Copyright (C) 1998, 1999, 2000 William F. Fitzgerald, Ph.D.

Answer page #27

Link to the Home Page of ASK THE SEX DOC

FLASH  Thursday January 4, 2001 at 6 p.m. California time Dr. Fitzgerald will be interviewed on eYada.com -- internet radio for one hour.  The link to the  radio show is www.eyada.com  and you can call in or e-mail a question.

                                               WORRIED

A:  (Chance Fisher, M.D. replies)  Yes, there are symptoms of AIDS.  Most commonly found symptoms are flu like.
Swollen glands, a lowered immune system which earns you frequent colds,
coughs, etc..., night sweats, weight loss, problems with sleep patterns,
etc... There are many, but remember that symptoms may not show up for
several years and the sooner you get tested and IF you find out that you are
positive, current treatment can help keep the disease in the HIV stage and
discourage it into becoming AIDS.

Bumps on the vaginal lips are common.  They usually are inflamed or ingrown
pubic hair.  This happens a lot if you shave your pubic area.  It can also
be a sign of herpes or genital warts.

Vaginal infections are usually caused by bacteria.  The most common
infection is yeast.  Most infections are not life threatening, they are just
a pain to deal with.  Infections can result from cuts or tears caused by
fingernail scratches.  Most are caused by an imbalance of the flora in the
vaginal environment.  Most infections can be cured by an over the counter cream
such as Monostat.  The most common symptom is itching, burning, and a
discharge with a white or yellow color.

Nothing happens if you don't take a bath after sex except that your friends
may look at you and say "Damn, you smell like
you just got laid!"  Seriously, nothing happens.  If you have sex one night
and don't take a shower until the morning you are not going to die.  Brown
discharge could be anything.  When you release an egg there may be some
blood release, if you have sex and there is stretching a small amount of
blood may show up, or since you stopped taking birth control the brown
discharge may be break through bleeding while your body is bouncing back to
normal.

Burning during sex can be linked to condom use, especially if you have a
small tear of scratch inside the vagina.  Try a different type of condom.
It is usually the spermicide or lubricant that causes burning.  But if you
do have a vaginal infection, the use of the condom could have caused it to
flare up a little.

Since you are seventeen you are correct in stating that going to the doctor
may cause problems in terms of your mother finding out.  Usually, if you go
into the exam room by yourself, the doctor will keep the conversation and
exam confidential unless you have a life threatening thing like AIDS that
needs to have parental notification.  Otherwise, there is no reason that you
cannot go to your doctor for treatment.  If you go to a free clinic, odds are
your mother will not find out.  In fact most free clinic offer total
confidentiality.  Your mother probably already knows you are sexually
active.  Parents assume these things.

Thanks for any advice you have.

p.s.  I neglected to mention that fecal incontinence does not occur during
orgasm in masturbation. I don't know if that helps you at all, but thought
it may make a difference.

Chance Fisher, M.D.  replies:  Fecal incontinence is not very common, but it does happen.  The reason for
this during sex, especially when a woman is on top, is most likely due to
sphincter disruption that stimulates a release of fecal matter.  Basically,
the pressure of a penis in the vaginal canal causes pressure on the muscles
of the anus which promotes it to the "release" mode. Also, the nerves that
are involved in experiencing orgasm are closely located and related to those
that are located in the entry to the anus.  Thus, when you orgasm all of the
nerves are affected.  You may or may not have noticed that your anal canal
clinches or spasms as you have an orgasm.    Really there is nothing that
can be done in a situation like this.  Since you can only seem to get to
orgasm while being on top, I would think about trying different positions
such as doggy style while you stimulate or your partner stimulates your clitoris.

A:  THIS is why our group is named the Silicon Valley Relationship and Sexuality Center!  The vast majority of people have sex with people with whom they feel mutual affection.  Being sexually intimate involves exposure, risk, acceptance, and recognizing the sexual partner as a source of pleasure, and over time, this leads, usually, to bonding.  So you will either trivialize the sex as a way of remaining emotionally shallow, or you will be more and more emotionally available to each other and want to spend more time together, increasing the tension and conflict.  When you say that you enjoy each other's company in bed and out of bed, I think that speaks volumes -- it's not "just" a lust thing.

The stress of deceit coupled with the thrill of good sex could cause him heart problems; a risk you take.  You have to decide whether you can protect your respective spouses from finding out, knowing that they would be hurt by what you are doing.  I am sometimes amused when couples are in therapy to find that so often when one is having an affair, the other knows it and pretends not to know.

But you are finding some needs fulfilled by this.  If it is not just the thrill of novelty (if that is it, it won't last long), figure out what you're getting here that you are not getting in your marriage and see if you can cultivate that in your marriage.
 

A:  First, it means that you have not been traumatized by religion or by homophobic societal messages.  Second, it means that you are flexible and uninhibited.  Third it means that you are a wonderful girlfriend who loves her boyfriend so much that she would let another woman have sex with her boyfriend (even if you want to see what sex with a woman would be like).  Sexual fantasies are imagined circumstances that have not yet happened and possibly never will.  They are seriously different from memories of things that have happened.  First and foremost, fantasies are safe.  You can imagine sex with multiple partners, with animals, involving force, or in front of specific people, all without any negative consequences.

Many people find that when they act on their fantasy, the reality of the situation destroys the value of the fantasy and it loses its excitement.  Fantasies often include a component of the forbidden, and doing something "naughty" and getting away with it is often part of the adrenaline rush.

Specifically in regard to a three-way, my standard advice is to do it only if you’re willing to sacrifice contact with the other two parties after the event.  If you and the other woman start "getting it on," your boyfriend might feel left out even if he verbalizes that he wants to watch.  And if you observe some change in his sexual behavior with the other woman, it could easily spark jealousy in you.  Plus, most people cannot resist a comparison.  How which you feel if her breasts were bigger, or her waist or her butt was smaller?

The other major problem with three-ways is that invariably, there will be disagreement among the three of you regarding a repeat performance.  It is rare that all three are really okay about never doing it again, or the frequency of repetition.  The sexual desire discrepancy between two people is difficult enough to manage, and adding a third person complicates the task exponentially.

So I applaud your lack of inhibition, I encourage you to embellish your fantasies as richly as possible, and I encourage you to consider the risk you are taking if you proceed to do this in reality.  Please let me know what you think of this and let me know what happens.

A:  Please relax!  Variety is the spice of life, and as long as she is satisfied sexually, it's just an alternative sexual event that does not violate monogamy.

sexdoc

A:  There are excellent reasons why the videotapes "Bend Over, Boyfriend" (available from Good Vibrations) have a distinct following.  Some women like strapping on a harness and dildo and some guys love having their prostate stimulated internally.  Plus, some of my patients who have tried this, report that it dramatically enhances insight into switching from a more active to a more passive (and vice versa) role.

If you have an agreement to be monogamous, you can no more have a live cock up your ass than you can have anal sex with anyone but your wife.

Wanting a live cock in your ass doesn't mean you are gay.  It means you are curious.  But you could be just as curious about having sex with other women and that would also breach your relationship commitment to monogamy.

All of the above having been said, what would you do if you found true passion being with men and that you were unable to then be sexual with women?  It's happened.  "Be careful of what you ask for ... ."

sexdoc

A:  The reality is that men and women fantasize about all kinds of things all the time.  Things and people they want to happen, and things and people they don't want to come true.  People who cannot fantasize have a problem!  The reality is that we are all bombarded constantly with sex images and you can't "legislate" that he shouldn't think of another woman.  Plus, masturbation is an alternative sexual experience for most people.  It isn't INSTEAD OF sex with a partner; it's IN ADDITION TO sex with a partner.

If you truly love your boyfriend you will want him to be as happy as possible regardless of who he is fantasizing about.  I encourage you to focus on behaviors.  So long as you are getting your emotional and sexual needs met, don't care if he is masturbating or what his thoughts are while doing it.  And if you and he have a bilateral monogamous commitment, accept his solitary sexual behavior and hold a hard line on him being sexual with anyone else.

I hope this helps.

sexdoc

A:  You are my kind of woman!  Good for you!  Go Girl!

This is highly idiosyncratic.  Some women have a peak orgasm from simultaneous clitoral and g-spot stimulation, others absolutely cherish anal sex doggy style while touching their clitoris.  And some have the top of their head blown off by oral sex followed by clitoral stimulation while simultaneously having a very well-lubricated finger sliding in and out of her rectum.

And for some, simultaneous nipple and clitoral stimulation do it.

Try different things and see the link to "Female Orgasm Matters" on my home page (and tell me what you try and what happens)

sexdoc

A: (courtesy of Dr. Fisher)  Sometimes if you are close to starting your period the contractions of the uterus caused by an orgasm can push the blood that has pooled from the shedding of the uterus out.  It is usually a result of intercourse, but can be caused by any form of sexual activity that causes an orgasm.  I doubt that you will bleed if your period is four to five days away from the date that you see your boyfriend.  This situation usually happens a day before you start and is very unlikely in your case.

Since you missed a few pills it is wise to make sure you use a condom if you have intercourse and make sure not one drop of semen comes into contact with your vagina...fingers, penis, etc.....

A:  (courtesy of Dr. Fisher)  First look at external factors...stress from raising children, a husband,
jobs, other changes in your life.  If you come up empty on putting the blame
here, we can start looking at internal factors.

It is normal to experience a bout of decreased sex drive up to two years
after a birth of a child.  You did not mention if you were taking any form
of oral contraceptive or any other type of medication.  If you are there is
a good chance that it may be dulling your libido and you may want to check
into switching.  You need to have a hormone assay completed by a
gynecologist to rule out a hormone imbalance.  Sometimes a dose or two of
Testosterone can jump start a sex drive.

Above all, take time for yourself.  If that means locking yourself in the
bedroom with a dildo or vibrator, so be it.  Try getting yourself off and
then work on sex with your husband.

A:  (courtesy of Dr. Fisher)   You are one of the people that are on the low end of the sex desire
spectrum.  What you feel when you take the Testosterone is probably a normal
display of sexual desire and it seems extensive because you naturally have a
low libido.  It takes time to get use to something different!  It is obvious
that Testosterone flips the switch.  I would suggest taking a low dose of
Testosterone, possibly in cream form, and try sexually experimenting all by
yourself with a vibrator, dildo or just your hand.  It WILL feel weird at
first!  If you can get use to the feeling gradually, experiencing sex with a
partner will come easier to you.

Your brain and body has to work together as a team to make sex happen.  Your
brain is pulling it's weight but your body is being lazy in a sense.  The
more physical touching you receive, the better.  If touching is that much of
a turn off for you, make it different.  Try different oils, lotions, ice and
heat.  Find something that makes you melt and go with it.

A.  (Courtesy of Dr. Hinkle)  Chris:
    Being gay means that you prefer having sex with guys.  Since you state
that guys don't turn you on sexually, you are not gay--at least not at this
time.  While people's preferences can change, it is unlikely at your age.
Most gay guys are aware of feelings of attraction earlier than age 17.  Many
non-gay males seek out sex with gay men from time to time, not because they
prefer sex with men, but because it is easily available and involves no
relationship hassles.  A sizable percentage of non-gay males have had at
least one same-sex experience involving orgasm, and most males wonder what
such an experience would be like.  Most everyone is capable of being
sexually aroused by someone of the same sex.  This is perfectly normal and
should not be a cause for alarm.  I suspect that the biggest reason you are
wondering about gay sex at this time is because a girl wouldn't date you.
If there were some girl who was coming on to you now, I doubt that you would
be thinking about the gay issue.   If  in the unlikely event that this issue
does not go away for you,  then by all means act on it.  How else can a
person find out what he really prefers if he has no experience?  There is
nothing wrong with being a gay person, just as there is nothing wrong with
being tall or short, right or left handed, Catholic or Jewish.  Can you
imagine how horrible this world would be if we were all exactly the same?
Diversity enriches everyone.
Dr. Dennis Hinkle

A:  You are inhibited by internalized messages regarding your self-esteem and your sexuality ("Nice girls don't ...").  While this can be effectively modified in Cognitive-Behavioral psychotherapy, I know of nothing I can communicate via e-mail that will help you enough.  Also, it may just be that you have such a positive attitude toward sexuality and relationships that it is too conflicting to be degrading and humiliating!

sexdoc

A:  Entire books have been written on this subject so what I contribute will be extremely modest.

For evolutionary purposes, the diversification of the gene pool and the survival of the fittest engineered modern man to WANT to spread his seed as widely as possible, and modern woman to hold out for the alpha male, allow him sexual satisfaction with her, and keep all of his seed for her reproduction only.

The last 2,000 to 3,000 years are extremely recent in evolutionary terms, and we have a systemically dysfunctional (indeed, destructive) fight or flight response, along with all these hormones pumping through us.  It was only 100,000 TO 200,000 years ago that human females developed permanently swollen mammary glands!

The last three millennia are seriously important for modern behavior, however, because they introduced, in progressively restricting ways, the concepts of morals, ethics, and religion.  Rational rules of conduct to control irrational emotions, impulses, and urges.  Prominent among these are murder, stealing, and adultery.  To best maintain social order, and to say it another way, to attempt to prevent social chaos, the rules were made and agreed to by people in any society, with consequences for breaking the rules.  I agree not to murder you if you agree not to murder me (even though some ignore this when driving).

The last great bastion of sexuality was the vote for women.  They were no longer treated as one of the slaves, and slowly began to become recognized for wisdom and intelligence although PMS and hot flashes give some people cause to doubt their constancy.  Now that men no longer owned their woman, her adultery was no longer grounds for theft (while his was patronized).  But the sexes still negotiate and agree on the ground rules.

So I suggest that you say to your SO "If you murder, there are consequences from society.  You might want to -- we all do sometimes -- but as a "civilized" culture we abide by the rules.  And while I fully appreciate that you have urges to be sexual with as many women as possible, my offer to you is that you hold me as your exclusive physical and emotional mate, if you wish my interaction with you physically, emotionally, and intellectually.  If that trade is not good for you, please let me know as soon as possible so I can mate with someone who values me enough that he is willing to make this commitment.

In a monogamous relationship you have a bilateral assurance that "I won't run the risk of infecting you with STDs (some of which are lethal), if you promise me the same.  If you love me as you say you do, you will be honest with me.  If you are not, I question your love and may decide to find someone who will match my love and my honesty."

A:  Many men are what we call "bi-curious" and a few act on it with varied reactions.  Some are disgusted with themselves and others discover true passion and are unable to be affectionate with their wife.

You have the advantage of age.  Better to deal with this at 26 than 46!

Some men find it attractive to fantasize about gay sex and some women enjoy fantasizing about "gentle rape" or sex with 2-3 men simultaneously.  The fantasy content is unimportant; behavior is all important.

I suggest addressing it directly in an inquisitive way without putting him on the defensive, if possible.

Please e-mail back what happened.

sexdoc

A:  I am absolutely not surprised that you have no desire to be sexual and affectionate with a man who so blatantly disregards your integrity and wishes!  He is behaving in a rude, inconsiderate, and extremely disrespectful manner, and if you were engaging in sexual behavior with him I would label it masochistic.

I believe that you do not have a sexual problem.  You have a relationship problem that is causing a sexual problem.  Don't expect to see a change in your interest in being open, vulnerable and literally penetrable until you are treated more respectfully.

sexdoc

My husband and I have a excellent sex life and communication.  We enjoy
tossing anal sex into the mixture about twice a week.  I find it very
exciting to let him 'cum' in there.  My question is after he has came, I have
to dart off to the bathroom within usually a minute or so, to release his
orgasm and some BM.  I've deduced that this stimulus happens because I have
never cleared out the rectum before engaging in sex.  Is this basically what
I'm experiencing?  And if I clear it out beforehand will I be able to have
longer and less internal pressure will having anal sex?

If that is the case, I may try the water-filled douche bottle technique I
read on the website.  Thank you for your help!!

A:  Your body is signaled to have a bowel movement by the pressure of contents of a sufficient volume in your rectum.  That's why an enema works to trigger evacuation.  And if your rectum thinks that your husband's erect penis is "enough" volume, it says "evacuate."  If it is the sum of fecal matter plus penis, you might not have that sense of urgency with penis alone.  But if penis alone is sufficient volume, your reaction might be the same.  In any event, rinsing the rectum before anal sex is a good idea anyway, because A) having his penis come out with fecal matter on it can be messy and smelly; B) depending on how moist it is, it can reduce the slipperiness of lubrication, causing tissue irritation for both of you, and C) if you have some hard fecal contents that can scratch the penis.

A:  My first suspicion is that if there are any other siblings in the house to avoid jumping to the conclusion that she swiped the sex toys.  What a GREAT way of getting someone in trouble!

The essence of what you need to communicate is that curiosity about sex is healthy and age-appropriate, but that she needs to use words to communicate her interest, not take other people's property.  Pretend that it was a hairbrush and lipstick that she took in terms of your emotionality, to avoid her associating "sex" with "bad."  Emphasize that sex is a private matter, and that she invaded your privacy.  Her intent -- learning more about sex -- needs to be validated.  What she did is not acceptable (the behavior was unacceptable, not she as a person).  I suggest that only one of you approach her; both will be too much like ganging up on her.  You have the opportunity to help her regard sex as normal, healthy, and a joy in life, but that some people are really weird about it.  Plus, if the sex toys were for insertion, she needs to know all the hygiene rules.  I get sad e-mails from young women who have scratched their vagina with something rough.  If she wants a vibrator, that's pretty uncontroversial (relatively speaking), but if she wants an insertable, I suggest explaining that some women make one from rolled up bubble pak, tightly rubber-banded, then condom-covered.  If you buy her a dildo, some zealous sexual assault officer might charge you with childhood sexual abuse or reckless endangerment.  Then again, candles and all kinds of vegetables have been used for hundreds of years.

I will sound self-serving here but what you describe is exactly why I wrote "SEX:  What Every Young Woman Needs to Know" (available on amazon.com; see my home page SEXDOC.COM).  AND I suggest encouraging your daughter to read it, also.

Please let me know what happens.

sexdoc

I am 67 and my wife is 64, but we are both healthy and both enjoy sex once
it is initiated. Thanks.

A;  (Dr. Chance Fisher replies:  After a complete hysterectomy a woman goes through a few changes in regards to sexual response and desire.  If a woman is missing her ovaries, she is
cheated out of several hormones including Testosterone, Estrogen and Progesterone, that are essential to sexual desire.  Second, when a woman has an orgasm her uterus and cervix contract and add to the pleasure level. Sometimes when one or both organs are missing, it feels "odd" and makes a woman desire sex a little less.

My main point: Keep having sex!  It is actually very good for your health.
Use it or lose it applies here.  If you quit having sex the lining of the
vagina becomes thin and brittle and on the flip side, the penis becomes a
source of plaque deposits, making erection dysfunction a great possibility.

Make sure your wife is well lubricated, as this is a problem after a
hysterectomy.

Testosterone can be a great help in situations like this.  Most patients
receive the greatest benefits from a mixture of Testosterone and
Progesterone or Estrogen.  Testosterone patches are by prescription only.
You usually apply them to the hip or buttock area and change then every two
to three days.  They can be quite expensive and results take a while to see.

A lot of women also use a Testosterone cream that is applied to the thighs
or any fatty area on the body.  It has the same results as the patch.

Your time and information is as always much appreciated.

Thank you,

B

A:  Chance Fisher, M.D. replies: There could be a chance that he has a STD and that he just hasn't passed it on to the two of you yet and he is just now harboring the symptoms.  BUT it could be a number of different ailments including a urinary tract infection or a male reproductive condition.  I would ABSOLUTELY request that he use a condom during ALL sexual encounters and activities until he gets this checked out by a physician.  His symptoms sound like those that stem from a
couple of sexually transmitted diseases.

needing help

A:  If you don't want people who can hear you to know, I suggest that you be quiet.  Just give him a sign -- an indication -- when the big O hits you.  Be as natural as possible.

A:  "Normal" ranges from once every six weeks to twice a day and three times a day on the weekends.  On the average, men want sex more often than women until about age 38, after which it flips.

Find the Sexual Desire Discrepancy protocol on my web page (and tell me what page number and date is on it, please).  Have you tried asking him to be sexual with you more often?

And if you have not masturbated, go girl!  It's down right upright!

sexdoc

A:  Attention male readers:  And you thought that women were always the gatekeeper.  HAH! How wrong you are!  My dear college student:  He is controlling, rigid, ignorant, and obviously (to me) neither loving nor considerate.  You two are sexually incompatible and I absolutely slam dunk GUARANTEE that 90% of the male readers are imploring me to give them your e-mail address so they can complement (be your sexual partner) your sexual flexibility and appetite.

My absolutely best advice to you is for you to seriously challenge why you are in love with such a person who is not in love with you.  PLEASE chalk this up to a "learning experience" and promise me (and yourself) that you will see the forest for the trees on this one and find a boyfriend who will cherish you!

I am not at all surprised that you are experiencing orgasm problems!  When (not "if") you are with someone with whom you are compatible and mutually powerfully attracted, I predict that you will not have that problem.  PLEASE e-mail your reactions and what you do (or don't) do.

Any suggestions?

Thanks.

A:  (Chance Fisher, M.D. replies)  During childbirth the physician  will usually make a small cut (called an episiotomy) in the perineum to allow for more room for the baby and to also
prevent tearing in this area.  Sometimes they stitch the incision a little too tight or if you tore naturally, it may have healed with a little extra scar tissue.  Careful stretching over a period of time and proper lubrication will usually remedy the problem.  Take two well lubricated
fingers and place them in the opening of the vagina and press downward for 30 seconds and repeat on the sides and upper part of the vaginal opening. Also, if you have a vibrator or something that can be used, lubricate it up and slowly stretch the opening.  If you do this twice a day, after a week or two you should see a difference.

You may also want to try different positions.....woman on top, rear entry,
spooning.

If it does not get any better you need to seek medical treatment from a
gynecologist to rule out any prolapses from the birth, which is unlikely.

A:  Dr. Fisher (M.D.) replies:  Yes, you probably do have a psychological block towards sex because it has hurt for a long time.  Since you have had a very complete examination and it
came back with good results, it is hard to say from an E-mail what is going on.  Vaginismus comes to mind.  It is a condition where you, without trying to do it,  clinch the muscles in your vagina and pelvic floor when you have sex.  It hurts like hell and can be caused be physical or psychological means.

Any large hospital, especially one that is associated with a medical school
can provide you with a great gynecologist in your area.  If you are close to
a medical school, call the department of gynecology and explain your
situation and they will direct you to the most appropriate physician to see.

You may find that it is psychological and that a sex therapist can be of
great service to you.

Thank you,

A:  Dr. Fisher replies:  Anti depressants and birth control pills together can kill or keep a libido
low.  If possible, see if you can change or go off of the two altogether.
You should have been placed on  hormone replacement therapy BEFORE you even
came out of the surgery for the hysterectomy.  You need to go see a
reproductive endocrinologist and have a complete exam, including a hormone
assay.  Your pituitary, thyroid and other glands need to be checked as well.

More than likely you are severely lacking one or more hormones.  Since the
ovaries are responsible for Estrogen, Testosterone, and other critical
hormones needed for libido, I am betting that your problem lies there.

A Testosterone and Progesterone cream mixture applied transdermally can be
used to help pick up sex drive.  You need to pin point which hormone is the
actual cause for the problem though, thus seeing an endocrinologist is a
good start.

10/30/00 Q:      I am a 67 year old male.  I have been married for 47 years and I believe my wife and I have a very good relationship.  For the past 12 years I have had increasing difficulty in achieving orgasm during sexual intercorse.  Six months ago it became completely impossible for me to achieve orgasm.  I have talked to doctors and searched the internet trying to find anyone who is working in this area with no success.  I have found a small bit of information by searching the Internet and from what I have read I am fairly certain that the problem has a physical basis since I cannot achieve ogasm during masterbation either.  The problem is in no way related to impotency since I can maintain an erection during intercourse for over 1/2 hour.  I know your specialty is sex therapy which will not do me much good if the underlying problem is physical.  However since you are an expert in the area of sex i am hoping that you can refer me to someone or some medical center that can give me a complete physical evaluation of my problem and even if they cant treat the problem at least find out what the cause of the problem is so that I can be certain it is physical and that there is no sex therapy that can help.

A:  Chance Fisher, M.D. responds:  You need to make an appointment to see an urologist or internist for a COMPLETE check up!  This has been an increasing problem over the past twelve
years and could be a sign of an underlying disease or problem such as diabetes, MS or a disorder that does not allow proper nerve function in the pelvis.  Your secondary anorgasmia seems to be physical.  It may be the result of a medication that you might be taking also.

Also remember that as you age your sexual responses change greatly.

10/25/00 Q:  When does a fantasy become just plain wrong?  My wife and I sometimes act
out that she's a little school girl (she shaves herself bare).  She will
sometimes call me Daddy, or act like I'm her "Big Boy".  Are these normal
fantasies people do in the bedroom, or are we freaks?  I sometimes worry
about having children after rollplaying like this.  We don't normally talk
about this stuff unless we're in the heat of passion (most wild fantasies
end up coming out when we're both intoxicated and becoming sexual).  I
would be horribly embarrassed to bring these things up with her while we
were sitting on the couch watching TV or something... does that mean I
should embark on the path to try to stop us from continuing like this?

Please help! Thanks very much,

A:  Anybody concerned about fantasies needs to read Nancy Friday's books "Men In Love" and "Women On Top."  I prescribe them to couples who want to spice up their sex life with each other.  My instructions are to treat the fantasies in those books like a rare cognac, to be consumed on special occasions.  One reads the fantasy aloud while the other touches both of them.  They take turns reading and from which book.  If you do this you will find that because we humans are powerfully motivated by novelty and numbed by the same old same old, that a fantasy that is particularly eroticizing on first reading will predictably be less exciting when re-read (that's why you ration the fantasies).

A fantasy becomes just plain wrong in two cases:  The first is when it is a planned rehearsal for a dangerous or illegal act.  Some pedophiles, for example, rehearse the -- what we call -- distorted cognitions such as that a child's smile conveys an informed consent message that he or she is inviting sexual touch.  By playing the fantasy over and over again in his head, the pedophile strengthens the rationalization and "convinces" himself that this is OK.  The second case is not so much "wrong" as it is limiting, and that occurs when someone is unable to be sexual without appealing to the same routine fantasy each time.  Theme fantasies such as gentle rape or multiple sex partners are fine if you change the players in the fantasy.  The problem is if you cannot be sexual unless you have exactly the same sequence of events with the same person(s) each time.

There is often a regression that occurs during sexual intimacy -- using pet or "baby" names is a manifestation of this.  For many people, when they are sexual they feel very exposed and particularly vulnerable, and the baby talk ("would my widow [little] snookums like daddy to lick her where it feels good?") renders an innocent simplicity to the proceedings.

And, dear e-mailer, because we live in a seriously repressed society, you are blissfully unaware of what other couples do in the privacy of their bedroom.  Fantasies and role-playing are common, and for folks who want to spice up their sex life there are books detailing precisely what the roles and choreography are.  Although many people express (to us sex therapists at least) guilt about their fantasies, there is rarely any rational reason for the guilt.  Enjoy your imagination.  It turbo-charges your sex life!
 

A:  If by "having sex" you mean penile-vaginal intercourse, I assure you, your hymen is not intact!  Back in the bad old days when men and families owned women, an intact hymen was considered to be very important.  But with modern times, many men consider it an asset that a woman has had a variety of sexual partners so she is experienced enough to appreciate his love-making ability and knows her sexual appetite and comfort zone for various sexual acts.

There is no reason for any woman to undergo the trauma of a ripped hymen!  Many women have only a trace of it.  Those who have some hymeneal tissue can prepare for intercourse by inserting washed fingers and stretching the tissue. NOTE:  Be careful with fingernails.  The inner two-thirds of the vagina is so insensitive that minor surgery can be performed on it without an anesthetic.  You can EASILY cut the fragile vaginal tissue with a fingernail!  Some women prefer to insert an object of progressively greater diameter.  Others just use tampons and add some side to side top to bottom motion to stretch the hymen.  Gradual stretching every 3 days for a few weeks can result in no barrier to an erect penis.  If there is much tissue and/or it is thick and does not stretch easily, asking her OB-GYN during a pelvic exam would be appropriate.  Ask if your question must be shared with your parent or guardian before you ask it, and be prepared for the "birth control and not younger than 18" talk.

If you do tear your hymen, moderate pressure with a warm washcloth for 5-15 minutes should be sufficient to allow the body's natural repair mechanisms to stop the bleeding.

10/24/00 Q:  okay, so here's the deal.  I have been having sex now for about 3 or 4
months. each time was with the same person.  The last two times, Small
traces of blood were found on the condom immediately after intercourse. The
next day, it seems as though I am on my period because I experience
bleeding. The thing is, it shouldn't be my period. The first time this
happened, the bleeding started two weeks earlier than my period, and there
seemed to be tissue in it.  This was very scary to me. But I just thought
maybe my cycle was off or something.  I didn't have sex for about another
2-3 weeks, and now the same thing has happened, only there hasn't been much
sign of tissue in comparison to the first time. Is there something wrong
with me? Should I get this checked out? I'm really scared, please help me!
thank you,

A:  Dr. Fisher replies:  I don't think your dying.  What probably is happening is that your hymen has become stretched and with each sexual encounter, it is expelling itself. That is the tissue that you are seeing.  This happens to a lot of women. Unless the bleeding is profuse and painful or is mixed with a bad smelling discharge, I do not think you need to seek medical help at this point.

You need to take it slow.  Rough sex can cause bleeding.  You can also try different positions to see if it makes a difference.  But most of all ALWAYS USE A CONDOM!

Thanking you in advance for your time and response to these questions, and
others that have been answered through your web site.
:)Continued success~!!

A:  Dr. Fisher replies:  Lactation is very complicated hormonally.  During pregnancy there is an
increase in Prolactin which is the hormone that primes the milk glands to
produce milk.  After the birth the suckling of the breast causes an Oxytocin
release that in turn allows for milk ejection.  There are several other
hormones that take part also.

So can you promote lactation without  springing forth a spawn from your
loins?  The general answer is yes. The real answer is yes, but you have to
have medical assistance to do so and not too many practitioners find
inducing lactation for sexual pleasure a medically necessary reason.  To
promote lactation outside of pregnancy, it requires hormonal supplements
(injections) on a regular if not weekly basis.  This  is costly and you do
run a risk of developing minor to major medical problems from the imbalance
or rollercoaster of hormones.

Since milk production is hormone based a lot of  birth control pills will
affect the lactation to a certain extent.  Lactation of this nature can be
reversed by simply stopping the hormone supplements.  The lactation itself
would not affect the ability to become pregnant and in fact a lot of women
become pregnant while they are nursing babies and toddlers.  The hormone
swings associated with the lactation most likely prevent a large majority of
pregnancies.  Once hormone levels stabilize pregnancy should not be a
problem.

After you wean an infant milk production usually ceases because there is not
stimulation of the breast to promote the release of Oxytocin to push the
milk ejection.  If you manually keep stimulating the breast you could string
it out for several weeks or months.

Now how can women breastfeed and not have sexual feelings by the
stimulation, but can when a man suckles?  It is called Pheromones.  When you
are with a sexual receptive partner or even in the presence of the opposite
sex, you automatically release Pheromones that attract the mate.  When the
Pheromones are detected by the opposite sex it causes an endorphin like
response in the brain that says "Hey, lets get it on, there is a man on my
tit."  When you are nursing a baby, your "mother" part of your brain
instinctually tells you that you are providing a natural function to sustain
your offspring.

A:  Dr. Fisher replies:  Your ovaries are the site of Testosterone, Estrogen, Progesterone, and
Prostaglandin production.  ALL of these hormones, especially Testosterone
and Progesterone, are responsible for libido in women.  It sounds like you
could be experiencing a decrease in libido due to the ovarian tumor removal.
I would get a complete gynecological examination to rule out any potential
tumor formation and also to check the ovarian function.  Scar tissue could
be causing a decrease in ovarian function.  A hormonal assay can pin point
exactly what hormone may be out of balance.

10/24/00 Q:  I am hoping you can answer a couple of questions for me. I have tried to do my homework on my own, but can't find the answers to my questions anywhere.

My fiancé has just had an IUD implanted (today actually), and I have some questions about it. To give you a little background, she switched after trying 3 different types of birth control with no satisfaction. The first one made her extremely moody, the second diminished her sex drive, and with the third she had bad cramping and weight gain. We are very sexual, but we want to enjoy a few years of marriage before we commit to having children, so we are very cautious about pregnancy.

The questions I have are these:

The IUD she has claims a 1% failure rate, but I would like to know how that data was collected. Is that with ejaculation inside the vagina every time? I am wondering how safe it is to ejaculate in her. I do know that not doing so dramatically decreases the chances of failure. I rarely ejaculated inside her when she was on the pill.

We both enjoy very energetic (hard, fast) sex. I also have a larger than average penis. Sometimes she says that she can feel me "bottom out" in some positions. I am wondering if either of these things could disturb or dislodge the IUD?

And just in general, is there any practices or positions we should stay away from? Is there anything else that I should know?

Any help you can give me would be appreciated. There doesn't seem to be much information out there on this type of contraception.

Thank you,

A:  Dr. Fisher replies:   The Intrauterine Device (IUD) is the world's most widely used birth control
method at 99% effectiveness.  Though it is not totally known how it works ,
it is thought to cause a hostile environment in the uterus by causing an
increase in uterine lining enzymes and causing prostaglandins to bounce.
Prostaglandins are needed to support a pregnancy.  Thus, this environment
causes any fertilized eggs NOT to attach to the lining.  It also causes the
egg to travel faster through the tubes and making fertilization almost
impossible.  So, it is real effective.

Data for the effectiveness is collected by pharmaceutical companies and
governmental agencies, like health departments.  They look at the
population, birth control use and the pregnancy rate and see what method if
any, the woman was using at the time of conception.  Then after the
statistics are gathered they average it out to how many per 1000 women using
that certain type of birth control got pregnant during it's use.  For IUD's
it is 8 women got pregnant out of the 1000 that were using the intrauterine
device.  It is not asked if ejaculation took place in all cases of
conception on the method, but it is assumed.

It is perfectly safe to ejaculate inside of the vagina while using an IUD.
After tubal ligation and Depo shots, it is the most effective.

Any position or practices are perfectly safe while using an IUD.  Some women
find that sex actually is more exciting because you dramatically reduce the
fear of pregnancy.  Do realize that if you place your fingers inside of her
and you come close to her cervix you will fell a tiny string that is attached
to the device.  DO NOT pull on it.  You may cause it to dislodge or move.

Something worth mentioning is that periods are sometimes heavier and longer.

A:  It is likely anxiety and sensory acclimation.  If you received strong messages about the evils of pregnancy or the horror of sexually transmitted diseases, you could be harboring unconscious anxieties that could easily inhibit orgasm.  Plus, firing any nerve over and over again renders it incapable of transmitting an impulse (sensory acclimation).

I suggest that you re-train your reptilian brain by stroking yourself until you are about to have an orgasm, then insert your condom-covered penis into her vagina to ejaculate.  Each time you do that decrease your hand stroking time and increase your intravaginal time.

Thank you for your time,

A:   I know that you are making a wise decision to abstain from intercourse until you are AT LEAST 18 or 19.  Women who start having intercourse early have a higher rate of cervical cancer and very often somewhere between late twenties and early thirties develop a serious disinterest in sex.

The cardinal rule about pregnancy is to make sure that NO fluid that comes out of a penis gets into your vagina.  The clear fluid that comes out when a man is sexually excited contains about 80,000 sperm, only one of which is needed to result in pregnancy.  When a man ejaculates, the semen usually contains between 200 MILLION and 400 MILLION sperm.

Some virgins have become pregnant by giving their boyfriend a hand job then sticking their fingers in their vagina as they pleasured themselves!  And more than one woman has become pregnant from anal sex where the semen oozed out of her rectum and got transported into her vagina.

A:  Thank all of your ancestors for selectively breeding you into an efficient reproduction machine.  Those erections will serve you well when you become sexually active with someone else.  This is NOT a problem.  It is a biological signal that your plumbing and wiring are working perfectly!

sexdoc

In one of your letters, I read ". . . DO NOT place it right on your
clitoris and hold it in the same spot for a long time.  That
causes "sensory acclimation" and can make your clitoris go numb (or
if you really mash it, you can cause nerve damage that takes months
to regenerate). . ."  I have used a vibrator for years (at least 12
yrs) and can bring myself to orgasm with one without a problem.
However, I did not have the obviously important knowledge about use
of vibrators and have likely, as you would say "mashed it and caused
nerve damage" However, I can still stimulate my clitoris with fingers
and bring myself to orgasm though it takes considerably longer to
achieve this and again only I can (much as the boyfriend would really
like to!). . .  If there is nerve damage (which I have no idea how
one would even test this!) and the nerve damage has accumulated over
years is there a chance for recovery?  Could this be the reason
achieving orgasm through other stimulation generally fails?  and are
there any recommendations you would make at this point?

Thank you in advance, I look forward to your response.

A:  It is entirely possible that you are simply one of those women on the low end of the nerve-response normal curve!

If you have caused nerve damage you would have to press harder and harder for longer and longer periods of time.  If your "mean time to orgasm" with the vibrator is approximately the same for the past 2 years you're probably fine.

It is beneficial for you to vary your routine (alternate vibrator and fingers, for example) so your lazy dumb reptilian brain responsible for sex doesn't become conditioned to respond ONLY to the vibrator.

Try also getting really close to orgasm with the vibrator then have your bf use his tongue or fingers to get you off.

If there is nerve damage you need to be very light on the touch for 3 to 7 months!

Also, your brain responds to the sum total of all nerve signals (which is why some women have much more intense orgasms when spanked during intercourse), and it might bring you to orgasm sooner if your nipples, anus, or buttocks (slapping) are stimulated simultaneously with vibrator stimulation.  PLUS:  There are good reasons to get on your hands and knees and use the vibrator while your lover enters you from behind.

Try different things and let me know what works for you.

sexdoc

The problem to me is what I still feel. Just thinking about it still turns me on and I still take myself in hand 3 or more times a week thinking about it. Can you help, am I a nut, do I have a problem I should see someone about or what. Should I have kept my mouth shout about this from the start. Could you advise me.  Thank You in advance.

A:  Ah, the thrill of the forbidden, the novelty, the Judeo-Christian guilt!

It would help if you two talked 3-5 times with a sex therapist.  You experienced a NEW thrill and it is no surprise that it was seriously eroticizing.

Her reaction is probably religious and self-esteem in origin, which is why I suggest a sex therapist.

What is wrong with you both deriving a great deal of pleasure from this?  So long as it is safe sex and consentual, only fear of sinning stands in the way.

Sexdoc,
Thank you for your reply.
I feel you are correct in a lot of ways. Her ex-husband tried for years to
destroy her self-esteem. I am trying to rebuild it and she was raised in a
very religious family although she is not a church person at this time.   I
know that she has felt guilty about the pleasure she experienced when those
acts were preformed on her and a couple of times has let slip that just
thinking about it is still very exciting, but days later she develops
selective memory and does not remember saying that.    Now her life seems to
revolve around nothing but computer games.   Could you recommend a couple of
sex therapists in the San Diego area that you are familiar with.    I know
this is a difficult question to answer but we really would like someone who
might have had some dealing with something like this before. Its obvious we
do need to talk with someone together, but I know for my part its going to
be very difficult to look a strange person in the face and admit to
masturbating often about is and how turned on I got watching other men
sodomize my wife.    Thank you again, with your help we can finally get this
problem settled.

We live in a seriously sexually repressed society and the adrenaline rush from doing something "naughty" -- indeed sinful and doubly so:  anal sex is a no no because it doesn't produce babies, and adultery is one of the ten commandments!  What you don't know is how widespread the fantasy of watching your wife have sex with another man (or another woman) is, and how often it is, in fact, carried out!  We just don't talk about these things in "polite" society!

We experienced sex therapists have heard it all, and what you describe is anxiety producing to you but rather ho hum to us.  I strongly endorse careful selection of a therapist who clearly specializes in sex therapy because while 50% of all psychotherapists' yellow pages ads say "sex problems," only about  2%  have received advanced specialty training in the broad spectrum of sexual problems.

I regret that I do not personally know any sex therapists in the San Diego area but a few years ago I came across a web site of a group with Ph.D.s and an M.D. in La Jolla (where I lived for 5 years and from whose high school I graduated).

If I were seeing you the goal I would propose is a re-examination of your assessment of your behavior to help you both more fully accept that so long as your primary relationship is secure and you are practicing safe sex, this is a matter of personal election.  Where is the harm in what you are doing?  It is a matter of informed consent and the emotional capacity to deal with the consequential reactions.

10/18/00 A Reader contributes:

Hi,

I consider myself very open minded and have read most
of your web site without batting an eye. But the
letter today from the guy who wanted his wife to have
anal sex with other guys while he watched, wow. I
don't want to pick on somebody else's fantasy, and I
guess I don't disagree with your answer, but can
anyone really do things like that and _not_ threaten
the primary relationship? He said his wife enjoyed
getting it from other guys more than him. How are you
supposed to enjoy sex with her knowing that nothing
you do is ever going to excite her as much? New things
are always exciting, but now you've gone to something
you can't do with just the two of you. Maybe I'm too
naturally jealous, but I think most guys are. What is
the turn on here? Are some people excited by feeling
jealous while watching their girlfriend get it from
somebody else? Is it something about seeing their
girlfriend treated like a pure sex object? Or does
somebody else digging her sexually make her seem more
exciting, more desirable? I just don't get it. I don't
see many people being able to deal with this all that
well. Great site, I thought I was unflappable, but I
flapped on that one.

A:  I made reference to Judeo-Christian guilt because we are so immersed in its messages that we accept it as the "right" way to "do things" and we are knee-jerk conditioned to label all else as "wrong" or "sinful."  I just delivered a 90-minute presentation on "Marital Sexuality" to students in a "Theology of Marriage" class at a local Jesuit University, in which I made the point that sexuality is culturally defined.  While we are horrified that there are cultures in the world today that surgically remove a young woman's clitoris (which we label "female genital mutilation") so she will not feel too much sexual pleasure and thus be tempted to stray, we accept without question penile circumcision, which some cultures consider to be male genital mutilation.

The focus on genetic lineage (and male supremacy) is so profound that in many cultures, female adultery is grounds for immediate divorce (and it used to be punished by being stoned to death in the public square!).  In the third millennium b.c. prostitution was universal in the oriental empires, which were the most advanced civilizations yet achieved by man.  It was a function of religious temples, and both males and females practiced the trade.  They were called "holy" and were regarded as servants of the gods.

In certain cultures today, it is perfectly permissible for a woman to engage in anal intercourse with any man before marriage, reserving vaginal intercourse for her husband.  There is a tribe in Africa in which the custom for men who meet is to shake each other's penis, with the same social convention that we Occidentals shake hands.

And so, Mr. Flapped, from a Judeo-Christian perspective, jealousy, threat, and guilt are the expected outcomes for a couple who involve other people in their sexual intimacy.  For those who feel comfortable that involving a third party will not interfere with the primary pair bond, however, it makes little difference that the "third party" is an adult human, a dog, an enema,  masturbation, or a vibrator.  The danger of any "third party" is that it will diminish the primacy or importance of the primary bond between the two people.  When that "third party" enhances the pair bond by contributing more pleasure than pain (guilt, jealousy, insecurity, etc.), it is perceived as valuable and will want to be repeated.  If it is more pain than pleasure, it has been "an interesting learning experience" (which is the case for 95% of three-ways) to be regretted.

Does this make more sense?

10/19/00 He writes again:

Hi, thanks for the reply.

Yes that makes sense, particularly your very last
sentence that 95% of three-ways will be regretted. I
think it's telling that due to male-dominated society
many things may have been acceptable in many cultures,
but I doubt there are many cultures that ever were
into watching their women get in on with other guys.
Men just aren't wired that way, and that may be more
evolutionary than cultural, or evolution influencing
culture. You alluded to that evolutionary psych stuff
(I read a book on it not too long ago) with your
comment about genetic lineage. So I agree totally that
culture has a lot do with it, but I think culture is
the way it is from our wiring. Men being what they are
then, possessive and easily jealous, I still don't
know why any man would enjoy that, other than that it
is totally new maybe, makes his wife look more like a
sex object, or whatever. Maybe the reason this doesn't
compute for me is that I'm thinking she is just
enjoying the other guy more than her husband, but
maybe she is enjoying it BECAUSE her husband is there,
THAT makes it dirty and exciting, and if he wasn't it
would just be sex just like with her husband. That's
the only way I can figure not to just think the other
guy is giving it to her better. I hope for their sake
that that's true. But 95% against is definitely not
good odds. I will try to return to being unflappable
now. Keep up the great work, I having a feeling your
site will zing me again.

A:  Thank you again for your interesting comments.  I am sure other readers will identify with them.

10/23/00 The original writer adds:  I think I have more confidence in myself and our relationship than to feel challenged by a strange male who during a one time purely sexual session helps make it possible for my wife to enjoy such excitement and pleasure that she is able to experience the deep and intense climaxes that she did. At least half of the pleasure I received was sharing hers. The excitement of one time sex with a stranger was the reason we did it that way.   thank you,

I WAS WOUNDERING IF GIVING MY BOYFRIEND ORAL SEX (WHICH I LOVE) BY SWALLOWING HIS CUM WOULD TASE DIFFERENT IF HIS DICK WAS FURTHER BACK IN MY MOUTH BEING THAT OUR TASE BUDS ARE LOCATED IN DIFFERENT SPOTS ON OUR TOUNGE, BECAUSE I HAVE BEEN SWALLOWING IT NEAR THE FRONT.THANKS

and:

Dear doc,

     I got a question. Now i was thinking...i love to give my boyfriend oral sex.I also dont mind swallowing his cum.Now the thing is the taste isn't too bad but since our tase buds on our tounges are located in different areas such as the sour and sweet ect. tase buds. Now would it make a difference if i were to put his dick further back in my mouth?
Cause i have been doing it near the front. Would this taste any different? Thanks!

A:  This is in the "try it and you decide" category

Link to Answers #26

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