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Time to end pelvic exams done without consent

Roarman — Fri, 29 Jan 2010 10:23:58 -0800

Imagine that you are undergoing a fairly routine surgery – say, removal of uterine fibroids or hysterectomy. During or right after the procedure, while you are still under anesthesia, a group of medical students parades into the operating room and they perform gynecological exams (unrelated to the surgery) without your knowledge.

Do you consider this okay, or an outrageous violation of your rights?

Regardless of your feelings, you should be aware that this is standard procedure in many Canadian teaching hospitals.

Medical students routinely practice doing internal pelvic examinations while surgery patients are unconscious, and without getting specific consent, at least in Canada.

Guidelines in the United States and Britain say specific consent is required but, by contrast, Canadian guidelines state that pelvic examination by trainees is “implicit.”

The practice – one of those dirty little secrets of medicine – has been exposed in a thoughtful, professional manner by a young doctor.

The story goes back to 2007 when Sara Wainberg was a medical student at McMaster University. Her younger brother Daniel, also studying to be a doctor, phoned for advice: As part of his rotation in obstetrics and gynecology, he had been asked to perform a pelvic exam on a woman who was under anesthetic. He refused, saying doing so without consent would be unethical.

“It got me thinking,” Sara Wainberg said. “I had done this numerous times in my training and it had never occurred to me that it might be unethical.”

She polled her fellow students and found 72 per cent had also done exams on unconscious patients, without consent, confirming that it is routine.

It is essential for medical students to learn basic techniques, including pelvic examination, in well supervised settings.

The long-standing argument in favour of allowing these exams to be done on surgery patients is that it provides a unique opportunity for students to practice the delicate, invasive examination without causing the woman pain or embarrassment.

There is also an assumption that women would never accept pelvic exams by students while conscious so sneaking them in, while not ideal, is acceptable.

When Dr. Wainberg took a position as a resident at Foothills Hospital in Calgary, she decided to study the issue further. She and fellow researchers polled 102 women who were patients at the Calgary Pelvic Floor Disorders Clinic.

The results – reported in The Medical Post and in the Journal of Obstetrics and Gynecology – are as fascinating as they are troubling.

Dr. Wainberg and her team found that fewer than one in five women were aware that a student might do a pelvic exam in the operating room. At the same time, 72 per cent expected to be asked for consent before such an exam was done.

The patients – unlike medical educators – seem to be quite clear on the concept of informed consent.

You don't probe, poke or otherwise invade the orifices of a patient without their permission, regardless of how educational it might be. Period.

The most intriguing part of the survey, though, is that it showed that women are quite willing to undergo these gynecological exams – if they're asked.

Sixty-two per cent of respondents said they would consent to medical students doing pelvic exams, and an additional 5 per cent said “yes” but only if a female student was doing the exam.

This lays to rest the notion that it would be impossible for medical students to get this training unless they were doing it in the current surreptitious, unethical manner.

But let's be clear: Even if all the women surveyed had rejected exams by medical students, the current approach would still be wrong.

There are other ways to do this training, using simulation models, paid volunteers and consenting patients in other settings such as clinics.

Patients have a right to say “No.” They are not merely a collection of body parts to be practised on. Patients are due respect and ethical treatment, whether they are awake or anesthetized, and no matter how potentially embarrassing the procedure may be.

The research done by Dr. Wainberg and her colleagues, in passing, exposed something else important: Patients have very little idea what goes on in the operating room. Most have no idea that, in addition to the surgeon and nurses, medical residents or medical students may be present and may even participate actively.

This is the result of a failure to communicate. It is also a striking example of a lingering bit of paternalism that is still all-too-present in medical culture – this notion that “we do the surgery and the details are none of your business.”

“It's definitely the patient's business who does what to them,” Dr. Wainberg said. “They have to be informed and they have to give consent.”

In fact, if she was starting over again as a medical student and was asked to perform a pelvic exam, Dr. Wainberg has no doubt she would refuse.

So too should every medical student and every teacher.

A good doctor does not merely possess good technical skills, she or he must behave ethically and treat patients with the utmost respect.

Source: http://www.theglobeandmail.com/life/health/time-to-end-pelvic-exams-done...

Wed, 31 Dec 1969 16:00:00 -0800

Sex is good for fighting cancer !

PinkNC — Sat, 07 Nov 2009 10:34:35 -0800

Sex is good for you: For fighting cancer to the common cold - it's just what the doctor ordered (and men benefit most!)

• By A. Magee

Making love could be one of the few pleasures in life that is genuinely good for you, say researchers.

Not only does a healthy sex life boost mood, but there is growing evidence to show it boosts your physical well-being, too - from increasing longevity to reducing the risk of erectile dysfunction and even heart attack.

Only last month, researchers at Nottingham University concluded that men who kept up a regular sex life in their 50s were also at lower risk of developing prostate cancer.

(Conversely, they found 'too much' sexual activity - more than 20 times a month - in the 20s and 30s could increase the risk.)

In fact, the research seems to suggest that men - particularly older men - benefit the most from healthy effects of sex. Feel-good hormones help explain some of the benefits, such as mood-boosting, but the explanation is not always obvious.

But one thing is clear, and this applies to both men and women: you need to be having sex regularly if you don't want to lose the ability.

'Use it or lose it' was the advice given to older men by Finnish scientists recently.

They had followed 1,000 men aged between 55 and 75 for five years and found that those who had sex less than once a week at the start of the study were twice as likely to develop erectile dysfunction (see below) as those who had it at least once a week.

Those who had sex three or more times a week lowered their risk fourfold.

As women get older their oestrogen levels drop, says Dr Peter Bowen-Simpkins, consultant gynaecologist at the London Women's Clinic and spokesperson for the Royal College of Obstetricians and Gynaecologists.

This hormone is key to a woman's sexual enjoyment - lower levels can make sex uncomfortable, he explains.

But American research found that menopausal women who had sex every week had oestrogen levels twice as high as their abstaining counterparts.

'Regular sex increases the production of oestrogen,' says Dr Bowen-Simkins. As long as other symptoms, such as dryness, are not a problem or have been treated, having more sex can decrease the risk of vaginal atrophy which can occur with age, he says.

So what else can a regular love life do for your health?

Heart

Sex can be good for your heart. The idea that men are more at risk of a heart attack during love-making is mostly misconception, say experts.

Professor Peter Weisberg, medical director of the British Heart Foundation, says there is no evidence that men who have sex regularly in their 40s, 50s and beyond are at an increased risk of heart attack.

'As far as the heart is concerned, sex is just another form of exercise,' says Dr Graham Jackson, consultant cardiologist at Guy's & St Thomas' Hospital and president of the Sexual Dysfunction Association.

'In fitness terms, it's equivalent is going for a mile-long walk or climbing up and down two flights of stairs.

'If you're physically fit enough for that, there should be no increased risk during sex.'

A study at Queens University in Belfast found that having sex three times a week could actually halve the risk of heart attack or stroke.

However, if you are over 50, overweight and unfit, there is a risk to your heart - just as there would be if you suddenly and vigorously took up any form of exercise.

Loving feeing: A study found those who had sex less than once a month had double the risk of dying prematurely than those who had sex twice a week (picture posed)

Prostate

Prostate cancer is the most common cancer in British men, affecting 35,000 a year.

Previous research suggested that greater sexual activity was linked to a higher risk of prostate cancer, but findings from Nottingham University (published in the British Journal Of Urology International) suggest the opposite is true: that increased activity is protective for older men.

This backs up the findings of a major study five years ago by the National Cancer Institute, published in the Journal of the American Medical Association.

Previous studies have suggested the reduced risk is due to the release of toxins from the prostate gland.

'We can't say for certain that having regular sex can protect older men from prostate cancer, because such studies don't prove the mechanism through which risk is reduced,' says Dr Geoffrey Hackett, consultant urologist at Good Hope Hospital, Sutton Coldfield, and former chairman of the British Society for Sexual Medicine.

'But many men who maintain a regular sex life are also likely to maintain a healthy lifestyle in terms of regular exercise and a better diet. That's likely playing a bigger part in their prostate cancer risk reduction.'

Bones

'Testosterone levels have been found to increase during and after sex,' says GP Dr Sarah Brewer. 'This may provide some protection against male osteoporosis.'

Sexual activity can also protect you against other unwanted changes. Some scientists have linked low levels of sexual activity to structural changes in the penis or testicles which appear to reduce them in size.

'We know that men who don't have regular ejaculations or sexual intercourse have lower levels of testosterone,' says Professor Pierre Bouloux, consultant endocrinologist at University College London and the Royal Free Hospital.

And if your testosterone levels fall and you don't get erections, there is some evidence that the penile tissues can lose some of their elasticity, which in turn could make them appear smaller.

Mood-lift: The neurotransmitter serotonin is the body's key anti-depressant and a major reason people smile after sex

Mood

The evidence suggests that the 'feelgood' effect of making love could be more about chemicals than sexual ability.

'During lovemaking and orgasm, a cocktail of endorphins (the body's natural mood-lifting opiates), neurotransmitters and hormones are released,' says Professor Nadir Farid, consultant endocrinologist and founder of the London Endocrine Clinic.

'Oxytocin, in particular, is a hormone released during and after sex that has been shown to make people more generous towards their partners and can also help induce calm and sleep,' he adds.

Oxytocin is called the 'cuddling' hormone because it's released after just 20 minutes of hugging. Women produce four times as much as men, for whom production is inhibited by the prevalence of the hormone testosterone, which drives libido.

Another key neurotransmitter is serotonin, says Professor Farid. 'Serotonin is the body's key antidepressant chemical and one of the major reasons people smile and feel happy and relaxed after sex.'

Sexually active women in longterm relationships were less likely to be depressed than women who went without sex, according to a study of nearly 300 women by American psychologist Gordon Gallup and published in the Archives Of Sexual Behaviour.

Gallup speculated that semen contains several hormones which may have a mood-boosting effect when they are absorbed through the vaginal wall into the bloodstream.

Immunity

Having more sex might increase immunity from colds and flu.

Having sex once or twice a week has been linked with higher levels of immunoglobulin A, or IgA, a substance found in saliva and the nasal lining thought to help our immune systems fight colds and flu.

In one study, scientists asked 11 volunteers how often they had had sex over the previous month, then measured levels of IgA in their saliva.

Those who had sex once a week or less had a slight increase, compared with those who abstained; but those who made love more often had 30 per cent higher levels.

Professor Ron Eccles, director of the Common Cold Centre and Healthcare Clinical Trials at Cardiff School of Biosciences, is not convinced, though, that sex itself is the key.

It's known that stress and anxiety can also make IgA levels go down, so according to Professor Eccles any connection between sex and colds may be related to other factors.

Cold cure? Having more sex might increase immunity from colds and flu

Longevity

One of the largest studies on longevity and sex - conducted on Welsh men - found that those who had sex less than once a month had double the risk of dying prematurely than those who had sex twice a week.

'Sexual activity seems to have a protective effect on men's health,' says GP Dr Sarah Brewer. 'This may be linked with the effects of the master sex hormone, DHEA or dehydroepiandroterone, which is made in the adrenal glands and functions as a building block of other hormones such as oestrogen, testosterone and progesterone.

'DHEA levels rise just before orgasm and ejaculation to three times higher than normal, and some claim this is how regular sex can prolong your life.'

Fertility

For people trying to conceive, one of the biggest myths associated with fertility is that refraining from ejaculation boosts sperm mobility - the rate at which individual sperm can move forwards to penetrate an egg for fertilisation, says gynaecologist Dr Gillian Lockwood, medical director of Midlands Fertility Services.

'When sperm is hanging around in the epididymis, the long coiled tube in the back of the testes where sperm is stored, it dies off rapidly,' she says.

'Unless a man has a low sperm count, the more often he has sex, then the better the quality of his sperm.'

Preliminary results of a small study two years ago, by Australian researchers, found that in men whose sperm showed significant DNA damage, daily ejaculation reduced this damage by 12 per cent.

'When it comes to sex for fertility, having sex little and often - at least every other night - is far better than lots of it on infrequent occasions.'

And the bad news

Just when you thought you'd had the green light for more passion, the experts strike a cautionary note. Unbridled romping - particularly with a new partner and without protection - comes with bigger risks, especially for the 'Viagra generation'.

Rates of sexually transmitted infections (STIs) in the over 45s have doubled in the ten years since Viagra was launched, and STI rates are now rising faster in older people than they are in the young.

A study last year from University College London found that those in their late 30s and 40s were least likely to use condoms with new partners.

Other research has found that 12 per cent of sexually active over-50s did not use contraception while also not knowing their partner's sexual history.

'This is a generation that didn't have the open sex education that young people get today,' says Professor Janice Rymer, professor of obstetrics and gynaecology at St Thomas' Hospital London.

'Today's 50-somethings probably know less about sexual protection than many of today's teenagers.'

Most STIs are treatable with antibiotics, said Professor Rhymer, but it's important to be aware that some, such as human papilloma virus (HPV), have been strongly linked to cervical, mouth and other cancers.

How to cope when the mechanics let you down

MEN

ERECTILE DYSFUNCTION: This affects 14 per cent of men in northern Europe and can be caused by underlying medical conditions such as high blood pressure, diabetes, smoking, high cholesterol, prostate surgery, or a psychological cause such as depression.

Repeated episodes of erectile dysfunction (ED) are a key indicator of undiagnosed early cardiovascular disease, warns Dr Graham Jackson.

'Two-thirds of men with erectile dysfunction have early onset coronary heart disease, in which no other symptoms - such as chest pain - are present.'

Studies have shown that erectile dysfunction could precede the onset of heart problems by three years. This is why men with ED should seek medical advice. 'The greatest risk to your heart comes with buying erectile-enhancing drugs without prescription on the black market,' said urologist Dr Geoffrey Hackett.

Treatments for erectile dysfunction include Viagra and Cialis, which have to be taken up to an hour before sex. These work by increasing blood flow by widening the blood vessels, but are effective in only 50 per cent of men. Cialis Once-A-Day, which is prescription-only, allows men to have sex whenever they want, and so restores the spontaneity lost with other treatments.

PREMATURE EJACULATION: Up to 30 per cent of Western men experience some form of this.

Treatments include condoms with numbing agents, anaesthetic sprays for the penis, antidepressant drugs to lower the anxiety that might cause the condition and pelvic floor exercise therapy.

WOMEN

FEMALE SEXUAL DYSFUNCTION: Up to 43 per cent of women are said to suffer from FSD, including low sex drive and inability to orgasm.

But medical experts question this figure, and the British Medical Journal has accused drug companies of medicalising the natural loss of libido that may come with age or relationship problems.

There are no drug treatments for FSD, though 25 are in development.

MENOPAUSE: The menopause causes a woman's ovaries to slow down and stop producing hormones, including testosterone, for sex drive, and oestrogen, which can reduce lubrication, making sex painful. 'KY Jelly can be effective,' says gynaecologist Dr Peter Bowen-Simpkins.

'Or we can prescribe estradiol, a weak oestrogen applied locally through pessaries or creams to help replace moisture and acidity'.

PAIN OR BLEEDING: 'Pain can be a sign of cysts, fibroids and, in very rare cases, ovarian cancer,' says Dr Gillian Lockwood, consultant gynaecologist. Bleeding is usually caused by benign cervical erosion and is easily treatable. Rarely, bleeding during sex can be a sign of cervical cancer. If it happens more than three times, see your GP.'

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How to Pleasure Your G-spot

DominaDoll — Tue, 29 Sep 2009 09:21:31 -0700

The G-spot: What is it?

The Gräfenberg spot or G-spot was discovered by Ernst Gräfenberg a German gynecologist who first described it as “an erotic zone located on the anterior wall of the vagina along the course of the urethra that would swell during sexual stimulation.” The area the G-spot occupies is called the urethral sponge and it is tissue that surrounds the urethra (the tube we pee out of) that swells with fluid during sexual arousal. It is associated with the prostate gland in men and is made up of a complex system of erectile tissue, secretion glands (the Skene’s gland), the internal pelvic nerve and muscles that engage with one another during the arousal cycle. In most women it is sensitive to pressure and stimulation which can lead to high levels of sexual arousal and powerful orgasms. The existence of a G-spot has been widely accepted and most popular sexology books treat it as fact. In one study of female ejaculation, 84% of the approximately 1300 professional women who responded reported a sensitive area in the vagina, and this was correlated with those who also reported ejaculation.

Where is the G-spot?

The G-spot has remained elusive in the past because in its sexually un-stimulated state, it is relatively small and difficult to locate, especially since it is internal and you can’t see it like the clitoris. It can be found inside the vagina about 1-2 inches deep with your fingers by feeling around the front wall or roof of the vagina, just behind the pelvic bone. There, a wrinkly, prune-like tissue (the urethral sponge) will swell with fluid when aroused via firm, deep pressure, thus making it noticeable to touch.

How to find it?

The best way to find the G-spot is through sexual play and experimentation with your partner or by yourself. When exploring solo make sure to get into a comfortable position on your bed or in a comfy chair, half-sitting with you back curled, your thighs apart, and your knees bent up towards you, so you can easily reach it. Since it only reveals itself when women are very turned-on, other forms of sexual stimulation and foreplay are encouraged before-hand. Once you become very aroused, you or your partner may then explore the internal vaginal wall (1-2 inches deep) and find the erectile tissue that will feel bumpy and more swollen than the surrounding smooth tissue. It is best to use your fingers for exploration at first by inserting 1-2 fingers and curling them in a “come-hither” motion that strokes the G-spot area. If you have long nails it is best to trim them short before exploration to avoid scratching the delicate inner tissues, or wear gloves. In some women, the G-spot can be as large around as an apricot, but in others it may be as small as a cherry. You’ll know when you hit the G-spot by the distinctive sensation it creates. Stimulating it may give you a rush of pleasure, or make you want to pee.

How to stimulate it?

Every woman’s response to sexual stimulation and sensitivity is different. Sensitivity may also vary at different times of the month. Just like some women enjoy direct stimulation to the clitoris while others do not, the same goes for the G-spot. The best way to find out how to stimulate it is to explore what feels good to you. To begin with, make sure you are already sexually stimulated by other means. Once you are warmed up, you can begin exploring your G-spot.

You should give yourself lots of time for this exploration and make sure you won’t have any disturbances. So turn off the phone, lock the door and get comfortable. Deborah Sundahl, author of “Female Ejaculation and the G-spot” recommends sitting in front of a full length mirror and a flashlight, so you can not only feel, but see your G-spot as well, once it becomes aroused. Also, make sure you have a big absorbent towel under you or a sex blanket like the Liberator Throe to absorb ejaculate. It is also a good idea, to empty your bladder before attempting G-spot stimulation, orgasm and female ejaculation.

Here are her Steps to Stimulating Your G-spot and Ejaculating

Breathe deeply and relax. Being relaxed is an important part of creating G-spot orgasms and female ejaculation. Begin squeezing your PC muscles and imagining that you’re G-spot is swelling and becoming aroused. Slowly stroke your vulva, clitoris, urethra and vaginal opening.
Insert a lubed up finger or two into your vagina and begin feel where your G-spot is. Feel the wrinkly spot in the middle, the two grooves on both sides and the tail at the back. Breathe deeply as your gently squeeze your G-spot with your fingers to stimulate the prostate gland to produce ejaculate fluid.
Apply gentle but firm pressure. The G-spot responds best to very firm pressure. Press all around the G-spot, feeling around, moving slowly. Notice the difference in how each touch feels, whether you feel numbness or erotic sensation. Try different types of strokes and varying types of pressure to see what feels best. Circular or back and forth stroking feels good to most women. Some women enjoy vigorous penetration and will thrust their pelvis up to meet and position the thrusts to their best advantage. Usually, most women find that a deep, firm pressure is needed to arouse the G-spot. Some women will prefer stimulation around the G-spot, but not directly upon it. You can also use various G-spot sex toys that are designed especially for G-spot stimulation. The strength of a woman’s PC muscles is directly related to her ability to reach orgasm through intercourse; therefore stronger PC muscles will promote stronger G-spot orgasms, and easier arousal of this zone.
If you feel like you have to pee, that is good. Don’t tense up and keep going with what feels good. Remember to breathe deep and relax. Continue to pump your PC muscles to stimulate the entire region.
Try slow circular movements while keeping the pressure firm. Notice as your G-spot begins to swell.
Build erotic arousal as you continue to press, rub, squeeze and massage your G-spot. Continue to breathe slow and deep, clenching and releasing your PC muscles with each breath. Build the erotic feeling so it is full and ripe. You can switch to a G-spot toy here if you like, or continue using your fingers.
Once your G-spot is swollen and engorged, you can now try to ejaculate. Build this to a level of arousal at which you feel you are about to orgasm. You may feel “ejaculation rockets” (streaks of pleasure) shooting down your thighs and you will most likely have the urge to pee. Continue to relax, breathe deep, and squeeze and release your PC muscles and you continue to massage your G-spot.
Practice pushing out the ejaculate. Stimulate your G-spot as your raise your buttocks off the floor, and firmly pushing OUT with your PC muscles. Hold. Stop. Then continue massaging. Repeat the PUSH-HOLD-RELAX-STIMULATE until you a craving climax. If you are very aroused, you feel you need to pee, and your G-spot is very swollen you are ready to ejaculate.
Lay back and stimulate your G-spot then take you finger (or toy) out and immediately push out as if to pee. If you ejaculate great. You can keep this going by pushing in with your finger again, the remove finger and push out with your PC muscles. Continue ejaculating until you are fulfilled, or can’t produce any more.

If you tried this method and didn’t ejaculate or orgasm, don’t worry. Many women can’t do it the first time they try. If your PC muscles are weak, you may have a hard time ejaculating. Luckily, you can do kegel exercises to strengthen them and there are a lot of great products available that can aid you. Sometimes women will also tense up and try to hold back the feeling that they need to pee. You have to go with the feeling of having to pee and not fight it. There also may be many other reasons why you can’t ejaculate at this time and I recommend reading “Female Ejaculation and the G-spot” to educate yourself more. Also, be sure to continue to practice as practice does make perfect.

What does it feel like?

Again, sexual response will be different in every woman. The G-spot is not a magic button that can be pressed and simply produce mind-blowing orgasms (at least in most women). Some women will feel little or nothing. Others may feel uncomfortable like they have to pee. Many women feel a powerful urge to “bear down”, the same sensation of pushing when delivering a baby. Still, some will experience deep, intense orgasms that are distinctly different to clitoral orgasms altogether. Stages of arousal will vary from woman to woman and will depend on many factors including:

The time of the month. G-spot arousal will vary during different times of the month and from day to day.
What kind of mood you are in and how sexually aroused you are. Most women need to be pre-stimulated to enjoy G-spot arousal. Also, the more relaxed you feel the easier it will be to arouse the G-spot. Full body massage and/or vulva massage are great ways to get you in the mood.
How comfortable you feel about sex and G-spot arousal in general. Some people will have misgivings about their G-spot. Does it really exist? How come I’ve never felt it before? Deborah Sundahl-an expert in G-spot stimulation-maintains that some women have difficulty finding their G-spot because “we have been told for over 400 years that the female prostate doesn’t exist; that it is shriveled up and non-functioning. If you are told by every corner of society that something doesn’t exist, you tend to believe it…” She also attributes G-spot numbing to the fact that we as a society don’t take time to explore the pleasures of our bodies or the sexual act as we race towards climax. Also, many people still feel uncomfortable about their sexuality or feel guilt at self-pleasure because of long-standing social stigmas surrounding sex and masturbation. Deborah furthermore attributes emotional and sexual abuse to women’s inability “to feel pleasure.”
Some women may find the feeling of having to urinate that is usually activated by G-spot stimulation uncomfortable. Remember that your G-spot is close to your bladder and associated with the male prostrate that is responsible for male ejaculation, so some women will experience female ejaculation from G-spot stimulation. We have been taught from young children not to “pee the bed” so this response to sexual stimulation may feel unnatural or make you embarrassed. There is nothing to feel embarrassed about, however, as this is a natural response and if it happens to you it can be extremely pleasurable if you allow yourself to let yourself go over the edge.
The first time is not always a charm. You may not feel G-spot stimulation the first time you try to explore it. Perhaps you are too nervous or expecting too much. Sometimes if you are too goal-orientated (wanting to experience female ejaculation and mind-blowing orgasms from the start) it may dilute the experience of sexual exploration for you. It is important to remember that it is the journey, not the destination that is important when exploring the G-spot.
Finally, some women will not enjoy G-spot stimulation. While some women enjoy vaginal penetration, others enjoy clitoral stimulation. Everyone is different. What is important is that you took the time to explore your body and learn more about your sexual response. It is important to remember that the G-spot is just another part of the female human anatomy. You need not feel pressure to try to enjoy it if you don’t or shame because you don’t respond to it as you think you should. The G-spot has been over-hyped in today’s media and stimulating it doesn’t send every woman to the moon.

The G-spot and Orgasm

Often during stimulation, the G-spot will become increasingly sensitive and many women feel a building euphoria and elevated arousal. Some women will enjoy deep, firm thrusting, while others may want to use clitoral stimulation to enhance the G-spot experience. As this euphoric sensation and the sexual energy of climax continues, you may feel as though you are going to burst. This is the time to let yourself plunge over the edge of sexual ecstasy and experience a G-spot orgasm.

Some G-spot orgasms with feel like a roar of sexual energy that is experienced as a deep, full-body quaking and total sexual release. Others are like a rippling effect that sends waves of pleasure tingling through you. G-spot orgasms can last longer than clitoral orgasms, with longer, deeper contractions and/or multiple contractions. Many women note that a G-spot orgasm comes after a series of smaller orgasms, when they are at the ultimate peak of arousal. To some women, G-spot orgasms are more powerful than any other type they have ever experienced. Not all women will experience female ejaculation (or notice it) with G-spot orgasm and ejaculation may not happen every time. All women have a Skene’s gland however and are capable of ejaculation.

Female Ejaculation

To some women, the G-spot is an erogenous zone that offers intense sexual pleasure and can lead to female ejaculation. Most women will feel the urge to pee when their G-spot is stimulated. As previously noted, this is because the G-spot is analogous to the male prostate and ejaculation in men. Women have what is called the Skene’s gland, which is like the male prostate and is responsible for female ejaculation. Female ejaculate comes from these glands and is expelled from two paraurethral ducts on either side of the urethra, or directly through the urethra. G-spot arousal may feel like a building of pressure as the G-spot and area swells with blood and fluid. This can be very unsettling at first and may make you want to abandon your mission. Some women may try to suppress their sexual response to avoid ejaculating. However, once you get over this strange sensation and allow it to simply happen, you will most likely enjoy a G-spot orgasm and perhaps even female ejaculation.

Some people in the medical community have denied the fact that both G-spot orgasms and female ejaculations do occur and have mistaken female squirting as urinary incontinence. However, there have been conclusive studies that prove the existence of both the G-spot and female ejaculation. Most women cannot ejaculate on command. For many women, G-spot ejaculation the first time is often a fluke and comes as a complete surprise. Some women only experience a few drops to a teaspoon of ejaculate fluid, while others may experience up to two quarts of fluid along with explosive gushes and squirting, sometimes up to several feet. Sometimes the ejaculation will occur multiple times during orgasm as well. 54-60% (reportedly) of women have experienced emission of fluid at orgasm. Also, some women can ejaculate with clitoral stimulation only or no stimulation what-so-ever. Like sexual preferences, every woman’s response to G-spot stimulation is different.

When trying to experience ejaculation, try to relax your body and your PC muscles. Relaxing will allow you to go with the flow and peak over the edge to orgasm. Sexologist Annie Sprinkle maintains that deep breathing, clenching and unclenching the PC muscles, as well as loud moaning will allow you to experience a deeper body orgasm and along with G-spot stimulation brings about ejaculation more easily. If you feel the urge to ejaculate, pushing out with the PC muscles may help to make you squirt as well. It is also important to maintain good PC health. Your PC muscles are what support your pelvis. You can feel them by stopping your urine midstream. You can keep you PC muscles healthy and strong by doing regular kegel exercises with kegel exercisers like Smart Balls by Fun Factory [review], Luna Beads by Lelo [review] or Natural Contour’s Energie [review]. Strong PC muscles aid in G-spot arousal, orgasm and female ejaculation.

Female ejaculate is not pee either. Analysis of female ejaculate has shown that it is distinct from urine and contains high levels of the enzyme prostatic acid phosphatase (PSA), glucose and fructose (all found in the prostate fluid of semen). Female ejaculate does not look, smell or taste like urine. It has the same consistency as water and is a clear or milky, usually odorless (although sometimes musky) smelling fluid that can be slightly sweet due to the sugar (glucose/fructose) content and alkaline. As with semen, female ejaculate will smell and taste different depending on the person and what you eat.

Health Concerns

Sometimes stimulating the G-spot can lead to negative effects in some women. The G-spot is a highly sensitive area and some women can experience irritation, pain or infection. This can be especially true of virgins or women with tense PC muscles. To avoid infection and irritation women should drink plenty of water before and after G-spot stimulation, especially if prone to urinary tract infections. Also, emptying the bladder before and after is also important. Cranberry juice is also effective in fighting the bacteria that causes infections. Be careful of how much pressure you apply during stimulation and work up to it slowly. Make sure to use only clean toys and clean hands or gloves. Make sure that fingernails are cut short to avoid breaking the skin.

Deborah Sundahl also notes that trauma (emotional and physical) can be stored in various places in the body including the G-spot and cause blockages in energy which is referred to as “body armoring”. This can make G-spot exploration overly sensitive, numbing, or even painful to some women. Sundahl recommends treatment for women who experience pain or emotional trauma during G-spot exploration with a qualified sex “body” worker. Again, please refer to her book: “Female Ejaculation and the G-spot” for more information on this.
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HOSPITAL CHART BLOOPERS (Actual writings from hospital charts)

lala788 — Mon, 01 Sep 2008 06:24:52 -0700

HOSPITAL CHART BLOOPERS (Actual writings from hospital charts)

1. The patient refused autopsy.

2. The patient has no previous history of suicides.

3. Patient has left white blood cells at another hospital.

4. She has no rigors or shaking chills, but her husband states she was very hot in bed last night.

5. Patient has chest pain if she lies on her left side for over a year.

6. On the second day the knee was better and on the third day it disappeared.

7. The patient is tearful and crying constantly. She also appears to be depressed.

8. The patient has been depressed since she began seeing me in 1993.

9. Discharge status: Alive but without permission.

10. Healthy appearing decrepit 69-year old male, mentally alert but forgetful.

11. Patient had waffles for breakfast and anorexia for lunch.

12. She is numb from her toes down.

13. While in ER, she was examined, x-rated and sent home.

14. The skin was moist and dry.

15. Occasional, constant infrequent headaches.

16. Patient was alert and unresponsive.

17. Rectal examination revealed a normal size thyroid.

18. She stated that she had been constipated for most of her life, until she got a divorce.

19. I saw your patient today, who is still under our car for physical therapy.

20. Both breasts are equal and reactive to light and accommodation.

21. Examination of genitalia reveals that he is circus sized.

22. The lab test indicated abnormal lover function.

23. Skin: somewhat pale but present.

24. The pelvic exam will be done later on the floor.

25. Patient has two teenage children, but no other abnormalities