which explains why it’s an over-the-counter teen favorite, but not for their moms. If you aren’t allergic to the Noxynol-9 (N9) used in the sponge it’s easy to forget the sponge is inserted. Depending on where you buy them three count boxes are $14 to $16 USD so if you are planning on a very active weekend, aren’t allergic to N9 and don’t have to worry about STIs the Sponge might be a good choice.

It can also be a good faux method to wear on top of a properly fitted FemCap, or in my case an Oves, if you think a mischievous partner is going to pull out your barrier protection. I’ve used a Today when a partner can’t reach my cervix when I’m aroused or fertile. Then I’ll wear an Oves for contraception and insert a moistened sponge to shorten the depth he needs to penetrate me to feel my cervix. Except of course he will be ramming the sponge from which I’ve carefully trimmed the removal strap. It’s amazing how much pushing into a sponge can improve a partner’s ejaculatory experience when he thinks he has completely filled me with his erection.

The young teens in their commercial boots were like colts walking shakily around on wobbling ankles. A few had boots that were obviously too large and most of them were fascinated by and in awe of my girls in Gepetto’s ballet heels. It was obvious we were the oldest group there and with no male partners we rented Hitachi wands and played with one another, had a coke and left. We were all wearing Penetrator plugs and the Hitachi is particularly effective in giving both clitoral and G-spot orgasms when held against the head of a Penetrator so our visit to the baby’s boot bar wasn’t a total loss and we left relaxed.  

Naughty’s ballet boots bar:  At Naughty’s I got Odette and Odile registered and entered into the clubs database so they both now have accounts that will eventually be paid by me.  Since their ID shows them as being 21 they have access to every part of the casino and associated holdings, except the High-Roller venues, where they can only enter as talent or guests. The first thing we did after registering the twins was to go to the Ladies and remove our Plugs. Because we had all masturbated with wands at Baby’s and our Penetrators seal extremely well we were full of vaginal secretions that needed to drain and be Kegeled out while on a bidet and then empty our bowels and bladders, clean up and check hair and makeup before going out to look over the selection of Bar-boys I had let know there were boot cherries to be harvested as partners for the twins initial boot-fuck.

All the club members and staff have recent clean full STI panels on file so there was no need to concern ourselves about the possibility of infections, just pregnancy and all the others, Including Yardley, have GyneFix copper IUDs implanted so I was the only one who checked that my Oves was screwed down tight on my ripe cervix. It didn’t take long for the guys to come over to admire the twin’s boots and some of them even asked knowledgeable questions which the twins answered while flirting with them. The guys I alerted were escort candidates the twins had trained with and they are exceptionally compatible with both so I thought the girls would pick the men they felt were most attuned to their needs and that’s exactly what they did. Perhaps the men were chosen for technique, but I think psychological support as well since the twins think being taken in ballet boots is far sexier than pointe shoes and they were being taken for the first time in such erotic footwear.

After the twins made their selections Cyndi, Yardley and I chose partners and the ten of us retired to a reserved encounter salle to enjoy watching the twins lose their boot cherries and then had an awesome ballet boot cluster-fuck. The cherry pickers were alternately gentle and brutal caressing the girls G-spots until their ankles wobbled even with shaft guards for support. Then I could tell that their shafts had swollen as the girls went forward on to their platform with their heels off the floor trying to get away from that momentary penis enlargement just prior to ejaculation as the boys pounded their soft open cervixes and the girls gasped and moaned in pain and ecstasy. The boys brought the twins to orgasm simultaneously and their powerful vaginal contractions pulled the men into ecstasy with them.

Asthma and ballet boots: Two hours later we all had just emerged from the encounter salle into the main bar completely sated, drained of all sexual tension and ready to leave when a medical emergency occurred. A woman in a pair of gorgeous high quality German leather ballet boots, a fitted leather jacket, fishnets and an M10 gasmask was in severe respiratory distress at the warm-up barre. Both Odette and Odile recognized her from her enlarged chest the result of asthma she has had since childhood.  Odette said the girl was a grad student and had been taking pointe at UNLV, but had to stop because her asthma had gotten worse and she no longer had the lung capacity and stamina.

What she was doing being penetrated from behind standing in ballet boots while wearing a gasmask given her limited lung capacity was a question that only occurred to us later when Yardley and I found out how severe her asthma was. She was being thrust into by a very energetic Bar-boy while bent over the warm-up barre against the mirrored wall. She was bleeding freely from her vagina and moaning in seeming delight.  Then as we were getting ready to leave there was a strangled gurgling moan only partially muffled by her gasmask as her right ankle turned out, gave way and snapped inside her boot and she shrieked as she toppled on to her right side almost pulling her partner with her. She lay writhing on the floor trying to get her mask off with one hand and holding her ankle with the other.

Odette knew right away what was wrong and ran to Gasmask-girl’s table grabbed her tote and emptied it on the table searching for her Asthma rescue inhaler. Finding it she ran back pulled the M10 off the chick’s face and had her partner pull her up and lean her against the mirrored wall so her chest and head were more or less vertical. Then had him hold her mouth open as Odette primed the rescue inhaler shoved it into the chick’s mouth and depressed the plunger sending a mist of medication down her throat as she struggled to breathe.  Her breathing didn’t seem to improve so she gave her another shot from the inhaler and then her breathing markedly improved. By then the duty manager and the EMTs called by the bartender had arrived and Odette stepped away as the professionals went to work.  Odile had gone over to gasmask-girl’s table and put all her things; wallet, car keys, tampons, a new pack of Beyaz, tissues and iPhone back in her tote and stood guard over it and when the EMTs wheeled her out Odette rode in the ambulance with her.

We followed the ambulance to the hospital to take Odette home, but she insisted on staying and our leather jackets, fishnets and ballet boots in the ER waiting room raised a few eyebrows, but most of the others there were too sick to notice what we were wearing. The twins decided to stay with their injured friend so I got their dance bags out on my Subaru and they changed out of ballet boots in to wind pants and GM pointes before we left them one of the cars and Cyndi, Yardley and I went home to shower and relax.

Adolph’s party: Today is Halloween so all of us are going to Adolph’s later for his party which is starting very late. It’s a school night so the girls will almost certainly cut classes tomorrow as we probably won’t get to bed (to sleep) until dawn.

 

 

Spring and latex diaphragms

A Vernal Equinox celebration at Stonehenge

The vernal equinox: On Tuesday March 20, 2012 at 5:14 UT the sun was directly over the Earth’s equator and the day/night were of equal length. It was also the first day of Spring in the northern hemisphere. The ancient Saxons in Northern Europe worshiped the Goddess Oestre (from which the name Eostre a.k.a. Eastre or Easter is derived) at the time of the Spring Equinox. The Goddess Easter represents the sunrise, springtime and fertility, the renewal of life. Anglo-Saxons made offerings of colored eggs to her at the Vernal Equinox and placed them at graves especially, probably as a charm of rebirth. Only later did the Christians appropriate the name for themselves and graft their religion onto the pagan celebration.

No Valentines Day party pregnancies: Speaking of fertility, returning readers will remember in my entry for February 17th - about Adolph’s Valentines Day party - there were three St Lucy’s girls who were fertile when they were acting as Subs for the evening; in pointes, vaginal hooks and eternity collars for the delight of his male guests. Even though they all have GyneFix IUDs inserted there was still the possibility, however slight, that one or more could find herself preggers. Not that that would have been something that couldn’t have been easily taken care of, but with multiple partners the girl wouldn’t have immediately known who the father was and there would have been the time and expense of the termination and replacing her GyneFix. I’m pleased to say that the three got their periods although they were all a few days late. We think the reason was because the excitement and stress of the party delayed ovulation four or five days and consequently their periods.

Spring Break and the contraceptive sponge: Some woefully unprepared women college students are here on Spring Break. One who lives here in Vegas is home and trying to connect with older college men in town for a good time. We saw her this past week, as a clinic walk-in, who wanted EC when her Today sponge disintegrated while still inside her after a weekend of heavy use. It was bad timing on her part as she had come off her pills because she forgot to go for the exam before she could get an Rx for another years worth of her contraceptive and she was fertile. I got all the pieces of foam out of her and a Gyn wrote her a new Rx for her pills and also had her take ella which usually prevents conception from unprotected sex and is effective for up to 5 days after the first encounter of concern.

Diaphragms and latex fetishists: Since the first of this year we have seen a fourfold increase in the request for the fitting of diaphragms as the up-market escort trade has discovered older rich client’s fetish for vaginal latex. As the economy worsened with the financial and real estate collapses of 2008 wealthy male clients seemed to want to relive times from their youth in the early 60s, before birth control pills were widely accepted and AIDS was unknown. A time when the use of contraceptive diaphragms was the most popular reversible method of birth control for sexually active women. Now male fetishists are actively seeking the very few young escorts who use diaphragms for contraception or who will insert them for vaginal latex encounters, which is far more likely.

Until 2009 the use of latex diaphragms as part of women latex fetishists wardrobes or as a requirement to meet their male partners tactile experience needs was virtually unknown, at least in the western U.S. And, as the demand for latex diaphragms began to increase in this niche market the major U.S. maker, Ortho-McNeil-Janssen, switched from latex to silicone for their most popular style, the All-Flex, and discontinued entirely their coil spring style leaving the British Lamberts Reflexions flat spring as the only latex diaphragm generally available.

While silicone diaphragms have several advantages, a much longer service life, are less likely to contribute to infections and can be used safely by couples with latex allergies, the drawbacks are considerable for latex fetishists because the silicone domes are less stretchy and don’t conduct heat nearly as well as latex so the tactile experience for vaginal latex fetishists is not nearly as pleasurable. To make the shortage of latex diaphragms worse the latex Reflexions flat spring diaphragm is not generally suitable as a fetish fantasy device because the rim is very stiff and folds in a single plane making it nearly impossible and extremely painful to under-thrust thus leaving no latex diaphragm suitable (except perhaps for a few masochists) for misuse by mischievous latex fetishists with breeding fantasies.

To fill the void for a contraceptive fantasy device acceptable to latex fetishists Gepetto has again teamed up with Labia Labs to produce a line of latex diaphragms with coil spring rims in standard sizes from 55mm to 90mm in 5mm increments. He decided against producing an All-Flex arcing spring rim device because there were patent licensing costs and an arcing spring rim is needed primarily for women with lax muscle tone which is of no concern to Gepettos target market, escorts with fetish specialties and some of the tightest and strongest vaginal grips in the world. The devices will be custom made and half sizes (2.5mm) can be provided by special request. The Labia Labs Latex (known as 3L) line of diaphragms is sold exclusively through our women’s clinic and only to escorts working for the casino and the Towel Girls at Splash, the services which Pirate operates for us. Exclusivity of the 3L coil spring diaphragm gives our girls a significant advantage over other escorts serving the hard core latex fetish community as coil spring rim latex diaphragms are otherwise difficult to obtain since they have to be special ordered a costly and time consuming process.

The sponge and the IUD

The Today contraceptive sponge

Sponge wary: There is a very pretty 26 y/o with an athletic build who was a patient at the clinic this past weekend. She was in again for Mifeprex. She works in the athletic department at UNLV and is obsessed with young male athletes. She told me her job was like being a taster in a candy store. I thought the comparison was apt since both a steady diet of candy or young men can be fattening. In her case she should have known better since this is her third pregnancy in two years using a sponge for contraception while having sex with student athletes. Go figure! If you are in your late 40s and marginally fertile the sponge may be a good choice, but not when you’re at the peak of your fertility in your twenties and are routinely being filled with semen by lusty young men at the height of their fertility.

The Today sponge is convenient and at about $5 each they aren’t that expensive when you consider that they can be worn for at least 24 hours for as many acts of intercourse as the wearer wants. You just open the packet, moisten the sponge with tap water to activate the N9 spermicide in the sponge and insert the sponge with the concave side facing the cervix. The sponge is left in place for at least 6 hours after the last act of intercourse then pulled out and tossed in the trash. However, I tell all my students in my Contemporary Sexual Health and Advanced Sexual Techniques classes at St Lucy’s that the convenience of the sponge is far outweighed by its lack of effectiveness. It’s not a barrier it’s a spermicide delivery device because there is nothing to hold the sponge over the cervix so it can be easily displaced by a penis large enough to reach it. That’s not to say it shouldn’t be used if that is the only option available.

So anyway, we gave her the Mifeprex and she will return for a follow-up in a few days to make certain she passed all the tissue associated with this pregnancy. I’m trying to talk her into having an IUD inserted so she won’t have to be going through a termination every few months. She said a diaphragm or a FemCap took too much effort to use correctly. She’s not a swimmer so dive-sex doesn’t seem too likely for her so she would be ideal candidate for a ParaGard that can be left in place for more than ten years. She said she would think about it. Her insurance would pay for it so it would be amazingly inexpensive and extremely effective contraceptive solution to her reoccurring problem.

An IUD expulsion: Also on Saturday while I was at the clinic fitting diaphragms for escorts I was between patients and was asked to try to help calm a patient who had come in because she had expelled her IUD during an intense underwater sexual encounter. The drama was because she had been with the husband of the friend - a roommate from med school - she was staying with. She was a Gyn in her early 30s who had come to Vegas to attend a seminar on birth control methods. Go figure! I’m not making this up! Her ParaGard had been inserted two months before in NYC where she practices as a clinical gynecologist. She said she hadn’t been having any trouble with it and that she was fertile and her lover had a very high sperm count (according to his wife) because he had fathered their two children (born 10 months apart) while she was on hormonal contraceptives.

IUD expulsions are fairly common, from 2% to 8% during the first year after insertion, but expulsions are most likely during the first three months after insertion and during menstruation when cramps may expel it. I found her in the exam room with Chuck, our lead male Gyn who knew her from medical conferences they had both attended. I talked to her about having a frameless copper IUD, a GyneFix, inserted. We weren’t supposed to insert a GyneFix in a woman who wasn’t going to be part of the clinical trial, but Chuck agreed to do it as a professional courtesy. The patient wasn’t excited about having a GyneFix until Chuck explained that the new implantation technique that was developed a year ago had decreased the expulsion rate dramatically so the percent of GyneFix devices expelled within a year after implantation using the new technique is less than 2%.

The nice thing about GyneFix is that it is not subject to expulsion from menstrual cramps or from uterine cramps caused by intense sexual encounters. And because it is copper once implanted it has an immediate emergency contraceptive effect so she would be very safe even after the expulsion of her ParaGard. She was given 800 mg of ibuprofen and since she was fertile her cervix was already soft and opens so she didn’t need to be dilated to get the implantation tool through her cervix and up against the fundus where the knot of the thread was buried deep in the muscle. Chuck gave her a ten day regimen of antibiotics to minimize the likelihood of infection while the implantation site healed.

Reflexions as a prophylactic: She was feeling frisky enough after her GyneFix was implanted that she asked to have a diaphragm fitted (she had used one her first few years in med school) so she could continue having sex with her roommate’s husband w/o having to worry about his sperm in her uterus complicating the healing of the implantation site. She said he is really Hot! So I asked if she had a latex allergy and when she said no I fitted her with a 75 mm Reflexions flat spring so it would be very difficult for her ‘hot’ married lover to under-thrust her diaphragm to get semen into her uterus. I also gave her a 100 ml tube of DiveGel+ because her vaginal walls were slightly abraded by the poor lube used during her initial dive-sex encounter. The wife is an ER doctor at a local hospital and as a junior member of the team she gets a lot of 12 hour night shifts leaving her husband available for what ever games her visiting friend wants to play with him.

God knows, I don’t mind a little adultery, as I think it can add spice to a relationship, but that woman was so fixated on her friend’s husband it’s hard to see anything good coming out of it as obsessive as she seems to be. Sometimes we think a guy is hot because he belongs to someone else. I don’t know enough about her to know if that’s what’s driving her lust or if she is just that competitive with all her women friends. Or, if there is real chemistry between her and the guy and he is coming on to her as much as she is encouraging him.