High and Dry

Dr. Kate,

I need answers to this question or I'm afraid it'll ruin my relationship. When I'm having sex with my boyfriend, most of the time I do not get wet at all. He says I used to, but now I don't. Even when I orgasm sometimes it doesn't get wet. Sometimes even when he's performing oral on me. He thinks he doesn't turn me on anymore or I'm with someone else, but that's not true. I'm enjoying every second of fooling around with him, so I don't understand why this happens so often.

How Dry I Am

Dear Dry,

Lubrication is tricky beast--we always seem to have either too much of it, or not enough. First thing, you may actually be getting wet, but he's not always noticing. Vaginal fluid can pool in the back of the vagina, where it's less noticeable, or it may be drying very quickly (on you or on the sheets). And if he's using saliva at all during oral sex (and how could he not?), how can he tell what "wetness" is from you versus what's from him?

But your boyfriend may be accurate in his perception that you're more dry than before. There are many causes of vaginal dryness:

Overdrying your vulva, from excessive washing or douching

Medications, including
• allergy medications used regularly
• anti-depressants
• any medication that says "anticholinergic" on the package insert

Low estrogen levels, from:
• cigarette smoking
• hormonal birth control
• really low body weight (along with no periods)
• removal of your ovaries
• cancer therapy
• childbirth
• breastfeeding
• menopause or perimenopause

Vulvodynia (because the pain isn't bad enough)

Chronic illnesses like:
• high blood pressure
• atherosclerosis
• diabetes,
• connective tissue disorders (especially Sjogren's syndrome)

Yes, lack of arousal can cause it, too...but it's possible to be aroused without much lubrication. (In the same way, you can actually get wet in a situation where you're not turned on in the slightest.) And orgasm won't often make you wet, either--medically, it's a series of muscle contractions that aren't linked to lubrication.

The most important thing is that you're enjoying yourself during foreplay and intercourse--if everything feels okay, then nothing is physically wrong. So tell your boyfriend to be happy that you're so pleased in bed...and to stop using your amount of lubrication as a barometer of enjoyment (or fidelity).

Best,
Dr. Kate

Photo credit: Alireza Teimoury

The Sponge Is Back (Again)

The Today contraceptive sponge is once again returning to U.S. drugstore shelves. The sponge has been intermittently available over the last 15 years, due to production problems and ownership switches. By this summer, we should once again be able to find the sponge in the major pharmacy chains, and not just have to search for it online.

The sponge is a little polyurethane pillow (with no latex) that contains nonoxynol-9 spermicide. It may be placed up to 24 hours before intercourse, and it protects against pregnancy for up to 24 hours, no matter how many times you have sex. After intercourse, you should leave the sponge in place for at least 6 hours, to allow maximum spermicide action. But make sure you remove it before 30 hours--just like a tampon, you don't want it to remain in your body past its prime or you risk infection (toxic shock syndrome).

On one hand, I think the sponge's return is wonderful. It's available over-the-counter, no prescription required, and women can buy them ahead of time just like condoms, to be used when you've deemed a fellow "sponge-worthy". And the more birth control options that women have, the better. The sponge is to be packaged in boxes of three and sell for $14.99.

But before you flush your pills or yank out your ring, be warned. The sponge is primarily a vehicle for spermicide--yes, there's a small physical barrier in front of your cervix that helps prevent sperm passage. But it's not that much more effective than the many spermicide products (film, foam, suppository) that have been available for years. How effective is the sponge? If you haven't had a baby, the failure rate is around 16%...and if you have had a baby, the failure rate is a whopping 32%. And unlike condoms, the sponge won't protect you against STDs. Risks of sponge use include vaginal irritation, allergic reaction, and trouble removing the sponge. So don't choose the sponge over more effective methods, if you're happy with what you're using now.

If you've used the sponge before, what did you think? Do you think you'd ever use the sponge in the future?

Photo credit: m kasahara

G Spot Not the Great Spot

Dr. Kate,

I have this great new boyfriend and we have fantastic sex--often including orgasm, sometimes rough and with lots of oral, all of which includes some heavy use of the G-spot (none of which I've done much of before). I am enjoying it and so is he, but I've been having a problem with feeling like something isn't quite right "down there" after our sessions. It basically feels like I have to go to the bathroom all day (but I don't need to actually go - it just feels that way) and is a general discomfort/feeling like I have some sort of problem with that area. It doesn't burn when I urinate and it doesn't seem to be a yeast infection. Could this discomfort be from over-stimulation of the G-spot? Is it a normal reaction or should I worry that this could be a signal for something else?

Thanks,
G-Spot Gal

Dear G-Spot Gal,

Discomfort isn't normal, especially when it lasts for hours after sex. The first thing to do is to rule out a bladder infection--not all UTIs have burning with urination, and they can present just like your other symptoms. Plus, it's more common to develop a UTI when you're having lots of sex. (Your gyno can also test you for STDs from your urine sample, just to make sure there's nothing scary going on, either.)

If your doc tells you that your urine is clear, your discomfort may be from vaginal chafing (ouch). The "g-spot" is really just part of your upper vaginal wall--it's not a separate structure. And any part of your vagina can become sore from too much friction. Perhaps your marathon sex sessions are leaving you a bit dry, or there's a bit too much attention paid to such a small area. Try adding lubricant during intercourse, or balancing tongue-attention to your labia and clitoris with your g-spot during oral. And you might want to think about giving the g-spot a bit of a break altogether for awhile, to see if that resolves the discomfort. Such an attentive, giving boyfriend is sure to work with you to keep the sex fantastic--as well as pain-free.

Best,
Dr. Kate

Photo credit: ubiquity zh

The Reason I Haven't Posted In A Week

Zachary Parker, born April 14th (by emergency c/section - but that's a topic for a future post). Healthy and lively, though he hasn't quite grasped the concept of day and night yet.

I'll be slowly resuming blogging as I get more sleep (and my typing skills return to normal). Please keep your questions and comments coming - I'll get to all of them in time. Thanks for your understanding!