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gt;gt;It’s trichomoniasis—an infection caused by a parasite called Trichomonas vaginalis—and more than 1 in 10 women in their 40s and 50s has it (compared with 8 out of every 100 women in their 20s), according to new Johns Hopkins University research. If left untreated, trichomoniasis can lead to inflammation of the vagina, urethra, and cervix, potentially leading to pelvic inflammatory disease, fertility problems, and low birth-weight babies.gt;gt;Luckily, "trich" is easily cured with a round of antibiotics—once it’s detected. The real difficulty is diagnosing it in the first place: It’s possible to contract trich without realizing it, since between one-third and one-half of cases have no symptoms. And even when there are signs, they can be confusingly similar to what you’d get with a yeast infection (think burning and itching). That means the disease may go undetected or misdiagnosed.gt;gt;gt;Past 40 and positivegt;gt;gt;So why are women in their 40s and 50s so vulnerable? Researchers have a few theories: "It’s possible that women are getting infected when they’re younger, but because doctors don’t regularly test for it, they’re never properly treated," says Charlotte A. Gaydos, professor of infectious diseases in the Department of Medicine at Johns Hopkins University and senior investigator in the Hopkins study. "The older you are, the more sex you’ve had, and the more time you’ve had to be exposed"—meaning you could have the disease even if you’ve long been married and monogamous. Another explanation: "Postmenopausal women may use less protection because they’re no longer worried about getting pregnant," says Paula Castaño, MD, assistant clinical professor of obstetrics and gynecology at New York–Presbyterian Hospital/Columbia University Medical Center. (In fact, a 2010 report in the found that women in their 40s use condoms—the only birth-control method that protects against STDs—just 20% of the time with casual partners.)gt;gt; What does this mean for you? Even if it’s been years since you thought about the letters S, T, and D, you should ask your gyno to test you, especially if you’ve had unprotected sex or multiple partners. While you may think you’ve been swabbed for everything under the sun, "everything" means different things to different docs, Dr. Castaño notes. "Trich is easy to treat," Gaydos adds, "but it’s also easy to miss."gt;gt;The good news: That’s a mistake MDs shouldn’t make anymore. Last April, a new, much-more accurate test came out that detects more than 95% of cases, Gaydos says. "I’m hoping the test"—which can be run on urine samples, Pap smears, or cervical swabs—"will mean that more doctors will regularly start to look for trich."gt;gt;gt;]]> Veronique Beranger/Getty Images

gt;Your yearly visit to the gynecologist is critical to your health—period. What's also key: going in with a list of specific questions, so your gyno can tailor her recommendations to your needs, says Jill Maura Rabin, MD, a spokeswoman for the American Congress of Obstetricians and Gynecologists. To get more out of your time in the stirrups, consider discussing these important findings with your doc.gt; gt;gt;Update #1: New relief for heavy periodsgt;gt;gt;gt;If you have menorrhagia—periods so heavy and painful they interfere with daily life—your gyno may have suggested going on the Pill or taking some other hormonal medication. If that didn't work, your only other option was surgery, from endometrial ablation (which destroys the uterine lining) to a hysterectomy (total removal of the uterus). Now there's a new nonhormonal way to lighten the flow: tranexamic acid, a prescription drug that works by stabilizing a protein that helps blood to clot. While the drug does carry a risk of side effects, such as unwanted clotting, Dr. Rabin says it's "a great option for women who can't or don't want to take hormonal treatments."gt; gt;gt;Update #2: A surprise upside to hormone therapygt;gt;gt;gt;Talk about confusing: First, gt;hormone replacement therapygt; (HRT) was hailed as a miracle drug that might not only ease menopause symptoms, such as hot flashes and insomnia, but also reduce the risk of gt;osteoporosisgt; and gt;heart diseasegt;. Then the landmark Women's Health Initiative (WHI) study found that an HRT treatment of estrogen plus progestin increased the stroke and breast cancer risk in some women. But in April, a WHI report yielded some good news: For one group—postmenopausal women in their 50s who'd had a hysterectomy—taking an estrogen-only form of HRT for up to six years lowered the rate of breast cancer without increasing any other risks. If you're seeking relief from menopause, talk to your doctor about HRT's pros and cons—whether you still have your uterus or not.gt; gt;gt;gt;Update #3: Beat fibroids without surgerygt;gt;gt;gt;Fibroids—or benign tumors in the uterus—don't always cause symptoms. But for an unlucky minority, they can lead to heavy bleeding, pain, and even infertility. Hysterectomy is a traditional treatment for the condition, but a recent study shows that two less-invasive options preferred by patients can help them just as much. One, called uterine artery embolization, involves injecting particles into the arteries supplying blood to the gt;fibroidsgt; to block them. The other, a focused ultrasound, heats and kills fibroid cells. "Though all treatments may not be suitable for all patients, they all lead to a significantly improved quality of life," says lead author Fiona Fennessy, MD, a radiologist at Brigham and Women's Hospital.gt; gt;gt;Update #4: You may need even more folic acidgt;gt;gt;gt;Sure, you know you need folic acid right before and during pregnancy to help prevent neural-tube defects, such as gt;spina bifidagt;. Since 1996, many common foods, like breads and pastas, have been fortified with this B vitamin. But you still may not be getting enough. While fortification has cut spina bifida rates in half, "many women now miss out on fortified foods because they're cutting back on carbs," says OB-GYN Diana Ramos, MD, consultant to the March of Dimes. Even if you're a carb addict, she says, not all the folic acid from food is absorbed by your body—and you need it in your system at least a month before you conceive to reap the benefits. Play it safe by taking a multivitamin with at least 400 milligrams of folic acid even if you're not pregnant or trying (half of all pregnancies are unplanned!); bump it up to 600 milligrams if you are.gt;]]> Rennie Solis

gt;gt;Last year, a string of restless nights sent the 46-year-old insurance agent from Lineville, Ala., to his doctor. After a blood workup, Coleman was informed that his gt;testosteronegt; levels were below normal, and were likely to blame for the symptoms he'd been experiencing.gt;gt;"It made sense," he says. "My energy levels were not what they used to be. But you kind of think, ‘How could this happen to me?' "gt;gt;Coleman's condition isn't all that rare. Quite a few men—up to 25%—have testosterone levels that fall below normal in middle age, and in some cases this transition causes a collection of symptoms that has come to be known as "male menopause" (or "manopause").gt;gt;"Testosterone levels gradually decline with aging, usually around age 40," says Alvin Matsumoto, MD, a professor of geriatric medicine at the University of Washington School of Medicine, in Seattle. Although the decline is natural, Dr. Matsumoto adds, "that doesn't mean it has no physiological or clinical consequences or shouldn't be treated."gt;gt;More and more doctors seem to agree. Between 1999 and 2008, the number of prescriptions filled in the U.S. for testosterone gels, shots, and patches—the first-line treatment for most men—increased by more than 400%, to 3.3 million.gt;gt;Testosterone treatments in men of middle age and older are largely unproven, however, and they carry a risk of serious side effects. The sharp increase in their use has led some experts to wonder whether testosterone is being over-prescribed—and whether the so-called male menopause needs to be treated at all.gt;gt;gt;gt;How common is it?gt;gt;Male menopause—or late-onset hypogonadism, as the condition is officially known—earned its nickname for a reason. It resembles the changes fortysomething women undergo, and the most common symptoms include a flagging libido, hot flashes, fatigue, weakness, insomnia, moodiness, and weight gain, all of which are also well-known symptoms of (female) menopause.gt;gt;But the comparison only goes so far. Unlike the relatively swift changes that occur during menopause, testosterone in men tends to decline slowly over many years and isn't always noticeable. Only a fraction of men with low testosterone develop problematic symptoms, whereas most menopausal women experience at least a few hot flashes.gt;gt;While as many as 25% of men 30 and older have low testosterone levels, only about 5% experience symptoms severe enough to warrant testosterone therapy. Although the symptoms are rare, many doctors have begun testing more middle-age men for low testosterone. This trend has led to wide-ranging—and perhaps inflated—estimates of how common male menopause is, says David Zahaluk, MD, a family medicine physician at Baylor Medical Center, in Carrollton, Texas.gt;gt;And it's not always clear that low testosterone is to blame for the symptoms that plague the 5% of men being treated, because they can be easily confused with those stemming from other health problems, such as stress, depression, or heart disease. "When you come in and say, ‘I'm tired,' there are so many [potential] causes," says Dr. Zahaluk, who recommends a gt;testosterone testgt; as part of an annual physical. "It may well not be low testosterone, but it won't be checked unless there's awareness of it."gt;gt;Earlier this year, for the first time, researchers in Britain tried to pinpoint the symptoms that are most closely linked to low testosterone. Only three—gt;erectile dysfunctiongt;, fewer morning erections, and fewer sexual thoughts—were reliably connected to testosterone levels, the researchers found. Six others—including low energy, fatigue, and difficulty engaging in physical activity—were linked less closely or not at all to low testosterone. The study concluded that far fewer men than previously thought—only about 2% of men between the ages of 40 and 80—are actually experiencing something that can be called male menopause.gt;gt;This and other research suggests that treatment is called for only when low testosterone and menopause-like symptoms occur together, says Dr. Matsumoto. "For a long period of time, people have treated individuals with only a low testosterone level," he says. "Only more recently has it been appreciated that treatment should only be considered in men with symptoms and signs of low testosterone as well as consistently low levels."gt;gt;gt;gt;To treat or not to treatgt;gt;The FDA first approved testosterone treatments for men with very low levels of testosterone caused by specific medical problems, such as testicular cancer. Studies over the years have concluded that testosterone therapy is effective for these—typically younger—men, but the value of treating men with age-related testosterone loss is still uncertain. The few studies that have been conducted in older men have yielded mixed results about the benefits and risks of this treatment.gt;gt;That hasn't stopped older men from wanting to be treated—or doctors from treating them. A man with very low testosterone and numerous symptoms—he's lost his libido, can't have sex, is tired all the time, and has no strength—fits the bill for treatment regardless of age, says Dr. Matsumoto. "There isn't any evidence to treat older men like this, but from what we know about younger individuals who have been treated with a combination of these symptoms and signs and very low testosterone levels, we would expect some benefits," he says.gt;gt;Dr. Matsumoto helped draft a set of updated guidelines for testosterone therapy that were released in June by the Endocrine Society, a professional organization focused on hormone research. He and his colleagues discouraged the general use of testosterone therapy in older men with low testosterone levels unless their levels were consistently low and they complained of significant physical and sexual symptoms. gt;gt;It's important for patients to discuss the risks and benefits of therapy with their doctors before making a decision, Dr. Matsumoto says. Monthly testosterone treatment can range from $50 to $200, depending on the method used and how frequently treatment is required, so men with relatively mild sexual and physical symptoms may be better off saving their money.gt;gt;gt;gt;Side effects, big and smallgt;gt;The cost didn't deter Coleman, who first tried a daily testosterone patch (which he found annoying), and then monthly shots (which he found uncomfortable). Discomfort aside, Coleman did start to feel better on the shots. He slept better, was less grouchy, and also noticed an increase in his libido—at least at first. But after about four to six months, he started to get mild headaches and noticed a spike in his weight after each shot. gt;gt;"I was dieting, so I'd get down to about 190. And then after I'd have my shot, I might put on 4 to 6 pounds in a week or two, for no apparent reason," he says.gt;gt;These reactions aren't uncommon and can be a nuisance, but there are graver potential side effects. Testosterone therapy can cause the body to ramp up red blood cell production, throwing off circulation and increasing the risk of heart disease and stroke. And although a link hasn't been proven, it may even up the risk of prostate cancer. "Even in the absence of any evidence, you have to inform patients that's a potential risk because of the experience in women with estrogen replacement and breast cancer," says Dr. Matsumoto.gt;gt;Because of these potential risks, doctors closely monitor the patients receiving treatment. If their bodies don't absorb testosterone or maintain the effects of treatment, some are even advised to stop replacement therapy. "That's not the majority of cases, but it does happen," says Dr. Zahaluk.gt;gt;It's far more common for men to stop testosterone therapy because it’s just not working for them. That was true in Coleman’s case. He ultimately abandoned his treatment when it failed to boost his testosterone levels into the average range. "I didn’t see that I was getting so much benefit as opposed to what I was having to put up with,” he says. ]]> Getty Images

gt;gt;It's not for lack of trying by pharmaceutical companies. Even before Viagra hit the shelves in 1998, the search was on for a drug that could ramp up women's sex lives. But more than a decade later, still nothing.gt;gt;The latest disappointment is flibanserin, a contender to be the first approved drug that enhances sexual desire in women. A Food and Drug Administration advisory panel recently reviewed this experimental drug, and advised against its approval. (The FDA usually follows the advice of such panels.) The modest increase in women's sexual satisfaction did not outweigh the side effects, which include fatigue and depression, the panel said.gt;gt;Some women do have sexual dysfunction. The problem, experts say, is often a lack of desire for sex rather than the ability to perform it, which would be akin to male sexual dysfunction. In fact, some experts object to the gt;creeping medicalizationgt; of women's sexual dysfunction, and say there's a potential to overdiagnose women with hypoactive sexual desire disorder (HSDD), a condition characterized by low sexual desire, to the point it causes distress.gt;gt;Karen M. Hicks, PhD, an adjunct professor at Lehigh University, in Bethlehem, Pa., and a founding member of the Consortium for Sexuality and Aging, says a lack of sex drive has been "framed by the medical community as a disease state that you need to be, or could be, cured from with a pill," says Hicks. For many women, however, sexual problems may be better treated with therapy or other approaches. "Taking a pill is the easy way out," she says. gt;gt;Although experts agree that women could get sexual healing from a pill, they're not sure how many women are actually in this group. The fact is that even if there were such a drug on the market, it's unlikely to be a one-size-fits-all cure like Viagra is for men with erectile dysfunction.gt;gt;gt;gt;What's killing your sex drive?gt; gt;About one in 10 women overall in the U.S. experience some type of HSDD, based on nationwide surveys conducted in 2006 and 2008, which were funded by pharmaceutical companies."Ten percent is a good estimate," says Sheryl A. Kingsberg, PhD, a clinical psychologist and chief of behavioral medicine at University Hospitals Case Medical Center, in Cleveland.gt;gt;There is no such thing as a "normal" sex drive that dictates how often women should want to have sex, says Kingsberg. But low sex drive can become a problem if there is a "relative change in what a women thinks is normal in her own life."gt;gt;In addition to HSDD, there are two other common sexual issues in women—arousal and orgasmic disorder. In the 2006 survey, about 5% of women reported that they had trouble getting physically aroused or having orgasms.gt;gt;So how do you know what's killing your sex drive, and whether you can fix it? If you feel frustrated by a low sex drive, the most important step is to talk to a doctor, says James A. Simon, MD, a clinical professor at George Washington University and medical director of Women's Health and Research Consultants, in Washington, D.C. A 2009 survey found that about two-thirds of women did not bring up sexual problems at doctors' visits because they were embarrassed or felt their doctor wasn't interested. gt;gt;Dr. Simon says that it is difficult to delve into the topic in the last few minutes of an appointment because the diagnosis is complicated, and other medical and psychological conditions may be involved. gt;gt;Sharon Parish, MD, an associate professor of clinical medicine at Albert Einstein College of Medicine, in New York City, says it's "a really good idea" to make a specific appointment to address sexual problems instead of trying to talk about it during your regular appointment.gt;gt;The cause of a lack of desire may vary with age. Like HSDD, arousal and orgasm problems are not uncommon in women between ages 45 and 64. In this group, hormonal changes that occur around menopause are the usual culprits of sexual dysfunction. Drugs like flibanserin purport to tweak the levels of brain chemicals to spur an interest in sex. However, they would probably do nothing for other common causes of low sexual desire: fatigue, depression, and low self-esteem. gt;gt;Dr. Simon says that if you're more interested in sex when you're on vacation and caught up on sleep, fatigue may be the cause of low sexual desire. In those cases, making lifestyle changes or counseling may be more likely to get your mojo back than a pill that alters brain chemicals. And sometimes medications, such as birth control pills or antidepressants, can gt;suppress sex drive too.gt; gt;gt;"I have no doubt that some women will benefit from drugs [like flibanserin]," says Dr. Simon. But "I've got to eliminate all of the other stuff first to see if my patient really has HSDD." gt;gt;gt;gt;Treatments available now gt;gt;Depending on the cause of sexual dysfunction, the therapies pioneered in the 1960s that teach patients to feel positively about sex are still some of the go-to treatments for women with HSDD, especially those who have had long-term low sexual desire. "I absolutely believe that the best therapy is sex education, where people become more comfortable with their own sexuality and knowledgeable about their anatomy," says Hicks.gt;gt;Hicks also recommends couples counseling to patients who have relationship problems to help them work on communication or becoming a better lover.gt;gt;This form of therapy could also serve women with medical conditions that commonly erode sexual desire: diabetes and thyroid problems. These conditions "affect weight and body image, which could impact a woman's desire," Dr. Simon says. "In some cases, I would recommend therapy or maybe a trip to the gym." Urinary incontinence is also frequently associated with embarrassment and low sexual desire.gt;gt;In addition to these triggers, experts like Kingsberg suspect that physiological changes, such as hormonal levels, can directly lead to HSDD. "For biologic causes of low sexual desire, unfortunately, there are no FDA-approved pharmacologic options to treat HSDD," she says.gt;gt;Levels of testosterone, an enhancer of sex drive, dip in women after menopause. One treatment is the off-label use of testosterone in post-menopausal women or women who have had their ovaries removed (surgical menopause). This hormone promotes the release of dopamine, which is a key neurotransmitter for enhancing sexual desire.gt;gt;"It can make empirical sense to try three months of testosterone [therapy] in post-menopausal women," Kingsberg says, adding that about 20% of testosterone prescriptions are written off-label for women. While she says the side effects of testosterone therapy are "usually mild" and include oily skin and thinning hair, its long-term safety has not been well studied. gt;gt;gt;gt;Other drugs in the pipelinegt;gt;Like testosterone, flibanserin seems to promote the dopamine pathway, based on studies in animals. However, these studies suggest that flibanserin acts at a different point in the dopamine reaction. gt;gt;Dr. Parish says that many of her patients feel that treatments like flibanserin are a ways off, and, so far, all signs suggest that the drug will be rejected at an FDA hearing coming up in the next few months. In the clinical trial, pre-menopausal women receiving flibanserin for six months had a moderate increase in the number of reported sexually satisfying experiences compared with the placebo group. But unexpectedly, the women who received the treatment did not notice a difference in their level of sexual desire.gt;gt;If this drug is rejected, Hicks expects that Boehringer Ingelheim, the maker of flibanserin, will next test its effect in post-menopausal women. Even with an FDA rejection, Hicks predicts that pharmaceutical companies would continue their "race to the finish line for the first female drug [for sexual dysfunction]."gt;gt;Currently, the only other drug that could be close to filing for FDA approval is LibiGel, a testosterone cream made by BioSante Pharmaceuticals. Women apply the cream to their arm, where it gets absorbed and enters the bloodstream. In an early clinical trial, LibiGel increased the number of sexually satisfying events in surgically menopausal women by 238%, and the company is now looking at the safety of the cream in women using it for a year.gt;gt;Kingsberg thinks that no single drug is likely to work for all women whose low sexual desire stems from hormonal levels. Having drugs with different effects on neurotransmitters could be important. gt;gt;"We don't really know what the exact neurotransmitter or hormone needs to be," she says, "I don't think it's a one-size-fits-all [but] fine-tuning the best option for each woman." ]]> Getty Images

gt;You probably don’t need a Pap every year.gt; gt;Women ages 30 and up who’ve had three consecutive normal gt;Pap smearsgt; (which screen for gt;cervical cancergt;) can go three years before their next, according to the latest guidelines from the American College of Obstetricians and Gynecologists. “These new guidelines basically try to keep things safe without doing a lot of overkill (too many Pap smears) for low-risk women,” says Jubilee Brown, MD, an associate professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center.gt; “The chances of developing cervical cancer in that window of time are extremely low, because the gt;human papillomavirusgt; (HPV) has a long latency period between infection and causing any abnormalities,” Dr. Brown explains. Just don’t go more than three years between Paps—60 to 80 percent of women diagnosed with invasive cervical cancer haven’t had a Pap in the past five years.gt;gt;gt;gt;An HPV test helps docs screen for cancer.gt;gt;Getting an HPV test along with your Pap smear as part of your cervical cancer screening regimen may help your doctor diagnose abnormal cell growth earlier, a recent study in The Lancet Oncology suggests. (The test determines whether you carry any of the 13 “high-risk” types of HPV most likely to cause cervical cancer.) Experts agree that the HPV test should accompany—not replace—Pap screening, since the test will show if you have HPV even if it hasn’t caused any abnormal cell changes. That means it could lead to false positives and unnecessary follow-up tests if done alone, especially in younger women. (While 75 to 80 percent of us have been exposed to HPV at some point in our lives, our immune systems clear it up in the vast majority of cases, says Bobbie Gostout, MD, chair of the obstetrics and gynecology department at the Mayo Clinic.) Ask your doctor if she’s running the test as part of your primary screening—some do, while others run it only if Pap results are abnormal. gt;gt;gt;gt;The HPV vaccine may work for older women, too.gt;gt;The vaccine gt;Gardasilgt;—which protects against the four types of HPV responsible for most cases of cervical cancer and genital warts—is currently approved by the Food and Drug Administration (FDA) for ages 9 to 26. (A newer vaccine, gt;Cervarixgt;, is also approved only for girls and young women.) But research shows that Gardasil may also be nearly 90 percent effective in women up to age 45. As of this writing, the manufacturer has asked the FDA to extend approval for the vaccine’s use accordingly. gt; “You need to have a frank talk with your health-care provider,” Dr. Gostout says. “As a doctor, I’d ask about the number of sexual partners the woman has had, the likelihood of exposure to new partners in the future, any history of abnormal Pap tests, and if she smokes, since smoking puts her at risk for not clearing the virus if she’s exposed.” Concerned about safety? The Centers for Disease Control and Prevention has investigated reports of adverse effects linked to Gardasil and considers the vaccine safe as approved.gt;gt;gt;Ovarian cancer can be caught early if you know the symptoms.gt;gt;Of all gynecologic cancers, ovarian cancer is the number-one killer—and it’s so deadly because it often goes undetected until a late stage. That’s why for many years women have been urged to be on the lookout for signs of this disease, including bloating, frequent urination, and abdominal pain or pressure. (Menstrual-type cramps aren’t considered a typical ovarian cancer symptom.gt;In general, however, any pelvic discomfort that’s unusual for you is worth getting checked out by your doctor.) But recently, researchers calculated that only 1 out of 100 women evaluated for symptoms like these would actually have ovarian cancer. That doesn’t mean you should dismiss those signs as nothing, though. “If you have more than one of these symptoms, and they’re occurring daily and getting worse day after day for two weeks, you should contact your doctor,” says Beth Karlan, MD, director of the Women’s Cancer Research Institute at The Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center in Los Angeles. As for lowering your odds of developing ovarian cancer, women who take birth control pills for five or more years have a 50 percent lower risk than those who have never taken the Pill.gt;gt;gt;Losing weight may lower your uterine cancer risk.gt;gt;With the rise in obesity rates, more women under 40 are being diagnosed with uterine, or endometrial, cancer, according to Dr. Brown. (Being overweight puts you at much higher risk for this disease—the most common, but also one of the most curable, of reproductive cancers—because estrogen is made in fatty tissue, and over time it can stimulate cell growth and abnormalities in the uterine lining.)gt; If you experience any significant changes in your menstrual bleeding—or you’re postmenopausal and have any bleeding (even pink staining)—tell your doctor. The good news? “There are options for treatment of early endometrial cancer that can preserve fertility; it doesn’t always mean a hysterectomy,” Dr. Brown says. To lower your risk, drop those extra pounds and exercise regularly. As with ovarian cancer, taking birth control pills may also reduce your risk. ]]> Getty Images

gt;gt;To some, saying you have a sex addiction is a bit like saying you’re addicted to the gym or eating cookies; it’s an innocent exaggeration. Add in the fact that many experts aren’t convinced either—sexual addiction is not formally recognized in the bible of psychiatry, The Diagnostic and Statistical Manual of Mental Disorders (DSM)—and the diagnosis smacks of a philanderer’s last-ditch grasp at redemption.gt;gt;While sex may indeed be akin to drugs in its ability to bring on serious gt;relationship wreckinggt; and life-altering (not in a good way) behavior, it is not supported by the same hard evidence that proves addiction, says Charles O’Brien, MD, the chair of the substance-related disorders work group for the American Psychiatric Association, which will publish the DSM-V, the fifth version of the manual.gt;gt;"Drugs activate [an addict’s] brain’s reward system directly, like getting food or water," says Dr. O’Brien, a professor of psychiatry at the University of Pennsylvania. "It could be that there are some similarities in those people who are called ‘sex addicts,’ but it hasn’t been studied or demonstrated."gt;gt;Sexual behavior that might elsewhere be called addiction will instead fall into a new DSM category called hypersexual disorder. Many of the symptoms are similar to what mental health providers consider sex addiction.gt;gt;But until larger studies are conducted by evaluators who don’t have a hand in providing treatment, there just isn’t enough proof. "Good evidence that it should be classified with addictions doesn’t exist," says Dr. O’Brien. "Established professionals won’t use that term."gt;gt;Still, addiction therapy and rehab programs are booming, and patients swear by their treatment. Despite the debate over the diagnosis, sex addiction counselors say there are distinct differences between the sexually addicted and people who just love sex.gt;gt;gt;gt;Sex as a coping mechanismgt;gt;"Individuals who act out sexually are usually doing so because they do not want to feel their feelings," says Maureen Canning, a licensed marriage and family therapist and the clinical consultant for sexual disorders at the Meadows Dakota, a sexual addiction recovery center in Arizona. "They’re using this as a way to get high, just like taking a drink or snorting a line of coke. They use their sexuality as a means of escape."gt;gt;Often sexual addiction has some basis in childhood experiences that have affected sexual development, says Canning. "It depends on how profound those experiences are and how the individual processes that," she says. "It could be traumatic for one child and not for another."gt;gt;About 25% of male sex addicts have experienced overt sexual traumas like sexual abuse or incest during their childhood, says Robert Weiss, a licensed clinical social worker and a certified sex addiction therapist who founded the gt;Sexual Recovery Institutegt;, an intensive out-patient treatment center in L.A. About 75% of female sex addicts have had a similar experience, he adds.gt;gt;The addiction is less about sex and more about the obsessive behavior pattern that accompanies it, says Weiss. Sex addiction is similar to gambling, over-exercising, and impulsive spending, which are known as process addictions—addictions to a set of rituals rather than to a mood-altering substance.gt;gt;"Neurologically, acting out or thinking about acting out [sexually] releases dopamine, serotonin, and adrenaline, creating a chemical cocktail in the brain that is extremely pleasurable," says Canning. "It creates a euphoria."gt;gt;This euphoria keeps them coming back for more. "It’s a lot more fun to look forward to than the day-to-day stuff that life brings—dealing with the finances or struggling with the kids," says Weiss. "Most [addicts] have difficulty tolerating day-to-day stressors and use fantasy and intense arousal to distract themselves."gt;gt;Research suggests that about 75% to 80% of sex addicts are men. Weiss says the typical client at his treatment center—where therapists see 150 clients a week, for two-week-long periods—is a heterosexual man in his late 30s who’s been married for 8 to 10 years and has two kids under the age of 5.gt;gt;gt;gt;Could you be a sex addict?gt;gt;Addicts often say they’ve experienced potentially life-altering—even life-threatening—consequences of their behavior, according to gt;SexHelp.comgt;, created by psychologist Patrick Carnes, PhD, a leading author in the field.gt;gt;Almost 70% have exposed themselves to AIDS and other sexually transmitted diseases, and 40% have had unwanted pregnancies. More than 70% have reported thoughts of suicide, and 17% have actually attempted to end their lives. Often the consequences worsen over time as the behaviors continue.gt;gt;However, when faced with the negative consequences of their behavior, many addicts still don’t want to stop. Even if they do want to stop, they often find they can’t.gt;gt;Addicts may move to a new house, thinking a fresh start will stop their behaviors, or get married, thinking a stable home life will curb their desire for sex. Some even turn to religion, but the behavior is likely to come back without treatment, according to SexHelp.com.gt;gt; A spouse or partner of a sex addict is likely to notice an emotional distancing, and a decrease in sexual intimacy in the relationship. And people may find their behavior has caused them to lose close friends, compromise their values, lie to those closest to them, or put themselves in serious danger, says Canning. "We [have] them look at where their life is today when they start [treatment] to help them see how much their behavior is encroaching on what they thought was important in their lives," she says. "Often they will start to see that it’s more of a problem than they thought."gt;gt;gt;gt;Treating sex addictiongt;gt;Therapists gather and analyze this information to help understand if a person’s behavior is a sign of addiction. Although sex addiction is not currently a psychiatric diagnosis like other addictions, Canning says therapists treat it like one by comparing behaviors to the list of criteria used to diagnose chemical dependency.gt;gt;Most treatments follow a typical 12-step model, just like Alcoholics or Narcotics Anonymous. Addicts can attend meetings through Sex Addicts Anonymous, spend a week at a rehab facility, or meet with licensed therapists in private practices.gt;gt;But treatment should not be viewed as a quick fix. "I don’t think you come to us and you’re never going to do it again," says Weiss. "What we can do is really spoil the behavior for someone, so they will never go see a prostitute or go to a massage parlor and say it was no big deal again. It will never be the innocent fun thing that they think they can get away with."gt;gt;Addicts re-learn crucial parts of healthy relationships, like how to foster friendships and how to interact with family in a healthy way, as well as new coping mechanisms for stressful situations that don’t involve sex, like how to put in extra hours at work "before it makes you want to stop at the adult bookstore on the way home," says Weiss.gt;gt;As with alcoholics, however, relapse is a slippery slope. Addicts need to make lifestyle changes that support their emotional, mental, and behavioral treatments. "You may need to travel with your wife and children, or [only] when you can come home at the end of the day," says Weiss. "You can’t go out with a whole bunch of guys anymore. Other guys can do that because they can walk away. [Addicts are] vulnerable to doing this again for the rest of their lives." ]]> Getty Images

gt;gt;I had long affairs. I wanted sex, but I also wanted somebody’s soul, in this really ego-driven way. My life was a constant juggling act of at least two men, making sure they didn’t find out about each other. I was unfaithful to every boyfriend I ever had. gt;gt;I thought that getting married would cure me. I hoped that I would never look at anyone else but my husband again. I remember praying the week of my wedding, “God, please let me be faithful.” Two weeks later, I started looking around. I got married in January 2000 and by April I was in a full-blown affair. gt;gt;Overall, while I was married, I had two 2-year affairs with only a four-month break in between the affairs. gt;gt;I felt like I got love from my husband, but as the intimacy level went up, my sex interest went down. My husband was really good-looking, nice, smart, funny—everybody says he’s such a great guy—but because he was so familiar I was tired of him. I’m just sort of wired wrong. Other women get turned on by a romantic date with their husbands. Me? I wanted to have sex if I had 10 minutes and there was a broom closet nearby. If we were in a fight and I wasn’t sure if he was going to stay with me, that’s when I felt really aroused. I’ve spent the last six years trying to rewire my brain when it comes to sex. gt;gt;We all have things in our past that set up a template that informs our sexual preferences later in life. That’s why some guys are turned on by schoolgirl uniforms or some people like spanking; something happened in their childhood that set them up for that. When I was young, I was sexually abused in a very large house, probably six rooms away from my dad. So what got me really excited was acting out with my boyfriend when my husband was probably 50 or 60 feet away. gt;gt;gt;gt;Marriage didn’t cure megt;gt;We’re the same as heroin addicts; it just usually takes us longer to get caught because the symptoms aren’t as noticeable. You can tell when an employee is coming into work high or drunk, but it’s harder to identify sex addiction. Most of us are very productive and good at our jobs. We’re compulsively efficient. We’re clever, manipulative, and a little evil. I never touched drugs or alcohol; sex was my drug of choice. I thought I was better than other addicts. The truth is that I was not. gt;gt;Before I got married, in the 1990s, I went to two therapists and told them exactly what was going on. They didn’t understand what they were dealing with. It was like how therapists in the 1930s told alcoholics to drink less. They told me I should masturbate instead of being unfaithful to boyfriends. They didn’t understand that’s just not possible. Today it seems ridiculous, because now a therapist would never say something like that, but I’ve heard the same story from a lot of people. gt;gt;I got caught when my husband found a bunch of sex emails between me and my boyfriend. He Fed-Exed the emails to my grandmother, my parents, and my brother, saying, “I’m filing for divorce from Jennifer, and here’s why.” It was very clear through the emails that we were having a very sexual relationship. I said all sorts of things because it never occurred to me anyone else would read them. I remember telling my dad that I really loved my husband and wanted it to work. He said, “Well, it’s hard to tell.” gt;gt;My husband confronted me and asked me over and over again, “Why did you do this, why did you do this?” I don’t remember ever hearing the words sex addict before that moment, but they just popped out. I said, “Because I’m a sex addict!” I remember thinking, I wonder if that’s true? I was so used to lying that I would just say things like that. I went home and bought a book by Patrick Carnes, PhD, called , and I read it and realized it described me through and through. gt;gt;gt;Getting helpgt;gt;Just being able to say “I’m a sex addict” was such a powerful beginning. Naming it was scary and upsetting, but at least I finally knew what to do. I decided to go for eight weeks of treatment at the Meadows because Carnes was the clinical director at that time. My family was incredibly supportive. But I still feel like they never needed to know about any of it; they never wanted to know about any of it. Then I started attending gt;Sex Addicts Anonymousgt;, worked the steps, and tried to get sober. gt;gt;The first meeting I ever went to I was really lucky because I immediately identified. I knew I belonged there and that these were my people. The meetings are always predominantly male, but we have started a female-only meeting because there are just some things you can only talk about in front of women. Working the 12 steps is really what got me sober and has helped me stay sober to this day. I continue to go to meetings and work with my sponsor, and I also sponsor other women. I try to do all I can to help still-suffering addicts. gt;gt;After I got sober, my husband and I tried to make a go of it. We lasted another two and a half years before we got divorced. There was just too much damage done. gt;gt;I will always be a recovering sex addict. That’s true of most sex addicts. We believe sex is the most important need, more important than food. If my partner says he doesn’t want to be sexual with me, I read that as he doesn’t love me. It’s been hard to retrain myself to realize that it doesn’t mean I’m not worthy, but just that he’s tired and has had a long day. Now when I have sex, I’m present for it. I’m there with the person that I’m with. But it’s been really hard to reprogram my brain to think like that. ]]> Sex Addicts Anonymous is a 12-step program that can help. Getty Images

gt;gt;The health effects of BPA have been hotly debated; although some studies have linked BPA to a risk of brain damage, birth defects, hyperactivity, heart disease, early puberty, obesity, and prostate cancer, other research suggests that the low level of exposure from plastics doesn’t pose a health risk to adults. (The picture is less clear for children.)gt;gt;Part of the problem is that much of the research has been conducted in mice and other animals, and its validity in humans is controversial. Although not conclusive, the potential health effects have caused some baby-bottle and water-bottle manufacturers to stop using the chemical, at least in part because of public concern. (BPA is not found in soft, pliable plastic used in most water bottles).gt;gt;Now, the new study—one of the first to be conducted in humans—seems to support a finding previously reported only in animal research.gt;gt;Among the men who work with BPA, the risk of having difficulty ejaculating was seven times greater than it was among the non-exposed group, and the risk of erectile problems was more than four times greater. The BPA-exposed workers also reported higher rates of low sex drive and lower overall satisfaction with their sex lives, according to the study, published this week in and funded by the National Institute of Occupational Safety and Health.gt;gt;Researchers compared the rates of sexual dysfunction in two groups of workers in China—230 men who worked at factories that produce BPA or epoxy resin (which contains the chemical), and some 400 men, including workers in other industries, who were not exposed to abnormally high levels of BPA. Epoxy resin is used in the lining of canned foods and is another potential source of BPA in addition to hard, clear plastic.gt;gt;gt;The men who worked in the BPA and epoxy-resin factories were exposed to levels about 50 times higher than average.gt;gt;The greater a worker’s exposure to BPA—which was measured using spot air and urine samples—the more likely he was to have sexual dysfunction. Yet the dysfunction was apparent even in workers who had worked in a BPA factory for one year or less.gt;gt;"This was a very compelling study," says Rebecca Sokol, MD, the director of the andrology program at the University of Southern California's Keck School of Medicine, who specializes in the effects of toxins on the reproductive system. "It's not cause and effect, but when you have the kind of ambient air quality assessment that they made, it comes pretty close to cause and effect."gt;gt; In the past, the scientists and industry representatives who have argued that BPA is safe at the low level of exposure that occurs for most people have pointed to the lack of BPA research in humans, says the lead author of the study, De-Kun Li, MD, PhD, a reproductive epidemiologist at Kaiser Permanente's Division of Research, in Oakland, Calif.gt;gt;"They keep arguing, 'Where's the human data? Where's the human data? You can't extrapolate animal studies to humans,'" Dr. Li says. "Which is true, sometimes. But now we have human data."gt;gt;The findings of Dr. Li and his colleagues are consistent with the hypothesis that BPA, when it enters the body, can mimic the effects of estrogen and may block male sex hormones (including testosterone). The study has implications beyond male sexual dysfunction, however, since sexual dysfunction is often associated with broader reproductive health problems.gt;gt;And the fact that a health effect observed in animal studies has been seen in humans, says Dr. Li, suggests that the other findings of animal studies—an increased risk of cancer and obesity, for example—need to be taken more seriously. “We cannot dismiss them anymore," he says.gt;gt;gt;Experts caution that the results need to be replicated in other studies, and also in the United States.gt;gt;The study “opens a new front in [BPA] research,” says Peter Myers, PhD, a BPA expert and the chief scientist at Environmental Health Sciences in Charlottesville, Va. “But as is absolutely necessary when a new front like this is opened up, we need to see replication.”gt;gt;It’s unclear, for instance, whether the everyday exposure to BPA that people receive from food packaging and other plastics is significant enough to produce the sexual dysfunction seen in workers who were inhaling the chemical all day.gt;gt; The BPA levels measured in the study were "extraordinarily high," says Dr. Sokol, and they may have little or no relevance to "somebody drinking water out of a bottle."gt;gt;But, she adds, "We need to be prudent and cautious about whether this chemical actually is impacting reproduction. People have to stop and say, 'Whoa, now we're starting to get data in animals that is manifested in humans.'"gt;gt;The study did have some weaknesses. It was relatively small for an epidemiological study, according to Dr. Sokol, and the rate of erectile difficulty among the BPA workers was still relatively low overall—a little more than 15%.gt;gt; This study comes amid mounting concerns over the safety of BPA from consumers, scientists, and public officials. In the summer of 2009, Canada said it was moving towards a ban on the sale and import of BPA-containing baby bottles. A number of states and cities, including Minnesota and Chicago, have passed similar bans or have taken steps to do so. Several companies have also announced that they will voluntarily phase out the chemical from their products.gt;gt;The U.S. Food and Drug Administration (FDA) is also in the midst of reconsidering its stance on BPA. In August 2008, largely on the basis of research funded by the chemical industry, the agency issued a draft assessment on the safety of BPA in food packaging, concluding that "an adequate margin of safety exists for BPA at current levels of exposure" from those sources.gt;gt;The FDA report caused an uproar in the scientific community and was soon contradicted. The National Toxicology Program (NTP), a federal agency that advises the FDA on chemicals and other environmental toxins, released its own report expressing "some" concern about the potential effects of BPA on the brains, behavior, and prostate glands of fetuses, infants, and children, as well as "minimal" concern about earlier puberty for girls.gt;gt; The NTP classified its concerns over reproductive effects from workplace BPA exposure as "minimal."gt;gt;Soon after, the FDA's own Science Board released a report that cited the FDA's exclusion of a large number of animal studies on BPA, and concluded that the agency may have overestimated the safety of the chemical. Following the release of these reports and a spate of media attention, the FDA announced that it would reconsider its assessment. In mid-August 2009, the agency indicated that it will continue to review the research on BPA effects in humans and will "decide next steps" by the end of November 2009.gt;gt;Although the study of Dr. Li and his colleagues isn’t likely to drastically change the course of the debate (additional studies will be needed for that to happen), it will help keep the spotlight on the health effects of BPA.gt;gt;“This study forces some new questions into the arena that need to be answered,” says Myers.]]> Getty Images

gt;sexually transmitted infectionsgt; such as gt;genital herpes and human papillomavirus (HPV)gt;, but not syphilis.gt;gt; This finding—published in a March, 2009 issue of the —adds to the evidence that there are health benefits to circumcision, the surgical removal of the penis foreskin, usually performed on newborns shortly after birth. It was already known that circumcision can reduce the risk of penile cancer, a relatively rare disease, as well as the risk of gt;HIV infectiongt;.gt;gt;But in the United States, newborn circumcision is an elective procedure, and rates are declining. In 1999, the American Academy of Pediatrics reviewed evidence of the potential risks, benefits, and costs of circumcision, and declined to recommend the procedure for all newborns.gt;gt;Circumcision should never be performed strictly because it seems to reduce the risk of sexually transmitted infections, experts agree, and it's important to note that circumcision should not be considered appropriate protection. Practicing gt;safe sexgt;, including gt;using condomsgt;, is still necessary to provide the best protection, whether a person is circumcised or not.gt;gt; Still, many scientists are hoping that this new research may persuade recommending bodies, both in the United States and around the world, to give the circumcision's benefits another look.gt;gt; gt;Circumcision remains a controversial topicgt;gt;In the United States, infant circumcision is declining. About 64% of American male infants were circumcised in 1995, down from more than 90% in the 1970s. Rates tend to be higher in whites (81%) than in blacks (65%) or Hispanics (54%).gt;gt;Some opponents say the removal of the foreskin is an unnecessary surgical procedure that may reduce sexual sensitivity in adulthood. In Jewish and Muslim cultures, young or infant boys are routinely circumcised for religious reasons. Circumcision rates have traditionally been higher in the U.S. than in Europe, but the American Academy of Pediatrics currently says that the medical benefits are insufficient to recommend circumcision for all baby boys.gt;gt;Study coauthor Thomas C. Quinn, MD, professor of global health at Johns Hopkins University, says that choosing circumcision, whether it’s the parents of an infant or an adult male for himself, is and should remain an individual decision.gt;gt;“But the critics need to really look at the benefits versus the risks,” he adds. “By now a large body of evidence has shown that the health benefits clearly outweigh the minor risk associated with the surgery. In our study, we didn’t see any adverse effects or mutilation. We’re recommending supervised, safe, sterile environments—not circumcision out in an open field with rusty instruments.”gt;gt;gt;gt;Study shows protection from HPV, herpesgt;gt;Efforts to increase the practice of male circumcision in areas with high rates of sexually transmitted infections, including Africa, could have a tremendous benefit, say the author of the 2009 study. Genital herpes has been associated with an increased risk of HIV, and HPV can cause genital warts as well as a higher risk of anal, cervical (in women), and penile cancers.gt;gt;In the study, a research team at the Rakai Health Sciences Program in Uganda—in collaboration with researchers from the Johns Hopkins University Bloomberg School of Public Health in Baltimore and Makerere University in Uganda—conducted two clinical trials involving 3,393 uncircumcised men ages 15 to 49. All the men were negative for HIV and genital herpes (also known as herpes simplex virus type 2); a subgroup of men also tested negative for HPV.gt;gt;Roughly half of the men underwent medically supervised circumcision at the start of the trial, while the other half were circumcised two years later.gt;gt;Overall, circumcision reduced the men’s risk of genital herpes by 28% (10.3% of uncircumcised men; 7.8% of circumcised men) and HPV infection by 35% (27.8% of uncircumcised men; 18% of circumcised men).gt;gt;Circumcision did not, however, protect against syphilis. (About 2% of men in both groups contracted syphilis.)gt;gt;Increasing circumcision rates in Africa may not only help men, but would likely protect women too, possibly lowering the rates of female cervical cancer, the authors say. Ronald H. Gray, MD, professor of public health at Johns Hopkins University and study coauthor, says that the researchers plan to look at whether male circumcision reduces the transmission of HPV to female sexual partners.gt;gt;gt;What does this mean for America?gt;gt;Even in the United States, this study has relevance, says Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (which funded one of the trials).gt;gt;“In this country, circumcision for infant boys remains a personal decision for the parents,” he says. “This makes us rethink whether doctors should be more aggressive in recommending that it at least be considered. If parents say no just because generations before them have said no, they should learn more about the significant health benefits before making that choice.”gt;gt;Roughly three-quarters of U.S. adults have had at least one HPV infection, according to an editorial by Matthew R. Golden, MD, and Judith N. Wasserheit, MD, both of the University of Washington. Although vaccines against some of the most dangerous HPV strains have been approved for girls ages 13 to 26, the vaccines are expensive and routine Pap tests are still necessary to pick up cervical cancers.gt;gt;Dr. Golden and Dr. Wasserheit note that “rates of circumcision are declining and are lowest among black and Hispanic patients, groups in whom rates of HIV, herpes, and cervical cancer are disproportionately high.” Medicaid, which insures many low-income patients in these populations, does not pay for routine infant circumcision in 16 states.gt;gt;The study authors hope that this growing evidence in favor of circumcision will persuade policy-making bodies, both in the United States and in other countries, to officially recommend the procedure—which could make patient education and insurance coverage more likely.gt;gt;It’s not clear why circumcision may affect infection rates. But the study authors suggest that penile foreskin may provide a moist, favorable environment for herpes and HPV to survive and enter cells on the skin’s surface. Once the foreskin is surgically removed, the risk of infection may be reduced.gt;gt;They also note, however, that male circumcision is not completely effective in preventing sexually transmitted infections. Safe sex practices such as consistent condom use are still necessary to provide the best protection.gt;gt;For more information to help you make a decision about circumcision, see the topic gt;Circumcisiongt;. ]]> Circumcising your baby boy may protect against future sexually transmitted infections. (GETTY IMAGES)

gt;Nell Bernsteingt;gt;Courtesy of gt;Caring.comgt; gt;gt;The sexual life of our elders is something we younger folks shudder to imagine (and I confess to being guilty)—whether it's an aversion to thinking about what goes on behind a parent's closed bedroom door, or horror at the notion of Viagra in the medicine cabinet.gt;gt;This willed ignorance about the sexuality of those who, somehow or other, managed to beget us, continues all the way to the nursing home, it turns out—sometimes with heart-rending consequences.gt;gt;A recent study by a team from Kansas State University includes a subtle, yet poignant, example. A married couple had moved into a nursing home room with adjacent hospital beds. One spouse had a condition that required him to elevate a leg, and the beds had been placed so that the leg was on the same side as his spouse, which made it hard for them to hold hands. Staff members didn't see this as a problem, and told the couple, essentially, to live with it.gt;gt;Slate offers an even more extreme example. gt;Bob and Dorothygt;, both of whom suffered from dementia, fell in love in an gt;assisted living facilitygt;. When Bob's son walked in on his 95-year-old father in , he demanded staff separate the two, and ultimately moved his father to another facility. Heartbreak ensued, as did the rapid physical and psychological decline of the graying Romeo and Juliet.gt;gt;Why all the suffering? Because Bob's son couldn't bear to think about it.gt;gt;gt;While we're not thinking about it, our elders apparently are. A study in the New England Journal of Medicine found that the majority of those 75 to 85 years old—about 53%—are in fact sexually active.gt;gt;The Kansas State researchers observed impediments to physical intimacy in nursing homes as basic as shared rooms with only a flimsy curtain for privacy. But the biggest obstacle was simply that staff, like the rest of us, weren't prepared to acknowledge sexuality among the elderly.gt;gt;The most common reason offered for restrictions on sex in gt;nursing homesgt; is the conundrum of Alzheimer's and dementia. Are those afflicted able to offer genuine consent? Who decides?gt;gt;We squeamish kids—although we may have legal decision-making power in some cases—are arguably the last ones who ought to be making decisions when it comes to the sex lives of our parents (remember how we felt as teenagers when they tried to butt into ours?). The Kansas State researchers are advocating for federal guidelines, and some elder advocates are now recommending that part of getting one's papers in order should include a sexual power of attorney.gt;gt;This seems like a pretty good idea to me, although frankly, I think I'd make a lousy candidate for the job of sexual trustee. Were my own divorced parents to move to retirement communities and luck into late-in-life romance, I imagine I'd be thrilled for them. But that's about as far as my imagination is willing to take me. If dementia entered the picture, and a sticky situation were to arise...well, I'd be more than happy to pull the curtain, and leave the decision-making to, say, a duly deputized second cousin.gt;gt;But that's not going to happen if I can't even bring myself to broach the subject in the first place.gt;gt;Certainly, when the time comes for our parents to move into a nursing home or assisted living community, the list of things to talk about—money, location, what to do about the house—is long enough as it is. But if we're going to treat our parents the way we wanted to be treated as, say, sexually nascent adolescents—as full human beings with needs and desires, capable of making choices and forming deep connections—it may be time to think about having "The Talk."gt;gt;Again.gt;gt;gt;More from Caring.com:gt;gt;•gt;gt;Sex For Lifegt;gt;gt;•gt;gt;Sex and Chemo: Is It Safe?gt;gt;gt;•gt;gt;Alzheimer's Romance: Why Sandra Day O'Connor Is Rightgt;gt;gt;]]>