Sex Advice From OBGYNs

Dr. Andrew Ditchik, 43

I'm nervous about going to my male OB-GYN. Will he get turned on giving my exam?
This is something that hasn't occurred for me, because it's such a clinical setting. You really move into professional mode. You're there as a provider of health care. You're there as a guide. You're there in some ways as a teacher, and it's important to maintain that distinction.

Sometimes I feel unfresh down there. Douching, sprays and powders are supposed to be unhealthy, right? What can I do?
In the absence of infection, normal vaginal lubrication keeps the vagina clean. When you bathe, you're not really cleaning out the vagina but the areas around it. Use some type of mild soap, Ivory or Dove. A lot of women end up with what they think are vaginal or vulvar infections, and it turns out they're using either an antibacterial soap, or soap with some other type of perfume or additive.

Will my OB-GYN freak out about my genital piercings?
If the piercing is between the labia, then obviously it's not a good idea to keep it in place if you're going to have a pelvic exam — or have sex, for that matter. But the majority of times, it might be something that you want to mention to the physician ahead of time just so that you can bring the subject up and control the conversation. We're professionals, we don't make judgments.  

 I'd like my girlfriend to start doing kegels to strengthen her vaginal muscles. How do I tell her without sounding like an asshole?
You could bring it up while you're having sex. Say, "Honey, why don't you tighten your muscles around me? I want to see what it feels like." And, then if you say: "That feels great. Can you do that next time?" If you integrate it into the play, it might be more acceptable that way.

Any tips on convincing your partner to have sex with you during your period?
Sometimes it's a little bit more uncomfortable for the woman because blood can be irrititaive. It's a lubricant, but it's sort of an irritating lubricant. But you could say: "It could be messy, but it could be fun, so let's not use the white sheets."

What is the strangest question a patient has ever asked you?
"Is it normal that every time I take a shower, my palms bleed?"

Does looking at vaginas all day affect your sex life?
Issues have come up with my own relationships, with my girlfriend or with my ex-wife. They wonder, "Don't you get aroused by the women? Could you still be interested in me?" Yes, I'm still interested in you. You're not on the table. You're not a patient. It's a completely different involvement.


Dr. Vanessa Cullins, 47

Sometimes I feel unfresh down there. Douching, sprays and powders are supposed to be unhealthy, right? What can I do?
Bathe daily, and consider those little Huggies baby wipes. You can carry them in your purse and use them whenever.

I'm not comfortable using my partner's sex toys because I know they've been used with other people. Should I insist on new ones?
My preference would be to get some new sex toys that are just for this particular union. Especially the penetrative sex toys. Bacteria and viruses don't live that long on inanimate surfaces, so technically soap and alcohol and water are okay. But if someone says "I'm not comfortable," she definitely needs to have new sex toys. She's never going to enjoy the sexual experience if she has it in the back of her mind that they're unclean.

Any tips for pre-anal-sex hygiene? Do I really need to have an enema?
Most people who have anal intercourse don't encounter a load of feces unless the person is sick or incontinent. The most important thing is never to go from anus to vagina — or from anus to mouth. Don't be moving that bacteria around.

Many women I know can't seem to have an orgasm during vaginal sex unless a finger is employed. Is there anything they can do to change that?
The woman-on-top position may allow the shaft of his penis more contact with her clitoris. Or he could figure out a way to stimulate her using another part of the body. Potentially, even clothing can result in direct stimulation of her clitoris. If she has a thong on, she could place the side of the thong up against her clitoris, then the motion of penetration may result in some direct stimulation. It takes experimentation, but that is what recreational sex should be about — finding what works best for you and him.

I'm worried that I will get turned on during my pelvic exam. What can I do to deal with the situation if it occurs?
Most women are not going to become aroused because of how clinical that exam is. It is not, however, impossible. If a woman becomes aroused during her pelvic exam or breast exam, she shouldn't feel embarrassed. In my opinion, it only needs to be addressed if she wants to address it. The provider is going to have a tendency to ignore it. However, if she is so aroused that she doesn't want the exam completed, then she should feel confident and assertive enough to say,"I don't want to do this at this point in time."

Dr. Aren Gottlieb, 33

What can I do to prevent catching HPV?
HPV is very common, but to say that someone should not to go out and have sex is unrealistic. Practice safe sex, and in the long run, limit the number of partners that you have.

What is the best way to tell a prospective partner I carry the herpes virus (but am currently outbreak-free with medication)?
There is no "best" way to tell someone, but you have to be honest. If you have an open relationship to begin with, then it really shouldn't be an awful thing to discuss. I think we really have to be able to talk about our sexuality and our past experiences because they will impact you in the future. And of course, you always have to practice safe sex.

I'm nervous about going to my male OB-GYN. Will he get turned on giving my exam?
If a patient feels at all uncomfortable then she's in the wrong environment and maybe should be concerned about it. All I do all day is look at vaginas. I can't imagine a man getting aroused after doing the same. It's just a job. We like what we do, but it's not that we're in love with the vagina.

I'd like my girlfriend to start doing kegels to strengthen her vaginal muscles. How do I tell her without sounding like an offensive boor?
Is there a good way? No. But it is something you could bring up in other ways. You might want to say, "Well I was sitting in the doctor's office waiting and I was reading in Glamour that doing kegel exercises can help you tighten your perineum and it can prevent you from having incontinence in the future." Something along those lines.

What do you think are the best terms to use for the genitals in a health setting and in a romantic setting?
I really hate it when patients come in and don't use proper anatomical language. To use the word "cunt" or "pussy," it's not appropriate. I feel like it is our job to educate the patients and the children that they bring, so I frequently use the appropriate word and I teach them that they have multiples holes. A lot of people think that the urethra, where they urinate from, is the same as the vagina, and it's not.

Dr. Sabria Ishoof, 31

What can I do to prevent catching HPV?
You can't. Any woman that is sexually active is going to have HPV exposure. Remember it's from genital contact. It's not just intercourse. It can live on your skin. It can live on the outer part of your vagina. Your labia. On the penis. But even no sexual contact can pass the virus.

I'm a guy whose penis is too big for several women I've been with. What can I do?
Try different positions. The more control she has over her vaginal muscles, the more control you can have over penetration. Put pillows under her bottom, which can tilt the pelvis up a little bit and allow a little bit more control. This is also good because you're not necessarily flat in an uncomfortable position where you can't control the extent to which penetration occurs. The other thing is lubrication. Make sure that if there's not enough natural lubricant that you use an artificial lube. I usually recommend Astroglide. It's not as drying as K-Y. But I wouldn't use baby oil, things like that.

Can those products give you an infection?
Well, you're dealing with very sensitive tissue. I've had patients come back with little funky infections like bacterial vaginosis, and I say, What have you been doing?, and it turns out they're using Crisco.

Will my OB-GYN freak out about my genital piercings?
I don't think genital piercings are healthy at all. You can cause a spreading infection, because it can spread to the abdomen from the top of the vagina. Genital piercings are raw. Anything that can live in the soil can live in the vagina. And believe it or not, there's some of the same species in both. So when you leave a piercing in, you leave a wick for infection to catch onto, kind of like in the '70s with the Dalkon Shield [IUD], which because a hotbed for bacteria.

Open relationships — good idea or invitation to disaster?
I think it's very dangerous emotionally and physically. Unless you are the one-person-in-forty sociopath, I don't think you can truly turn off your feelings like that. By swinging with these different partners, you might introduce infections, because no condom is going to protect you 100 percent. The people I know who've had those relationships? I've never seen them go more than two or three years.  n°