I hate you, Jack Daniel.

Q: I don’t know if you’ll know this but I was wondering if you had any advice for curing a hangover? I always feel super crappy for days after a long night out and I don’t know what I can do to feel better. I drink a lot of water and try to get a lot of sleep but nothing helps!

You know bodies – do you have any ideas?

A: Oh, I hear you. We’ve all been there. Unfortunately, there is no magic home remedy (although I can tell you that hungover medical students have been known to hook themselves up to bags of IV fluid, which I’ve been told works wonders!). To some degree, a hangover is just par for the course – one of those lessons the Universe likes to teach us to keep us out of trouble. But assuming the deed is done, what can you do to minimize your suffering? Here are a few tips:

1. If you’re conscious enough in the midst of your drinking binge, make sure to alternate your alcoholic beverages with non-alcoholic ones to help your body stay hydrated in the presence of such a strong dehydrator.

2. After you’ve thrown up in the cab and rid yourself of any strays who might have followed you home, down a very large glass of Gatorade, which can help replace the electrolytes you’ve lost. If you can keep it down, chug two or three glasses.

3. Avoid caffeine. Coffee will not help sober you up. It will just make you a jittery, nervous drunk. Because it also dehydrates you, it will only worsen your hangover.

4. Although people may tell you to take two aspirin or a dose of Tylenol before you hit the hay, both can cause more harm than good. Aspirin can irritate the stomach and make you more likely to wind up praying to the porcelain gods. And Tylenol can be toxic to the liver, which is likely busy trying to break down alcohol. Try some extra B vitamins instead.

5. Sleep in. Call in sick if you must. Your body needs rest to repair itself.

6. Forget the hair-of-the-dog advice. Unless you’re an alcoholic in the midst of withdrawing (in which case you’ve got bigger problems and need help), a little nip of alcohol in the morning is likely to just prolong the agony. Try a virgin Bloody Mary instead.

7. Get something into your stomach in the morning, even if you don’t feel like eating. Your stomach gets pretty beat up when you’re drinking heavily, and food helps to coat it.

8. Take ibuprofen or naproxen in the morning to fight off your headache. You tummy will likely have settled down by then and can handle the medication. Take it with food so it doesn’t sit on an empty stomach.

9. Take a shower. It’s likely to perk you up and get the stink off you.

10. If you can stand it, get outside and move your body. It gets your blood flowing and provides welcome endorphins to help you fight the after-effects of too much booze.

Keep in mind that hangovers are our body’s way of responding to an overdose. Because our livers can’t keep up with the alcohol we put in, the whole body rebels. Do your body a favor and stave off hangovers the best way – prevention.

To get even more awesome advice from Dr. Rankin, check out her other posts here or pick up her book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend. It’s awesome!

And of course, there are plenty more old faves where this came from.

Q: I am 23-years-old and have been with my boyfriend for 6 years. I got the Gardasil shot last year and my paps have been fine until I got my last Gardasil shot. The doctor told me my pap was abnormal a couple months after my 3rd shot. Was the shot what caused the adnormal pap? The other doctor took a look and did not find anything so she did not do a biospy.

I went back 8 months later and she found a small wart and removed it. I do not know what to do or how to feel? Should I worry now that I have HPV? Should I stop having sex? My boyfriend has not had any problem and I heard that they can not be tested anyway. What can I do to prevent getting warts? Sorry to ask, but we have been having oral sex as well does that mean we both have it in our mouth? I just do not understand what I did wrong. I have been on birth control as well. PLEASE HELP… I only been having sex with one person for 6 years but I feel so helpless.

A: I’m so sorry you’re having to deal with an abnormal Pap smear and HPV. But believe me- you’re not alone. Up to 80% of us will contract HPV at some point in our life, and HPV vaccination isn’t perfect. Gardasil only guards against the four most common strains of HPV, but there are many more.

No, the vaccine didn’t give you HPV or cause your abnormal Pap smear. It doesn’t work that way. It may simply have been given too late.  You may have contracted HPV before you received the full series of vaccinations and the virus is just wreaking havoc now. There’s no way to know whether you already had HPV or whether you just caught it, but it’s a strain the vaccine doesn’t cover.

As for how you feel, feel whatever it is you genuinely feel. Don’t beat yourself up about it. You’re one of many who deals with this every day. But I certainly understand if you feel embarrassed, ashamed, betrayed, or bummed out.  Contracting a sexually transmitted infection has a way of making you feel about two inches tall. (I know. I caught HPV too. It can happen to anyone.)

Should you stop having sex? That’s a personal decision. It’s entirely possible that your boyfriend gave you the HPV in the first place since you’ve only had sex with one person. When I was diagnosed with an abnormal Pap smear for the first time and told the guy who is now my husband, he said, “That’s so weird! All of my girlfriends have had abnormal Pap smear.” Duh, dude. It’s you! So your guy probably already has it and most likely gave it to you.

You certainly should tell him about your diagnosis. And condoms can help protect you from transmitting it if you wind up in future relationships. But even condoms aren’t perfect, since infectious vulvar skin can still touch exposed scrotal or perineal skin, putting you at risk. To some degree, you just have to do the best you can and surrender the rest to the Universe.

Can it cause oral warts? Yes. Very rarely, HPV can cause warts on the larynx, but these are extremely uncommon.

Remember, you did nothing wrong, sweetie. You got the vaccination, have been careful to select a partner, and care enough to ask these questions. You should be proud of yourself for being so aware, so conscientious, and so health-conscious. I’m sorry you’re in this situation and I understand that you feel helpless, but I know you’re going to be okay.

Find out more about HPV here.

Wishing you peace and health,
Dr. Lissa

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

Got a health question? Don’t trust those “Doctors” at the University Health Center? Are you scared of Web M.D. because it always tells you you’re gonna die? Ask a real doctor, like our friend Dr. Lissa Rankin. She’s here every Thursday to answer whatever you throw at her – like how to deal with HPV

Q: I just started having sex and all of my friends tell me I have to pee after. They say that if I don’t pee I can get a UTI. The problem is that I never have to go. I try every time – I run to the bathroom and sit there but nothing ever happens. Is that bad? Do you HAVE to go after? Is there something wrong with me that I can’t go?

A: Your friends are giving you good advice. In general, it’s a good idea to pee after sex. Sex can introduce bacteria where it shouldn’t be, up inside the normally sterile urethra (the tube from the bladder to the outside world). Urinating flushes out an bacteria that may be lurking near the opening to the urethra, just dying to crawl inside and wreak havoc with a urinary tract infection (UTI).

That said, if you don’t have to go, you don’t have to go. Although I would question why you don’t. Assuming you spent more than 5 minutes in the sack, a well-hydrated person would have likely collected at least a wee bit of urine in the bladder. If you never have to pee after sex, you may not be hydrating enough. In general, you should be drinking the equivalent of about eight 8oz glasses of water (or other healthy liquid, such as herbal tea or green juice) per day. If you’re not drinking enough, this also increases your risk of UTI’s. Drinking a glass of water before sex should fill up your bladder and help you flush things out.

So, no. There’s nothing wrong with you. But it sounds like increasing your fluid intake would be a good preventative health strategy for you. Drink up- and try to pee afterwards. And if nothing comes, don’t stress out. You’ll likely be just fine, girlfriend!

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

Got a health question? Don’t trust those “Doctors” at the University Health Center? Are you scared of Web M.D. because it always tells you you’re gonna die? Ask a real doctor, like our friend Dr. Lissa Rankin. She’s here every Thursday to answer whatever you throw at her – like post-sex soreness – so ask away. Leave your question in the comments or send it over to us. Don’t be shy; she’s waiting for ya!

Q: I found out that I have HPV. So, having sex with my boyfriend, does that mean he has HPV too? And if either of us perform oral sex – can the warts then be transferred to our mouths? Will this lead to cancer? On the paper I got back from the doctor it said to come back in 12 months for another pap smear; will it get worse by then? I’m nervous.

A: HPV can be a sneaky bastard. Unlike sexually transmitted infections like gonorrhea and chlamydia, HPV can hang around, unexpressed and asymptomatic, then suddenly rear its ugly head with little warning. Chances are that your partner also has HPV. In fact, chances are good that your boyfriend gave it to you. But it’s possible you could have contracted it from a prior partner and that he doesn’t have it. No way to know for certain, so the best strategy is to behave as if he doesn’t have it, just to protect him.

It’s unclear to me whether you have warts already or whether your HPV just came up on a pap smear. If it’s just a pap smear, chances are good that you carry the type of HPV that causes abnormal paps and cervical cancer, but not genital warts. The good news about this for your partner is that these strains of HPV tend to cause nothing in guys (which is why guys are passing it around like candy. They don’t even know they have it).

If you do have warts, you’ll want to be a bit more careful.  While condoms can help reduce the chance of transmitting warts, they can’t protect you completely. Because the condom only covers the shaft of the penis, it leaves vulnerable scrotal skin in contact with potentially infections coochie skin, so it’s important for him to realize that he may still wind up with warts.

As for oral sex, yes, laryngeal warts (warts in the larynx) have been reported. But they’re very rare. HPV tends to prefer the genitals and the anal area, so oral sex is relatively safe. If you want to be uber careful, you can use a dental dam to protect your boyfriend when he’s going down on you, and if you’re worried, have him wear a condom. (I know, it’s not sexy, but it is safe).

If your doc told you to wait a year to repeat your pap smear, I would wait a year. While abnormalities on paps can get worse, they change very slowly, and as long as you don’t miss a pap, you should be fine. Most of all, though, don’t worry. HPV is more of a nuisance than a life-threatening disease, as long as you listen to what your doctor recommends. I know it can be scary and embarrassing, but I commend you for trying to get the information straight. Take a deep breath. Now, let go of any anger, frustration, or shame you feel around this. And let it go. Stressing about HPV only makes it worse. You’ll be fine, sweetie.

For more about HPV, visit my website Owning Pink

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

Got a health question? Don’t trust those “Doctors” at the University Health Center? Are you scared of Web M.D. because it always tells you you’re gonna die? Ask a real doctor, like our friend Dr. Lissa Rankin. She’s here every Thursday to answer whatever you throw at her – like performance anxiety

Q: I just recently started having sex with my boyfriend. It always feels fine (great, actually) when we’re in the act, but everything just feels…weird the next day. It sorta hurts when I go to the bathroom (mostly when I’m…er…cleaning up), when I sit, and the muscles in my inner thighs hurt. And I’m just so sore down there that I need a couple days before I can even do it again.

Is that normal? Is it something I’ll get used to? Should I be worried?

A: Sex can be uncomfortable in a variety of ways, especially for women. What you’re describing sounds more like the result of a serious sexual workout than any medical condition.  Most people with sexual pain disorders, such as vulvar vestibulitis (inflammation of the vestibule) or vaginismus (involuntary tightening of the muscles in the vagina), experience pain during intercourse. The fact that you’re enjoying the act itself is good news.

If the muscles in your inner thighs hurt, it’s probably because you’re using them to cling to your partner during sex- and just like any workout, they can ache afterwards, especially if you’re using muscles you’re not used to using. Try taking ibuprofen (Motrin) or naproxen (Aleve) to help the aching you feel. And just like spin class or lifting weights, chances are, the more you do it, the less it will hurt. (Which I’m sure your boyfriend will enjoy…)

As for the hurting when you’re cleaning yourself up, I’m a little vague on what you mean by that. Does it burn afterwards? If so, you could be sensitive to the acidity of the sperm. Or in rare cases, people can be allergic to sperm. Try using a condom. If that doesn’t help – that’s not it. It’s possible you could have a vaginal infection, like a yeast infection, and sex is triggering symptoms. Or it’s possible that the act of sex itself is irritating to such a sensitive area; if that’s the case, try using lube. That should help make things go a little more smoothly.

Since it’s not quite clear to me what the problem is, I’d recommend seeing a gynecologist. You may feel embarrassed talking to someone about sex, but I swear- it’s what we do all day. Don’t be shy. We can help.

Wishing you pain-free bliss,
Dr. Lissa

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

Got a health question? Don’t trust those “Doctors” at the University Health Center? Are you scared of Web M.D. because it always tells you you’re gonna die? Ask a real doctor, like our friend Dr. Lissa Rankin. She’s here every Thursday to answer whatever you throw at her – like why you can’t get any sleep – so ask away. Leave your question in the comments or send it over to us. Don’t be shy; she’s waiting for ya!

Q: I’m not really sure if you’re the right person to ask but I’m really not sure who else to go to with this. Basically, I’ve been with my boyfriend for 4 months now. We just started to have sex but he can never seem to…keep it up. I don’t know if it’s something I’m doing (or not doing…), and I don’t know if this is something we can fix? Is there something I should do? And how do I even talk to him about this? He gets really upset after it happens (or doesn’t happen) and I just don’t know what to do here. This has never happened to me before…

A: Thank you for trusting us with what is, undeniably, a delicate issue. It’s funny.  If women have issues with decreased libido or sexual performance, we tend to discuss these things with our girlfriends, ask questions openly, and put our cards on the table. But men- forget it! You don’t hear men sitting around the coffee shop discussing their erectile dysfunction. But I wish they would. Making it a taboo subject shrouded with embarrassment serves no one.

I don’t know how old your boyfriend is, but the incidence of erectile dysfunction increases with age. If your boyfriend is young, chances are good that his issue may be caused by a medication side effect (anti-depressants are classic erection killers) or alcohol or drug use (alcohol increases the desire but decreases the performance). If he’s older, health conditions like high blood pressure or diabetes could play a role.  Often, the problem is psychological. Perhaps he’s worried that he’s not pleasuring you, and the more he worries, the more he droops.

Try talking to your boyfriend, but make sure not to do it in bed. He’s already feeling fragile and vulnerable when he loses his woodie, so there’s no point adding salt to his wound. Bring up the conversation when you’re both fully dressed. Let him know you care about him and genuinely wish to find solutions so you can both enjoy each other’s bodies. Ask him how he feels and share how you feel in a gentle, nonjudgmental way. Suggest that he see his doctor, who might be able to help him investigate the issue. If drugs or alcohol regularly play a role in your sex life, try skipping it or play around with morning sex, when men tend to be a bit more randy.

Do what you can to make him feel safe. The more he feels pressured to perform, the more likely he is to lose his erection. You may find that it helps to break the cycle by avoiding intercourse for a while. Snuggle.  Kiss.  Fool around. Try oral sex or manual sex if you wish.  But stay around from sexual acts that have an expected outcome.

Keep in mind that your relationship is relatively new, and some things work themselves out in time. Perhaps, he’s just so into you that he gets freaked out. If none of this helps and you’re committed to making this relationship work, consider seeing a sex therapist.  His doctor may even recommend Viagra, if he’s a good candidate for it.  If you really care for each other, you’ll find a way…

Wishing you bliss,
Dr. Lissa

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

This year, I invite you to OWN your health. What does that mean? That means loving yourself exactly how you are – flaws, warts, addictions, and all. Until you can love yourself, you’ll never affect lasting positive change in your life.  If you have bad habits, own it! Love your body just the way it is. Accept yourself, even if your health is not optimized. Learn to live in your skin and be present with what is. It’s the only path to sustainable change.

Once you learn to love yourself as you are, you may find that you naturally want to nurture yourself. When you’re coming from a place of loving acceptance, you may no longer feel like grabbing for that bag of potato chips. You’re more likely to feed a body you cherish fresh, organic fruits and vegetables. When you love yourself- curves, lumps and all- you may find that you naturally morph into your ideal body weight.  When you feel comfortable in your skin, you’ll relish moving your body- doing yoga, going for a hike in nature, jogging on the beach.

From this place of self-love and acceptance, radical change can happen. And you don’t need to resolve anything. You will want to do it. Your body will know what it needs to be healthy. But in case you’re searching for some inspiration, here are some thoughts.

5 Tips For Owning & Improving Your Health in 2010

1. Buy a juicer and start making green juice. Do a detoxify cleanse or add it as a supplement to your diet. By nourishing your body, you allow it to heal whatever ails you. Even if you’re already very healthy, adding green juice to your body can change your life by improving energy, mood, immune function, and confidence.  You may even help your body fight cancer. So love yourself enough to feed it well.

2. Get moving. Get up and move at least 20 minutes each day. If that feels good, rev it up. Love yourself enough to get your body moving. The health benefits are endless.

3. Be still. Most of us run around like chickens with our heads cut off, which leads to overwhelming levels of stress. Let your nervous system rest by spending some time in stillness. Try meditating, listening to guided imagery, sitting outside in nature, or taking a nap. Love your body enough to let it rest.

4. Take a multi-vitamin and talk to your doctor about preventative supplements that might benefit you, such as fish oil and calcium. Love your body enough to optimize your preventative medicine.

5. Listen to the wisdom of your body. Our bodies send us messages about what we can do to improve our health- and we tend to ignore what we don’t wish to hear. Love yourself enough to listen.

These are just some suggestions. But don’t let anyone else’s suggestions guide your path. Make a commitment to cherishing your beautiful, magnificent, sexy, healthy, radiant self. Then watch what happens. You may be surprised that 2010 is YOUR year- and all your dreams will come true.

Wishing you health and peace in 2010,
Dr. Lissa

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

Got a health question? Don’t trust those “Doctors” at the University Health Center? Are you scared of Web M.D. because it always tells you you’re gonna die? Ask a real doctor, our friend Dr. Lissa Rankin. She’s here every Thursday to answer whatever you throw at her – like how to know if your guy is clean – so ask away. Leave your question in the comments or send it over to us. Don’t be shy; she’s waiting for ya!

Q: Between finals, graduating and other personal stress, I can’t fall asleep at night. And then when I do, I can’t stay asleep. I’m always tired and grumpy and it’s only making everything even more stressful. Do you have any ideas for getting sleep? I heard sex might help, but I’m not sure if that’s true or if my boyfriend is just telling me that for his own selfish reasons. I really need to be alert and focused for exams and this is killing me. Help?

A: I hear you, sweetie. Insomnia can kill you (trust me, I’ve been there), especially when you’re in school, with tests, projects, and grades looming over you. The question is why can’t you sleep? Is it stress? Is it hormones, like your thyroid? Is it caffeine, alcohol, or other drugs/medications that are disrupting your sleep? Is it poor nutrition?  Is it the crazy sorority girl next door who keeps banging you up with her rocking orgasm? How to treat your insomnia depends on what’s causing it. Here are some causes:

Why Can’t I Sleep?

1. Emotional disturbances: Anxiety and depression tend to sap your energy and they may also contribute to insomnia, which leads to poor sleep.
2. Nutrition: If you’re filling up on junk, it’s no wonder you have trouble sleeping. Food is fuel, and if you’re filling your tank with caffeinated sugar water instead of whole foods and green things, you can’t expect to sleep well. If you treat your low energy with sugar and/or caffeine, you’re stimulating our sympathetic nervous system and revving up your pancreatic insulin production. Then when you crash, you only feel worse. Insomnia follows.
3. Thryoid imbalance: If your thyroid hormones are out of whack, you may have trouble sleeping.
4. Sex hormone imbalance: Fluctuations in sex hormones, such as estrogen, progesterone, and testosterone, may lead to insomnia.
5. Change in your Circadian rhythms: Do you pull all-nighters and then sleep all day? If you’re messing with your body’s schedule, you’ll have trouble sleeping.
6. Poor sleep hygiene: Do you engage in restful activities before bed, or are you cramming until 3 minutes before lights out? We can’t expect our bodies and minds to just shut down without some help.
7. Caffeine/alcohol/medications: All of these can affect your sleep patterns.

10 Tips For Helping You Sleep

1. Try to get 8 hours of sleep at night on a regular schedule. Go to bed earlier and rearrange your schedule to allow your body the rest and rejuvenation it needs to recapture energy.
2. Establish bedtime rituals; herbal tea, a warm bath, cinnamon milk, reading a relaxing book, meditation – whatever works for you.
3. Avoid studying, having tough conversations, or other stressful situations just before bed.
4. Eat a balanced whole foods diet rich in produce, lean proteins, and whole grains.
5. Avoid caffeine, sugar, high carb foods, alcohol, and nicotine. If you’re taking medications, talk to your doctor about whether any of them might have insomnia as a side effect.
6. Buy a juicer and drink green juice. It works miracles for insomnia and improves energy and performance, I swear!
7. Exercise regularly, but not right before bed. It helps you fall and stay asleep.
8. Listen to guided imagery (I love Belleruth Naparstek’s CDs and listen to them almost every night.)
9. Sure, go ahead and try sex. Orgasm has been scientifically proven to help you sleep (won’t your boyfriend be jazzed?)
10. If all else fails, try a safe, over-the-counter sleeping aid like Benadryl (an anti-histamine that makes you drowsy). But be aware that regular use can lead to psychological (though not physical) addiction that may make it hard for you to sleep without it. Sometimes breaking the cycle makes all the difference.

Sleep well, love!

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

Got a health question? Don’t trust those “Doctors” at the University Health Center? Are you scared of Web M.D. because it always tells you you’re gonna die? Ask a real doctor, our friend Dr. Lissa Rankin. She’s here every Thursday to answer whatever you throw at her – like the getting over your fear of sex– so ask away. Leave your question in the comments or send it over to us. Don’t be shy; she’s waiting for ya!

Q: I recently started hooking up with a boy who has, well, gotten around. I asked him if he’d been tested recently and he said he did (and he was “all good!”), but I don’t know if I trust him. Maybe he’s just saying that to get in my pants? I obviously plan on using a condom when I sleep with him, but are there any things I can look for before I go down that path?  Any visible signs I should pay attention to so I know if he’s telling me the truth or not?

A: Honey, if you can’t trust the guy, do you really want to sleep with him? I mean- yeah, there are some things you can do to check him out, but it’s not necessarily enough to protect you.  Make sure you care enough about this guy that, if you do get a sexually transmitted infection, it’s not the end of your world. Because the truth is- even if he got tested for “everything,” you may still be at risk.

Why? Because condoms don’t protect you against all STI’s, and testing doesn’t always test for everything. Most testing will not reveal whether a guy carries HPV, and often, it will not represent whether he might be infectious for herpes.

So what’s a girl to do? Here are a few tips:

1. Ask your partner to be honest about whether he has really been tested. Explain that you value the health of both of you, and that if he cares about you, he needs to demonstrate this. Ask for a copy of his test results if you can’t trust him but want to sleep with him anyway. Offer him a copy of yours first. Then inspect him.
2. Look for cauliflowery warts on and around his penis.
3. Inspect the tip of the penis for funky discharge (anything greenish or yellowish) that may represent gonorrhea or chlamydia. (Wetness in this region should always be clear).
4. Hunt for reddish ulcerations that might represent genital herpes.
5. Check for little round bumps that can represent molluscum contagiosum.
6. Take a gander at his pubic hair to make sure there are no pubic lice or little white eggs.

Remember, a clean inspection doesn’t mean you’re good to go. Most sexually transmitted infections have absolutely no signs on a clinical exam. Which is why it all comes down to trust. At the end of the day, do you really want to hook up with someone you can’t believe?

Hope that helps!

- Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

As you may or may not know, there was a recent recommendation made regarding how often women should be getting pelvic exams. Since most of us are used to getting them yearly and the new recommendation is to get them every 3 years, I asked Dr. Lissa Rankin what she thought. Here is what she has to say:

The American College of Obstetricians and Gynecologists recently announced new recommendations that cut back on Pap smear screening. Why are we recommending cutting back on women’s health screening? Let me fill you in on the news.

New Pap Smear Guidelines:

1. Instead of recommending that Pap smear screening begin after you’re sexually active, new guidelines say that even a sexually active 13 year old should wait until 21 for her first Pap.
2. After 21, Pap smears are recommended every 1-2 years until age 30.
3. After 30, if you’ve had three consecutively normal Pap smears with no history of a seriously abnormal Pap, new guidelines say you only need to do Paps every three years.

Why the Change?

There is evidence to support the changes.  The truth is that you’re unlikely to go from having a normal Pap smear to having cervical cancer in 3 years, even if you contract HPV. Because cervical cancer grows slowly, it’s still likely to be precancerous by the time it gets picked up. And yearly screening does increase the number of procedures performed, and some of those procedures can affect fertility and pregnancy in rare cases.  Plus, cutting back on Pap smears saves health care dollars. And if we’re not saving lots of lives and potentially causing harm by implementing procedures that may not be necessary, why do annual Pap smears?

I understand why they’re recommending pushing back the age of first Pap smear.  HPV, the virus that causes cervical cancer and abnormal Pap smears, is almost ubiquitous among teens. As such, doing Paps will lead to many abnormal results that would require colposocopies, biopsies, and other possible treatments. If left untreated, the issues would resolve themselves, meaning these procedures (and potential risks) are not necessary.

BUT (and this is a gigantic BUT) there is a GINORMOUS problem here that carries far-reaching consequences for women’s health. Though women come to the gynecologist under the guise of their annual Pap smear, they actually come for WAY more than that.

Here are some examples of issues I handle under the guise of an annual Pap smear exam:

* Sexual problems that threaten your relationship
* Debilitating depression and anxiety
* Chronic fatigue that prevents you from living vitally
* Menstrual disorders like hemorrhaging or menstrual cramps that cause you to miss important life functions.
* PMS/PMDD that may be hampering a happy life

And that doesn’t even include the oh-so-necessary annual breast exam, internal pelvic exam to check for ovarian tumors and such, and the opportunity to make sure a woman is up to date on other cancer prevention procedures, such as the HPV vaccine for teens.

If women don’t come in for their annual pap smear, how will they ever fix the other problems that may exist?

The Bottom Line
Based on the information presented, it is totally up to you if you want to get an annual pap smear or stretch it out a few years. Regardless of what you decide, though, please don’t stop seeing a doctor every year. That is the only way to sort out any issues you have, especially those you don’t even know about.

–Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).