Clubbing supplies, Odalisques, first Rhiannon equine celebration

One of my Minaudières by Monique Lhuillier

The Photo: A Minaudière, a Monique Lhuillier evening handbag. “A rose gold-tone tassel and mirrored hardware add glittering appeal to this luxe mink Monique Lhuillier clutch. Zip closure. Leather interior. Fur: Natural Mink, from the United States. Weight: 11oz / 0.31kg. Made in Italy. Measurements Height: 3.25in / 8cm Length: 8.75in / 22.5cm Handle drop: 7in / 18cm.” Actually, this one is more practical for the theater than clubbing since the real mink can be stained by a spilled drink or splattered semen. Just saying…  I bought it at the Monique Lhuillier shop on East 71^st Street in NYC. Since the seller wasn’t supposed to ship it out of the U.S. because it was made with mink fur I had one of the flight attendants on Limnaea pick it up for me when they landed there a few weeks ago. Minaudière is pronounced mēnōdˈyer.

Clubbing supplies and equipment: When Clubbing I use the Minaudière I’m carrying (I have several of them) as a miniature slit-kit. I like to keep several disposable applicators of DiveGel+ (a lubricant spermicide/biocide), several latex condoms of various sizes, a spare Oves cap, two 25mg Viagra tablets, a tiny sewing kit to repair torn ribbons as I’m often in pointes, a credit card and £100 in cash in £5 and £10 notes for tipping and cabs. The Pfizer risers are for a partner who needs help focusing after the third time.

Odalisques; the pregnancies continue: Another, the third, of Nikolai’s small harem of dancers I have servicing him to keep him from becoming interested in some of the younger girls in the Corps while he is not at my side has tested positive for hCG. This one thinks she has a weight problem and w/o telling anyone began taking diet pills that sped up her metabolism. The progestin in her IUD that was supposed to suppress ovulation was being eliminated more quickly from her body leaving her IUD far less effective resulting in her pregnancy.  It’s not like she didn’t know. I warned her about the possible effect of diet pills on the efficacy of hormonal contraceptives before I introduced her to Nikolai. It is an inconvenient time for a dancer to be out as the holiday performance schedule is very heavy (not that it was in the least convenient for her either) but she will probably be out more than the standard ten days for recovery from a vacuum aspiration as she is having psychological issues with the termination. Fortunately I had another lovely young dancer as an Odalisque-in-waiting (who has a GyneFix copper IUD inserted) and introduced her to Nikolai while pregnancy #3 was being sucked out of Miss diet-pills.  

The initial Rhiannon equine celebration: Friday, December 18^th will be my initial celebration of Rhiannon’s Feastday as the Roman Goddess of horses. As I mentioned in a previous post Cambridge Christmas vacation extends from Monday December 14 (Last day of undergraduate and graduate classes) to Monday January 25, 2016 (when Undergraduate and graduate classes begin.) so Marvin, Morning Wood, will be available and is thrilled to be my partner for the ritual planting of seed. The celebration of her Feastday on the 18^th will be far more intimate than the equinox and solstice celebrations that occurred at Location Z.

It should be more like my offering of pomegranates to Aphrodite/Venus in her Roman era temple in the undercroft of Crag Abbey in the mountains overlooking Loch Ness with only myself and my partner as the celebrants. My Celtic expert, the Oxford Don, says this Celtic grotto temple of Rhiannon predates the Roman Aphrodite/Venus temple at Crag Abbey by hundreds of years.  This will be the first time Marvin has been involved in a Goddess celebration and in the foundation grotto under the east tower of Blackthorn castle we will be out of the elements with the torches providing enough heat to make things relatively comfortable when compared to the rain and icy winds of Location Z or on the fighting top of the East tower for the this years Winter Solstice.

Mellten: Mellten is a Welsh word for Lightning. In one of the legends surrounding Rhiannon she is being pursued while riding a horse which can’t be overtaken when she is riding it. So far I’ve found no source that names that horse. So, I’ve decided to rename a lovely young mare in the Blackthorn stables’ Mellten’ in honor of Rhiannon’s horse, until I can find the correct name if was ever set down. Mellten is extremely fast, sure footed, has been trained for fox hunting (actually drag hunting now) and seems very fond of me. When I’m astride her we are like a single entity jumping hedges, ditches and galloping flat out. It feels marvelous to have that much power between my legs and I always end our rides on an amazing high that is almost sexual in its intensity! Umm… well, it is sexual when I have a pair of Ben Wa balls inserted during my ride!

Fortunately I learned to ride when I lived in Southwest Virginia, rode some while in ballet school in upstate NY and rode a bit while in Vegas so it’s just getting used to it again. Being a dancer the balancing and use of my strong legs makes getting back in shape for riding relatively easy.

Riding the Dragon: Marvin and Bea – with a boyfriend - came down to London and on the 16^th rode up to Caersws with me, the Dryads, Bryony and Claire, and their current boyfriends for Rhiannon’s first celebration at Blackthorn Castle (on 18 December) in probably 800 years or more. A convoy of Land Rovers met us at the station for the ride to the castle. It’s always fun to have new riders aboard the Dragon as they think traveling in a private railroad car is the height of luxury. Of course it is, but once you get use to it you begin to take it for granted. The weather forecast for Llanidloes (the closest weather forecast to the castle) is for light rain and temps in the low 50s.  Fortunately on the 18^th Marvin and I will be inside.

Timing: We will be staying at the Castle until after the first of the year. I’m not yet sure if we will be staying for 12^th Night since I want to spend several weeks at my place on Lost Cove on Virgin Gorda. It will be my first major Holiday season as Baroness and I want to do things properly so my villagers won’t say that Edith, my predecessor, could have done it better. Of course Charles, my Chamberlain of the Household, is taking care of the details. All I need to do is pay for it and circulate among the guests. It is for the entire village and all the vendors who have the Barony’s warrant so it is a splendid opportunity to get to know everyone who has anything to do with the running and provisioning of the Barony. I am going to try to be on my best behavior as I will be fertile for the Solstice and ovulate on Christmas day. Isn’t that awesome! The Goddess is looking out for me! I’ll be CD21 and Luteal on New Years so I can take lovers on New Years with no contraceptive protection whatever so I can have live sperm in my tubes and be safe until after my period which should start on January 8^th.  

Planning for the Winter solstice: We will be celebrating at sunrise on Tuesday December 22^nd and I will have the Dryads; Bryony the daughter of Lord A**** and Claire her cousin, who are working on their PhD theses for doctorates in Clinical Psychology at University College London. As well as Bea, my ward who is a student at Cambridge and Willow, a ballerina who is the granddaughter of the Duke of M****, and is scheduled to dance Nutcracker performances at the ROH on the 18^th and 24^th so I’m sending The Dragon to pick her up at St Pancras so she can participate in the Winter Solstice celebration. Morning Wood will be my partner, though I’m not sure how he will do with sex on the top of the east tower in a cold rain at dawn. It’s not certain that it will rain then, but there is a very high probability. The other four men I need, one for each of the ladies at the cardinal points of the compass, have yet to be named. Tanaquil will probably send men from the POB which is in the middle of a six week run of La Bayadère at the Ballet Opéra Bastille. It is a ballet requiring a huge corps and few men so we should be able borrow four glorious young males for several days. They can take class daily with the women and all of us can have sexual workouts afterward. Tanaquil will ensure that the men all have had pneumonia vaccine (the women have already) so no one gets seriously ill from sex in an icy rain.

Lesbian protection with FemCap

A lesbian ballerina’s protection

 

The photo: Gaynor Minden pointes for a Lesbian ballerina’s art and a FemCap for dildo thrust-buffering and to direct a vibi’s impulses into her fornices for A-spot and P-spot pleasure. The FemCap pictured with a pair of my Gaynor pointes has a 26 mm inner diameter which fits me perfectly. The outer edge of the brim is 50 mm in diameter for the 26 mm FemCap.

 

Lesbians and FemCap: Our clinic fits quite a few Lesbian ballet dancers with FemCap, a transparent silicone contraceptive device the brim of which seals against the vaginal walls. Since I joined the clinic at the first of the year I’ve been doing most of our Lesbian patient’s contraceptive barrier fittings and teaching them insertion and removal techniques.  They are very straightforward; for women new to cervical barriers I always have them first insert two fingers to feel how the vagina s slopes up and then back and have them feel their cervix so they know what it feels like and how far in it is when not aroused. That way they have an idea about how to push the folded cap down the vagina toward their cervix. Then compress the brim with one hand and spread the labia with the other and insert the cap with the concave side of the dome up. FemCap is pushed along the back wall of the vagina and when it hits the cervix the brim is tilted up with the fingers and should slip into the posterior fornix with the dome over the cervix. Once on the cervix a finger sweep all around the cervix and feeling it through the dome ensures the cap is properly in place. At that point the removal strap is pushed down forcing the base of the cap as deep as it will go in the fornices and should be held there for ten seconds while a strong suction is developed.

 

Some users new to FemCap panic when they try to remove it the first few times and find that even when depressing the dome enough of the vacuum isn’t released to remove the cap by tugging on the removal strap. While that can be initially disconcerting it shows how well the cap fits since with suction that strong it is very unlikely to be dislodged. For women who can’t release enough suction to comfortably withdraw the cap a long handled ice tea spoon can be used as a removal aid. With the convex side of the bowl against the vaginal wall slip it between the wall and the brim. Then push the bowl of the spoon into the anterior fornix and twist the handle to break the suction between the brim and the vaginal wall. Lesbians who don’t need contraceptive protection can wear FemCaps dry, no spermicide in the dome, and the cap can be safely worn continuously for at least forty-eight hours though I’ve worn mine for four days with no ill effects.  FemCap shouldn’t be worn while menstruating as the flow can float it off the cervix.

 

Most of our cervical barrier fittings for Lesbians are for FemCap, but a few are for latex Reflexions flat spring diaphragms if the patient needs dive protection for underwater dildo play at depths greater than 25 feet. Below that the pressure squeeze on the FemCap dome becomes very uncomfortable. Now that the Reflexions is no longer being made our clinic is having our own latex flat spring diaphragms produced as there is still a small but pressing need for that style rim and material. FemCap is preferred for penetrative surface sex protection and shallow dive sex by Lesbians because it allows the skin-on-skin fingering of the wearer’s G-spot and as I mentioned above when a vibrator head is pushed against the FemCap removal strap and dome the entire device vibrates gently and the impulses are transmitted to the wearer’s A-spot and P-spots simultaneously which almost always generate powerful orgasms

.

Lesbian Dommes and the need for contraception: Most Lesbians who come to us are cycling naturally and enjoy their cyclical hormonal swings.  Spermicide is not needed when FemCap is used in a pure Lesbian Domme/submissive relationship. However, there are instances when a spermicide should be used. One fairly common example is when the Domme has the hots for a Bi-sub - who is on the pill or a LARC - and having sex with unprotected males. In that situation the Domme needs to use an effective spermicide (usually ContraGel with lactic acid as the active ingredient) to protect herself if playing with the Bi-sub when she and her partners fingers are in each other’s vaginas while her Bi-sub is still draining fresh semen.

 

You would be surprised by how many gorgeous Bi-sub ballerinas there are who are as comfortable with bedding a marvelously virile man as sleeping with a hundred and ten pound Domme and taking them quickly one after the other. Since it is impossible to know for sure if the sperm in coitial discharge is dead to be safe a Bi-sub should only be played with while wearing an effective barrier contraceptive with spermicide in the dome since transferring motile sperm from one vagina to another with the fingers resulting in the pregnancy of the woman who did not have penile/vaginal intercourse is quite possible.

 

Sizing: Most Lesbians take the smallest FemCap size, a 22 mm inner diameter designed for women who have never been pregnant although some few take the larger sizes 26 mm if they have been pregnant, but have not delivered vaginally (which is my size though I’ve never been preggers) or the 30 mm if they have delivered vaginally. And we do have one or two patients who have found they are primarily Lesbian after being in unsatisfactory traditional heterosexual marriages and having children.

  

Comfort and uterine protection: Since most Lesbians don’t have to worry about the discomfort of a large male partner hitting the removal strap they can comfortably and confidently wear a FemCap for safety since it is important during cunilingus to prevent air blown into the vagina from entering the uterus and possibly causing an air embolism. This is especially true during dive-sex when a playful partner could use her buddy reg to push against her partner’s labia and hit purge sending a jet of compressed air into her partner’s vagina, through her cervix and into her uterus, unless she is wearing a well suctioning cap. And FemCap performs a cervix thrust-buffering function when a dildo is being used on the wearer by her partner by substantially lessening the discomfort of the dildo ramming her cervix.

 



Underwater conception

A sperm penetrating and fertilizing a human egg

The Photo: A microscopic view of a human egg being fertilized by high quality sperm. Look at the tails on those little swimmers!

The Lorelei’s underwater conception package:  Adolph’s luxury spa, The Lorelei, is offering dive conception packages and I’m helping with the sperm donor and the client’s preparation for insemination. The interest in underwater conception first caught the interest of the wealthy when female sports divers blogged about becoming preggers in training pools during unprotected sex with boyfriends. I’m guessing a substantial portion of those pregnancies occurred to push lovers toward marriage as no modern woman familiar with the value of birth control to female athletes could possibly ‘forget’ to properly use contraception if she intended to use it at all. Regardless of initial motivation dive conception has recently caught on with wealthy young adventuresome European women as a unique way to conceive and Adolph hopes to make The Lorelei a destination for planned underwater conceptions.

My involvement is to fit the client with a Reflexions diaphragm for flood insurance so she can take dive-sex orientation/familiarization training with a male escort and to work with the selected sperm donor to familiarize him with the basic techniques of dive-sex so he can successfully inseminate an unprotected fertile client while she is tethered to the bottom of an encounter pool at The Lorelei. The most important thing that we have to train both the dive-sex client and donor to do is to take deep breaths during the encounter so prevent them from hyperventilating.

We recommend the client be penetrated while floating vertically – tethered to the bottom with an ankle leash with a partially filled buoyancy vest to hold her almost vertical during insemination - so her vagina is less likely to flood and dilute the donor’s semen or have water forced into her uterus by the hydraulics of her donor’s thrusts. Both the client and donor have two test dives, the donor with me and the client with an escort, to get them used to the delights of dive-sex before the actual three encounters while the client is fertile when she will be inseminated.

A sperm donor is selected by the client from a list of men fitting the physical description of the man she would like to father her child. The candidates are made up of medical doctors between the ages of 28 and 35 whose genomes have been analyzed and found to contain no serious gene abnormalities. The men also have to be producing large quantities of high quality sperm and their penile shaft and glans above average in size and functioning correctly with strong ejaculatory contractions that guarantee sperm placement directly into the open cervical os of the fertile client. While the donor and client are intimate they both wear exterior mirror finish lenses in their OTS Guardian FFMs so neither knows who the other is.

An underwater conception package consists of a deluxe suite and all meals and spa access in addition to three acts of intercourse one day apart with the donor of choice while the client is fertile the last day being the day of ovulation. The client is tethered to the bottom of a 30 ft deep encounter pool with an ankle leash and the sperm donor mounts her from the front in a modified missionary position. So far seven clients have completed single cycle underwater insemination encounters and four of them have become pregnant which is an awesome achievement as the expectation was a 50% success rate.

First pregnancies of the fall semester: We are beginning to see bookings for terminations as the first fall semester pregnancies of university and high school students are detected. Of course it’s so soon into the school year that some or all are could be from accidents during summer encounters.  The first Contemporary Sexual Health classes have some students concerned about the effectiveness of their protection and some have talked with me after my lectures about switching methods.

It’s surprising how many women are careless about their birth control. Things like not routinely checking to see that their partner is still wearing his condom after he withdraws, or don’t realize that weight reduction pills can speed up the metabolism of users so that contraceptive hormones are flushed through their systems too fast to maintain a therapeutic level to prevent ovulation. And then there are a few students who use a cervical barrier (other than condoms) borrowed from a roommate or family member and which doesn’t fit correctly or they forget to insert it before penetration.

The only LARC method that is truly safe is a copper IUD and it has its own drawbacks since ParaGard is the only one generally available in the U.S. and some small women can’t be fitted with it and a fixed frame IUD can cause pain and heavy bleeding. My wards Bea, Willow and the swan twins Odette and Odile and most of my dancers all have the frameless copper bead GyneFix IUD implanted so they can cycle naturally enjoying the cycling of their hormones while being protected by copper ionization in the uterus which is 99% effective against pregnancy.

Scotland’s independence referendum: On Thursday September 18^th the voters of Scotland will decide whether they will split from the United Kingdom. The referendum question will be "Should Scotland be an independent country?” At this point polls indicate Scottish voters seem evenly divided and there are significant issues of citizenship, defense, currency and the economy that would need to be resolved should the vote be yes. His Grace and Jack are busy talking with the voters’ who live on their estates and villages. His Grace and his father and grandfather before him have been kind and honest with the people who work for the Duchy and the villages that count on its patronage for a living.  There could be both benefits and drawbacks for the Duchy should the vote be yes, but there could be severe consequences for the rest of the UK (England, Wales and Northern Ireland) should Scotland declare independence. For now there are a great many important unanswered questions.

 

St Lucy’s invitational ballet summer intensive

Barre girls in tights before pas de deux class

The photo: A group of summer intensive students warming up before PDD class.

St Lucy’s invitational ballet summer intensive: We changed the format this year to draw participants only from ballet students 21 or older whose names were submitted by their teachers for their outstanding grace, technique, stamina and fearlessness. We had more than 450 submissions and had places for only 15, limited primarily by the number of professional male dancers suitable to be their partners and those 15 were on full scholarship (from my casino/resort) including meals, travel and medical expenses.

In addition to technique, pointe, PDD and mime we are offering ‘contemporary sexual health for the dancer’ for the first time this year as feedback questionnaires said given the opportunities offered while at our summer intensive a more complete foundation in contraception choices and their use would be helpful to first time students to the ballet summer intensive we offer here in Las Vegas.

Screening: All the students and faculty were required to bring recent full STI panels indicating that they are all free of STIs and all have completed their series of Gardasil shots. And the girls were given pregnancy tests upon arrival. Two failed and as they were both 21 were given the chance to terminate their pregnancy w/o their parent’s knowledge (the termination would have been covered by medical insurance through the scholarship) or return home. Both decided to return home – their mothers flew out to take them home - and two alternates were accepted in their places. We think what happened in both cases was the students were on very low dose estrogen/progestin pills and took weight loss pills to trim down for the SBI that speed up their metabolisms so the girls flushed the hormones through their bodies too quickly and the remaining levels weren’t sufficient to suppress ovulation. The literature we sent out in the spring when we selected them cautioned about taking weight loss pills if the student is on contraceptive hormones.

The weather: With the appearance of July it has turned very hot here in Vegas. The forecast is for temps from 111° F to 108° F thorough the weekend so latex catsuits, hoods and gloves are out except for in clubs with the a/c turned full on. Fortunately the practice clothes of thong-back tank top leos, bare legs and pointes in fully air-conditioned studios and encounter sallies are ideal for this weather. Tights are only worn and over leos, for PDD classes. We cautioned the BSI students to bring at least a dozen pairs of shoes as the students are expected to be in pointes for all classes as well as barre.

The Men: The men were chosen from recommendations to and personal knowledge of Willow, Jack’s 20 y/o daughter, who was in the corps of the Royal Ballet and had danced with the Paris Opera Ballet until last year. They were chosen not only for their ability as classical dancers, but physical strength, personality and sexual stamina. The sexual stamina is important during a Ballet Summer Intensive as students are far more likely to experiment sexually while away from home and with strangers and what happens in Vegas stays in Vegas, we hope.

Some of the women students have much higher sex drives than others so a hyper-sexual girl can arrange to swap men with a girl with a lower libido to find a guy who can satisfy her more frequently. Performance enhancing meds are available to any man who asks. If he is on an enhancing med it’s usually his secret even though he’s expected to perform satisfactorily as frequently as four times a day for the entire 14 days of the course.

Protection for play: In my welcoming remarks to the girls during their orientation I suggested that they might want to try wearing Gaynor Minden pointes for play as they often provide better support and the shanks and blocks last far longer than pointes made of traditional materials. The only problem with GMs is that they don’t breathe, so are hot to wear and take longer to dry. We have taken care of the drying problem by providing drying boxes that circulate warm very dry air across sweat soaked shoes. Our GM representative fit them all with at least two pairs of shoes each, the cost of which is included in the scholarships.

I made it a point right up front that the students male partners were highly fertile and would be having sex with them unprotected unless the woman asked for him to wear a condom. So it is the responsibility of each woman to ask her partner to wear protection or use an effective contraceptive method and if there is any concern about a birth control failure the morning-after pill is available 24/7 at student health.

Also mentioned in my introduction to contemporary sexual health class is that if they wanted to experience dive-sex - and they all did - they would have to be fitted for a diaphragm to be used as flood insurance since the vagina commonly floods during underwater sex, so the diaphragm is used as flood insurance to prevent a partner’s thrusting penis from forcing water or an air bubble into the uterus which could cause PID or an embolism.  Fortunately they all use menstrual cups so were familiar with folding and inserting vaginal devices so none had an ‘ick-factor’ associated with using a diaphragm

Dive-sex was high on their list of recreational choices so no one had a problem with being fitted with a diaphragm and since only one woman (and no men) was allergic to latex Chris, our male Gyn, fitted them with the latex Reflexions flat spring style which is nearly impossible for a mischievous partner to under-thrust and showed them how to use the 10 ml prefilled disposable applicators of DiveGel+. The latex allergic student was fitted with a silicone Milex wide seal arcing spring diaphragm which, with its two elbow hinges, is the next best thing to a Reflexions for flood insurance.  As a confidence builder I have them all wear their diaphragms during ballet classes so they could get used to inserting, removing and moving with it inserted finding that once inserted and properly positioned they can’t feel them.

Toe-tape, the pointe-shoe club: Returning readers will recall that in my post for April 14, 2014 I introduced you to Toe-tape a new Mini-club, writing: “Our Casino/Resort has opened ‘Toe-tape’, a ballet club for adventuresome young women who want to show off their feet and legs for admiring men. I know the name sounds like it should be a Chick band, but we tested it and found it’s the sort of name that appeals to young highly motivated female dancers craving excitement.”

I’m introducing the BSI students to clubbing in pointes, where they can be admired by men with a pointe fetish. Having students 21 or older this year simplifies entertaining them on the clubs scene since I’m not trying to pass them off as older than they really are.  Their male BSI partners (English and French straight ballet dancers from major companies) are here as much for the sex as for what we are paying them and having them along gave the girls time to get to know the guys personally and sort out sleeping arrangements. We prefer that couples sleep in the dorm at St Lucy’s which has private rooms with full baths.  That way there is excellent security and it’s close to the studios.

Fourth of July celebration: Tomorrow evening Adolph has invited the BSI students and faculty to his 4^th of July party. He has promised to have no wood chipper within … well he said “nowhere near” the party so it should be safe enough. And the students will get to dive The Well, his 216 ft dive training facility. He has a net spread across it at 100 ft so none of the newbies to the facility can go deeper accidently.

Lara Croft and extended cycle BCPs

Advert for Lybrel the continuous regimen oral contraceptive

“Why Do Oral Contraceptives that Cause Monthly Bleeding Still Predominate?

Healthcare providers' attitudes about menstruation and medically induced amenorrhea are key factors.

Extended or continued use of oral contraceptive pills (OCs) remains low despite obvious advantages of menstrual cycle regulation and symptom management. To determine the factors that influence physicians' OC prescribing habits, researchers analyzed survey responses from 211 obstetrician-gynecologists (OB/GYNs) and family medicine physicians (FPs) in Oregon. Physicians were asked whether they prescribed extended-use (hormone-containing pills for >28 days with scheduled withdrawal bleeding) and continuous use (hormone-containing pills indefinitely without a scheduled withdrawal bleed) OCs, and, if yes, how often. A 5-point Likert scale was used to assess attitudes toward menstrual suppression.

In all, 90 respondents (44%) identified their principal specialty as OB/GYN, and 115 (56%) as FP. Most respondents who reported ever prescribing OCs also said that they prescribed extended- or continuous-use OCs sometimes (50%) or often (23%). OB/GYNs were more likely than FPs to suggest these options (92% vs. 60%), as were urban (79%) versus rural (58%) physicians.

OB/GYNs and urban physicians showed greater acceptance of medically induced amenorrhea as well as more-favorable attitudes about health and economic benefits of suppressing ovulation and safety of extended-use OCs. Most respondents (68%) did not realize that menstrual-related symptoms are most common during the placebo week, and 17% of respondents (most of whom were FPs) were unaware that endometrial thickening does not occur with extended-use OCs. After adjusting for physicians' age, practice location, knowledge, specialty, and sex, the only factor that was significantly associated with prescribing extended- or continuous-use OCs was attitude toward medically induced amenorrhea.

Comment: The gaps in knowledge among the respondents are surprising and underscore the need for ongoing education about menstrual suppression. The authors acknowledge that their small sample size (particularly of rural providers) curtails the generalizability of these results. Moreover, nurse practitioners, physician assistants, and certified nurse midwives were not included. Despite these study limitations, the benefits of extended- and continuous-use oral contraceptives remain clear — and the attitudes of healthcare providers are critical in promoting acceptance of these dosing regimens as mainstream options. — Anne A. Moore, WHNP/ANP-BC, FAANP”

Extended cycle pills in real life: The first combined (estrogen/progestin) oral contraceptive pill designed to be taken continuously with no hormone free days is Lybrel. Lybrel has .90 mcg of the progestin levonorgestrel and 20 mcg of the estrogen ethinyl estradiol and is taken continuously 365 days/yr, in 28 day packs (13 per year). For women who can adjust to the continuous dose of hormones – it can take three or four months for a significant percentage of users to stop experiencing irregular bleeding – being period free can be liberating if the woman has been experiencing heavy or painful periods or significant PMS. Another positive for Lybrel is that it uses a very low dose of an older progestin, levonorgestrel, which has a lower incidence of causing blood clots. Most other extended cycle pills have 84 active and 7 placebo pills limiting a woman taking them to four pill-periods a year. Some of those are Seasonale, Jolessa, Quasense, Seasonique and LoSeasonique and they all use the progestin levonorgestrel.

The down side of extended cycle pill is that in addition to taking a long time to adjust to being continuously on hormones levonorgestrel does not have the long half-life of the progestin drospirenone used in Yaz and Yasmin and as a result the hormone levels can more easily drop below the effectiveness level if a woman is late with or vomits her pill. Too, there is no monthly assurance that the user is not pregnant by the arrival of ‘Aunt Flo’. Unless a user is cautious enough to test every few weeks she has no way of knowing if she is pregnant until she begins to develop symptoms such as noticeable breast changes, lethargy and repeated nausea.

A consequence of the Hex or Sex party: Returning readers will remember from my post entitled ‘The Doorman’ on October 31, 2011 and the following post on Nov 2 about the wood chipper that a UNLV friend’s sorority was running a bordello charity over Halloween at one of Adolph’s vacant estates in the hills. The 13 girls who were hostesses in latex body condoms are fine and suffered no ill effects other than sore muscles from their unusual level of exertion. Even the girl who had her cervix battered so brutally is recovering well and probably will only have to wear a supportive pessary for a few months.

However, one of the other sorority sisters, a 26 y/o grad student, who was working as support staff and was costumed as Lara Croft in a silver latex dive-skin had apparently gotten off her pill regimen enough that she was fertile and had breakthrough ovulation during the four days the bordello was operating. We knew she was sampling unprotected male customers, but she was on Lybrel and since there was a waiting list and she was discreetly servicing men who were waiting at the bar for seconds or thirds no one called her on siphoning off potential profits that we didn’t have time to handle. The fourteen of us, Cyndi and I pitched in when it became apparent that the sorority girls were under staffed as far as available commercial pussy was concerned, were getting the guys off as fast as we could while ensuring we were giving them their moneys worth.

Lara Croft and the fertilized egg: So Lara Croft called me on Saturday. I could tell she was nervous and she told me about the struggle she had been having getting regulated on Lybrel with irregular bleeding that would come and go and she couldn’t get a good pill taking regimen so she could develop a habit of taking her pill at the same time each day. I’m wondering why she was calling me about that when she finally got to the point. She began getting nausea attacks three days ago, tested and found she was positive for hCG and she wanted my help getting an abortion. I said she could go to UNLV Student Health and she freaked out. She is terrified of her father finding out she is not only sexually active, but that she wasn’t careful enough and has no idea who the father is. Her father is a prosperous evangelical fundamentalist in a state in the Deep South and she is scared to death of him. She has a bit of money of her own that she gets from her mother so she can pay clinic rates for the termination.

It was pretty early to be having pregnancy symptoms after only fifteen days (she began sampling the clients the day the place opened for business on the 28th) but certainly possible so I had her meet me at the clinic and one of the NPs did a serum pregnancy test and she was indeed very newly preggers. Go figure! So she signed the patient agreement and was given the first three pills (Mifepristone) and Saturday counted as day one in the Mifeprex regimen to terminate her pregnancy. She was so relieved to be getting the problem quickly taken care of. I told Adolph about her pregnancy and he wondered if it was his since he had taken her each of the four days she was helping at the estate. She was to return to the clinic on day three, today, so I met her at the clinic and the NP said she should take two misoprostol tablets which she did. The misoprostol can cause cramping, bleeding and nausea so I took her back to the sorority house where there will be other students to take care of her if she starts to bleed heavily. Mifeprex is about 95% effective in terminating pregnancies so she should be fine. In two weeks she will need to go back to the clinic to make certain that everything is normal and her reproductive tract has recovered.

Videoing porn during a 6 ATA dive

Looking toward the surface of Adolph’s training facility

Videoing in ‘The Well’: When the Producer from Taryn’s Adult Media video crew (in town to video the ‘French Schoolgirl’ story) saw Adolph’s 200 ft deep training facility, which we call ‘The Well’, she decided to have the script rewritten to have The Well included in the video. It wasn’t as though there was a lot of dialogue to rewrite since the audio will be background music and the sound of gas being sucked through demand valves, moans and gasps of the copulating couple and roar of bubbles rushing toward the surface. The change worked out well since I wanted to give Gigi her first 200 foot (6 atmospheres) dive and she was going to help me clean up the debris, primarily contraceptive devices and bits of bondage apparatus off the bottom. The bottom was overdue for a cleaning since the last time Taryn and I had cleaned it was in December of last year and the debris hadn’t been picked up since.

Deep diving and Reflexions as a gas-guard: The Director wanted the obligatory underwater teen sexual encounter for this sort of video and since Gigi has had sex with Adolph several times and enjoyed him being rough with her we figured why not give her two bites of the apple and let her experience his style of lovemaking at 6 atmospheres and she was enthusiastic about the opportunity. She would wear her Reflexions gas-guard since 200 feet below the surface is no place for something to go wrong during sex. Returning readers will remember that the Reflexions flat spring diaphragm is the only style that can safely protect a diver below 10 meters (30 feet) since the rims of other styles will distort and cause leakage at depths below 30 feet. That isn’t usually a problem because there are so few training facilities deeper than 30 feet, but in my 68 ft deep pool and Adolph’s 216 ft deep facility Ortho or Milex diaphragms are useless below 30 feet. Of course an embolism is an embolism and is either extremely serious or fatal. It’s bad enough if an air bubble is forced into the vagina in water at any depth, but the deeper the woman is when that happens the larger the bubble becomes as it expands during her ascent. So if a woman’s gas-guard failed at a depth of 200 feet the bubble would expand to 5 times its size when it entered her bloodstream by the time she reached the surface, almost certainly assuring her death.

Adolph and contraception: Adolph is a very dangerous man for a woman to have sex with if she is serious about avoiding pregnancy. One of his favorite tricks is to provide ‘vitamin supplement’ pills to the female students sent to him for training. This supplement has a progestin receptor blocker in it that makes the woman’s hormonal birth control worthless. There is some initial withdrawal bleeding as her body adjusts to the lack of a continuous level of progestin which he explains away by saying it’s a side effect of altitude diving – his facility is 3,000 feet above sea level – and the extreme depth of his training facility. Not even women with traditional IUDs (Mirena and ParaGard) are safe because he will try to pull them out by the strings during a training exercise. While the wearer is menstrual, when her cervix is low and soft, she will rarely feel it being removed. That’s more difficult to do with a woman who has a Mirena inserted because 20% of them stop bleeding completely, but if he can reach the strings he can pull it out.

With the young ones who have recently had IUDs inserted it’s relatively easy for him to do and he’s getting better at it with practice. Adolph says that getting a trainee pregnant, even after the pregnancy is terminated, gives him a powerful psychological hold over her that no other domination technique will since she has experienced his ability to tamper with her reproductive biology which most young Subs don’t realize is possible until it happens to them. Most trainees he impregnates say that while they feel violated they find themselves bonding very closely with him. Perhaps that’s a little known aspect of the Stockholm Syndrome. In recent months he has had about a 20% pregnancy rate with the women sent to him for training. When they test positive He will send them to the casino’s reproductive health clinic for menstrual extractions which are much quicker and more effective than taking Mifeprex. The only IUD that Adolph hasn’t yet tampered with is the GyneFix which has no strings and which is implanted deep in the muscle of the fundus. Although, there have been GyneFix expulsions during intense cervical thrusting encounters that caused severe uterine cramping. The expulsions are thought to be because the device was improperly implanted. GyneFix expulsions have diminished almost to zero since new implantation techniques were developed several years ago.

Gigi has a GyneFix implanted so as far as pregnancy is concerned she is as safe as possible. And, Adolph agreed to leave her Reflexions gas-guard in place, which I insist on when he has underwater penetrative sex with me or any of the women in my inner circle. Even so, I went to the bottom of the well with Gigi, Adolph and the video crew breathing Trimix just to make certain he didn’t compromise her upper reproductive tract protection. The water is a constant 85° F and it took us a while to descend all the way to the bottom at 216 feet as we manipulated our masks to equalize the pressure. We all wore string bikinis weight belts and flippers – including the camera crew - except Adolph who was in a Slingshot. We used Adolph’s deep dive gear. Ocean Technologies Guardian FFMs equipped for Trimix and a Trimix blend of 19/30 in Worthington HP steel X8-130 twin sets with a tank cluster of 100% oxygen pre-positioned at our 40 ft. deco stop accessed by a quick disconnect to a gas block switch worn on the tank harness waist belt.

FFMs for deep dives: The importance of a using an FFM for deep dives and dive-sex can’t be overemphasized. For dive-sex if it gets rough for the woman having her cervix rammed can cause her to expel her reg at best that interrupts the moment. At worst she ingests enough water that she needs to terminate the dive. The other reason a FFM is so important is in case of decompression sickness (DCS) or oxygen toxicity where the diver might pass out or have a seizure and expel his/her regulator and it may be impossible for a dive buddy to get the reg back in his/her mouth. That is a very common cause of dive fatalities especially where the ascent will take too long for there to be a reasonable chance of survival w/o being able to breathe. The only down-side to using FFMs during dive-sex is that it’s impractical to give cunilingus or fellatio while using one.

We didn’t dive for two days before the 6 ATA dive to minimize our nitrogen loading so we could stay down as long as possible and we took a Divemaster who was responsible for the dive safety of all the divers so we could pay attention to what was happening as far as the video storyline and the cleanup were concerned. On the bottom Gigi shed her fins, weight-belt and tanks (which she kept right beside her) and straddled Adolph who was on his back lying comfortably on the padded twin-set tank harness while the tanks were broad enough to provide a stable base for a penetrative encounter. She helped him out of his cup and he was already massively erect. She checked the position of her gas-guard and her lube, nodded and lowered herself onto his erection and gasped when he entered her.

We had talked about how she should take him before the dive and she followed my suggestion. She wrapped her legs around his hips and tightening her legs pulled herself further on to his shaft a bit at a time until he was fully inside her. She said later that she was afraid he would be able to hit her cervix, but she has been thinking how much fun it would be getting pumped full of highly motile German sperm 200 feet below the surface and had psyched her self into nearly full arousal while we were still descending. Once she found he wasn’t able to hurt her she bore down forcing her cervix to push against the tip of his shaft through the stretchy latex membrane of her gas-guard – just to show him he was very close, but unable to reach her prize on his own. With her strong vaginal muscles she was able give herself G-spot orgasms and get them both off several times while the camera crew was recording the encounter. I’ve rarely seen Adolph as exhausted after a sexual encounter, but Gigi tired him out which she and I were very pleased about because shortly after she pulled herself off him he started his ascent leaving us to collect the contraceptive and BDSM debris off the bottom and the camera crew to record it for a ‘behind the scenes’ segment for the blue-tooth version of the video.

Discarded contraceptives inventory:

Ortho latex Coil spring diaphragm: two, 70 & 75mm with tears in the dome
Latex Ortho coil spring diaphragms: two 65 mm one of which had a tear in the dome.
Silicone All-Flex arcing spring diaphragms, six of various, but mostly 65 mm sizes two of which had punctures in the domes.
Cooper Surgical (Milex) Omniflex silicone diaphragms: three a 65 mm and 70 mm
Reflexions latex flat spring diaphragm: five 70 and 75 mm.
FemCaps: four one small 22 mm and three mediums size, 26 mm
Prentif Cavity rim cervical caps: one 22 mm.
Oves cervical caps: three a 26 mm and two 28 mm
ParaGard framed copper IUDs: four, two with bent frames
Mirena, IUD: 1 with a bent frame
FC1 condoms: 2
FC2 condoms: 23
Filled DiveGel applicators: 4
Empty DiveGel applicators: 45
Filled Semécide applicators: 2
Empty Semécide applicators: 54
Filled Conceptrol spermicide applicators: 2
Empty Conceptrol spermicide applicators: 7

From the Number and type contraceptive products we found it seems clear that women being sent for training at a facility deeper than 30 feet are still not being told that if a diaphragm was to be used for training only a Reflexions flat spring latex diaphragm would provide under-thrust and distortion free protection down to at least 200 feet. I’ve told Adolph I would check the fit of his trainees gas-guards and give them a Reflexions to properly protect themselves (Adolph has an account with our clinic), but he seems to like to let most of the women take their chances, knowing any gas-guard other than Reflexions, or a FemCap, used below 30 feet will be ineffective. The only positive thing in this last inventory is that no GyneFix implants totally dislodged while their wearer’s were in the water.

Bottom sweep conclusions: As before the previous bottom sweep inventory all the women sent for training in the past 5 months are adults, tall, beautiful and slim. Therefore, it seems likely that the 65 mm silicone All-Flex devices were too small (under-sizing is a common mistake made by inexperienced fitters) making them easier to dislodge and expel. The number of full lube and spermicide applicators on the bottom suggests that the women were nervous about being in training and not confident about the use of vaginal applicators. Additionally, a lot of their diaphragms or caps are being either expelled or intentionally pulled out by their partner/instructors. That being the case one hopes they are being removed after providing protection as gas-guards during dive-sex since upper reproductive tract protection from a pelvic infection by pool water or an embolism is vital to the woman’s safety.

A contraception failure is a different matter entirely since it can be taken care of easily with emergency contraception especially since Ella is now available in the U.S. And pregnancy at least through the 8th week with Mifeprex or later by vacuum extraction so while it might put the woman in a moral quandary she has options readily available. That isn’t the case if she gets an embolism because her gas guard was pulled out during dive-sex before she was penetrated or it was under-thrust.

The ascent: After we cleaned up the bottom our ascent was uneventful. During our 20 minute deco stop at 40 feet breathing O2 the camera crew and I all masturbated to take care of our arousal from watching Gigi and Adolph fuck each other’s brains out. Gigi really enjoyed her encounter with Adolph because of the depth at which it occurred – she found breathing Trimix ‘awesome’ - and because he let her be in charge and she loved that from a man who can be so demanding and brutal most of the time. We both knew he was doing that for the camera and she probably won’t find him that easy to control again.

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.

Birth control pills and obesity

Ortho Cyclen 0.25mg norgestimate, 35mcg ethinyl estradiol

The pill equally effective in obese, thin women
Reuters Health
By Anne Harding
Fri Jul 30, 2010

“NEW YORK (Reuters Health) - Despite studies suggesting that birth control pills might not work as well in obese women, a new study suggests that they prevent pregnancy the same no matter what a woman weighs.

As long as a woman-heavy or thin--took the pill consistently, Dr. Carolyn L. Westhoff of Columbia University Medical Center in New York City and her colleagues found, it prevented her ovaries from producing eggs. Westhoff and her team report their findings in the August issue of Obstetrics & Gynecology.

Studies have found that obese women are 30 to 40 percent more likely to get pregnant while taking the pill than were normal-weight women taking it, perhaps because excess weight might blunt its effectiveness. Overall contraception failure rates are estimated between 2 and 8 percent per year.

In their study, Westhoff and her colleagues enrolled 226 normal-weight or obese women, randomly assigning them to take a lower or higher dose version of the pill. After three or four cycles of oral contraceptives, the researchers then had the women undergo multiple ultrasounds and blood tests to determine if their ovaries were making eggs.

The researchers tested women's blood levels several times to determine if they were using the pill consistently; about 90 percent of the normal-weight women had hormone levels indicating consistent use, compared to 72 percent of the obese women.

Ninety-seven percent of the 150 consistent pill users did not ovulate, the researchers found, meaning they would not have gotten pregnant during that cycle. Whether or not a woman was obese didn't affect her likelihood of ovulation; among the consistent pill users, three of the 96 normal-weight women ovulated, and one of the 54 obese women did.

Two ovulations occurred in women taking the higher-dose pill, and two occurred in women on the lower dose.

But more than a third of the 13 women who were inconsistent pill users ovulated, and two-thirds of the 18 non-users produced eggs.

The new findings, along with more recent clinical trials, should put to rest concerns that obese women are more likely to get pregnant while on the pill, Westhoff says. The issue has confounded doctors, she notes, because some companies have pushed physicians to prescribe higher dose formulations to their obese patients based on the idea that lower doses aren't effective.

The problem with this approach, she explains, is that obese women are at increased risk of developing life-threatening blood clots in their veins. Taking the pill-especially at higher doses-further increases the risk these clots will occur.

But according to her findings, Westhoff says, obese women who take lower-dose pill formulations can be reassured that they will be effective in preventing pregnancy.

Westhoff has consulted for drug firms that make oral contraceptives, including Duramed, Schering-Plough, and Bayer.

The problem with previous studies, Westhoff told Reuters Health, was that women were asked to recall unintended pregnancies that had occurred in the past; the women also reported their own weights, rather than being weighed by the research team.

Dr. Victoria Holt of the University of Washington in Seattle, who led the studies finding different failure rates among obese and normal-weight research, said she still believes obese women are more at risk of becoming pregnant while on the pill.

She argues that Westhoff's research suggests obese women are less likely to achieve adequate hormone levels while taking the pill, because just 72 percent had levels indicating consistent oral contraceptive use, compared to 90 percent of the normal-weight women.

"If indeed there is lower effectiveness among obese women, then this does not appear to be the mechanism through which it works," Dr. James Trussell, the director of the Office of Population Research at Princeton University in New Jersey, told Reuters Health. Trussell studies contraceptive failure, but wasn't involved in Westhoff's research. "But nobody has any idea what the other mechanism would be."

This November, the National Institutes of Health will convene a group of experts to investigate whether further research should be done on obesity and oral contraceptives, he noted, while the Food and Drug Administration is also planning a hearing to address evidence that a new emergency contraceptive pill is more likely to fail in obese women.

"It's a particular concern in the United States because obesity is increasing so rapidly," Trussell said. "I would say that the pill is still not going to be the front line, the top tier contraception for obese women."

Methods with a lower risk of failure due to human error, like the IUD, hormonal implants, or vasectomy for the male partner, would likely be a better choice, he said.

"If a woman really doesn't want to become pregnant I would suggest combining oral contraceptives with a barrier method," Holt advised, such as condoms or a diaphragm.

SOURCE: link.reuters.com/wez52n Obstetrics & Gynecology, August 2010.”

Personal comment: Our escort training and service operations don’t employ heavier girls. The classical ballet dancers with Balanchine bodies that are our specialty are the very opposite of heavy; toned sleek and hard-bodied with small firm breasts and high tight buns. Even so I’ve been following this research (still in its early stages) for some time. What we can all agree on is that heavier women are more likely to become preggers while on the pill than are their thinner sisters. That may be due to metabolism subtleties or the fact that heavier girls are noticeably and consistently less compliant (perhaps for psychological reasons) in taking their pills correctly, or both.

The bottom line is that most of the services that supply heavier escorts – it’s a niche market – require the girls to have IUDs inserted for insurance purposes. They use the standard framed versions generally available - Marina or ParaGard - tending more toward Marina because it reduces menstrual flow and sometimes stops the woman’s periods entirely. Heavier escorts tend to offer only vanilla sex options because getting into most fetishwear when heavy is an exhausting process and the weight on their feet in ballet-boots will often lead to severe injuries so at best they only pose sitting down or on their backs when in ballet boots.

Young peoples sex knowledge lacking

Abstinence-only sex education

CNN.com
By Elizabeth Landau, CNN
December 15, 2009 12:03 a.m. EST

Gaps found in young people's sex knowledge

“Most sexually active unmarried young adults believe pregnancy should be planned, but about half do not use contraception regularly, according to a study published Tuesday.

The survey of 1,800 people age 18 to 29 was conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy.

"What is surprising is just how wide the gap is between single young adults' intentions and behavior on this very important issue," said Bill Albert, chief program officer at the organization.

Also, 29 percent of women and 42 percent of men said it is at least slightly likely they will have unprotected sex in the next three months -- and it's quite likely or extremely likely for 17 percent of women and 19 percent of men.

The discrepancy between both wanting to plan pregnancy and having unprotected sex may have something to do with a focus in recent years on abstinence-only education, said Laura Lindberg, senior research associate at the nonprofit Guttmacher Institute.

"Abstinence-only curriculums have gone explicitly out of their way to teach misconceptions about contraception," she said. "This generation of 20-somethings have missed many opportunities to get medically accurate and correct information."

But for abstinence education advocates, the problems stem from not enough focus on refraining from sex until marriage.

"I don't think we'll be able to overcome this problem unless we restore the social norm of not having sex and not getting pregnant before marriage," said Peter Sprigg, senior fellow for policy studies at the Family Research Council. "Even when people are informed, they just don't choose to consistently practice contraception."

Many of the people surveyed said they did not know much about contraception to begin with -- 63 percent said they knew little or nothing about birth control pills, and 30 percent said they had scant knowledge about condoms.

The numbers may reflect that while most people have heard of the pill and condoms, they have never been taught how to use the pill or where to get it, or how to put on a condom, said Dr. Yolanda Wimberly, assistant professor of clinical pediatrics at the Morehouse School of Medicine and an adolescent medicine specialist with Grady Health Systems in Atlanta, Georgia.

Myths about pregnancy and sexual activity continue to permeate circles of young people. For instance, 28 percent of men incorrectly believe they will get extra protection from wearing two condoms at once, a practice that actually leads to condom breakage. At the same time, 18 percent of men wrongly believe that having sex standing up reduces the chance that they will get a female partner pregnant.

These are the kinds of myths often heard in Wimberly's office. Wimberly, who sees young people from age 12 to 30 about sexual health issues, commonly hears rumors like these that have spread among friends. Anecdotal evidence that a behavior is safe is sometimes more convincing for young adults than the recommendations of health professionals.

"If other people have been doing it, and nothing bad has happened, then they'll do it," she said. "We have definitely got to do a better job of dispelling myths."

Albert said it was shocking that about four in 10 respondents said it doesn't matter whether people use birth control, believing that people get pregnant when it's their "time."

But this was not surprising for Wimberly. She pointed out that some people are not opposed to having children in their 20s and are at a point in their lives at which they would be relatively comfortable going through with an unplanned pregnancy.

There are also exaggerated doubts and fears about birth control pills, the study said. Twenty-seven percent of women and 34 percent of men in the survey said serious health problems such as cancer are likely to result from using the pill or other hormonal contraceptives.

Experts say hormonal contraceptives are relatively safe, but there is some mixed scientific research on the topic. According to the National Cancer Institute, oral contraceptives have been shown to increase the risk of cervical cancer, although human papillomavirus is the major risk factor for the disease.

Some studies have found an increased risk of breast cancer, but others found no connection. There is also evidence that oral contraceptives decrease the risk of ovarian and endometrial cancer, but that they increase the risk of liver cancer in women who are otherwise considered at low risk for the disease.

But the known evidence does not suggest it is "highly likely" that cancer will result from the pill, the National Campaign to Prevent Teen and Unplanned Pregnancy said. The survey cites a recent Mayo Clinic study that suggested an additional 2 to 3 percent increase of developing breast cancer as a result of being on the pill.

Wimberly always goes through all the pros and cons of using the pill with her patients, including the noncontraceptive benefits. Each individual should discuss all the positives and negatives of the pill with a health care provider before deciding to use it, she said.

Nearly half the adults surveyed said they agreed that "drug companies don't care if birth control is safe; they just want people to use it so they can make money." Thirty-two percent said they agreed that "the government is trying to limit blacks and other minority populations by encouraging the use of birth control."

Still, according to a 2002 study from the Centers for Disease Control and Prevention, the leading contraceptive method among women ages 15 to 29 is the pill.

While the actual rate of infertility among people 18 to 29 years old is 8 percent, a great deal more think they may fall into that category -- 59 percent of women and 49 percent of men said it is at least slightly likely they are infertile, and 75 percent of people who had concerns about fertility did not worry about it because of information from a doctor.

About half of all pregnancies in the United States are unplanned, according to the American Congress of Obstetricians and Gynecologists.

The survey calls for more sex education for adults, given that about one in five participants said they had never had sex education in school. Colleges -- both two-year and four-year -- should educate students about pregnancy and contraception, and such programs should also be available in workplaces, job training sites and the military, the survey said.

Health care providers also have a role to play in ensuring that young people know all their options for family planning, and in providing patients with these methods, the report said.

Wimberly added that other community-based venues such as churches, community centers, hospitals and after-school programs could all disseminate information about contraception and family planning.

Parents can also play a big role in helping educate their children about these issues, Albert said.

Groups such as the Family Research Council continue to advocate for abstinence-only education at the K-12 level, but the organization does not have an official stance on what sex education should happen beyond that, Sprigg said.

"But as far as investing taxpayer dollars and making a strong public policy effort, we think the principle focus should be on encouraging abstinence," he said.

The survey also touches on a distrust of the health care system more generally, Lindberg said. The challenge is to "create more positive attitudes and make health care providers and the health care system feel like a safe and trusting place," she said.”

Personal comment: ‘Just say no’ doesn’t work. In today’s sex-saturated society in the U.S., I think it’s sad that there are still people who think that ‘Abstinence Only’ Sex-ed is enough to responsibly prepare teens for their roles in society. Abstinence Only sex-ed leaves teens unprepared to protect themselves against STIs and at greater risk of unintended pregnancies.

The Withdrawal Method

An egg and sperm just before conception

Withdrawal: There has been a lot of publicity recently about some ‘research’ done on the ‘withdrawal’ method of birth control. Below is one of the more balances articles. Buried in the article is the comment that how well it works depends a lot on the woman’s fertility which is key to any success it might have. For a woman practicing Natural Family Planning where she abstains from sex when she is fertile I can see withdrawal being highly effective. However, I’m betting that used during the 8 or so days a woman is fertile each cycle withdrawal is not at all effective as birth control. I agree with a comment in the article that the studies cited were poorly conducted.

Simple method turns out to be a popular form of birth control:
Healthy Cleveland Tuesday June 23, 2009, 8:00 AM

“The last time I checked, nobody was actively touting the withdrawal method (also known as coitus interruptus or "pulling out") as an effective form of birth control.

So when a colleague suggested that I check out the article in the June 2009 issue of the journal Contraception titled "Better than nothing or savvy risk-reduction practice? The importance of withdrawal," I rolled my eyes.

Then I decided to give it a glance.
Written by Rachel K. Jones and three of her colleagues, the commentary analyzed previous studies and unpublished research on the withdrawal method as a means of birth control.

Based on what they analyzed, they came up with the conclusion that the method of withdrawing prior to ejaculation not only was pretty common -- especially by younger women and their partners -- but that it also was used as a back-up to condoms or oral contraception and was "almost as effective as the male condom."

The commentary cited some interesting statistics. The withdrawal method has a 4 percent perfect-use failure rate, and an 18 percent typical-use failure rate over a one-year period.

In comparison, condoms have a 2 percent perfect-use and 17 percent typical-use failure rate.

Jones, a Tulane University-trained sociologist who joined the Guttmacher Institute 10 years ago, told me during a telephone interview that she and her colleagues aren't in the business of endorsing one method of birth control over another.

But the topic of withdrawal -- how many people do it, how often it works -- is something that deserves further research. More isn't known about its effectiveness because the research community hasn't been interested in the topic, Jones said.

"Whether you like it or not, people are using it," she said. "The majority of women have used it at some point in their lives." It makes sense then, she said, that people be armed with better information about coitus interruptus.

Predictably, reaction has been swift, not only in academic circles and in the blogosphere, but by those who make a living in the study and marketing of birth control.

I asked a couple of condom makers to weigh in on the debate, especially since Jones' writing suggests that pulling out is nearly as effective as their products.

Here's an excerpt from a statement from Jim Daniels, vice president for Trojan Brand Condoms:

"When used consistently and correctly, condoms have been shown to be 98 percent effective in preventing pregnancy. In contrast to withdrawal or hormonal methods, condoms provide visual confirmation, to both partners, that contraception is being used during sexual activity."

Visual confirmation. Got that?

Both Daniels and Carol Carrozza, vice president of marketing for Ansell Healthcare, which makes LifeStyles Condoms, mentioned the added protection that condoms have against sexually transmitted diseases, including HIV and AIDS.

Given the times in which we live, that's not an insignificant point.

Carrozza questioned the "perfect-use" rate of withdrawal. "The scary thing about withdrawal is that it really requires that the male be in control, that he properly know how to use the method," she said.

While he agreed that it would be nice to know how effective the withdrawal method is, Planned Parenthood Northeast Ohio chief medical officer Dr. Lazlo Sogor said that would be difficult to research.

"It probably does some good, but we don't know how well," he said of the method. "Some days you pull out quick enough, and some days you don't. A lot of it depends on a woman's fertility."

The studies that were referenced in Contraception are "poor science" from which no solid conclusions can be drawn, Sogor said.

Then he raised two important issues:

First, where would you find people willing to be observed in a clinical trial?

The only way to do it right, Sogor said, would be to randomize research subjects into two groups -- one using only the withdrawal method, the other using only condoms -- and study them for at least six months.

And, secondly, he said:

"Let's face it -- who's going to fund this?" he asked, sounding a bit incredulous. "Pharmaceutical companies certainly aren't interested in this. There's no money to be made." “