Podcasts Jan 29, 2013 at 1:00 am

Comments

1
Okay, I've just listened to the beginning of the podcast about not being able to feel things in condoms, and I have to comment.

I'm one of those guys. I don't use it as an excuse to pressure women into bareback sex, but I do say up front that we'll be having very little penetrative sex. I've tried female condoms, but that's like fucking a baggie. No good.

I've been able to get off with a condom on maybe 4 or 5 times. It can work sometimes, but I've yet to figure out what the magic formula is. Lube or not, special sized condoms (my first condom experiences were with ones that were too small; no wonder there was no sensation) or not, it's all just sort of dead. It *may* have something to do with being uncircumcised, but I don't know. Now I've got a weird phobia of them and even just trying to put one on makes me lose my erection. So they're sort of out of the picture.

But I also know people--like, personally--that have stopped while having sex because it DID feel better all of a sudden. I know WOMEN that have stopped their partners because they noticed the condom break because it feels better for THEM all of a sudden.

I'm not one to criticize science, but I don't think it's so cut and dry as 'there's no difference'. There's necessarily a difference; latex isn't the same as flesh. Condoms are more abrasive; they chafe if you don't keep them super lubed (which is one of the reason why porn stars don't like them).

It's not an excuse to force anyone to do anything, but I don't buy the claim. (But I'm going to go find that study and see what it says. Science!)
2
I like that Dan is so ready to accept science about condoms but is so ready to dismiss statistics majors or people who study statistics. I know it's a joke, but we need people to elevate science and math, not jokingly trash it.
3
WHOA. A polysaccharide is not a protein. It's a complex of sugars.
4
Public lice are not going extinct. Please don't assume that your cultural norms (shaving) are shared by everyone in your culture, let alone the other billions of people on the planet.

http://skepchick.org/2013/01/pubic-lice-…
5
My husband and I had a condom break midfuck once. All we knew, *both* of us, was that suddenly good got *great*. Upon pullout, we saw the condom and figured it out. Now, we had *not* used lube, so Dan's point there might stand, but... I know an anecdote doesn't stand up to a study, but studies don't speak for Each And Every Individual, either.
6
@1, @5, I'm going to have to agree, it just does feel a little bit better, often because the con.doms are cold to begin with. Not enough to whine and complain about, but there's a little bit of positive difference there. In my last relationship, both my gf and me enjoyed teasing without the rubber before putting it on. So, Dan, I don't think you should just chalk it up to "men are pigs".
7
For the woman with chronic yeast and urinary infections:

First, just double checking on whether these have been documented each time. Do you feel pain and then go get meds? Or do you pee in the cup/get checked for yeast and have the infection definitively proved first? I ask because in my experience, the pain from yeast can feel like a UTI and vice versa--and my doctors have on occasion taken my word for an infection and then we realized later I didn't have one, or that I had a UTI, not a yeast infection.

Second, have you used diflucan pills? I eventually realized that the topical yeast meds were causing irritation that would last 1-2 weeks after the infection was gone. Plus, as I hit my late 20s, I found I was getting more and more yeast infections. Then diflucan came out, and after 2-3 doses over the next few years, I stopped getting yeast infections. I felt like it really cleared things out.

Last, are you sure you're having pain from infections, rather than other kinds of pelvic pain? I have lichen sclerosis, a painful condition that affects only my clitoris. My regular ob/gyn didn't recognize it; you need a pelvic pain specialist. You may have something else. But I think if you're getting into that horrible fear-pain loop with sex (been there) it's worth talking to a pelvic pain specialist. They know so much more than a regular doc.

Basically: keep investigating. Make sure you are correctly diagnosed, and look into other ways to treat. Good luck!
9
Very interesting about the possible effects of carageenan lubes and the update on nonoxynol-9 --- I knew it had been found to irritate some people's skin but didn't know it was a net negative for transmission.
10
Having Dr. Anna back was a welcome return to form. It was nice having a guest with no agenda other than dispensing health information.
11
This is the second time I've heard Dan promoting the idea of the ethical necessity of disclosing a history of herpes. But I can't quite reconcile this supposed urgency with the information that basically 100% of the population is infected. (Let's not belabor the distinction between HSV1 and HSV2.)

In more than 30 years of sexual encounters with a wide variety of men I have NEVER had someone tell me they have a history of herpes. So, I'm having a hard time imagining a community where this is an active ethical standard.

If I'm having an outbreak I will decline sexual contact and may even frankly give the reason. This has sometimes elicited a response from the other guy that he has a prior herpes infection, too.

But I'm not convinced that it is important for me to mention this in a casual encounter when I'm asymptomatic.
12
About the bees, all the vegans I know object to bee-products on the grounds of a possibility of harm to the insects. I didn't get the impression that they were overly concerned about "enslavement."
13
I really get the impression from the information given here that testing for herpies really doesn't work. It sounds like if you have it, you'll test positive. if you don't have it, you'll test positive. If you engaged in 'high risk' activity, then a positive test result actually means something. huh?
I wish they'd spent more time on the very awkward conversation that we are supposed to have with potential partners and the inevitable negative reaction they will have. That's the hardest thing about having it i bet.
14
Five minutes to say it's a bad idea to drink blood? Assuming you can find someone who's OK with it? Really? That only took me five seconds. Dracula, build yourself a new, practical fetish while you're still young enough.
15
I need to challenge Dr. Anna on her half of the herpes discussion. Dan is doing his part, but what is with medical professionals continuing to say it’s “no big deal”? Anyone saying that should be sentenced to sitting in herpes support group meetings for a year.

Because I’d like my money back. I’d like it back from all of the doctor visits and the many years of medications I still need; I pay for them out of pocket. I’d like it back from the lost work because I was in too much pain to sit. I’d like it back from the tests I have to buy to make sure the drugs aren’t damaging my body. Herpes costs a lot of money. Herpes makes you pay a lot more in premiums if you have an individual insurance policy. Herpes makes you change your life to avoid outbreaks. Herpes puts you at greater risk for other STDs/STIs.

I may be “atypical” in my herpes persistence, but I know a lot of people who are. That’s why we have support groups. And as Dan mentioned, I do worry about what happens when I’m 70 and my body is declining. It has a hard enough time battling while I’m young, and I’m a health nut.

If public health professionals are going to keep up with this “it’s no big deal” thing, then the onus is on them to actually make it no big deal on the medical interpersonal level as well. I never want to go to another doctor who urges me to get STD/STI testing I’d have to pay for out of my own pocket, even though I’ve said I honestly haven’t had sex in years, I was thoroughly tested after my last partner, and I have zero other symptoms. I never want to see another licensed counselor who has no clue how prevalent herpes is or who doesn’t understand it on the most basic level.

On a wider level, I’m tired of dealing with the lack of public knowledge. I never want to go on another date with a fellow H person (via our special dating websites of course) who is (bizarrely, it’s not like I have herpes written on my forehead) afraid to be seen in a restaurant with me and terrified that if his brother finds out, he won’t be allowed around his nieces anymore. Get better information out there to those of us who know we have it and those of us who don’t. Let people know that it’s not included in standard testing. You’re failing terribly on that point.

We still have non-Dan advice columnists responding to letters of “I disclosed on the third date (pre-contact) that I had herpes, and the guy got up and left, and I never heard from him again,” with, “well, can you really blame him for not wanting herpes?” True letter I read last year.

The tide is still anti-herpes. It’s still a dirty disease that only promiscuous people get and will definitely give you if you have sex with them – statistically false on both counts. It’s mischaracterized among many health professionals, and it’s that way in the general public, if you do a sweep of herpes jokes and herpes comments. Educated people should know better – they don’t.

So public health officials – get out there and start spreading the word that “it’s no big deal, you may already have it, and you’ve probably already been exposed.” People aren’t getting that information right now. So be more responsible and get it to them, because I’m tired of this. Many of us are doing are part to spread accurate data. Do yours.

And for the record, my boyfriend who knew he had it and gave it to me without disclosing – he was a medical professional. He thought it was “no big deal.”
16
I defiantly can tell when a condom breaks. Sometimes I've said I couldn't tell when the condom broke because it felt really good and I didn't want to stop.
17
Love love Anna. Have her back more often! She's a wealth of knowledge, pragmatic and very funny.
18
So, Dan, you're terrified of spiders. BEHOLD!

http://www.cracked.com/quick-fixes/6-ter…
19
Oh My God that discussion of scabies made me want to hurl. And never shake anyone's hand ever again.
20
Dan's comment about condoms making no difference in pleasure is nonsense. It does help if there is lube inside the condom. I know this because I have stopped having sex in the past because I noticed that it was feeling entirely too good for the condom to still be in place. We are not liars, Dan. We can tell the difference, so stop telling us that our personal experience is wrong. If condoms made no difference to pleasure, then explain how I've known in the past when a condom broke - am I psychic?

I'll also add that I've never used the "sex feels better without a condom" claim to try to talk anyone into having sex without a condom. It feels about half as good with a condom, but I still use condoms because it's better than getting someone pregnant.
21
Dan seemed uncomfortable with a full hour of medical advice and epidemiological information. He kept trying to toss in little jokes like he was worried we'd get bored. Come on Dan, we can take it. It's useful and informative and in no way boring.
22
For the girl suffering the infections: I have been there, I know your pain, and it is mighty. For several years I would get yeast infections about every 6 weeks, often times so bad that I couldn't walk straight :(

Here's what's worked for me
1) Increase probiotics bigtime: eat lots of yogurt and/ or take a daily probiotic. Acidophilus kills Candida, which is the bacteria that causes yeast infections.

2) This is a bit out there, but it works for me. If you feel a bit of discomfort like you're on the verge of a full-on infection, take a clove of garlic, remove the peel, and insert it into your vagina overnight. Remove it in the morning and repeat as many nights as you feel is useful. Its a natural anti-biotic, probably won't do much once you're really fully infected, but it can head it off at the pass. Downside: gives you strong garlic breath.....

3) Also in terms of diet, I've seen recommendations to reduce things with baker's/ brewer's yeast in them (i.e. bread and beer). Not sure if this works, but it might help.

4) You're probably already doing this, but only wear cotton underwear, don't wear underwear at night if possible, and never stay in a wet bathing suit longer than possible.

5) If you suddenly have pain during sex, bring the intensity down immediately, if you keep pounding away it will make it much worse. Go down to the lightest most basic touch until it stops hurting, or give it a rest and blow your guy for a while, then try again slowly.

Good luck!
23
He said Eskimo Kisses. I was thinking Butterfly Kisses: when your partner feels your eyelashes on his or her skin.
24
Re: the girl with yeast and UTIs, if you are wary of chronic use of antifungals and antibiotics as prophylaxis, you may want to look into trying D-mannose supplements as a UTI preventative. It's a simple sugar that inhibits the ability of E.coli bacteria to stick to your membranes down there. Take 2-3 capsules with water either before or right after intercourse, in addition to all the washing/peeing/hygiene you're probably already doing.

Also, I'm seconding everything the above commenters said about probiotics, and continuing to investigate your conditions. Also of note - putting yogurt up there does NOT cure yeast infections, because the acidophilus strains used in yogurt are not the ones that persist in the vagina. You'll get temporary relief but may wind up getting more yeast after your next encounter. If you find a probiotic that contains naturally-occurring vaginal strains, that is your best bet for repopulating the healthy microbes.
25
For the girl with the infections, boric acid/water solution to rinse out the vagina has recently been accepted by the medical establishment as a remedy. The vagina environment needs to be acidic to maintain proper good bacteria balance. Semen and menstruation can be alkaline and thus damage this balance. Just rinse the vagina after sex and perhaps once per week. Also, take probiotics or eat yogurt every day to promote the healthy bacteria in the vagina. I had terrible trouble with yeast infections for several years after having babies, but cured myself by eating 6oz. of plain (unsweetened) yogurt every day, and then eating nothing but yogurt if I had an outbreak. It would only take one or two days of yogurt only diet for symptoms to disappear. My gynecologist had never heard of this and didn't believe in it, but there were studies done in Europe on this cure.
26
Between listening to this podcast and finally getting round to watching Girls (I'm always last on the bandwagon) I have to say - Americans, seriously, calm the fuck down about HPV and Herpes.

Working in a clinic in the UK, we do not test for HPV or HSV routinely because there is no need to - unless you have symptoms, what is the point? I was glad to hear Dr Anna stress that point although I think Dan was still a little too hysterical with his point regarding disclosure.

I would be interested to know what tests Dr Anna would actually do in her clinic for someone who is asymptomatic but requests an HSV test. In my clinic, we do PCR testing if someone presents with visible sores, which would test for both HSV I and II, as well as syphilis. If there are no sores, there is nothing to sample - surely blood tests would only test for antibodies, which merely show if you've been exposed to an infection?
27
UK_Nurse, I'd love your responses to my points:

1) Herpes costs a lot of money on a public health scale as well as on an individual level. Here in the U.S., if you apply for an individual health insurance policy, you can be charged hundreds of dollars more per month if you have herpes and may affect your ability to buy coverage at all until the new law takes affect. HSV-2 has cost me thousands of dollars, a lot of pain, a lot of life changes, and I will continue to have costs from treatment. How is this not a big deal? Why was it okay for my boyfriend, a medical professional who knew he had it and lied to me about his STD status, to give it to me against my will? Thus, why is it okay to not disclose as he did not disclose? Why would it be okay for me to put someone else at risk without their knowledge as you are encouraging with nondisclosure?

2) When I disclose that I have herpes to someone I'd like to date, I have to know that rejection is fairly probable no matter how educated each of us is and what facts I provide. This is because there is little good information out in the public. Ask anyone who has done this. The guy will say something to the effect of, "I'm clean, you're not, I don't want to risk it." When he may in fact not be clean, because there's a good chance due to health policy that he was not tested for herpes, but no one informed him of that. Why is it okay for so many people to assume their STD status is 'clean' when it might not be?

3) Few people in the general public are rational about the high prevalence of HSV-2 but the low transmission rates if condoms and antivirals are employed. Why are our public health outlets not informing the public about this common disease as they are regarding the bacterial STIs? Why are people not informed about a virus that could cause consequences (monetary, health, and social) for life?
28
Also, UK_Nurse, please respond to why we in the U.S. should calm down about HPV as well.

Our vaccination rates, particularly in a land of so much anti-vaccine hysteria, are still too low, less than half the rate in the UK: http://scopeblog.stanford.edu/2013/01/08…

We still have many people who are in denial about the prevalence and consequences of this virus as well as many people who are in denial about sexual reality at all. Thus kids aren't getting the vaccine.

The cost is still prohibitively expensive for some families, and even if they do understand the need to buy it, they might not be able to. (I paid $600 for the series myself.)

We still have people who cheat when they claim to be monogamous and give their partner the virus. The partner can end up with cancer. Sometimes it's not caught early enough, and sometimes the financial costs of treatment cripple the person.

So why should we calm down about a virus that causes cancer, when the rates are still too high?
29
Adding to the other condom comments; it seems the study reported, "Sexual Satisfaction," which might be unaffected by condom use.

However, actual sensation must be. If you rub two fingers together, and then put a condom on one finger and rub them together again, those sensations will of course be different.

Some penises seem to respond more to pressure than friction, but most respond to friction. I can see there really being no difference for some dudes.

So, not using a condom certainly doesn't feel as good for most people; but do you know what else doesn't feel good: getting an STD or dealing with an unplanned pregnancy!

So, encourage condom use; but don't pathologize people for stating a simple fact.
30
For the woman with chronic bladder infections / UTIs: you should try pure, unsweetened cranberry juice from your health food store. Everybody always says that cranberry juice helps prevent and even sometimes treat bladder infections. But not Ocean Spray or normal grocery store cranberry juice: they have too little cranberry and too much added sugar, which can aggravate infections. And not cranberry pills. When a friend suggested pure cranberry juice to me, I didn't think it was going to work because grocery store cranberry juice and cranberry pills never worked for me. But it works, I swear!

So here's what you do: Get 100% unsweetened cranberry juice from the health food store. Take a shot glass full of it and dilute it with water to taste. Don't add any sugar... it tastes great already! Drink one glass of this after sex, and also a couple glasses throughout the day after. I just pour about a shot glass full into my nalgene bottle and bring it to work and fill it up with water there.

This has helped me go from one UTI every 1-2 months to 1 UTI per 6-9 months. And it's much better than the prophylactic antibiotics that I used to take after every time I had sex: these prevented my UTIs, but at some point I said to myself, I don't want to be on antibiotics regularly for the rest of my life! Cranberry juice just feels healthier.

Another product that has helped me is Urinary Tract Helper (U.T.H.) from Wish Garden Herbs. A couple droppers full of this into a glass of water can even get rid of an infection if I take it as soon as I slightly feel one coming on. And it's easier to travel with than pure cranberry juice.

Good luck!
31
Ah Dan your podcasts are great but 327 was especially so. I missed you saying the phrases I associate with you though...'Calm the fuck down' 'chill the fuck out' 'grow the fuck up' You give me hope man.
32
Hi Dan
About safe pussy eating - what about putting the focus on the clitoris when talking about this. That's what gets most of us off anyway. If I'm on my period and using a tampon or mooncup there's no blood outside the vagina anyway so I would think that would be a safe practice, just sucking on the clitoris. Right?
33
I came here to comment on Dan's assertions that men who claim to feel less with condoms on are lying, but I see a number of others beat me to it, and explained why better than I would have. @29 said what I would have said very well. I definitely agree that people shouldn't feel pressured into being unsafe just because their partner doesn't feel as good with a condom on, but it's just BS to claim there is no difference in feel. All you're accomplishing by denying it is to lose credibility with those who know from personal experience that you're wrong. It's far more helpful to acknowledge that for a lot of men condoms do cause some loss of sensation, reiterate the risks and irresponsibility of unprotected sex, and give some tips on how to make sex feel better with condoms on.
34
Free the bee slaves!
35
re: lesbian sex, it is so interesting that the experts, educators, and medical professionals seem know about as much as (often less than) the average person practicing lesbian sex. For the caller asking about safer lesbian sex practices:

a) Oral sex isn't the only type of sex a female-bodied person can have with another female-bodied person. That said, there are dental dams (which ~no one uses) which are made for sex and not the actual (thick) dental dams Dr. Anna is talking about. I have a bunch of glyde dams sitting in my drawer in case of the lesbian sex apocalypse. I hope they're still good.

b) There is also manual sex, which is still good when using barriers (gloves!), including fisting. Just get gloves that fit snugly and that you aren't allergic to.

c) You can have safer sex with toys (put condoms on them, get high-quality silicone, glass, or stainless steel toys that can be boiled and sanitized).

I have yet to hear actual transmission rates from anyone for STIs between female-bodied people. Personally I am most worried about HSV, HPV, chlamydia, and gonorrhea. For me, safer sex is manual (with gloves) and/or strap-on sex with condoms. I avoid oral sex with people I'm not fluid bonded with.
36
This podcast made me question what I had previously learned about herpes. I have HSV1, and entering the dating world for the first time since diagnosis. I'm terrified about "the conversation" with a new guy. Everything I've read about HSV1 talks about asymptomatic shedding, and no matter what, it is still possible to transmit it even without a current outbreak. In addition, since its preference site is in the mouth, its more likely to transmit it with oral sex. I just assumed that casual encounters are now off the table for me. Does anybody know more about actual transmission rates, or can point me to any resources?
37
http://abcnews.go.com/blogs/health/2013/…

This article debunks the "pubic lice are endangered" myth. As the article points out, it really takes a catastrophe to wipe out such a species.

Also, I find it a bit hair-splitting to argue that there -is- a difference with a condom. The gist is that there is not enough of a difference for the vast majority of people (eg. EVERYONE) to know when a condom breaks. It's like a seatbelt; you should wear one no matter what. If you whine that it feels funny, you're not gonna wear one, what you're really doing is putting yourself and others at needless risk. THAT is the point.

Yes, there is a difference in sensation, but if you can learn to enjoy coffee, beer, etc., you can learn to like sex with a condom--both have desirable results in the end!
38
To the Vampire fetishist who can't think of a way to safely indulge, try this: add a few drops of your partner's blood to a strong cocktail like a martini, but pretend it's this ancient bonding ritual between you and your human lover. The alcohol will kill anything in the blood - which is why the CDC recommends that drug users who share needles should sterilize them with vodka. Although - for the love of god please double check this with an expert. I'm just some random know-it-all on the internet.
39
Outdoorsygirl, there is a lot of good info online (http://www.westoverheights.com/handbook.… is a favorite site of my group's leader, CDC has a lot too).

But I'd recommend finding a herpes support group in your area if you can. Sometimes the first meeting is scary, but you'll find a lot of nice people in exactly your situation. They will share their experiences and walk you through the dating process.

Realistically, I think you're better off going into it being honest and expecting to be rejected sometimes. I have been rejected A LOT by men who were previously super interested. People (even otherwise liberal and educated ones) just freak when you say it. I was reminded as I listened to this podcast that Dan's audience is perhaps not your average dating pool (depending on what you're into, of course).

If you want to date casually without the rejection, you have options. If you're a meet-in-person kind of person, a lot of larger cities have herpes social gatherings. (They aren't specifically for dating, but it tends to happen.) If online is your thing, there are paid and free sites where you check off what you've got and hookup tonight if you want to, or look for longer relationships, whatever you're seeking. I've not had great luck on the H dating sites -- I've had a couple of guys treat me like I'm a lot less of a prize than on a normal date, many have been pretty battered in the self-esteem department. But I've had some quite nice dates too. Good luck!
40
@1 "I know WOMEN that have stopped their partners because they noticed the condom break because it feels better for THEM all of a sudden."

That's a totally different animal. Dan contests that men don't feel a different on their dick w/ or w/o a condom. NO ONE contests that a condom feels different inside a vagina.
41
To the woman having problems with urinary tract infections:

I used to have exactly the same problem, UTI after sex almost every time. Hospitalized for kidney infections twice. I read an article discussing new research on how vitamin D affects the body and started taking a vitamin D supplement every single day. NO MORE INFECTIONS. I know everybody and their mother has some crazy hippie remedy for shit, but try it out. You might need to take a higher dose (like more than 100% of your RDA) for a bit to build it up in your system.
42
Dan, I'm interested in knowing more about what study you cited on the issue of pleasure/sensation with vs. without condoms? Can you provide publication information, or information about it, if it is avilable online?
43
To the vampire fetishist--perhaps drinking your own blood? Your partner could also draw blood at the same time, but the only stuff getting consumed is your own?
44
www.sexwithherpes.org learn about sex with herpes
45
www.sexwithherpes.org learn about sex with herpes
46
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Best health to you!

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