U.S. Pediatricians Decry Media's Portrayal of Sex

TUESDAY, Aug. 31 (HealthDay News) -- The nation's leading group of pediatricians has issued a strong policy statement directed toward pediatricians, parents and the media on the danger of messages American teens and children are getting about sex from television, the Internet and other media outlets.

The statement, Sexuality, Contraception, and the Media, was published online Aug. 30 and in the September print issue of the journal Pediatrics.

"The media represents arguably the leading sex educator in America today," said Dr. Victor Strasburger, the lead author of the paper. "We do such a poor job of educating kids about sex in sex education classes in school, and parents are notoriously shy about talking to kids about sex. The media picks up the slack."

Seventy percent of teen shows contain sexual content, Strasburger added, "and less than 10 percent of that content involves what anyone would classify as being responsible content. There's no mention of contracting an STD [sexually transmitted disease] or the need to wait to have sex until later."

The United States leads the western world in teen pregnancy rates and American teens have an alarmingly high rate of STDs -- one in four children.

Meanwhile, U.S. children spend seven hours and more a day with various types of often-sexually explicit media, including music, movies, television shows, magazines and the Internet.

"The research shows us that the portrayal of sex in the media is really unrealistic. It's unhealthy. It doesn't consider the consequences of sexual behavior," said Alan Delamater, professor and director of child psychology at the University of Miami Miller School of Medicine. "This is what our kids are growing up thinking. This is what sex is about. To deny its impact is ignorant because there's so much knowledge of it at this point."

Many pediatricians would like to flip the equation and see media outlets introduce more responsible programming.

"Media has an opportunity to continue doing the same old thing, which is to have an adverse effect on child development, or turn it around and shape attitudes and behavior that could have a positive effect on child development," Delamater said.

The statement contains a number of recommendations for parents, physicians and the media.

"We want physicians to ask two media questions at every well-child visit: how much entertainment screen time per day does the child engage in, and is there a TV set or Internet connection in his or her bedroom," said Strasburger, professor of pediatrics at the University of New Mexico School of Medicine. "That takes 20 seconds and may be more important than asking about childproofing or car seats or bicycle helmets."

The authors of the statement ideally would like ads for erectile dysfunction drugs to not be shown on TV until after 10 p.m.

"Half a billion dollars of ads for erectile dysfunction drugs and virtually no ads for birth control pills or condoms or emergency contraception," Strasburger said. "There's not a single shred of evidence that exposing kids to birth control ads or even making birth control available to them makes them sexually active at a younger age. We're doing things completely backwards."

There should also be more attention paid to how kids use social networking sites on the Internet. And parents can use media story lines as teaching tools to discuss sex with their children, instead of having "the big talk," the statement said.

On the more idealistic side, the statement also recommends that advertisers no longer use sex to sell a wide range of products.

"We want parents to realize that kids are spending more time with media than in any other activity but sleeping, and that the media represents a powerful source of information and in this case a powerful sex educator," Strasburger said.

More information

To learn more about children and the media, visit the American Academy of Pediatrics.

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German researchers testing veggie Viagra: reports

BERLIN (AFP) – German researchers are testing an impotency treatment for men made using only natural ingredients that in some cases works better than Viagra, newspapers reported Monday.
"In clinical trials, 50 men had much better sex afterwards, more fun in bed and just generally felt better about themselves," the Sueddeutsche Zeitung daily cited Olaf Schroeder from Berlin's Charite hospital as saying.
"Their libido was even higher than the control group taking Viagra," he said.
The potent cocktail includes tribulus terrestris, a herb already used in alternative medicine, a root vegetable found in the Andes called maca and grape juice extract, newspapers said.
The treatment, dubbed "Plantagrar", is due to be launched in early 2010, the Bild daily said.
But some of those tested had unwelcome side effects.
"Two of the subjects had bad diarrhoea," the Berliner Kurier quoted Schroeder as adding.

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Second-Generation Female Condom Approved

WEDNESDAY, March 11 (HealthDay News) -- The Female Health Co.'s FC2 Female Condom has been approved by the U.S. Food and Drug Administration, the company said Wednesday. The product helps protect women against pregnancy and sexually transmitted diseases.
The second-generation condom is similar in design and performance to the FC1, except that it is made of a synthetic rubber called nitrile and costs about 30 percent less, the company said. The FC1 was approved in 1993.
The FDA approval of the FC2 will allow the U.S. Agency for International Development to distribute the condoms via global HIV/AIDS programs, the Associated Press reported.
The first-generation FC1 has been distributed by United Nations agencies in 142 countries, the wire service said.
More information
To learn more about female condoms, visit the U.S. National Library of Medicine.

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Suriname starts free circumcision project

PARAMARIBO (AFP) – Suriname has launched a three-month pilot project offering free circumcisions in a bid to cut sexually transmitted diseases, Health Minister Celsius Waterberg said Friday.

Circumcision "could also minimize the risk of HIV infection", he said, adding the project would run in the capital city, Paramaribo.

Some two percent of the Suriname population is HIV-infected, about 10,000 people, and the project aims to carry out the operations on 100 men aged between four and 21 years old over the next three months.

If successful then the project will spread nationwide, Waterberg said.

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Weight loss enhances obese men's sexual well-being

NEW YORK (Reuters Health) – Obese men who undergo gastric bypass surgery will not only lose weight; their sex lives are likely to improve, too, new research shows.
"We wanted to know if obesity was biologically associated with an unsatisfying sex life, and if so, could it be reversible," Dr. Ahmad Hammoud of the University of Utah in Salt Lake City, who led the study, said in a press release accompanying the new report. "Our results show that the answer to both questions may be yes."
While obesity in men has been linked to low testosterone levels, high levels of estrogen, impaired fertility, and worse sexual quality of life, Hammoud and his colleagues note in the Journal of Clinical Endocrinology and Metabolism, there is little information on what happens to these men's sex hormones and sexual function if they lose weight.
To investigate, Hammoud and his team looked at 22 men who had undergone gastric bypass surgery and 42 obese men who didn't have the operation. At the study's outset, participants weighed 330 pounds, on average, while the average BMI for the group was 46.2, what is considered to be .
The heavier the men were, the lower their testosterone, and the more likely they were to report dissatisfaction with their sex lives-especially avoiding sexual encounters and having difficulty performing sexually.
Two years later, the men who'd had weight loss surgery had dropped an average of nearly 17 points from their BMI. Their estrogen levels had fallen significantly, while their testosterone levels had gone up. And all showed improvements on each of the four measures of sexual quality of life the researchers looked at: they were less likely to avoid sexual encounters, have difficulty with sexual performance, have little sexual desire, or report not enjoying sex.
There were no significant changes in measures of sexual quality of life or hormone levels in the group of men who didn't have the surgery.
Because other both biological and psychological factors involved in obesity can affect both sexual health and hormone levels, Hammoud and his team conclude, more research is needed to determine whether there is a causal relationship between hormone changes and sexual quality of life.
SOURCE: Journal of Clinical Endocrinology and Metabolism, April 2009.

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Future of abstinence-only funding is in limbo

NEW YORK – With the exit of the Bush administration, critics of abstinence-only sex education will be making an aggressive push to cut off federal funding for what they consider an ineffective, sometimes harmful program.
How quickly and completely they reach their goal is uncertain, however, as conservative supporters of abstinence education lobby Congress and President-elect Barack Obama to preserve at least some of the funding, which now totals $176 million a year.
And even if federal funding is halted, some states — such as Georgia — are determined to keep abstinence programs going on their own, ensuring that this front in the culture wars will remain active.
Obama is considered an advocate of comprehensive sex education, which — unlike abstinence-only curriculum — includes advice to young people about using contraceptives if they do engage in sexual activity. However, Obama spokesman Tommy Vietor declined to elaborate on what the new president would propose in his own budget plan.
Cecile Richards, president of the Planned Parenthood Federation of American, depicted the federal abstinence-only program as "an utter failure that has wasted more than $1.5 billion" over the past decade. Like other critics, she noted that several major studies — including a federally funded review — have found no evidence that the abstinence-only approach works in deterring teen sex.
"Talking with Obama, he totally understands the need for young people to have comprehensive sex education — they need information that protects their health," Richards said. "I hope that will be the position of the administration, but when Congress gets involved, sometimes things get more complicated."
Even after Democrats took control of Congress in the 2006 elections, liberals lacked the votes to end abstinence-only funding, and President George Bush stuck by his strong support for it.
But Rep. Louise Slaughter, D-N.Y., said the 2008 elections not only put Obama in the White House but also increased the ranks of senators and representatives who share her opposition to funding abstinence education.
"We believe the amount of money that goes into it would be so much better used on things to prevent unwanted pregnancies," she said. "I think we'll have enough votes to deal with it."
Slaughter is a lead sponsor of the Prevention First Act, introduced this month in the House and Senate, that proposes multiple initiatives to reduce unintended pregnancies. One component calls for promoting "medically accurate" comprehensive sex education.
Supporters of abstinence education acknowledge the shift of political power in Washington, but they have appealed to Obama to preserve some federal funding for their programs.
Valerie Huber, executive director of the National Abstinence Education Association, suggested that one option would be for Congress "to allow true choice" by approving funding for both comprehensive and abstinence-focused programs.
Referring to recent data showing increases in teen births and sexually transmitted diseases among young people, she said, "Now is not the time to remove even one of the tools that can help teens."
However, Slaughter said she would oppose any effort to fund both approaches.
"We can't have both, because abstinence-only doesn't work," she said.
Among the organizations attempting to bridge the ideological divide on sex education is the National Campaign to Prevent Teen and Unplanned Pregnancy.
Its director, Sarah Brown, said the campaign's approach is "science-driven" — favoring comprehensive sex education over the abstinence programs.
"In a highly constrained fiscal environment, it's critical to focus precious dollars on programs that have evidence of good effects," Brown said. "When you look at the best science, the abstinence-only programs come up short."
Still, she said there could be a long-term benefit to conducting research on whatever abstinence programs do endure.
"I suspect that if research community keeps testing them, there might be a couple that do have an effect," she said.
Georgia supplements its federal abstinence money with more than $500,000 of state funds.
"Abstinence education will remain a strategy of our youth development initiative regardless of what happens at the federal level," said Jen Bennecke, executive director of the Governor's Office for Children and Families.
She credited the Georgia program — which includes character-development curriculum — with contributing to a 50 percent decrease in teen pregnancies since its inception 11 years ago.
Roughly half the states receive federal abstinence funding — the others have spurned the program, under which instructors are directed to teach that sexual activity outside of marriage is likely to have harmful psychological and physical effects.
Supporters of abstinence education say it promotes the only method that's 100 percent effective in preventing pregnancy and sexually transmitted disease. Critics say the abstinence programs don't deter teens from having sex, leave them without crucial information on avoiding pregnancy and STDs, and in some cases provide false information about condoms' reliability.
___
On the Net:
Abstinence Education Association: http://www.abstinenceassociation.org/
Campaign to Prevent Teen Pregnancy: http://www.thenationalcampaign.org/default.aspx

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New 'Joy of Sex' Slim on Science

An updated edition of "The Joy of Sex" is newly released this month with more sexological detail, but the how-to manual remains scientifically superficial on the topic of anatomy.
In 1972, the British doctor Alex Comfort published "The Joy of Sex," an illustrated guide for couples of a newly liberated generation. His goal was to remove shame and confusion from an act that he saw as intrinsically human and healthy; as he wrote in 1991, he had hoped his book would "undo some of the mischief caused by the guilt, misinformation, and lack of information."
There have been several editions of "The Joy of Sex" in subsequent years, the most recent being Susan Quilliam's "Ultimate Revised Edition" (Crown, 2009).
Quilliam removes some of Comfort's more dated passages - including racist undertones and the encouragement of open relationships - while adding the findings of "key scientific discoveries in recent years in the fields of physiology, psychology, psychotherapy, and medicine." In addition, as she writes in the preface, "the advent of sexology - the specialist study of sexual matters - has resulted in both rigorous academic research and a more widespread public awareness of, and skill in, sex."
Most of these key scientific discoveries come early in the book, in a section called "Ingredients" ("The Joy of Sex" was modeled on "The Joy of Cooking," and uses culinary metaphor throughout).
Topics in "Ingredients" include pheromones, which are thought by some to be responsible for the correlation of desirability and smell; hormone replacement therapy; and sex education, where it is noted that "sex education actively raises the age at which adolescents first have sex and lowers the number of partners they have and the number of risks they take."
In "Appetizers," Quilliam offers three pages on STDs, including a step-by-step illustration of proper condom use. Readers might also be interested to learn that a man's average ejaculate is approximately 5 calories and contains "a dose of vitamin C."
Despite these additions, "The Joy of Sex" is by no means a scientific treatise: Its most popular section has been and will likely remain "Main Courses," which features instructional illustrations of different sexual positions. There is also some unscientific wording surrounding body parts and their functions: the scrotum is "basically, a sperm factory," and the vagina is almost always called the "p****." (The penis, it should be noted, is never given a more colloquial name.)
Scientific or not, the new edition continues its tradition of good intentions. The first ingredient of sex is listed as "tenderness," which is defined as "a constant awareness of what your partner is feeling, plus the knowledge of how to heighten that feeling, gently, toughly, slowly, or fast." That's experimentation that anyone can conduct.
The Sex Quiz
Video - Aspirin and Sex Drive
Top 10 Bad Things That Are Good for You
Sally Law has written about health and sexuality for the Cleveland Clinic, and has appeared regularly as a guest host on Sirius Radio. Her column, The Science of Sex, appears weekly on LiveScience.
Original Story: New 'Joy of Sex' Slim on ScienceLiveScience.com chronicles the daily advances and innovations made in science and technology. We take on the misconceptions that often pop up around scientific discoveries and deliver short, provocative explanations with a certain wit and style. Check out our science videos, Trivia & Quizzes and Top 10s. Join our community to debate hot-button issues like stem cells, climate change and evolution. You can also sign up for free newsletters, register for RSS feeds and get cool gadgets at the LiveScience Store.

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U.S. Chlamydia Infections Hit All-Time High

TUESDAY, Jan. 13 (HealthDay News) -- The number of Americans newly infected with the sexually transmitted diseases chlamydia and syphilis continues to rise, federal health officials reported Tuesday, with chlamydia infections hitting a record million-plus new cases annually.


The numbers, from 2007, show that cases of chlamydia as well as syphilis rose for the third year in a row, according to a report by the U.S. Centers for Disease Control and Prevention (CDC).


"The bad news from last year has continued," said Dr. John M. Douglas Jr., director of the CDC's Division of STD Prevention. "These infections remain at very high levels, and frankly, unacceptably high."


Chlamydia and gonorrhea, the two most commonly reported infectious diseases in the United States, together accounted for almost 1.5 million reported cases of sexually transmitted disease (STD) in 2007.


"Chlamydia is at a new all-time record 1.1 million cases -- it went up about 7 percent since 2006," Douglas said. "Gonorrhea is about at 355,000 cases."


STDs, although easily diagnosed and treated, frequently occur without symptoms and may go untreated. Left untreated, chlamydia and gonorrhea can result in pelvic inflammatory disease -- a condition that causes as many as 50,000 U.S. women to become infertile each year, according to the report, Sexually Transmitted Disease Surveillance, 2007.


The overall rate of chlamydia infections among women was 543.6 cases per 100,000 females, almost three times the rate among men -- 190 cases per 100,000 males, the report said.


The increasing number of chlamydia cases is actually a reflection of more people being screened, not a greater incidence of the disease in the population, Douglas said. "It's kind of a mixed piece of good news. We wish those numbers were going down, but we know they have to go up before they go down," he said.


Gonorrhea rates have been stable for about the last 10 years, Douglas said. "This is stable at quite a high level. It represents an example where we have a job half done. Gonorrhea has come down since its highpoint in the 1970s, but we just got stuck in the late 1990s, and we've been stuck ever since then," he said.


Rates of gonorrhea were also higher among women -- 123.5 per 100,000 women -- compared with 113.7 per 100,000 men, according to the report.


But these numbers are probably just the tip of the iceberg, Douglas noted. The CDC estimates that only half of all new chlamydia and gonorrhea infections are reported, bringing the actual number of infected people to more than 3 million.


"We think there are really 2 to 2.5 million cases of chlamydia a year," he said.


The report also found continued increases in rates of syphilis. On the verge of elimination just a decade ago, syphilis rates began increasing in 2001 and rose 15.2 percent between 2006 and 2007, Douglas said.


"We got set back in a recurrence of syphilis among men who have sex with men," Douglas said. "There has been limited success in trying to curb that, but we have begun to see a slide in some of the better-controlled populations."


The increases in syphilis in 2007 were predominately among women. "We have seen increases in babies, which is the ultimate innocent bystander population," Douglas said.


What's more, if you have syphilis, you also have a 50 percent chance of being HIV-positive, he added.


The report found continued racial disparities for STD cases. Gonorrhea was 19 times more common among blacks than whites; chlamydia was eight times more common; and syphilis was seven times more common, Douglas said.


Black women 15 to 19 years old had the highest rates of both chlamydia (9,647 per 100,000 population) and gonorrhea (2,956 per 100,000 population), according to the report.

Sexually transmitted diseases take a significant economic toll -- the CDC estimates that STDs cost the U.S. health-care system an estimated $15.3 billion annually.

Douglas said greater public health campaigns are needed to reverse the trend.

"These diseases can be treated, and we need to have better awareness about how extensive these infections are and what the prevention opportunities are," he said.

Dr. David L. Katz, director of the Yale University School of Medicine Prevention Research Center, said sexually transmitted diseases are a considerable public health burden.

"By serving up crucial details on where and in whom sexually transmitted diseases are most likely, this report helps inform disease-control programs. By highlighting the persistent prevalence of these diseases, it also issues a call to action," he said.

More information

To learn more about sexually transmitted disease, visit the U.S. Centers for Disease Control and Prevention.

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Sexually spread diseases up, better testing cited

ATLANTA – Sexually spread diseases — for years on the decline — are on the rise, with reported chlamydia cases setting a record, government health officials said Tuesday.

The increase in chlamydia, a sometimes symptomless infection that can lead to infertility in women, is likely because of better screening, experts said. In 2007, there were 1.1 million cases, the most ever reported, said officials at the Centers for Disease Control and Prevention.

At least 15,000 women become infertile each year because of untreated chlamydia and gonorrhea infections, said Dr. John M. Douglas Jr., director of the CDC's Division of STD Prevention.

Syphilis cases, which number only in the thousands, also rose modestly, while the number of gonorrhea cases remained roughly the same. Syphilis can kill, if left untreated, but chlamydia and gonorrhea are not life-threatening.

Chlamydia can infect men, but rates are nearly three times higher for women. That's at least partly due to 1993 federal recommendations that emphasize testing for sexually active women age 25 and under. That focus on screening in recent years is no doubt driving the record numbers, said Dr. Jonathan Zenilman, a professor of infectious diseases at the Johns Hopkins University School of Medicine.

"The issue with chlamydia is the more tests, the more you'll find," Zenilman said.

The percentage of young women being tested for the infection rose by double digits from 2003 to 2007, according to the National Committee for Quality Assurance, a nonprofit that monitors health care.

The latest case numbers for chlamydia translate to a rate of 370 cases per 100,000 people in 2007, up 7.5 percent from 2006.

The reported cases are just part of the picture. Health officials believe as many as 2.8 million Americans get chlamydia each year.

Many men and women have no symptoms from it. Some women experience pain in their lower abdomen or notice a burning sensation or a pus-like discharge when they urinate. Some men may also feel a burning during urination or have a discharge.

Gonorrhea cases appear to have plateaued and are currently at about 356,000 cases. Syphilis was on the verge of being eliminated in the United States about 10 years ago, but lately has been inching up. More than 11,000 new cases of the most contagious form of the disease were reported in 2007.

Syphilis is relatively rare but has become a growing threat, particularly for gay and bisexual men, who accounted for about 65 percent of the 2007 cases.

___

On the Net:

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Male circumcision lowers cervical cancer risk: study

WASHINGTON (Reuters) – Three studies published on Wednesday add to evidence that circumcision can protect men from the deadly AIDS virus and the sexually transmitted virus that causes cervical cancer.

The reports in the Journal of Infectious Diseases are likely to add to the debate over whether men -- and newborn boys -- should be circumcised to protect their health and perhaps the health of their future sexual partners.

Dr. Bertran Auvert of the University of Versailles in France and colleagues in South Africa tested more than 1,200 men visiting a clinic in South Africa,

They found under 15 percent of the circumcised men and 22 percent of the uncircumcised men were infected with the human papilloma virus, or HPV, which is the main cause of cervical cancer and genital warts.

"This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women," they wrote in their report.

A second paper looking at U.S. men had less clear-cut results, but Carrie Nielson of Oregon Health & Science University and colleagues said they found some indication that circumcision might protect men.

The circumcised men were about half as likely to have HPV as uncircumcised men, after adjustment for other differences between the two groups.

PREVENTING AIDS

In the third report, Lee Warner of the U.S. Centers for Disease Control and Prevention and colleagues tested African-American men in Baltimore and found 10 percent of those at high risk of infection with HIV who were circumcised had the virus, compared to 22 percent of those who were not.

"Circumcision was associated with substantially reduced HIV risk in patients with known HIV exposure, suggesting that results of other studies demonstrating reduced HIV risk for circumcision among heterosexual men likely can be generalized to the U.S. context," they wrote.

Studies supporting circumcision to reduce HIV transmission had all been done in Africa and U.S. studies were less clear.

Dr. Ronald Gray of Johns Hopkins University in Baltimore and colleagues said they found the reports encouraging.

"In the United States, circumcision is less common among African American and Hispanic men, who are also the subgroups most at risk of HIV," they wrote in a commentary.

"Thus, circumcision may afford an additional means of protection from HIV in these at-risk minorities."

But they noted that the American Academy of Pediatrics does not recommend routine circumcision for newborns.

"As a consequence of this AAP decision, Medicaid does not cover circumcision costs, and this is particularly disadvantageous for poorer African American and Hispanic boys who, as adults, may face high HIV exposure risk," Gray and colleagues wrote.

"It is also noteworthy that circumcision rates have been declining in the U.S., possibly because of lack of Medicaid coverage."

Medicaid is the state-federal health insurance program for the poor and disabled.

Thirty-three million people globally are infected with AIDS, which has no cure and no vaccine. HPV is the most common sexually transmitted infection in the world, with 20 million people in the United States infected. It causes cervical cancer, which kills 300,000 women globally every year.

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Effectiveness of peer-led sex education questioned

NEW YORK (Reuters Health) – Among 13 to 14 year-old girls who received either peer-led or teacher-led sex education, abortion rates by the age of 20 were the same -- 5 percent -- regardless of the education method, a study shows.

This may "temper high expectations" regarding the long-term impact of peer-led sex education, Judith Stephenson, of University College London, and colleagues comment in PLoS Medicine, a journal from the Public Library of Science.

However, there were some indications that the peer-led program reduced unwanted pregnancies, and Stephenson's group suggests further investigation of pupil-led sex education programs as part of a broader strategy to minimize teenage pregnancies.

"Peer-led sex education is widely believed to be an effective approach to reducing unsafe sex among young people, but reliable evidence from long-term studies is lacking," Stephenson and colleagues note.

The Randomized Intervention trial of Pupil-led sex Education, known as the RIPPLE trial, compared the efficacy of peer-led versus teacher-led sex education delivered to over 9000 male and female 8th grade students in the United Kingdom.

Peer-led sessions, conducted by specially trained older students, focused on information similar to that offered in the teacher-led program.

Follow-up through the age of 20.5 years showed 7.5 percent of girls taught in peer-led session had unintentional pregnancies compared with 10.6 percent of those taught in teacher-led sessions. This difference wasn't significant from a statistical standpoint, but the reduction in unintended pregnancies before age 18 was significant -- 7.2 percent versus 11.2 percent.

As noted, however, the investigators found no difference in the number of girls having abortions, and there were no differences in teens' reports of unprotected first sex, pressured sex, sexually transmitted diseases, contraception practices or use, or in the percentage of boys or girls reporting sex before age 18.

In a related commentary, Dr. David A. Ross, from the London School of Hygiene and Tropical Medicine, points out that the use of actual, rather than self-reported abortion and pregnancy data is the major strength of the Ripple trial.

However, "it does not tell us how effective either intervention was relative to no sexual health education," Ross told Reuters Health. Therefore, development and rigorous evaluation of approaches to reduce teens' adoption of risky sexual behaviors should continue, he said.

SOURCE: PLoS Medicine, November 2008.

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Safe Sex

It's been exactly 15 years since the FDA first approved "female condoms," but it still hasn't found its niche, except perhaps in the sex trade. In fact, while engineers at Apple have already released the next iteration of the 18-month-old iPhone, there hasn't even been a second-generation product of the lady-centric contraceptive.

But the Chicago-based Female Health Company is hoping to change that. Its redesigned product, which contains a softer type of rubber called nitrile as well as adhesive foam, is being reviewed by the FDA and, if approved, could be available for sale in the U.S. sometime next year. As a "Class 3 Medical Device," female condoms are held to the same rigorous FDA standards as pacemakers, heart valves and silicone breast implants, with clinical trials costing as much as $6 million. Male condoms, which are Class 2 devices, are much cheaper to produce and need only pass breakage tests. (See the 50 best inventions of 2008.)

Complaints about female condoms are not so different from those about the male version: slippery, noisy, awkward, uncomfortable. "The yuck factor was a problem," Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, told the New York Times last year when explaining the device's failure to catch on. Then there's the stigma associated with buying condoms, a topic even the Golden Girls once addressed.

Of course, the history of protected sex, in the broadest sense, used to be a whole lot yuckier. Take the practice of women in ancient Egypt, who resorted to using crocodile dung as a spermicide. Modern research has shown that crocodile dung actually created optimum conditions for sperm because of its alkalinity, but the sheer grossness of the practice might have worked if only to completely ruin the mood. (See pictures of animal attraction.)

In the 1540s, an Italian doctor named Gabriele Fallopius - the same man who discovered and subsequently named the fallopian tubes of the female anatomy - wrote about syphilis, advocating the use of layered linen during intercourse for more "adventurous" (read: promiscuous) men. Legendary lover Casanova wrote about his pitfalls with medieval condoms made of dried sheep gut, referring to them as "dead skins" in his memoir. Even so, condoms made of animal intestine - known as "French letters" in England and la capote anglaise (English riding coats) in France - remained popular for centuries, though always expensive and never easy to obtain, meaning the device was often re-used.

In 1844, Charles Goodyear patented the process of vulcanizing rubber, inadvertently ushering in an entirely new era in contraception - condoms as thick as bicycle tires and still considered re-usable. But getting one's hands on this new-fangled "technology" became a whole lot harder in 1873, when Congress passed the Comstock Law, prohibiting the transportation of obscene material like prophylactics and pornography. (See pictures of pin-up queen, Bettie Page.)

The 1930s saw the invention of latex as well as the invention of the first-ever female condom in the U.S., the "Gee Bee Ring." In 1965, the Supreme Court ruled that married couples had the constitutionally protected right to contraception; in 1972 that same right was extended to unmarried couples. (Ireland prohibited condom sales until 1978, the Catholic Church still condemns them).

Condom use waned in the 1960s after the introduction of the birth control pill and remained stagnant until the arrival of the AIDS virus in the 1980s, when sales exploded, jumping 33% in the U.S. in 1987. Today, some 6 billion condoms are sold worldwide each year, though sales have plateaued in the past decade - policy experts blame "prevention fatigue" while condom-makers (the ones targeting men anyways) have responded by becoming increasingly creative, or perhaps ridiculous. What began as a simple choice between lubricated, ribbed or custom-fit now includes flavored, novelty (Star Wars prophylactic anyone?) and glow-in-the-dark. One can even purchase condom accessories like the $28 Condo-M, a plastic and aluminum bedside container. (Think Pez dispenser for grown-ups). Even the presidential campaign spawned Barack Obama and John McCain-themed condoms with corresponding slogans ("Who says experience is necessary?" for the former, "Old, but not expired" for the latter). (Read about permanent birth control.)

The origin of the word "condom" is unknown, though the story of a certain Dr. Condom in 19th century England remains one of the more persistent myths. The term at least trumps "intravaginal pouch," a phrase suggested in lieu of "female condom" by an FDA panel tasked in the early 1990s with reviewing an early prototype of the women's contraceptive.

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Health Tip: Having Sex Despite Illness

(HealthDay News) -- People who have a chronic illness -- which may include heart disease, diabetes or asthma -- may have ongoing pain or fatigue that can hinder a healthy sex life.

The American Academy of Family Physicians offers suggestions for how to enjoy sex, despite having a chronic illness:

* Figure out what time of day you feel healthiest and most energized, and plan sex around those times.
* Try to get plenty of rest, and make yourself feel as relaxed as possible.
* Don't have sex within two hours of eating.
* If you take pain medicine, take it at least 30 minutes before having sex.
* Drink only limited amounts of alcohol, and don't use tobacco. Both can affect sexual performance.

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FDA panel set to weigh new female condom

WASHINGTON (Reuters) – A new, potentially less expensive version of the female condom faces U.S. regulatory review this week when a Food and Drug Administration advisory panel weighs whether they adequately prevent pregnancy, HIV and other sexually transmitted diseases.

The FC2 Female Condom, made by Female Health Co, is made with a synthetic rubber using a process similar to male condoms that the company says is less labor intensive and should reduce its current cost.

Male condoms, which come in a variety of brands and cost consumers between 50 cents and $2 a piece, are far more widely used than their female counterpart, which costs between $2.80 and $4.

Chicago-based Female Health is seeking FDA approval to market the new version. On Thursday, the agency will seek a recommendation from its panel of outside experts before later making its final decision.

"The whole idea is to increase access," said Mary Ann Leeper, an adviser and former president of the company.

But FDA regulatory staff questioned whether the company should have conducted specific trials to show how well the FC2 prevents women from contracting diseases or becoming pregnant.

Female Health said it did not conduct such studies because FC2 uses a new material but is otherwise similar to the version already on the U.S. market, the FDA staff said in documents released on Tuesday ahead of the panel meeting.

The company "asserts that such studies are not necessary. This is an important review issue," the staff wrote.

The company said it also looked at durability of the new material, a synthetic rubber called nitrile. The original condom uses polyurethane.

Both versions are comprised of a sheath with a closed ring on one end that is inserted near the cervix and an open ring on the outer end that stays outside the woman's body.

Conducting another trial would have taken five more years and cost millions of dollars, Female Health's Leeper said.

"The design is exactly the same, how you use it is exactly the same ... we just don't believe there is any more information required," she said.

FDA approval could help boost sales in the United States, which make up just 10 percent of the female condom's 34.7 million unit sales in 2008, according to Female Health Co.

"We haven't been able to market the product," Leeper said. But Female Health is seeking to partner with another company, perhaps a male condom manufacturer or a drugmaker invested in human immunodeficiency virus (HIV) awareness, she said.

Most of its U.S. sales are to aid agencies, including the U.S. Agency for International Development, which Leeper said needs FDA to approve FC2 before it can distribute it abroad.

The bulk of the condom's use is in other countries, particularly in Africa where public health agencies provide it to help prevent the spread of the HIV virus.

The female version gives women their own option for protection and allows them to insert a condom before intercourse. Most other countries have already adopted the newer version, the company has said.

It also offers other advantages over the male condom, according to the company, including greater protection by covering part of a woman's outer genitals.

Shares of Female Health Co. were up nearly 5 percent, or 13 cents, at $2.98 on the American Stock Exchange.

(Editing by Gerald E. McCormick, Derek Caney and Bernard Orr)

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Male hormone patch increases libido in women

NEW YORK (Reuters Health) – Postmenopausal women with low sexual desire levels reported improved sexual function after they were treated with a patch in which the male hormone testosterone was applied through the skin, a clinical study has found. However, more studies are needed to confirm the safety of this treatment.

"Many postmenopausal women continue to be sexually active despite a high level of sexual dissatisfaction, engaging in sexual activity to please their partner and maintain domestic harmony," lead author Dr. Susan R. Davis, at Monash University in Prahran, Australia, and fellow researchers note.

While testosterone has proved effective for increasing libido among postmenopausal women who are on hormone replacement therapy, the effectiveness of this approach in women who are not taking estrogen is unknown.

There has also been some concern that testosterone administered without being tempered by another hormone may adversely affect circulating lipid (fat) levels, glucose (sugar) metabolism or breast tissue.

The APHRODITE trial (A Phase III Research Study of Female Sexual Dysfunction in Women on Testosterone Patch without Estrogen), conducted at 65 centers in Australia, Europe, and North America, included postmenopausal women who reported significant loss of sexual desire that was causing personal distress.

In this study, 267 women were assigned to receive transdermal testosterone at 150 g/day, 267 were treated with the patch testosterone at 300 g/day, and a third group of 277 women received placebo. The patches (Intrinsa, Procter & Gamble) were applied to the abdomen twice a week. The group assignments were all random and neither the patients nor the clinicians knew what each group was given.

At 24 weeks, an increase in the frequency of satisfying sexual episodes was significantly greater in the group receiving the 300 g testosterone dose than the placebo group, but not significantly greater in the group that received the lower dose of testosterone.

Both testosterone groups also had significantly increased scores for sexual desire and decreases in personal distress.

"The increase in the frequency of satisfying sexual episodes was modest but appeared to be clinically meaningful," the authors comment.

The most common hormone side effect was an increase in unwanted hair growth in the higher-dose group. The frequency and severity of other side effects events -- acne, baldness, and voice deepening -- did not differ between the treatment groups. There were no clinically relevant changes in blood lipid levels, glucose metabolism or liver function in any of the groups.

Of concern was the diagnosis of breast cancer in four women in the testosterone groups. The authors note that one of the subjects was symptomatic, with a bloody nipple discharge prior to study entry, and another was diagnosed after 4 months of treatment. The other two were diagnosed after 52 weeks and 104 weeks of treatment.

"Additional data are needed to assess the long-term safety of testosterone use in women with estrogen depletion," the researchers conclude.

SOURCE: The New England Journal of Medicine, November 6, 2008.

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