Conservatives Are Gaslighting You About the Post-‘Roe’ Hellscape

It’s been a month.

Almost 30 days since the Supreme Court dropped its decision in Dobbs v. Jackson Women’s Health Organization and millions of women and other people capable of becoming pregnant were instantaneously relegated to second-class citizens. One minute we were people, and the next minute we weren’t. Six unelected justices told half of the U.S. population that we don’t control our uteruses anymore. The state does.

But to hear conservatives tell it, the Court’s decision barely did anything at all. It was merely a trifle. Sure, the Court reversed Roe v. Wade, but what’s the big deal? It’s not like the Court criminalized abortion. Calm down! That’s what they keep telling us.

Dobbs didn’t criminalize abortion!” As if that’s relevant in a world where 26 states will likely have banned abortion by this time next year.

According to conservatives, the justices simply returned to the states a controversial issue that the Court should never have waded into in the first place. And in doing so, it ushered in a return to democratic principles, which would allow people to decide whether abortion should be legal through their duly elected representatives.

This is, of course, nonsense.

Anyone who has been paying attention to politics over the last decade, following along as the Supreme Court rubber-stamped gerrymandered maps and voter ID laws intended to combat nonexistent voter suppression, knows this is nonsense. The people who will be impacted by the reversal of Roe are not being permitted to elect their own representatives. The Supreme Court won’t let them. (And to thank for that, we have Chief Justice John Roberts’ hopium-filled majority opinion in Shelby County v. Holder in which he essentially declared that racism was dead before shivving the Voting Rights Act in the kidney.)

But this is the sort of nonsense that conservatives are leaning into. They are forced to obfuscate the facts and lie to the public about what the Dobbs decision does and what it permits anti-choice state lawmakers to do, because everything they’re doing is unpopular. And those people who cheered the reversal of Roe may soon realize that reversing Roe was a terrible idea because, in truth, abortion is necessary health care, even if you believe that only “promiscuous sluts” get abortions.

The decision itself is cruel in its disregard for women and pregnant people. In an opinion penned by Justice Samuel Alito, the majority flat-out ignores that for nearly 50 years, millions of people have relied on the constitutional right to abortion in the most personal way. They organized their lives and relationships with the knowledge they had a legal right to terminate a nonviable pregnancy. They chose careers, turned down marriage proposals, snuck a quick shag in a car—all because the constitutional right to abortion existed. But none of these concrete facts mattered.

“Too intangible,” Alito wrote.

“Generalized assertions about the national psyche.”

He might as well have just written, “Bitches be crazy.”

The fallout has been equally cruel. The decision is only one month old, and the consequences have already been devastating.

This isn’t the world the “pro-life” community signed up for. At least not the community’s foot soldiers. It’s obvious from the frantic messaging about how “pro-life laws” don’t hinder pregnancy care. But they do. They already have.

When Students for Life members were protesting abortion at college campuses, did they envision that their nonviable ectopic pregnancy would be quickly treated by terminating that pregnancy? Or did they expect to wait until their fallopian tubes rupture before doctors take action?

When they were harassing patients outside abortion clinics, did they imagine that their ten-year-old daughter would be able to obtain abortion care to terminate a pregnancy conceived via rape? Or would they have to cross state lines and risk national media attention? Did they think their right to travel would be hindered?

Because that’s what is happening.

The media is replete with reports of doctors waiting until pregnant people are on the brink of death before treating them. Hospital administrators and lawyers are making decisions about the medical care doctors can provide their patients. People are being denied prescription drugs they’ve taken for years because of concerns the drug is an “abortifacient.”

A ten-year-old Ohio girl traveled to Indiana to get an abortion after she was sexually assaulted. Later, Ohio Attorney General Dave Yost denied the story as a fabrication before claiming to rejoice in the arrest of a child predator while Fox News plastered the photograph of the doctor who provided the abortion all over TV, just as they did with Dr. George Tiller, an abortion provider, in the months before he was murdered.

Sarah Blahovec, who has Crohn’s disease, was told that her prescription for methotrexate could not be filled. Millions of people take it for everything from psoriasis to cancer, but since an off-label use of methotrexate includes ending ectopic pregnancies, people who use it for non-reproductive health-care reasons are being denied the medication.

In Louisiana, a pharmacist refused to fill a prescription for Cytotec. A doctor had prescribed it to their patient to make the insertion for an intrauterine device less painful.

The Idaho Republican Party rejected an amendment to the party’s platform that supports criminalization of abortion in all cases that would have permitted an abortion to save a person’s life. Doctors shouldn’t give priority to the pregnant person over the pregnancy—that’s what one of the Republican candidates running for state senate said about the law, which he enthusiastically supports.

And national Republicans just voted against a bill that would have enshrined the right to travel. Are you prepared for a Fugitive Abortion Patient Act akin to the Fugitive Slave Act? Because states are considering it.

This is what reversing Roe has wrought.

None of these real-life harms and consequences that are already flowing in the month since the Court issued its decision were worthy of consideration by the Alito Court majority. (It didn’t much matter to Roberts either, who was willing to uphold the 15-week ban while pretending that somehow, doing so would not be an outright reversal of Roe. It would be.)

But those consequences mattered to the liberals on the bench. Justices Stephen Breyer, Elena Kagan, and Sonia Sotomayor knew that reversing Roe was the culmination of a decades-long campaign to appoint justices to the Court who would—despite their fervid protestations during their confirmation hearings that Roe was precedent—reverse the 1973 decision, and they shamed the majority for it in their joint dissent.

“The majority has overruled Roe and Casey for one and only one reason: because it has always despised them, and now it has the votes to discard them,” the dissenting justices underlined. “The majority thereby substitutes a rule by judges for the rule of law.”

The liberal justices also made it clear in their dissent that they understood what the majority had done: reversed nearly 50 years of precedent on the thinnest of grounds, without considering how many people had relied on the constitutional right to an abortion, and consigned millions of people to second-class citizenship status.

The justices wrote:

“After today, young women will come of age with fewer rights than their mothers and grandmothers had. The majority accomplishes that result without so much as considering how women have relied on the right to choose or what it means to take that right away. The majority’s refusal even to consider the life-altering consequences of reversing Roe and Casey is a stunning indictment of its decision.”

Dobbs v. Jackson Women’s Health Organization is a lawless decision that ignores decades of precedent by dismissing the very factors that would have required this Court to uphold Roe. The principles of stare decisis were absent from this case. The fix was in as soon as Mississippi attorneys decided in the middle of its appeal to the Supreme Court that it would change what they were asking the Court to do. Originally, Mississippi wanted to know if its 15-week ban was constitutional under current law. At the time, current law was Roe v. Wade and Planned Parenthood v. Casey, both of which say that people have a constitutional right to terminate a nonviable pregnancy. No pregnancy is viable at 15 weeks. No one even argued it was.

But after Mississippi had submitted its petition for writ of certiorari—the document that lays out what the asking party wants the Supreme Court to do—Ruth Bader Ginsburg died, followed quickly by the nomination, confirmation, and appointment of Amy Coney Barrett in the middle of an election season.

By the time Mississippi’s merits brief—the document that fleshes out the arguments set forth in their petition for writ of certiorari—was due, the state changed its ask. No longer were they asking for a ruling under current law. They asked the Court to change the law.

And the Court happily obliged. The Supreme Court is not supposed to overturn cases just because the justices don’t like them. The Court shouldn’t have even taken the case in the first place. There was no circuit split. There was no confusion about what the law was. The Federalist Society-captured justices just didn’t like the law—and so they changed it. And the way they did it was, quite simply, mean. The anger dripping from Alito’s opinion is distressing. The majority just doesn’t care. About women. About pregnant people. About the Black maternal mortality rate jumping by more than a third. About any of it.

The conservative mantra that “Dobbs didn’t criminalize abortion” missed the point. The Alito Court knew that almost two dozen states were champing at the bit to enact abortion bans; they read the amicus briefs. The Alito Court also knew exactly what the impact would be. Dobbs was the final cog in a state-mandated baby-making machine.

And that baby-making machine would not be nearly as effective without the sustained campaign of conservative gaslighting meant to prop up this lawless decision and convince the myriad people who were manipulated into “marching for life” that their reproductive health-care emergencies won’t be targeted.

In congressional hearings last week, Catherine Glenn Foster, the president and CEO of Americans United for Life and former lawyer at Alliance Defending Freedom, insisted that the abortion that terminated the ten-year-old’s pregnancy wasn’t really an abortion. It was something else. A not abortion.

It couldn’t possibly have been an abortion because if it is, then people like Foster would have to admit that abortion is health care and it’s a necessary good. Even if both sides of the issue are going to argue around the edges of when and what kind of abortion should be allowed, surely the foot soldiers of patriarchy will admit that forcing children to have babies is bad policy. They may even have to admit that they miscalculated this country’s stomach for mass death and incarceration.

Then again, maybe they haven’t. Maybe we are monsters. Maybe doctors will continue to let people die rather than risk a lawsuit. Maybe the doctors who don’t will find themselves in jail, unable to care for their own families and their other patients.

I don’t know what the future holds. But I do know one thing, as my colleague Jessica Mason Pieklo has said: The only way out is through.

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4 Things Sex Workers Can Teach Us About Digital Surveillance

With the Supreme Court overturning Roe v. Wade, reproductive justice activists are fearful about what this will mean for the digital privacy of people seeking abortion services, providers, and advocates. Without any federal protections, states will continue to criminalize abortions, and our digital footprints can and will be used against us.

In our present reality, our devices and apps are constantly collecting personal information about us, and we often have no control over where this data gets shared. Mass digital surveillance is a threat to all of us, but especially for the most marginalized and vulnerable to criminalization.

The criminal cases against Purvi Patel and Latice Fisher show how women of color are targeted for their reproductive choices and miscarriages—and how their digital data can be used to criminalize them. In 2013, when Patel went to the hospital for bleeding after a claimed miscarriage, she was arrested and her texts were used to charge her with feticide and child neglect. In 2017, when Fisher’s pregnancy ended in a stillbirth at home, her internet searches were used to charge her with second-degree murder.

These cases show how digital surveillance is already being weaponized against pregnant people for their reproductive outcomes. And as abortion is increasingly criminalized and our digital privacy becomes less secure, these cases will become more commonplace.

Sex workers have been ringing the alarm on digital rights and privacy, especially since the 2018 passage of FOSTA-SESTA, which cracked down on sexual services and content online under the cover of anti-trafficking legislation. Activists for sex workers rights and digital privacy warned that the law, which holds digital platforms responsible for any content that might promote trafficking, would have dire impacts on all people’s free speech and privacy online. Since FOSTA-SESTA’s passage, personals sites have shuttered, and digital platforms have increased censorship and discrimination against sex workers and sexual content.

“With the overturning of Roe, it becomes harder to ignore the ways in which the abortion rights movement and the sex worker rights movement are inextricably linked,” said Danielle Blunt, a dominatrix and organizer with Hacking//Hustling.

“Bodily autonomy and survival are increasingly criminalized. Now more than ever, we all need the tools to more safely share harm reduction information, navigate getting our healthcare needs met, and stay connected to community.”

Sex worker organizers like Blunt are on the front lines fighting against the encroachment of digital surveillance and online discrimination. Blunt is currently working with other organizers to share knowledge across the sex worker and abortion rights movements in order to build a stronger collective movement.

“The creep of criminalization is moving online and deputizing private actors to be its eyes and ears,” Blunt and Kate D’Adamo presented during a Hacking//Hustling and Digital Defense Fund webinar on digital criminalization.

“Digital evidence is and will continue to be used to prosecute abortion and miscarriages,” Blunt told Rewire News Group. “I think that the most important thing right now is to learn how to talk about behaviors that may be criminalized.”

Digital information such as search histories, text messages, emails, credit card charges, and location tracking can all be used as evidence against pregnant people seeking abortions in states where abortion is outlawed. Blunt shared some strategies sex workers use to mitigate interactions with law enforcement and online censorship.

Keep phones off and meet in person

If subpoenaed, your smart phone or other devices can give away your location data and other personal information and communications. The best way to not be traced is to keep devices off. Having conversations in person (with trusted/screened people) is the most secure way to discuss potentially incriminating topics.

Talk through coded language

When the Abortion Counseling Service of Women’s Liberation operated from 1969 to 1973 (pre-Roe), it adopted the code name “Jane,” which when requested organizers understood abortion services were needed. Because sex work is still very much criminalized and censored on some digital platforms, sex workers and activists use coded language to ensure their posts or accounts aren’t taken down, disabled, or shadowbanned.

In activist spaces and shadow economies, adopting code words can keep recorded correspondence, if subpoenaed, from incriminating you. On platforms like social media, code words can also keep mass surveillance tools like AI from flagging your speech or content.

Switch chats to Signal with disappearing messages

Using end-to-end encryption through apps like Signal keeps correspondence private and protected from third parties. Setting up disappearing messages creates an added layer of security in case you or your recipients’ devices are seized or compromised.

Sex worker activists have been raising a red flag about the Earn It Act, as it would allow the banning of encryption, as well as opening the door for more censorship and policing online.

Use more secure browsers like Tor for sensitive searches

In both Patel’s and Fisher’s cases, their online search histories were used against them. Switching to an encrypted browser, such as Tor, and using a VPN can mitigate these scenarios by anonymizing your IP address and internet activity.

Adopt “stricter digital security protocols” and create “community guidelines for how you will talk about something, how that information can or cannot be shared and sticking to those shared values,” Blunt said. “Digital security is a form of community care and it works best when we are all taking care of each other.”

Disclaimer: Please keep in mind that articles like these are public online and accessible by law enforcement, so utilize these strategies with caution and care. Clear your browser history if you have any concerns your browsing data may get into the wrong hands or be used against you in a criminal case.

“Every time criminalization increases, there is a lot of fear and a lot of desire for information that will make people ‘safe,’” sex worker organizer Lorelei Lee cautioned on Twitter. “Please, please remember that there is no such thing as perfect safety, there is only harm reduction. Relatedly, if you are arrested, it is not your fault.”

FOSTA-SESTA served as a model for how online platforms end up acting as “deputized private actors” by censoring sexual content and deplatforming sex workers. It isn’t far-reaching to predict a future where discussions of abortion and reproductive care are targeted similarly. This future may already be here, so be prepared.

Additional resources
Digital Defense Fund
Electric Frontier Foundation
Hacking//Hustling
If/When/How’s internet safety thread
Surveillance Self-Defense’s toolkit

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Update on Male Contraception: Do Vasectomies Still Rule?

the male pill
Wondering if there’ll ever be a “little pink pill” for male oral contraception (Courtesy Unsplash)

I know you’re wondering: What’s up with the male pill? Exactly where are we with male contraceptives other than condoms or vasectomy? Well, it’s a good time to ask as it’s now very clear that the desire for alternatives to vasectomy is great and growing. Studies of couples around the globe found that 25-75% of them would use a male hormonal contraceptive. That means that between 44 million and 130 million men in those nine surveyed countries alone would consider a male pill. That’s a need indeed!

A Storied Past

Contraception has been defined by innovations on the male side for almost 5000 years:

3000BCE: Evidence of condom use made from animal bladder or intestine or linen cloth in Crete and Egypt.

1800 BCE: Spermicides made by combining crocodile feces and fermented dough in Egypt

1830: First vasectomy performed in a human by R. Harrison in London. Its popularity rose dramatically after WWII. The first national program for vasectomy was launched in India in 1954

1855: The first rubber condom is made by…wait for it…Charles Goodyear, who later invented the rubber tire.

Over the last century, however female contraceptive innovations surpassed male contraception like it was standing still and female contraceptives are currently the preferred choice for most couples by a wide margin (5:1). What happened here? The most glaring issue is that funding has been sporadic as pharmaceutical companies haven’t been interested in developing male pills due to high development costs and the fear of lawsuits.

The Male Pipeline

Approaches to male contraception involve  stopping sperm production, rendering sperm immotile so they don’t move, or blocking the exit path from the testicle. They can be hormonal, non-hormonal or surgical in nature. There is currently one hormonal male contraceptive in clinical trials: a non-oral testosterone-progesterone gel applied to the skin daily to turn off or turn down sperm production. The goal is to reduce sperm to less than 1 million/mL in the semen. The questions are whether it can do this reliably in all men (remember the gold standard is vasectomy which is 99.99% effective) and whether hormonal side effects are tolerable: acne, moodiness, changes in sex drive or erections. After all, having significant sexual side effects from a pill that aims to take the worry out of sex kind of defeats the purpose, wouldn’t you say?

There is also good research developing on a sperm binding agent called Eppin that renders sperm immotile so they just sit there and can’t reach the egg to fertilize it. It’s being billed as “non-hormonal” and “reversible” but it has only been shown to be effective as an immunocontraceptive in monkeys (i.e., essentially a vaccine). It’s not clear to me how complete the sperm motility block generated with this pill can be, as we all know that sperm love to wiggle. Also, I am not entirely sure how reversible anything is with the human immune system as it literally remembers everything that it has ever seen. To date, this approach has not seen clinical trials. Lastly there is ADAM*, a non-hormonal, non-oral, hydrogel polymer “plug” that blocks the flow of sperm in the vas deferens without interrupting fluid flow. It is essentially a “screen door” for sperm and should be an improvement over the classic 100-year-old vasectomy, especially if it lives up to its promise of being reversible. It’s also in clinical trials right now. So, there’s a lot of window shopping in male contraceptive research right now, but no available product inventory.

Vasectomies Rule

So, it appears that we are left with the good ole’ vasectomy. Tried and true, nonhormonal and compliance-free, nothing on earth beats it in terms of reliability. In fact one of the reasons it’s so well-loved is that you don’t have to think about doing something every time sex is contemplated. All set to go, time after time after time. And, it has new and improved versions including the no-scalpel vasectomy, the Brosectomy® and the Nitrous-powered vasectomy, all developed with the goal of making the procedure as much of a “non-experience” as possible.

*Disclosure: I advise this company.

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Case Report: Disease Causing Low Testosterone: Look and You Shall Find

Male Fertility Specialist Los Angeles, CA
Your empty tank can be refilled but it’s good to ask why it emptied (Courtesy: Unsplash)

He came to my office out of sorts, looking for answers to his medical issues. As a 30-year-old, he had been experiencing fatigue, depression, low sex drive and erectile dysfunction for 8 years! Knowing that the average young male thinks about sex every 10 minutes during waking hours and ever so rarely fails to have an erection, I was very concerned for him and took his symptoms very seriously. He had seen his primary care provider, an endocrinologist and a neurologist before me. He was given antidepressants, psychotherapy and other treatments to no avail. This led to a diagnosis of low testosterone and subsequent treatment with testosterone injections. Like a recharged Energizer® bunny, testosterone replacement revived him entirely, making him feel “absolutely better in every way.” All good. Yet, he sat in front of me wondering whether or not he would have to take testosterone for the rest of his life, maybe 60+ years! He was more worried about how he would stay fertile when he learned that testosterone therapy acts as a contraceptive.

The Bottom of Things

I am a “root-cause” guy. By figuring out why things happen, you have the best chance for cure. The simple question here is: What was causing the testosterone drain on this young man, and could it be reversed? So, I went to work.

His medical history was a blank slate for risk, including no pot or other drug use, no untimely stress, and no sleep apnea or obesity. His physical examination was also unremarkable with normal testicle size and no varicoceles. The finding of normal sized testicles told me that whatever happened to his testosterone occurred after puberty and was not a lifelong problem of testicular failure. His blood work showed no diabetes, anemia, prolactin or thyroid issues, all of which can be associated with low testosterone.

But then I saw it, deep within his bundle of laboratory studies: his blood counts were high. He was polycythemic. But why? Well, just being on testosterone could do this, but he wasn’t taking high enough, anabolic doses of testosterone. Then, I came upon blood tests taken before he started testosterone and, lo and behold, he was polycythemic then too. Bingo! The diagnosis: hemochromatosis.

A Bloody Disease

Hereditary hemochromatosis is caused by a mutation in a gene that controls the amount of iron your body absorbs from food. It occurs in 1 of every 200-300 people and is found far more often in men than women. Because of this gene defect, excess iron is absorbed and then gets stored in body organs like the liver, pancreas and spleen. Over time, the stored iron causes scarring and organ damage that may lead to liver disease, diabetes and heart failure. Infertility, erectile dysfunction and low testosterone are also consequences of hemochromatosis. And, left untreated, it can be fatal.

You’ll never guess how it’s treated: Bloodletting (now known as therapeutic phlebotomy). Bloodletting, or draining of a patient’s blood to prevent or cure disease, was the most common medical procedure performed by surgeons from antiquity until the late 19th century, a span of over 2,000 years. And it still has application today. Does it cure hemochromatosis? No, but it prevents damage to organs by keeping iron from accumulating in them and results in an essentially normal lifespan.

So, this root cause analysis paid off handsomely. I asked this young man to consider donating blood regularly. I also took him off of the testosterone injections and started him on clomiphene citrate pills to push his “lazy” pituitary harder to make more of his own testosterone levels. In this way, we maintained his normal (high) quality of life that he enjoyed while on testosterone without using testosterone; he now also enjoys good sexual health and is fertile, and we added a few more years to his life.  We have done what Hippocrates, the Father of Medicine, ordered us to do: “Declare the past, diagnose the present, foretell the future.” And that, my friends, is the hat trick of great medicine!

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How Soon Should Couples Seek Fertility Treatment?

Snoopy is pretty smart
Charlie Brown had it down. And Snoopy did too. (Courtesy: Unsplash.com)

You’ve been trying to conceive but sparks just aren’t flying. You stopped using birth control pills (or pulled the IUD) and started having unprotected sex. With the help of an app, you figured out your most fertile time of the month and began timing sex to increase the odds. You switched to vegetable oils for lubricants and tried all sorts of positions, from missionary to doggie to cowgirl to kneeling lotus to quarter moon, full moon and even no moon, but still no luck. Maybe it’s time to get some help.

When To Seek Help?

Society guidelines define infertility as the inability to conceive after one year of trying. It’s that simple. How, when and where you have sex is all up to you, but if it doesn’t happen after 12 months, then infertility is present. The basis for this definition becomes apparent when you look at the trigonometry of trying: 30% get pregnant within the first month of trying, 60% get pregnant by 3 months, and 80% are pregnant by 6 months. After that another 5% of couples will conceive by 12 months and 15% will not have conceived.

So, the classic recommendation is to try for one year before seeking help. But, as a fertility specialist who sees infertile couples for a living, I would suggest that couples seek help whenever they get concerned about it. I say this because concern snowballs into stress and anxiety, and all of this can negatively impact the relationship, quality of life and fertility potential. Realizing that women’s fertility is known to decrease with age, I also recommend that couples seek help after 6 months if the female partner is older than 35 years. And, if either partner has a known medical history that might impact fertility, say like cancer treatment or surgery on their reproductive parts, then they should also consider seeking help even sooner than 6 months.

Who Goes First?

Society guidelines are clear on the issue of who gets evaluated once care is sought: Both partners. And at the same time.  However, what usually happens is that women make the first call to their gynecologists and the process begins. That evaluation should include a detailed medical and menstrual history, a physical examination and further blood and imaging studies as indicated. The male partner evaluation should also include a history, a proper physical examination, two semen analyses and blood and imaging studies as indicated. Importantly, since gynecologists do not typically take care of men, the male evaluation should be performed by a urologist with an interest or expertise in male infertility. In my practice, a thorough male infertility evaluation is completed in a single office visit, and one that I promise will not hurt.

Remember, although making babies is the most fun you might ever have without laughing (Woody Allen), behind the scenes there is a virtual symphony of precisely orchestrated biological events that must occur for its success.  The beauty and complexity of human conception is staggering if you really think about it. And getting professional help to tweak the process can mean all the difference in the world. Charlie Brown hit the nail on the head when he said: “Asking for help isn’t weak, it’s a great example of how to take care of yourself.”

Call us today at 1-888-887-3563 or visit our Los Angeles or San Francisco clinics to schedule an appointment.

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Does Producing More Semen Make You More Potent?

Sperm production treatment, Beverly Hills, CA
How to read spilled milk (Courtesy: Unsplash.com)

When it comes to health, love and possibly money, more may be better. But what’s the scoop when it comes to the amount of semen produced with ejaculation? Does more mean more potency or better fertility?

Funny thing is, this issue really runs deep with men. In several religions, semen is precious and can’t be spilled or wasted. Throughout human history, this liquid has some serious gravitas; in fact its importance is…wait for it…seminal.

A Poker Hand

As a male fertility specialist, I have reviewed literally hundreds of thousands of semen samples from tens of thousands of men. From this experience, I have concluded that a semen sample is like a hand of cards. Each measurement, such as semen volume, sperm concentration, motility and shape, is like a poker card with its own value or meaning. But together they also have a larger meaning or “look” that can have clinical significance. For example, if the semen volume and the sperm concentration are both low, then this could reflect something called retrograde ejaculation, in which semen preferentially goes backwards into the bladder instead of forward through the penis into the real world. In essence, the big picture matters most, and as with many things in life, the “look” and not the amount matters more for semen.

Larger Loads

Although one may think that unleashing a bigger load of semen makes you more of a man, outside of pornography, the facts do not bear this out. There is no real correlation of semen volume or force of ejaculation with testosterone levels, virility, erectile capability, sexual competence or fertility. Semen volume has less to do with manhood than simply the size of the seminal vesicles that produce it, as these paired internal organs behind the prostate are the main contributors to semen volume. And since, sperm enters the semen from separate channels leading out of the testicle, their numbers are relatively independent of semen volume. Therefore, high volume ejaculates may in fact have lower sperm concentrations due to dilution issues. However, fertility is typically unaffected either way, so no worries here.

Smaller Spurts

The story is quite different when semen volumes are low (< 2 mL). When this occurs, my interest perks up considerably as there are only a few good reasons for having a low ejaculate volume.

The most common among them is incomplete collection. Sometimes men simply miss the cup and hit the wall instead. This is especially common on the first attempt at procuring a semen sample as men must think about what they’re doing (and collect the sample) while ejaculating. I refer to this as “first sample syndrome” and it typically goes away with more experience and repeat samples.

If the seminal vesicles are missing or blocked, due to genetic or acquired disorders, ejaculate volumes are typically low, and fertility is impaired.

With low testosterone levels, semen volumes can also be reduced as sex gland secretions are Vitamin T-dependent in general.

Medications such as alpha blockers for prostatic enlargement or finasteride for hair loss can also impact semen volume by reducing production in the seminal vesicles.

Finally, medical conditions such as diabetes and multiple sclerosis and procedures involving the back and lower abdominal can redirect ejaculate toward the bladder instead of the outside world, causing reduced semen volume.

So, semen volume is more reflective of a man’s biology than his manhood. This means if you want to increase it, spend time thinking about how to stay healthy: eat well, sleep well, maintain a lean body weight, and eat a balanced diet. Exercise regularly and reduce your stress. These are the forces that matter most for sex and semen.

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Will the Office of Men’s Health Finally Arrive?

The hallowed halls of congress and the healing of men (Courtesy: Unsplash.com)

“You should go and see a doctor.” Who ignores this advice more often: men or women? To help you answer this, look at these U.S. medical facts:

  • Men lead in 9 of the top 10 causes of death.
  • 80% of suicide deaths are men.
  • There is a 5-year difference in life expectancy between men (76.2 yrs) and women (81.2 yrs).
  • The average black male in America barely lives long enough to collect social security.
  • Cancer death rates are 40% higher for men than women.
  • Women are twice as likely as men to seek preventative medical care.
  • The cost to government and society at large for early death and illness in men exceeds $300 billion annually.

It’s pretty obvious that the answer is “men.” The issue at heart is why such an egregious gender health care disparity exists in American medicine today. It starts with “typical” male behavior fed by testosterone and an immortality complex, leading to symptom avoidance and risk-taking behavior that is largely unregulated due to lack of mentors, communication, and poor access to care. Whatever the root causes, the consequence is that men are medically underserved.

A Captain Needed

The solution to this medical epidemic is clearly complex and involves many stakeholders, including family, friends, employers, peers, religious and sports organizations, and local, state, and federal governments working together. How best to pool and organize all these resources to improve men’s health? A federal Office of Men’s Health would be a great start! An Office of Women’s Health was established at the federal level in 1991. With the goal of improving awareness of, access to, and delivery of better health care to women, it succeeded in spades. Witness the fact that 90% of women with breast cancer are now cured of their disease.

The time has come for men to catch up! Bill H.R. 5986 entitled “Men’s Health Awareness and Improvement Act” was introduced into the 117th Congress this past month by Rep. Donald Payne (D-NJ). Hallelujah! It proposes to use the resources of the Department of Health and Human Services to promote, educate and coordinate men’s health activities at all levels in both the public and private sectors, just like the Office of Women’s Health has so successfully done over the past 30 years. It’s the ship captain that we so desperately need to bring men’s health into the 21st century.

A Sailing Ship

What excites me the most about this initiative is it’s potential to improve the health of males at all ages, from boys to men. Remember that after leaving the care of pediatricians as teenagers, men are essentially provider-less, whereas women have gynecologists who care for them throughout adulthood. This Congressional act has the potential to commit to and codify the medical care offered to American men throughout their lives by organizing all resources at hand around this great country, and thereby raising the tide of better medical care and floating all boats along with it. In so doing, we can teach men to invest in themselves, improve their lives and enhance the lives of those around them. In the words of Ernest Hemingway: “There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.” Please join me in supporting this long-overdue act of compassionate medical care and write your congressperson!

 

 

 

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Things That You Didn’t Know About Your Penis

Mona Lisa
Da Vinci knew a lot more about us than how to paint a great smile (Courtesy: Wikipedia)

Honestly the human penis, that ultimate love muscle, is an architectural and biological marvel. At rest, it serves as a conduit for urine. When rubbed like a genie’s lamp, it takes on a whole other, Jekyll and Hyde-like character. And did you know that pound-for-pound the human penis is the largest in proportion to body size among all mammals? But it’s also unique in other ways. Yep, this little appendage is a full of surprises.

A Boneless Organ

Here is another Snapple-cap fact: pretty much every mammal besides humans has a bone in their penis. The baculum or os penis bone evolved in mammals more than 95 million years ago. For some reason, humans lost that bone about 1.9 million years ago, sometime during our homo erectus phase. Theory has it that the bone was no longer needed as human reproduction drifted from polygamy to monogamy. Apparently, bony penises can stay in the female reproductive tract longer, keeping other penises away, and thereby increasing reproductive fitness.

Amazingly enough, even without a bone, one can still “fracture” a human penis. It’s not easy to do, but it happens when serious weight suddenly comes down on a semi-erect penis, bending it until it makes a snapping sound and then turning it all hues of black and blue. So be careful how and where you direct this little sword.

Sleepless Nights

Another little-known fact is that it takes more energy to keep a penis soft or flaccid than it does to keep it erect. Erections occur when blood flow opens like a spigot after being tightly clamped down. Notably, the blood pressure within the erect penis can be twice as high as your blood pressure; this is necessary to attain the required stiffness essential for a firm erection and proper use.

Along these lines, did you know that your penis “sighs” and relaxes about 3 times every night for 1 hour each while you are asleep? During these sighs, which occur during deep REM sleep, there is a full-blown erection. Since you’re in your deepest, dreamiest state, you might never know that it happened. Your partner might though.

Loading the Gun

The act of ejaculation is actually a reflex that, like a sneeze, has a point of no return. Fundamentally, it consists of two distinct events. The first, termed “emission,” occurs during foreplay and arousal. During this time, the body is busy pumping a glob of sperm from the scrotum up to the prostate through the vas deferens, effectively loading a bullet in the gun’s chamber. It may be felt as a pulsating sensation down there. Then comes the “ejaculation phase,” which is what we know as ejaculation. What happens here is a series of well-orchestrated events: the seminal vesicles contract, the bladder neck closes, and the urinary sphincter opens, all to allow the semen to traverse the penis and enter the free world. This clockwork-like activity is aided by contractions of the pelvic musculature every 0.9 secs to help force fluid from the penis. A magical moment in more ways than one.

Flipping the Switch

To get a good erection, the body must be relaxed. That’s why stress kills erections. Remember, our nervous systems are pretty primitive: Who wants an erection when being chased (stressed) by a woolly mammoth? But, once an erection is achieved and climax is imminent, the dormant “fight or flight” nervous system kicks in again and is responsible for ejaculation. Afterwards, the erection falls and cannot be regained for some time. This is termed the “refractory” period and it is during this post-coital moment when the nervous system switches back to “rest and restore” mode to allow for yet another erection. The marvelous interplay of both halves of our nervous system is present in every moment of the climacteric.

You know who knew a whole lot of these little penis secrets? Leonardo da Vinci, who said: “The penis does not obey the order of its master, who tries to erect or shrink it at will, whereas instead the penis erects freely while its master is asleep. The penis must be said to have its own mind, by any stretch of the imagination.”

The post Things That You Didn’t Know About Your Penis appeared first on The Turek Clinic.

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Abortion Access One Month After Texas Ban Goes Into Effect

Since news broke that SB 8—a law that bans all abortions after embryonic cardiac activitywould go into effect in Texas, the state of abortion access has been in chaos. Coverage of the law and challenges to it have been all over the map.

The ban also created a ripple effect: Other states, including Florida, have introduced similar bills, and abortion clinics in states bordering Texas are receiving more patients than they can handle, creating havoc for abortion providers.

In a virtual subscriber-only event, advocates and experts on the ground joined Rewire News Group‘s Executive Editor Jessica Mason Pieklo this week for an illuminating and urgent conversation on what the Texas ban actually means for providers and patients, not only in the state but across the country.

Hear from:

Watch the event below:

To be the first to learn about future events like this, subscribe to our newsletter here.

The post Abortion Access One Month After Texas Ban Goes Into Effect appeared first on Rewire News Group.

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Should You Buy ED drugs Online?

When is a pill just a pill like other pills? (Courtesy Unsplash.com)

It’s simply incredible to see how the way we buy things has changed over the last two decades. In just 20 years, online shopping has gone from being non-existent to becoming a trillion-dollar industry. What with 360-degree product views, videos, consumer ratings, detailed sizing instructions, free shipping, front door delivery and EZ returns, shopping online has become more like shopping in person than ever. And the facts about online shopping are also staggering: In 2021, more than 2.1 billion people are expected to shop online, with e-commerce sales expected to reach $4.9 trillion. As a car guy, I never imagined that anyone would purchase a 6-figure car online without a test drive or kicking the tires, but it happens all the time now. Amidst this e-commerce revolution, one key question is whether it is a good idea to buy prescription drugs online. And more specifically, how about buying “embarrassment drugs” for erectile dysfunction?

Cybermedicine Legality

Just because you can buy a drug online and from the comfort of your home does not mean that it is legal or safe. Remember, prescription drugs in the US must be “prescribed” by a licensed medical provider, and that includes a doctor’s visit with a consultation and examination. Lawsuits to date and statements made by prominent medical societies make it clear that the “physician-patient” relationship still matters for prescribing drugs. Foregoing this time-honored process could prove dangerous for consumers.

Cybermedicine Safety

The online drug commerce market has grown very quickly. So quickly, in fact, that state and federal drug agencies are overwhelmed and understaffed when trying to enforce interstate commerce laws among pharmacies and physicians. Part of “prescribing” a drug is a responsibility to educate the consumer about risks as well as benefits of a medicine. This has huge implications for patient health and safety.

You should never take a prescription drug without a consultation with and prescription from a physician. Moreover, there are some important questions you should ask yourself before taking a prescription drug:

  • What’s actually in the drug? Many drugs sold online do not meet the quality standards of FDA-approved pharmaceuticals. FDA-approved, pharma-grade prescription drugs may cost more but they are quality-guaranteed. Not always true with online medications.
  • Is the drug legal? The lack of enforcement means that access to illegal or unapproved drugs is widespread. And with this comes the issue of fake health claims.
  • Is the drug right for me? The loss of the patient-provider relationship could result in missed warning signs regarding prescription medicines and lead to untoward health consequences.
  • What if I have a drug reaction? If things go wrong with the medication, who are you supposed to contact for problems?

Buying “Embarrassment Drugs”

When it comes to buying “lifestyle drugs” like erection pills, the benefits of going online are clear: cost, confidentiality, convenience, speed, and access to oodles of information not readily available in brick-and-mortar pharmacies. But a study by the grandfather of Viagra®, Dr Irwin Goldstein, found that 77% of pills purchased from 22 different websites were counterfeit and contained only between 30-50% of the active ingredient advertised on their labels. In light of this, here is my advice regarding buying ED drugs online:

  • Be cautious when visiting online drug sites. Understand that the legality and product quality of many online drug stores is questionable. Try to buy from reputable pharmacies.
  • Realize that consultation (and preferably a visit) with a doctor is technically required for buying prescription drugs. Seek a similar interaction when buying drugs online and talk to a professional before buying.
  • Prescription drugs are not sold “over the counter” for good reason: they have known side effects which could have health consequences. Get educated from a provider or pharmacist regarding these issues as it’s your health at stake!

As we wander deeper into cybermedicine, we should heed the words of George Herbert: “The buyer needs a hundred eyes, the seller not one.”

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