All posts by jmascari

Communication, Dating, Relationships

Stressed Out and Struggling: Healthy Relationships Amidst Academic Stress

Dear Sexpert,

Lately, I’ve been feeling overwhelmed with school. Between exams, assignments, and all the pressure to perform well, it feels like there’s barely any time to relax. I’ve noticed that the stress is starting to affect my relationship, and causing some tension with my partner. I feel like they are starting to feel rejected. They seem disinterested in our conversations (whether it’s in person or texting), they are not as receptive to physical affection, and have stopped sharing their thoughts and feelings with me, instead deciding to confide in their close friends. It makes me feel shut out. Overall, they seem distant. I don’t know what to do. I love my partner, but the stress from school has me feeling drained and emotionally distant. Could this be something temporary? How do I navigate the stress without letting it damage my relationship?

– Stressed Out and Struggling

Dear Stressed Out and Struggling,

First of all, thank you for reaching out! It sounds like you’re going through a challenging time balancing the pressures of school and your relationship, and I want to assure you that you’re not alone in feeling this way. Stress (from any source, including academics) can have a huge impact on both your emotional and physical well-being—and that includes your desire for intimacy. You’re absolutely right to acknowledge how this stress is affecting your relationship, but it’s important to remember that this is something you can manage.

Stress can take a serious toll on libido. When you’re stressed—whether from school, work, or personal life—your body goes into a state of “fight or flight” mode, which triggers a surge of stress hormones like cortisol. While cortisol is necessary for dealing with immediate threats, high levels of it over time can interfere with the production of other hormones, like estrogen and testosterone, that are crucial for sexual desire. As a result, you might find yourself feeling emotionally and physically drained, with little interest in intimacy.

This response is entirely natural, but it doesn’t make it any easier to navigate, especially when it starts to affect your relationship. When you’re overwhelmed, your energy and focus naturally go toward surviving the pressure, leaving little room for sexual desire or even emotional connection.

The emotional strain caused by academic stress can also influence your interactions with your partner. When you’re constantly stressed, it can be hard to be present in your relationship. You might find it more difficult to communicate openly, feel less affectionate, or even shut down emotionally. This can understandably lead to feelings of frustration or rejection from your partner, which, in turn, can worsen your stress and create a negative feedback loop.

One of the main things you can do is to communicate proactively with your partner. Honest communication about how you’re feeling can help your partner understand what you’re going through. By discussing your feelings, you can reduce the potential for misunderstandings and open up a dialogue on how to support each other during stressful times. Be clear about what your partner can do to support you, and ask if they are willing.

For example, if you’re not in the mood for physical intimacy, that’s completely okay! Instead, focus on building emotional intimacy with your partner. You can discuss with them what might help boost connection. Take time to engage in activities that you both enjoy—whether that’s cuddling, talking, or doing something relaxing together. 

Additionally, it is understandable that you are feeling emotionally overwhelmed in periods of stress. It’s normal for stress to impact your libido, which can impact emotional connection. It can be helpful to openly discuss with your partner about what you need, whether that is talking more often, holding space for sensitive topics, or setting boundaries for your relationship. Participating in these acts are important forms of self-care. It is good that you are already noticing signs like feeling disinterested in communication. Continue to monitor your feelings and comfort level during conversations, and give yourself the grace to take care of your mental and physical health. 

Most importantly, you need to find ways to prioritize your own well-being. Even during a busy academic period, it’s important to schedule time for self-care, whether it’s getting enough sleep, eating nourishing food, or taking a few minutes each day to decompress. Regular exercise can also help reduce stress levels and improve mood, which may in turn help you feel more present and relaxed with your partner. Try not to rush through your self-care with productivity in mind, instead allow yourself to truly use practices that serve and center you. 

Remember, your libido is deeply tied to your overall well-being, and when you’re stressed, it’s okay to step back and give yourself time to recharge. By addressing the root causes of your stress, you’ll likely find that your desire for intimacy comes back naturally as you begin to feel more balanced and relaxed. Take care of yourself, and be kind to your body and mind as you work through this challenging time. You’ve got this!

-The Sexpert

Information for this article obtained from RockvilleOBGYN, Journal of Affective Disorders, Kelsey Seybold Clinic.

Communication, Dating, Protective Barriers, Relationships, Sex Positivity, STDs/STIs

Hookup Hopeful: On the Pursuit of Casual Sex

Dear Sexpert,

I’ve realized that I want to pursue something casual and am not looking for a relationship right now. While I’ve had some hookups, I haven’t found a consistent situation that works for me. I know that finding something casual can be difficult, but at the end of the day I know it is what I want. How can I approach this in a healthy manner and keep what I want in mind?

– Hookup Hopeful

Dear Hookup Hopeful,

It’s great that you’ve come to know yourself well enough to realize that a casual relationship is truly what is best at the moment. Being self-aware of your own wants and needs is one of the fundamental steps involved in seeking out experiences that both feel good and are good for you. 

When engaging in casual sex or intimacy, communication becomes all the more crucial  in finding a partner (or partners) and maintaining a healthy, respectful relationship. Before you do anything physical, have an open and honest conversation about expectations, boundaries, and comfort levels. Make sure you and your partner(s) are on the same page about what a casual relationship means, whether it is a one-time thing or an on-going arrangement. Not everyone will share the same definition of “casual,” and different expectations can lead to confusion or hurt feelings. Being honest about your desires and listening to what the other person wants creates a zone for mutual understanding and respect. It’s perfectly okay if this conversation is uncomfortable to have, as learning how to discuss sex and boundaries in open terms is often a skill we are not taught, and thus, need to learn.

When engaging in casual sex, taking care of your sexual health is as important as  your emotional boundaries. Getting regular sexually transmitted infection (STI) tests is also a responsible self-care measure you can take to protect yourself and your partner(s), even if you have no signs of concern. Many STIs, including chlamydia and gonorrhea, may remain asymptomatic but can have permanent health effects if left untreated. Other STIs, including syphilis and herpes, are also common and can be transmitted through oral sex or skin-to-skin contact. Prevention of HIV is also a high priority, and  having protection and researching preventative options like PrEP can prevent transmission. Remember that protection doesn’t just mean external and internal condoms– dental dams and other barrier methods also reduce risks from oral sex. University Health Services offers STI testing as well as regular exams to support your sexual and reproductive healthcare needs.

Keep in mind that risks will depend on the kind of sexual activity you and your partners are engaging in (and not just with each other). Having a conversation with your partner about whether either of you are having sex with other people, and using barrier methods or other forms of prevention, is another important discussion to promote health and safety. Taking responsibility for your health not only makes you healthy, but it’s also respectful and caring of your partners’ health.

Another aspect to keep in mind is how these casual hookups are initiated. Not always, but often “hookups” commonly occur in the setting of eating clubs, pre-games, and parties in which substances (such as alcohol or other drugs) are present. These substances can impair decision-making, impact attention to interpersonal cues, and challenge clear consent. You should check in with yourself and your partner(s) to ensure that you and they are able to consent. If you ever are unsure if someone is in the right state of mind to give consent or if you are being pressured and feel uncomfortable, it’s always better to back out of the situation. Hookup culture can be exciting, but physical and emotional safety always comes first.

Lastly, remember that feelings change with time, and that is completely normal. What feels right for you now might evolve as you continue to explore your likes and reflect upon experiences. You could start out wanting something casual and find that you require something deeper, or you might feel more certain that a casual relationship is ultimately what you want. Your partners have similar autonomy to change their feelings, so open discussion is required to navigate through changes. Check in with yourself regularly and have honest conversations with your partner(s), if something starts to feel different. If the relationship is no longer what you want or if your partner shows a change in feelings, being respectful and direct about it will make it easier for both of you. Casual sex, as with any other form of intimacy, is a two-way street, and should be comfortable for everyone involved.

Casual sex can be a positive and enjoyable experience when approached with honesty, awareness, and sensitivity. By making clear communication your priority, practicing safe sex, being mindful of hookup culture dynamics, and being open to change, you can create experiences that fit what you desire. Whatever path you take, make sure it’s one that centers your well-being and is respectful of those you engage with.

You got this!

– The Sexpert

Information for this article obtained from Sexual Harassment/Assault Advising, Resources, and Education (SHARE), UMatter, and University Health Services (UHS).

Communication, Relationships, STDs/STIs

PrEParing Partner: PrEPping for your relationship

Dear Sexpert,

I’ve started to see a guy, and I’ve been struggling to talk to him about the possibility of me or both of us going on PrEP. I myself haven’t had former sexual partners, and he claims he hasn’t had sexual partners since he was last tested, but we aren’t yet exclusive in our relationship. I’m worried that going on PrEP — or suggesting he do so also — will breach trust in our relationship, but I also want to prioritize safety. 

— PrEParing Partner

Hi PrEParing Partner, 

It’s normal to have concerns and questions about using PrEP and discussing your use of it with your partner. Taking PrEP (like other preventative medications) is an indication of investment in your — and your partner’s — health, not a barometer of your trust. Hopefully with a little preparation (pun intended) and well-timed conversation, you can prioritize safety for both of you! 

First, let’s discuss what PrEP is. PrEP (pre-exposure prophylaxis) is a prescription medication that reduces the risk of getting human immunodeficiency virus (HIV) from sex by 99 percent when taken properly. It is intended for HIV-negative individuals and available in oral pill-form, Descovy and Truvada, and a bimonthly injection, Apretude. The latter two of these options have been approved for individuals with vaginas in addition to individuals with penises. These drugs block the enzyme HIV needs to replicate in the body, reducing the risk of contracting the virus when used as prescribed. 

PrEP could be worth exploring if:

  1. You’re in a serodiscordant relationship, meaning one partner is HIV-positive and the other is negative. 
  2. One or more partners engage in activities that increase HIV transmission risks, such as having multiple sexual partners, lack of or inconsistent condom use, and sharing needles. 
  3. You do not know a partner’s HIV status. 

Before starting oral PrEP, patients get an HIV test. Patients either take PrEP as one tablet per day for seven days before contact and every day following as needed, or immediately before having sex — a method called “on-demand.” Taking oral PrEP requires a visit to a healthcare provider every 3 months for HIV testing, prescription refills, and a follow-up; for injectable PrEP (Apretude), patients will need to see a provider for their first injection. They receive another injection in one month, returning every two months for testing and the injection.

Sexual health appointments, sexually transmitted infection (STI) testing, and barrier methods such as condoms are available through Sexual Health and Wellness at University Health Services. Remember that if you and/or your partner decide to go on PrEP, it is only effective against HIV; condoms should be used to lower the risk of contracting other STIs. Consistent condom use and regular testing are essential to ensuring sexual health. 

Sharing what you’ve learned about PrEP can be a productive way to frame your conversation with your partner. You will want to emphasize shared responsibility, collaboration, and trust in your discussion. Start by finding a good time and place to discuss this where your conversation won’t feel rushed or distracted. Lead with your feelings and invite his perspective on exploring PrEP together. 

Be prepared to reassure him that your interest in PrEP stems from a desire to protect yourself and him, not from mistrust. Taking PrEP is about taking care of each other, and it does not suggest a high-risk lifestyle for either partner. Rather, it serves as an additional tool for promoting sexual health, just like using condoms.  

Be prepared, too, to discuss any barriers to accessing PrEP, such as cost or time. The Student Health Plan (SHP) insurance covers emtricitabine/tenofovir (generic Truvada) and Apretude (injectable PrEP) at no cost to students. Other insurances may not cover every PrEP option, or a co-pay may be needed, so speak to your insurance provider to find out more information. Keep in mind that consistently taking the daily pill without missing doses and committing to routine testing and check-ups may be difficult lifestyle adjustments at first. But with time and tricks to help create a routine (e.g., calendar reminders, app tracking), keeping up with PrEP can easily become second-nature.

If your partner is fully supportive of your decision to begin treatment with PrEP, great! You can discuss next steps and work through solutions to any remaining concerns or issues accessing the drug and maintaining the regimen. If he’s hesitant, you might provide more resources, or suggest you see a healthcare provider together to learn more. If he resists or dismisses your concerns, consider your own values. Just remember that protecting your health is paramount. 

— The Sexpert

Information in this article obtained from University Health Services,HIV.gov and Healthline.

Communication, Masturbation, Relationships, Sex Positivity, Sex Toys

Eager Explorer: Navigating curiosity, sex, and self-discovery

Dear Sexpert,

I’m starting my first year here, and everything feels so new and exciting — especially when it comes to dating and sex. I’ve never really explored my sexuality before, but now I’m meeting new people, and I feel excited to try new things. I’m curious about toys, protection, and different types of intimacies. I’m also questioning my sexual orientation and gender identity, and I want to have the space to explore that. Is this normal? How do I know what’s right for me without feeling pressured or overwhelmed? How do I know I’m choosing the right partner? How do I know I’m making the right decisions regarding my identities? 

–Eager Explorer 

Dear Eager Explorer,

Starting college is a time of immense personal growth, and it’s completely normal to feel both excited and nervous about exploring new aspects of yourself — especially when it comes to sex, intimacy, and identity. You’re not alone in having these feelings. Many students, especially in their first year, are exploring their sexual desires, gender identities, and sexual orientations. For many people, the new environment presents a chance to reinvent yourself and explore new perspectives. It is important to remember that self-exploration is a personal journey, and there’s no definite way to go about it. The key is to take things at your own pace and make decisions that feel authentic to you.

When it comes to exploring your sexuality the most important thing is education. The more informed you are, the more empowered you’ll feel. For example, if pregnancy prevention is a concern, understanding the different types of contraception — like internal and external condoms or birth control methods — and how they protect against pregnancy can allow you to feel confident and prepared to engage in sexual activities. The same is true for barrier methods and testing for sexually transmitted diseases, which lowers the risk of STI transmission. Additionally, you can always make an appointment with a Sexual Health and Wellness (SHAW) provider through MyUHS to discuss different contraceptives or barrier methods more thoroughly and figure out which may be best for you.  

Similarly, experimenting with toys can ensure your safety when exploring your own anatomy, sexual desires and boundaries, either alone or with a partner. Check out this past Sexpert article to learn more about how to explore self-pleasure.

Furthermore, sexual orientation and gender identity are deeply personal aspects of who you are, and they can evolve over time. It’s completely normal to question these aspects of your identity as you grow, and college can be a great time to give yourself the space to do so. Feeling overwhelmed by these new experiences is also common, especially considering such new possibilities intertwined with the pressure to figure everything out. What’s helpful to know is that there’s no timeline for figuring out your sexual identity or orientation, and there’s no “right or wrong” decision to make. Decisions that feel right to you now may shift as you continue to grow. The  Gender + Sexuality Resource Center (GSRC) has various online educational guides that may help guide you through exploring and understanding different gender identities and sexual orientations. You can also connect with professional staff, student staff and peer educators, or student groups coordinated through the GSRC. Give yourself the grace to explore without pressure to define anything and know that there’s no need to fit yourself into any discrete category.

When exploring sexual experiences, communication and consent are essential. Talk openly with your partner(s) about what you’re comfortable with and what you’d like to try. This “How I Like It Inventory” can assist you in your self-reflection and even how you communicate your needs and wants. The right partner should respect your boundaries, listen to your needs, and make you feel safe. Trust your gut — if someone makes you feel uneasy, it’s important to listen to those instincts. Remember, consent is ongoing, so you can always change your mind about anything you’re not comfortable with, no matter what you’ve agreed to in the past. When it comes to navigating your sexual orientation and gender identity, take your time. It can be helpful to find supportive communities, either on campus or online, where you can explore these questions without judgment.

The Gender + Sexuality Resource Center (GSRC), located on the second floor of the Frist Campus Center, has many resources for students. They provide contraceptives, have peer educators, and hold numerous events throughout the academic year which can be a great place to meet other students. Seeking community amongst students who may be going through similar experiences can help you reflect on your feelings and better understand who you are and what feels right for you.

If you ever feel overwhelmed or just want to talk things through, you can always reach out to University Health Services (UHS). Whether you’re interested in speaking with a counselor at CPS, getting more information about sexual health and contraception, or exploring gender-affirming care, the resources on campus are here to support you. Remember, there’s no rush to figure everything out right now. College is about exploring and learning — not just in the classroom but also about yourself. Take it one step at a time, and don’t be afraid to seek out support whenever you need it!

— The Sexpert

Information for this article obtained from University Health Services and UMatter.

STDs/STIs

Tentative Test-taker: STI Testing

Dear Sexpert,

I have been sexually active with multiple partners for three years now. Though I am not currently experiencing symptoms nor know of exposure to anyone with an STI, I am really nervous that I may have contracted one. I remember learning that many STIs may have no signs or symptoms, so I am getting really anxious that I may have one, and it will be too late. I feel too embarrassed and scared to talk to my friends and family to ask about testing, however, I am concerned for my health and want to get checked out ASAP. Do you have any guidance for where I can get help?

— Tentative Test-taker

Dear Tentative Test-taker,

I am sorry to hear you are feeling anxious. You are being very proactive by reaching out with your concerns. To alleviate some of your anxiety, I want to first remind you that all sexually transmitted infections, when identified early enough, can be treated (i.e., those caused by viruses), if not cured (i.e., bacterial infections). So even if you test positive for an STI, medications can manage symptoms or even clear up infection entirely. You can still have healthy and fulfilling sexual experiences in the future. You also noted that you may be asymptomatic and have had no known exposures. If you have been practicing safer sex by doing things like using barrier methods consistently and properly, the chances of contracting an STI are very low.

One of the first steps that you may want to take is to communicate with your sexual partner(s). Ask them if they have any STIs that they are aware of or if they have recently had testing and share that you are concerned about transmission. Initiating the conversation will allow both you and your partner(s) to make well-informed decisions about the next steps to take. If you have not already discussed your partner(s) being non-monogamous, this is also an important conversation to have, as it can increase risk for your partner(s).

STI testing recommendations vary and depend on multiple factors, including behavioral and identity-based risks. Finding out more about whether you need testing is a smart decision, and you should not feel embarrassed about it. There are indeed resources right here on campus that can help you get answers.

Your MyUHS online portal features a new online STI testing program for asymptomatic testing, designed to include evidence-based educational information and enable you to make an informed decision about the type of testing you wish to pursue. Additionally, this testing is confidential, so you do not have to be concerned with other individuals, such as your family, finding out from UHS.

It is important to note that self-directed STI screening will be sent through Quest Laboratory and billed through insurance. If you wish to avoid using insurance (where an Explanation of Benefits will be mailed to the insurance holder [e.g., parent, guardian] and may result in questions about the procedure/testing), you should make an appointment with a nurse for a screening. Read more about costs if you choose not to use insurance — see “STI Testing” and “Lab Tests” on this page. Positive results for some STIs may be shared with state or city health departments for tracking purposes, but there are laws preventing health departments from sharing your test results with your family, friends, or employer.

To begin the STI testing process, follow the steps below:

  1. Log into your secure MyUHS online portal and choose “Princeton University” if prompted.
  2. Navigate to the Forms page.
  3. Scroll down to the Sexual Health and Wellness section and click on “Self-directed STI Testing.”
  4. Use the educational materials provided and/or access the application: STD Wizard, to decide what you want to be tested for and which body parts should be tested.
  5. Order your desired labs.

Once you receive a notification that your labs are ordered, you can go to the reception desk at McCosh Health Center during a time that is convenient for you (Monday–Friday, between 9 a.m. and 3 p.m.), to collect your specimen(s). 

According to the UHS website, lab test results are typically available within 24–48 hours. The UHS electronic health record automatically releases normal lab results to students via the patient portal. Positive lab results are reported to students by a nurse, enabling a discussion of any needed treatment. UHS is currently processing approximately three to ten online STI tests requests daily. This means that your peers are also taking advantage of this offering, even if they aren’t talking about it openly.

If you would prefer to go to an off-campus resource, such as an urgent care or Planned Parenthood, to get tested, that is also always an option. Thank you so much for reaching out about your concern. You are doing the right thing for your health by getting tested, and we are glad to be able to highlight this convenient UHS resource for you. If you have further questions or concerns, feel free to reach out to any of the PHAs.

We wish you all the best,

— The Sexpert

Communication, Masturbation, Personal Health & Hygiene, Sex Positivity, Sex Toys

Private Pleasure-Seeker: Navigating Self-Pleasure in College

Dear Sexpert,

I’ve been reading here on the Sexpert about the benefits of masturbation, from stress-relief and to being a healthy activity, and I even read about sex toys. My question is though, when or where can I masturbate? I share a double room with a roommate, and we have communal restrooms. My concerns are that: A) it would be weird to bring up the subject to ask for alone time, B) the walls are paper thin, so it may be obvious what I’m doing, and C) where would I wash my sex toy? It may seem quite weird and perhaps even embarrassing to be caught washing a sex toy in the restroom, let alone having to find a place to let it dry in my room.

Thanks, Sexpert!

— Private Pleasure-Seeker

Dear Private Pleasure-Seeker,

Great questions! There are a lot of benefits to masturbation and exploring self-pleasure, but navigating sexual exploration while maintaining privacy can be tricky in shared living conditions. Fortunately, following a certain etiquette will allow you to maintain privacy, while also feeling comfortable to explore sexually. 

Simply put, masturbation should only be done in private places where you can feel comfortable while not creating an uncomfortable environment for others. The only exception is consensual exhibitionism — but that can only take place when all individuals in the space have consented. Therefore, a communal/public restroom is not the best place to engage in sexual pleasure. You can perhaps figure out some time that you know your roommate will be out of the room and you can have alone time. Alternatively, if you feel comfortable, have an open or discrete discussion with your roommate about creating a designated “alone time” in the room for either of you. For example, you can discuss each other’s schedules and plan out some time when you know the other won’t be in the room, or you can compromise certain times blocked out where you or your roommate can get the room to yourselves. Discussions of alone time in the dorm and privacy, regardless of the reason, are completely normal conversations to have with a roommate and can be productive in understanding each other’s comfort zones and needs regarding sharing a living space. 

To maintain privacy and discretion if you’re worried, there are soundless sex toys that may reduce any noise concerns you have. 

Cleaning sex toys after use is important for maintaining your health and safety. Most toys can be surface cleaned — especially if only being used by you — with a mild soap and warm water. You can also purchase cleaning supplies specifically made for sex toys, like a spray, but these often need to be washed off after anyways. Make sure whatever cleaner you are using is compatible with the toy’s materials. Avoid using any products that you would not also put on your skin (e.g., bleach, alcohol, glass cleaner, hydrogen peroxide, and abrasives). There are also ways to be discreet when washing and drying sex toys. For example, you can transport them in some sort of bag and wash them in the shower. When drying, you can wrap it in a towel to dry or leave it to air dry when you know your roommate will be out of the room. At the end of the day, all of this depends on the comfortability between you and your roommate and the level of discretion you two feel comfortable with. 

It’s important to remember that sexual exploration is completely normal and healthy! Conversation is beneficial to come to a consensus with your roommate on boundaries and privacy in the dorm so you can feel comfortable in your sexual journey.

Sincerely,
The Sexpert

Please note that the inclusion of external hyperlinks does not constitute endorsement or recommendation of any particular product or company by The Sexpert.

Photo credit: Morderska, CC BY-SA 3.0, via Wikimedia Commons

Contraception, Dating

Puzzled BC-Taker: On birth control

Dear Sexpert,

I’ve been dating my partner for over a year now, but I fear things are not going well, and we are likely close to the end of our relationship. A couple of months into dating, I decided I was ready to begin being sexually active, and I started using birth control pills. My body seems to have adapted well to them, but I am unsure if I should continue using them if my partner and I break up. I’m afraid that if I keep taking them, others will assume it’s because I have already moved on and that I’m seeing other people. What should I do? If I stop taking them, what should I expect? 

— Puzzled BC-taker

Dear Puzzled BC-taker, 

I am sorry to hear that your relationship might be nearing its end. I hope you and your partner ultimately make the decision that is right for you, and if you do break up, do so respectfully.

Regarding your birth control dilemma: birth control pills, also referred to as oral contraceptives, are a reliable, easily reversed form of contraception, but they can also be used for various reasons beyond pregnancy prevention. Oral contraceptives are generally a combination of the hormones estrogen and progestin — two hormones necessary for the sexual development of the female and for the regulation of the menstrual cycle. Consistently taking birth control pills is a reliable form of contraception and can be easily reversed. 

Each different type of birth control pill has a unique dosage of estrogen and progestin. Those with both the hormones estrogen and progestin are known as combination pills. Combination oral contraceptives can be used to treat hormone-related health issues, such as acne, severe menstrual cramps (also known as dysmenorrhea), and irregular menstrual cycles. Birth control pills may even be prescribed to help relieve endometriosis symptoms, a condition during which the tissue that lines the uterus grows outside of it. There are also pills that only contain progestin, colloquially known as “mini-pills.”

Using oral contraceptives can have several benefits besides their main purpose, such as the lessened probability of developing cysts in the breasts and ovaries, and of developing endometrial and ovarian cancers. Of course, this depends on the person and type of combination pill used.  

Evidently, there are several reasons why someone might use oral contraceptives. Nonetheless, there can be a stigma regarding contraceptive use, so your concerns about the assumptions someone may make are completely valid. However, you know your body better than anyone else, and thus should not be afraid of what others may think of your health-related decisions. Of course, that is easier said than done.

The main thing you should consider is your well-being: What would make you feel the most comfortable? If you are not looking to become pregnant, continuing to take birth control may keep your mind at ease. It is important to note that you can become pregnant immediately after you discontinue taking regular or low-dose oral contraceptives, so consider whether you may engage in vaginal sex in the near future before stopping your regimen. Given that oral contraceptives are easily reversible, you can resume taking them at any point (before their expiration date) after stopping, but they may not be effective at preventing pregnancy immediately. Depending on the type of pill, they may become effective only after seven days of usage. If you plan to have vaginal sex, also use a barrier method, like an internal or external condom, to prevent pregnancy.

Something else you should consider before you discontinue taking birth control pills is whether there are additional benefits of using oral contraceptives and how they affect your current lifestyle. Perhaps you are experiencing a lighter menstruation flow and less cramping, which may be a relief, especially in a high-stress environment where you have less time to rest during the day. Ultimately, it is your decision, but those are two factors to consider. 

If you do decide to stop taking the pill, you should expect your menstruation cycle to return to how it was before birth control. This might mean your menstruation flow will become heavier, and you will have more cramping. It might also take a couple of months for your hormone levels to balance themselves, and this readjustment phase may lead to irregular periods. Fortunately, this readjustment phase is based on how long you were on birth control and may last less than three months.

Before making a final decision, it may be helpful to speak with your healthcare provider, or a Sexual Health and Wellness clinician at UHS, to weigh the pros and cons and consider an alternative contraceptive form — for example, an intrauterine device, patch, or hormonal shot. If you would like more guidance but do not feel ready to speak with a professional quite yet, you can schedule a Wellness Chat with a Peer Health Adviser to explore resources and create an “action plan.” Regardless of your decision, remember that there are many resources available to you on campus if you want to talk through your options or simply to have someone listen. 

Sincerely,
The Sexpert 

Information in this article is from MayoClinic, Go Ask Alice Columbia University, Planned Parenthood, and Psychology Today.

Contraception, Pregnancy, STDs/STIs

Summer Fling Seeker: Maintaining sexual health during the summer

Dear Sexpert,

I’ve been using McCosh’s services to remain diligent about my sexual health and have gotten used to the easy, accessible resources on campus. I’m going home for the summer in a few weeks, and I am worried about accessing resources at home, especially without my parents knowing about it. My home state is also extremely strict about abortions, and while I don’t plan to get pregnant, unwanted pregnancies could still happen and I’m not in a place to have a child right now. I could use some guidance regarding this matter.

Sincerely,
Summer Fling Seeker

Dear Summer Fling Seeker, 

Planning ahead and being cautious are certainly important goals! If you intend to be sexually active this summer — especially if you are engaging with new or multiple sexual partners, it is a good idea to have a plan in place to continue practicing safer sex. It’s also great that you’ve been able to take advantage of the services at McCosh while on campus. If you already have a provider at McCosh who you are comfortable with, you can message your provider through your MyUHS portal with non-urgent questions throughout the summer. They may also assist in getting you connected to resources near you. However, this should not be used for urgent or immediate care concerns or services.

If you are not connected with a care provider at home, Planned Parenthood has clinical locations across most of the United States. These clinics offer sexually-transmitted infection (STI) testing, contraception, physical examinations, consultations, pregnancy testing and prenatal services, abortion care, and sex education. Your local pharmacy may also offer consultations, evaluations, STI and pregnancy testing, and vaccinations or treatments, as needed. 

You note being concerned about unwanted pregnancies. If you do not have a consistent or reliable contraception method, consider making an appointment at McCosh with Sexual Health and Wellness (SHAW) to explore your options before your departure from campus. There are a ton of different methods — hormonal, non-hormonal, daily use, or ones that last years once inserted. Remember that external and internal condoms also prevent STIs, in addition to pregnancy.

Even with these options, no method  is 100 percent foolproof, other than abstinence. Should you suspect a pregnancy, it can be more cost efficient to get a test at a Planned Parenthood location (since they accept insurance or offer a sliding scale fee, if paying out-of-pocket) than to pick up an at-home testing at a pharmacy. But at-home testing does ensure more privacy. Just keep in mind that if you are on your family’s insurance plan and use it, an explanation of benefits (EOB) may be mailed to the policy holder. Learn about some strategies to navigate this.

If you find yourself pregnant and want to explore your options, you may want to learn more about state laws and restrictions (e.g., ultrasound and waiting period requirement, parental consent or notification) to know more about your options, including what you could expect at a provider’s office. You can also look to any of these resources for supportive talk or text lines regarding options to navigate pregnancy. Additionally, Hey Jane is a startup that connects menstruating people to healthcare providers who can educate and prescribe contraceptives and abortion medication. This company caters to those who are less than 10 weeks pregnant and over 18 years old, and in the states Calif., Colo., Conn., Ill., Md., N.J., N.M., N.Y. and Wash. (which may not be applicable to your situation). This service is private and will work with you to financially support your decision. Plan C is another resource that has up-to-date information about accessing at-home abortion pills. More than 54% of abortions in the United States are medication abortions, and they are often chosen over surgical abortions because of the desire for privacy.

Taking preventive measures to maintain your sexual health is incredibly important for your overall well-being, as well as to avoid STIs and unwanted pregnancies. Using condoms and other forms of contraception are the easiest ways to stay diligent about this, but the only way to definitively prevent STIs and unwanted pregnancies is practicing abstinence. If you choose to be sexually active, make sure you are on top of your self-protective behaviors, know your options, and can get connected to care. 

Stay safe,

The Sexpert

Information for this article is provided by the Guttmacher Institute, Plan C, Hey Jane, Bedsider and Reproductive Rights.

Communication, Masturbation, Relationships

Sincere Survivor: Finding Intimacy After Trauma

Content warning: The following column contains references to sexual assault. If you or a friend have experienced sexual misconduct and are in need of assistance, Princeton has a number of resources that may be of use. You can also reach SHARE, Princeton’s Sexual Harassment/Assault Advising, Resources and Education service at 609-258-3310. 

Dear Sexpert, 

I feel safe and respected by my partner, but my past experience with sexual assault has made it so that I have trouble focusing during sex. I find it pleasurable, but I cannot orgasm. I have disclosed to my partner that I am a survivor, and they’ve been understanding and patient. Lately, I’ve been feeling pressure from them to orgasm, but I don’t want to fake it. Just because I don’t reach an orgasm doesn’t mean that I’m not enjoying being intimate with them. I’m so confused.   

— Sincere Survivor

Dear Sincere Survivor, 

Dealing with intimacy can be a delicate topic in any case, not only between you and your partner, but for yourself as well. Layering on the complex feelings, both physical and emotional, experienced by many survivors rarely makes things simpler. Navigating intimacy after assault, harassment, or other harm can be a confusing and variable process, as you’ve observed, but it’s not one you are alone in. Many people have explored and shared what has been helpful for them, which we will discuss a bit here, but at the same time, only you can decide what does and doesn’t work for your body, mind, and desires. 

Sex and sexual assault are not the same things, and it can take time for your body and mind to understand the different experiences and sensations since the trauma caused by an assault can actually change the way your brain reacts or how it associates sex. It is possible that you might feel ready to move on from your assault in one moment and experience flashbacks or activations in another, making it seem like you’ve taken a step back in your healing journey. No one’s experience is the same, but it is not uncommon for survivors of sexual assault to dissociate (which is often described as feeling detached from one’s body) during sex when activated by a smell, sound, touch, etc. This can make it challenging to experience or focus on pleasure. 

One helpful approach, if you would like to try it, might be to focus on solo sex or masturbation. It can also help you to reclaim your body on your terms and under your control. This can be a great way to explore your likes, dislikes, and activations without the pressure of another person’s timeline or expectations. You can even document activations, body sensations, and emotions that you experience during solo sex, so you can find what is pleasurable and safe for you.

When talking about the idea of pleasure vs. orgasm, a common shorthand is to use these terms interchangeably. This association supports a checklist-oriented mentality, which can contribute to individuals putting their sexual goals (i.e., orgasm) above others’, and supports an attitude that may uphold violence. For most people, it is possible — and not atypical — to experience pleasure during intimacy without reaching orgasm. However, this “pleasure equals orgasm” shorthand can often result in pressure to reach orgasm during sex. In your case, it sounds like you are feeling pressure to orgasm from your partner. This may come from a variety of causes — perhaps they themself have the desire to orgasm frequently and assume you have a similar one, or perhaps they worry that the joint sexual experiences aren’t bringing you pleasure at all, or it could be something else entirely. You might currently have some insight into their thought process, but gaining clarification on their thinking may be helpful for your confusion and could give you an opportunity to share your own thoughts too. 

Communicating with your partner, whether it be verbal and independent from intimate moments or any other situation which you deem fit, is an important step towards not only creating a stronger relationship but in making sure that your voice is heard. Find a time and place to chat where you both feel comfortable in sharing your perspectives and conveying your boundaries. For example, you could let them know that you really enjoy having sex with them and want to continue doing so while taking your own orgasm out of the equation, or you could start by asking if they have any concerns regarding your mutual sex life. It’s completely normal, no matter how close you and your partner may be, to have boundaries during intimacy. Identifying and communicating your boundaries and expectations to your partner and hearing about theirs is an essential, though not always easy, step in any sexual relationship, but it may be particularly relevant for yours. 

This can be a very challenging, stressful, and delicate topic, but there are many resources available to help you through it. Some resources are intended to be long-term, while others are shorter-term and often more immediate. Likewise, some resources are confidential, and others are private – both of which you may find useful when you are preparing for your conversation with your partner and afterward. If you are looking for more professionally-oriented support, consider connecting with clinicians in the SHARE office or Counseling and Psychological Services (CPS) (confidential), or chaplains in the Office of Religious Life (confidential). SHARE Peers or Peer Health Advisers (private, non-confidential) may be an option if you feel more comfortable speaking with peers. (Note: SHARE Peers are only non-confidential because they let the SHARE office know that you spoke with them. You can request that the SHARE Peer keep your identity anonymous, and just the general details will be shared.) For off-campus options, you could connect with Womanspace, a support and counseling resource that serves all survivors and their families in Mercer County. It is normal to feel anxious when accessing new resources or even talking to friends about this challenging topic.

I hope you know that whatever you are feeling is valid and that you are worthy of comfort, support, and safety. Hopefully, this information can help make intimacy with your partner enjoyable, both for you and them, and take off the pressure of orgasming. Remember that we are all here to support you. 

Sincerely,  
The Sexpert

Uncategorized

Scared Spouter: Vaginal Discharge 101

My boyfriend and I had sexual intercourse for the first time. We used a condom, and 1 day after I showered I saw that a bit of sperm-looking liquid was coming out of my vagina, but I don’t know whether it was discharge or sperm. It was only a little bit, and it didn’t smell at all.

–Scared Spouter

Dear Scared Spouter , 

Vaginal discharge is a topic that is often overlooked and underdiscussed, especially when it comes to sex, so I’m happy to give you some more information. Discharge, also known as “cervical mucus,” or secretions from the vagina, occurs as a natural part of the vagina’s “self-cleaning” process and serves, in part, to remove dead cells and bacteria from the vagina. As you have probably noticed, the amount and type of discharge you have can change throughout your menstrual cycle. Typically, you may notice that your discharge is tinted brown or red towards the end of your period, clear, stretchy, and fairly thin during ovulation (about halfway through your cycle), and more white or creamy during the other times of your cycle. This is most likely the discharge you noticed after having sex with your boyfriend. This type of discharge is normal and healthy, especially if it has a mild (or no) odor, doesn’t have any chunks, and doesn’t cause your vagina any discomfort. During arousal, whether through masturbation or partnered sex, you probably notice more “arousal fluid” coming out of your vagina, which may be clear or white. This is simply to provide extra lubrication to your vagina, to make penetration (by a toy, finger, penis, etc.) more comfortable. Many folks don’t find this secretion to be enough lubrication on its own, so adding lube is always helpful!

In general, if you notice a strong or unpleasant odor, a chunky consistency, or discomfort — such as pain, itching, or burning — associated with your vaginal discharge, this could be a sign of a bacterial or yeast infection, and would be cause for consulting  your sexual healthcare provider. These infections often have causes other than sexual transmission, including the use of antibiotics or estrogen-based birth control, especially if you are consistent about practicing safer sex. 

I’m glad to hear that you and your boyfriend are practicing safer sex by using a condom – that’s helpful even if you are monogamous or if you use a non-barrier method form of birth control. The best way to prevent both pregnancy and the spread of a sexually transmitted infection (STI) is the use of a contraceptive, such as a birth control pill, intrauterine device or vaginal ring and a barrier method, such as an external or internal condom. Condoms are an effective barrier method when used properly — checking the expiration date and making sure the condom packaging isn’t compromised can offer peace of mind as well as bolster protection against pregnancy and STIs. As long as your boyfriend wore a condom while ejaculating, there is almost no chance that any sperm entered your body. It is much more likely that the discharge you noticed was just natural vaginal discharge. Since the purpose of vaginal discharge is to clean the vagina, it’s consistency or color can change after sex, even if no semen — the fluid that carries sperm — entered the body. If any type of lubricant or spermicide was used, whether from the condom or from a bottle, it could cause a change in your discharge while your vagina cleans itself out. This could be why you noticed a possibly unfamiliar type of vaginal discharge after having sex. 

Finally, it is completely understandable to feel nervous about pregnancy or STIs even when you know that semen couldn’t have entered your vagina, especially if you are newly sexually active. The prospect of pregnancy and STIs can be  scary, and it can take time to become confident in your contraceptive / protection methods, even if you know logically that they are effective.

If you have further questions or want to learn more about sexual or reproductive health in general, you can make an appointment online with a sexual health provider through MyUHS.

Sincerely,

The Sexpert

Information for this article was obtained from Scarleteen, Cleveland Clinic and Mayo Clinic.

Uncategorized

Date Dreamer: Finding love in college

Dear Date Dreamer,

Starting college opens you up to so many opportunities to try new things and meet interesting people, so it can be quite an exciting time! The possibility of exploring a romantic relationship adds another layer of emotions and questions about what to expect in this new environment. Perhaps you are excited about opening yourself up to your first romantic relationship, or maybe you dated in high school and want to see what college has to offer. Whatever the case, when entering this opportunity-filled environment and thinking about all the new people you are going to meet, it’s understandable that you might think about meeting someone you could eventually marry. 

It’s great that you are taking some time to think about approaching relationships before entering one, because it gives you space to think about what you want. You may be coming in with a whole set of expectations for dating and finding a partner with whom you can have the perfect relationship (i.e., free of conflict and effortless, etc.). After all, these kinds of relationships are shown in TV shows, movies, and social media all the time. You may have even had your relatives ask about your love life and make assumptions about things. This can cause you to put some pressure on yourself and bring on feelings of anxiety on what your relationships should look like or might make you feel that looking for a partner and getting married should be your priority.

Unfortunately, it can also feel like if your first relationship in college isn’t perfect, then maybe you never will get your “happily ever after.” Realistically though, there are many ways and places to find a long-term partner, and college is just one possibility. 

That is not to say that you cannot find a long-term partner in college. Princeton and other colleges host a big concentration of people with common interests and future goals, and it is not unusual for people to marry their college partner. Some students use surveys like DataMatch and Marriage Pact, normally released in the spring semester, to connect with potential partners (or just make new friends!). However, the fact that it works for some people does not mean it has to be how you find your partner. It can be helpful to ask yourself what being single or in a relationship means to you, especially at this point in your life, and maybe even make a list of what qualities you look for in a partner. Spend some time reflecting upon where you got these ideas, and if they are in fact what you are looking for. Knowing what you want in a relationship helps improve communication and contributes to relationship satisfaction for all partners involved. 

It is equally important to think about and respect the wants and needs of your partner (or potential partner). Relationships, especially committed ones, are an investment and serious time commitment when on campus, and not everyone wants to or is ready to enter one. People may also be looking for different kinds of relationships — open vs. monogamous, casual vs. committed, sexual vs. non-sexual, romantic vs. aromantic. Whether you have figured out what you want or are still thinking it through, make sure you communicate your hopes and expectations clearly before entering the relationship, so that you can be on the same page as your partner. Check out the UMatter website to explore more elements of healthy relationships.

If you are looking for a relationship that involves sexual activity, you may want to seek out University Health Services with any questions you have or to learn about protecting your health and safety. You can make an appointment with a Sexual Health and Wellness (SHAW) provider through MyUHS. As a first-year student you will also have the opportunity to participate in the Safer Sexpo, a peer-facilitated interactive FYRE program on sexual and reproductive health and wellness in your residential college. You can also make an appointment for an individual counseling session with CPS on MyUHS if you would like to talk through your relationships, as well as your personal wants and needs.

Remember, college is a time of change for many people. It can become overwhelming to try to make friends, get acclimated academically, find social groups, and discover activities you like, while also trying to find a romantic partner. Trying to focus on these activities first can allow you to get to know yourself, so that there’s more space and time for relationships later. In your first year of college, try not to put pressure on a relationship. Instead, focus on finding things you can enjoy on your own, and let a relationship with a partner happen naturally.

— The Sexpert

Uncategorized

Tentative: Previously had sex with an undergrad in a class I’m teaching

Dear Sexpert,

I am a grad student and I had sex once with an undergraduate student, but we never saw each other again. I am teaching a course in the fall and saw this student has enrolled in the class. What should I do?

– Tentative TA

Dear TA,

It shows good judgment that you are questioning whether these previous relations (albeit brief) may impact your teaching role, and are being proactive in managing the situation before interacting with the undergraduate student.

As discussed in this Sexpert, graduate student/undergraduate student relationships can create a power differential. Even though you are no longer involved with the undergraduate student, there may be a perceived or existing conflict of interest, not to mention a potential awkwardness in seeing one another.

Regarding what to do about the situation, the first place to start would be with policies of the institution. At Princeton, Rules and Procedures of the Faculty of Princeton (Ch.V. Sec.C.) Consensual Relations with Students states that “Relationships which pre-date either this policy or the role at the University which causes the conflict must also be disclosed promptly to the parties’ respective department chairs and to the Dean of the Faculty.” Additionally, these procedures recommend that “Any member of the University community who is uncertain about how a power asymmetry may impact a relationship or adversely affect the community should contact the Office of the Dean of the Faculty, the Vice Provost for Institutional Equity and Diversity, or the Office of Human Resources.”

This indicates that you should speak with your department chair, and/or the Dean of the Faculty (depending on which you feel more comfortable starting with) about this potential conflict of interest. You need not go into the specifics of the relationship but just share generally that you have previously had sexual relations with a student who is enrolled in the class you are teaching this fall. There may be a number of ways to handle the situation, including swapping you to a different section of the class being offered.

Best wishes,

The Sexpert

Personal Health & Hygiene

what you should know about menstrual cups

I saw an email about groups on campus giving out free menstrual cups, and I was curious about trying one out. I like the idea of having a more sustainable option compared to tampons or pads, but I’m worried about it being messy or uncomfortable to insert or remove. I was also thinking about getting an IUD soon and was wondering if the menstrual cup would interfere with it. 

– Curious about Cups

Dear Curious about Cups,

Menstrual cups are a great alternative to pads and tampons and definitely worth trying out if you think they might be right for you! Not only are they more sustainable, but they can also be a super cost-effective option compared to pads and tampons. If you take advantage of the campus initiative, your cup will be free and could last you up to five years with proper cleaning and care! If you buy one later, it will cost anywhere from $6–40 depending on the brand that you chose, meaning you’re still spending less than you would on tampons or pads over several years. 

Lots of brands make menstrual cups, and they are typically bell-shaped and made of flexible, medical-grade silicone. Unlike pads and tampons, the cups do not absorb blood but simply collect it. This means it will need to be emptied about every 6–12 hours, depending on how heavy your flow is. If you are interested in tracking your menstrual fluid volume for personal or medical reasons, menstrual cups are a great choice. For many people, menstrual cups can be changed less often than pads or tampons, making them a convenient option! Furthermore, compared to tampons, menstrual cups also have the advantage of reducing period odors.

To insert your cup, you will need to fold it. There are many options for how to do this and lots of online tutorials showing different folding styles. If you are nervous, you can watch videos and/or practice folding your cup before you go to insert it. Don’t be afraid to try a couple of different shapes to find the one that works best for you! Once inserted, simply twist the cup using the stem at the bottom to create an airtight seal against the vaginal canal. If inserted properly, you shouldn’t feel the cup, and it shouldn’t leak. If you experience any discomfort, calmly remove the cup and try again. You can also use lubricant or water on the rim of the cup for easier insertion.

If you are still concerned about the insertion of your cup, you can explore different menstrual cup sizes. The size you choose may be dependent on your age, your anatomy, and whether you have given birth vaginally. Many companies sell small, medium, and large cup sizes and will have specific information to guide you in selecting the appropriate size for you! The size you select may also impact how frequently you have to change the cup. 

Mess when removing the cup is definitely a common concern and worth considering if you choose to use a menstrual cup. To remove the cup, simply pull the stem down slightly so that you can squeeze the bottom of the cup to break the seal. This is crucial for an easy and painless removal. Pull down to remove the cup and empty it into the sink or toilet. 

Ideally, you should wash the cup with gentle soap and warm water after each use. If you are in a shared or public restroom, this can be a challenge. Many companies sell wipes that can be used to clean the cups inside of the stall. If you are in a pinch, you can wipe the cup out with toilet paper and reinsert, but try to avoid doing this after more than one use and wash thoroughly afterward. 

Luckily, because they can be changed less often, you may be able to avoid changing them during the day. If you want privacy, change your cup and wash it with you in the shower! Obviously, menstrual cups are not ideal for everyone, and if doing this would make you uncomfortable, it might be worth sticking to other options. 

If you do decide to get an intrauterine device (IUD) as contraception, you probably shouldn’t use a menstrual cup. The suction of the cup creates an increased risk of dislodging or removing your IUD. However, if you still want to use a menstrual cup with an IUD, you could potentially lower your risk of IUD dislodgement by going to your healthcare provider and having your IUD strings shortened. Furthermore, it is important that you are careful when removing the cup and always break the seal before pulling it out. 

If you have any further questions or specific concerns about menstrual cups, Sexual Health and Wellness providers at University Health Services are there to help and can provide you with specific advice. You can make an appointment by calling (609) 258-3141. 

– The Sexpert

Sources:

https://www.webmd.com/sex/birth-control/features/menstrual-cup-iud

https://putacupinit.com/

https://newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/

https://store.lunette.com/blogs/news/how-to-clean-menstrual-cup-in-public-toilet

https://www.plannedparenthood.org/learn/health-and-wellness/menstruation/how-do-i-use-tampons-pads-and-menstrual-cups

https://beyouonline.co.uk/blogs/news/how-do-you-fold-a-beyou-menstrual-cup