Sexual and Reproductive Health
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!
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.
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!
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!
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.
You’re absolutely right to point out the lack of information and discussion around the use of dental dams. It’s a shame because dental dams are excellent barriers for safer oral sex. For readers who may not be as well versed on this topic, here’s a brief rundown: Dental dams are small, square pieces of latex — the same material used in standard male condoms — that are used for cunnilingus (oral-vaginal sex) and anilingus (oral-anal sex or rimming). As the name suggests, dental dams were originally created to help dentists focus on a particular part of the mouth during dental procedures. But, alas, dental dams also create an effective barrier to keep bacteria, viruses, and STIs at bay during oral sex. For example, dental dams are great at preventing accidental ingestion of fecal bacteria or parasites during anilingus, reducing the transmission risk of oral-genital herpes, HPV, and oral chlamydia and gonorrhea.
Now, it’s time for the nitty-gritty details. The first order of business is to squash any fears you may have about using dental dams. What better way to do this then by practicing and planning ahead. Seriously, just like when using condoms, the more familiar you become with dental dams, the better you may feel about introducing and using them during sex play. So, grab a few, open the package, and get familiar! Have a nice supply of dental dams (and condoms) available wherever you like to get down and dirty. Further, there are lots of creative ways to incorporate dental dams into sex play while maintaining an intimate atmosphere. For example, you could ask your partner to touch her or himself while you (very) slowly unwrap and apply the barrier. Another way to keep it sexy is by experimenting with different dental dam colors, sizes, and flavors.
When it comes to keeping the dam in place, try applying a water-based lubricant to the vulva or anus. This can help keep the dam secured with an added bonus of also enhancing pleasure. In terms of placement, make sure the dental dam is covering the vulva or anus, allowing for oral stimulation of these areas without transmission of bodily fluids and skin contact. Either you or your partner can use your hands to hold the dam securely in place. To prevent slippage, it’s a good idea to first wipe any lubricant off the hands and fingers before attempting to do this. Also, if you are a fan of the DIY, consider making a dental dam with secure “handles” by cutting off the three middle fingers of a latex glove. Added bonus: Use the remaining thumb or pinkie “handles” for penetration with the fingers or tongue! Just keep in mind that if you’re going to make your own dental dam, you should choose non-lubricated condoms that haven’t been treated with spermicide as well as powder free latex gloves — your taste buds will thank you.
Here are some additional considerations:
- Always check your chosen barrier for holes or tears before using it. You can do this by holding it up to a light. Don’t attempt to work around any holes or tears — it’s much safer to use a brand new barrier instead.
- Only one side of a dental dam should be used. Flipping a dental dam around to use the other side defeats the purpose of the barrier, potentially exposing the dam user to bacteria and viruses.
- Do not use one dental dam on multiple parts of the body. For example, moving the dam from the anus to the vulva can cause a urinary tract infection due to the introduction of fecal bacteria to the urethra, and moving the dam from the vulva to the anus could transmit genital herpes from the labia to the anus.
- Never save a dam to reuse at a later date or time, even if you plan to use it on the same body part. Dental dams are strictly intended for one-time use.
- Dams are not intended for insertion. If you wish to use a barrier to permit vaginal or anal penetration with fingers, it’s a better idea to use a latex glove with some water-based lubricant.
- Make sure not to use oils or oil-based lubricants when using dental dams, because they can break down the latex and reduce barrier effectiveness.
Dental dams are a great addition to your safer sex repertoire. For free safer sex supplies at Columbia, take a peek at the safer sex map and check out Where can I get dams for oral sex? For more information and personalized advice, Columbia students can schedule an appointment with a health care provider at Medical Services on the Morningside Campus via Open Communicator. Students on the CUMC campus should contact Student Health. The Gay Health Advocacy Project is also a great resource for Columbians. Readers — Do you have additional advice on how to integrate dental dams into your oral sex play? If so, leave it in the comments! Cheers to dental dams!
August 16, 2013534934
You’ve posed an interesting and complicated question. While you’re right that an HPV (human papilloma virus) infection may become undetectable or clear on its own, it’s hard to know for sure if it’s truly “gone.” Using a condom during casual sex can definitely reduce the risk of passing HPV to your partner(s), but it’s not guaranteed. For this reason, honesty is always important in any type of sexual relationship.
Healthcare providers firmly advise disclosure when it comes to STIs like gonorrhea or chlamydia, but disagree on the necessity of sharing your HPV status with a sexual partner or significant other. Some advocate for disclosure as a general rule, while others suggest talking to partners only when infections are symptomatic (i.e., you have visible genital warts). But even though the health benefit of HPV disclosure isn't clear, there are other reasons why telling partners about your past HPV diagnosis might be a good idea.
Honest communication is crucial to relationships, even casual ones, and talking about HPV could reduce the stigma surrounding this extremely common sexually transmitted infection (STI). Along the same lines, opening up a discussion about your sexual health history may prompt your partner to do the same. Talking with your partner(s) could also be a learning opportunity — for example, maybe s/he doesn’t know about the vaccines Gardasil and Cervarix, which can protect both men and women against several HPV strains. Also, having an open conversation might end up being a stress reliever for your partner(s) – nearly all sexually active adults have had at least one type of HPV at some point in their lives.
If you aren’t sure how to broach the subject with your partner(s), you can find some helpful suggestions in How to tell partner about herpes. Good luck!
While many people have probably not heard of it, Tongkat Ali has historically been used to treat health problems ranging from fevers to intestinal worms. This herbal extract is most popularly known (no wonder!) as an aphrodisiac for men. Although it comes from a plant in the Southeast Asian rainforests, it is now widely available either as a pill or an instant coffee additive. This herbal supplement, also known as Eurycoma Longifolia (EL), has not shown any severe health consequences in experiments conducted with rats. However, as a non-FDA approved substance which has not yet been tested extensively in humans, caution and careful consideration should be given along with consulting with a healthcare provider.
In one study, rats given various doses of Tongkat Ali were found to have increased sexual activity and greater sperm quality. Bigger effects were seen at higher doses, and doses ranged from 30 to 150 milligrams of drug per one kilogram of body weight (mg/kg). In another experiment with rats, administering doses of 1200 to 2400 mg/kg caused some liver damage in a few test subjects but did not otherwise harm them. While there are not studies of long-term use in animals or humans (including studies in women), researchers suggested further investigation of the impacts on the liver as well as research into sustained use.
If you are considering or taking Tongkat Ali pills, the largest dose usually recommended for humans is 400 milligrams per day, which is far below the toxic dose observed in the rat study. If you prefer Tongkat Ali-based coffee mix (TACM), a small trial with 20 human subjects showed that drinking 21 grams of TACM daily for four weeks improved participants’ ability to orgasm and sexual satisfaction, but had no significant impact on their body mass index (BMI), waistline, erectile function, or blood pressure. It is important to note, however, that the study subjects were overall healthy individuals. As always, if you have any health problems or are taking other medication, it’s best to talk to your health provider before starting any supplement, including Tongkat Ali. Columbia students can make appointments by contacting Medical Services (Morningside) or Student Health (Medical Center).
Wishing you safe and pleasurable experiences!
There is a possibility of HIV transmission any time there is sexual contact without a barrier, such as a condom or dental dam, especially if someone has a cut. However, the risk of transmitting or contracting HIV from anal fingering is not very likely if there is no anal or rectal bleeding. The risk of spreading or contracting HIV from anal fingering is much lower than from vaginal fingering, anal-penile intercourse, or penile-vaginal intercourse. This is because HIV is spread through the exchange of certain bodily fluids via open cuts or mucous membranes. Unlike the genitals, fingers do not have mucous membranes; therefore, the only way to contract the virus via the finger would be from a cut or scratch. The only way to spread the virus via the finger would be through bleeding, or through touching fluids containing the virus before penetrating your partner. The vaginal secretions and semen of an infected person both contain HIV; however, the anus is not self-lubricating and thus does not produce fluid — so there is significantly less fluid exchange. That said, the lining of the rectum is very thin and delicate, much more than the lining of the vagina. Since it does not self-lubricate like the vagina, it can bleed much more easily. Avoiding anal bleeding is good practice, not only because it can hurt, but it can reduce your HIV risk, especially if you have a cut on your finger and/or if you don’t know your partner’s status or sexual history. Here are some tips to avoid bleeding from anal or rectal fingering:
- Clip and file fingernails very short.
- Wear latex or nitrile gloves, clip your nails, and wash and dry your hands before donning the gloves.
- Use plenty of water-based lubricant to prevent friction and tearing of the tissue. Some lubes are designed especially for anal play.
- If you like to keep you finger nails long, wear latex gloves and use cotton balls at the tips.
- Scrapes on your hands are not as concerning, but an open cut on your finger can definitely increase the chance of transmission of HIV or of some other STI. Consider waiting until it heals if there is any chance that either your partner(s) or you have HIV.
- Go slowly and start small. The anus and the rectum need to relax before you can properly enjoy anal play. Follow the lead of your partner and stop if it hurts.
If you’re a Columbia student on the Morningside campus and interested in HIV testing, you can get tested for free. Just check-out the HIV drop-in testing hours at GHAP. If you are on the Medical Center campus, contact Medical Services to find out about HIV and other STI testing. For more information about HIV/AIDS or other STIs, visit the Sexual Transmitted Infections (STIs) section of the Go Ask Alice! archives.
Being cautious doesn’t mean you shouldn’t experiment. Anal fingering can be very pleasurable for any gender, but especially for a man because when done “correctly,” it can stimulate the prostate and result in an intense orgasm. However, be sure to remember that sexual play involving the anus includes risks of bacterial infection as well as STIs if fingers or toys aren’t washed properly before and afterwards, or if you don’t use a new condom before moving on to another body part. Be safe and have fun!
First, it’s awesome that you opened up to your boyfriend. That’s a difficult discussion to initiate. Not only is clear and honest communication the foundation of a healthy relationship, but for many folks, it can also be integral to a satisfying and fulfilling sex life. Second, it sounds like your boyfriend is being supportive, which is also awesome. These are good first steps. You mentioned that you feel like you shouldn’t have told him. Here’s the thing — not telling him would probably have meant more of the same thing in the bedroom. It would’ve been very difficult to seek your own pleasure without him knowing something was up. In other words, by faking orgasms, your boyfriend was under the impression that whatever you two were doing was satisfying to you. And maybe it was pleasurable, but from your question, it appears that maybe it hasn’t been as satisfying as you would like. You are both on the same page now and, as your boyfriend said, can “start from the beginning.” Now, let’s talk about this mental block you’re having.
You say you are having problems becoming aroused. What made you aroused before you told him? It may just be that you need a little time to get back there. Be patient with yourself. Many women find it hard to orgasm, either on their own, with a partner, or both. Some women can orgasm through oral sex or masturbation, but not intercourse. Other women only get off through manual stimulation. Still others can orgasm when working solo, but not with a partner. When you say you’ve never had an orgasm “from sex,” are you referring to intercourse only or oral sex, too? If this is specific to intercourse, you should know that most women have relatively few nerve endings in their vaginal walls, making it more difficult to come without at least some stimulation of the clitoris. In fact, for most women, sexual pleasure comes from direct or indirect stimulation of the clitoris. Can you get yourself off through masturbation? If so, it may be worth showing your boyfriend how you do it. Each woman is different in terms of what brings her to orgasm, so giving your boyfriend a “how-to” lesson may help. Some couples also find it useful to bring a vibrator into sex play. Many women find a vibrator can help them reach orgasm.
Easing orgasms for women offers many potential reasons for difficulty in reaching orgasm, such as worrying about not having an orgasm, being unable to focus on the sensations you’re feeling, and not wanting to ask your partner for too much. It sounds like you’ve felt a lot of pressure to climax lately, and perhaps fear that you won’t be able to. This could be distracting you from getting aroused and causing your mental block. Try to relax and concentrate on what you’re doing with your boyfriend — the excitement, the sensations, the atmosphere — instead of what you expect to happen at the end. If you like something, don’t be afraid to tell him and ask for more. You might find that staying “in the moment” relieves some of your anxiety and allows you to have an extremely pleasurable experience, regardless of whether you end up having an orgasm or not. Climaxing doesn’t have to be the be all and end all of sex — getting there can be exciting, too!
The Go Ask Alice! Orgasms archives also contain a wealth of information and suggestions on how to achieve an orgasm, and ask your boyfriend if he would be willing to help you test out some new strategies. Just remember to have fun trying!