Question:
Dear Dr. Debby,  I have been using The Keeper  menstrual cup for 15 years. It is the best product since sliced  bread, just an FYI.  I thought I might see it
mentioned on  your site since you are promoting good health for our female parts. Any thoughts on this product?

Answer:
There are a variety of alternatives to tampons and menstrual pads and The Keeper menstrual cup is one of these. Other popular menstrual cups include the Instead cup, the Diva Cup and others. Other women prefer to use menstrual sponges. If you choose to use a reuseable menstrual product (such as certain types of cups, or a sponge) you should learn more about hygiene practices - a very good source of information is The V Book: A Doctor’s Guide to Complete Vulvovaginal Health (available at amazon.com and through many local bookstores).

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Question:
Hello.  Like another person whose question you answered, I have pain during sex. (Penis-in-vagina sex, I mean.)  We use lots of lube, so I don’t think it’s a
friction problem.  And I don’t have vaginal pain at any other times or other symptoms (itching, etc.).  Also, it’s not constant.  At the beginning it always hurts, but sometimes it subsides later, usually if I’m hornier.  But sometimes it doesn’t.  Different positions don’t seem to help, and while slowing down helps some, the pain doesn’t go away entirely, and if it doesn’t stop, gets worse.  Although my boyfriend’s penis is of average size/girth, I’m wondering if perhaps I’m too small for him.  I am small-boned and have fairly slim hips.  Do you know what the problem might be?  (I’d consult a professional in person, but I’m in a foreign country right now.) Thank you.

Answer:
It is possible - but unlikely - that you are simply "too small" for comfortable sex. If you are not sure, you can ask your gynecologist whether your vagina is of a typical size. No need to be embarrassed - many women wonder whether their vagina is like other women’s vaginas in terms of size, shape, or smell and what better person to give you feedback than a healthcare provider who has probably seen thousands of vaginas over her or his career? (Plus, since you are sexually active, you should be having annual gyn exams anyway - so this is a great excuse to make an appointment for a check-up).

Regardless of the size of our bodies, the little research that has been done on vaginas suggests that our vaginal size is pretty similar from one woman to the next. That doesn’t mean that vaginas always feel the same size - to you or to your partner. Things can feel more "roomy" or comfortable during sex when you are highly aroused. In part, this is because when we women feel sexually excited or aroused, our bodies tend to produce vaginal lubrication that usually makes sex feel more comfortable, slippery and may even make it feel like you can’t feel what your partner is doing down there. Then again, you also might be feeling less pain or discomfort when you are highly aroused because high levels of arousal also tend to be associated with a higher threshold of pain - meaning that what normally might feel painful may not feel painful when very aroused.

Since you are already using lubricant, and you are more comfortable when highly aroused, consider spending more time in foreplay getting sexually excited before taking the plunge to begin vaginal penetration (penis-vagina intercourse). Some sex therapists recommend that women don’t begin penetration until they feel so ready for intercourse that they can’t bear to wait any longer (which is very different than the apathetic "well, I guess we can have sex" attitude that some women or men go into sex with). You also might consider, then, waiting until you are positively hungry for sex and your vagina needs penetration right away!

You also might try switching lubricants as it may be that your vagina is irritated from the lubricant you are using. Common irritants found in some lubricants include propylene glycol and chlorhexidine. If you can find a lubricant such as Bliss, Pink, Good Clean Love, or Just Like Me (the latter two are among my favorites), you may find that it makes a difference.

Finally, even though you are in a foreign country, that doesn’t mean you can’t get checked out by a gynecologist. In fact, countries other than the US often have very good and affordable care (whereas some places in the US can be quite expensive). The UK, for example, has excellent specialists in the area of vulvovaginal pain (see the Vulval Pain Society for more information) as do France, Australia, New Zealand, Italy and France, among others. You can make contact with specialists in a range of countries by contacting the International Society for the Study of Vulvovaginal Disease or by contacting the National Vulvodynia Association in the US.

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Question:
Dear Dr. Debby, I have been reading your site and it help me somehow with discovering somethings about myself. The thing is I have this problem which is kind of private and it makes me feel worried. I am 22 years old and I never had any sexual experiences because I believe that I want to have it after marriage (I am getting engaged to a man that I am deeply in love with). The problem is that I am afraid that I cant give him what he needs because I dont have a "clit" if that was the right word of it in English. In the town where I am from, they cut a piece of it when a new baby girl born, because they believe it might let the girl do sins when she gets older. It’s an old thought, they don’t do it anymore, but my grandmother when I was born was really serious about it and forced my mom to take me to the woman who does this thing. I tried to look down there and see myself. It wasn’t there but when I touch that place it makes me feel good somehow. I told my boyfriend about it, because we will get engaged soon. I heard that the clit is a very sensitive part and some woman can’t get orgasm without it. What can I do? PS: I am sorry if my email wasn’t that clear.. English isn’t my mother language  and thanks for reading my email.

Answer:
Thank you for trusting me with your story. I think your English is very good. I don’t know that I would be able to ask such a personal and detailed question in any language other than my own, so I commend you for your abilities and for your courage and faith in me that I would try to answer your question in an honest and helpful way.

People have different terms for what happened to your clitoris. Some people, especially in the US or in Europe, call it female genital mutilitation. I tend to not like that term because many women do not feel that their genitals have been mutilated just because they have been cut. Others call it female circumcision, as that sometimes more accurately reflects the purpose of the cutting of the clitoris in the cultures where the procedure still takes place. I tend to use another commonly used term - female genital cutting - especially when I’m not sure whether the specific cutting we’re talking about (yours) was as part of a circumcision ceremony or not, or how you feel about it. 

Millions of girls have their genitals cut - even today. Sometimes a small amount of the genitals is cut. Other times quite a lot of the genitals are cut, and the vaginal entrance may even be sewn shut (which can be problematic later on when you try to have intercourse). If you are not sure how extensive the cutting was that was done on your genitals, you might check in with a healthcare provider. I would suggest calling local gynecologists offices and asking whether the doctor or nurse has experience seeing women who have had female genital cutting or female circumcision. Sometimes there are special issues that women with your experience may be dealing with, and it can be good to see a healthcare provider who has expertise in this area.

It sounds to me like you are saying that only a small bit of the clitoris was cut, which is probably why you still feel a good deal of sensation (like how it makes you feel good) when you touch the area of your clitoris. The clitoris itself is much bigger than meets the eye. Only the tip of the clitoris (also called the "glans clitoris") can be seen from looking at a woman’s genitals. The clitoris actually extends backward into the body in two branches that are called "crura". Therefore, if only the tip (glans) of your clitoris is cut, you may have quite a lot of it left inside of you (which is good!!).

Women experience orgasm in many different ways. Some women enjoy direct stimulation of the clitoris. Others enjoy direct stimulation of the vagina (the inside part; also called the "birth canal"). Still other women actually are able to orgasm from breast stimulation. In other words, regardless of what has or happened to your genitals, I think there is reason to believe that you can have a satisfying, pleasurable sexual life with your fiance.

It is also worth noting that even if you do not orgasm, you are not alone. Many women - even women who have never had their clitoris - do not experience orgasm, particularly during penis-vagina intercourse. Other women do learn to experience orgasm but it may take them weeks or months or years to learn to do so. Orgasm seems to come more easily to men than women, but that does not mean that our sex lives are any less pleasurable, meaningful, enjoyable or satisfying.

You can learn more about female orgasm by reading Becoming Orgasmic. You can learn more about connecting with your husband by reading For Each Other: Sharing Sexual Intimacy by Dr. Lonnie Barbach.

If you have a question about sex, love, dating, relationships, pleasure, orgasm, tips, techniques, positions or sex terms you’ve heard but don’t understand, email me at DrDebby@mysexprofessor.com. Your confidentiality will be respected.

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Question:
Hello, I have a question for you. Okay, I shower every day so I’m a clean person, but why do I have a bad smell from "down there"? I don’t understand and I’m nervous to talk to my doctor about it. I have no pain, no itch, no nothing except the odor. What could it be and why?

Answer:
Many women - and men, too! - have questions about their genital smell. In most cases, people’s genitals smell just fine assuming they are taking regular showers or baths, wiping after they go to the bathroom and such.

When a woman notices an unusual genital odor, however, it is important that she make an appointment to check in with her healthcare provider. It may feel scary or embarrassing to ask your doctor or nurse why your vagina smells the way that it does but it’s actually a very common question that women ask at medical appointments. Many women want to know if they smell "normal" or not.

There are some health conditions that can cause strong or unpleasant vaginal odor including bacterial infections (such as trichomoniasis) and bacterial imbalances (such as bacterial vaginosis, also called BV). You can read more about these in The V Book: A Doctor’ Guide to Complete Vulvovaginal Health.

Other times women or men might have strong or unpleasant odor in their genital area due to problems with their sweat glands. These are also issues that your healthcare provider can address. There are new research studies looking at ways to address these problems. In one recent study that I read about, a doctor injected Botox into the area of the problematic sweat glands and the patient’s smell got much better. Researchers and doctors are coming up with new ideas to treat health problems all the time, so it’s worth checking in with your healthcare provider.

As a side note, unless advised by your healthcare provider, it is also worth staying away from various feminine "hygiene" products such as douches, feminine hygiene wipes and sprays as those can cause genital irritation. Vaginas are self-cleaning (lucky us) - read more in The V Book.

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Question:
I am a almost 22 year old woman and I have some questions I don’t know who to ask. I have what I call extra skin (meaning skin that goes half way over the hole where I have sex) and when I have sex it hurts bad. I also have a really low sex drive.

Answer:
It can take a lot of courage to write to someone you don’t know about personal matters such as your body or your sexuality, so thank you for trusting me with your question. Most girls are born with a thin layer of tissue (called the "hymen") that partially covers the vagina. In some girls, the vagina is more completely covered than other girls, and this can cause discomfort or pain when trying to have sexual intercourse. This is something that you should make an appointment to talk with a healthcare provider about. You can find a healthcare provider at a local Planned Parenthood clinic or, if you are a college student, then perhaps you can make an appointment for a gynecological exam at your campus health center. 

This is definitely something that I would encourage you to have looked at by a healthcare provider, particularly because all sexually active women should have a gynecological exam (also called a "pelvic exam") at least once per year anyway - just to  make sure that your sexual and reproductive health are in good shape, as well as to ask any questions that you might have about effective ways to prevent pregnancy or to reduce your risk of sexually transmissible infections (STI). You can learn more about preventing pregnancy and STI here.

In terms of your sex drive, you may find that once you get the "extra skin" issue checked out and addressed by your healthcare provider, that you may soon develop more of an interest in sex if it begins to feel more comfortale or pleasurable. You might find a book such as For Each Other: Sharing Sexual Intimacy by Dr. Lonnie Barbach to be helpful as you work on communicating your needs to your partner, as well as learning how to feel comfortable expressing to your partner both when you do and when you do not want to have sex. Finally, the importance of a healthy lifestyle when it comes to sexuality cannot be underestimated (e.g., exercise, getting enough sleep, avoiding cigarette smoking, and eating a diet that has plenty of fruits, vegetables, lean proteins, and whole grains).

If you have a question about sex, love, dating, relationships, pleasure, orgasm, tips, techniques, positions or sex terms you’ve heard but don’t understand, email me at DrDebby@mysexprofessor.com. Your confidentiality will be respected.

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Question:
What happens to the female body if a male’s ejaculated semen is swallowed? Is it harmful? Thanks for your help.

Answer:
Great question! Fortunately, if a woman swallows ejaculate (semen) she won’t turn into an oompa-loompa. She’ll still just be a woman, albeit with ejaculate in her gastro-intestinal (GI) tract. 

Unless, of course, she picks up an infection from the guy who she’s just performed oral sex on. Gonorrhea, syphilis and herpes can all be transmitted through oral sex. HIV can be transmitted through oral sex, too, although that appears to be less common. Because of these risks, many sexual health educators suggest that people use male condoms when they perform oral sex on men, or latex dental dams when they perform oral sex on women. If you don’t like the taste of the condom, add on a tasty flavored lubricant - many flavored lubes taste like cough medicine but I like the "Blue razzberry" flavor from Climax Fruit Bomb (available from Babeland). 

All that said, there are occasionally other unexpected things that can happen during oral sex. I once heard from a woman who would have very bad diarrhea within an hour of performing oral sex on her husband and swallowing his semen. Puzzled, I asked an ob/gyn friend of mine who suggested that it might be that the woman’s body was unusually sensitive to prostaglandins which are found in ejaculate (and which also rise in a woman’s body as menstruation approaches). Prostaglandins can trigger several bodily reactions, including diarrhea.

If you have a question about sex, love, dating, relationships, tips, techniques, pregnancy, birth control, sexually transmissible infections, or you simply want to pass a few sex myths by me, email me at DrDebby@mysexprofessor.com. Your confidentiality will be respected.

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Question:
Hi, I’m 20 years old. I’ve been married for over 1 year now. I’m having a big problem with my sex life. I do not have a sex life because I just don’t feel like I want to have sex at all and I dont like it when my husband touches me anywhere down there. It feels weird and repulsive. Sometimes my vagina itches and burns without sex and when I do try to have sex my vagina burns a lot and we have to stop. And also I’m so scared to go to the doctor and even to talk about it. This has been going on for about 7 months now and I dont know what to do. Please help me so that I can regain my sex life again. Thank you and hope to hear from you soon.

Answer:
Thank you for trusting me with your worries and fears. I am so sorry to hear that your vagina hurts - with or without sex. I understand that you are scared to go to the doctor; however I would like to encourage you to get up the courage and go. If it will make you feel more comfortable, please ask a close friend or a family member (such as your mom or an aunt or cousin) to go with you to your appointment with a doctor or nurse. Sometimes women have allergic reactions (like to laundry soap or a bath gel, or even to a medication they might be taking) and this can cause vaginal pain - even when you are not having sex. Other times women have pain conditions such as vulvodynia that cause pain - again, even when you are not having sex.

I also hope that you feel comfortable to tell your husband that you do not want to have sex or to be touched on your genitals, if you do not want to do that. You do not have to have sex if you don’t want to. You don’t have to do anything sexual that you don’t want to. That is okay to feel and it is also okay to say to your husband. 

If you would like to reconnect sexually with your husband, you might find a few books to be useful including For Yourself: The Fulfillment of Sexual Pleasure and For Each Other: Sharing Sexual Intimacy. I also think you might benefit from connecting with The National Vulvodynia Association (NVA) where you can learn more about vaginal pain and perhaps get connected to a support group of other women who are experiecing pain problems (about 10 - 15% of women experience chronic vaginal pain). You might also be able to talk to someone at the NVA about how to find a doctor or nurse in your area who specializes in helping women who experience vaginal pain. You are not alone in your experience and there is definitely reason to feel hopeful that you can enjoy your sexuality again.

Thank you again for writing to me.

If you have a question about sex, love, dating, relationships, pleasure, orgasm, tips, techniques, positions or sex terms you’ve heard but don’t understand, email me at DrDebby@mysexprofessor.com. Your confidentiality will be respected.

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Question:
Can pills really enlarge the penis? If not, is there anything that can?

Answer:
No, we don’t have any scientific evidence to suggest that any pills, herbs, weights, or even surgery can safely and effectively enlarge a man’s penis - in spite of the various marketing messages you might come across. There just is not the evidence. Some companies go as far as to mislead men about the average penis size, which is about 5-6 inches of erect length. However, some penis pill companies will tell men that the average penis size is 7 inches long which, of course, is aimed at making most men feel inadequate so that they will buy their product. 

Some of the surgeries that are available may make a man’s penis longer or wider but they may not do so safely and the scar tissue that can build up can actually cause shorter erections or painful erections, so please tread carefully and check in with quality healthcare providers before choosing surgery. 

Finally, it’s worth asking: why make the penis longer to begin with? You don’t need much length to stimulate the G Spot in a woman’s vagina (if your partner is female) or the prostate in a man’s anus (if your partner is male). Also, a big penis doesn’t necessarily make for better sex. And if your penis is too big, then your partner might find sex uncomfortable or painful, which means you now have to be extra strategic about positioning, lubrication, and such. It gets complicated. There are certain positions that may be better suited for penises of different sizes, and different ways you might want to apply personal lubricant on your own or your partner’s genitals depending on penis size. You  may even want to handle foreplay in different ways depending on genital size issues. But those are lessons for other days… if you have specific questions about sex, love, dating, orgasm, ejaculation, pleasure, relationships, communication, positions or other aspects of sexuality, please email me at DrDebby@mysexprofessor.com. Your confidentiality will be respected.

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Question:
Is there any proven correlation between prostate massage and prostate health?

Answer:
Great question! The short answer is: yes and no. I am not aware of any studies that have specifically looked at prostate massage and prostate health. That said, there are studies that have shown that men who ejaculated more frequently when they were younger tend to have a lower risk of prostate problems as they age. It does not seem to matter whether the ejaculation is from self-masturbation, partner masturation, intercourse, oral sex - or prostate massage. The point is that ejaculation is good for men and their prostate! Just do it, you know, in private or with a partner. Not on the subway. Not on a park bench with people nearby.

So what does ejaculation have to do with the prostate anyway? TONS! Sperm make up only a very tiny amount of ejaculate (semen) - the rest comes from the prostate, seminal vesicles and Cowper’s glands. When men ejaculate, then, they give their prostate a healthy workout! That doesn’t mean, of course, that their partners have to help men’s prostate health by having sex whenever men want. After all, men can masturbate or do their own prostate massage too. 

Fun times…

Check out the below diagram (from this site) to see where the prostate is in relation to other yummy male parts.

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