These sexual health Q&As were generated by Andi Orben, Sarah Robinson, and Carlos Hoyt after collecting questions from the student body and elaborating on the most common ones. They were kindly donated to BOSS magazine so that they could be shared with our readers. If you have any more questions about sexual health, feel free to email firstname.lastname@example.org.
Q: Is it possible to contract and/or transmit an STD/STI through oral sex?
A: Yes! STD/STIs can be passed through semen, vaginal fluids, blood, saliva, and through skin-to-skin contact. Performing oral sex on a partner and/or receiving oral sex from a partner without a condom or dental dam can put both partners at risk. Some STIs (herpes, gonorrhea, HPV) are more easily transmitted through oral sex than others. Yet, less than 2% of PA students who engage in oral sex report using any form (condom/dental dam) of protection. Please use protection!
Q: Is it possible to get pregnant and/or be involved in a pregnancy through oral sex and/or anal sex?
A: This is a very common question—It is not possible to get pregnant through oral sex (sperm and egg must meet for pregnancy) and it’s very, very unlikely to get pregnant and/or to be involved with a pregnancy through anal intercourse. If semen from anal intercourse is deposited close to the vaginal opening, sperm could potentially drip or crawl into the vagina. But, it would take one good swimmer!
Q: Is anal sex dangerous/ more dangerous?
A: Anal sex, without proper lubrication and/or protection can pose risks of STI transmission. Since the anal glands do not secrete natural lubrication, it is always necessary to use plenty of lubricant for anal intercourse. Proper lubricant reduces the risk of anal tissue tears. Tears allow bacteria and viruses to enter the bloodstream. Use water-based lubricant and a condom to provide the best protection during anal intercourse.
Q: Is there a cure for HIV? Do I need to worry about contracting HIV/AIDS? What is pre-exposure prophylaxis (PrEP) and how does it work?
A: Unfortunately there is no cure for and no vaccine to prevent HIV. Anyone who engages in unprotected sexual activity with risk of transmission of blood, semen, pre-seminal fluid (pre-cum), rectal fluids, and/or vaginal fluids should be concerned about HIV transmission. More than 1.2 million people in the US are living with HIV infection, almost 1 in 7 are unaware of their status, and 50,000 people in the US are infected with HIV each year. Please consider getting testing and protecting yourself and your partner.
PrEP is a daily pill, which offers protection against HIV for those with substantial risk for HIV infection. High-risk individuals should talk to a medical provider about using PrEP consistently (daily) and in combination with condoms. PrEP does not protect against any other STI (gonorrhea, chlamydia, hepatitis).
Q: Am I normal? When will my pubic hair grow? Is/are my penis/breasts shaped correctly? Do my body parts smell okay?
A: Chances are, it’s all perfectly normal! You are unique and so is your body! Breasts, penises, hips, noses (and we could go on) grow in different shapes and sizes. The media often provides unrealistic images to which we are supposed to aspire, but the reality is that there is a wide range of normal, healthy shapes and sizes. One breast may be larger than the other, your penis may curve a bit to the left or right, and you may or may not grow enough pubic hair to have the choice to decide what to do with it. It’s all normal and if you ever need a bit of extra reassuring just check with a health care provider.
Moist body parts have a natural scent, but a foul odor/ strong unpleasant smell is one sign of a possible infection. Always see a health care provider if you have ANY reason to believe that something is not normal. A medical professional can provide reassurance, testing and treatment. While seeing a provider is recommended for any symptoms, it’s important to remember that the most common symptom of STIs is no symptom at all (asymptotic). Meaning, without testing there is no way of knowing if you or your partner has an STI. If you are sexually active, be honest with your partner and medical provider and get tested.
Q: What can I do to improve my stamina/performance time? Are there specific workouts or exercises that help?
A: It’s likely that your stamina is perfectly normal and that your perceptions are what need improvement! The average sexual intercourse encounter lasts between 3 and 5 minutes. While clearly variation exists among partners, we sometime judge performance time and stamina based on what we see in the movies and in pornography (not realistic!). Instead of focusing on performance time, consider focusing on creating a consensual, mutually pleasurable, safe encounter for you and your partner. How do you do this? You know your own boundaries and ask your partner about theirs, determine how to protect yourself and your partner against the potential risks of intimacy, and be sure that the lines of communication are open throughout the intimate encounter to ensure that the moment(s) is consensual and mutually pleasurable.
Q: What can I do to please my partner?
A: One of the super important keys to safe and satisfying sex is MUTUALITY — so it’s helpful to reframe this question when it comes into your mind. That is, change it from “What can I do to please my partner?” to “What can I do to please my partner in a way that pleases me to do it.” And of course vice versa! In other words, anything you do to please your partner must be pleasing to you, otherwise you might find yourself doing something you are uncomfortable with, against your values, etc. Sex should never be about that.
This conversation should never go anything like this: “If you really care about me and want to make me happy, and if you want me to still like you, then you’ll do THIS for me.” Instead, it should look more like this: “Thanks for asking me what would make me feel great. I don’t know if this is something you would enjoy doing with me, but if you would, then I really like/would like to try/have been thinking about…. It’s OK if you’re not into that. I really appreciate that you even asked me!.”
Q: Why do people use lubricant and should my partner and I use it?
A: Lubricant is used to increase comfort and enjoyment during intercourse and/or stimulation of the genitals. While the vagina provides some natural lubricant, and lubricated condoms may provide a bit of lubrication, additional lubricant may be needed for comfort and enjoyment. For anal intercourse, since the anal glands do not secrete natural lubrication, it is always necessary to use plenty lubricant for anal intercourse. Proper lubricant reduces the risk of anal tissue tears. Tears allow bacteria and viruses to enter the bloodstream. Use water-based lubricant and a condom to provide the best protection during anal intercourse.
Q: What is the correct way to use a condom? What should I do when/if I lose my erection and/or my partner loses their erection?
A: Losing an erection at the sight of a condom and/or at any moment during the sexual act happens. In fact, some research shows it happens about 30% of the time. Condoms are designed to roll onto an erect penis and to stay on an erect penis, so please wait until the penis is erect (partners, here is a good time for you to help) before attempting to roll on the condom. If the user loses their erection and the condom slips off during the sexual act, dispose of the condom and put a new condom on. The condom should be removed from the penis, after ejaculation, while the penis is still firm (so that the condom does slip off and the semen leak out).
Q: What services are available at Isham? Can I get an abortion at Isham?
A: Isham provides confidential reproductive health services for students ages 16 and above. We provide STI and pregnancy testing, birth control consultations and emergency contraception (Plan B). If a student needs a service that a gynecologist would perform (surgery, procedure or specialty visit), we can refer them to a local specialist.
Q: What birth control methods are prescribed at Isham?
A: The providers at Isham will spend time chatting with you to determine what birth control method(s) makes sense for you and your partner considering your behaviors and any medical history. Most commonly, we recommend condoms for anyone who is sexually active because condoms are the only form of contraception that protect against STIs and we commonly prescribe birth control pills. Students also use other methods including the ring, shot, patch, implant and the intrauterine device (IUD). Here is a helpful website to learn more about contraception options: http://www.itsyoursexlife.com/pregnancy/comparison/birth-control-methods
Q: Does my parent need to know?
A: No, Isham sexual health visits are confidential and parents, house counselors and teachers are not notified of your visit to Isham. Most options for birth control are free. If a medication is recommended that is not free and might be billed to insurance, and therefore possibly not confidential, we will discuss this with you beforehand.
Q: How does the pill/plan B/an IUD really work? Do these methods abort a pregnancy?
A: All of these hormonal methods work to block ovulation and make the uterine environment unfavorable to implantation. None of these would do anything to harm an existing pregnancy and could not cause an abortion of an implanted embryo.
Q: When during the month can I get pregnant?
A: Technically females are most fertile between days 10-14 of their cycle, assuming that they have a regular, 28-day cycle. Meaning, 10-14 days after the first day of your period, you will ovulate and the egg will be in the prime position to merge with the sperm and implant. Adolescent females however are notorious for having irregular ovulation—stress, jet lag, exercise, and nutrition and living with other females can all affect ovulation. Plus, sperm can live for up to 5 days after intercourse so it is important not to have protected sex anytime during the month!