September 27, 2016

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oral sex ›   UTIs ›   women's sexual health ›  


Q: Can a woman get a UTI by receiving oral pleasure from her partner?

It’s likely that a urinary tract infection (UTI) is coincident with, but not necessarily caused by oral stimulation. Menopause includes the loss of estrogen, which leads to the thinning of urogenital tissues--which include the vagina, vulva, and urethra. Because those tissues are thinner, they can be more fragile and susceptible to “trauma.”

We don’t think of sex as “traumatic,” but the activity can cause minor tissue damage. And sex can introduce bacteria to the bladder via the urethra, which can lead to bladder infections. That bacteria may come from hands, saliva, toys… anything that comes into contact with fragile urogenital tissues during sex.

You asked. Dr. Barb answered.And note that UTIs are often more frequent for women after menopause, whether they’re sexually active or not. You can reduce the chances by using a lubricant during intimacy to minimize “trauma” to tissues. Empty your bladder soon after sex; that may flush out bacteria before they proliferate and become an infection. Therapies like localized estrogen and Osphena, which improve vaginal tissue health (with proper pH and increasing cell layers), also benefit the urethra. And, if you’re prone to UTIs, you may find it helpful to take a dose of oral antibiotic with sexual activity.

Head over Heels: A Little Primer

In the last post, I ran up the flag for oral sex—mostly as a way of keeping our repertoire broad and deep as we and our partners face age-related issues with sexual sensitivity and/or function. After all, there are many ways to skin this particular cat.

But, as with any kind of sex, a little technique and creativity can put some spice into what too often devolves into a boring routine. All the tricks in the world, however, can’t take the place of communication and some interest and even excitement about the task at, um, hand.

Some level of communication is fundamental to sexual play and exploration. You can encourage: “I love it when you do that.” You can ask: “Does this feel good?” “What would you like better?” And you can pay attention to non-verbal cues: breathing, muscle tension, sounds, movement.

I’d also like to emphasize that, while it’s good to push your boundaries, if any part of sexual exploration feels really uncomfortable or off-putting, you don’t have to go there. We all have lines, and it’s important for both partners both to draw them and to respect them. But don’t just draw lines, continue to look for ways to keep the intimacy alive.

I’ve had women tell me that fellatio (oral sex on men) gave them a sense of empowerment, because they were controlling the action. By the same token, it gives the guy a break—he’s not in charge, plus he still has a good view of the action, which can be its own kind of turn-on.

With loving attention and communication on the front burner, here are some ways to change up your oral sex technique.

  • Take it slow. Don’t go for broke right away—let momentum build. Start with sensitive areas at the periphery—belly, inner thighs, buttocks. Use light touch, blow, kiss, lick. Take your time.
  • Move in. When you get to the genitals, keep the action soft and slow at first. Cup his testicles in your hand or mouth. Slide your tongue up the shaft of his penis. The frenulum is a particularly sensitive spot on the underside of the penis where the shaft meets the head. Tease a little before you commit.
  • Take a break. If your jaw gets tired, use your hands or your tongue to keep the action going.
  • Cool off. For a surprising change of pace, take a drink of ice water. The change of temperature is startling.
  • Heat and spice. Don’t keep doing the same old thing while you’re in warm-up mode. Use different sensations, change the speed and the rhythm. Build up to a firm, steady rhythm. Even if he isn’t totally erect, he can still orgasm and ejaculate.
  • Avoid the gag. You don’t have to deep-throat. Use your hand on his shaft and only take the head of his penis in your mouth. Then, you can suck or use your tongue creatively while stroking the rest with your hand.
  • Swallow—or not. You’ve probably already settled this, but if you don’t want to swallow his ejaculate, you can tell him to warn you just before he comes.
  • Hold him gently afterward.

Of course, the need for skill and technique apply equally to cunnilingus (oral sex on female genitalia). If your partner could use some coaching, slip him the highly rated “essential guidebook to oral sex,” She Comes First: The Thinking Man’s Guide to Pleasuring a Woman by Ian Kerner.

Women whose men have taken it to heart (and to bed) give it rave reviews.

Kerner also has a female guide to men’s sexuality, which includes pointers on oral sex: Passionista: The Empowered Woman’s Guide to Pleasuring a Man.

Now that you have your required bedtime reading, maybe you want to give each other an occasional pop quiz.

"Eating at the Y": Why It's a Good Thing

I may be going out on a limb here, but I’d like to make a case for oral sex. It gives us another avenue to intimacy and pleasure, and as such, is an important component of a lusty love life. It’s a skill that couples should try to develop. Or at least keep an open mind toward.

Here’s why.

First, most women (70 percent. Did you get that number?) don’t climax with vaginal penetration alone. In my practice, postmenopausal women commonly tell me that the only way they can orgasm is through clitoral stimulation or oral sex.

For all women, no matter the age, the most dependable orgasm is clitoral—which, as we’ve said before, is a powerful organ with twice as many nerve endings as the penis.

Sure, the clitoris (and the penis) can be stimulated in many creative ways, but the mouth and tongue are darned effective.

Second, I know I sound like a broken record, but we lose sensitivity and the ability to lubricate vaginally as we age. And our partner’s ability to maintain an erection will eventually wane as well, despite the little blue pill. As the old penis-in-vagina sex becomes less dependable, it’s helpful to have other tricks up our sleeve.

Oral sex is one way to keep sexual pleasure alive as a couple. No less venerable an institution than the AARP says so in this article. It makes sense to give ourselves alternatives and room for compensation, so that when one capability diminishes, another can fill in the gap.

Now, I’m not for a minute suggesting that you haven’t tried oral sex. Sex coach Kathleen Baldwin, says that “It’s somewhat rare in my experience to find a woman over 40 who doesn’t enjoy oral sex.” She thinks that mature women are less influenced by cultural norms and are more familiar with how their bodies function, including their lady parts.

For many women, however, the “yuck” factor presents an impediment. Some women consider their genitalia “gross.” They worry about cleanliness or odor. They worry that it will take them too long to climax.

Funny thing is, most men really like oral sex—both giving and receiving it. I ran across an article by a man on the topic, who writes:

It’s an amazing feeling to satisfy a woman, and cunnilingus is the most foolproof way to do it. It also minimizes our own performance phobia. Women can’t see what we’re doing, our tongues will never need Viagra and we’ve all got a similarly sized piece of equipment. But most of all, [cunnilingus] is a five-sense experience that places us up close and personal in a way that no other act can. …most vaginas smell and taste pleasantly mild…

The pleasure you can give your partner (and ultimately yourself) may be worth getting over any squeamishness. And you can always address the cleanliness issue by showering (or a bath!) before sex.

Oral sex, whether cunnilingus (oral sex to a woman’s genitalia) or fellatio (oral sex to a man’s genitalia) works best with some technique, and like any other skill, practice makes perfect. The most direct path to improvement is communication. You have to let your partner know what feels good. (More on technique in the next post.)

One final consideration: if you aren’t sure about your partner’s status with regard to sexually transmitted disease (STDs): you can still transmit them with oral sex. Chances of infection are lower, but Chlamydia, gonorrhea, herpes, human papyllomavirus (HPV), even HIV can still be “caught” through oral sex. For example, one woman I know caught genital herpes from a cold sore on her husband’s mouth!

So, if you’re with a new partner and you aren’t completely knowledgeable about his or her sexual history, you need to use protection—a dental dam (piece of latex placed over the vulva) condom, or femidom (female condom).

Kind of takes away the sexy, but it sure beats the alternative.

Oral sex is just another way of expressing intimacy and sharing pleasure. And it’s a particularly nice option if more traditional forms of lovemaking become problematic. Well, heck. It’s a nice option any time.

Q: Intercourse is no longer possible; what now?

As we grow older or experience physical changes, our sexual abilities may change. Oral sex is one alternative, as is anal sex, although that has some drawbacks. There are also variations called "outercourse." The woman holds her thighs together, and the man inserts his penis between, either face to face or from behind. Cupped-together breasts are another "outercourse" option. And remember that orgasm is an important part of intimacy, but it's not the only part. Cuddling, massage, and even erotic talk are also important alternatives to intercourse.

Q: Is my vaginal moisturizer safe for oral sex?

Vaginal moisturizers for comfort

Both Replens and Yes, the vaginal moisturizers we offer at MiddlesexMD, are perfectly safe for oral sex. In fact, all of the products we offer are chosen with safety in mind.

Your partner may have personal reactions to a taste or texture of either product, or to personal lubricants. Feedback through our personal lubricant selection kit proves just how individual those reactions are!

If you or your partner isn't happy with a moisturizer or lubricant, don't think you've got to give it up! Just check out some other options to find one that works for both of you.