Oct 192015
 

206px-Polytat.svgIf you were to ask 10 strangers the #1 way to prevent a sexually transmitted infection, what do you think they might answer? Very likely one of their answers will be “monogamy.” And they wouldn’t, strictly speaking, be wrong. The fewer numbers of people you have sexual contact with, the less likely it is you’ll have been exposed to a sexually transmitted disease. This concept gets drilled into high schoolers lucky enough to have a sexual education class: Be abstinent. If you’re not abstinent, at least be monogamous.

But monogamy isn’t for everyone. Some chafe at the practice, strongly preferring to share their love and sexuality with more than one individual. Monogamy is not for them. Instead of relying on monogamy to protect them from disease, they use barriers such as condoms and test themselves and their partners for disease. And they communicate.

Here’s a question though: Does the use of barriers protect as well as monogamy does? I’ve felt it probably does, but haven’t seen any data to say one way or another.

And then this study was published!

This week’s study polled monogamous and (consensual) non-monogamous people and asked them about their sex life, their use of barriers, their STI testing, and so on. They recruited around 550 participants, 70% female, 63% monogamous, 77% heterosexual.

What did they find?

Among the nonmonogamous participants, 72% had sex with a partner other than their primary partner. 37% reported that their primary did not know about this sexual encounter.

Among the monogamous participants, 24% had sex with a partner other than their primary partner. 75% reported that their primary did not know about this sexual encounter.

In other words: both monogamous and nonmonogamous participants, as groups, had sexual encounters with people other than their primary partner. Nonmonogamous people were more likely to have that sex and to tell their partners about it. When monogamous people had sex outside their partnership they were far less likely to tell their partner.

And what about safe sex? Both monogamous and nonmonogamous participants were equally likely to use barriers with their primary partner. However, nonmonogamous participants used barriers with others more often than monogamous participants.

When it came to STIs, there was no difference in actual diagnoses of STIs. But nonmonogamous people were more likely to get tested.

Now — let’s translate all that.

What this ultimately means is that people who practice consensual nonmonogamy are no more likely to get a sexually transmitted infection than are monogamous people. This is very likely because nonmonogamous people use barriers/condoms with other partners and get tested more often.

As the paper stated: “Persons who have made monogamy agreements often break them, and when they do, they are less likely to take safety precautions, get tested for STIs, and disclose those extradyadic encounters to their partners than persons who agree to some form of negotiated nonmonogamy.” Absolutely.

Monogamy is one way to try to prevent the spread of STIs…and it is equally as effective as clear communication and relationship negotiation with the use of barriers and STI testing in non-monogamous relationships.

The study was published in the Journal of Sexual Medicine, and its abstract is publicly available.

Jun 152015
 

Mortier_PillonTestosterone replacement therapy has become nearly common place recently. Marketing of testosterone creams is everywhere. In addition to the big pharmaceutical companies, compounding pharmacies are now making and selling testosterone creams too. Compounding pharmacies are typically small local pharmacies where the medications are made and mixed on site. A compounded medication can be helpful to someone who, for example, is allergic to a filler used in a commercial product. Compounded products are often cheaper than commercial non-generic products. Compounded products are supposed to be standardized just like commercial products are. But are they?

The Federal Food and Drug Administration (United States) produced a report back in 2006 that showed that somewhere around 33% of compounding pharmacies were not making or selling standardized products.

Now a Canadian study confirms that compounding pharmacies may not be well standardized either. The researches took samples at two different times from ten randomly selected compounding pharmacies in Toronto. The samples were then analyzed and compared to two different commercial forms.

The commercial forms were consistently within 20% of the prescribed dose. Only 50% of the compounded forms in the first batch were within those limits. Worse, only 30%  of the second compounded batch were within that limit. Yikes! One pharmacy even had no testosterone in its product at all. The consistency within a pharmacy’s products also varied wildly. One pharmacy had 91% of the of the testosterone it was supposed to have in one sample, and only 8% in another sample.

The compounded testosterone was generally cheaper than the commercial testosterone. Compounded testosterone ranged from $57-161 for a 30-day supply, averaging around $105. The commercial stuff was $140-150 for 30-days.

This has very serious concerns for patients. Wild swings in testosterone level are not safe. For their safety and health, a patient should receive the dose that was prescribed. Not “half the dose one month” and “double the dose the next”. The lower price of the compounded products could easily lure a lower income patient into purchasing the compound instead of the commercial.

What can you do as a patient? Make sure that you get your prescriptions from a non-compounding pharmacy. If cost is an issue, talk with your pharmacist about using a generic. Generics are held to the same standards are brand-name drugs and are often made by the same company. Alternatively, consider discussing medication options with your physician and/or pharmacist.

Want to read the study for yourself? The abstract is publicly available!

Aug 152011
 

Felching is the act of sucking semen out of an anus or vagina. It can be accompanied by “snowballing”, where the semen is shared between people orally. Felching can be done by both straight and gay partners. Felching is also relatively common in the gay male barebacking community. A recent study found roughly one in sex men who bareback also do felching.

There is relatively little information about felching in the academic literature. The greatest risk with felching or snowballing is the potential to spread STDs, including HIV and hepatitis. These diseases are spread most often from the inserting partner to the receptive partner. There is also a risk of spreading intestinal parasites, if the receptive partner has one. For that reason, it’s considered a “high risk sexual behavior”.

There is no way to use barriers to reduce risk with felching. The best way to protect oneself is to get all potential sexual partners STD tested before felching. Keep in mind that HIV can take up to three months to show up on an HIV test, so you may wish to wait until a test at three months is clean.

Resources:

Jun 252011
 

Bondage(noun): the state or practice of being physically restrained, as by being tied up, chained, or put in handcuffs, for sexual gratification. Bondage can be done with many materials, including: rope, chains, body wraps, and cuffs (whether metal, leather, hand- or thumb-). Today we’re focusing on rope bondage.

A few notes before we begin: First, remember BDSM should never be done without consent. Also, consider using a safeword. Second, some acts may be illegal in your jurisdiction. Please check your laws and choose your actions accordingly. Third, I won’t be talking about suspension, or self-bondage. Those are topics for another time. And lastly, for simplicity’s sake, I’m going to use the term “top” for the person doing the tying, and “bottom” for the person being tied.

Rope? Yep, rope. What kind? Many kinds! Multifilament, nylon, and hemp are common materials for rope. Natural materials usually need some conditioning before use. Make sure the rope doesn’t have the potential to splinter, stretch or shrink.

A warning: Do Not use things like ribbons, scarves, or ties instead of rope. They narrow as they tighten and can end up cutting through skin. Ow!! Essentially: don’t use ribbons/scarves/etc any place you wouldn’t be willing to use dental floss.

Safety concerns:

  • Falling: Restrained arms and legs limit how well the bottom can balance. This increases the chance of a fall. If the bottom’s arms or hands are tied, they may not be able to catch themselves. Falls can be avoided by: a) having the bottom sitting, lying down, or leaning, b) watching the bottom carefully, c) making sure they don’t get lightheaded, d) tying certain areas but not others (e.g., the ankles, but not the hands).
  • Fainting. Yes, bottoms can and do faint. Some people are more prone to fainting than others. Bondage can create a light-headed sensation. Be careful when doing bondage with those at higher risk.
  • Joint issues. The positions involved in some bondage can make some joint problems worse. Choose positions accordingly, and change positions as needed. Discomfort should be taken seriously, since it can signal an imminent problem, like torn ligaments or dislocated joints. Ow!
  • Restricted blood flow. Without fresh oxygen, provided by blood flow, tissue can die. Dead tissue cannot magically recover. Check bound extremities (hands and feet) frequently. If they are cool to the touch or pale in color, loosen the binding. Also watch out for tingling and burning sensations.
  • Rope burn. Rope can burn skin when it’s dragged across it, just like a carpet burn. Synthetic fibers are particularly prone to this. Slow down.
  • Nerve damage. Tingling and/or numbness in a limb? Loosen the rope immediately! The best way to help prevent this is to communicate frequently.
  • Breathing constrictions. Some positions can make breathing difficult – avoid these or limit the bottom’s time in them and communicate frequently.
  • Emotional. Bondage can be a very emotional experience. Aftercare is highly recommended. If you think you might need professional help, there are bondage-friendly professionals you can turn to.

Special precautions may need to be taken with people with certain medical conditions, like diabetes (which affects circulation), fibromyalgia, or joint problems.

So… how can you improve the safety of rope bondage?

  • Frequent, open, and clear communication before, during and after the experience. Don’t just rely on a safeword!
  • Be careful about who you do bondage with. This goes for both tops and bottoms – both are vulnerable here.
  • Be very careful about mind-altering substances, like alcohol and marijuana. Many people avoid them altogether when doing BDSM. The ability to think and judge clearly is very important for safety.
  • Never tie certain areas of the body, like the neck and joints. I really do mean Never on this. Neck restriction can choke, and joint restriction can do a lot of damage. Just don’t do it.
  • Make sure the rope isn’t too tight. One way to tell is the “one finger” rule: Can you slide one finger between skin and rope?
  • Keep EMT (bandage) scissors nearby, just in case. They’re designed to cut fabric off skin without hurting the skin.

Curious? Want more information? Check out these resources (recommendations are always appreciated!):

  • SM 101 by Jay Wiseman. Has a good beginner’s section on bondage, including technique and rope selection.
  • Bondage safety on Wipi
  • Wikipedia’s article
  • TwistedMonk.com has tutorials
  • Graydancer’s Ropecast (a podcast)
  • And, as always, your local BDSM community and its workshops. Can’t find your local group? Try your adult shops, or FetLife.
Jun 112011
 

Recent posts have been rather serious and depressing. So today it’s time for something completely different — genital piercings!

(By the way: All the links today are NSFW.)

Basic types

Genital piercings can be done for a variety of reasons. These include sexual pleasure, aesthetics, and individual expression. The types of piercing you can get depend on your anatomy. Not everyone can get every piercing type for their sex. Dydoes, foreskin piercings, triangles, and clitoris piercings are good examples of piercings that only certain people can have. In theory, people who have had genital surgery also may be able to get piercings, but should consult with a piercer and/or their physician. Additionally, people with certain medical conditions (like hemophilia), should not get these piercings.

For men, piercings can involve…

For women, piercings can involve…

There are, of course, other types of piercings, but I think this is a good generalization.

Healing, aftercare, and long-term care

Healing time varies depending on the type of piercing. Four to six weeks is the shortest healing time I’ve seen, and it’s generally for piercings that go through minimal tissue (e.g., inner labia, Prince Albert). The longest healing time can be six months or more! Generally, the more tissue the jewelry goes through, the longer the healing time.

The Association of Professional Piercers has very clear fliers with information on how to care for new piercings. It’s pretty simple: be hygienic and avoid trauma.

Potential problems include:

  • Infection. This is most likely during the early healing process. Good hygiene ought to help prevent infections. Viral infections, like hepatitis B, may be spread by the needles used in piercing… so please choose your piercer carefully!
  • Trauma. This can be caused by lots of tugging or jostling of the jewelry, Jewelry can even be torn out…Ow! The surrounding tissue can be torn, leaving an open wound vulnerable to infection. If that happens, head to the nearest urgent care center.
  • Migration and/or rejection. The jewelry can move around, and possibly even be pushed out of the body. This is most common with “surface” piercings (those that do not pass through. A belly button piercing is a surface piercing, as opposed to an earlobe piercing). Choosing surgical steel jewelry may help prevent rejection. Surgical steel should always been used for new piercings. Reducing trauma and pressure to the area may help prevent migration.

Genital piercings have a few special notes:

  • Barriers may be required for future sex, even for people who are fluid bonded. This is mostly relevant for penis piercings and vaginal or anal sex. The combination of the jewelry movement and contact with other fluids means potential infection. Barriers can help prevent that.
  • All urethral piercings (like the Prince Albert) may affect the way you pee. Some men, for example, may need to sit down to pee. For women, urethral piercings may increase the risk of urinary tract infections. Note that urine is sterile unless there is an active bladder infection, so it by itself usually doesn’t cause a problem.
  • Perineal piercings (like the Guiche) may need to be kept extra clean. They’re close to the anus and fecal matter, after all.

Got more questions? Ask! Or check out these resources: