Posted in Health, news, sex

Losing One’s Virginity: Breaking it Down

Many adolescents and young adults ponder this life-altering decision with very little guidance.  And understandably so as discussing losing one’s virginity with one’s parents fails to be a popular dinnertime conversation.  And big brother and sister don’t always give accurate and unbiased advice.

In Biblical times it was easy….one was told to “wait till you’re married.”  The timing, partner, and societal acceptance was already laid out, eliminating much decision-making.

Today, however, there’s immense pressure for both boys and girls to lose one’s virginity, for many as early as middle school.

So the average child or adult contemplating losing one’s virginity relies on social media, television, movies, friends and classmates to help form this decision.

So what does one need to take into account before they lose their virginity?


It’s permanent

You’re only a virgin once…..until you lose it, meaning you will never get it back once its lost.  Virginity is not a bad thing so don’t give it up so quickly.  If you have any doubts on who to give it to then he/she is probably not the right person.




It’s not the ultimate show of love

Many times teens are goaded into having sex as a sign of their true commitment and love.  Yet there are many other ways when a relationship is new to show your compassion and dedication.  Love is a feeling, not an act.


It won’t always resemble what you see in the movies

Unlike what we saw in 50 Shades of Grey, losing one’s virginity may instead be 3 minutes of pain and awkwardness.  Love-making includes love, passion, intamcy…so if that’s how you want to lose your virginity than make sure all the ingredients are there first.


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There is no “golden” age in which one should lose it

In school, students commonly boast about losing one’s virginity before 16.  Yet this random choice of age has no scientific basis.  True, many of us in caveman days had full families before that age, but in today’s society, a teen pregnancy is not that easy.  Which brings us to….


You could risk getting pregnant

Most young single teens or adults are not ready to start a family, despite their youthful fertility advantage.  Hence one unprotected sexual encounter could make a soon-to-be ex-virgin a new mom or dad within 9 months.


You could risk getting an STI

Likewise a night of what you anticipate to be passion could give you a week, month or lifetime of a sexually transmitted illness.  Condoms are a must.


Many may lose their virginity when they don’t want to

Tragically many who engage in pre-sexual activity such as foreplay or 1st through 3rd bases may find themselves in a situation where their partner advances to penetration without their consent.  Many thus lose their virginity to rape.



A recent study last summer carried out by ZavaMed found 31% of those surveyed , specifically 45% of women, regretted how they lost their virginity.  Unfortunately they can’t take that moment back. Which brings us to….


Alcohol is not your friend

Many unfortunately lose their virginity when they lose their inhibitions due to alcohol.  One drink is all it takes to bring one’s guard down.


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There’s no doubt losing one’s virginity is a rite of passage into adulthood. It could be the most amazing  and beautiful moment or one full of cringeful regret.  So don’t rush into giving away what could be your most precious commodity.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

Posted in drugs, Education, Health, news, opioids, sex, suicide

Is Your Teen in Trouble? Your Guide to Their Code Words

This generation of teens communicates differently from any others as smartphone technology has outpaced the normal evolution of day-and-age vernacular. As a result, adolescents use abbreviations and emojis to convey their thoughts while parents and society scramble to catch up.

What Are They Saying? Your Guide to Teen Slang

However, within these bite-size “codes” could be volumes of meaning, some delineating at risk behavior, some foreboding suicide.  These codes many times come from the letters that correspond to the key pad on a phone.  So here’s a guide to some of the unfamiliar terminology the young ‘uns are using:



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  • NIFOC – nude in front of computer
  • CU46 – see you for sex
  • 8 – “ate” used in discussions on oral sex
  • 831 – I love you – “eight letters, three words, one you/meaning”
  • 143 – I love you (denotes letters on keypads, or #’s of letters in each word (love has 4 letters)
  • 2N8, 2NTE – tonight
  • 4AO – four adults only
  • 2B@ – to be at
  • 4EAE – for ever and ever
  • 53X – sex
  • 775 – kiss me
  • ?^ – hook up?
  • BAE – before anyone else
  • IWSN – I want sex now
  • ITX – intense text sex
  • NP4NP – naked pic for naked pic
  • 1174 – strip club





  • < 3 – broken heart or heart
  • 182 – I hate you (1 stands for “I”, 8 stands for “hate”, 2 stands for “you”)
  • 2G2BT – Too good to be true
  • 2M2H – Too much to handle
  • Blarg, Blargh – similar to “darn” but deeper
  • Butthurt – receiving a personal insult
  • Salty – being bitter about something or someone
  • Watered – feeling sad, hurt
  • Wrecked – messed up
  • 4FS – For F***’s Sake
  • Poof – disappearing
  • ::poof:: – I’m gone
  • Ghost – disappear
  • 555555 – sobbing, crying one’s eyes out
  • ADIH – another day in Hell
  • KMN – kill me now
  • VSF – very sad face
  • KMS – kill myself
  • KYS – kill yourself
  • 187 – homicide


Drugs/Risky Behavior (to be revisited more in depth)


  • 420 – marijuana
  • 420 – let’s get high
  • A/S/L/P – age/sex/location/picture
  • A3 – anytime, anyplace, anywhere
  • LMIRL – lets meet in real life
  • WYRN – what is your real name?
  • Chrismas tree – marijuana
  • Catnip – marijuana
  • Gold – drugs
  • Gummy Bears – drugs
  • Blues/Bananas – narcotics
  • Bars – benzodiazepines
  • Smarties/Skittles – Adderall/Ritalin
  • Ski Equipment/Yayo– cocaine
  • Cola – cocaine
  • Candy/Chocolate Chips/Sweets/Smarties/E – ecstasy
  • Crystal Skull/Wizard – synthetic marijuana
  • Hazel – heroin
  • Gat – gun/firearm
  • Lit – getting high/drunk
  • Smash(ed) – getting drunk, stoned, or having sex


Parents nearby


  • 9 – parent is watching
  • 99 – parent is not watching anymore
  • P911 – parent alert (parent 911)
  • PAL – parents are listening
  • PAW – parents are watching
  • POS – parents over shoulder
  • AITR – adult in the room
  • CD9 – code 9 – parents in the room
  • KPC – keep parents clueless
  • RU/18 – are you over 18


And the above is just a small sample of some of the terms used these days.  This list continues to grow by the day so parents need to always be aware.  Kids want to KPC and avoid POS so be ready for the next group of codes being created as we speak……



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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.


Posted in food, Health, news, sex

Did the Legalization of Marijuana Lead to a Rise in STD’s and Foodborne Illness?

Reports of increasing cases of STD’s appear to correlate with the legalization of marijuana.

Could marijuana be leading to a complacency when it comes to handwashing and condom use?



This Fall the CDC reported a continued rise in cases of sexually transmitted diseases by the following:

Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, according to preliminary data released today by the Centers for Disease Control and Prevention (CDC) at the National STD Prevention Conference in Washington, D.C. This surpassed the previous record set in 2016 by more than 200,000 cases and marked the fourth consecutive year of sharp increases in these sexually transmitted diseases (STDs).

And this week, the World Health Organization sounded the alarm of rising HIV cases in Eastern Europe.

At the same time more countries are easing up on legal restrictions when it comes to marijuana.  Which leads to the question, has the legalization of marijuana led to the rise in STD’s? released this graphic displaying STD rates by state.

SexuallyDiseasedStates (1).png

Strikingly, there are some similarities to a map outlining state cannabis programs.

state cannabis.gif


Cannabis use is known to decrease anxiety and motivation and so an unintended consequence of increasing access to its use may be the decrease in precautionary thinking when it comes to unprotected sex.

Rare STD Evading Doctors and May Become Next Superbug


On that same note, multiple outbreaks have been reported in the food industry when it comes to pathogens such as Salmonella, E. coli, Hepatitis A and Listeria.  Could complacency with proper food handling and hand washing be related to marijuana use?


This could easily be analyzed by screening those with an STD for marijuana use, as well as those involved in a foodborne illness outbreak.

Now the legalization of marijuana allows more studies to be done to to determine its health benefits. I suggest, however, we also study, any links to complacency issues when it comes to home and workplace safety and exposures.


Why is food borne illness on the rise?

Multiple issues could be playing a role.

  1. Fresh produce is not cooked like meat and can therefore harbor more germs
  2. Preservatives, used in fast food, help to deter pathogen growth, and more people are shying away from fast food than in the past, opting for “fresh”, healthier options.
  3. On-the-go produce may not be washed after packaging due to a false sense of security that the vegetables are “clean.”
  4. As our population ages, and as more people suffer from immunocompromising disease such as diabetes and cancer, they may be more susceptible to food borne illness.
  5. Our gut microbiome has changed as our diets have shifted to food with more preservatives, hence possibly being less resilient to new pathogens that enter.
  6.  In regards to the ground turkey, it is not the same as ground beef and leaving the patties pink in the center mean you are consuming raw poultry. Turkey meat may need to cook longer until no pink is seen and core temperature is at least 165 degrees for at least 15 seconds
  7. We’re less strict about cleaning than we used to be.  Counter tops used to be bleached and scrubbed for longer periods of time than we do now-a-days with antimicrobial wipes.

Therefore be diligent about cleaning counter tops, cook your food thoroughly, wash produce before eating and be aware of any reported recalls.


A Review of Syphilis

Syphilis is also called “the great imitator”.  Many don’t realize they have syphilis as the symptoms mimic so many other diseases.  Syphilis has been on the rise and hasn’t been routinely tested in STD/STI panels.  It’s caused by a spirochete (spiral bacteria) called Treponema pallidum, and can cause infection in stages.

Primary Syphilis can manifest as a painless ulcer on the genitals, mouth or skin.

Secondary Syphilis can manifest as a rash, along with fever, joint pain, malaise…mimicking other illnesses. In this stage it can also manifest as warts on the genitals called condylomata lata.




As the course progresses, syphilis may become latent. For years one may have no symptoms at all.  The patient may mistakenly feel they suffered the flu and think nothing more of it. But if left untreated, syphilis can enter the final stage, Tertiary Syphilis, which can cause severe neurological disability (neurosyphilis) and can also severely affect the heart.

Penicillin is the treatment of choice for any stage of syphilis, including the latent stage of the illness.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada


Posted in dating, football, Health, relationships, sex, Sports

Football Fans May Be More Successful Lovers

For those of us who are football enthusiasts, we may be at an advantage when it comes to relationships.  Makes sense….when things go sour with our partner we turn to football.  When we get sidelined we wait for a signal to get back on the field.  And we instinctively “suit up” before each encounter to protect us from the blows we may incur.  So the question arises, do football fans fare better in relationships?


We know the field

Before any play, we need to position ourselves correctly on the field.  Being too close to the “end zone” when you’re supposed to be yards away can give you a severe penalty.

So we start at the line of scrimmage and respect the “neutral zone.”




An infraction of this space could again inflict a costly penalty.  There’s a time and a place when beginning a play and entering this zone is allowed.


neutral zone.jpg


True our goal is to get to the end zone but it will take some strategy, finesse, and opportunity.  Some good drives will get you a long way, and patience and persistence is key.




We study our competition

Before any play we size up our competition.  Some may block your advance but most you can overcome.  As long as you know your routes and can keep other players at bay, you have a chance of advancing.



How do we fumble?

Holding a ball loosely and carelessly could cause it to easily fall into another player’s hands.



But if you hold it too tight it may squeeze out the first opportunity it gets.  A proper cradling, warmth, and protection may be the right recipe.




We need to rely on others during a fumble

Losing the ball is devastating and someone else can pick it up and run with it.  It takes your buddies to help you regain possession so you can start over.




Treat your partner right and don’t lose them to begin with.


We are always prepared for an interception

The field is fluid and players are out there watching, waiting to grab your ball and take advantage of the yardage you acquired.




Always be mindful of your position and don’t take your possession for granted.

We adapt when we’re in the red zone

Although the red zone is not officially marked on the field, we understand it to be the 20 yards closest to the end zone, or time during a relationship where you can either advance to your goal or fail miserably, losing all the time and work you put into the relationship.  Being too aggressive may cause a fumble, interception or even injury.  Being too chill could prevent you from ever making a touchdown.

So us football folk know how to stop, huddle, and plan,  hopefully resulting in the ball sailing into the end zone without a hitch.



So if you’re in the dating scene and find yourself getting encroached, needing to scramble, or facing a blitz, watch some football and learn how to treat your date right.  It might get you a whole new set of fresh downs…….


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, sex

Genital “Rotting” Reported with Rare STI

Warning Graphic Content Below

A rare sexually transmitted illness named “donovanosis” has affected multiple people in the UK by destroying their genital tissue.

Donovanosis’ medical term is Granuloma inguinale, a condition caused by the bacteria Klebsiella granulomatis.  It is found in tropical and subtropical climates, reportedly in India, Africa and Australia.



Image from Medscape



Approximately 100 cases occur in the US each year.  Men are affected twice as often as women and it is transmitted through vaginal and anal intercourse.  Oral sexual  transmission is rare.



Female patient with Granuloma inguinale:  Wikimedia Commons


The CDC reports the following:

Symptoms usually occur 1-12 weeks after infection. The infection begins with the appearance of relatively painless nodules that break down into shallow, sharply demarcated ulcers with a beefy-red friable base of granulation tissue. The lesions may occur on the skin, genitalia, or perineal areas, and slowly spread to the lower abdomen and thighs. The lesions may develop secondary bacterial infection and can co-exist with other sexually transmitted infections.



“Donovan bodies” found histologically in which the bacteria are being engulfed by the immune cell


Not only can lesions become infected but Sardana et al published a case in which one turned malignant with squamous cell carcinoma.

Some studies have found the incubation period to be as long as 360 days, hence one could be infectious for a year without having symptoms.

O’Farrell et al reports 4 types of donovanosis: (1) ulcerogranulomatous—the commonest type, beefy red, non-tender ulcers that bleed readily to the touch and may become quite extensive if left untreated (fig 1);

(2) hypertrophic or verrucous ulcer—growth usually with an irregular edge, sometimes completely dry (fig 2);

(3) necrotic—foul smelling deep ulcer causing tissue destruction;

(4) dry, sclerotic, or cicatricial lesion with fibrous and scar tissue.

Fortunately, most cases are susceptible to antibiotics.  The CDC recommends Azithromycin 1 g orally once per week or 500 mg daily for at least 3 weeks and until all lesions have completely healed.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, sex

CDC Reminds us NOT to Wash Used Condoms

If you thought the “Wear A Seatbelt” campaign was recommending the obvious, now comes the “Throw Out Your Used Condom” campaign.

This week the CDC urged Americans in a tweet to “not wash or reuse condoms.”



If used correctly, condoms offer 98% protection against unwanted pregnancy.  STD protection varies as some skin on skin contact can transmit viruses such as HPV and herpes.

According to a study published in the Journal of Sexual Health (reported by NBC News),  between 1.4 percent and 3.3 percent of respondents had re-used a condom at least twice during a sexual encounter.

Key phrase: At least twice….

Condom prices average between $0.50 – $1.00 a condom, and many clinics and health departments dispense them for free.

Condoms may leak, slip off or break rendering them useless, hence new, unused condoms offer the best chance of success.

The History of the Condom

Although the first “rubber” as we know it was developed in the 1850’s, thanks to Charles Goodyear and the vulcanization of rubber, prophylactics were created in all shapes and sizes for centuries.

Materials included tortoise shells, sheep intestine, animal bladders, horns, silk and even gold.

gold-condom.jpg A rare Glan condom from Asia Minor created during the Bronze age and made of silver and gold.

Around the 16th century the deadly STD, syphilis, began to spread rapidly and Gabriele Fallopio devised a linen sheath to be tied onto the penis.  When tested on 1,100 men none contracted syphilis.  His name, ironically, is carried by women who still have their fallopian tubes.


Condom from the 1600’s

Following this period, condom use became controversial as some believed it promoted immoral behavior. Animal skin then became a popular material, but users complained of the condom falling off.

When Charles Goodyear patented the vulcanization of rubber the first condom as we know it was created in 1855.  Vulcanization is the heating of rubber with chemicals such as sulfur, making it stronger and more elastic.

By the 1950’s Durex added lubrication to the condom and by the 1980’s spermicidal gel was included.

How to use a condom correctly

Again condoms should never be reused and the following should be ensured to make sure they provide adequate protection:

  1. Always inspect the condom first for breaks, leaks, and tears.
  2. Unroll the condom before putting it on.
  3. Make sure there is some space at the tip, allowing room for semen
  4. Put the condom on before intercourse
  5. Leave the condom on until after intercourse
  6. Do not reuse or turn it inside out



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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, sex

Rare STD Evading Doctors and May Become Next Superbug

A sexually transmitted disease (STD) may be gaining strength and increasing resistance to antibiotics.

Mycoplasma genitalium (MG) was first identified in the 1980s.  Many may not realize they have it, having no symptoms at all. However some may report burning with urination, penile discharge, vaginal discharge, or bleeding after sex.  Medical providers may confuse these symptoms with chlamydia, the most commonly reported STD, thereby offering a different antibiotic treatment and not ensuring an MG cure.  And antibiotics given incorrectly breed resistance.

If STD’s such as MG evade treatment they can fester causing pelvic inflammatory disease, urethritis, and eventually male and female infertility.

Since many do not realize they have it, or fail to elicit symptoms, prevalence rates are under-reported.  In 2016, Getman et al found the prevalence to be approximately 16.1% for females and 17.2% for males in the 946 test subjects seeking care at an STD clinic. But they reported then that macrolide (azithromycin) resistance of the bacteria was found in 50.8% of females and 42% of males.

The treatment for MG, according to the CDC, is a 1 gram one time dose of azithromycin. However they note increasing resistance and suggest if suspected to take a Zpack (azithromycin- an initial 500-mg dose followed by 250 mg daily for 4 days).  And if resistance is still seen to add Moxifloxacin (400 mg daily x 7, 10 or 14 days) which thus far has shown a 100% cure rate.

The treatment for chlamydia is also a 1 gram one time dose, with use of doxycyline 100mg twice daily for 7 days if not cured.

So how is resistance being bred?

When one believes he/she has an STD, most medical providers will not wait for the cultures to come back to treat as results can take days.  So many will prescribe the 1 time dose of azithromycin empirically.  However if a medical provider is only testing for gonorrhea and chlamydia, they may not know if the patient is cured of MG.  The MG bacteria that withstood the original dose of azithromycin may flourish and become resilient to the antibiotic in the future.

To prevent resistance, providers need to check for cure after the medication is given to ensure the infection is gone.  If not, a second antibiotic needs to be instituted immediately to prevent the resistant bacteria from spreading.

Macrolide resistance has also been  noted when treating gonorrhea, another STD with superbug potential.

What is a Superbug?

A superbug is a pathogen, most commonly bacteria, that can survive antibiotics that most species would buckle under.  It’s resistance could be caused by a variety of factors.  Maybe it has a mutation that makes it stronger.  Maybe its genetic material shields it from the toxic medicine.  Maybe it’s luck.  So shortly after it celebrates surviving the antibiotic assault, it divides to reproduce, making more bacteria.  If this progeny bacteria maintain the same genetic material as its parent, or if included, mutation, they can be now be resistant to the antibiotics as well.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada