Sexual and Reproductive Health

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Compulsively watching porn - addiction?

Dear focus on us,

Let's put aside the "can he really be addicted to porn" question for a brief moment. Let’s focus on the two of you and what is known: First, you and your boyfriend are having much less frequent sex than in the past (and you are, presumably, disappointed about this). Second, your boyfriend told you he believes he is addicted to porn and, despite his best efforts, is finding it hard to abstain. When a person is compulsively doing anything, so much so that it causes her/him distress, interferes with relationships, or otherwise negatively impacts day-to-day life, it’s important to consider reaching out for help. This is especially true when attempts to stop the undesired behavior are not successful. One option is for your boyfriend to seek out the expertise of a mental health professional, many of whom can assist with strategies to overcome compulsive behaviors. Alternatively, or in addition, both you and your boyfriend could try therapy together, in the form of couples counseling. Columbia students can make an appointment with a counselor through Counseling and Psychological Services (Morningside) or Mental Health Services (CUMC).

Have you talked with your boyfriend about what he enjoys about porn? How about what it does for him (feelings, emotions, thoughts, etc.) that he may feel like is not getting from other sources in his life? In some situations, compulsive behaviors are linked to other thoughts and needs in the person’s life. If your boyfriend is unsure about these issues or not comfortable discussing them with you directly, a mental health professional is likely a good next step.

Let’s get back to your question about whether your boyfriend could actually be addicted to porn. There’s quite a lot of debate in this area. The general consensus among researchers is that compulsive porn consumption isn’t a true addiction, at least as defined in the traditional clinical sense. This doesn’t mean that your boyfriend’s porn habits aren’t causing him troubles, just that many in the field don’t find it helpful or particularly appropriate to classify this as an addiction. Further, medical professionals seem conflicted on whether or not problematic consumption of pornography should be considered a disorder of its own or a symptom of other disorders; however, it has been generally documented that heavy and compulsive use of pornography occurs, has neurological effects, and can be treated through therapy (and, in some cases, medication). Regardless of an official diagnosis, compulsively viewing pornographic materials so often that it affects other areas of your life, such as your health, job, or relationships, can be a serious problem and something worth exploring.

Lastly, let’s focus on YOU for a few moments. Clarifying your feelings and thoughts about this situation may help you decide how to proceed. So, a few reflective questions for you to ponder: What would an ideal sex life with your boyfriend look like? How often would you like to be intimate? What are your general feelings toward pornography or erotica? If the decrease in sex is related to something else, not his use of porn, will you still view his porn usage negatively? All questions for you to consider as you think about next steps.

Wishing you the best,

Alice

Orgasms and making babies?

Dear Reader,

The quick answer to your question is no — orgasm is not necessary for someone to become pregnant. It may, however, make the baby-making experience more exciting! Conception and pregnancy are typically dependent on the convergence of a few factors: namely, a healthy egg, healthy sperm, and favorable cervical mucus all being in the same place at the same time. Penis-in-vagina intercourse is the most practiced method for getting the egg and sperm together; however, check out Sperm motility for alternate routes of joining the two (e.g., in vitro fertilization). The role of orgasm as it relates to penile-vaginal intercourse and conception, no matter what your anatomy, is still highly up for debate.

With that being said, there’s some interesting research on how orgasm may increase the likelihood of pregnancy. Orgasm is thought to heighten the sperm-meets-egg probability by both positively reinforcing ejaculation from the penis (in other words, making the ejaculate shoot further), as well as increasing uterine contractions. These pelvic contractions happen due to the presence of oxytocin, which is released from the brain during orgasm. Uterine contractions help sperm towards the goal of fertilizing an egg by moving them up the vaginal canal and into the uterus.

Here’s something else to ponder: Women are much more likely to experience orgasm from clitoral stimulation than from vaginal-only penetration. The vaginal wall contains relatively few nerve endings (unlike the clitoris which contain 6,000 – 8,000 nerve endings), making the in-and-out of intercourse less likely to lead to the big “O” for many women. Unless, of course, there’s some simultaneous touching, pressing, or other type of clitoral stimulation happening. So, biologically speaking, the “purpose” of female orgasm in terms of baby-making isn’t clear, beyond the very simplistic (yet important) element of pleasure.

Penile orgasms on the other hand are very common with vaginal intercourse. And while ejaculation can occur without orgasm, the co-occurrence lends itself more strongly to the idea that this type of orgasm has a purpose beyond pleasure.

All those fun facts aside, there has yet to be any definitive studies that show a connection between orgasm and fertility trends. As far as we know now, orgasm is less of an evolutionary tool and more of a sexual bonus.

Enjoy!

Alice

STI transmission via skin-to-skin contact?

Dear Reader,

Since your question was submitted via a reader response for the question Shedding light on viral shedding, you are most likely referring to skin-to-skin transmission in the context of herpes and other STIs. Information about STI transmission can be confusing, so kudos to you for seeking clarification. In general, most STIs are transmitted either through bodily fluids (such as semen, vaginal fluids, blood, breast milk, or saliva) or skin-to-skin contact. An uninfected individual doesn’t necessarily have to have an opening in the skin for transmission to occur via skin-to-skin contact. Many STIs can also be transmitted through mucous membranes, such as the mouth and lips, nostrils, eyelids, ears, anus, and parts of the genitals. Transmission is possible only when an infected person’s mucous membranes, bodily fluids, open lesions, or infected shedding skin cells come into contact with an uninfected person’s mucous membranes or open lesions. And yes, antiviral creams can decrease the chances that an infected person will transmit the herpes virus to her or his partner. If a person doesn’t have herpes, however, using an antiviral cream on her- or himself won’t prevent the possibility of contracting herpes from an infected partner. Antiviral creams and medicines are not intended for prophylactic use by uninfected individuals.

STIs spread by skin-to-skin contact include oral and genital herpes, HPV, and syphilis. Skin-to-skin contact occurs when an infected site of one individual’s skin (for example, the genitals of an individual with human papillomavirus, or HPV) come into direct contact with a mucous membrane or lesion on an uninfected person’s body. For example, if an HPV-infected shedding skin cell were to touch an uninfected person’s cut-and-scratch-free hand, the HPV virus would have no route of transmission — the hand is not a mucous membrane, nor does it have any open lesions. However, let’s say that the infected shedding skin cell were to make contact with the mouth of an uninfected person (or any other mucous membrane or lesion on her or his body), transmission would be possible in that case.

Take note of one exception: molluscum contagiosum, a superficial skin disease than can be transmitted sexually and is therefore often classified as an STI, can be spread not only through the avenues mentioned above, but also through indirect contact. The small bumps that arise from molluscum contagiosum infection can inhabit any surface on the body, and there are documented cases of molluscum contagiosum transmission via wrestling, surgery, towel or sponge sharing, pool and gym equipment sharing, and sauna and communal bathroom use. Fortunately, molluscum contagiosum resolves naturally after 6 to 12 months.

To reduce your risk and protect yourself from STIs, consider the following:

  • Ask your partner about her or his sexual health. It doesn’t have to be awkward — there are lots of ways to approach this conversation. Consider getting tested together!
  • Although oral and genital herpes and HPV are commonly spread when an infected person has no symptoms, the highest risk for transmission occurs when s/he experiences a flare-up. Avoid direct skin-to-skin contact during active outbreaks.
  • Use barriers such as condoms and dental dams to prevent transmission through skin-to-skin contact. If you’re a Columbia student, refer to the Safer Sex Map for free safer sex materials on campus.
  • Wear protective clothing if you are a healthcare worker or athlete who is in physical contact with others’ skin, mucous membranes, lesions, or bodily fluids on a regular basis.
  • Females between the ages of nine to 26 and males between the ages of nine to 21 may receive Gardasil, the HPV vaccine. This can help curb the spread of HPV and reduce risk for cervical cancer.
  • To prevent spreading herpes through childbirth, women with genital herpes can take antiviral medication from 36 weeks into pregnancy until delivery.

For more information, take a look at the Sexually Transmitted Infections section of the Go Ask Alice! archives. Columbia students who wish to speak to a medical provider about skin-to-skin contact, antiviral medications, or any other medical concerns can set up an appointment with Medical Services on the Morningside campus via Open Communicator, or with Student Health at the Medical Center at 212-305-3400.


Hope this clears things up!

Alice

College students and STIs

Dear Readers,

Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) are infections transmitted through sexual activity or behavior. Most college students are between the ages of 15 to 24 (most commonly 18 to 22), which has been found to be the group that is most susceptible to new STI infections. In fact, people in this age group acquire almost half of all new STIs every year, with individuals between the ages of 20 to 24 accounting for the highest infection rates. This annual increase of new infections can be explained by many sociocultural phenomena, including lack of sex education, insufficient access to safer sex materials, inability to pay for testing and treatment, discomfort with reproductive health facilities and services, and concerns regarding confidentiality. However, the risk of STI infection is palpable, and there are many ways you can protect yourself.

Although young adults are the age group most affected by new STI infections with approximately 9.5 million new cases each year, STIs do not discriminate on the basis of age. STIs affect individuals of all backgrounds, races, ethnicities, genders, and ages. With that said, according to the Center for Disease Detection, the following STIs are most common among college-aged young adults:

  • One of the most common STI among people between the ages of 15 to 24 is chlamydia. In fact, chlamydia is the most prevalent bacterial STI in the United States, with over 1 million new cases reported annually. Rates of reported chlamydia infections continue to increase steadily with time: between 2010 and 2011, chlamydia infection rates increased by 10.5 percent among women and 12.4 percent among men between the ages of 20 to 24.
  • Also very common among the young adult population is herpes infection. Herpes Simplex Virus 1 (HSV-1), or oral herpes, is so common that epidemiologists believe it infects between 50 to 80 percent of adults in the United States. Herpes Simplex Virus 2 (HSV-2), or genital herpes, affects one in five college aged students in the United States.
  • Human papillomavirus (HPV) affects many: there are approximately 5.5 million new cases of it every year, which accounts for 33 percent of all new STI infections annually. There are many strains of HPV, many of which show no symptoms. Fortunately, the Gardasil vaccine, which is recommended for everyone under the age of 26, protects against four strains of the virus, including two that cause warts and two others that are associated with the development of cervical cancer.
  • Another prevalent STI among young adults in gonorrhea. Between 2010 and 2011, gonorrhea infection increased 5.4% among women and 6.2 percent among men aged 20 to 24. Again, the young adult age group demonstrates the greatest increase in number of infections compared to all other age groups.
  • Trichomoniasis, commonly referred to as “trich,” is a parasitic STI that can be treated with antibiotics. It affects approximately 7.4 million previously uninfected individuals on a yearly basis, and is unusually difficult to detect in men.
  • The last STI commonly found in young adults between the ages of 20 to 24 is syphilis. Syphilis presents in several stages: primary, secondary, and late or latent stages. Syphilis is relatively rare, but infection rates are on the rise particularly among men within this age group. The shift of syphilis infection to younger adults reflects a trend; it used to be more common among men between the ages of 35 to 39, but now affects more college-aged men.

Many STIs are able to remain dormant and not show symptoms for years after infection occurs. This is true for both bacterial and viral infections. For example, up to 90 percent of individuals infected with HSV-1 or HSV-2 never exhibit symptoms. For this reason, you might consider undergoing a routine STI screening before having unprotected sex. Better yet, you and your partner can show each other your test results, which is the only fail proof way to tell if someone has an STI or not.

If you have any symptoms or test positive for an STI, don’t fret. Your doctor will help you decide how to treat the infection, and many STIs, including chlamydia, gonorrhea, and syphilis can be treated with antibiotics. Although herpes cannot be completely cured, there are prescription medicines that can help reduce the frequency and severity of HSV-1 and HSV-2 breakouts.

If you’re a Columbia student and you think you might have an STD, contact Medical Services on the Morningside Campus or Student Health at the Medical Center Campus to schedule an appointment. For HIV testing, counseling, and treatment, reach out to the Gay Health Advocacy Project. Finally, consider picking up some free condoms, dental dams, lubricants, and other safer sex materials on campus by checking out the Safer Sex Map. If you’re not a Columbian, find an STI clinic in your area for testing and treatment.

Alice

Arousal while breastfeeding

Dear Reader,

Breastfeeding is often pleasant for women because of feelings of closeness and tenderness with their child, and yes — sometimes it can even be arousing. In fact, in some studies up to 50 percent of women found breastfeeding to be an erotic experience, but sadly a quarter of these women also experience shame and guilt over this. Although feeling sexually stimulated during breastfeeding may be uncomfortable and jarring, it is actually a completely normal response.

The hormones released during lactation explain some of the connection between breastfeeding and arousal. When a baby suckles at her/his mother’s breast, the nipple stimulation causes the release of prolactin and oxytocin. Affectionately known as the "cuddle hormone," "trust hormone," and "love hormone," oxytocin is also released in large quantities during childbirth, and in lesser quantities during hugging, touching, and orgasm. The release of oxytocin can sometimes cause uterine contractions, similar to those experienced during orgasm. Again, while these sensations may feel odd and uncomfortable in the context of breastfeeding, it does not mean this sexual desire is directed towards the child. It simply means these hormones are working properly!

As mentioned, some women feel embarrassed and “wrong” because they experience pleasure during breastfeeding. Some even go so far as to cause themselves pain during breastfeeding to combat their feelings of arousal or stop breastfeeding altogether. If you are breastfeeding and facing shame or guilt such as this, you may want to seek support from a counselor, from an online or in-person mommy support group, or from your friends and family. If you are a Columbia student, you can make an appointment with a therapist by contacting Counseling and Psychological Services (Morningside) or Mental Health Services (CUMC).

Alice

My boyfriend wants me to hit him

Dear Reader,

Talking openly about your previously secret fantasies can be a big step in a relationship — it shows a building of trust, willingness to be vulnerable, and the desire to explore together. It sounds like you and your boyfriend are at a unique place to try new things and support one another in that discovery. But before you switch things up between the sheets, taking your time and picking up your pillow talk where you left off may be a good place to start.

Many people take on different roles when they have sex, often referred to as “role-play.” Your boyfriend asking you to be more aggressive and physical with him during sex is one example of role-play.  When one partner acts out a more powerful role (sometimes by hitting, restraining, biting, etc.) they may be referred to as dominant, while the other partner may be referred to as submissive. This power/pain dynamic in relationships often falls under the category of BDSM (Bondage, Discipline, Domination, Submission, Sadism, and Masochism). It sounds like you have some familiarity with the terms dominant and submissive. Power dynamics in healthy relationships, especially during sex play, benefit from a lot of communication — before, during, and even after roles are acted out. Each partner should feel physically and emotionally safe and able to communicate their needs throughout.

As someone new to a more physically dominant role during sex, taking the time to talk and establish guidelines you both can agree on first really sets the stage for playing later.

Here are some tips to get you both started:

  • Pick a neutral time & place — Finding a time and a place will allow you to both speak comfortably and in depth about what you want and don’t want sexually/erotically. It’s a good idea to have this conversation outside of the bedroom, so as to avoid mixing business with pleasure.
  • Avoid assumptions — Try not to assume either one of you already knows the ropes of how to navigate a fantasy. Asking each other lots of questions helps to clarify desires, fears, and boundaries. Making a commitment to do some learning together will help ensure that you are both on the same page.
  • Consent to consent — One critical aspect of healthy sexual relationships is mutual consent, especially during role-plays. Agreeing to respect a “go,” “slow down,” or “stop” request — no matter what you are doing — is a way to establish guidelines for communicating each other’s wants and needs clearly. There may be times when one person wants to stop or slow down, and there may be moments when one person wants to make sure it is okay to keep going. Discussing how to navigate those feelings before they come up will help you both feel prepared and safe.
  • Make a list — Sometimes, it’s helpful to actually put pen to paper and write out what you want and don’t want. Try making a list of “yes,” “no,” and “maybe” columns for each of you. You can both write what you are completely open to sexually/erotically, what you are not interested in at all, and things you are maybe interested in, but just not sure about yet. This is a good way to learn more about one another, discuss boundaries and limits, and share ideas about potential role-play scenarios and sex. You can revisit these lists, as people’s desires can shift or change over time.
  • Pick a “safeword” — A “safeword” is an unambiguous word that will signal you or your boyfriend want to stop, slow down, or check-in. Some people simply use “safeword” as their signal. Others use “red” for “stop,” “yellow” for “slow down,” and “green” for “keep going.”
  • Start slow — Because it’s hard to predict what you will like or dislike until you try something out, consider starting out slowly as you take on a new adventure in your sex life. Agreeing to be patient with one another and checking-in regularly can help you both along the way.

If you both agree to experiment with aggressive sex play, many BDSM practitioners advise creating what is known as a “scene,” as opposed to using real-life frustrations as inspiration. Your scene is a guide for each of your roles during your agreed upon time and dynamic. Scenes can help partners maintain clear boundaries between reality and fantasy. Beginning to experiment with hitting, slapping, or other forms of “inflicting pleasure” can start with more gentle versions of the desired act (e.g. gentle pats that become progressively more firm).

Resources are available for introductions to BDSM guidelines and practices in print, online, and sometimes in workshops facilitated by community groups, sex toy stores (like Babeland and Good Vibrations), and even health promotion offices on some college campuses. If you’re a Columbia student, there is a student run BDSM education group, Conversio Virium, which organizes educational workshops and discussions.

As far as working out those real-life frustrations, it's generally a good idea to keep them separate from the bedroom. Consider talking about those in a different setting with your boyfriend, a friend, or a counselor. If you’re a Columbia student, you can contact Counseling and Psychological Services (Morningside) or the Mental Health Service (CUMC) if you want to pursue counseling options.

Learning more and continuing to talk honestly about what you both want (and don’t want) can make your sex life more enjoyable, as well as increase intimacy in your overall relationship. Have fun and play safely!

Alice

Privacy and STI testing — who will know my results?

Dear Nervous,

Many people have wondered about their level of privacy with regards to STI test results. A patient’s test results for sexually transmitted infections (STIs), including HIV/AIDS are protected under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPPA sets limits over who can access your health information — whether it’s electronic, written, or oral. HIPAA regulates covered entities such as health plans, health care providers, and clearinghouses. Different states have other policies that further protect a patient’s privacy. For example, in New York, Article 27-F of NYS Public Health Law requires a signed release form from a patient in order to disclose any information pertaining to individuals who have been tested, exposed, infected with, or treated for HIV/AIDS-related illnesses.

People who test positive for STIs or HIV/AIDS are reported to the state and local health department for the purposes of public health surveillance. At the state level, only public health personnel have access to this information to understand rates of HIV in the state. The state health department then removes personal information about you to share with the Centers for Disease Control and Prevention (CDC), so they can track national public health trends. This information is not shared with anyone else.

There are two options for HIV testing — confidential and anonymous. Most states offer both; however, some states only offer confidential testing services. Confidential testing means that your results are connected to your name — other identifying information will go into your medical record and may be shared with your health care provider and insurance company.  However, you are protected by state and federal privacy laws and your name cannot be released without your permission. An insurance company should not drop you for being tested for HIV or testing positive for HIV. Anonymous testing means that your name is not connected to your results. When you take an anonymous HIV test, you get a unique identifier that allows you to get your test results. It should be noted that not all HIV testing sites are bound by HIPAA regulations, so be sure to check beforehand.

The U.S. Department of Health & Human Services has more information regarding confidential versus anonymous HIV testing if you have further questions. You can also contact your local health department or call 1-800-CDC-INFO (800-232-4636) to learn more about the confidential and anonymous STI test sites in your area. If you’re a Columbia student on the Morningside campus, the Gay Health Advocacy Project is a fantastic resource for testing and information about HIV/AIDS. They also have free and confidential drop-in HIV testing hours. In addition, you can contact Medical Services on the Morningside campus or Student Health at the Medical Center to get tested for STIs in a confidential environment. If you’ve been raped, molested, or sexually assaulted, don’t hesitate to reach out to Columbia’s Sexual Violence Response team, as well as Counseling and Psychological Services on the Morningside campus and Mental Health Services at the Medical Center for support.

Hope this helps you make a decision to get tested!

Alice

Birth control and food cravings

Dear Reader,

Food cravings are caused by many things — stress, mood changes, hormone fluctuations, and even just the sight of a specific food can cause you to salivate. But, contrary to popular belief, science has not linked food cravings to birth control pill usage.

There are a lot of myths that similarly connect birth control pills and weight gain. Understanding how birth control pills work helps to debunk those myths. Birth control pills work by balancing hormone levels, which stops your menstrual cycle and prevents ovulation, making pregnancy very unlikely. Hormone fluctuations are more often responsible for food cravings. A lot of people experience these hormone induced cravings during pregnancy, when hormones shift a lot. While some increases and decreases in appetite may occur with birth control pill usage, this experience is not consistent. Most weight gain experienced by people on the pill is likely a result of existing exercise and eating habits, not the pill itself.

Food cravings are actually the most predictable in relation to stress level. Upsetting thoughts, fatigue, and other types of stress are interpreted in your body as threats and cause your adrenal glands to release cortisol. This release of cortisol sends a message to your liver that your body needs glucose (sugar). This is part of your body’s “fight or flight” response — when your body experiences a stressor, it engages those “fight or flight” instincts by preparing to use available glucose for energy.  Your body will first use available sources of glucose, and then, if the stressor continues, glucose levels become depleted, and you will crave sweets and carbs — the types of food easily converted to glucose. This interplay of psychological and physiological responses can often catch people in a vicious cycle of cravings. In addition to lowering stress, eating foods higher in protein can help reduce the dramatic changes in blood sugar levels and the severity of cravings. 

If you’re concerned about changes in your food cravings, appetite, or potential side effects of your birth control, discussing your observations with your health care provider can help get to the root of what may be causing the changes you have noticed. If you’re a Columbia student, you can make an appointment with a medical provider or registered dietitian at Medical Services (Morningside) or the Student Health Service (CUMC). You can also learn more about healthy eating resources through Alice! Health Promotion’s nutrition initiatives.

Hope this helps!

Alice

Sex toys for men?

Dear Reader,

Whether you’ve grown a little too accustomed to the touch of your own hand (hey, it happens to the best of us) or are simply curious about spicing things up during your “me time,” there are lots of sex toy options to choose from. Many sex toys on the market are designed specifically for men. Men can also use many of the  sex toys that are traditionally marketed toward women. There’s something out there for almost every guy, and with a little bit of thought and experimentation, you’re likely to find a toy that works for you.

It sounds like you’re interested exclusively in masturbation toys. However, keep in mind that many “masturbation” toys can be used during foreplay or intercourse with your partner(s). And now, without further ado, the toys:

  • Masturbation sleeves and strokers: These toys surround the penis with silicone or other rubbery material, imitating the sensations of penetrative sex. The most well-known masturbation sleeve, called the Fleshlight, is sold in various models, including those that are designed to resemble an anus, mouth, or vulva. Use a good amount of lubricant when playing with masturbation sleeves to reduce friction and increase stimulation.
  • Cock rings: Designed to hold blood in the penis, cock rings help to make an erection feel harder and slightly larger for a longer period of time. Cock rings can also be worn around the testicles to prolong pleasure and delay ejaculation. They come in various materials, such as adjustable leather and plastic, stretchy silicone, and non-adjustable metal. Some rings vibrate, adding extra stimulation to the area below the testicles (and/or the clitoris when used during vaginal intercourse).
  • Prostate massagers or stimulators: Also known as the “male g-spot,” many men experience intense pleasure from stimulation of the prostate. Some are able to orgasm from prostate stimulation alone, while others report a more intense orgasm when the prostate is involved. Butt plugs are well-known for prostate stimulation as are dildos and anal beads. One helpful piece of advice: When it comes to any type of anal play, lube is your best friend!
  • Penis pumps: Like cock rings, penis pumps trap blood in the penis to make your erection harder and slightly bigger for a longer period of time. The increase in size is short-lived, though. Eventually the penis will go back to its regular size. Basically, penis pumps work sort of like a vacuum. As air is pumped out of a cylinder placed over the penis, blood rushes and engorges the erectile tissue. Some men find the suction pleasurable.
  • Fetish toys: Cock cages, electronic stimulation toys, nipple clamps…the list goes on and on! A vast universe of fetish toys exists, and possibilities for experimentation are limitless. A well-stocked adult store will be able to help curious customers explore what kind of toys that might interest them as well as how to use these toys. Think about what you already know you like as a starting point for fetish exploration.

Sex toys come in all shapes, sizes, materials, and price ranges. Lots of people prefer buying online due to increased privacy and discretion. However, if you’re interested in seeing how a toy works in person before buying it, consider going to your local adult store to check out demo models. If you choose to examine your potential toy in person, pay attention to its size, texture, intensity of vibration, and control options. Once you’ve purchased and used your toy(s), be sure to wash them thoroughly. Gadgets made of non-porous materials, such as glass, silicone, and metal are preferable because they can be completely sterilized. Toys made of porous materials should be used with condoms. To clean your toy, follow the instructions on its packaging — most are cleaned with mild soap and water. Don’t use germicidal soaps, as they’ve been known to irritate genital tissues.

If you decide that sex toys aren’t your thing, you still have options! If you’re generally satisfied with manual masturbation and you’re simply looking for something to intensify pleasure, try out a new hand trick or add new or different types of lubricant into the mix. Toys aren’t necessary for experimentation, so if none of these toys strike your fancy, you can still explore various masturbation techniques. Happy experimenting!

Alice

Reaching orgasm with and without sex toys

Dear Reader,

Fidelity to your tried and true vibrator may seem like a problem in the context of a sexual relationship with another person; however, your situation actually presents many positives: First, you already know what feels good to you (and what it takes to reach orgasm), and second, you have an opportunity to keep things interesting by introducing your partner to your vibrator. Many women do not reach orgasm through intercourse or manual or oral stimulation alone, but societal pressures make some feel uncertain about using sex toys. Whether you feel you’ve habituated to this particular masturbation style or you simply prefer it to other types of stimulation, there are many ways for you and your partner(s) to enjoy sex, with or without your trusty vibrator.

People masturbate regardless of relationship status: In a study conducted by the National Survey of Sexual Health and Behavior, approximately 75 percent of women ages 18 and older had experience with masturbation, and nearly 50 percent of these same women had engaged in masturbation in the presence or with the assistance of a sexual partner(s). It seems that you have solo masturbation covered, but you may be interested in learning more about how you can involve masturbation into your partnered sexual experiences.

Mutual masturbation with a sexual partner(s) takes many forms. It can involve masturbating simultaneously, or touching, watching, or listening to your partner(s) masturbate. It can also occur during intercourse — for example, a vibrator may be used to stimulate the clitoris during penetrative sex. If your partner feels a little uncertain about incorporating a vibrator into your next sex session, try your best to reassure your partner that you are sexually attracted to her or him, but that you need a little superhuman stimulation to get things going. Perhaps suggest that s/he take control of the toy and use it on you. By experimenting with the vibrator and seeing your reactions to various movements and techniques, your partner might find it to be a lot of fun. You can also use your vibrator on your partner(s) to share the love.

If you’re not keen on using your vibrator during partnered sex, there are alternatives. For example, many women find reaching orgasm easier with a little muscular training. You don’t have to hit the gym to train your pubococcygeus (PC) muscles, those that support pelvic anatomy around the urethra, vagina, and anus. Training these muscles may significantly increase a woman’s ability to orgasm from intercourse. To locate your PC muscles, simply stop the flow of your urine the next time you go to the bathroom. Squeezing these muscles several times a day strengthens them and increases blood flow to the area, assisting in the achievement of orgasm.

Another way to increase your ability to orgasm without your vibrator is to experiment with stimulating various areas of your vulva and vagina. Many believe the clitoris is composed solely of the small button-shaped organ at the top of the vulva, but the clitoris actually consists of 18 parts (!), many of which are not visible. Try stimulating the areas around the perimeter of the visible part of the clitoris, as well as the labia, area near the vaginal opening, perenium (the area between the vagina and the anus), and the g-spot.

Betty Dodson introduced a technique that may also help you achieve orgasm through intercourse. Her Rock ‘n Roll technique involves rocking the pelvis during sex, rocking backward while inhaling and forward while exhaling. The main idea here is to breathe deeply, relax the body, and keep the pelvis moving. Dr. Debby Herbenick, sexual health researcher and educator, also has tons of information about masturbation and achieving orgasm on her site My Sex Professor.

For some women, a vibrator is necessary to achieve orgasm, and that’s perfectly normal. For more information about sex toys, check out the Tools and Toys section of the Go Ask Alice! archives. While you’re at it, check out the Safer Sex Map to pick up some free safer sex materials on campus.

Alice

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