All posts by jmascari

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.

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

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

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

Curious and Careful: About PrEP

Dear Sexpert,

Pill icon

I’ve seen a couple of ads for a drug for people at risk for HIV. What exactly qualifies as “at risk” and how safe/effective is this drug?

Signed,
Curious & Careful

Dear Curious & Careful,

You’re right, PrEP, or Pre-Exposure Prophylaxis, can be used in prevention of human immunodeficiency virus (HIV). PrEP is a prescription pill (commonly sold under the name Truvada®) designed for daily use by people who are HIV-negative and at substantial risk for HIV exposure. PrEP is a combination of two drugs, tenofovir and emtricitabine. If used correctly and consistently, it has been shown to reduce risk by up to 92%. Additionally, many health insurance plans cover PrEP.

There are several situations that can qualify a person to be considered at substantial risk. The Centers for Disease Control and Prevention (CDC) recommend PrEP for anyone who meets any of the following circumstances:

  • is in an ongoing relationship with an partner who is HIV-positive;
  • is not in a mutually monogamous relationship with a partner who recently tested HIV-negative;
  • is a gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the last six months;
  • is a heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status, who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners); and
  • has injected illicit drugs in the past 6 months and who has shared injection equipment or been in drug treatment for injection drug use in the past 6 months.”

If you fall into any one of these categories, or feel that you may benefit from PrEP, schedule an appointment at Sexual Health and Wellness (SHAW) or your primary health care office to discuss with a clinician whether this is an option for you. It’s important to keep in mind this is solely a preventative drug for people with on-going risk of being infected with HIV, and is not recommended for those who have had a single incidence of potential, high-risk exposure.  (There is a different medication, called PEP, or post-exposure prophylaxis, in those instances.)

Additionally, PrEP is a drug that needs to be taken on a daily basis. Like birth control or other daily-prescribed drugs, irregular use will decrease its effectiveness. Anyone prescribed PrEP should return

to their health care provider every three months for consistent HIV monitoring and follow up. PrEP is not 100% effective at preventing HIV acquisition and does not protect you from other sexually transmitted infections (STIs). Precautions should still be taken to reduce your risks, including using a condom with every intercourse, getting HIV tested with your partner(s), practicing less risky sexual behaviors (e.g., oral sex while using a barrier method), reducing your number of partners, and/or sterilizing injection equipment or joining a substance treatment program.

Best of luck and be safe,
The Sexpert

Information regarding PrEP retrieved from Centers for Disease Control and Prevention (CDC).

Condom Queen: What if my partner doesn’t want to use a condom?

Dear Sexpert—

I just started dating a new guy, and he’s really great! But there’s one thing he does that makes me kind of uneasy: he’s really resistant to wearing condoms when we have sex. He always comes up with some excuse and tries to make me feel good about it, and sometimes I go along with it. Usually, I am a real stickler about condom use, so it worries me that he is so against using them. On the one hand, I want to tell him to wear one; but on the other, he’s made it seem like wearing one is a deal-breaker and I don’t want to lose him over it. What should I do?

–Condom Queen

 

Dear Ms. Queen,

There are a lot of different factors and attitudes that go into decision making and preferences, especially when it comes to something as intimate as sex. You have already decided that your preference is to use a condom every time, without exception. However, your boyfriend has other preferences.

Communication is the best way to improve sex. Talk with him about his dislike of condoms at a time when you’re not engaging in sexual activity. Figuring out his reasoning questions may help the two of you to come to an agreement about condom use. It is possible that he has had a bad experience with condoms in the past, or maybe he has not found one with the right fit. Trying out different condom styles or having open communication about wants and needs is a great way for him to see the fun of safer sexual experiences.

It seems like that you are concerned your boyfriend will end things if you push him. You have the right to make a decision for yourself, and he has the right for himself; but when you are making decisions that impact your partner, any and all decisions must mutually be agreed upon. I know it feels like saying something may put your relationship with him in jeopardy, but not saying something could also put your and his safety at risk (See the Sexpert archives.).

Be prepared with a response for the excuses, like “You’re just so sexy, I can’t wait” or “It’ll feel so much better without one”. Having condoms on-hand will discredit his “I can’t wait” argument, and it’ll make it easier for you to stay strong in your decision. Keep some condoms in your purse or bedside table for easy access. (You can get 10 FREE condoms, daily, at McCosh.) Also, there are many ways in which using condoms can be a fun part of the fun of your sexual experiences. Using the ultra-thin, ribbed, or heat-activating varieties or even adding a dab of lube to the inside and outside of the condom can all enhance the overall sexual experience for you both. If you aren’t interested in trying these options, you can always refer to the recent study published in The Journal of Sexual Medicine that stated that both men and women enjoy sex as much with condoms as without. This might alleviate his concerns, or at least make him more open to trying condoms.

When communicating about safer sex with your partner, feel free to be creative with ways to cooperate and come to a conclusion that makes you both happy. Just being willing to acknowledge his desires or worries may get him to acknowledge yours.

Good luck,

~The Sexpert