How to Do It is Slate’s sex advice column. I have a question? Send it to Stoya and Rich here. It’s anonymous!
dear way,
I have been with my partner for about 12 years. The last time we had PIV sex with her was before the pandemic. Since then, due to a combination of physical and mental health issues for both of us, sex has been off the table, but we still enjoy cuddling, holding hands, and hugging each other for intimate moments. Maintaining relationships. Recently we started talking about getting back into sex. .
But there is one thing that baffles me. I hope you and your experts will share your thoughts. My partner is on immunosuppressants, which come with warnings that they reduce his ability to fight fungal infections, especially against oral sex.
How likely is this to be a problem in a practical sense? I have never had a yeast infection or urinary tract infection. I usually keep my room fairly clean and dry (no soap or cleaning products, of course). Is there anything I can do to limit his exposure? I’m not trying to blow off his concerns. Because he takes most of the risk and I get most of the profit. But I would love to have this back in our repertoire, especially since his PIV may still be around. Quite far.
—There are no fungi among us.
There is no fungus among us, dear.
My source, Dr. H. Hunter Handsfield, a professor emeritus at the University of Washington and a nationally recognized STI expert, found the lack of verbal guidance odd and explained to me via email and phone why. He gave it to me. Assuming the warning specifically refers to yeast (or candida) infections, Handsfield noted: “Yeast is rarely transmitted sexually, and the risk of oral sex is probably even lower than vaginal or anal sex.”
Handsfield said he has heard of patients being told to avoid sex completely (for a period of time) in cases of severe immunodeficiency, such as those who have received (or recently received) a bone marrow or organ transplant. . “But for the average person who is healthy and active and on medications such as Humira for Crohn’s disease or methotrexate for arthritis, I have never heard of oral sex or sexual intercourse being prohibited. , my colleagues who work with immunocompromised patients have never heard of it either. I had other types of sex to treat yeast infections,” he continued.
Handsfield also pointed out that “sex partners share a shared microbiome, especially the genital microbiome.” We share a lot with the people we live with (especially when we use the same bathroom), and “sex itself isn’t something that tips the scales very often,” he said. Assuming you and your partner are monogamous, non-verbal guidance becomes even less intuitive. Keep in mind that yeast infections also tend to be a flare-up of your own yeast already present in your microbiome.
but! Handsfield and I agree that it seems wrong to tell people to ignore their doctor’s orders. If I were you, I would get more information about this directive. Why is only oral sex prohibited? Why is sex prohibited? Can the doctor cite the studies or tell us a little more about the thinking behind the oral warnings? Can dental dams reduce the questionable risks? The second doctor’s opinion is that it is important to gather knowledge and It can also help put your mind at ease and give you the best idea of the options available to you.
-rich
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