Substance use disorder: contraceptive options counseling

What’s New in Contraception?

Contraceptive Technology Conference!

Biologic sexism of STIs

Excess breast cancer deaths after COVID-19

Contraception for patients with medical conditions

Pelvic Floor Dysfunction

Treating vulvodynia

Puzzling Over the Hurt Down-Under

Serious Mental Illness and Contraception

New 13-Cycle Vaginal Contraceptive System

The Future of Family Planning in Post-COVID America

New ASCCP Guidelines: Implications for FP

On the alert: mood disorders during 2020 stressors

Sex in the Time of COVID-19

Challenges old and new during the pandemic

Reproductive health in the time of Covid-19

Talking about toys

Missed Pills: The Problem That Hasn’t Gone Away

Find the “yes! . . . and” rather than “no” or “but”

Digital Family Planning: the Future is Now

Irregular Bleeding Due to Contraceptives

When she’s low on libido…

Ouch! Best approaches to menstrual pain

Contraceptive efficacy: understanding how user and method characteristics play their part

Strategizing treatment for chronic heavy menstrual bleeding


Untangling the literature on obesity and contraception

High tech apps for no-tech FABM

Menstrual exacerbation of other medical conditions

From Princeton University: Thomas James Trussell (1949-2018)

The Short and Long of IUD Use Duration

Selecting a Method When Guidance Isn’t Clear-cut

Healthcare in the Time of Digital Expansion

The Scoop on Two New FDA-Approved Contraceptive Methods

Pregnancy of unknown location—meeting the challenge

Big “yes” (with caveats) to CHCs during perimenopause

The role of IUDs (LNG IUDs, too!) in emergency contraception

Combined pills’ effect on mood disorders

Abortion in the U.S.: safe, declining, and under threat

Hope for ovarian cancer screening test

Breast cancer still a small risk with some hormonal contraceptives

New treatment modality for BV

Record rate of HPV-related throat cancer

Viruses in semen potentially transmissible

Don’t Abstain from Your Role in Abstinence

Teens births declining but geographic ‘hotspots’ defy trend

Online Medical Abortion Service Effective and Safe

Do Women Really Need to Wait That Long?

Reassuring news on depression and OC use

PMDD: Genetic clues may lead to improved treatment

Breast cancer risk when there is a family history

Body weight link to breast and endometrial cancers (and 11 others)

Family Planning in 2017 and Beyond

Make Me Cry: Depression Link (Again)?

Managing implant users’ bleeding and spotting

Zika: Updated guidance for providers

Pharmacist-prescribed contraceptives

Hot off the press! 2016 MEC and SPR

Zika virus fears prompt increased request for abortion in nations outlawing abortions

Opioid use epidemic among reproductive-age women

Good news on the family planning home front!

War Against Planned Parenthood Hurts Women

Win-win for both treatment and prevention

Center of the Storm


Menopause, mood, mental acuity, and hormone therapy

Emergency contraception for teens

Postpartum Contraception: Now, Not Later

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”

Are we practicing what we preach?

Be alert to VTE in hormonal contraceptive users

LARC among teens increased 15-fold, but not enough

Brain cancer and hormonal contraception

Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use

Alcohol consumption when pregnancy is unwanted or unintended

Latest Data on Contraceptive Use in the United States

LateBreaker sampler from Contraceptive Technology conference

Emergency Contraceptive Pill Efficacy and BMI/Body Weight

Handout on Unintended Pregnancy and Contraceptive Choice

Ask About Withdrawal (Really!)

Rules to Practice By: Safety First and Cleanliness is Close to. . .

What’s Vanity Fair Got Against the NuvaRing?

Promising New Treatment for Hepatitis C

Numbers matter, so make them simple for patients

The Recession’s Effect on Unintended Pregnancies

Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative

Applying the “New” Cervical Cytology Guidelines in Your Practice

Acute Excessive Uterine Bleeding: New Management Strategies

Medical indications for IUD use in teens

Whatever happened to PID?

Update on Emergency Contraception New and Improved

Talking about toys
March 2020


The reproductive health field would be non-existent without sex, but conversations about sexuality remain taboo and are often omitted from clinical encounters. Clients report that practitioners rarely ask them about sex, despite the evidence suggesting that discussions about positive sexual experiences and satisfaction (and not merely sexual risk) yield significant benefits for patient health as well as the quality of the provider-patient relationship.[1],[2]

So here is the proverbial “elephant” in the exam room: penile-vaginal intercourse is much more strongly associated with satisfying orgasm for the person with the penis than for the person with the vagina.[3] Female-assigned people are more likely to experience orgasms through direct stimulation of the clitoris and surrounding structures by way of a hand or mouth, and by way of sex toys such as vibrators or other objects, write Jenny Higgins and Patty Cason in Contraceptive Technology. [4]

So let’s talk about sex toys.

Sex toys enable exploration and self-satisfaction. Take for example, masturbation, which plays an important role in both sexual activity and in abstinence. Individuals can masturbate solo, or mutually with a partner. In the last year alone, 40% of all women (except women over 70) had masturbated, and 20% had masturbated within the last month. Many of those women used a sex toy such as a vibrator.

Using a vibrator with a partner is common, too. In a cross-sectional survey of over 2,000 heterosexual, lesbian, and bisexual U.S. women,[5] most users felt comfortable using a vibrator with a partner. A significant predictor of sexual satisfaction for heterosexual women was having a partner who knew about and liked that they used a vibrator.

While half of heterosexual women report having ever used a sex toy, three-fourths of women who have sex with women report having ever used a sex toy and one fourth report use in the previous month, according to a cross-sectional web-based survey from 2,192 women who have sex with women.[6] Compared to those who reported not using a vibrator or using one only during masturbation, those who used the vibrator with a female partner scored higher on sexual satisfaction. More likely to use a vibrator in this study? Women who were older, white, and in a long-term relationship.

So, maybe it is time for you to talk about toys. Counselors and providers may wish to emphasize the following points when talking to patients:2

  • Use of lubrication is important. A variety of lubricants can be bought at most drugstores.
  • A helpful experiment: trying vibrations on different parts of the body. People should try a range of speeds and types of vibrations to see what they like. •   Patients should be encouraged to relax and have fun! There is no right or wrong way to use a vibrator; it’s about pleasure.
  • Some people like to use vibrators on the clitoris directly (intense); others use them on the lips of the vulva; others use them on the inside of the vagina. Some like to move the vibration around to all three places. Patients won’t know unless they try.
  • For most people, arousal that can lead to orgasm occurs when the clitoris, lips of the vulva, and first 1 to 3 inches of the vagina are stimulated.
  • People will not become addicted to vibrators or unable to orgasm without them. Vibrators may help someone orgasm more quickly, but they will not create desensitization to the stimulation that leads to orgasms.

Many people enjoy partnered vibrator play. You may want to suggest that your patients use their vibrator with a partner. Reassure your patients that using a sex toy does not mean a partner is not good enough, or that the sex toy will replace the partner or make someone overly reliant on the device to achieve arousal or orgasm.[7] These are common misconceptions, however. Positive communication is the key, as it is in creating any satisfying relationship: listening to and hearing partners who feel threatened and then responding with reassurance about their virility, desirability, and prowess.

More good associations? In a recent nationally representative internet-based survey, women who used vibrators currently or in the past were significantly more likely to have had a gynecological exam during the past year than women who had never used vibrators.[8]

How to help your patients enjoy their toys safely? Counsel them that they should avoid toys that may damage or irritate tissue or cause injury. A list of products that may be associated with the potential for hazard can be found at

Inform your patients that the sex toy industry is highly unregulated. You know, those companies making unsafe products with more regard for the cash than for the customers. Look for transparency in what a company’s products are made of and how. Patients avoid toys that are made of toxic materials that contain phthalates; they should seek out toys that do not have a chemical or plastic smell. Safe options include:

  •  non-porous materials
  • 100% silicone
  • glass
  • surgical steel
  • sealed ceramic
  • medical-grade plastics

Just to get you started, here are websites, mentioned in Contraceptive Technology, that sell sex toys:

[1] Nusbaum MR, Hamilton CD. The proactive sexual health history. Am Fam Physician 2002;66:1705–1712.

[2] Nusbaum MRH, Gamble GR, Pathman DE. Seeking medical help for sexual concerns: Frequency, carriers, and missed opportunities. J Fam Practice 2002;51:1–5.

[3] Blair KL, Cappell J, Pukall CF. Not all orgasms were created equal: differences in frequency and satisfaction of orgasm experiences by sexual activity in same-sex versus mixed-sex relationships. J Sex Res 2017:1–15.

[4] Higgins JA, Cason P. Sexuality & contraception. In: Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS, Edelman A, Aiken ARA, Marrazzo J, Kowal D, eds. Contraceptive technology. 21st ed. New York, NY: Ayer Company Publishers, Inc., 2018

[5] Herbenick D, Reece M, Sanders SA, Dodge B, Ghassemi A, Fortenberry JD. Women’s vibrator use in sexual partnerships: results from a national representative survey in the Unities States. J Sex Marital Ther 2010;36:49-65.

[6] Schick V, Herbenick D, Rosenberger JG, Reece M. prevalence and characteristic of vibrator use among women who have sex with women. J Sex Med. 2011;8:3306-3315.

[7] Schrieber K. How sex toys impact relationships. Do they always increase satisfaction? Psych Today May 2017.

[8] Herbenick D, Reece M, Sanders S, Dodge B, Ghassemi A, Fortenberry JD. Prevalence and characteristics of vibrator use by women in the United States: results from a nationally representative study. J Sex Med 2009;6:1857–1866.