A Girl's Guide to Safer Sex
Newsflash, ladies: your body gives you a lot of power in sexual decision making.
But, as Spiderman’s Uncle Ben once said (that’s right, I’m quoting a fictional superhero's uncle…), “with great power comes great responsibility.”
I had an appointment at Planned Parenthood for a routine physical, pap-smear, STI testing and string-check on my IUD. As one of the older female students in my medical school class at PNWU, 36 years to be exact, having my vagina inspected and breasts checked for lumps has become a routine annual event for me. Like filing taxes and car registration renewal, it is necessary and important if you are a sexually active female to visit your women’s health provider for regular checkups. Your provider can also help you choose a plan for contraception and infection protection that fits your lifestyle.
As I’m sure you are already aware, if contraception is not used there is the possibility of having a new unexpected tenant inhabiting your uterus for 9 months. There are also some very scary things that can happen to your vagina and even your whole body if you do not protect yourself against sexually transmitted infections. These facts may be more relevant to female readers who are not in a monogamous relationship, but it is worth noting that some STIs can lay dormant in the body for years before manifesting themselves.
As a second-year medical student, I do not claim to be an expert in all things sex… yet. But if you are thinking about taking a walk around the block, going to the rodeo, or farming some wild oats, there are some things I think you should consider beforehand.
To help navigate those sticky and awkward situations that may arise in a moment you least expect them, here is a game plan for reducing regrets.
Step 1. Realize you are a female and that you are taking the bigger risk in the moment.
According to the Washington State’s Department of Health online database, the latest stats for the Yakima area show that women between the ages of 15-29 years old, are more than three times as likely to contract chlamydia, than men in this area. The trend for women generally being at a higher risk for most STIs is the fault of our anatomy, most likely not because men are more responsible.
Having an exposed mucous membrane lining in our vaginas, compared to the thicker skin of the male penis, just encourages bacteria, yeasts, and viruses to take up residence in the warmth and wetness of the vaginal canal. In addition, it can be challenging to see up inside ourselves unless we get real creative with a mirror. If we do have an infection, we are not as likely to realize it until the invader has had a chance to do damage. Our male friends, on the other hand, can typically see their penis without much effort, making it easier for them to know when their situation is awry.
Realizing you are at greater risk is important. You may have to be the one to make sure you are protected, and cannot simply assume that your male partner has a condom on his person. More times than not in my own experience, it seems like it is conveniently forgotten. So this is your moment to impress him with your Girl Scout training of always being prepared.
As women with purses, we have the advantage when it comes to stashing items for on the go. I can admit to buying the Costco pack and stashing them in easily accessible places should the moment arise. This includes, but is not limited to, my purse, book-bag, nightstand top-drawer, truck glove box, under the couch cushion, and bathroom cabinet.
When adding to your condom collection, be aware that condoms come in different materials. Some condoms are made of latex and your romantic encounter could come to a screeching halt if you or he have an allergy to this material.
If your partner is pushing for no condom use, please remember your higher risk compared to his, and you can even pull up the Yakima infection stats on your phone when you explain to him that condom use is your policy.
Step 2. If you choose oral sex and/or receiving hand play instead of intercourse, you are not out of the danger zone.
I hate to be the bearer of bad news, but if you opt for the unprotected oral sex because it seems “safer” than intercourse, you should be aware that you are only safer from getting pregnant.
Don’t be that girl that gets blindsided several days to months to years later when suddenly all hell breaks out in your oral cavity, or worse yet on your face. Gonorrhea, herpes, chlamydia, HPV and even HIV can be spread from genital to oral contact. According to the CDC, HPV has even recently been linked to some oral cancers.
If this list of diseases doesn’t get you thinking about protecting your mouth, then google image some of these mouth infections. I bet you will start rethinking protection during oral sex.
In my opinion, using oral protection for sex is definitely less talked about than that for intercourse, and some of the options for barriers to infection can seem a little foreign.
Condoms and dental dams can be purchased at your local drug store. In case you’re wondering what a dental dam is, I’m sure you are not alone in having never seen one before. It is a thin sheet of latex your partner can stretch over his or her mouth to create a barrier for oral sex involving the vagina or even the anus. For an even cheaper and more creative option to barrier building, plastic wrap can also work if you forgot to stock up on your dental dams.
Contrary to popular belief, receiving hand play also presents an interesting risk of infection. Any body part that is not your own will likely have different patterns of normal “healthy” bacteria living on it. Even your vagina has its own environment, wherein normally non-infectious bacterial organisms live and there may even be some yeast present. When someone puts their finger (especially if it’s dirty and belongs to someone who isn’t you) into your vagina, new bacteria are introduced to your bacteria.
You stand a chance that they may not play well together in the sandbox.
Bacteria have an ability to create toxins to kill other bacteria and yeasts, so that they can colonize their environment. Essentially, they use biological warfare to conquer and claim vaginal territory. The colonies of organisms within the vagina usually keep each other in check, so that no one overgrows their limit. However, disruptions in the vaginal microenvironment can lead to the overgrowth of organisms, including yeast and/or bacteria. They may have been there before the invading finger incident, but were given the upper-hand to increase their numbers as a result.
“Washing your hands is very effective at reducing bacteria and thus, better for your health after the deed is done.”
This can happen if some foreign bacteria killed off a native, who was actively keeping others from growing out of control. Some common infections that result from finger (and really any other foreign body part) interactions with the vagina include itchy yeast infections and/or a fishy smell caused by bacterial vaginosis. Even though these infections are not as likely to spread as some of the more classic STIs, word on the street is that they are also not fun. Maybe wear a latex glove with some lube on it if you choose this route. Or, since I know most of you won’t do the glove thing, at least wash your hands before getting busy. Washing your hands is very effective at reducing bacteria and thus, better for your health after the deed is done.
Step 3. Lube is your friend and should be invited to the party.
Initially, be sure to choose a lube that does not break down latex and be aware that they come in a variety of container types to fit your lifestyle.
Water-based lubes are a good choice for safety, while coconut oil and similar products will likely lead to a broken condom mess. Like disposable mustard and ketchup packets, the onetime lube packet is also a good idea to stash in your purse, along with the emergency condom.
One more tip on this: steer clear of lubes that have glycerin in the ingredient list. Glycerin is a type of sugar. Yeasts love sugar.
One of the most popular and cheapest lubes you’ll find in the store is full of glycerin. Because it is sugar based, the lube tastes like candy. However, this sugary treat also feeds the vaginal yeast and is likely to leave you with an itchy cheese-like, burning mess of a yeast infection. Since yeast infections tend to be very itchy, scratching the vulva can leave small open sores that make you even more susceptible to contracting an STI.
Quality lube serves a couple purposes in protection from infection, by defying friction. When a body part glides smoothly across a delicate mucous membrane lining like that in the vagina, the chance of tearing it is less likely. This is ideal because it can hurt to tear tissue, but as I mentioned before, tears also allow bacteria and viruses easier entry to your blood. Most people would agree that less friction is better for the all-around experience.
Condoms should be lubed to prevent friction from tearing them. I’m not just talking about the outside of the condom here. A couple drops can be added to the inside of the condom before putting it on. Some condom brands even promote this practice in their “how-to” instructions. This will further decrease friction and I’ve heard through the grapevine that it also makes “condom sex” more pleasurable for him.
Step 4. The walk of NOT shame.
Regular STI testing is a healthy practice to get into. As I’ve mentioned before, even if you are in a monogamous relationship, STIs can lay dormant in the body for years and it is important to know if you are harboring an unwanted and potentially dangerous passenger. Your health care provider can recommend the appropriate tests based off your sexual history. Regular STI testing can be quick, easy, and affordable. This is possible even in the Yakima Valley, where it seems like you won the lottery if you find a physician to take you on as a new patient. Planned Parenthood of Yakima even takes walk-ins for STI testing. Many of the tests just require you to urinate in a cup, but a few require you to get your finger pricked or a vein tapped.
Before starting medical school at PNWU, I naively thought STI symptoms were usually localized to the genital region. However, I’ve had my mind blown because so many of these infections can have whole body involvement. For instance, Gonorrhea can cause joint pain and skin rashes and even more alarming is that Syphilis can cause brain damage! Many of these infections can be cured with antibiotics. However, if it is viral or a very resistant strain of bacteria causing the problem, you may only be able to manage the symptoms with medication. It’s much easier and cost-efficient to prevent the problem than have to treat it in the long run. So go forth with your plan in hand, “Buckle up” and enjoy the ride without regrets.
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Heather Bird
Osteopathic Medical Student - 2nd Year (OMS II)
College of Osteopathic Medicine
Pacific Northwest University of Health Sciences