Anal Issues

I had anal sex with a very well endowed man. Ever since then I have had constant anal pain. It hurts to sit down, once I'm sitting and situated the pain subsides until I move or try to get up. My first BM had blood in the stool and I had have had a constant feeling if having to go #2. I notice that when I wipe there is spots of blood (still). When I went to bed Saturday night I woke up sore and achy with a headache. Also sometimes when I go to urinate I am forced to sit down because I have to BM which is excruciatingly painful. As a seasoned 'bottom' I have never had this before... Should I go to the doctor (I don't have insurance). I'm scared...

I would wait a couple of days and if the bleeding and pain continues you should see a doctor. Do you have hemorrhoids? Anal sex could make them bleed, creating pain, blood in the stool, and often a feeling that you got to do # 2. It may be nothing more serious than that -- they can be pretty painful --  but if it doesn't clear up you should have it checked out. If you think it is hemorrhoids, also known as piles, you can get a cream for it at the drug store. If you do decide to see a doctor, there are low-cost clinics you can go to. If you're in New York, a place called Callen Lorde Community center services the LGBT community, including uninsured, on a sliding scale and there may be similar places in your town if you're in another city. Or you can call a gay center and ask for referrals. Try not to be scared, it may be nothing, but DO check it out if it continues more than a week to ten days, especially if it gets worse or is really painful. 

Should add that the "worse case" scenario could be an anal fissure or tear, which can be caused by anal sex and other reasons. However, in most cases this self-heals within two weeks. Again, hemorrhoid cream can be helpful. So definitely see a doctor if this doesn't clear up in two weeks. Don't worry -- surgery is only required in the most extreme cases, which I doubt you have -- and there are simple ways of healing it without surgery. But in all likelihood it should clear up on its own. And I probably don't need to add -- no anal sex until it does! Bill   

Crabby

Hello Dr. Bill,

First, thank you for your time in answering this question.

I am a 50-year-old gay man and have been out since I was 16.  I lead a rather conventional suburban lifestyle in the SF Bay Area.  A few years back, I ended a 17 year relationship and I have been with my current boyfriend for two years. We don't live together but we are in a sexually and emotionally monogamous relationship.

I would hate to think that I am being naive, but what are the chances of getting crabs without having had sex with someone?  I got them but I did not have sex with anyone and my boyfriend said he did not have sex with anyone as well.  I have not tried on new clothes or slept in anyone else's bed.  I am completely baffled on how I could have gotten these little "buggers."

Any light you can shed would be greatly appreciated.

Thank you, again.

 

Well, first let me make it clear that yes, you can get crabs without having sex with anyone, but there are certain conditions. The problem in your case is that you have not shared anyone's clothing, slept in someone else's bed, and presumably have not shared towels with anyone, either. That eliminates most of the possibilities. Technically, I suppose one could get crabs from a toilet seat if you use it not long after an infected person has been sitting there, but remember that crabs do not live too long away from the warmth of the host body -- and they have little reason to leave it just to hang out on a toilet seat. Is it possible that your boyfriend borrowed clothing from someone, or crashed in someone's apartment [without necessarily having sex with them]?

However, the truth is that people generally wind up with crab lice after having sex -- or at least some kind of close physical contact -- with someone else. Perhaps your boyfriend can shed some light on where he picked them up? Or perhaps be a little more honest? But remember, if he did have a one-night-stand, don't over-react. Sometimes these things happen and they really don't mean anything. 

That being said, most people can forgive an occasional "indiscretion" more than they can getting crabs -- especially without the pleasure of sex!

Stomach Pain After Anal Sex

Dear Dr. Bill,

I have recently started dating a new guy (he is 23) and we have had anal sex twice now and the day after he gets stomach pain (cramping) and nausea. He does not have diarrhea or anything like that, just the cramps. Last week, he went to the doctor and the doctor gave him a CT scan because the doctor thought it could be Crohn’s disease. My guy did not tell him that he had anal sex the night before, but did tell the doctor he was gay.

He has an appointment with a specialist next month to confirm the diagnosis of Crohn’s. I have a feeling that it is not Crohn’s but that since I am very thick, that I am pumping a lot of air into his bowels and it is gas pain. Last time this happened to him with another guy, the doctor prescribed an antacid and this took the pain away. This time the doctor has prescribed Prednisone. He has decided not to take it, as there are a lot of side effects.

I have been researching this question online with no real answers.

Thank you in advance for your help.

People's systems react differently to anal sex [especially if it's a comparatively new or infrequent experience] and getting gas or nausea is certainly not unusual, or necessarily something to worry about. Undoubtedly this condition will clear up in time. I suggest if this guy sees any more doctors he tells him or her that he engages in anal sex as a bottom, as it will help in their diagnosis. [If he feels he is in any way being judged, he should see another doctor.] As for prednisone, it is prescribed for a great many conditions, including cancer, arthritis, AIDS, etc., often in combination with other drugs, but a doctor would probably not prescribe it for gas or indigestion. The guy may have other medical conditions you may not know about.

Douche for Anal Sex

Hi Dr

I wonder if you can help me and I am fed up with my problem. I douche my arse with a douche connected to the shower. I can spend half an hour cleaning myself only to find during sex I am still shitty. Am I douching too much? Why does the shit keep pushing into the anal tract?I am not really sure how all this works.

I would appreciate your advice.

Thanks

During anal sex there is so much constant and repeated pressure into the rectum that it's nearly impossible for some fecal matter not to wind up on your partner's pole -- or rather, the condom that he uses. Forget about douching and just take a normal shower sometime before and definitely after sex.

Gay Teen with Questions

I am a gay teen, a virgin. I have no idea about real gay sex; I only read them in stories.

Here are my questions:

1. When having anal sex, doesn't the top feel disgusted when they insert their fingers/cocks into the ass? Don't they will smell like shit or something like that? And when pull it out, doesn't shit will cover it? No, they aren't disgusted, especially if the bottom has showered beforehand and is clean. Sometimes the penis will become covered with some feces, but then they two men can simply shower together.

2. When bottoming, is the pleasure gotten from prostate stimulation same as when we are cumming when jerking off? Some of the pleasure. Is it worth the pain? Most bottoms only feel some pain in the beginning but get used to it.

3. How long does gay sex last? That depends on the participants and on what they like to do. If you include foreplay -- making love [kissing and hugging] leading up to the actual sex act -- it can take hours. Most sex acts -- gay or straight -- take a few minutes up to about half an hour.

4. Does gay sex require condoms? Is it more pleasurable without condoms? All sex, gay or straight, requires condoms these days to protect against HIV infection and other sexually-transmitted diseases. Some men feel it is more pleasurable to engage in sex without a condom, but anyone who "barebacks" today [going without a condom] is being very foolish, especially if they are a bottom. Do not let anyone penetrate you if they aren't wearing a condom. For more information on safe sex and risky sex go to the web site for the Gay Men's Health Crisis.

5. When bottoming, when the top cums inside the ass, is there any side effect?
There is no side effect as such, except that semen carries the HIV virus and therefore condoms should always be worn by the top. [While it is rarer for tops to contract HIV through anal intercourse, there have been cases of this happening.]

6. When rimming, can the tongue really touch the prostate? Actually, how far is the prostate from our entrance? Uh, this is a little technical and while require further research, LOL.

7. Is it true that cumming from sex is more intense than cumming from jerking off? Is it true that when you cum while having sex, the cum is more than while jerking off? An orgasm during sex with another person always seems to have more intensity since you're presumably attracted to the person you're with and getting physical with someone always adds an extra-sexual dimension that you don't get when you're jerking off by yourself. However, this doesn't mean that you ejaculate more sperm. If depends on how long it's been since you last had an orgasm.

8. After having sex, can the guys immediately have the second round? I ask this because after jerking off, my sexual desire instantly disappears; thinking about sex makes me feel disgusted for a while. Some men can immediately have a second round; others can't. It depends on how excited they are. Sexual desire often fades after having an orgasm, but you shouldn't feel "disgusted." Sex isn't disgusting, gay or otherwise, though it may have elements to it that are less appealing than others.

9. While having double penetration, is it true that the pleasure that the bottom receive becomes double? Is it true that the pain is unbearable? If you're talking about two dicks, I wouldn't recommend it. Or fist-fucking, for that matter.

10. Can the bottom cum without any physical stimulation to the cock? Sometimes if a man is very aroused and excited he can cum without his penis being stimulated.


Thanks in advance :)

Your welcome. Hope this helps.

Fisting

Some years ago I had the opportunity to fist a really sweet guy during a one night stand. It was awesome. More recently, I had a fuck buddy who was into leather and showed fisting videos while we were having hot sex. The leather and the fisting porn really got me hot. I am interested in both top and bottom fisting. How do I initiate myself into the nyc fisting scene? Anon.

Just for those who are new to "fist-fucking" or fisting, it is a type of anal sex in which a hand is used for penetration instead of a penis or dildo. One doesn't actually make a fist, but gathers their fingers into a kind of beak, I'm told.

Sometimes people approach me in bars thinking I am into fisting because of my shaved head look and so on. I'm not into the scene. I've heard that it can be dangerous if not carefully practiced, but I'm definitely not judging those who are into it. Different strokes! [I've also been told that fisting is not strictly a gay practice.]

As for the New York fisting scene, you could approach people in places like the Eagle on 28th Street and see if anyone can give you this information. Or you can go directly to the web sites of such leather/fetish groups for men such as Iron Guard BC [Brotherhood Club] and Gay Male S/M Activists. I would suggest using their contact emails to get the information you're looking for. At the very least they should be able to direct you to people who can guide you in the direction you want to go. I'm sure you can get hlepful advice from members of the leather/fetish/kink community.

Sleepytime Oral Sex

I always read your blog and have once before asked you a question. . . which by the way was very helpful. [Thank you -- Bill]. Here's my new question for you:

For the past two years now I have been seeing a guy that I am very much in love with. Our relationship is going great and our sex life is well; since meeting him I feel like I am discovering sex for the first time. (I was married before to a woman for ten years; she was a great woman but sex never thrilled me). Anyway the other day I was talking to a friend of mine (he is gay also) and the topic came around to sex. I mentioned that we have the hot and heavy times but then we also have times where I just go down on him and I have literally spent 3-4 hours [wow!] just snuggled between his legs giving him oral pleasure. There have been times we both get so relaxed we have fallen asleep. Even at times I have woken up and his penis is in my mouth so I just continue. He enjoys this. I enjoy it. These times are very fulfilling to us. My friend was shocked saying that it was weird that I would do this. I thought he was actually kidding me but the conversation ended quickly with him leaving angry. I guess what I am wondering is . . . Is what I do with my partner so uncommon among gay couples? Or is this friend just way out there. It's not like this is all we do. We have the quickies and the bang sessions it's just these other times just seem so nice and relaxed. Is gay sex just meant to be focused on one thing and it's over? Your thought please. T.

Falling asleep during sex certainly isn't uncommon, especially if one or both partners is exhausted, up way past their bedtime, or -- in some cases -- has been partying a little too much. Or simply because, as you put it, they're very relaxed and comfortable. Guys often fall asleep because they've had too much to drink, but this isn't always the case. And in the situation you describe it's certainly not uncommon that two lovers who are very comfortable with each other might fall asleep in each other's arms, or even in the middle of some oral sex.

If your lover isn't angry that you fall asleep [I can imagine some guys getting insulted, saying that sex with them must bore you if you go to sleep], then I don't understand why your friend is ticked off, especially as you've told him that you have the usual hot sessions where both you and your guy are wide awake. It's perfectly acceptable for a gay sex session to consist primarily or exclusively of one guy giving head to the other. I mean, if both men are enjoying it, what's the problem?

I think your friend's problem is that he has a limited notion of what constitutes good sex. For him, he may be bored in the bedroom unless there's anal interplay or something he finds more exciting. Why he gets angry is perplexing. Some people want you to agree absolutely with them or they get ticked off.

Or maybe he's just upset that your boyfriend has a lover who will suck his dick for four hours and he doesn't!

Self-Hating Lover

SO, phew, where to start, I'm currently in a relationship with my, might I add, very cute boyfriend. We're both young (don't worry we're 18) and nearly out, not all of our friends know about this, not even family, but we love each other very much. But not all is happy -- first of all because of his christian upbringing, he is very ashamed of his orientation, making it even more difficult for him to come out to his parents and the rest of the world, besides really close friends. And that's the first issue, the bigger problem is that in the several months that we have been in a relationship we have only had sex once, he has given no explanations why, and every time we get to making out and are about to go all the way he flinches, which is odd -- the only time we did it he was even more into it than I was! How could he have changed so badly?... I mean, we're very close in every other respect and from time to time he gets really hot and jumps at me to make out, but when it goes to the next level, he simply stops; when I ask why he does that he gives no explanation, besides saying "I just don't feel like it."

Now everybody has urges, and while I don't know how he deals with his I just can't deal with mine, I mean I'm only getting worked up but can't get any real action, and its killing me! I've asked what's wrong and I don't get a conclusive answer; I talked about this to the guy that is his closest friend, and he said that he had only heard good things about our relationship from him, so I'm stumped; I honestly don't know what's wrong! and I can't stand it!

In a fit of desperation I told him that I couldn't stay loyal to him if I didn't get any action; he had a sudden expression of sadness or something, and he gave the classic response that I couldn't really mean it. Ok, I must admit I almost cheated on him in the past, but I did not go through [with it], because I love him, and I feel like a complete ass. I haven't seen him since, but I'm very sad for having said that -- that was only said by my libido. But I can't deny there is something in it too. I mean, I'm not a bad person or anything but if things don't work in bed well... but even though I love him very much, I don't want to say something I'll regret along the way. Why do you think my boyfriend acts like this? Is what I did terrible? Or is it a bit rational? WHAT SHOULD I DO!

To be blunt, I would get a new boyfriend. But wait -- there's also a less drastic solution.

You already know what this guy's problem is. You stated it in your first paragraph. He's full of self-hatred due to his religious upbringing [and probably other reasons]. The reason he won't have sex with you is that -- even though he's attracted to you and other men -- he's ashamed of his homosexual feelings. That's why he keeps pulling away. He wants to make love to you because he's attracted to you but then his shame and guilt get in the way and he backs off. That's the only reason the two of you have had only one sexual encounter in all the months you've been together. [He may also have a fear of HIV/AIDS, so even if you're negative always stick to safe sex.] He also may have other hang-ups you don't even know about.

Sex may not be the only thing that matters in a relationship, but it is an important part of a relationship, and you have a right to expect that your lover will want to make love to you on a regular basis.

I realize that you love the guy, but it really doesn't sound like he's at all ready to make a serious commitment to another man. You must suggest -- even demand it if you have to -- that he go for counseling, possibly even therapy. If there are any gay centers or groups in your community, find out if they offer free counseling to troubled, conflicted gay men, and believe me, your boyfriend is one troubled and conflicted fellow.

Until he's comfortable with himself and his sexuality, he won't make much of a lover either in or out of the bedroom -- but I suspect you already know this. It's just that he's cute and you care for him a lot. But he needs help.

If you can't see yourself breaking up with him [and you should certainly threaten to do that or consider doing it if he refuses to get help] at least insist that you want an open relationship -- the two of you remain a couple but can have [safe] sex with others -- because you have a right to satisfy your sexual urges.

This may have a happy ending. But if being with you and his other gay friends hasn't convinced this guy that it's okay to be gay, he needs to get counseling or see a gay-friendly therapist who will help him accept his orientation. He also needs to know that not all Christians or religions are homophobic or see homosexuality as an evil perversion. Find a gay or gay-friendly church in your neighborhood for a start. If we meets other Christians who are okay with being gay, it might help him on his long road toward self-acceptance. [You can read more about internalized homophobia and gay self-hatred here.]

Let me know how it goes.

Cock Rings

I just want to know, what is a "cock ring." It sounds painful. Anon.

A cock ring is not like a ring through the lip or a ring through the nose. No wonder you thought it sounded painful.

A cock ring goes around the bottom of the shaft of the penis. It's purpose is to hold the blood up in the penis so that a man will get a bigger erection and be able to sustain it longer. It also increases the sensation of an orgasm. It's sometimes used by men are who tired or tipsy and have trouble getting or keeping it up because of that. However, there is a danger in using one if you're drunk. A guy could fall asleep and leave it on for hours which is not a good idea. A prolonged erection of several hours is called priapism and requires a trip to the emergency room. The blood in the penis coagulates and the erection won't go down, which can cause severe damage to your erectile tissue. You do not want this to happen.

There are different kinds of cock rings. The best kind is one that is adjustable and easily removed, with leather or rawhide straps, not one made of metal. If a man uses a cock ring and feels pain, he should immediately take it off. A man's cock ring should provide a comfortable fit, so it's either the exact size he needs or is, as I say, adjustable.

Used with care, a cock ring can enhance the sexual experience for a man and his partner.

Hi Doctor? What health hazard is there in sucking a penis which has STD? thanks

The health hazard is that you can get whatever disease your sex partner is infected with. I assume you are talking about performing fellatio on someone who has an STD [sexually-transmitted disease] that particularly affects the penis, such as gonorrhea, which causes a discharge from the penis. Gonorrhea and chlamydia can cause infection in your throat if your partner is infected; there may not always be symptoms or they may seem like something else. There have been conflicting and confusing reports on the possibility of acquiring HIV through performing fellatio on a man who has the virus. There have been some reported cases, but there is always the possibility that some men did not want to admit they'd been the "bottom" in anal sex. Unprotected anal intercourse is still overwhelmingly the main way gay men get HIV. (Although rare, "tops" can also get HIV if they have sex with an infected person and don't use a condom.)

Don't panic. If you know that you've had sex with a person who has an STD go to a health clinic where your anonymity will be respected, and get tested. Most STDs can be easily treated with antibiotics and you'll be fine, and can't pass along an STD to anyone else. Even HIV, although not curable as such, can be treated.

Don't delay. You'll be okay. You may not have caught anything but if you have, getting tested for an STD is the smartest thing you can do.

Let me know if you have any more questions.

A Question of Monogamy -- and More

You've had some posts about casual sex and promiscuity and they've bothered me. If the gay community is going to find acceptance, it had better clean up its act. I'm a gay man, but I'm not a pig. Let's face it, if gay men are filthy and spread diseases, who can they blame but each other? It's not straight people giving them AIDS. Why can't gays be monogamous and then their image will improve? Anon.

Their image, huh? Your question bothers me on so many different levels that I'm not certain where to begin, but here are some points to consider.

A.) You are part of the gay community. It's not You versus Them. And you are hardly the only gay man who believes in monogamy. Look at all the couples lining up to get married. I'd bet most of them intend to have a strictly monogamous relationship. Get past the stereotypes.

B.) AIDS/HIV affects heterosexuals as well as homosexuals. It is not a "gay" disease. Let the homophobes call it that -- you certainly shouldn't.

C.) You reveal a fair amount of self-hatred when you talk about "pigs" and gay men are "filthy." To be blunt, have you not been getting any lately? This is the kind of talk I often hear from gay men who have no love or sex lives and are, frankly, jealous of those who do. Sorry to be so blunt with you but this has to be addressed. (More on this in a future post).

D.) Whether to be monogamous and faithful or have an open relationship is a personal choice made by the two parties involved. One person -- and this is equally true in straight relationships -- may prefer a monogamous relationship and the other one does not. This leads to problems when the latter partner, gay or straight, is unfaithful. But this happens in many relationships regardless of the orientation of the individuals involved.

E.) There is a big difference between a man who is sexually active but responsible, who practices safe sex, and one who is unsafe and irresponsible. This is true of straight people as well as gay. Being sexually active does not necessarily add up to being "promiscuous," or a "sex addict" or someone who sleeps with anything that moves and is irresponsible in their sexual practices and choices. Not everyone wants to be monogamous, and I see no reason why all gay men should do so just to supposedly be accepted by a society that will hate them anyway whether they have sex with one man or many men. It is foolish to believe that if all gay people got married, adopted children, and lived monogamous relationships in the suburbs that we would find instant acceptance. Some people hate us for who we love and who we have sex with, and being "monogamous" would not change that. (And who on Earth says that all straight couples are monogamous? What a joke!)

F.) There's more to be said on this whole matter, but I'll save it for future posts.

Dressing to Advantage

Am I out of date or is there still a gay dress code, something that tells you if someone is a top or a bottom, into kinky sex, water sports, and so on? Or has all that been done away with? Don't get out to bars much these days. Anon.

I'm not saying that that's all been done away with but it does seem a little dated. I personally never ascribed to the business of dressing in a certain way or wearing certain items -- color-coded hankies in your left or right pocket and so on -- to reveal your sexual tastes. I believe that sort of thing was once more common in leather bars. If it's still practiced by some guys, I don't know.

I suppose if you wear tight jeans with a big hole cut out showing off your buns, well I'll let you guess what that means -- and I'm sure you can, even if you haven't been in a bar for awhile!

Tops or Bottoms?

What percentage of gay men are tops and what percentage are bottoms? Anon.

I have never, ahem, actually done a scientific survey on this subject, but I would say it's about evenly divided. Of course there are men who are versatile, both top and bottom, but judging from what I see on gay dating/sex/friendship sites, there don't seem to be as many of them.

I can tell you that in my experience you can't assume the butcher gay men are automatically tops and the "femmes" are bottoms, because sometimes the reverse is true. When two men get together, it's two men getting together -- neither one is the "lady." Men who are bottoms should never feel that they are somehow less male because of it. There are some men who think of themselves as being "straight" because they are always the top when they have sex with another guy -- they're fooling themselves.

And, as usual, I remind everyone to stick to safe sex. This is true even if you are a top. Although there have been fewer cases of HIV infection in men who are tops than bottoms, it does happen. When it comes to anal penetration, always wear a condom.