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Sex Ed 102: Implants/Transcervical Sterilization


What are Implants / Transcervical Sterilization?

When the word “transcervical” (meaning “through the cervix“) sterilization is used, it’s meant to encompass any method of Permanent Contraception where a health care provider reaches the fallopian tubes through the cervical opening of the uterus to block the tubes, preventing an unintended pregnancy.

In 2002 the U.S. Food and Drug Admisitration (FDA) approved a small metallic implant called Essure as safe form of Permanent Contraception. The implant itself is a small, soft, flexible metal and fiber coil that is placed into the fallopian tubes to prevent pregnancy.

How does a the Essure Implant work?

Once the Essure Implants are in place it works by making scar tissue form over the implant, blocking the fallopian tube and preventing fertilization of the egg by the sperm.

Essure Benefits 2How is a Transcervical Sterilization performed?

The procedure does not require cutting into the body or the use of radio frequency energy to burn the fallopian tubes. Instead, a health care professional inserts the soft, flexible implants through the body’s natural pathways (vagina, cervix, and uterus) and places one into the opening of each of the 2 fallopian tubes. The very tip of the device remains outside the fallopian tube, which provides immediate visual confirmation that it is in place.

What can a patient expect after the procedure?

During the 3 months following the procedure, the patients body forms scar tissue over the inserts to form a natural barrier that prevents sperm from reaching the egg. During this period, the patient must continue using another form of birth control like a condom.

After three months, it’s time to get a confirmation test to verify that the patient is protected from the possibility of an unplanned pregnancy. The test uses a dye and special type of x-ray to ensure both that the inserts are in place and that the fallopian tubes are completely blocked.

What are the advantages?

  • No surgery, burning or anesthesia
  • No hormones
  • No slowing down to recover
  • Can be performed in less than 30 minutes
  • Allows sexual spontaneity and requires no daily attention.
  • It is a permanent form of birth control.
  • There are no changes in sexual desire, menstrual cycle, or ability to breastfeed
  • May be covered by Heath Insurance

What are the disadvantages?

  • May not be reversible.
  • It is meant to be a permanent form of birth control, and some women may regret the decision later.
  • The two most common factors associated with regret are young age and unpredictable life events, such as change in marital status or death of a child.
  • It can be expensive, usually around $2,000 with insurance covering a portion
  • Allergic reaction to the materials
  • Perforation, expulsion, or other unsatisfactory location of the micro-insert
  • Symptoms during or immediately after the procedure may include mild to moderate cramping, nausea/vomiting, dizziness/light-headedness, and bleeding/spotting
  • Not all women will achieve successful placement of both inserts

How effective is the Essure Implant/Transcervical Sterilization?

During clinical trials the Essure procedure was found to be 99.74% effective.


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Sex Ed 102: Tubal Ligation

If you’ve watched my videos on YouTube over the years you’re likely well versed with my support of safe sex practices.  You know, the kind that leave you free of worries about an unintended pregnancy or possible transmission of an STD. As such, I hope this page gives you the insight you need to help find a method of protection that’s right for you.

tuballigation1What is a Tubal Ligation?

For those who have decided that they do not want more (or any) children, tubal Ligation, commonly referred to as “getting your tubes tied,” is a surgical sterilization technique that can be done at any time.

Before we go over what tubal ligation is, it’s important to understand how pregnancy occurs; every month the fallopian tubes carry an egg from one of your ovaries to the uterus. By blocking or removing the path egg takes through the fallopian tubes, the egg cannot travel to the uterus and be fertilized. If the egg doesn’t become fertilized by sperm, a pregnancy cannot occur.

In a tubal ligation, the fallopian tubes are cut, burned, or blocked with rings, bands, or clips (pictured right) with the intention of permanently blocking or removing the path the egg takes therefor stopping any chance of a pregnancy occuring.

How is a Tubal Ligation Performed?

The procedure is an out-patient surgery done in a clinic, doctor’s office, or hospital which can be performed under local or general anesthesia.

There are 3 ways in which a Tubal Ligation may be performed

1.) As an outpatient procedure; a needle is inserted through the navel and the abdomen is inflated with gas (carbon dioxide or nitrous oxide). Then a laparoscope (a thin tube equipped with a camera lens and light, pictured left) is inserted into the abdominal cavity to help them see the pelvic organs. Using instruments passed through the abdominal wall, the doctor will seal the fallopian tubes by destroying segments of the tubes or blocking them with plastic rings or clips. If the laparoscope doesn’t contain a channel for passing instruments, the doctor may make a second incision above the pubic bone to insert special grasping forceps. After the procedure has been completed the gas will be withdrawn from the abdomen and the small incision will be sewn up. Patients may be allowed to go home several hours after the procedure or required to spend the night in the hospital depending on the health of the patient and any previously made arrangements.

2.) After child birth; If having a tubal ligation after vaginal childbirth is a more fitting option, the doctor will likely make a small incision under the navel, providing easy access to the still enlarged uterus and fallopian tubes. The health care provider then cuts and ties the fallopian tubes.

3.) During a C-section: with easy access to the area, the health care provider will cut and tie the fallopian tubes after the baby is delivered.

Generally the procedure takes about 30 minutes. In some cases, it is done immediately after a woman gives birth. If the procedure was done in combination with childbirth, the tubal ligation isn’t likely to prolong the patients hospital stay.

What can a patient expect after the procedure?

Whether or not the tubal ligation was performed in combination with childbirth, patients usually need to rest for at least a day after the procedure.

Common side effects may include:

  • Abdominal pain or cramping
  • Fatigue
  • Dizziness
  • Gassiness or bloating
  • Shoulder pain
  • Sore throat

It has been advised that patients avoid using aspirin for pain relief, since it may promote bleeding. Bathe 48 hours after the procedure is usually okay, , but avoid straining or rubbing the incision for one week. Carefully dry the incision after bathing making sure that it is clean and there is no discharge which could be a sign of infection. Also avoid strenuous lifting and sex for one week. Patients are advised to resume normal activities gradually as they begin to feel better. More often the health care provider will use stitches that will dissolve and won’t require removal. It’s also important to make an appointment to see your doctor a week after the procedure to make sure the body is healing properly.

What are the advantages?

  • Female sterilization does not involve hormones.
  • It is a permanent form of birth control.
  • There are no changes in sexual desire, menstrual cycle, or ability to breastfeed.
  • The procedure is usually a same-day procedure done in a surgical outpatient clinic.
  • Immediately effective.
  • Allows sexual spontaneity and requires no daily attention.
  • Cost-effective in the long run.

What are the disadvantages?

  • The procedure involves general or regional anesthesia.
  • May not be reversible.
  • It is meant to be a permanent form of birth control, and some women may regret the decision later.
    • The two most common factors associated with regret are young age and unpredictable life events, such as change in marital status or death of a child.
  • It can be expensive, ranging between $1,500 and $6,000
  • Does not offer protection against STD’s, so a secondary method may need to be used.

How effective is Tubal Ligation?

A study taken from the The United States Collaborative Review of Sterilization has shown the cumulative 10-year failure rate with each method of tubal ligation as follows:

  • spring clip method is 3.7%,
  • electrocoagulation is 2.5%,
  • interval partial salpingectomy (partial removal of tubes) is 2%,
  • silicone rubber bands is 2%,
  • postpartum salpingectomy (tubes cut after delivery) is 0.8%.

To learn more about each of the above methods of tubal ligation please speak with your health care provider.


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First Time Sex: Erection Issues

premature-264x300Question :


I’ve just recently found your videos and I’m hooked! You’re adorable and so fun to watch. But anyway, I was hoping you could help me out with a problem I’m having.

I’ve been with my boyfriend for a little over 2 months now. And in those two months we’ve done pretty much everything but intercourse. Keep in mind we’re both virgins. Today we both decided to take the next step and have sex. Well that did not work out at all.

Penis erect, condom on, attempt to insert… and fail.
It just would not go in. And then… erection gone.

I knew I’d be tight so we even agreed that he would kind of prep me with one finger… then two.  But even just two fingers is tight. He WAS having a problem keeping it up (not the norm for him) Maybe nerves? So it maybe could have been hard but not hard enough? Could the addition of lube helped at all?

Any advice would be great.



First of all thanks for watching my vids!!

As for the questions, what you went through is completely normal.  I hear it all the time so dont be too worried.

For your part, the fingering was a very good idea and usually helps. It may have been that you were nervous and tensed up when he went to insert his penis, causing you to “tighten” up. It could also be that you werent “wet” enough for an “easy” insertion. For next time you may want to do what you did previously with the fingering, add some lube and try to relax. Dont let this be something that makes you nervous or scared, instead make it something that is enjoyable and exciting.

As for his part, he was probably very nervous about “failing” you. There seems to be a huge difference when it comes to males and females and sexually pleasing their partners. Women aren’t expected to do very much, or so it seems, however there is a lot of pressure placed on males to “perform” and have their partner orgasm. (By the way, if you don’t have an orgasm during intercourse it’s completely normal, that may just come in time) For him this was/is going to be a defining moment of his “manhood”, and there is a lot to go wrong.

  • He could go soft
  • He could orgasm too soon
  • He could go on for too long
  • He could be too big and it could hurt you
  • He could be too small and not enough to please you
  • He could get it in but then not know what to do with it
  • Not to mention the list of other fears/doubts/anxiety that go through a males head.

When it comes to sex, especially first time sex, there is so much to think about. The best advice I can give is to be supportive and let him know that it’s okay no matter what happens and that when it’s meant to happen it will. Let him know that if he goes soft it’s normal, especially for the first time, and that you don’t judge him for it.

Also in the future, if he does go soft you can always do other things to help him regain his erection like give him oral sex or manual stimulation (hand job). Or if he’s willing to wait it out, you can have him stimulate you until he is ready again.

If you’d like a better understanding of what’s going on, and possibly some products that might be helpful, I suggest giving these articles a read:


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Male Sexual Response Cycle

Today’s video is going to cover the Male Sexual Response Cycle and all of the phases the ‘male’ body goes through from arousal to after the orgasm. For those of you that haven’t seen it,  I created a previous post on the Female Sexual Response Cycle to help educate about what happens for a female and the way the body reacts when she goes through the phases. If you haven’t seen it yet, I suggest you check it out.

I’m hoping that through watching this video all of you will not only become better educated in regard to your own body, but also will have a better sexual experience because of it.

male sexual response cycleThe Phases:

1.) Arousal / Excitement~ This phase begins when your body first begins to respond to sexual stimulation.

  • Physical reactions like the following can be expected
  • an increase in heart rate,
  • flushing of the face and/or neck,
  • nipples becoming hard,
  • partial raising of the testicles
  • erection of the penis

2.)Plateau ~ This is the stage where your body is highly aroused and on the verge of orgasm.

Physical reactions like the following can be expected

  • everything that happens during the first stage continues and increases
  • testicles will enlarge and be fully raised
  • a few drops of pre-cum will be secreted by the Cowpers glands. (This precum is meant to lubricate the urethra, as well as clean out any bacteria that may have been left behind)

3.)Orgasm / Climax

This phase tends to be slightly different between men and women, with the men experiencing it in two parts; the first tends to be a moment of inevitability characterized by sensations that mark the point of no return with contractions occurring in the testicles, prostate and seminal vesicles. The in second part is the ejaculation of sperm due to contractions in the urethra and penis. Typically the actual orgasm lasts less than one minute for most males.

4.) Resolution ~ the body slowly returns to normal

Unlike the female, who can be responsive to stimulation even after orgasm and even have multiple orgasms, the male typically goes through a period of unresponsiveness or a refractory period where he is no longer able to be aroused and needs some time before he can get another erection and orgasm. Tho this is true for most males, its not true for every one.

I do highly suggest that you take the time to learn about your body, either during masturbation or intercourse and see if you can identify the phases as you are going through them, which will in turn help you to become a better lover.

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Sex: Getting Ready For Your First Time

Contrary to what most movies depict, first times are rarely what we expect.

There aren’t rose petals or candles casting a glow. There’s no moment of tender, all encompassing bliss or the crooning voice of our favorite music artist in the background. Rather than a bed, many first timers find themselves in the back of a car, couch, or even in a park, as the thought of holding out for a time when the parents are out is just too bothersome, or too long of a wait.

On top of that (and based on the messages I’ve received) the majority of writers found their “first time” to be clumsy, anxiety ridden, overwhelming, scary, ill planned, uncomfortable and confusing (or any mix of the above), even when it was a good one.

It’s because of this that I thought I’d write a series of posts on the subject of first times, all with the hope that I’d be able to transform what was once a scary and overwhelming experience, to one that’s a bit better planned, a little more fun, definitely more comfortable and a lot more enjoyable.

Unlike a lot of my other written articles that are completed in one go, my first time sex tips have been split into 3 separate entries:

Tips/Suggestions For The Guys –  Tips/Suggestions For Girls – Basic Suggestions To Help Make The Experience Not So Painful/Scary – Products You’ll Want To Keep on Hand

Sex: Getting Ready For Your First Time

When it comes to having sex the first time there are a few things I highly suggest you take into consideration before deciding to act on the impulse;

What’s Your Motivation?

1.) The first thing you might want to think about is the personal motivation you have behind your choice in actions. While I’m not here to judge, I am here to remind you that intercourse, intimacy, and any form of sexual relations can and do often have emotional, mental, physical and spiritual after effects. For some the after effects will be wonderful, comfortable, confidence boosting and/or blissful, for others it may be a period of guilt, regret, disappointment or anger (all of which are “normal”).

That said, if the reasoning behind losing your “virginity” is one that’s due to peer pressure, societal factors or doing it “for the sake of it”, I suggest you take a moment to rethink your motivation and make sure it’s something you can live with after. Like I said, I’m not here to judge, I just don’t want you doing something you’ll live to regret or beat yourself up for.

Choices, Choices…

Sex Tips: Getting Ready For Your First Time2.) The second thing I highly suggest you think about is the method(s) of protection you’ll be using;

*For hetero sex, what type of Contraception/STD protection will you be using?

*For same sex relations what type of STD protection will you be using?

On that note, while I understand where people are coming from with the belief that the female should have to deal with the pill (or other methods) and the male should be the one responsible for getting the condoms, I’m not someone who shares that belief.

In my opinion, each one of us owes it to ourselves to take responsibility for our bodies and our own personal well being. If you want to stay STD free and you want to avoid the chances of an unplanned pregnancy, come prepared.

For the ladies that means getting your hands on condoms, should that be your choice of protection (or even just your back up). For males that means discussing all of the options open to the female (if it’s hetero sex) and if you’re in a relationship, making sure she’s taking them on time or applying them as directed.

I’m sure most of you would think this is common sense but all too often I hear about “scares” that happened all because someone relied on someone else, only to realize after, that they were the person who should have taken responsibility of things for themselves. Don’t leave your safety in someone’s hands, 7 times out of 10 they’ll fail you.

Getting Ready For Your First TimeContraception: Practice Makes Perfect

3.) Since the #1 complaint I hear regarding condoms is that they ‘spoil the mood‘ I think it’s very important to practice putting them on properly (and taking them off properly) as it’ll help to make the moment move a lot smoother and quicker.

When it comes to practicing I think the best advice is to go with the flow; if you masturbate use that time to practice putting on a condom, masturbate with it on (which will get you used to the sensation) and then take it off following the directions on the box (using toys to experiment with while you wear a condom is also a good idea).

While it might be a bit of a pain in the ass, and maybe a mood kill, when it comes to the actual moment all the planning and prepping will go a long way in saving you from embarrassment or potentially doing it wrong.

4.) For those that choose to use a diaphragm, female condom or any other barrier method of protection I also suggest you take the necessary time, before being sexually active, to learn and practice putting the product in place, as well as safely removing it.

If you choose to use a hormonal method of protection, I suggest you speak with your doctor about how long it takes to become fully effective since the time on them varies.  The last thing you need is to start taking a product and become sexually active because you think you’re protected, only to realize you weren’t.

Speak Up

5.) I realize that for a lot of people the topic of sex and sexuality are still touchy subjects, even with that in mind I think it’s important to have someone to talk to after. Whether it’s a friend you trust, a teacher, parent, doctor, guardian, mentor, coach or other relative, having a person who’s willing to listen and help can make a world of difference – especially if something goes wrong or you’re dealing with negative emotions like guilt.

Get Tested

6.) Finally, if you’ve had unprotected sexual interactions with another person, whether it be oral, anal or otherwise I suggest you get tested for STI’s/STD’s just to be on the safe side. While the majority of them require the transmission of bodily fluids to be transferred, it doesn’t mean that there aren’t others that need skin to skin contact to cause an

Just Get Tested STD Blood TestingI realize that for most of you the thought of going to get STD tested can raise a mountain of fears and anxiety, making the suggestion easier said then done. That said, if there is one thing I want to make very clear it’s that the process it self is very easy; all you need to do is to visit a local STD testing lab, hassle free clinic, or talk to your doctor. If you’re in a real hurry sometimes you can even call ahead for setting up an appointment the same day.

In most cases testing sites are conveniently located throughout the country and are staffed by caring and highly trained individuals. While you’re there they will perform the tests as well as answer any questions you may have about your risk, possible diagnoses, or the testing process. Then, within three days (sometimes shorter, sometimes longer) you’ll be able to get the results of your STD test. These results are most often delivered by a counselor who can assist you in dealing with emotional and practical considerations if a test comes back positive.

For those of you that just can’t bring yourself to visit a clinic or talk to a doctor there are other options available like online sites that send out STD Testing Kits allowing you to do the test in the comfort of your own home. Once you receive the test kit, follow the simple instructions then mail it back to the lab and you can receive your results online within 1-3 business days. After that you have the option of calling and setting up an appointment to speak with someone should you need to, or you can go to your own doctor and speak with him or her instead.

Final Thoughts

Sex can be a wonderful experience that allows us to bond, explore, ignite and surrender to a person in ways nothing else can. It can also be the cause of heartache, regret, disappointment and life altering choices that leave us questioning why we did it in the first place.

For those of you that are just happening to come to this stage of exploration, whether it be by yourself or with a partner, I hope this series of blogs can help you shape and create your moments to be closer to the former, rather then that latter.

If you have any questions or concerns please feel free to go through Sex Ed 102 videos or the Sex Ed 102 website first, as more often then not your answer will be found there. Still feeling lost? No worries, head over to my contact page and send in your question. If it’s one I get often enough – or one that I think would really benefit others – I just might include it in my Sex Ed 102 Q & A (don’t worry, I never identify who sent the question in).

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