Tuesday, April 8, 2014

Don't Get Your Birth Control Information from Cosmo

I found this little gem on the cosmo website today. Don't ask me why I was on the Cosmo website - it's complicated, I don't want to talk about it.

The author of the article claims to want to help women make decisions about birth control because there just isn't enough information out there. That's true. There isn't enough accurate information about birth control that helps women make decisions that work well for them. This article doesn't provide that either. The 'article' is just a list of all the different types of contraceptives out there and their failure rates. It contains only a one sentence description of the method, a picture, a pithy joke or two, and the failure rate.

There's two problems with doing things this way. First, just listing the failure rate and putting them almost in a descending list of most effective to least, implies that one is actually better than the other simply because of the effectiveness rate. There are a lot of other considerations though - such as whether it's even available to you, if the way it must be used fits your life and your needs, if there are side effects, if the method is contra-indicated for any health issues you might have, and whether you can afford it or not. It is true that hormonal contraceptives have the highest effectiveness rates of all the methods. It is also true that they have the greatest number of side effects and the most serious side effects of all the methods. Pregnancy is not the only thing to consider when making a choice.

Second, the author has chosen to use typical use rates of failure. That is mentioned only on one method so it's a little confusing as to whether it's typical use just for that method or for all. But it is for all. She might have thought she was giving the real info by doing that - after all, condoms are said to be 95 to 98% effective but that is only if they are used properly every time. A typical failure rate, though, is an aggregated statistic. It combines all the people that use the method. It includes people who are trying it for the first time and people who've used it for a long time. It includes people who read the instructions before they used it and people who didn't. It includes people who asked questions or practiced and people who didn't. So yes, overall, the failure rate is what is printed in Cosmo's little list there, but what she doesn't say is that an individual can greatly increase the effectiveness rate by making sure s/he understands the method, practicing, and taking care to use it properly. The effectiveness rate for almost every method, particular things like condoms and fertility awareness, usually increases for each person the longer they use it. The author really needed to include the perfect use rate because, if you are careful to use them perfectly, they can be as effective as the perfect use rate.

The author also includes the cervical cap in her list. In Canada, this is pretty much non-existent now. I've had several calls over the last few years from women trying to find the jelly that goes with cervical caps. They have had a cap for awhile but can't get the jelly. This is because doctors here are just not fitting these devices anymore. I'm not sure why this is but I suspect that it's because they've fallen from favor as more effective and easier to use methods have become available. I'm not saying that's necessarily a good thing - they have been good choices for some. But whether they are, or not, you're going to have a hard time finding them here. Unless things are very different in the USA, putting them on that list is a complete waste of time.

If you want accurate, comprehensive, information on birth control, check out the BedsiderInsider. It has all the same stuff but it explains it all - including a really good list of pros and cons for each method and stories of the experiences of people who used them.

Thursday, April 3, 2014

Take the Porn-Related Erectile Dysfunction Test and You'll Fail. I Guarantee It.

A few days ago, a lovely colleague of mine alerted me to this post on the Global News site about a new condition called 'porn-related erectile dysfunction'. This is by no means the first time I've encountered these types of arguments about internet porn but this is the first time I've heard this term. The doctor who participated in this discussion claims that young men who watch a lot of internet porn find that they can no longer get it up with a real person. He calls this 'porn-related erectile dysfunction'. There was also a man involved in this discussion who says the he was addicted to internet porn and has this dysfunction. It sounds distressing when you hear them talk about it but the concept raises a heck of a lot of questions.

I wanted to get to the bottom of it so I went to the site Your Brain on Porn - which is the mother of all sites when it comes to this whole movement about brain chemistry and pornography. I wanted to understand their definitions and their research to see if there really is any validity to these claims. I wanted to look at this site page by page and do a detailed analysis of the complex issues involved. I would still like to do that. But when I got the first page about 'porn-related erectile dysfunction' wherein you can learn if you have this problem, my blood pressure became dangerously high and my brain almost exploded.

So, said detailed analysis of the whole idea and this 'brain on porn' movement will have to wait. For this post, I offer only an analysis for the test for 'porn-related erectile dysfunction'.

The site goes through a lot of information, resources and advice for men (as they only consider that men could have this problem) who think they have this issue. The first step is to test yourself to see if you really do have it. Here is the test:

"Once you have ruled out organic causes, try this simple test to isolate porn-induced ED from performance anxiety-induced ED.

On one occasion masturbate to your favorite porn (or simply imagine it).
On another masturbate with no porn/porn fantasy. That is, no recalling of porn.

Compare the quality of your erection and the time it took to climax (if you can). A healthy young man should have no trouble attaining a full erection and masturbating to orgasm without porn or porn fantasy.

If you have a strong erection in #1, but erectile dysfunction in #2, then you have porn-induced ED.
If #2 is strong and solid, but you have trouble with a real partner, then you have anxiety-induced ED.
If you have problems during both 1 and 2, you may have progressive porn-induced ED, or an organic problem. When in doubt, see a good urologist."

Do we see any problems here? There are some obvious ones such as the fact that the test is incredibly subjective and vague. They don't explain exactly what constitutes ED. Is it not getting hard at all? Is it getting only somewhat hard? Is it getting hard but losing your erection? Is it getting hard but not as hard as you think you should be? That's not explained here. So how is a guy supposed to know that what happening to him is ED? The definitions and description of the test are vague but the diagnosis is totally conclusive. If you have this experience, you have porn-induced ED. There is no equivocation there. It makes it sound as if these very complex issues can be boiled down to a simple definitive diagnosis. That's just not the way it is.

But my biggest concern about this 'test' is that it belies a complete lack of understanding as to how sexual arousal actually works. The author of this test is telling men to actively TRY not to think of porn or a porn fantasy when they masturbate. This is almost impossible. Our brains are a key part of our sexual desire, arousal, and response. We get more turned on, more stimulated, more excited, when our brains are focused on something sexually exciting to us. That brain excitement triggers body excitement which then triggers more brain excitement and it creates one big cycle of yum! That's how it's supposed to be. It is not only normal, but actually almost impossible, to have absorbing exciting sex, without having some kind of sexual imagery in your head. Now I'm not saying that imagery has to come from porn. For a lot of people it doesn't. It could be as simple as getting visual pictures of the last time you did this very thing, or other fantasies you've had about your partner, or someone else. The point is that for most of the time, when we have any kind of sex, including masturbation, our brain is filled with sexual images. It will be natural for someone who's seen any porn at all, to have flashes of imagery go through their brain. If that person is trying not to have those thoughts, every time one comes in, they would be acutely aware of it and trying to dismiss it and focus on something else.

What happens when we actively try to control what goes on in our head during sex, or allow ourselves to become distracted by non-sexual thoughts? You guessed it, we lose our hard-on. I'm not necessarily speaking literally. It might be that you don't totally lose the hard-on but that everything just slows down and it's harder to get off. Some people actually do lose their hard-on because they've disrupted that yum cycle. People without penises lose their figurative hard-on - their train just jumps off the track and often can't get back on. Men are actually taught to think about something they don't find sexy in the least if they are really turned on and not able to have sex or masturbate or if they want to slow down and take longer. It's a running joke we've all heard. (Austin Powers repeatedly thinking 'Margeret Thatcher naked on a cold day' comes to mind). I talk to women in my female orgasm workshops about this very thing. We work on techniques to allow yourself to stay focused on sexy yum thoughts instead of getting distracted by non-sexual things that take you out of the game. The more yum, in the moment thoughts you have, the more into it you'll be and likely the more able to feel pleasure and maybe have an orgasm. The more non-sexy thoughts you have, the more likely you won't get much out of it.

This 'test' is actually directing men to do something that, by its very nature, will make them less able to stay hard and masturbate to orgasm. It's not so much that they can't get hard if they aren't watching porn or thinking about porn, it's that they can't do it when they are focusing all of their mental energy on not thinking about porn. Very few people could. Add to this the fact that if you are trying to test yourself for function, you're naturally going to be pre-occupied and nervous and that will affect your response too. So if this is the definitive test as to whether you have 'porn-induced erectile dysfunction', I guess most of us have it. I know I certainly do.

There is a lot of other troublesome stuff here such as the completely heternormative view of sex; the covert and insidious shaming of men for their sexual desire; the insistence that there are 'real' types of sex and 'non-real' types of sex; and the heavy emphasis on the idea of dysfunction in the first place. But for now, this is all I can bare to even look at. The rest of it will have to come later (no pun intended). Until then, go take that test and see if you can pass it. At the very least, you'll have fun failing.