Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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A woman's health needs continue to evolve from her teen years through her golden years. Being active, eating well, and getting your recommended health screenings are the foundation for good health at any age.


Sex is natural. To keep sex healthy for you and your partner(s), it’s important to practice safer sex. This means knowing how to prevent sexually transmitted diseases (STDs) and surprise pregnancy. This includes:

  • Using barrier protection, such as a condom. This keeps semen (for women), vaginal fluid (for men), or blood from entering your body during sex.
  • Being intimate without sex. There are many ways to do this, such as kissing, touching, massaging, or watching each other masturbate. 

Sex can be complicated. It can affect your emotional health, as well as your body. First, decide what’s essential for you to feel safe in your relationship and during sex. Then, clearly communicate your desires and boundaries to your partner before and during sex.

Prevent STDs

Whenever you’re sexually active, you can be at risk for sexually transmitted diseases (STDs). This includes oral, vaginal, or anal sexual activity. 

STDs are:

  • Caused by bacteria or viruses.  
  • Passed between partners by skin to skin contact, or through bodily fluids (sperm, vaginal fluid, or blood). 

Some STDs are easily treated with no long-term effects. Others can be carried for life, causing pain, infertility, or serious, life-threatening diseases.

Except for not having sex (abstinence), there’s no way to prevent STDs. You can reduce your risk by:

  • Limiting your number of partners.
  • Using condoms correctly and consistently.
  • Knowing your partner(s) sexual practices.
  • Saying no to anything that feels unsafe to you.

Before using sex toys, always:

  • Wash them in a solution of 1 part bleach to 10 parts water.
  • Put a condom over them. 
Use condoms and oral dams during oral or anal sex

Some STDs, such as herpes, gonorrhea, and genital warts, can be easily passed on during oral sex. It’s less likely, but possible, to pass HIV this way. 

Many STDs and other diseases are easily spread by anal sex. Fecal material in the anus carries germs. Any time you have unsafe anal sex, you’re at risk. 

Should I get immunized?

Some STDs can be prevented by immunizations, including:

  • Hepatitis A and B
  • Human papillomavirus (HPV)

Ideally, boys and girls get the HPV vaccine series starting at age 11 or 12, before becoming sexually active. If you’ve started having sex, you can still get the HPV vaccine. It’s another way to stay as healthy as possible.

Symptoms and Testing

Common STDs include chlamydia, gonorrhea, herpes, and hepatitis B. Symptoms may include: 

  • Bumps or sores 
  • Pain when urinating (peeing) 
  • Unusual discharge from the vagina or anus 

Many STDs don’t have symptoms, especially in their early stages. Even without symptoms, you can have an STD and pass it on to others.

Should I get tested?

Contact us and get tested if you:

  • Are concerned that you may have an STD.
  • Have a partner who recently told you that they have an STD.
  • Are under age 25 and sexually active. Get tested at least once a year.
  • Have a new partner, or have more than one partner.

It’s best to get tested and treated early, before possible symptoms appear. Your test results are confidential. This means they won’t be shared with anyone without your signed consent (unless required by law). 

Community health clinics also provide free STD testing.

Prevent Surprise Pregnancy

Did you know that about half of pregnancies in the U.S. are unplanned?

Getting pregnant when you aren’t ready can seriously affect your health and life. Protect yourself by using a reliable birth control method that’s right for you.

You may need to try more than one type of birth control before finding a method that works best for you. Women often change methods at different life stages.

Safer Sex

Be cautious, especially with a new partner. Sharing sexual intimacy doesn’t always guarantee trust and honesty. 

Communicate clearly about sex with your partner(s). This can build trust and intimacy, so you feel better and safer together. Still, talking about sex can feel awkward. It’s usually best to be:

  • Clear about what you will and won't do.
  • Direct about what you need and expect.
  • Honest about your feelings.

It's normal to have conflicting feelings about sex and intimacy. Talk to friends who practice safer sex and find out what works for them.

Contact us if you have an upsetting problem, such as pain during sex, or have any questions about sex.

How to Use a Condom

The male condom (rubber) is a narrow sheath that you unroll to cover the penis. They:

  • Are usually made of latex.  
  • Help protect against STDs and pregnancy, when put on before any sexual activity and used consistently.

About 15 of every 100 women will get pregnant if they and their partner(s) use only condoms for birth control. Using spermicide makes condoms more effective. It’s a good idea to use an additional birth control method, and not rely on condoms alone.

Talk with your partner about condoms

It can be fun to use condoms, as part of foreplay, for example. Remember, it’s not okay for your partner to refuse to wear a condom to protect you from STDs or pregnancy.

If your partner says...You can say...
I don't like condoms.We can make using condoms more fun. I want to be safe.
You don't trust me.It's not about trust, it's about being safe.
I don't have one.We can wait until we have one.
How to use a condom

Use a new condom each time you have sex. Always check the expiration date on the package. If the condom is dry, sticky, or stiff, throw it away.

  • Don’t use lotions, baby oil, Vaseline, or cold cream when using condoms. Oils in these products can weaken condoms.
  • Always use a water-based lubricant (Astroglide, KY, or Probe).
  • Don’t use condoms packaged with spermicide lubricant. Some types increase STD risk.
  • Place spermicide in the vagina to reduce pregnancy risk. Women who have HIV or are at high risk for getting HIV should not use spermicides.

Put the condom on before the penis touches the vagina, mouth, or anus.

  • Hold the condom by the tip to squeeze out the air. Leave some space at the tip, for the semen.
  • Unroll the condom all the way down over the erect penis.

To remove the condom after sex, the man holds the condom at the bottom rim and pulls out slowly while the penis is still hard.

Help for Partner Abuse

Being pressured or forced to have sex is common, unfortunately. It can happen even in long-term relationships. But it’s never OK.

It's also never OK for someone to:

  • Refuse to wear a condom to protect you against pregnancy or STDs.
  • Interfere with another birth control method you’re using.

If this is happening to you, get help by talking to us. Or you can call the:

Additional References:

Contacting Me

You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.

For nonurgent questions or concerns, you can: 

  • Email me using this site. 
  • Book an appointment online to see me in person.

For immediate concerns, or you prefer to use the telephone:

  • Call our 24/7 Appointment and Advice line at 1-866-454-8855. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to a specialist

My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.

If you are due for preventive screenings or tests

As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.

Convenient Resources for You

As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions and schedule appointments.
  • View your past visits and test results.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at our medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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