Dr J's Sex Facts

Fun sex facts and accurate information from a clinical sexologist for a hotter and more fulfilling sex life.

Friday, February 23, 2007

Managing Your Sexuality: More Fun Than Brushing Your Teeth!

“Just saying ‘No’ prevents teenage pregnancy
the way 'Have a nice day' cures chronic depression”

Faye Wattleton, former President of Planned Parenthood


Growing up, we learn to manage various aspects of personal hygiene and care such as bathing and brushing our teeth, integrating them into our daily routine. Why, then, is it so difficult for us to incorporate sexual management issues into our regular routine? Could it be our discomfort with acknowledging our sexuality as something so valuable that it needs attention and management? And could it also be because we don’t approach risk reduction as having a potential for being fun?

Let’s take a moment to review the most effective means for risk reduction and/or pregnancy prevention:

1. For Both Risk Reduction and Pregnancy Prevention: Barrier methods such as condoms, latex gloves, etc. (prevent contact with sperm and semen)

2. For Both: Detergents such as Nonoxynol-9 (the active ingredient in spermicides), hydrogen peroxide and bleach kill sperm and many pathogens

3. For Both: Non-wet activities such as phone sex and mutual self-pleasuring (if you get pregnant this way, you’re definitely doing this one wrong!).

4. For Pregnancy Prevention: Hormonal contraceptives such as birth control pills, patches and shots (prevent ovulation)

It’s important that you experiment with these methods to determine which work the best for you in terms of ease of use, cost and comfort. Tip for men: To find your favorite condom, audition various brands during self-pleasuring (this also makes clean-up a snap).

What about Ineffective Methods?

Here are a few methods that automatically set you up with unrealistic expectations of protection:

HIV Test: “If I only have sex with someone who has tested negative, I’ll be safe, right?” So I carry around a card that says on October 1, I tested HIV-negative. Would you feel safe with me? What if I had unprotected sex on October 2, and now, on December 15, I’m HIV-positive? The test only tells you that on the day you took it, you tested negative. This is no guarantee of anything other than that fact. It may reassure you, but once you expose yourself to risky behavior again, all bets are off. And did I mention false positives and false negatives?

Monogamy/Chastity: Unfortunately, these two methods are being promoted as being ideal “protections” against STDs and pregnancy. Why don’t they work? Let’s talk monogamy. Current estimates indicate over 70% of committed primary relationships will end at some point. Many of those endings will involve previously monogamous partners engaging in sexual behavior with someone outside of their relationship. And when we do that, do we tell our primary partner we’ve just been sexual with someone else? Ha! The fact is most of us feel uncomfortable just talking about sex, so very often we end up saying nothing. The relationship continues on its inevitable slide; but in the meantime, we’re having sex with our partner and not talking about any other activities. In some cases, someone will be sexual one time outside the relationship and never tell their partner. That’s precisely how many people in primary relationships end up with various infections. Some STDs, like Chlamydia, can actually remain undetected in women for years, leaving the unsuspecting “hostess” merrily going about infecting others.

“But Dr. J, my partner and I have been monogamous for YEARS, why should I worry about risk reduction?” Why indeed. This is a grey area that falls into what I like to call my “seat belt rule.” Now, you wear a seat belt when you drive to ensure your personal safety, even though you don’t anticipate having an accident, right? It’s possible that you don’t need to use risk reduction at this time, but here’s a thought: what IF, some day, you find yourself in a situation where you DO need to use it, and you have no idea how to put on or use a condom, for example? It might behoove you to learn. You could even make a sexy fantasy game out of it. Pretend you and your partner are having your first sexual encounter: the two of you can negotiate what to use and then learn how to use it together JUST IN CASE
.

Chastity: Many of the programs that promote this—particularly to teenagers—have a covert moral agenda that contributes to sexual guilt and shame. My students report receiving these messages in high school, and many of them—particularly the young women—take the chastity pledge, ignoring their own sexual feelings and desires, with the usual result being that they go into total denial about their sexual selves. Then, one evening at a party, they get loaded on three wine coolers and end up having unprotected sex right there on the bathroom floor. (“But that was just one time” is the inevitable cry.) This is followed by yet another commitment to the pledge, then falling off the pledge wagon again—and so the cycle begins. Because of the guilt involved and the idea that one shouldn’t plan for sex that you’re not supposed to have in the first place, these interludes remain mostly unsafe and unprotected, leading to high rates of infection and pregnancy among those afflicted with this moral agenda.

Another contributing factor: We all know what happens when you tell someone not to do something: it becomes that much more attractive, right? So, paradoxically, this “just say no” message actually encourages our high rates of infection and pregnancy.

Whenever I speak about management, some of my students roll their eyes, as if to say, “Why do we have to pay attention to this stuff? Shouldn’t it just happen when you’re in love?” Or “When the moment is right, you’ll know, and you’ll do the right thing.” However, after considering the factors discussed here, most realize just how and why they’ve been living with their heads in the sand.

What Does Work?

These myths continue to prevent many of us from effectively managing our sexuality. Once we recover from the guilt and shame, we can acknowledge our right to pleasure and accept the necessity for risk reduction, treat it like brushing our teeth or similar acts, and begin to make it fun instead of a chore. Isn’t it your own experience that the more positive you feel about something, the more likely you are to do it correctly?

If risk reduction were actually treated as a public health issue instead of blunted with a covert moral agenda, our country would have an effective national policy like those of Scandinavian countries, which routinely report the lowest rates of HIV infection and unintended pregnancies.

Keep in mind that those who feel the most positively about their sexuality and are the ones who are the most comfortable with it will be the least likely to become infected and/or accidentally pregnant.

So have fun and play safe! Note: For contemporary, accurate information about contraceptive/risk reduction technology, please visit http://sfsi.org/links/medical.html

Coming Attractions: The Sexual Continuum, Desire Differences

This is a very hot topic; and as always, I welcome your comments and questions. We’d all love to hear about what works for you. The doctor is definitely in.

With Pleasure,
Dr. J

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