Tag Archives: Female Sexuality

Make Him Change or Donate to Goodwill

As an Gynecologist and Sexual Educator, I am often asked by my patients why they don’t enjoy sex or find it difficult or impossible to reach orgasm. After a physical examination and lab work, we discuss the problems they have with their partners or husbands. These types of problems are very common, affecting over 40% of women under the age of 40 and greater than 60% of women over the age of 40. Unfortunately ladies, the problem is not with you, it is with them. My best advice in order to fix an unsatisfactory love life is first to stop trying to change yourself for him and instead ask him to change for you. You will usually find that a man willing to listen to what you want in bed is usually the one you want to keep, and the man that thinks he is “God’s Gift” is the one you should “rewrap” and give to Goodwill. SINCERELY, DR. NOVOA

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Sexual and Reproductive Coercion

The American College of Obstetrics and Gynecology (ACOG) recently published a committee opinion discussing the subject of Sexual and Reproductive Coercion (SRC).

SRC is a pattern of physical violence or psychologically coercive behaviors intended to control a woman’s sexual decision making, contraceptive use, or pregnancy.

These behaviors are examples of intentional attempts of others, most commonly the male sexual partner, to control the sexual and reproductive rights of a woman.

The coercion includes contraceptive sabotage, where a patient’s partner intentionally hides birth control pills, refuses to wear a condom during intercourse, makes holes in condoms, or forcefully removing intrauterine devices or vaginal contraceptive rings in an attempt to get their partner pregnant against their will.

The coercion, however, may also include pressure from family and friends by embarassing or pressuring a woman through guilt or intimidation into having a child before the woman is ready. It also includes forcing a woman to have an abortion or termination of pregnancy.

Sexual and reproductive coercion is commonly associated with sexual and physical violence. One study involving adolescent mothers on public assistance reported birth control sabotage by over 50% of their dating partner.

Recommendations in order to assist patients at risk for sexual or reproductive coercion include (1) offering  hotline numbers and referrals to local domestic violence shelters and agencies, (2) offering long-acting methods of contraception less detectable to their partners such as the IUD, the Implanon or Depo Provera Injectable. (3) When using an IUD, trimming the string inside the cervix in order to prevent the partner from feeling the string or being able to pull the IUD out, (4) Provide Emergency Contraceptive (Plan B) pills and (5) Provide harm-reduction strategies and safety planning.

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ASK DR NOVOA – I have heard to women reach their sexual peak at age 35 while men reached it at age 18. Is this true?


This is a myth which has been passed on as fact for decades. There is no scientific data to support this comment.

Some may believe that measuring sexual hormones may help determine sexual peak, in reality, there is no set minimal value to determine either a sexual low or high.

A relatively new state of sexual health for men, known as Andropause, has been described as the sexual equivalent to the female Menopause.

Menopause, which generally ranges from age 40-50, with an average age of 50.5, is most often demonstrated by the cessation of the menstrual cycle and decreased libido (sex drive).

For Men, the beginning of the decrease in the sexual hormone Testosterone begins as early as age 30. This is most often marked by a decrease in physical strength and endurance, decrease in sexual drive, decrease in strength of erection, decrease in seminal and sperm count, increase in weight from fat and at the same time decrease in muscle size.

For women, the use of hormone therapy to include estrogen and progesterone can not only help with symptoms of the menopause but increase vaginal wall thickness, sensitivity and lubrication.

What is most interesting is that studies have shown that for both men and women, the off label use of Testosterone has been shown to increase the sexual drive.

So ladies, if your having trouble with your man and he is starting to get soft EVERYWHERE, you may want to suggest that he consider a combination of Viagra and Testosterone. But….. remember that just because he puts high octane in the gas tank, doesn’t mean that he will be a better driver.

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ASK DR NOVOA – I occasionally have this bad vaginal smell and discharge. I clean myself and am always self-conscience since I always think I have it. My Primary Care doctor said its BV. What is BV?

BV, represents Bacterial Vaginosis and is cause by a variety of bacteria in the vagina. What happens is that your vagina has a natural balance of bacteria and yeast. When there is a balance, the discharge is white or clear in color, has no smell and produces no discomfort. When you have too much bacteria, the discharge can be heavy yellow or greenish in color, can have a strong fishy or foul smell and can cause the area to be red, itchy and tender to the touch. When you have too much yeast, the discharge is heavy, white in color, have the consistency of cottage cheese, has no bad smell and may produce an itch.

Although not considered a sexually transmitted disease, BV can occur or worsen by having sex with a partner who has a heavy amount of natural bacteria themselves, especially uncircumsized men.

The treatment is usually easy. If it is the most common bacteria, Lactobacillus, your doctor may recommend either Flagyl or Cleocin.

You should never try to treat BV as if it is a yeast infection because it will make things worse.

BV can recur and if its does, you should ALWAYS see your GYN first because there are over 20 different organisms that can mimic BV. A simple culture test can identify the source of the infection and you can start to feel better after about 3 days with different medications.

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ASK DR NOVOA – I have heard that a woman can start crying or may even faint right after achieving an orgasm. I have never seen it happen. Is this possible?


Crying is very common with orgasm.

Fainting is not very common and in some circles very rare requiring a very high degree of arousal. This is why the French call Orgasm, “La Petite Morte” which means “the little death”. It is a reference to the refractory period following orgasm. The term has generally been interpreted to describe the post-orgasmic fainting spells or unconsciousness some lovers experience following orgasm.

Crying or fainting can usually be achieved by either vaginal or oral sex and is most commonly associated with male to female stimulation [Men Don’t Cry 🙂 ].

Fainting can be seen after one orgasm, but is more common when a combination of oral and vaginal penetration is maintained with stimulation continuing from one orgasm to another producing a “stair-step” level of stimulation until an orgasmic plateau is achieved lasting from a few seconds to up to 30 seconds. The techniques to achieve this are varied but are reproducible from one partner to the next.

So guys, this may be the only time that seeing a girl crying may be good. If she starts laughing, better go back to the drawing board. 🙂

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ASK DR NOVOA – I work out everyday and have lost weight, but I still can’t lose weight I gained from my kids and the loose skin from my pregnancies. Do I really need a tummytuck or will liposuction fix this?

Above all else, I want to commend anyone willing to exercise in order to look their best.

Unfortunately, there comes a point that no amount of exercise will be able to get you back to your pre-pregnancy look.

IN GENERAL, if you are in a standing position and you can grab 5 inches or a handful of skin and babyfat from ur abdomen and especially each hip, this fat will rarely retract back to your pre-pregnancy figure. Mother Nature created the body to store fat in case of emergency or in the case of starvation. Your body doesn’t know the difference between a diet or starvation. One of the last places it will eliminate fat are the love handles and lower back. And yet elimination of fat in these areas can give you the “hour glass” appearance that most women look for and consider when they look at a slim person.

The tummytuck and liposuction of the love handles and lower back , a procedure called lipoabdominoplasty and body sculpturing can do what exercise will rarely be able to do, even in tri-athletes. The goal is to give you confidence to wear a bikini.

So, if you are not happen with your look and can grab a lot of skin, consider seeing both a cosmetic surgeon and your exercise trainer for optimal results.

And never stop thinking and living healthy. 🙂

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ASK DR NOVOA – Why do MEN always want to have ANAL Sex?


A survey performed by the Center for Disease Control (CDC) in 1992 showed between 20-25% of both men and women were having anal intercourse. The most recent CDC survey (2006-2008) showed that over 44% of men and 36% of women ages 15-44 who are heterosexual engage in anal intercourse. This means that almost 1 in 3 men sexually active heterosexuals have engaged or regularly engage in anal intercourse. It appears that the popularity of anal intercourse has significantly increased over the past 20 years. The most recent data shows that 1 in 4 couples routinely practice anal sex.

So, despite the fact that the subject of anal sex seems to be initiated more often by the male partner, a significant number of women are requesting anal intercourse. Nevertheless, studies still show that heterosexual men are more likely to request anal sex with their female partners than the other way around. To be specific, we are talking about heterosexual intercourse between a man and a woman, where the man penetrates his partner with his penis in her anus.
Five Common Reasons Heterosexual Men like Anal Sex with their female partners are:

  1. It gives him a sense of power … It may sound very territorial and Neanderthal, but men often state that they enjoy the control and empowerment anal sex gives them. Since anal sex can produce a significant amount of pain, allowing the male partner to penetrate you in this way can represent a complete sign of submission, as well as entrusting your partner not to hurt you while at the same time hoping to pleasure you. If you enjoy it and are able to reach orgasm because of it, this simply caters to the male ego even more than with vaginal intercourse. FYI, the anus has more sensory nerves than the vagina, although most believe that “anal orgasms” are actually due to pressure applied/stimulation to the clitoris or G-Spot.

  2. You trust him … The fact that you let him share a part of you that requires the utmost trust gives him a sense of being special. And it is more than just about participating in a sexual act. If you are nervous about anal sex but you agree to try it, your partner will feel that you are putting all your trust in him.

  3. It’s something new … While vaginal sex is often considered to be the most pleasurable, at some point, everything can become routine. So if and when the topic of anal sex is brought up, most men will be willing or excited to try it. And let’s be realistic, he is going to be more excited about it than you because IT’S NOT GOING TO HURT HIM!!!! It’s like the saying, “If Men had to get pregnant and have babies, the human race would go extinct.”

    Also, always remember the number one rule. Never tell your man you have tried anal sex before unless you are willing to try it with him. Men always compare themselves to other men, so NEVER tell your man anything you are not willing to try again, or he will always feel that he was not as special as your previous lovers. Remember we have very fragile egos!!! So, it is best to let him think you have never tried it before, so it can be new for both of you.

  4. Men love your butt … The three most common areas of attractiveness on a woman, besides her face, are the breasts, legs and buttock. Men often say, “I’m a butt man” or “I’m a breast man.” Thus, anything to do with the buttock can be very attractive. For some men, it is a very exciting modification to the “doggy-style” position.

  5. It’s very tight … The most common reason for wanting to have anal sex, is that the anus is expected to be tighter than the vagina. The anal sphincter is designed to keep the anus almost “air-tight” closed. The vagina has the pelvic muscles to help keep it tight but not closed. No degree of Kegel exercises can make the vaginal and the pelvic muscles tighter than the anal sphincter. For the man, the idea of a tighter opening is often thought that it will produce more pleasure for him.

Although anal sex has now become a relatively common practice, it is still considered a taboo. It still carries a significant amount of stigma, especially for woman who enjoy it. In a loving, mutually beneficial relationship, there is nothing wrong with enjoying anal sex. However, engaging in anal sex does pose problems. Anal sex is associated with an increased risk of transmitting disease, such has Herpes, HPV or HIV. Despite this, and an increased risk of gas and fecal incontinence, there are no significant medical risks associated with anal intercourse.

There are also concerns about keeping everything clean. You should never switch from the anus (A) to the vagina (V) without having your partner completely wash his genitalia. This could lead to fecal contamination of the vagina and a very bad vaginal infection.

Therefore, when having anal sex, just remember the slogan, V to A is ok. A to V, no way!!!!

If discussing or having anal sex is a real turn off for you, consider telling him the following, “I will, if you let me do you first!” That usually makes him change the subject really fast!

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