This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

There Are More STDs Than You Think

A recent report by the science publication Mosaic highlighted four bacteria described as emerging sexually transmitted infections (STIs) that could become serious public health issues.

Experts agree that we should be concerned about—and try to prevent—the spread of all existing or emerging STIs. But not everyone agrees that these particular bacteria are new, that they’re part of the problem, or that some of them are actually STIs at all.

Mycoplasma genitalium—nicknamed M-gen—was discovered in the 1980s and officially acknowledged as an STI by the Centers for Disease Control and Prevention in 2015. Similar to chlamydia and gonorrhea, M-gen is a bacterium that can infect the cervix or urethra. If left untreated in the female reproductive system, it can cause pelvic inflammatory disease (PID), which can lead to a build-up of scar tissue in the reproductive tract and ultimately to infertility.

M-gen is widely acknowledged as public health problem because it packs a triple whammy that makes it difficult to detect and treat: it often has no symptoms; there is no regular screening or testing process for it; and it is becoming resistant to some antibiotics.

The other confirmed STI in the report is Lymphogranuloma venereum (LGV), which is actually a form of chlamydia. It causes a severe infection that can makes its way into a person’s lymphatic system. And, if contracted rectally, it can mimic inflammatory bowel disease and cause anal issues such as fistulas (tunnels that runs from inside the anus to the skin around it).

Dr. Maria Trent, a professor of pediatrics and public health at Johns Hopkins Medical School, told Rewire.News in an email that people should be concerned about these emerging STIs because testing is inadequate and the health consequences can be serious.

But she added: “People shouldn’t panic because scientists are actively working to sort out the clinical correlates of disease and to make sure we have a solid test, and because consistent condom use can prevent transmission and acquisition while allowing people to have healthy sex lives.”

But Mosaic also mentioned two other “emerging STIs”—Neisseria meningitidis and Shigella flexneri. The former causes meningitis, a potentially life-threatening swelling of the brain and tissues around the spinal cord. Shigella causes—no other way to say it—explosive diarrhea.

Dr. H. Hunter Handsfield, professor emeritus of medicine at the University of Washington, told Rewire.News via email that it’s a stretch to call either STIs. Yes, they can be spread through sexual contact (oral sex and oral-anal sex being the most likely culprits), but they can also be spread through nonsexual, close contact with an infected individual or through contact with feces.

Handsfield was unimpressed with the Mosaic report in general: “What’s the fuss about? There’s nothing new or emerging about sexually transmitted meningococcus or shigella. Mycoplasma genitalium and LGV of the rectum in men who have sex with men indeed are important emerging STIs, but they’ve been the subjects of active attention for several years.”

Ultimately, we don’t need any new STIs to convince us there’s a problem. There were more than  2 million cases of chlamydia, gonorrhea, and syphilis—STIs we’ve all heard of—in 2017. The risk is real, and the need to take precautions—including using condoms and getting tested—is crucial for anyone who is sexually active even if we just worry about the STIs that have been around for decades (or even centuries).

Kotex Recalls Defective Tampons

Kimberly-Clark, a manufacturer of personal hygiene products, announced this week that it is recalling some Kotex tampons, specifically certain lots of the U by Kotex Sleek Tampons regular absorbency line. The recall affects products in the United States and Canada.

The problem? The product appears to have unraveled during use. That raises the risk that pieces could remain inside a consumer’s vagina.

A company statement explains that it has received reports of tampons that came apart as they were being removed and users who had to seek medical attention to have pieces of tampons removed from their body. There was also a small number of reports of infection, irritation, and localized vaginal injury.

Dr. Treasure Walker, assistant professor of obstetrics and gynecology at New York University School of Medicine, told This Week in Sex that the main risk for anyone who experiences this tampon malfunction would be toxic shock syndrome (TSS).

“That’s the life-threatening thing. Anything else would be just uncomfortable and maybe gross,” she said.

As This Week in Sex discussed earlier this year, tampon users are at some risk of TSS, a condition in which bacteria grow out of control and release toxins into the body. Those toxins can bring a drop in blood pressure that then deprives vital organs of oxygen. Toxic shock has other causes—including surgery, cuts, or burns—but it has been linked to the use of tampons, especially after the introduction of super-absorbent tampons. These are no longer on the market, but experts advise that people who use tampons choose the lowest absorbency that will work and change them frequently (every four to eight hours).

Of course, that might not be enough if a part of the tampon were to remain in the vagina when a user pulled the string. Walker says most women don’t really look at their tampons when they pull them out, but if you do and notice that it’s not intact, you might want to check in with your gynecologist or other health-care provider.

Other symptoms to look for would be irregular bleeding and discharge that is heavy, yellow, or foul-smelling. This could be a result of having a foreign body in the vagina or a signal of an infection like bacterial vaginosis. “We usually feel lighter and fresher after our periods are over. If things are not going in that direction, you should call your provider,” said Walker. Fever or pelvic pain would be particularly worrisome.

Kimberly-Clark is warning consumers to stop using the affected lots and to seek medical attention if they have symptoms. You can find out if the tampons in your bathroom cabinet are part of the recall on the U by Kotex website. Have the lot number on the back of the box handy.

Canadian Porn Preferences for 2018

I know it’s wrong, but we tend to think of Canadians as kinder, gentler, and colder versions of people in the United States. Now, Montreal-based adult website Pornhub has some information that distinguishes our neighbors to the north from those of us in the 50 states and the rest of the world.

Canada came in fifth in site traffic behind the United States, the United Kingdom, India, and Japan. MILF—which we defined for you just a few weeks ago—was the most searched term, and second place went to lesbian. Those two topics were in opposite positions last year. Other top spots went to classics like anal, gang bang, big ass, and squirt. JOI—which apparently means “jerking off instructions”—came in at number six.

According to Pornhub, Canadians are 60 percent more likely to view the “Asian” category. Anime or manga pornography or “hentai” was the third most searched term. And the words “Chinese,” “Indian,” and “Korean” all made the top ten.

But Canadians are also paying attention to U.S. politics; Stormy Daniels, the adult film star embroiled in our ongoing presidential saga, was the third most popular actress on the site. As for viewing stamina, Canadians tend to spend 10 minutes and 26 seconds on the site (a little higher than the worldwide average).

All we can say is: Go, Canada! We applaud your efforts to stay warm during the long, snowy winters.