Electrosurgery

In electrosurgery, an electrified blade or wire is used to cut out a wart, usually after the area has been numbed with a local anesthetic. It can be used to treat oral warts, external genital warts, and warts around the anus. This is one of the more expensive treatments, and although it may be slightly more effective than topical treatments, the success rate depends to a large extent on the skill of the health care provider performing the procedure. It has a clearance rate of 35-94 percent and a recurrence rate of 22 percent.

Surgery

Surgery on warts is usually performed with a scalpel after the area to be treated has first been numbed with a local anesthetic. Surgery is often the treatment of choice for very extensive warts, either in the external genital area or in the anal area, and it can be used for oral warts as well. After the procedure stitches may be used to close the area. This is another more expensive treatment. It has a clearance rate of 93 percent and a recurrence rate of 29 percent.

Laser Surgery

In laser surgery, a high-intensity beam of light is focused on the affected tissue, usually with the aid of a microscope, in order to remove it. The procedure is primarily recommended for extensive external genital or anal warts. The success of the procedure depends on the skill of the health care provider performing the surgery. Because it is expensive and usually involves an outpatient visit to a hospital and general anesthesia, it is most often recommended for warts that are difficult to treat or extensive. It has a clearance rate of 43 percent and a recurrence rate of 95 percent.

The entire genital area should not be treated with the laser in an attempt to rid the genitals of the virus; this treatment method has been shown to cause precancerous changes in the vagina from the extensive tissue destruction.

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When condoms are used correctly, and used every time you have sex, the failure rate from a condom breaking is usually less than 2 percent. In other words, condoms break about twice out of every one hundred times they are used. However, in the real world, condoms fail more often, sometimes ten out of every one hundred times used. Not surprisingly, this is usually because they are not used correctly or consistently. Here are the “top twelve rules” of male condom use. These rules apply to both latex and plastic condoms except where differences are specifically noted.

1. Condoms should be used for every sexual contact with a person whose status for STDs is not known. This includes oral, anal, and genital contact. If you or your partner uses them only “some of the time,” then you are not protecting yourself against STDs. It can take only one unprotected sexual encounter to transmit an STD.

2. Condoms should be put on before any genital contact. It is not enough to use the condom only during ejaculation and not during the earlier sexual contact. Pre-ejaculate can also cause pregnancy and transmit STDs if a male partner is infected.

3. Latex condoms should not be used with any oil-based lubricants, such as mineral oil, vegetable shortening, massage oil, or petroleum jelly, since this will increase the chances of their breaking. Only water-based lubricants, such as those that are glycerin based, are recommended for use with latex condoms, since these do not increase the risk of breakage. Watch out for lubricants that say they are “water soluble.” This is not the same as water based, and water-soluble lubricants may actually contain oils and are therefore not to be used with latex condoms. Plastic or polyurethane condoms can be used with either oil- or water-based lubricants.

4. Latex condoms should not be stored in a warm or hot place, such as a wallet or the glove compartment, since this will increase the risk of breakage. Plastic condoms are not destroyed by heat exposure.

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Molluscum contagiosum. Often confused with warts, molluscum skin lesions are usually white, waxy, painless bumps with a dimple in the center. In the center of the lesion is a hard white core, which contains the virus. There are usually many lesions at a time, and they can continue to appear long after the initial infection (sometimes for months to years). The lesions will clear up without treatment, but treating them usually speeds up the healing process. Molluscum lesions can become infected with skin bacteria and take on a pimple-like appearance, which may resemble that of herpes lesions.

Psoriasis. Psoriasis is a usually benign skin rash that is not sexually transmitted, although its cause is not known. It can occur anywhere on the skin, but the genitals are a common site. The typical rash is characterized by red splotches, often with silvery or white scales on top. It can look very similar to fungal rashes in the genital area, and it is often suspected when the usual antifungal creams do not work. The rash usually does not hurt or itch. Several topical treatments, including steroid creams, are effective. Treatment is usually best coordinated with a dermatologist.

Scabies. Scabies usually forms very itchy bumps and lines in the genitals as well as other areas of the body (the webs between the fingers, wrists, beltline, buttocks, ankles, and armpits, among others). The bumps appear about two to four weeks after the initial infection, but they can appear sooner in someone who has previously been infected. The itching tends to be worse at night and after a shower.

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Whenever we discuss sexual intercourse, questions about pregnancy and childbirth naturally come up. Here are just some of the questions we’ve been asked.

Are there only certain times of the month when a girl can get pregnant and if so, when?

A woman’s ovum can be fertilized only during the twenty-four hours (sometimes experts say forty-eight hours) immediately after she’s ovulated. It’s only in this first day or so after the ovum has popped off the ovary that the ovum is at the exact ripeness to allow for fertilization. After that, the egg is ‘overripe’ and cannot be fertilized. Within a few days, it will break down and disintegrate completely.

Because there’s only, at most, forty-eight hours during which a woman’s ovum can be fertilized during each menstrual cycle, it would seem to be a pretty easy thing to avoid getting pregnant: just don’t have sex during those forty-eight hours. Unfortunately, it’s not that simple. First of all, sperm can stay alive in the woman’s body for three to five days. So, let’s say a woman ovulated on the tenth day of the month. If she’d had sex on the seventh and the man had ejaculated, the sperm could still be in her body, alive and well, waiting for the ovum when it popped off the ovary on the tenth.

Also, there’s no way to predict exactly when a woman is going to ovulate. A woman usually ovulates twelve to sixteen days before the first day of bleeding of her next menstrual period. So we can count backwards and get an idea of when she ovulated in the previous cycle. But we can’t tell when she’ll ovulate in the next cycle because, as we’ve explained, women’s menstrual cycles aren’t always regular. One month a woman’s cycle may last twenty-eight days, the next month thirty-two, and the next twenty-one. Even women who have fairly regular periods – say every twenty-seven or twenty-eight days-will occasionally have longer or shorter than usual periods. There’s just no way of telling ahead of time exactly when a woman will ovulate. So, even though there are only certain times of the month when a female can get pregnant, it’s impossible to tell exactly when that time will come.

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Girls also grow new hair on their arms and legs during puberty, although such body hair isn’t usually as thick as it is on boys. Some girls shave the hair on their legs with razors or use chemical hair removers. Others don’t bother. Again, this is an individual thing, a matter of personal choice.

Underarm hair also develops during puberty and some girls shave this hair. Perspiration and oil glands in the genital area, the underarms, the face, neck, shoulders and back become more active in girls during puberty, just as they do in boys. Some girls choose to use underarm

deodorants; others don’t. Some women use the deodorant sprays made for the vulvar and vaginal area. But these sprays can cause irritations, so we don’t think they’re a good idea.

Beginning with puberty, a girl’s genitals may have a moister feeling due to the change in the oil and sweat glands in this area.

Spots, acne and stretch marks may be a problem for girls, just as they are for some boys.

The genitals-A boy’s scrotum and penis develop and change during puberty, and a girl’s genital organs also change in appearance. Pubic hair grows on the mons and outer lips. The mons, the outer lips and the inner lips get fatter and fleshier. The lips get larger, more wrinkly and darker. The clitoris, urinary opening and vaginal opening get a bit larger too.

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Can masturbation affect your athletic performance?

Many people like to imagine things that make them feel more excited as they are masturbating. Imagining or pretending that something is happening is called daydreaming or fantasizing. We day-dream and fantasize about all sorts of things. We might, for instance, day-dream about being a first division football player or a rock star. When our day-dreams are about sexual things, we call them sexual fantasies. Almost everyone has sexual fantasies. We may have them while we’re masturbating and at other times too. Sexual fantasies are a rich and varied way of experimenting with your sexual self. Sometimes the things we fantasize about are things we might actually like to do someday; other times we fantasize about things that we’d feel embarrassed or even bad about if we actually did them.

Some people worry that there might be something odd about their sexual fantasies. If you’ve ever been concerned about this, you can relax. Human beings (both males and females) have sexual fantasies about all sorts of things. If you think you’re the only one who’s ever had a particular fantasy – you’re wrong. We guarantee that there are plenty of other people who’ve had almost exactly the same fantasy.

Can masturbation affect your athletic performance?

In general, masturbating won’t affect your athletic ability. Some athletic coaches think that it’s a good idea for boys to masturbate before a big match. Masturbating is a way of relieving tension and is very relaxing. But there are some coaches who think that athletes perform better when they’re somewhat tense and not completely relaxed, so they tell their teams to lay off masturbating or having sexual intercourse for a few days before a match. If you’re an athlete, you’ll have to decide for yourself what works best for you.

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It usually takes an entire class period for us to cover the changes we’ve been talking about in this chapter. The pupils in our classes are curious about these things, and they often have a lot of questions. Most of them agree that knowing about things like sore or swollen breasts, spots, stretch marks and breaking voices helps you to deal with them if they happen to you. Still, hearing about all of them at once can be a bit overwhelming. As one boy put it:

I’m not sure I’m exactly looking forward to all these things happening to me. Puberty is beginning to sound like some kind of disease!

Puberty definitely isn’t a disease. The changes we’ve described in this chapter and in other parts of this book are natural and healthy. They’re a normal part of growing up and becoming a man. Still, when we start focusing on things like perspiration, spots, breaking voices and so on, puberty can start to sound like just one hassle after another. By the end of the class in which we cover these things, we can see that some people are starting to think that puberty sounds like more trouble than it’s worth! So we tell them, ‘Hey, don’t get discouraged!’

First of all, the problem things don’t happen to everyone. Not everyone has spots, a voice that breaks or swollen, sore breasts. For most boys, the physical changes of puberty happen without any difficulties. And even for those who do have some problems, it’s not such a big deal. So your voice breaks. Even if it’s embarrassing, no one ever died of embarrassment.

Sometimes, spending a whole class period — or, in the case of this book, a whole chapter – on these problems can give you a distorted picture. It can make them loom larger or seem more important than they really are. So at the end of the class, we ask everyone to make a list of the five things they like best about going through puberty and growing up. Here are some of the things the boys in our classes have come up with.

more privileges hanging out with the older

getting to stay out later boys

being more my own boss getting a job

driving a car dating

new friends getting into films rated 15

new school having my body get stronger

more respect going to parties

more pocket money having my own money

making my own decisions joining the school team going to college

(sometimes)

Perhaps you’d like to take a few minutes to make a list of your own, to help yourself remember that puberty is a lot more than just spots and perspiration!

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Doctors have divided the growth and development of the genital, or sex, organs into the five stages. You may be in one of these stages or you may be between one stage and another. See if you can find the stage you are closest to.

Stage 4

By the time a boy reaches Stage 4 his penis has become quite a bit larger. It is both wider and longer, and the glans, or head of the penis, is more developed. The scrotum hangs lower and the testicles are also larger. The testicles are usually about 38 mm (1 ½ in) long by the time a boy has reached this stage and they are usually between 12 and 24 ml (2 2/5 and 4 4/5 teaspoons) in volume although some boys’ testicles will be slightly smaller or larger than this in Stage 4.

During this stage the skin of the scrotal sac and penis continues to get deeper in colour. The oil and sweat glands continue to develop too. The usual age at which boys reach Stage 4 is about 14, although again some boys will be younger than this and some will be older.

Most boys will have quite a bit of pubic hair by the time they reach Stage 4. As a boy continues to develop, the pubic hair gets curlier, coarser and darker. It usually grows in an upside-down triangle pattern on the lower part of his stomach, round the base of the penis. In many boys the pubic hair continues to grow up towards the tummy button and out towards the thighs. As we mentioned before, it may also grow on the scrotum and round the anus.

Your pubic hair is often the same colour as the hair on your head, but it may also be lighter or darker. When you become an old man, the pubic hair, like the hair on your head, is likely to turn grey.

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