Sex and intimacy
Definitions
“Virginity” is a fuzzy and, ultimately, useless concept that varies from person to person. The best way to discuss sex and intimacy is to be as straight-forward as possible because each type of sex carries its own risks (and benefits). Here are some types of sex:
Oral sex is mouth to genitalia (penis, clitoris, vagina, anus).
Penis-to-vagina sex is the only one that carries risk of pregnancy.
Anal sex is penis to anus.
Tribbing is clitoris/vagina to clitoris/vagina.
Manual genital stimulation of a partner and self-stimulation (masturbation) are the only of these sexual acts that do not carry the risk of STIs.
What are blue balls?
The medical term for blue balls is epididymal hypertension, and this kinda describes what happens during the process. When aroused, our bodies send extra blood to our private areas. For males, more blood goes to the penis and testicles. With orgasm, blood rushes from the area. However, when someone is aroused and there is no orgasm, that extra blood can sit there for a while and put pressure on the nerves within and around the testicles. This causes some temporary pain that resolves with time or orgasm.
When to start?
From a medical standpoint there is no official minimum age for sex, but you should be of an age where you can assess the pros and cons of sex, can mentally process the implications of sex and can consent to sex with a full understanding of what it entails. Only you know when you’re truly ready.
It might seem like everyone is having sex, but the truth is that only about half of high schoolers (53%) are having vaginal or anal sex. Give it a lot of thought, talk with your partner and know that, whatever your decision, you are in good company.
If you decide to have sex, remember a few things:
Females who have vaginal sex with males are at risk of pregnancy. If you do not want to create a baby, take precautions. Guys, condoms are also a form of birth control.
ANY type of sex (oral, anal and vaginal) carries the risk of transmitting STIs. The only way to protect against transmitting STIs is barrier protection in the form of male condoms or dental dams.
What if you get caught up in the moment and aren’t protected? What if the condom breaks? Plan B is one of the most common forms of emergency contraception for females. It works to prevent pregnancy up to 72 hours after sex. It is not free but is available in most drug stores. Anyone, any age can buy it. (So guys, as a consenting partner, it’s nice if you offer to help pay.)
Once you start having sex, you should also know how often to get STI testing and what symptoms to look out for.
How much bleeding after the first time is normal?
Everyone will be a little different, and there are a few different things that can cause bleeding after sex.
The first is tearing of the hymen. This will bleed, and it can bleed more if the hymen has torn in multiple places. That’s okay, and it’s totally normal. Bleeding should slow significantly after the first 24 hours, and should stop shortly thereafter. However, repeated irritation of the torn hymen can delay healing. Think about any other cut on your body. It takes time to heal, but reopening the cut will obviously cause more bleeding and take longer to heal. Things that can irritate a torn, healing hymen are rubbing or reinserting things that stretch the skin (like a tampon, dildo or penis).
The second thing that can cause bleeding after sex is irritation of the lining of the vagina and the cervix. If you felt a little dry down there, didn’t use lube or DID use a condom (good job!) without lube (eek!), you might have some vaginal bleeding. That’s okay, and the bleeding/spotting should resolve in 24 hours or so.
A third thing that can cause bleeding after sex is, obviously, your period. Double check your calendar. If you were due for a period around the time you had sex AND if you had an orgasm (congrats!) then it’s possible you triggered some early release of period blood. Totally fine.
Finally, if you are bleeding excessively, like filling a pad and bleeding beyond 24 hours, it’s worth seeing a doc. The reason would mainly be that there are some minor bleeding conditions that cause prolonged bleeding and wound healing. (Feel like you’ve always had really heavy periods? This might be you.) The doctor can confirm with some lab tests, and make sure you aren’t anemic due to all of the blood loss. Nothing to worry about, but definitely something that’s good to know.
Erection difficulties
Erectile dysfunction (ED) is defined as the inability to get an erection or to keep an erection firm enough for sexual activity. By this definition, it is possible to have ED but still be able to masturbate with orgasm. And while the chance of having ED increases with age, it is still very possible to have ED as a teenager.
So what are the causes of ED? This will be different as you get older (and/or develop health conditions that impair blood flow like diabetes or high blood pressure), but here are some of the most common risk factors for developing ED in teens and young adults:
Obesity
Smoking
Sitting for long periods of time (like watching a lot of TV)
Frequent and prolonged bike-riding
Peyronie’s (or a problematic bend in the penis)
Heavy use of alcohol or drugs
Depression or anxiety
Certain types of antidepressants
Performance anxiety
Relationship problems
I’m 15, in great shape, but I’m having problems with erections. What’s wrong?
For starters, try to relax. You’re young and the chance of you having anything seriously wrong is super low. You may not have found exactly what turns you on just yet.
Second, there are lots of things that can interfere with erections in a young person. Do you get erections at night? Wet dreams? Chances are that the cause of your erection problems is more mental than physical. Problems with depression, anxiety or relationship issues all interfere with sexual arousal. Your PCP (pediatrician, family medicine doctor) should be able to help.
The other thing to consider is exercise. You said you are “in very great shape.” Any chance you’re using steroids or other supplements to enhance your athletic ability? If so, these can also mess with erections. Lastly, if you really don’t get nighttime erections, wet dreams or have other concerns, your PCP is the one to talk to.
Going too fast
Many individuals with a penis worry that they do not last long enough during sexual interactions. However, there is actually a fairly specific definition of premature ejaculation (PE). And while the definition has historically been related to penis-to-vagina sex, it’s also possible to experience PE with penis-to-anus sex. The strict definition requires either ejaculation within 1 minute with nearly every vaginal penetration OR the inability to control ejaculation with nearly every vaginal penetration AND personal distress caused by quick ejaculation.
It’s also worth noting that even though many individuals feel that they should be lasting longer in bed, studies have shown that the predominant preference among heterosexual couples is between 3 and 7 minutes. So…cut yourself some slack.
Is it normal that I don’t feel ANYTHING with vaginal penetration alone? I can only feel the clitoris.
Believe it or not, this is totally normal. Not everyone has sexual pleasure in their vagina, and that’s okay! Some statistics state that only about 25% of females are able to orgasm exclusively from vaginal penetration, and most need extra stimulation (like of the clitoris) to achieve sexual arousal. So don’t worry – you aren’t alone. It’s more a misconception (likely reinforced by loads of false descriptions and expectations out there) that vaginal stimulation is all it takes. Don’t be afraid to talk with your future partners about what feels good, and in the meantime just focus on your own exploration and discovery.
Orgasm difficulties
No matter what the anatomy, it’s possible to struggle with achieving orgasm. Figuring out why this is happening begins with an understanding of what area(s) of the body experience sexual arousal. The source of pleasure for those with male anatomy is primarily the penis, but the testicles and anus can also provide pleasure. The main source of pleasure for those with female anatomy is the clitoris, while the vagina, anus and nipples can also experience pleasure. So anyone struggling with orgasm should start by considering the parts of their own body that are most receptive to sexual arousal (and no two people will be exactly alike — so whatever you discover is okay!). Once you’ve identified your areas of pleasure, try mixing up the focus of stimulation with your partner. Try different positions and keep an open mind.
Mental health and wellness can also play a major role in the ability to orgasm. This may be in the form of an emotional connection with your partner (in which case, spend more time connecting and communicating wants and needs). This may also be in the form of a formal mental health diagnosis. Depression and anxiety can certainly interfere with the ability to orgasm, as can the medications that treat them. And if you’re comfortable, you can discuss orgasm issues with your doctor. While there is unlikely to be anything PHYSICALLY causing your problem, there are things we can test for or rule out that may be making your orgasming difficult.
Sex isn’t as amazing for me as everyone makes it seem. Is something wrong with me?
You’re totally fine! There are so many factors to consider when it comes to sex. Connection with your partner, comfort around your partner, arousal, orgasm and expectations can all contribute to the act of intimacy. Sex is also different for everyone, so try not to measure your own experiences against those of your friends. That said, don’t be nervous to use your voice during intimacy. If something feels good or you’d like to try something different – say so! Also, it helps to know your pleasure spots. For females, the main spot is actually the clitoris, not the vagina. And lastly, it’s okay to NOT love sex! It doesn’t do it for everyone, and that’s totally fine. If you’re still interested in sharing something special with your partner, talk it out. And if you’re not interested, don’t force it. There’s nothing wrong with you.
Painful vaginal penetration
Despite what you may have seen or heard, it’s normal if vaginal penetration hurts the first few times. This is generally because the hymen has to stretch or break (which is also what can cause some spotting or bleeding after the first few times of vaginal penetration). Thereafter, painful vaginal penetration may be due to a few other things.
The first consideration is tension in the muscles within the vaginal wall. You may or may not be aware that you’re feeling tense, but the best way to approach this is clear your mind of previous painful experiences, relax and try a little (or a lot) of foreplay. Foreplay will also help increase the moisture in the vaginal canal which can also contribute to painful penetration. A little bit of lube is also a great idea. STIs (sexually-transmitted infections) can also cause painful intercourse, so keep up with regular STI checks.
Finally, some individuals struggle with painful penetration for medical reasons. Skin conditions (such as lichen sclerosis), vaginismus (pelvic muscle contraction in anticipation of vaginal penetration) and vulvodynia (vulvar pain syndrome) can all be causes of vaginal pain. The good news is that there are some interventions for all of these conditions, so talk with your doc to get more information (and check out the video link).