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The "Ins and Outs" of Booty-Bumping

Dear Readers,

Do you know the ins and outs of booty-bumping? While it may seem like a piece-of-cake, booty-bumping (keistering) is not harmless! Here's some important info to help you have a bummer-free experience:

WHAT IS IT?
• "Booty-bumping" refers to putting drugs in the anus (up the butt) as a way to get high. The drug solution is absorbed through the lining of the intestines (gut).

WHAT ARE THE RISKS?
• TISSUE DAMAGE: We know that crystal-use shrinks your blood vessels. So when
you booty-bump crystal, you shrink the blood vessels in the anal cavity. This means
there's less blood to nourish that tissue. With repeated booty-bumping, the blood
supply to the inner lining of the butt is cut off and the tissue dies from lack of
nutrients.
• SCAR TISSUE: When the tissue in the anus gets damaged, scar tissue can build
up. If scar tissue builds up, your hole may become smaller, which can make
pooping and anal sex painful!
• HIV/STDS: Booty bumping likely increases your risk of getting HIV or other sexually
transmitted diseases (STDs) by causing small tears and other changes to the
tissue in your rectum.

REDUCE THE HARM-STEP BY STEP
1) KEEP IT SPOTLESS:
• Start with a clean surface free of dirt and debris.
• Wash your hands with soap and water before preparing your hit.
• Use fresh water and a clean container for mixing your hit.

2) DON'T GET SCREWED:
• Use a brand-new syringe with a screw-off needle. Breaking the needle off of a
syringe can create dangerous sharp edges that can tear you up!
• After you remove the needle, feel the tip of the syringe with a clean finger to ensure
there are no sharp edges. Discard the needle in a Sharps container.
• Before you booty-bump, put some Vaseline (petroleum jelly) on your finger and
coat the inner lining of the rectum. This can help create a protective seal and
prevent water-soluble crystal meth from doing as much damage to the tissue in the
anal cavity.
• Carefully do your booty-bump, then throw the syringe and plunger in a Sharps
container. Wash your hands to clean away germs.
• Some guys like to insert a vitamin E capsule (with water-based lube) in their butt
after booty-bumping to help the tissue heal.

3) NO ENTRY:
• Booty-bumping can create small tears in the tissue of the anus and rectum (in and
around your hole). These tears make it easier for infections like HIV and STDs to
get into your body.
• Carefully clean the skin around your hole after booty-bumping.
• Use a condom and lube if you have anal sex after booty-bumping.
• Use a dam if you rim your partner after they booty-bump. You can get hepatitis A
and Shigella through fecal-oral contact (poop getting in your mouth).
• Get vaccinated for hepatitis A & B.
• Use elbow-length latex or nitrile gloves if you fist after booty-bumping. Dispose of
the gloves in a Sharps container after use.

4) OTHER TIPS:
• Booty-bumping can cause muscle contractions that give you a strong urge to
poop (like when you use an enema or douche). Be aware that you may get
intestinal cramps!
• Avoid enemas. Using an enema before booty-bumping can dehydrate you. Enemas
can also create small tears in the delicate lining of the anus and rectum. If you must
use an enema, plain warm water is the safest option.
• Give your butt a break. Try not to booty-bump very often! Switch between booty-
bumping and other methods (like smoking or snorting).
• See a medical provider if you have any concerns about your ass after you booty
bump.
• Don't use alone: have someone with you so you can take care of each other if
something goes wrong.
• Hydrate! Water and 100% juice are good options.


-Dr. Dick

*C*h*e*m* *S*e*x*

Dear readers,

It's been awhile since I wrote an article about P n' P (party and play) also called Chem Sex. I could go for hours (literally) about all the little things you can do to have a comfortable and safe experience, but I'm going to keep it short and sweet. Here are my top 5 favorite harm reduction tips:

1) HANDY J
When you're in the moment, you don't want to be stumbling around for a condom, or accidentally mixing up your needles and safer-use supplies with a partner. Keep safer-sex supplies handy, and mark your needles and safer-use supplies with a sharpie and store them in a personal bag. For more safer-use tips: Keep Calm and Reduce Harm

2) "IT'S OK, I'M CLEAN"
Be discerning when deciding to hook up with someone. Some people may say "I'm clean," or "I'm negative," because they want to get in your pants, but what does that actually mean? Some people have HIV and/or other STDs. Some people don't. Some people have actually never been tested, or got tested 15 partners ago. Some people ARE telling the truth. Some people don't know they are infected. You can't be sure from looking or talking to someone right? When in doubt, consider using a condom or other type of barrier.

3) CHANGE IT UP
Condoms can dry up faster than you can. Dried up condoms can tear or break completely! Stop every hour to change condoms, and add lots of condom-safe lube each time: Well-Oiled Machine

Insertive "female" condoms are a great option when standard "male" condoms don't sound fun or aren't available to you. You can put one in up to 8 hours before sex. Non-latex and less mess. Learn more here: Too Big to Fit in Here and check out the diagram below.

Reality.jpg

4) WASH YOUR HANDS
Shigellosis is on the rise among gay and bi men in King County. Shigellosis is spread when poop (even the tiniest amount) gets in the mouth. This can happen during oral sex, rimming, or not washing hands properly. To help prevent Shigellosis and other intestinal bugs, wash your hands before and after:
• Touching your genitals, butt, or mouth, or those of a partner
• Removing a condom or insertive condom
• Eating anything

For more info about Shigellosis: Sh-Sh-Sh-Shigella

5) PrEP & PEP

PEP
If you're negative for HIV, and think you might have come in contact with HIV through condomless sex, a condom break, or a needle stick, you might consider getting on PEP (Post-Exposure Prophylaxis). PEP can lower your chances of getting infected with HIV. How does it work? You take a 28-day course of HIV medication to decrease the chance that the virus will settle in your body.
If you feel you might have been exposed to HIV, go to the emergency room at Harborview within 24 hours of the exposure, to get a prescription for PEP. You can also see your primary care provider, if they can see you immediately. PEP works best when started right away, and will not be prescribed for you after 72 hours (3 days). For more info on PEP, check out my article Feelin' Peppy.

PrEP
Guys who are HIV-negative and at high risk for getting HIV can take PrEP. How does it work? You take a pill once a day, every day, to lower your risk of getting HIV. It's important to keep in mind that PrEP alone won't stop you from getting infected with HIV.
It's strongly recommended that guys who take PrEP also do the following:
• Use condoms every time for anal and vaginal sex
• Talk to their partners about their HIV status and using protection
• Get tested regularly for STDs, and get treated if an STD pops up
• Get tested every 2-3 months for HIV
• Take their PrEP meds every day
• Use brand new needles and works every time they inject

TALK TO YOUR MEDICAL PROVIDER if you are interested in PrEP. For more info about PrEP, check out my article That Little Pill.

Happy Humping,

-Dr. Dick

Uncovered in the U District

Dear Dr. Dick,

 

I'm a bi guy who has a couple of intimate partners (both men and women). At this time of year when it's freezing out, it's basically a 24/7 orgy. We all tested negative two months ago, and we're good about getting tested regularly. I feel like I don't have to worry too much about getting HIV. The only thing is, I really don't like condoms. They don't feel good and I have a hard time getting off when I use them. My partners are OK with me not using them.  Two of us use crystal, but we smoke only (we don't inject or booty-bump).

 

How worried should I be about getting HIV? Dr. Dick, I'm not about to start covering myself up. Is there anything I can do to play it safer?

 

Sincerely,

 

Uncovered in the U District

 

 

Dear Uncovered,

 

I'm glad you brought this up! While condoms can make sex a whole lot safer--it's important to acknowledge that some people just don't like them or use them. For many guys, sex without condoms just feels better---but it can come with a price (pardon the pun). If you're NOT in a monogamous relationship (where you and your partner only sleep with each other, and are sure you are both HIV/STI free) --- barebacking is risky.

 

Here's Why:

 

1) The lining of the anus and vagina are delicate. Micro tears can happen easily (especially with rougher, prolonged crystal sex), which leaves you and your partners vulnerable to HIV and other sexual bugs.

 

2) It's always a possibility that your partners have other partners. Even though you trust them, you should never assume you're 100% safe when it comes to sex.  Whether its oral, anal, or vaginal sex, all sex carries some risk.

 

3) Even though you and your partners test often, people are most infectious in the weeks right after they get infected with HIV. If one of your partners gets infected and doesn't yet know it, they could infect you.

 

With that said, if you're sure that you're never going to use a condom---consider the following tips for safer sex:

 

 

1) SKIP DOUCHING:

Douching (using an enema) damages the skin in and around your hole--making it easier to spread or get an STI. If you absolutely MUST douche before sex, use warm water only. Check out my recent article on enemas for more info.

                                                          

2) SMOKE SAFER:

Talk about sex before you smoke. Do you have the supplies you need? (water-based or silicone-based lube etc.). Crystal can make you forget everything when you're caught in a moment of passion.  

 

Try to use your own pipe only. Passing the pipe around can expose you to diseases and infections that can weaken your immune system.

 

3) TEST:

Test every 2-3 months

?        If you test positive for an STI--connect with a medical provider ASAP. You and your partners must all get treated. Otherwise, the bacteria/bug will continue to be spread back and forth. Your immune system will also be more compromised---which will make barebacking riskier.

 

4) EXPLORE YOUR OPTIONS:

Have you thought about trying an insertive condom? Insertive condoms are used in the anus or vagina, and offer protection against HIV, pregnancy, and STIs. You can put one in yourself, or ask your partner to do it. This is a great option for guys who have a difficult time staying hard with condoms on. Have fun with them by making them a part of foreplay.

 

For more info, see my recent article Too Big to Fit in Here.

 

5) REDUCE:

Have fewer partners. Fewer partners = less chance of getting or spreading a sexual bug.

.

6) PrEP & PEP:

PrEP

HIV-negative guys who are at high risk for getting HIV can take PrEP (Pre-Exposure Prophylaxis). PrEP involves taking a pill once a day, every day, to help prevent getting HIV. Guys who take PrEP should also use condoms, & get tested often for HIV and other STDs.

Talk to your medical provider if you are interested in PrEP.

 

PEP

(Post-Exposure Prophylaxis) can also lower your risk of getting HIV. PEP is the use of an HIV drug after a possible exposure to HIV. If you feel you might have been exposed to HIV, visit your medical provider ASAP. PEP needs to be started within a couple days of being exposed to HIV. 

 

7) COMMUNICATE:

It sounds like you're doing a superb job of talking with your partners. Keep it up. Talk about your HIV and STI status with your current partners--and if/when you get a new partner. You might say "I tested negative for HIV 2 months ago." If you don't talk with your partners, you don't have the chance to find out their status or sexual history.

 

8) LUBE:

Some guys use lube because they feel like it decreases friction and trauma to the skin. Friction can tear the lining of the anus or vagina, which makes you or a partner more likely to get a sexual bug.   

 

We really have no idea whether lube increases the risk of HIV and other STIs, decreases the risk, or has no effect.  More research is needed in this area. Your risk of spreading or getting HIV and other STIs may depend more on the kind of lube you use. 

Not all lubes are safe! Some lubes hurt the lining of the rectum and may increase HIV replication (the virus making copies of itself).  Here's a bit more info:

 

         If you are using condoms, don't use oil-based lube--which breaks down condoms. Crisco, Vaseline, and chapstick (lip balms) are oil-based and are NOT good options--even if you're desperate!!

 

         Stay away from lubricants that contain nonoxynol-9. Nonoxynol-9 is a spermicide that can irritate the delicate lining of the rectum and vagina, increasing the risk of HIV and other STIs.

 

         Some evidence suggests that lubricants containing an ingredient called polyquaternium-15 may boost HIV replication. Some of the lubricants that contain polyquaternium-15 are: Astroglide Liquid, Astroglide Warming Liquid, Astroglide Glycerin and Paraben-Free Liquid, and Astroglide Silken Secret.

 

         Some evidence suggests that certain lubricants can damage the cells in the lining of the rectum. These lubricants include: Astroglide, Elbow Grease, Gynol II, KY Jelly, Relpens, and Boy Butter.

 

 

         Some evidence points to the following lubricants as safer choices: Good Clean Love, PRE, FC 2 lubricant, and Wet Platinum.

 

9) CONSIDER THIS:

Have you thought about how important it is to you to stay HIV-negative? What would you do if you tested positive? It's worth thinking about....

 

 

Here's to safer humping.

 

 

Dr. Dick

 

 

*For more info on PrEP and PEP visit

 

PrEP

Go to: http://www.kingcounty.gov/healthservices/health/communicable/hiv.aspx

& click on PrEP Q&A: Using HIV Drugs to Prevent HIV Infection.

 

PEP

Go to: http://www.kingcounty.gov/healthservices/health/communicable/hiv/links/pep.aspx

 

& http://www.cdc.gov/hiv/topics/treatment/post-exposure-prophylaxis.htm

Hard Times

 

Dear Dr. Dick,

 

I never thought it would happen to me, but I think I've got a bad case of crystal dick. No matter what I do, I can't get it up anymore. I've heard about this happening with other guys who shoot crystal, but I've been partying for years and never had a problem before. I tried Viagra, but that didn't really help. I'm super embarrassed... Is this a permanent thing?

 

- One Panicked Penis

 

Dear Panicked,

 

Ah, good ol' crystal dick! Speed's little practical joke isn't so amusing when it happens to you, is it? Not all crystal users will develop erection problems, but it does happen more often with long-term or high-dose users. And you guessed it - that usually means injectors. Erection problems are one of the real downsides of shooting crystal, but you do have some sex-saving options!

 

Your garden-variety erection happens when specific brain chemicals (mostly serotonin and dopamine) react to things that turn you on. When you see a hot guy or he starts rubbing your crotch, your brain sets off signals to the muscles and blood vessels in your pelvis that cause you to get hard. The rest, as they say, is history.

 

There are many things that can affect your ability to get hard. Your testosterone or hormone levels may be low, especially if you have HIV or AIDS. Levels can also be low if you are taking certain medications or have other health problems. And, erection problems become more common as we get older. Your medical provider can help sort it all out. But back to crystal - it is the factor we're most concerned about here.

 

Crystal causes huge changes in dopamine and serotonin. Over time, your brain can have trouble sending the right messages to your penis. Regular crystal use also puts stress on parts of your nervous system that regulate normal blood flow between muscles and the tissues of the penis. Finally, crystal shrinks your blood vessels, making the problem even worse. Using more crystal will NOT fix the problem!

 

SELF-MEDICATING = DANGER

Boner-uppers like Viagra aren't the answer to fixing crystal dick either. Viagra is designed to treat specific health conditions that you may NOT have--so you should never take Viagra without a prescription. It's also very dangerous to mix boner-uppers with poppers. The strain on your heart could cause a heart attack. The combination can be fatal!!! Click here to read more: Crystal, Poppers & Boner-Uppers

 

WHAT CAN YOU DO?

The best solution for you may be to lay off crystal for a while. Most men see their erections return once they take a sizeable break from speed or seriously cut down their use. It's hard (pardon the pun) to say how long it will take for your dick to rise again. The recovery time varies, but the results are usually positive. Unless you have other health issues, this type of impotence is usually not permanent once crystal is out of the picture.  

 

For some guys, it's not an option to quit crystal. You might be able to cut back though.   

 

If cutting down or taking a break from speed doesn't help, then definitely talk with your doctor. Otherwise your little soldier should be saluting in no time!

 

Sincerely,

 

Dr. Dick

 

Show Your Balls Some Love!

 

Your testicles may be worth $1 Million...but to most men, they're priceless! You love them and protect them at all costs! But, I'm always surprised by how little most of my patients know about their balls. Testicle injury, cancer, and other ball problems happen more than you might think!

 

Below is a short list of common ball problems I see:

 

 

1) Too much wear and tear from rougher, marathon crystal sex. My advice: take the weekend off!

 

2) Torsion. The testicle receives its blood supply through the spermatic cord. Sometimes during strenuous activity like (s)exercise, or from trauma, the spermatic cord gets twisted, and blood supply gets cut-off to the testicle and surrounding structures in the scrotum (ball sack). Severe pain in the testicle comes on quickly, and might be joined by swelling in the scrotum, nausea, vomiting, and lightheadedness. If not treated right away, the testicle can die! Get to the emergency room ASAP!

 

3) "Blue Balls." Men often use this term to describe when their balls hurt during or after sex where they didn't ejaculate. The pain is simply caused by blood backed up in your erect dick and balls. For relief, let your erection go down a bit or self-stimulate so you can cum.

 

4) Epididymitis is an infection of your (you guessed it) epididymis-- the mass of tiny tubes on the top and back of your testicles. It can cause pain, swelling, or sensitivity in your testicles. Epididymitis is often caused by untreated STDs like chlamydia and gonorrhea. If epididymitis doesn't get treated, it could lead to problems like chronic pain (pain that doesn't go away).

 

In many cases, epididymitis can be prevented. Use condoms to lower your risk of getting an STD, and get tested regularly. Guys who have sex with guys should test every 3-6 months (or as recommended by your healthcare provider). 

 

5) Testicular Cancer

This is the most common cancer in men ages 15-34 - but it's good to know that cure rates for testicular cancer are very high. Symptoms of testicular cancer can be: discomfort or pain in the testicles, lower back pain, enlargement of the testicles, & a lump or swelling in the testicles. It's important to examine your balls each month, so that you can check for any changes (see below for more information). If you think you might have any of the symptoms for testicular cancer, make an appointment to see your healthcare provider for a check-up.

 

Get to know your balls

Get to know what your balls normally feel like--that way you can notice anything that doesn't seem right or normal. It's nice that we have two, because we can compare one to the other! All men should do self-exams once a month. Some guys like to check their balls when they're in the shower, or lying in bed. Here's how:

 

1)      Carefully hold one of your balls between your thumb and index finger.

2)      Feel your way from back to front, and bottom to top.

3)      Repeat with your other ball.

 

 

You can also ask your partner to help you check. You might even choose to make it part of your shower sexcapades!!!

 

If you feel anything that doesn't feel normal, don't freak out.  There are many things that can happen to your balls, and you should see a healthcare provider if you notice something that doesn't seem right. You'll feel better once you get it checked out.

 

Take care,  

 

Dr. Dick

 

 

Updated and Reposted 1/4/13

Hep C Positive

 

Dear Dr. Dick,

 

I was part of a study where they tested my blood for all kinds of stuff. They told me I was HIV positive. I knew this already (for six years). The woman also told me I have hepatitis C. HIV was bad enough--now this. She gave me some information but I lost it. She also told me some stuff but I wasn't too clear-headed at the time. I'm worried. What's going to happen to me? I hear a lot of different things from a couple of friends who have hepatitis C and HIV. Is there anything I can do to help keep healthier? I'm not going to stop shooting meth--at least for now--but I might in the future. I know shooters mostly get hepatitis C from sharing dirty works.

 

Since I switched to IV speed four years ago, I've been real careful--except for one accident, I never used anything that belonged to anybody else. It happened once when I was too geeked and mixed a hit with my ex-lover's dirty rinse water. I also used his old cotton and spoon. He was HIV positive but so am I. Did I get hepatitis C through just this one time?!! Maybe I got it through sex but I've been pretty careful on that score. I need some direction and advice.

 

Thank you,

 

-Anonymous

 

 

Dear Anonymous,

 

Everybody slips up once in awhile--so don't be hard on yourself. What's done is done. It sounds like other than that you've been faithfully practicing harm reduction.

 

About 80% of HIV-positive people who inject drugs also have HCV--and having both infections can make HCV progress faster in the body. Make an appointment to see your doctor so you can get your questions answered and discuss your health. You'll feel a lot better when you know what's going in on your body, and can talk about treatment and care.

 

In the mean time, let me give you some info about the hepatitis C virus (HCV). Hepatitis simply means inflammation of the liver. HCV is a contagious liver disease (just like hepatitis A and B). It is spread mostly through contact with the blood of a person who has HCV. Common symptoms of HCV are tiredness, mild fever, nausea, loss of appetite, stomach cramps or side pain, dark yellow or brown pee, pale or white bowel movements, and jaundice (yellow eyes and skin). Unlike A and B, there is NO vaccine for HCV.

 

HCV infection can be acute or chronic. Acute HCV is a short-term infection that shows up within the first six months of getting HCV. 70-80% of individuals with acute hepatitis C don't have symptoms--so many don't know they're infected. About 15-25% of people will clear the acute HCV infection from their systems.

 

For the other 75-85% of folks infected with HCV, the acute infection leads to chronic HCV infection--meaning the virus stays in their system. Chronic HCV can lead to more serious health problems, such as scarring of the liver (cirrhosis), and liver cancer. That's why going to your doctor regularly is important if you have HCV.

.

A lot of injectors get HCV.  Why?? Hepatitis C can live on a surface or in a used needle anywhere from 16 hours, to four days. So, any object that has blood in it (like a cooker), or any surface that blood may have been on (like a counter top you use to prep your injections) can be a risk. While bleach can kill HIV, it is unknown if it kills HCV. That's why even if you bleach a syringe, you still run the risk of spreading or getting HCV.

 

It is possible to get HCV through sex. A small percentage of HCV is transmitted through sex--and it happens more among guys who have both HIV and HCV. If you have HIV and HCV, you should use condoms to prevent spreading HCV (or getting another strain from a partner). There are many strains of hepatitis C, so don't think that you're immune just because you already have the virus.

 

You are more likely to spread HCV when you don't use condoms and lube, have multiple sex partners; engage in rough sex; or when you or a partner has HIV or another STD. You CAN avoid getting another strain of HCV by protecting yourself!

 

taking care of yourself when you have HIV and HEP c:

 

1)     Visit your healthcare provider so they can monitor your liver health. Some people with HCV take medications to reduce the inflammation. These medications are effective, but can reduce how well HIV medications work. Seeing your provider so they can talk to you about treatment and care options is important.  

2)     Be kind to your liver! Try not to drink alcohol, as it will cause more damage to your liver.

3)     Get immunized for hepatitis A, and B, unless you have already had these infections. Getting A and/or B could cause more damage to your liver.

4)     Join an HCV support group. Be in a safe space with other folks who have HCV: HEP C Support Group.

5)     As always, take care! Rest, a healthy diet, and exercise are important ways to keep your immune system up.

 

 

Ways to reduce your risk of spreading or contracting HCV:

1)     Use condoms when you're getting some booty.

2)     Do not share personal items that may have blood on them. Razors, tooth brushes, sex toys, and nail clippers should be kept to yourself.  

3)     Cover cuts and open sores with a bandage.

4)     Use clean works, keep them to yourself, and don't share. Need clean works? Click here for the Seattle & King County Needle Exchange Schedule.

 

 

If you'd like to read more, I recommend visiting Hepatitis C Facts.

 

Take care.

 

Dr. Dick

 

Updated & Reposted 12/28/12

 

 

 

 

 

 

Too Big to Fit in Here

insertivecondom.jpg Dear Dr. Dick,

 

What's the deal with female condoms? My roommate told me he's used them before, and I was totally grossed out. They look awkward, and the thought of sticking a plastic ring up my butt is frightening to say the least. What's wrong with regular condoms? Please enlighten me in regards to this madness.

 

Sincerely,

A Seattle Skeptic

 

 

Dear A.S.S.,

 

Thank you for your great question! I understand just how you feel, but first of all, let's get PC here. Around here we call them "insertive condoms" because they are not just for the ladies anymore. Men have been using them anally for years, and you might be surprised how well "received" they are.

 

Insertive condoms are made of nitrile--a soft, smooth and flexible material that feels similar to latex. Just like "regular condoms," they are for one-time use only.

 

The "inner ring" (made of polyurethane) is used to easily insert the condom, and to hold the condom in place during sex. Both the "outer ring" (made of nitrile) and the end of the condom bag stay outside the anus, and actually provide some extra protection against sexually transmitted infections.

 

Insertive condoms may not be the most fashionable protection--but they can be a fabulous addition to your repertoire of protection. Here are the top benefits guys like:

 

top five reasons to use insertive condoms:

 

1) You can put one in hours or minutes in advance. Since crystal can make it hard to remember to use a condom, you'll already be covered when it's time to play.

 

2) No boner required! This means less pressure and more fun all around for you and your partner.

 

3) You get to be in charge of your health. It's no secret that it can be difficult to talk to a partner about protection. Saying, "I have an insertive condom in," or "I'm going to put a condom in," can help start a conversation. In addition, you won't have to rely on a partner to use protection. Remember: it's your health, and you have the right to use protection. 

 

4) Variety is the spice of [sex] life. "Regular condoms" are no longer your only option.

 

5) Extra protection against HIV and other STIs. Since the outer ring and the end of the condom bag stay outside the anus and lie against the surrounding area, you get extra coverage from fluids, sores, and STIs.

 

 THINGS TO KEEP IN MIND

1) Like with "regular condoms," you'll want to use lots of water-based lube. Too much lube is almost enough.  

 

2) You can put an insertive condom on your sex toy or partner (instead of inserting the condom directly) to mix things up. You can also ask your partner to put the condom in for you. Make it a part of foreplay.

 

3) You can take the inner ring out once the condom is inserted. Some guys find this more comfortable. (See instructions below).

 

4) Insertive condoms are 6.5 inches in length--the same as your standard male condom. They are one-size-fits-all (unless your partner is the Hulk).

 

 How to use

It's recommended that you practice putting in an insertive condom a couple times before using one with a partner. Then you can make the choice if it's right for you. Here's how:

 

1)      Open the package carefully by tearing the notch on the top right corner.

2)      Squeeze the closed end of the condom including the inner ring, so it becomes long and narrow.

3)      Gently insert the inner ring into the anus.

4)      Place the index finger inside the condom and push the inner ring up as far as it will go. The outer ring should remain on the outside of the anus. Once the condom is inserted, you can reach in with your index finger and pull the inner ring out. Some guys find it's more comfortable to take the ring out.

5)      Insert the penis or the sex toy in the bag of the condom, not to the side!

6)      To remove the condom, twist the outer ring and gently pull the condom out. Wrap the condom in the package or in a tissue and throw it in the garbage. Do not put in the toilet.

 

 

I hope I've helped calm your insertive condom trepidation. Good luck!

 

Sincerely,

 

Dr. Dick

Abnormally Abstinent

Dear Dr. Dick,

 

I think there's something wrong with my sex drive. I like sex and don't have any trouble getting hard, but I just don't get horny when I get high. As soon as my friends shoot up, they pop instant hard-ons. They spend days partying at the bath house or on chat lines. But I don't have any desire to have sex when I'm tweaked. Most of the time I'd rather stay home and do projects or work on my writing. Could it be a psychological problem? What's wrong with me?

 

Abnormally Abstinent

 

Dear Abnormally Abstinent,

 

Thanks for asking one of the most common and perplexing questions for men everywhere: "am I sexually normal?" Every man wants to think he's got it all together in the sex department. But in private, most guys are quite anxious. Issues like arousal, performance, and body image can be big worries. Then when crystal is involved, our ideas about what is "normal" sex get tossed right out the window. Before we look at this issue of sexual desire and speed together, let's talk about male sex drive in general.

 

First of all, there is no "normal" male sex drive. We as men, and gay men at that, feel a lot of pressure to be "hot, hard, and ready" all the time. Advertising, porn, and magazines tell us we're supposed to be obsessed with sex: Maintaining erections. Giving good head. Fucking all the time. "That's just what gay men do." These expectations are cultural stereotypes. But they're really not true for a lot of gay men. Some guys want a lot of sex. Some guys don't. Neither side is right or wrong. It's really an individual preference.

 

According to most sexperts (and I'm NOT talking about Dr. Laura), you should judge your sexual interest and activity by what feels healthy or "comfortable" for you. If your sex life feels good to you AND it's not causing harm to yourself, your partner, or your life in general, then whatever you're doing is OK. Lots of sex is fine. But so is a little sex or none at all.

 

Your need or desire for sex may increase and decrease on a natural cycle. One month you could care less about sex. The next month you may be hornier than a goat! This is normal. And it's true for gay men, straight men, and women as well. Also, there are many outside factors that can affect your sex drive. Illness, medications (especially some HIV meds and antidepressants), stress, emotions, and environment can all dampen your libido. Aging brings about changes as well. Your testosterone levels naturally decrease as you get older.

 

If you think you might have a physical problem, talk to your doctor. Together you can talk about your symptoms and their causes. You may also want to check your testosterone levels, especially if you have HIV. The tests are simple and can be very helpful.

Now let's talk about speed. Contrary to what many people think, there are no secret chemicals in crystal that make it a "sex drug." Rather, crystal is a powerful stimulant that floods your brain with chemicals. These chemicals may make you focus intently and exaggerate your feelings of pleasure. They may also increase your sense of stamina. This change in brain chemistry may enhance your dancing, artistic creativity, sex, or any other activity you enjoy. But, depending on dose and time, crystal may interfere with these and other desired functions. While crystal can intensify sex, it does not automatically trigger sexual desire.

 

Most of the sexual desire men experience on speed is learned or "expected" behavior. Here's how it works. At first, you don't know what sex on crystal is like. Then during your next high someone engages you in a sexual situation and you quickly find out! At this point your brain makes a connection between getting high and having sex. This response is "learned behavior." Now your brain expects that when you get high, you want to have sex. This is expectation. A lot of guys have such intense expectation with crystal and sex that the events get reversed. Just thinking about sex makes some men want to get high.

 

Of course, your brain can make connections between crystal and unpleasant sex as well. For some, crystal sex is empty and isolating. Some men talk about feelings of shame about what they did or who they did while high. They might feel guilty about not using condoms or not disclosing their HIV status. For others, the connection between crystal and sex may not exist. Some men use their high to focus on other activities like writing, drawing, painting, or cleaning their house.

 

Crystal can be a sexual drug if a man wants it to be. But the sexual effects of crystal are not the same for everybody. Sexual response will depend on how much, how often and how long a person has used. Your environment has a lot to do with it as well. If you get high in a bath house, chances are you will be aroused! If you are high at the QFC, you may just get caught up in reading the food labels for several hours.

 

It's your high and you can have sex if you want to. There's nothing wrong with you if you don't have a screaming urge to head to the bath house. But if you do get horny, remember that crystal may also lessen your resolve to fuck safely. So plan for safety before you get high. Have those condoms and lube ready before you enjoy!

 

Sincerely,

 

Dr. Dick

 

Reposted & updated 12/14/2012

What's a freak to do?

 

Dear Dr. Dick,

 

Halloween is my favorite holiday, but I always end up with too much candy in the bowl. Any advice for how to keep my tricking in-check?

 

Yours truly,

 

Joe McFreaky

 

 

Dear Mr. McFreaky,

 

You'd be surprised how many people write me at this time of year, concerned about too much tricking on Halloween. Below is a sure-fire list of ways to get your freak on while reducing fright on Halloween night.

 

       Keep costumes to yourself. To avoid coochie critters and other fright-night cooties, keep your pants on and don't share!

 

       Keep condoms and lube handy. Planning to get some booty? Go trick-or-treating at Seattle Counseling Service on Friday, October 26 from 3-5 p.m., for free condoms (many sensual varieties available) and lube.

 

       Use the condoms and lube. Use a new condom every time you have sex. Remember, condoms may wear out before you do. Check them often during sex, when you change position, or withdraw. Worried you'll forget to use one? You can put an insertive condom in up to eight hours before sex. It could make a great addition to your costume!

 

*ALWAYS use LOTS of condom-safe lube (water-based) with condoms.

 

       Stay hydrated! Shaking your ghoul thing will make you sweat buckets. Drink plenty of water before the fun begins. It's also important to drink lots of water if injecting is on your list of plans for Halloween night.    

 

       Be smart about glitter. Apply it generously, but avoid your dick! Glitter has no place on your delicate flower (unless of course you dress up as a giant flower).

 

       Avoid biting. Wearing fangs? Avoid biting, and especially avoid drawing blood. You put yourself and your partner at risk for HIV and Hepatitis when playing Dracula.

 

       Don't mix crystal, boner-uppers, and poppers!  Your heart will shift into overdrive, causing changes in your heart rate and blood pressure. Read further.

 

       Be a smart sexual being. Get tested often. How about Tuesday? Sign-up for Health Night at Seattle Counseling Service to get free, confidential testing for STIs, Hepatitis, and HIV. Health Night happens every Tuesday from 4-6 p.m. Call 206.323.1768 to sign up. Snacks provided.

 

Planning on bare backing?

 

       Don't douche or use an enema before going out. You could damage the delicate skin around the anus, making it easier to get or spread HIV.

 

       Pull out before cumming. You'll lower your chances of getting or spreading HIV and other STIs.

 

       Avoid booty-bumping. Booty-bumping can damage your bowels and anus. It can increase your chance of getting HIV, and can also make anal sex painful. Ouch!

 

       Use LOTS of lube. Lube will reduce friction and lower your chance of tearing the skin around the anus.

 

I hope this helps reduce the trickery. Happy fright night!

 

Dr. Dick

 

Crystal and Breastfeeding

Dear Dr. Dick,
I am a bi- guy who's got a girlfriend. We have a baby together. She breastfeeds her baby. We still use. Will our baby get high from breastfeeding?
--Concerned Bi-dad

Dear Concerned Bi-dad,
First, congratulations on your baby!

I'm glad you asked this question. It is very important that you and your girlfriend understand that continued crystal use by your girlfriend while she is breastfeeding could seriously endanger your baby. There are several deaths documented from meth among infants whose only potential source of exposure was through breast feeding.

I highly recommend that she stop breastfeeding your baby. The baby (whose tolerance for drugs is much less than an adult's would be) can easily overdose on crystal meth through the breast milk. Or very easily grow up with negative effects later in life. Your baby's ability to process information and communicate can be impaired, and have developmental delays. Also,depending on how the drug is produced, it can have other harmful ingredients not only to the baby, but the mother as well. Some babies have developed wounds on their bottoms because of the chemicals in their feces.

But your girlfriend does have options:

  • She can stop using meth and after stopping for at least a couple days resume breastfeeding the baby.
  • She can learn how to pump breast milk while she is drug-free and store it for later use.
  • She can use infant formula.
If she must breast feed, know that crystal meth stays in breast milk for 24 hours. Remember that breast milk is generally best for your baby. It may protect the baby from diseases, such as diabetes and cancer, and as simple as allergies.

Watch out for withdrawal which your baby might show through behaviors like screaming, throwing up and shaking.

Find a pediatrician who will understand and respect your situation, and can care for your baby the best way possible.

Ask friends, they may already have one that you and your girlfriend will like.

Best wishes,
Dr. Dick