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Authors: Mark Leyner

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DOES THUMB SUCKING CAUSE BUCKTEETH?

Thumb sucking is a normal behavior. Well, sucking your own thumb is normal. If you are sucking someone else’s, that’s a little weird!

Thumb sucking only becomes a problem if it continues for too long. It can begin during the fetal period, but should be curtailed by the time that permanent teeth come in. Permanent teeth begin to sprout around age six. If thumb sucking continues past this age, your child can develop an overbite or buckteeth.

There are other problems that come along with late thumb sucking. An article in 1993 in the journal
Pediatrics
looked at the “influence of thumb sucking on peer social acceptance in first grade children.” They found that thumb-sucking children were judged as less intelligent, happy, attractive, likable, and fun and less desirable as a friend, playmate, seatmate, classmate, and neighbor than the nonsuckers.

So if buckteeth aren’t bad enough, social ostracism is yet another reason to quit the thumb.

WHAT IS THAT THING HANGING DOWN IN THE BACK OF YOUR THROAT, AND WHAT IS IT FOR?

We mentioned that lovely fleshy thing in the back of your throat earlier when we described how milk comes flying from your nose when you laugh. It’s called the uvula, from the Latin word
uva,
which means grape. If you take a look in the mirror, you will notice that this skin flap is shaped like a tear or a grape. If yours has a little fish tail, don’t panic, that’s called a bifid uvula and it’s not a problem at all.

The uvula is an interesting little thing. The uvula has its own little muscle, the muscularis uvula, which allows it to move and change shape. This prevents food from going down the wrong way, and it also has a minor role in speech. Some singers believe the uvula helps them produce a vibrato.

Don’t worry if your uvula is swollen. Many things can cause this including: tonsillitis, viral infections of the throat, allergies, or trauma.

If you are passing through Los Angeles, Billy can introduce you to his close friend who will be happy to show you that he has no uvula. No, he wasn’t maimed at birth, it was removed in a procedure called a uvulopalatopharyngoplasty. Try saying that five times fast. Removal of the uvula is performed as a treatment for sleep apnea or excessive snoring.

WHY DO YOUR EARS POP IN AN AIRPLANE?

We are now making our final approach into the end of this chapter. Please put your seat backs and tray tables in an upright and locked position…we couldn’t resist. We always wanted to give that speech.

When you take off in an airplane, the air pressure decreases as you ascend. The air trapped in your inner ear needs to escape and equalize the pressure between your inner ear and the atmosphere. The air escapes through the eustachian tube, a small passage between the inner ear and back of the nose/throat. This equalization of pressure is that pop you feel. The same thing happens when landing, but in this case, air pressure increases and air needs to get into the inner ear where the pressure has adjusted to the lower pressure during flight.

You can help your ears to equalize by swallowing, yawning, or chewing. All these aid in the opening of the eustachian tubes. If these don’t work, pinch your nostrils shut, take a mouthful of air, and blow. Decongestants and some nasal sprays also help ease the passage of air, especially if you are already congested.

CHAPTER 7

WOMEN WANT TO KNOW

We had
finished a long morning of patients and Leyner had taken our receptionist Wendy out to lunch. I was catching up on paperwork when I realized that several hours had passed since they’d left. I called his cell phone but when I heard Leyner’s signature ringtone, the theme from
Popeye,
emanating from his bag in the office, I realized I was out of luck. I continued reviewing charts until I heard a loud and continuous thumping coming from the outer office. I opened the door to find Leyner and Wendy playing hopscotch on a board that Leyner had painted on the carpet with Liquid Paper.

A drunken Leyner tripped over a floor lamp and after a graceful somersault landed at my feet. “My brother, you missed a glorious celebration, a Dionysian blow-out of epic proportions, a bad-assed bacchanalia fit for the likes of Caligula and Kim Jong Il and Kate Moss…and…” Leyner seemed to pass out momentarily. Then his eyes fluttered open. “I think I just had a petit mal seizure,” he said. “It was awesome.” Leyner began crawling around on his hands and knees. Soon Wendy was on the floor with him, making a high-pitched orgasmic sound somewhat akin to the emergency broadcasting tone.

I got down on my own hands and knees and crawled toward Leyner. Worried that I had forgotten some special occasion, I whispered into his ear, “Did I forget Wendy’s birthday or something?”

Leyner reared up. “No, it’s nobody’s birthday…. Today’s February 4…. C’mon, Professor, don’t you know what that means?”

I looked at him blankly.

“You call yourself an intellectual, a…doctor?!” he sneered. “How could you be so insensitive to women?”

I still had no idea what he was getting at.

“Wendy has a lot of female questions she wants to ask you but first you need a little refresher in the annals of gynecology. Fifty-five years ago today in Chicago skilled surgeons removed a 308-pound ovarian cyst from Gertrude Levandowski and it only took them ninety-six hours.”

“How could I have forgotten?” I said.

Wendy stumbled across the office.

“How much did she drink?” I asked, having never seen Wendy intoxicated in the least, never mind three sheets to the wind.

“Seven or eight whiskey sours, I think. I outran her two to one…. Anyhow, in honor of the day she’s become very inquisitive about…uh…”

Leyner cleared his throat. “About her…cycles…and her…infrastructure.”

Wendy perked up and stared at me with an unfocused look. “Can I trust you?”

Not knowing what was about to come, I replied, “Of course, Wendy. Anything you ask I will hold in my strictest confidence.”

Leyner stood erect and gave a crisp military salute. “What happens in Vegas stays in Vegas.”

“Okay, then.” She took a deep a breath. “Please tell me. I have to know.” She hiccupped. “Is there danger that if I watch
Herbie Fully Loaded
too many times, that I will…synchronize my period with Lindsay Lohan?”

With that, she and Leyner passed out in perfect unison.

WHY DO WOMEN ALWAYS GET URINARY TRACT INFECTIONS?

Many women are familiar with the symptoms of a urinary tract infection or UTI. It usually starts with a persistent urge to urinate or a burning sensation when you pee. You also can have blood in the urine, cloudy, strong-smelling urine, or pain in the lower part of your abdomen. About 50 percent of women will have a urinary tract infection at some time during their lives. The female-to-male ratio for urinary tract infections is about 30:1.

Why are women so blessed with this uncomfortable gift while men are spared?

Everyone’s urine is sterile and meant to stay that way. The difference between women and men begins with the urethra, the tube through which urine leaves the body. The urethra is shorter in women than in men, thus making it easier for bacteria to travel the wrong way up this one-way street. The urethra also is located closer to the rectum in women, and there are more bacteria in this area that can find their way into the bladder. Sexual activity can also push bacteria into the sterile urine.

The medical term for bladder infections is cystitis. If there is a lot of blood with a urine infection, we call it hemorrhagic cystitis. There’s even a special variety, “honeymoon cystitis,” which refers to the urine infections that women get on their honeymoon from frequent and prolonged sexual intercourse.

Luckily, there are some ways to help prevent urinary tract infections. Women should always urinate after sexual intercourse, wipe themselves from front to back, and empty their bladders fully when they go to the bathroom. Proving once again that a woman’s work is never done. Men only tend to get their infections when they are older as the prostate grows and causes a blockage of the urinary flow.

WHAT IS THAT SOUND A VAGINA MAKES AFTER SEX?

This is definitely an embarrassing question to both ask and answer, but we’ll give it a shot.

The sound occurs when air gets pushed into the vagina during sexual intercourse. After sex, when the penis is removed, air is released and you get some vaginal flatulence. “Queef” and “vart” are two colorful slang terms that are used to describe these noises that a woman may emit after sex. These sounds are perfectly normal, so there is nothing to worry about.

ARE FAT WOMEN MORE FERTILE?

The best way to answer this question is to refer back to one of our favorite childhood fairy tales, “Goldilocks and the Three Bears.” Remember when sweet little Goldilocks was looking for a bed to sleep in and she found one that was “too soft,” one that was “too hard,” and, yes, ultimately one that was “just right.” The same goes for this question. Both obesity and extreme thinness can be associated with infertility. You need to be “just right” to conceive easily.

There are several reasons why very high or very low body fat can affect fertility. Fat tissue is involved in converting androgens (male hormones) to estrogen. Since body fat is a significant source of estrogen, it would seem logical to think that more body fat means more hormones and that that would be a good thing. Well, fertility requires a fine balance, and it really depends on the type of hormones that are around. If you are too thin, you make a form of estrogen that is too weak, but if you are too fat, the higher level of estrogen sends signals to the brain that affect your ability to stimulate the formation of eggs.

Now, we need to clarify exactly what “fat” means. In our society, there are crazy definitions of fat and thin. Magazines are littered with starving actresses and models who are thought to exemplify the ideal weight. Let us try to stop the insanity.

Body mass index (BMI) is a reliable indicator of total body fat and is the most commonly used measurement related to the risk of disease and death. It is calculated using the formula, BMI= kg/m
2
. Sound hard? There are many online calculators where you simply enter your weight and height and get your BMI. The score works for both men and women, but it does have some limitations. BMI may overestimate body fat in athletes or people who have a very muscular build. It also can underestimate body fat in older persons and those who have lost muscle mass. In general, a body mass index between 19 and 30 will keep you in the right range to have normal reproductive ability.

ARE TOP AND BOTTOM HERPES THE SAME THING?

Herpes is everywhere. Yes, we said it, but don’t panic. There is no need to duct-tape your doors and windows, wear surgical gloves, or cover your home toilet seat with one of those paper rings. We just want to break the herpes stigma.

Herpes viruses are extremely common and rank just behind influenza and cold viruses in frequency. Chicken pox virus, shingles, and mononucleosis all are caused by members of the herpes family. And then there are the two most famous herpes viruses, Herpes simplex virus 1 (HSV-1) and Herpes simplex virus 2 (HSV-2).

HSV-1 and HSV-2 are virtually identical under the microscope. Herpes simplex virus 1, or “top herpes,” is usually associated with infections of the lips, mouth, and face. HSV-1 causes cold sores (or fever blisters) and is transmitted by contact with infected saliva. Herpes 2 or “bottom herpes” is sexually transmitted. This type is responsible for genital herpes. Despite these generalities, either type can reside in either or both parts of the body.

By the time you are an adult, about 90 percent of people will have antibodies to HSV-1. On the other hand, only 30 percent of adults in the United States have antibodies against HSV-2. Luckily, many who are infected have almost no symptoms. Cross-infection of type 1 and 2 viruses can occur from oral-genital contact.

CAN FRIENDS SYNCHRONIZE THEIR MENSTRUAL CYCLES?

Oh my! We had no idea that we needed a PhD in statistics to read about this topic. There have been about thirty years of research about the possibility that women who spend a lot of time together can synchronize their menstrual cycles. We invite you to delve into the annals of research on estrous synchrony or menstrual synchrony yourself and read about the controversy surrounding this topic. It is exciting stuff!

In 1971, Martha McClintock, a psychologist, published a paper that first reported this phenomenon. Since then, many scientists and statisticians have investigated the possibility and haven’t found any link. There is no physiological explanation as to why this happens. But, based on statistical analysis—in other words, simply by sheer coincidence—some overlap of periods can be expected in any group of friends.

WHY CAN YOU EAT THREE TIMES MORE THAN NORMAL WHEN YOU HAVE PMS?

When we looked into food cravings
during
menstrual periods, we weren’t able to find any scientific cause. Premenstrual gluttony (lovely term, we know), on the other hand, has an explanation.

Imagine the cycle divided in half, with the time of ovulation being the midpoint. The first half is called the follicular phase and the second half, the luteal. Studies in baboons, Rhesus monkeys, and pigtail monkeys have shown increased food intake in the premenstrual period, or the luteal phase of the menstrual cycle. In humans, food intake has also been observed to be highest in the luteal phase. It is not entirely clear why this happens, but researchers think it has to do with changes in serotonin levels during the menstrual cycle that make you crave more food.

IS YOUR WAIST TWO TIMES THE SIZE OF YOUR NECK?

Anthropometry is the study of human body measurement for use in anthropological classification and comparison. What fun! Let’s whip out those tape measures and calipers!

There is a lot of research out there, so prepare yourself if you’re going to explore this area. Unfortunately, I sat down in my kitchen to do the research and before I knew it, four hours had passed and I had made my way through a box of Mike and Ikes, two Twix bars, a jar of peanuts, and a leftover roast beef sandwich. Now my waist and neck are the same size and I can barely reach the keyboard, but I am prepared to pass on some information.

Our editor was the inquiring mind who asked this one, and unfortunately there is only one nonmedical mention that relates directly to the comparison between neck and waist size. Apparently in dressmakers’ guidelines from the turn of the century, a girl’s eligibility was said to be judged by the size of her waist—which should be “twice the circumference of her neck, which, in turn, should be twice the circumference of her wrist.”

The medical literature has many references to both waist circumference and neck circumference, but they do not address any direct correlation in size. According to the National Institutes of Health, a high waist circumference is associated with an increased risk for type 2 diabetes, high cholesterol, high blood pressure, and heart disease. A British study showed that over the past fifty years, waist measurements alone have increased by 6.5 inches in women. Neck circumference has also been linked to increased heart disease, diabetes, and sleep apnea risk.

Before we leave the topic of body size behind, we have to mention one article from the November 1995
International Journal of Eating Disorders.
In their article “Distorting Reality for Children: Body Size Proportions of Barbie and Ken Dolls,” K. D. Brownell and M. A. Napolitano used hip measurements as a constant, and calculated the changes necessary for a young, healthy adult woman and man to attain the same body proportions as Barbie and Ken. Among the changes necessary were for the female to increase 24 inches in height, 5 inches in the chest, and 3.2 inches in neck length, while decreasing 6 inches in the waist. Male Ken wannabes need to increase 20 inches in height, 11 inches in the chest, and 7.9 inches in neck circumference. If Barbie were a real female, she would be 7 feet 2 inches with a 22-inch waist and a neck that could barely support her head. Ken would be 7 feet 8 inches with a 43-inch waist. A little unrealistic, no?

WHY DO YOUR BOOBS GET TENDER BEFORE YOUR PERIOD?

Some breast pain before your period is perfectly normal. Hormonal fluctuations cause changes in the breast ducts and the breast lobules. The lobules are the milk-producing tissues of the breast. Each breast has about fifteen to twenty lobes that branch into smaller lobules and each lobule ends in a bulb. Milk originates in the bulbs and is carried by ducts to the nipple.

The boob pain usually starts during the second half of the menstrual cycle. When estrogen production increases and peaks just prior to the middle of your cycle, it causes enlargement of the breast ducts. Then, right before your period, another hormone (progesterone) peaks and causes growth of the breast lobules. These increases in size lead to pain.

Premenstrual breast pain can be mild or severe. Pain is usually less acute in women who are taking birth control pills. Some women find that caffeine intake can increase breast pain during that time. Simple anti-inflammatory medications can reduce the pain. Also avoid very aggressive teenage boys who want to feel you up, but haven’t yet learned the correct method.

WHY DON’T WOMEN HAVE HAIRY CHESTS?

Well, actually some women do.

As a culture, we are obsessed with becoming hairless. There are waxing salons, threading salons, laser hair removal treatments, electrolysis, and who could forget good ol’ Nair. The truth is that as mammals we are designed to be covered in body hair. We have the same number of hair follicles as our hairier simian friends, but our hair is shorter and finer. The only truly hairless parts of the body are the umbilicus (belly button), the lips, the nipples, the palms, and the soles.

There are two types of hair on the body, vellus hair and terminal hair. Vellus hair is soft, fine, colorless, and short. Vellus hair helps the body maintain a steady temperature by providing some insulation. Terminal hair is found on the head, the armpits, and the pubic area, and on the face and chest in males. It is coarser, darker, and longer than vellus hair.

Hirsutism is the growth of long, coarse hair on the face and body of a woman in a pattern similar to men. Hirsutism can be the result of many medical conditions including polycystic ovary syndrome, hormonal imbalance, tumors, thyroid disease, obesity, anorexia, or medications. Excess hair on the face or chest may simply be due to your genetics. Luckily, there are plenty of ways to get rid of excess hair.

2:05
P.M
.

Gberg:
Leyner?

Gberg:
I need your hirsute help.

Leyner:
No, it’s Manny being Manny.

Gberg:
What?

Leyner:
Are you making fun of my back hair?

Leyner:
Manny Ramirez…my hero.

Gberg:
I would never mock your back hair but I would occasionally recommend a grooming of your neck.

Leyner:
Just got manscaped the other day…you haven’t seen me since.

Gberg:
Manscaped?

Leyner:
Haircut…the works.

Gberg:
That is fantastic.

Leyner:
That word…?

Leyner:
Learned it from Gabs or Mercedes…I used it in my eyebrow-shaving answer.

Gberg:
Yes. I had never heard it before

Leyner:
Me either…isn’t it great?!

Gberg:
I am answering the question on Why don’t women have hairy chests? and I now you are the evolutionary expert of the two of us.

Leyner:
Hmmmm…

2:10
P.M
.

Gberg:
I have the
Naked Ape
book that my brother gave me but I thought I would take a shortcut and seek your sage advice.

Leyner:
Humans did reach some wonderful mutation somewhere along the road to the present…that resulted in uniquely large and hairless breasts for our females.

Leyner:
Let me check something I printed out…hold on.

Gberg:
Well, not entirely hairless. There is that layer of almost invisible fur.

Leyner:
That’s “down.”

Leyner:
That’s what keeps women from being confused for porcelain figurines.

Gberg:
Is that a hip-hop expression or are you talking about vellus hair.

Leyner:
Vellus hair…sounds like a salon.

Gberg:
We should open a salon. You could be like Warren Beatty in
Shampoo.

2:15
P.M
.

Leyner:
Have you read “Breast Asymmetry, Sexual, and Human Reproductive Success” by Anders Pape Moller of the Zoological Institute in Copenhagen?

Gberg:
No, have you read “The Hairlessness Norm: The Removal of Body Hair in Women”?

Leyner:
I’d love to read it. Print one out for me. I’ll stick in a copy of
Anna
Karenina
so I can pretend to be reading Tolstoy on the subway, when I’m actually reading about the axillary hair of women throughout history.

Gberg:
I have found some great articles this time around.

2:20
P.M
.

Gberg:
Here is another one for you to read on the train…“Body Hair Scores and Total Hair Diameters in Healthy Women in the Kirikkale Region of Turkey.”

Leyner:
I’m not sure I’d risk reading that one on the PATH…I don’t want to have the soles of my feet beaten by some enraged Turk.

Leyner:
I think women’s body hair is sexy…but not chest hair.

Gberg:
I am surprised, you seem to be somewhat pugilistic when traveling underground.

Leyner:
My uncle Fred used to tell me (when I was a wee little lad) that potato salad made hair grow on your chest…

Leyner:
I’m most alive the farther down I go.

Gberg:
Yeah, what was with that “it puts hair on your chest” line?

Leyner:
You had an Uncle Fred too????!!!!

Gberg:
As we are becoming more hairless, the line will probably reverse itself and you will see a macho guy drinking moonshine and saying “It takes hair off your chest!”

2:25
P.M
.

Leyner:
It was some piece of old folkloric aphoristic wisdom…do this or do that and it’ll put hair on your chest. Shot of whiskey, spoonful of castor oil, half-pound of potato salad…

Leyner:
Body hair does seem to have an important evolutionary function…

Leyner:
But I can’t tell you what it is…cause it’ll give away my brilliant 208-page response to the question: Why Do We Have Pubic Hair?

Gberg:
We need an evolutionary biologist as a co-author.

Gberg:
They could do all the waxing in the salon we open.

Leyner:
I’d say that evolutionary biology is just speculative enough that I can qualify as an expert.

Leyner:
I think women are becoming too hairless.

Gberg:
You are the expert of all experts. Who else uses the word
aphoristic
in
an IM?

Leyner:
Thank you.

Gberg:
De nada.

Gberg:
I disagree. I suffer from
hirsutophobia.

Leyner:
I know…you need to deal with that.

Gberg:
I totally made up that word but it turns out to be a real one.

Leyner:
Don’t certain apes have hairless chests?

Leyner:
How’s about trichomania?

Gberg:
Baboons have those red hairless butts. What an evolutionary kick in the pants!

2:30
P.M
.

Leyner:
That’s the species that anal-bleaching was invented for, see?

Gberg:
Must you come back to that again.

Leyner:
Couldn’t help it. Look, if we’re going to open a salon…we need to offer a FULL range of services…

Gberg:
What goes around, comes around.

Leyner:
Manicures, pedicures, facials, waxing, and anal bleaching.

Leyner:
And if a woman comes in and needs her chest waxed…and you’re to squeamish to do it…I will.

Leyner:
Too squeamish—sorry.

Leyner:
I got too indignant to type.

Gberg:
I am. I will leave that to you. And the biologist.

Leyner:
Who thought it would come to this…that I’d end up a fraudulent evolutionary biologist who owns a chest waxing/anal bleaching salon?

2:35
P.M
.

Gberg:
A fitting last hurrah.

Gberg:
All right, I need to get back to the hairy chest question. Onward and upward.

Leyner:
Here’s to the generative powers of good potato salad, comrade.

Leyner:
Victory or death!

Gberg:
Hallelulah.

Leyner:
Ciao, baby.

Gberg:
Adios.

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