Secret Sex Questions Answered

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Vaginoplasty; pap smears

I've been hearing about new laser procedures to increase sexual satisfaction. What's involved? Are they risky?

More doctors are now offering -- and more patients are requesting -- laser procedures designed to enhance the appearance of the female genitals or tighten and support vaginal muscles weakened by childbirth or aging. With vaginoplasty or "labial contouring," surgeons trim vaginal lips, or labia, that are excessively large or uneven. Laser vaginal rejuvenation tightens the vagina, purportedly to increase sexual satisfaction.

So far, there is scant evidence to support the safety and effectiveness of such procedures, which cost upward of $4,000. Still, says Stuart Fischbein, for women who find intercourse painful due to oversized labia that get pulled into the vagina, for example, these procedures may be worth it.

I recently read that I can wait three years before having another Pap smear if my last one was normal. Is that really safe? Can I trust a "normal" reading?

A recent study of 128,000 women from the Centers for Disease Control and Prevention (CDC) suggests that for women who have a normal Pap screening it may be safe to wait for up to three years before their next one. This is true in part because cervical cancer is typically slow growing. (However, most doctors and the American College of Obstetricians and Gynecologists advise against this, partly on the grounds that annual exams check for more than just cancer. Also, the American Cancer Society recommends that women have three consecutive normal readings one year apart before switching the frequency.) To get the best possible test, it pays to ask your doctor a few questions. Find out whether she has direct contact with the pathologist at the lab that reviews the smears, says Stuart Fischbein. If your doctor and the pathologist don't communicate, the pathologist may not have all the information needed to make a correct diagnosis.

Also ask your practitioner about the tools (swabs, brushes or "spatulas") she uses to collect cervical cells. Research suggests that a cytobrush, which looks like a mascara wand, is more effective than cotton swabs at obtaining a good smear, and spatulas equipped with extended tips can reach further into the cervix to sample hard-to-reach areas. You could broach the topic by saying, "'Doctor, I've been reading about so many options lately, what do you use to do Pap smears?'" advises Fischbein. "If you offend somebody because you're looking after your care, you need a new doctor."

Finally, ask your physician whether she obtains cells from both the outside of the cervix and the canal that leads to the uterus. Sampling from both areas gives the doctor a better chance of catching abnormalities.

Continued on page 3:  Anal itching; genital herpes

 

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