Tag Archives: sex ed

When we think of yeast…

Typically, we think of yeast when we think of baking. Sometimes we think of it with respect to beer.

On a human level, we tend to think of yeast infections in connection with women, because seemingly, women are more prone to them. However, such is not necessarily the case.

Before I continue, I will be discussing candidiasis (yeast infection) – and while I know that it can be transmitted sexually, and it can result from taking antibiotics, etc…I will be talking about manifestation of candidiasis without any other seeming origin…such as in non-sexually active, circumcised men (who often seem surprised they’ve got yeast)…or in children.

I received a question from a woman with two young daughters a few weeks ago about one of her daughters (age 6), wondering about her daughter’s itch “down there.” I asked if her daughter takes bubble baths (yes) and a few other pertinent questions. I told the woman that the only way to diagnose for sure was to take her daughter to a physician (recommended a gynecologist), but that the likely culprit was yeast. Just plain ol’ yeast. She seemed to be surprised (“but in a child?”) — and I suspect strongly that her greater concern was that someone might have touched her daughter sexually.

Of course, that is a possible concern, but given that her daughter approached her very plainly with no shame and told her that her vaginal area was itching, and mom noted the redness…and the daughter denied any inappropriate touching “down there” — my first thought was that a child who has been touched inappropriately has often been warned to not tell anyone, which would make talking about anything “down there” off-limits — the likelihood was that she hadn’t been harmed.

She was also surprised that children can (and do!) get yeast infections. Most moms (and some dads) know that babies get yeast (in the form of thrush), but that usual “blame” for that is passage through the vaginal canal during birth (it’s not really blame, per se, but yeah…vaginal birth is often seen as the “culprit”, which doesn’t seem to explain C-section babies who get thrush…but anyway…). The fact is, we all have yeast in our bodies. Most of us have it in very small amounts, but it is just a part of us.

Certain factors for yeast growth make overgrowth (leading to itchiness and infection) more common in adult women. Interestingly, you don’t hear too often about men getting candidiasis (yeast infection (at least not who are willing to openly talk about it)…and even the medical literature says that it’s “more common” for men to get a yeast infection if they’re not circumcised. I suspect that, given that the majority of adult men in the United States are circumcised (since that was a matter of course at birth for a very long time), the seeming lack of proper genital hygiene taught to young boys contributed to the wrong idea that boys and men are not susceptible to something like yeast. Which is, of course, frustrating.

Men (circumcised or not) are prone to yeast in the same way that women are…and for the same reasons…though the yeast infection may not manifest quite in the same way, or with the same likelihood as in women. To grow, yeast simply needs a warm moist place. For girls and women, well, no need to state the obvious. That growth might be more common in adult women is not surprising, either, since many adult females are sexually active, which adds more moisture. And…of course…even with that, some women never experience a yeast infection. Men (or at least many men) have been taught that if they’re circumcised and if they “keep their dicks clean,” they’ll never-ever-ever have aaaaaaaaaany problems like “that”…which is a load of hooey.

And…which is why you will find (if you look) men’s online forums discussing exactly this topic with surprised comments like, “But I’m circumcised!” or “But it’s on my nutsack, not on the tip of my dick!” Which makes me sigh.

An ill-informed mom (or dad) might completely freak out if her toddler son (circumcised or not) suddenly has redness at the base of his penis and on his scrotum that seems to smart at the touch and is itchy to the child.

Again, we human beings have yeast in our bodies…and all that’s needed for growth is warmth and moisture. The genital area (in men as well as women) is prone to moisture, particularly in hot and humid climates.

In cases like these…while I would encourage men and parents of young boys to certainly have a physician examine them if they aren’t completely certain…but my first (very educated) guess would be -simply- yeast. Go to a store and buy some Monistat cream. Apply it to the red, itchy areas. It is the same over-the-counter cream that women who get yeast infections use to get rid of their own. Just the topical cream, though, guys. We women do have a couple of other things we get because our anatomy is slightly different from yours. 

Of course, keep everything “down there” clean and dry as much as possible. For you parents out there with uncircumcised boys…(and for folks whose sons are circumcised)…yes, your little boys can get yeast infections. As best you’re able, keep their genitals clean and dry…and teach them how to keep clean and dry as they become old enough to understand. Note to parents of uncircumcised sons…do not attempt to retract your son’s foreskin (it will do that all on its own when the time comes…usually during puberty) — but you can clean the entire penis thoroughly (plain soap and water and soft pat-dry without pulling the foreskin back). For my sons, I have long preferred a gentle powder. I know there are folks who discourage this, but I prefer it, particularly on the scrotum, which can get moist due to simple sweat under the scrotum (the perineum) and on the rest of the scrotal area, including the inner thighs. And…I am teaching him how to do this for himself as he gets older.

For parents of young girls…yes, prepubescent girls can and do get yeast infections. Back when I worked as a medical assistant in a pediatric clinic, we had many young girls who were brought in by concerned parents…and one of the biggest culprits was bubble baths. This is not to suggest never giving your daughters bubble baths…far from it. However, be aware that the vagina is not a vacuum, and even in very young girls, liquid irritants can get in and wreak minor havoc. Also, when you’re teaching your daughter how to clean herself after using the bathroom (and I cannot stress this one enough), front to back. For my daughter, I’ve taught her that this is important both in the bath/shower and on the toilet after using the bathroom, so that it is an ingrained habit of front to back. Also, ensuring that all those folds and in-between all those folds are thoroughly cleaned and dried.

I have long suspected (and continue to suspect) that one reason women seem more prone to yeast infections is that we’re not taught the importance of thorough cleaning and gentle drying of everything — and again front to back. We’re just told “keep it clean” without any specific instructions. I remember the first time I read the instructions for a “clean catch“, I remember thinking…why weren’t we taught to clean like this as children? (Instructions for both men and women are in that link…and this is how we should be cleaning our genitals when we bathe, not just for a “clean catch” urine sample.) I know, too, that nobody ever told me that this is doubly important after I indulge in a bubble bath (one of my rare indulgences) because of the different potential irritants in the bubble bath itself.

Anyway, I hope this has been informative, and that you find it useful.

Cheers,
Dr. Weird

April is *also* STD Awareness Month

Mirrored from my personal blog’s Hump Day Special.

First things first today…I need to openly admit that I don’t have the very best memory. Life gets busy, and other issues surface, and sometimes I forget things that are important and that sometimes fly completely under the radar. Such as the point that not only is April Sexual Assault Awareness Month, but also STD Awareness Month. Given my personal and professional focus, you might think I would remember that more readily (suuuure); like I said just a few sentences up, my memory isn’t the best.

Second, to knock this question out of the way (since it’s one of the questions I am often asked) — the terms “sexually transmitted disease” (STD) and “sexually transmitted infection” (STI) are frequently used interchangeably. They are notexactly the same thing (as diseases and infections are not the same), but more people tend to be familiar with the term “STD” as opposed to the frequently more (clinically) accurate “STI” — in much the same way that just a generation ago, “VD” (venereal disease) was more commonly used. Many folks today haven’t even heard the term “VD,” but most are familiar with “STD” ~ hence the coining of “STD Awareness Month” even within the CDC.

With those two bits knocked out, I got my reminder yesterday about April & STI Awareness from one of my favorite places: Bedsider. LOVE Bedsider! Yesterday, an entry was posted – entitled “The Fine Art of Condom Negotiation” — and it is worth clicking through to and watching the videos in the entry. In today’s Hump Day special, I want to discuss condom negotiation, and its importance on a wider scale.

I know there are folks (I am one of them, actually) who get annoyed with “Awareness Months” — and yet, the importance of awareness of certain realities in our society cannot be overstated. Three major points noted in the CDC link above:

  • 20 million – new STDs that occur each year.
  • $16 billion — the cost of treating STDs contracted in just one year.
  • ½ of all new sexually transmitted infections each year are among youth.

The numbers are truly frightening, and there are distinct connections between those numbers and sex education in public schools…particularly those that accept Title V funding for sex education (aka Abstinence-based and AOUM sex “education”).

When I began my own research for my dissertation, my initial focus was on chlamydia, which is currently the fastest spreading STI on the planet. The numbers, both in terms of transmission, the cost of treatment (compared with the cost of prevention), and the ages of the hardest hit demographic are appalling. I won’t pull those numbers, but I will note that the cost of prevention is significantly lower than the cost of treatment, and the hardest hit demographic is females between the ages of 15 and 24 — with diagnoses of chlamydia being three times more frequent than males in the same demographic. Additionally, minorities are disproportionately affected by all of the above.

What does this have to do with the art of condom negotiation? Quite a lot, actually. Particularly with respect to females. In my research, I interviewed parents of female teens for their perspectives and perceptions about sexually transmitted infections across the teenage population, and one of the themes that surfaced (with respect to condoms) was a “good girl” versus “bad girl” notion that has been prevalent in American culture (and elsewhere, too) for many, many, many years. Further, there exists a really depressing lack of understanding of how exactly STIs are transmitted across the cohort I interviewed — which translates sadly (and is documented elsewhere outside of my research) into teenagers (both male and female) lacking knowledge and understanding.

Example: Blow jobs. Oral sex is not seen as “real” sex by a large percentage of the teenage population. Why? Because the primary focus of sex education is pregnancy prevention (automatically organizing sex education by gender, I might add)…any and all sexual activity that falls outside of the singular sexual act that can result in pregnancy is ignored and omitted entirely. Further, in abstinence-based settings, kids are taught that condoms have x-percentage failure rates (without the explanation of why those failure rates exist — which has to do with inconsistent and incorrect use)…it’s essential fear-mongering in the hopes of getting kids to simply abstain from sex. And mainly females.

It’s a nice idea…and, in fact, abstinence is encouraged as a leading preventive measure against pregnancy and STI transmission by organizations like Planned Parenthood. However, given the actual reality of kids having sex…and not just penis-in-vagina sexual intercourse…the potential for STI transmission increases exponentially when complete, comprehensive information is omitted in sex education. The evidence? Look again at those bullet points above. That is the stark truth, no matter how much parents might squick out over it. It’s not girls “being sluts”…it’s teenagers doing what teenagers have always done.

So now, we have female teens giving head and not using condoms (because if oral sex isn’t real sex, and condoms don’t work anyway, and she can’t get pregnant from giving head…et cetera) — then being shocked to discover that what they thought was tonsillitis was really chlamydia. And…the numbers continue to climb.

Negotiation of condom use can be touchy…it can be uncomfortable…but it is certainly necessary. Not just to prevent chlamydia (which, as I said, was my initial focus), but to prevent most STIs — regardless of whichever sex act is involved where fluids are exchanged. Further, “accidentally” getting carried away in the heat of the moment (“turning the situation somehow more innocent”) is a notion that needs to be done away with if we’re ever going to actually reduce the transmission numbers. As a parent of both a young adult son, a teenage daughter, and a toddler son…I know how uncomfortable thinking of kids as sexual beings really is. There is a lot of what I call “Squick Factor” involved. But the bottom line is, if we wouldn’t teach our kids preventive measures for their protection when teaching them how to drive a car (which is a machine with the potential to kill), why would we knowingly treat sex any differently? Much as it squicks me out, I would rather my daughter know how to put a condom on a guy (with her mouth, if needs be) than contract an STI or become pregnant. Would I rather she not have sex at all? Sure…the Mommy in me would prefer that. The human being (and health care professional) in me knows thathoping for abstinence is simply not enough.

Learn the realities of STIs…read up the CDC numbers…learn the importance of prevention…teach your kids the importance of prevention…it MATTERS. Safe sex is the sexiest sex there is!

That’s all for today. Wishing you the happiest of Hump Days!