WEBVTT 00:00:00.040 --> 00:00:03.240 Welcome to Prep and Play, where we have conversations 00:00:03.240 --> 00:00:06.480 about safer sexual pleasure. This podcast is 00:00:06.480 --> 00:00:09.080 dedicated to empowering listeners through open, 00:00:09.339 --> 00:00:11.679 honest discussions surrounding keeping our minds, 00:00:11.900 --> 00:00:14.800 bodies, and spirits healthy while being sexually 00:00:14.800 --> 00:00:20.699 active. My name is Danielle and I am the Rural 00:00:20.699 --> 00:00:23.980 Outreach Specialist at AIDS Alabama South. And 00:00:23.980 --> 00:00:26.280 today we're going all in talking about anal health 00:00:26.280 --> 00:00:28.339 and pleasure with somebody who knows a lot about 00:00:28.339 --> 00:00:30.480 it. Dr. Kuttner, could you introduce yourself? 00:00:31.480 --> 00:00:34.460 Yes. Hi, I'm Brian Kuttner. I'm a clinical psychologist 00:00:34.460 --> 00:00:37.340 and assistant professor at Albert Einstein College 00:00:37.340 --> 00:00:41.700 of Medicine in the Bronx in New York. I had the 00:00:41.700 --> 00:00:46.659 pleasure of taking a workshop with Brian last 00:00:46.659 --> 00:00:50.179 year and I learned a lot about it. Yeah, I guess 00:00:50.179 --> 00:00:51.640 let's just jump right in so you can hear a lot 00:00:51.640 --> 00:00:53.960 of the stuff that I learned from Brian. First 00:00:53.960 --> 00:00:55.219 up, we're going to be talking about pleasure. 00:00:55.469 --> 00:00:58.570 And specifically why anal sex can be pleasurable 00:00:58.570 --> 00:01:01.850 for all genders. So let's start at the root here. 00:01:02.530 --> 00:01:04.989 Why can anal sex be pleasurable for both men 00:01:04.989 --> 00:01:08.370 and women? Yes, anatomically speaking. Okay, 00:01:08.370 --> 00:01:11.849 great. So the anatomical answer is that there 00:01:11.849 --> 00:01:15.030 are sources of pleasure in that region of the 00:01:15.030 --> 00:01:18.870 body. And I can give an example of this for your 00:01:18.870 --> 00:01:22.689 listeners. If your listeners just take the palm 00:01:22.689 --> 00:01:26.349 of their hand and with a finger from another 00:01:26.349 --> 00:01:29.450 hand just certainly touch the palm of their hand, 00:01:29.590 --> 00:01:33.209 just rub that, and then flip their hand over 00:01:33.209 --> 00:01:36.150 and then touch the top of their hand, they may 00:01:36.150 --> 00:01:39.109 notice that there's a difference in sensation. 00:01:39.810 --> 00:01:43.310 And so one reason that anal pleasure occurs is 00:01:43.310 --> 00:01:46.950 because the anus is very densely packed with 00:01:46.950 --> 00:01:49.090 nerve endings, like the palm of the hand, but 00:01:49.090 --> 00:01:51.230 in a slightly different way. So it's just very 00:01:51.230 --> 00:01:54.680 sensitive to touch. So the quote, right kind 00:01:54.680 --> 00:01:57.599 of touch from someone that you're aroused by 00:01:57.599 --> 00:02:00.040 or attracted to, can feel really pleasurable 00:02:00.040 --> 00:02:03.459 that way. And then there are a couple of other 00:02:03.459 --> 00:02:06.319 sources of pleasure that are important. So if 00:02:06.319 --> 00:02:10.539 someone has a prostate, a prostate is located 00:02:10.539 --> 00:02:13.860 about, if you go past the opening of the butt, 00:02:14.039 --> 00:02:17.860 the anus, about two inches in and toward the 00:02:17.860 --> 00:02:19.800 belly button, you'll be able to feel the prostate 00:02:19.800 --> 00:02:21.879 if someone has one of those. It feels a little 00:02:21.879 --> 00:02:23.939 spongy. It's about the size of a walnut, but 00:02:23.939 --> 00:02:27.860 it's not hard. It's more squishy than that. But 00:02:27.860 --> 00:02:30.759 pressure against the prostate also is really 00:02:30.759 --> 00:02:33.520 pleasurable. And that's because the sensation 00:02:33.520 --> 00:02:36.439 of orgasm in people who have a prostate, that 00:02:36.439 --> 00:02:40.360 is what is responsible for the sense of orgasm. 00:02:40.599 --> 00:02:42.400 So it's the squeezing of muscles around the prostate. 00:02:42.460 --> 00:02:44.780 So you can imagine if you're applying pressure 00:02:44.780 --> 00:02:47.400 from the inside of the body against the prostate, 00:02:47.759 --> 00:02:51.340 that can be pleasurable. And then another source 00:02:51.340 --> 00:02:53.800 of pleasure is that people who have a clitoris, 00:02:53.840 --> 00:02:56.879 the clitoris is pretty extensive organ. And it's 00:02:56.879 --> 00:02:59.960 also what I've learned is it's the only organ 00:02:59.960 --> 00:03:02.139 in the human body whose sole purpose is pleasure. 00:03:02.139 --> 00:03:04.400 So it's pretty enviable if you've got one of 00:03:04.400 --> 00:03:08.599 those. The clitoris, even though like what I 00:03:08.599 --> 00:03:12.060 was taught early on in my life was that the clitoris 00:03:12.060 --> 00:03:14.860 is just like what's beneath the hood, just like 00:03:14.860 --> 00:03:17.860 a little button there. But actually, that's just 00:03:17.860 --> 00:03:21.639 the part that you can see it extends with some 00:03:21.639 --> 00:03:25.460 legs and a bulbous part of it, too, that extends 00:03:25.460 --> 00:03:28.939 back into the body. And those extensions also 00:03:28.939 --> 00:03:32.759 reach back toward the rectum. And in a similar 00:03:32.759 --> 00:03:35.840 spot to where the prostate would sit, you can 00:03:35.840 --> 00:03:38.460 reach into the rectum a couple of inches, move 00:03:38.460 --> 00:03:40.000 toward the belly button with a little bit of 00:03:40.000 --> 00:03:43.219 pressure, and you can stimulate a legsiler clitoris 00:03:43.219 --> 00:03:45.879 that way. And then the last way, I said there 00:03:45.879 --> 00:03:47.219 are two more, but there's actually one more, 00:03:47.259 --> 00:03:49.479 which is the sensation of fullness inside of 00:03:49.479 --> 00:03:51.099 the rectum some people find pleasurable too. 00:03:51.439 --> 00:03:53.400 And you might notice this if you just have a 00:03:53.400 --> 00:03:56.800 very like full bowel movement and you release 00:03:56.800 --> 00:03:59.659 it, the movement of that going through the rectum, 00:03:59.759 --> 00:04:01.759 the sense of fullness can also be pleasurable. 00:04:02.860 --> 00:04:06.000 So those are the main anatomical sources that 00:04:06.000 --> 00:04:10.379 I've learned about. Awesome, awesome. And so 00:04:10.379 --> 00:04:13.509 outside of our... physiological anatomy, what 00:04:13.509 --> 00:04:17.089 role do our brains and mindsets play in how we 00:04:17.089 --> 00:04:19.990 experience anal pleasure? Yeah, this is a good 00:04:19.990 --> 00:04:22.949 one. So, you know, in the same way I asked people 00:04:22.949 --> 00:04:26.730 to rub the palm of your hand with your other 00:04:26.730 --> 00:04:30.490 hand. Well, you know, I have lived in New York 00:04:30.490 --> 00:04:32.689 City for a while, so there's a lot of unwanted 00:04:32.689 --> 00:04:34.410 touching that happens in New York City on the 00:04:34.410 --> 00:04:35.790 subway, just the people are bumping into one 00:04:35.790 --> 00:04:38.439 another. So, you know, you can imagine like you 00:04:38.439 --> 00:04:39.980 know, someone on the subway, you don't know, 00:04:40.139 --> 00:04:43.420 suddenly rubbing your hand, maybe not so pleasurable. 00:04:43.579 --> 00:04:45.800 I mean, it might be something that you are aroused 00:04:45.800 --> 00:04:50.079 by because it's a stranger. But in general, unwanted 00:04:50.079 --> 00:04:52.160 touching is not something that people really 00:04:52.160 --> 00:04:55.420 enjoy. People want to feel a sense of connection, 00:04:55.420 --> 00:04:57.660 even if it's anonymous, a sense of connection 00:04:57.660 --> 00:05:01.240 with another person or people. So even though 00:05:01.240 --> 00:05:04.399 I've described these anatomical sources of pleasure, 00:05:04.639 --> 00:05:07.040 it's not like a button that you press. It's not 00:05:07.040 --> 00:05:09.600 like you know, apply pressure and suddenly someone 00:05:09.600 --> 00:05:12.379 is incredibly aroused and experiences pleasure 00:05:12.379 --> 00:05:15.779 in the same way that, you know, like rubbing 00:05:15.779 --> 00:05:18.620 someone's arm or having your arm rubbed by someone 00:05:18.620 --> 00:05:21.399 else. It depends on the person or people who 00:05:21.399 --> 00:05:23.699 are touching you and your relationship with them 00:05:23.699 --> 00:05:27.160 and your level of connection and interest and 00:05:27.160 --> 00:05:32.040 arousal and attraction. So the brain or how we 00:05:32.040 --> 00:05:35.160 respond emotionally is certainly tied to how 00:05:35.160 --> 00:05:38.779 we respond to the stimulation that could be pleasurable. 00:05:39.180 --> 00:05:42.259 And the other part of that is that the heart 00:05:42.259 --> 00:05:44.759 of a body that we're talking about also responds 00:05:44.759 --> 00:05:49.100 to stress and threat. So if people are feeling 00:05:49.100 --> 00:05:51.040 anxious or threatened, that part of the body 00:05:51.040 --> 00:05:56.019 can tighten up. But if we feel relaxed and welcomed, 00:05:57.019 --> 00:06:00.000 warm connection with other people, sexual arousal, 00:06:00.279 --> 00:06:03.730 that part of the body starts to relax. And that's 00:06:03.730 --> 00:06:06.810 when people can experience pleasure without any 00:06:06.810 --> 00:06:10.430 pain in that part of the body. Do you find that 00:06:10.430 --> 00:06:13.889 a lack of education or shame around anal sex 00:06:13.889 --> 00:06:16.730 interferes with people's ability to fully enjoy 00:06:16.730 --> 00:06:20.470 it? Okay, I'm going to say yes, but then I'm 00:06:20.470 --> 00:06:23.050 going to pause because you mentioned that you 00:06:23.050 --> 00:06:26.470 participated in this workshop last year. I did. 00:06:27.189 --> 00:06:29.910 And I've been doing a lot of talking and it's 00:06:29.910 --> 00:06:32.649 not really my MO to talk this much in response 00:06:32.649 --> 00:06:34.730 to questions. I really want to ask other people. 00:06:35.290 --> 00:06:37.509 So I'm just curious from you, if you're willing 00:06:37.509 --> 00:06:39.170 to answer this, we can have a little bit of a 00:06:39.170 --> 00:06:40.990 dialogue. What do you think? And then we can 00:06:40.990 --> 00:06:43.870 go back and forth about it. Yeah, I would say 00:06:43.870 --> 00:06:46.829 in general, like I would say shame, I feel like 00:06:46.829 --> 00:06:50.629 keeps a lot of people from trying it or being 00:06:50.629 --> 00:06:52.790 open to trying it because they're like, oh, that's 00:06:52.790 --> 00:06:55.550 not. That's not what that's for. And then I would 00:06:55.550 --> 00:06:59.589 say lack of education can affect that in that 00:06:59.589 --> 00:07:03.569 a lot of people don't know about that anatomy 00:07:03.569 --> 00:07:05.649 wise, especially men will be like, no, there's 00:07:05.649 --> 00:07:07.529 nothing supposed to ever go in there. But like, 00:07:07.589 --> 00:07:10.009 OK, that's literally what you just explained. 00:07:10.250 --> 00:07:12.310 How you experience orgasm is feeling those muscles 00:07:12.310 --> 00:07:15.329 contract around the prostate. So obviously stimulating 00:07:15.329 --> 00:07:19.029 that would be pleasurable. Or yes, I would say 00:07:19.029 --> 00:07:21.790 in those regards, those types of preconceptions 00:07:22.220 --> 00:07:25.980 can affect. Yeah. Yeah. I mean, there's a lot 00:07:25.980 --> 00:07:29.000 of shame around sex in general. In the United 00:07:29.000 --> 00:07:31.860 States, it's not always the same in different 00:07:31.860 --> 00:07:34.240 subcultures. It's not the same across the world 00:07:34.240 --> 00:07:36.920 that we experience shame related to sex. But 00:07:36.920 --> 00:07:39.100 then you take something that's as stigmatized 00:07:39.100 --> 00:07:45.139 as anal sex, and people tend to not learn information 00:07:45.139 --> 00:07:48.560 because they expect shame about asking questions. 00:07:49.069 --> 00:07:51.149 about the things that they want to experience 00:07:51.149 --> 00:07:53.550 or curious about experiencing or have experienced 00:07:53.550 --> 00:07:58.110 but want to learn more about. And the evolutionary 00:07:58.110 --> 00:08:01.490 purpose of shame, at least as I've been taught 00:08:01.490 --> 00:08:04.589 and learned, is to protect ourselves from rejection 00:08:04.589 --> 00:08:07.689 from other people, which means that then we retreat 00:08:07.689 --> 00:08:10.790 from being open with other people about the things 00:08:10.790 --> 00:08:13.970 that we want to experience or learn about. What 00:08:13.970 --> 00:08:17.189 I've learned from the science of this that I've 00:08:17.189 --> 00:08:20.209 done over a number of years is that Most people 00:08:20.209 --> 00:08:23.829 who have anal sex or have experimented with it 00:08:23.829 --> 00:08:27.509 have learned by trial and error. And they learn 00:08:27.509 --> 00:08:29.569 by trial and error because they don't have great 00:08:29.569 --> 00:08:32.470 sources of information or resources of people 00:08:32.470 --> 00:08:35.250 that they can contact that they think are credible 00:08:35.250 --> 00:08:37.629 and reliable and have their best interest at 00:08:37.629 --> 00:08:40.070 heart. So most people are learning from pornography, 00:08:40.669 --> 00:08:44.289 resources that they can access online now. But 00:08:44.289 --> 00:08:47.440 then they encounter all sorts of problems. they 00:08:47.440 --> 00:08:49.539 think okay it's supposed to hurt before it's 00:08:49.539 --> 00:08:51.679 going to be pleasurable or just have to tolerate 00:08:51.679 --> 00:08:53.799 the pain which is not true there's really no 00:08:53.799 --> 00:08:56.379 reason to experience physical pain or emotional 00:08:56.379 --> 00:09:00.220 pain during anal sex at all can be purely pleasurable 00:09:00.220 --> 00:09:03.059 but people don't have that little bit of information 00:09:03.059 --> 00:09:05.840 they also don't have knowledgeable credible reliable 00:09:05.840 --> 00:09:09.139 sources that are accurate about how to do that 00:09:09.139 --> 00:09:11.399 how to approach it in a way that doesn't cause 00:09:11.399 --> 00:09:15.110 pain so there's a lot of A lot of reason why 00:09:15.110 --> 00:09:17.330 lack of education and shame are linked together 00:09:17.330 --> 00:09:20.330 in that question that you asked. Thank you for 00:09:20.330 --> 00:09:24.350 that. So next up, let's talk about being clean 00:09:24.350 --> 00:09:26.929 and comfortable. Anal sex can bring up a lot 00:09:26.929 --> 00:09:30.629 of concerns around cleanliness. So what's a realistic 00:09:30.629 --> 00:09:34.889 way to think about that? Yeah, I love this question 00:09:34.889 --> 00:09:39.710 too. When I was doing my dissertation work, I 00:09:39.710 --> 00:09:42.389 was trying to measure stigma toward anal sex 00:09:42.389 --> 00:09:44.330 and then see if it had any public health impact. 00:09:44.490 --> 00:09:46.789 And so to measure it, I was interviewing a bunch 00:09:46.789 --> 00:09:50.110 of people and then trying to create a scale. 00:09:50.210 --> 00:09:51.850 And as I was interviewing people, I was just 00:09:51.850 --> 00:09:54.129 asking them about what they had learned about 00:09:54.129 --> 00:09:58.789 anal sex, what their experiences were. And one 00:09:58.789 --> 00:10:01.870 person was talking about the shame that some 00:10:01.870 --> 00:10:05.850 people experience about cleanliness. People are 00:10:05.850 --> 00:10:09.509 concerned about contact with poop. fecal matter, 00:10:09.629 --> 00:10:12.309 shit, whatever you want to call it. And the concern 00:10:12.309 --> 00:10:15.549 about that is because if something is going inside 00:10:15.549 --> 00:10:18.710 of past the anus, the anal opening, and then 00:10:18.710 --> 00:10:20.169 into the rectum, which is about five to nine 00:10:20.169 --> 00:10:22.350 inches long, they're concerned that they're going 00:10:22.350 --> 00:10:26.590 to come in contact with fecal matter. And one 00:10:26.590 --> 00:10:29.370 thing that people may not realize is that when 00:10:29.370 --> 00:10:32.309 you've got enough fiber in your diet, generally 00:10:32.309 --> 00:10:35.470 when you've got enough fiber in your diet, then 00:10:35.470 --> 00:10:40.169 poop that enters the rectum, is properly bulky 00:10:40.169 --> 00:10:44.429 and full. And when you have that experience of, 00:10:44.769 --> 00:10:46.210 I've got to go to the bathroom, that's the sense 00:10:46.210 --> 00:10:48.669 that poop has actually entered the rectum. And 00:10:48.669 --> 00:10:51.409 then when you release it, it generally all releases 00:10:51.409 --> 00:10:55.149 as a whole material or bulky material. And then 00:10:55.149 --> 00:10:57.570 there's very little, if anything, left inside 00:10:57.570 --> 00:11:00.190 of the rectum. There's some microscopic bits 00:11:00.190 --> 00:11:02.980 of fecal matter that can be in there. But in 00:11:02.980 --> 00:11:04.679 general, if you were to then insert an object 00:11:04.679 --> 00:11:06.980 into the rectum, you wouldn't come in contact 00:11:06.980 --> 00:11:10.659 with any visible signs of fecal matter. The problem 00:11:10.659 --> 00:11:13.080 is that most of us don't have enough fiber in 00:11:13.080 --> 00:11:18.179 our diets. Also, we've got medical conditions, 00:11:19.039 --> 00:11:22.039 medications that we take, irritable bowel syndrome 00:11:22.039 --> 00:11:25.820 is something that people experience, gluten allergies, 00:11:26.419 --> 00:11:28.899 HIV medications themselves sometimes can cause 00:11:28.899 --> 00:11:31.200 some Difficulty with bowel movements or just 00:11:31.200 --> 00:11:34.080 living with HIV for a long time can also have 00:11:34.080 --> 00:11:38.440 an impact on people's bowel movements. So, you 00:11:38.440 --> 00:11:41.480 know, I'm describing the ideal, right? But none 00:11:41.480 --> 00:11:44.519 of us actually live in the ideal. Many of us 00:11:44.519 --> 00:11:47.679 are living with the reality of, like, you know, 00:11:47.759 --> 00:11:51.299 our poops are not always so clean. When we wipe 00:11:51.299 --> 00:11:53.200 with a piece of toilet paper, usually there's 00:11:53.200 --> 00:11:55.299 something left on there which suggests, oh, there's, 00:11:55.299 --> 00:11:57.500 you know, something still in there. So that's 00:11:57.500 --> 00:11:59.620 the reason why this question keeps popping up. 00:11:59.899 --> 00:12:03.460 Okay. It's a long answer to get to it, but you 00:12:03.460 --> 00:12:06.220 asked specifically, what can people do about 00:12:06.220 --> 00:12:09.779 it? Right. So I asked a realistic way to think 00:12:09.779 --> 00:12:11.600 about that. And actually you did, you did kind 00:12:11.600 --> 00:12:14.659 of give like a little, and I think the only thing 00:12:14.659 --> 00:12:17.259 that I would say I would add to that is that, 00:12:17.259 --> 00:12:20.750 you know, In general, sex isn't necessarily the 00:12:20.750 --> 00:12:23.350 cleanest activity, right? There are bodily fluids. 00:12:23.490 --> 00:12:25.570 And so when we're thinking about anal sex, just 00:12:25.570 --> 00:12:27.750 because it's a different area of the body and 00:12:27.750 --> 00:12:29.269 different matter that we're coming into contact 00:12:29.269 --> 00:12:32.009 with, it's just remembering that we're dealing 00:12:32.009 --> 00:12:36.509 with human bodies. Yes. Yes. So I'm so glad that 00:12:36.509 --> 00:12:39.149 you said that because you reminded me the reason 00:12:39.149 --> 00:12:41.669 I was talking about that dissertation work and 00:12:41.669 --> 00:12:43.129 interviews is because there are two things that 00:12:43.129 --> 00:12:45.049 people said to me in those interviews that really 00:12:45.049 --> 00:12:48.629 are memorable. One is someone said, or when you're 00:12:48.629 --> 00:12:50.129 digging for diamonds every once in a while, you're 00:12:50.129 --> 00:12:53.309 going to encounter coal. And that was this person's 00:12:53.309 --> 00:12:56.169 way of saying, you know, be realistic. It's part 00:12:56.169 --> 00:12:57.909 of the body, right? You can experience pleasure, 00:12:58.409 --> 00:13:00.730 but you might, you know, you might encounter 00:13:00.730 --> 00:13:02.970 something that you didn't want to encounter. 00:13:03.110 --> 00:13:04.409 But it doesn't mean that you didn't experience 00:13:04.409 --> 00:13:06.269 the pleasure. You can still experience the pleasure, 00:13:06.529 --> 00:13:09.929 even if you do encounter that. And a related 00:13:09.929 --> 00:13:13.269 story to that is someone telling me he had a 00:13:13.269 --> 00:13:16.669 sexual experience with someone and During the 00:13:16.669 --> 00:13:19.049 experience he felt like he had a little bit of 00:13:19.049 --> 00:13:21.610 an accident and he left some fecal matter on 00:13:21.610 --> 00:13:26.269 this person's Penis and he was this guy was mortified 00:13:26.269 --> 00:13:29.049 that he had done this just mortified He said 00:13:29.049 --> 00:13:33.509 but then his partner Just got up went over to 00:13:33.509 --> 00:13:36.149 the kitchen got a paper towel wiped it off came 00:13:36.149 --> 00:13:38.529 back and said it's not a problem and then just 00:13:38.529 --> 00:13:41.049 continued to enjoy each other's company and he 00:13:41.049 --> 00:13:44.379 said it was a very lovely, corrective experience 00:13:44.379 --> 00:13:47.580 that he had internalized this message that there's 00:13:47.580 --> 00:13:49.679 something wrong if that happens or it's a bad 00:13:49.679 --> 00:13:52.799 thing. But as you said, Danielle, like sex is 00:13:52.799 --> 00:13:55.500 not always like a, or sex generally is not a 00:13:55.500 --> 00:13:57.519 like a clean endeavor. There are body fluids 00:13:57.519 --> 00:14:00.500 happening. And actually, in fact, we want body 00:14:00.500 --> 00:14:03.580 fluids to happen because you need them in order 00:14:03.580 --> 00:14:07.519 to make things fun and lubricate it. So, you 00:14:07.519 --> 00:14:09.639 know, you could be realistic about it and accept 00:14:09.639 --> 00:14:11.889 it. If you're really concerned about it, then 00:14:11.889 --> 00:14:13.649 there are, you know, of course, resources of 00:14:13.649 --> 00:14:15.570 other things you can do. And we can talk about 00:14:15.570 --> 00:14:17.389 this website we've developed for this project 00:14:17.389 --> 00:14:19.509 and where you can learn a little bit more information 00:14:19.509 --> 00:14:25.070 about that if you want. Yeah, yeah. And so speaking 00:14:25.070 --> 00:14:28.230 of things that you can do, douching, is it necessary? 00:14:29.169 --> 00:14:31.350 Well, in a way, we've kind of already answered 00:14:31.350 --> 00:14:33.870 it, right? It's not necessary if you feel comfortable 00:14:33.870 --> 00:14:37.179 not doing it. But so if people do want to douche, 00:14:37.399 --> 00:14:39.840 what are the safest methods and how often should 00:14:39.840 --> 00:14:43.440 this be performed? So in answering this question, 00:14:43.460 --> 00:14:47.659 I have to preface it by saying there is some 00:14:47.659 --> 00:14:51.019 scientific information about the topic of douching. 00:14:51.120 --> 00:14:53.799 And in general, when it comes to anal sex, there's 00:14:53.799 --> 00:14:57.360 like information we know, information we really 00:14:57.360 --> 00:14:59.460 don't know, and then somewhere in between like. 00:14:59.659 --> 00:15:02.320 kind of best practices, a little bit of science 00:15:02.320 --> 00:15:04.720 there, but we're not completely sure about the 00:15:04.720 --> 00:15:08.340 best answer. And douching is one of those. There's 00:15:08.340 --> 00:15:10.779 been more research in recent years about douching, 00:15:10.820 --> 00:15:14.159 in part because there are HIV scientists who 00:15:14.159 --> 00:15:17.360 want to figure out a way to introduce something 00:15:17.360 --> 00:15:20.720 like pre -exposure prophylaxis, or even potentially 00:15:20.720 --> 00:15:25.720 post -exposure prophylaxis, in douches, so that 00:15:25.720 --> 00:15:29.370 people can like prevent HIV. that way. If they're 00:15:29.370 --> 00:15:31.570 already douching, then it makes sense to do something 00:15:31.570 --> 00:15:35.029 that, as scientists call, is behaviorally congruent. 00:15:35.049 --> 00:15:36.850 You're already doing it. It's congruent with 00:15:36.850 --> 00:15:38.990 what you're already doing. Then let's see if 00:15:38.990 --> 00:15:41.590 there's a way to help you do that and prevent 00:15:41.590 --> 00:15:44.509 HIV, too. So there's a little bit of research 00:15:44.509 --> 00:15:48.210 on that. So what I have learned from that is 00:15:48.210 --> 00:15:50.549 that, in general, if you're going to introduce 00:15:50.549 --> 00:15:55.269 a liquid into the body, it should be just water 00:15:55.269 --> 00:15:57.649 that's body temperature. You don't need to add 00:15:57.649 --> 00:16:02.289 anything to it. Just introduce that water into 00:16:02.289 --> 00:16:04.549 the body. It should be about the size of like 00:16:04.549 --> 00:16:07.029 a, you know, like a small bottle of water that 00:16:07.029 --> 00:16:11.129 you get at a store. Yeah, like that. Thank you. 00:16:11.230 --> 00:16:13.950 Yeah, I couldn't remember the number of it. Thank 00:16:13.950 --> 00:16:16.970 you. So about that size, you hold in the body 00:16:16.970 --> 00:16:19.409 for a little bit. You let it evacuate. You can 00:16:19.409 --> 00:16:22.389 do that two more times. That's generally the 00:16:22.389 --> 00:16:24.549 rule of thumb that I've learned from people who've 00:16:24.549 --> 00:16:27.879 been studying. rectal douches in the context 00:16:27.879 --> 00:16:30.500 of trying to come up with what we call microbicides, 00:16:30.559 --> 00:16:32.379 something that could prevent HIV in the future. 00:16:33.019 --> 00:16:35.960 But we don't have a lot of great data on that. 00:16:35.960 --> 00:16:38.120 This is just from those studies that have been 00:16:38.120 --> 00:16:41.580 conducted so far. Awesome. Awesome. I didn't 00:16:41.580 --> 00:16:44.000 even know that they were attempting to put microbicides 00:16:44.000 --> 00:16:46.759 and douches. Learn something new today. Yeah, 00:16:46.779 --> 00:16:50.480 it's been a long, long effort to do that. So 00:16:50.480 --> 00:16:53.789 to make those available and In this context around 00:16:53.789 --> 00:16:55.830 science these days, we don't know what's going 00:16:55.830 --> 00:16:57.690 to happen to that research or if it's going to 00:16:57.690 --> 00:16:59.269 continue. But there have been a lot of people 00:16:59.269 --> 00:17:00.610 who have done a lot of great work on that front. 00:17:02.269 --> 00:17:03.990 I want to talk a little bit about lubrication, 00:17:04.130 --> 00:17:07.849 toys, and protection. But just to bridge between 00:17:07.849 --> 00:17:10.029 the conversation about douching and this other 00:17:10.029 --> 00:17:12.890 conversation, what are some things that people 00:17:12.890 --> 00:17:17.789 should avoid putting in or around the anus? Yes. 00:17:18.250 --> 00:17:22.990 I'm going to make a plug. I'm going to make a 00:17:22.990 --> 00:17:27.150 plug for a podcast that was done a couple years 00:17:27.150 --> 00:17:29.490 ago, maybe just a year ago. It's on our website 00:17:29.490 --> 00:17:33.089 and it's by the Queer Health podcast. Just because 00:17:33.089 --> 00:17:34.390 it says Queer Health doesn't mean you have to 00:17:34.390 --> 00:17:37.349 be queer to listen to it. It's just a very thorough 00:17:37.349 --> 00:17:40.589 discussion about douching and very accessible. 00:17:40.789 --> 00:17:43.990 It's got resources and links to things too. So 00:17:43.990 --> 00:17:46.089 we can talk about that. I think maybe in your 00:17:46.089 --> 00:17:48.990 show notes we can link to that specific podcast 00:17:48.990 --> 00:17:52.190 or to our website. So what you do not want to 00:17:52.190 --> 00:17:55.069 introduce are things that have a lot of sugars 00:17:55.069 --> 00:17:56.950 or salts in them. You want to just introduce 00:17:56.950 --> 00:18:00.609 something that's neutral. It's just water. Because 00:18:00.609 --> 00:18:04.269 if you introduce sugars and salts, it draws out 00:18:04.269 --> 00:18:08.009 the water that's already in the rectal lining 00:18:08.009 --> 00:18:10.809 and then can compromise that rectal lining. So 00:18:10.809 --> 00:18:14.609 this is like high school science that I'm not 00:18:14.609 --> 00:18:16.329 sure I'm going to remember perfectly, but the 00:18:16.329 --> 00:18:20.630 term is osmosis. So the water is going to pass 00:18:20.630 --> 00:18:24.930 through a porous membrane and move into the more 00:18:24.930 --> 00:18:30.109 concentrated area. So it depletes in some studies 00:18:30.109 --> 00:18:33.829 that have sown at least with lubricants, that 00:18:33.829 --> 00:18:35.970 if you introduce a lubricant that's high in sugars 00:18:35.970 --> 00:18:40.730 or salts, then it can draw out that liquid and 00:18:40.730 --> 00:18:43.269 then compromise the lining. So we don't want 00:18:43.269 --> 00:18:45.609 to do that, is the idea. Some people have concerns 00:18:45.609 --> 00:18:47.890 about the amount of liquid that they introduce. 00:18:48.529 --> 00:18:50.630 So I mentioned that the rectum is five to nine 00:18:50.630 --> 00:18:52.750 inches long. And when I say five to nine inches, 00:18:52.829 --> 00:18:55.650 I don't mean like it goes from five to nine inches 00:18:55.650 --> 00:18:58.230 in an individual person and expands. I mean like 00:18:58.230 --> 00:18:59.950 there's this human variability and diversity. 00:19:00.309 --> 00:19:03.309 So in some people it's five inches, in some people 00:19:03.309 --> 00:19:04.990 it's nine inches, in some people it's shorter, 00:19:05.089 --> 00:19:07.789 some people it's longer. The reason why we were 00:19:07.789 --> 00:19:10.690 talking about this 12 ounces is because that's 00:19:10.690 --> 00:19:12.970 about how much you can hold inside of the rectum. 00:19:13.009 --> 00:19:15.089 So you want to put in as much as you feel like 00:19:15.089 --> 00:19:17.470 is comfortable for you to hold, but don't feel 00:19:17.470 --> 00:19:19.930 like you have to push the entire bottle in. The 00:19:19.930 --> 00:19:21.789 more liquid that you introduce, the more likely 00:19:21.789 --> 00:19:24.910 you are to go past the rectum and into what we 00:19:24.910 --> 00:19:27.410 call the sigmoid colon, which is a little S curve 00:19:27.410 --> 00:19:32.210 that's up above the rectum. And then that is 00:19:32.210 --> 00:19:33.990 where there's more likely to be fecal matter. 00:19:35.099 --> 00:19:37.920 waiting to enter the rectum. So we generally 00:19:37.920 --> 00:19:41.480 want to avoid washing that into the rectum because 00:19:41.480 --> 00:19:43.279 then you're introducing more fecal matter rather 00:19:43.279 --> 00:19:44.839 than washing out anything that might be in the 00:19:44.839 --> 00:19:48.680 rectum. You talked a little bit about lubes with 00:19:48.680 --> 00:19:52.059 sugars and salt and lube can be very, very good 00:19:52.059 --> 00:19:54.920 for anal play. So can you walk us through the 00:19:54.920 --> 00:19:57.259 types of lube like water -based, silicone, oil 00:19:57.259 --> 00:19:59.380 -based and how to choose the right one? You said 00:19:59.380 --> 00:20:01.579 it can be very good and for many people it's 00:20:01.579 --> 00:20:04.490 absolutely essential. because the rectum doesn't 00:20:04.490 --> 00:20:06.809 really produce a lot of natural lubrication. 00:20:06.970 --> 00:20:10.890 There's some mucus that it produces, but generally 00:20:10.890 --> 00:20:15.450 not enough for the friction of stimulation of 00:20:15.450 --> 00:20:19.490 an object going in and out of the rectum. So 00:20:19.490 --> 00:20:22.549 people generally then apply some kind of lubricant. 00:20:22.710 --> 00:20:25.930 And there are naturally occurring lubricants, 00:20:26.390 --> 00:20:30.529 for example, saliva, spit. If people are not 00:20:30.529 --> 00:20:35.759 using a barrier method. Pre -ejaculate also can 00:20:35.759 --> 00:20:39.740 be a source of lubrication. And if people are 00:20:39.740 --> 00:20:43.500 having vaginal sex and anal sex, it's possible 00:20:43.500 --> 00:20:46.400 if there's natural lubrication in the vagina, 00:20:46.839 --> 00:20:50.240 then that can help lubricate inside of the rectum 00:20:50.240 --> 00:20:52.779 as well. I'm not saying that this is what we 00:20:52.779 --> 00:20:55.220 recommend and these are best practices. I'm saying 00:20:55.220 --> 00:20:58.359 this is realistically what people do. One note 00:20:58.359 --> 00:21:01.279 on that about vaginal and anal sex is that the 00:21:01.279 --> 00:21:03.980 bacteria that live in the vagina and the bacteria 00:21:03.980 --> 00:21:06.240 that naturally live in the rectum. You don't 00:21:06.240 --> 00:21:08.640 want to introduce bacteria from the rectum into 00:21:08.640 --> 00:21:12.920 the vagina, because you can create UTIs and other 00:21:12.920 --> 00:21:15.380 issues. The vagina doesn't like to live with 00:21:15.380 --> 00:21:17.500 the bacteria of the rectum. So basically, in 00:21:17.500 --> 00:21:20.319 the same way that you would wipe after peeing, 00:21:20.660 --> 00:21:24.079 you go front to back rather than back to front. 00:21:25.019 --> 00:21:26.839 So you don't introduce bacteria from the rectum 00:21:26.839 --> 00:21:29.809 into the vagina, right? I would like to repeat 00:21:29.809 --> 00:21:33.029 that because a lot of people engaging in these 00:21:33.029 --> 00:21:35.670 activities don't seem to understand. You can 00:21:35.670 --> 00:21:38.609 penetrate the vagina and then subsequently penetrate 00:21:38.609 --> 00:21:41.230 the anus. Penetrating the anus and subsequently 00:21:41.230 --> 00:21:45.309 penetrating the vagina is not good unless you 00:21:45.309 --> 00:21:50.109 are washing after or in between. Yes, yes, yes. 00:21:50.230 --> 00:21:52.809 Gold star to this explanation. Thank you for 00:21:52.809 --> 00:21:55.599 saying it again. So those are some natural sources 00:21:55.599 --> 00:21:57.940 of lubrication, the sense of like they're in 00:21:57.940 --> 00:22:01.200 your bodies already and people tend to use them. 00:22:01.599 --> 00:22:04.259 But they may not be sufficient to be able to 00:22:04.259 --> 00:22:06.759 have anal play in a way that feels really like 00:22:06.759 --> 00:22:09.519 relaxed and comfortable because may not be enough 00:22:09.519 --> 00:22:12.680 natural lubrication in that way. So then people 00:22:12.680 --> 00:22:15.059 introduce lubricants and there are three general 00:22:15.059 --> 00:22:17.819 types of them. Some people know this already, 00:22:17.819 --> 00:22:20.980 but some people really haven't heard this. So 00:22:20.980 --> 00:22:23.759 there are water -based lubricants, They get pretty 00:22:23.759 --> 00:22:27.099 well absorbed into the body pretty quickly. So 00:22:27.099 --> 00:22:28.819 if you're going to use a water -based lubricant 00:22:28.819 --> 00:22:32.799 for anal sex or anal play, then you need to keep 00:22:32.799 --> 00:22:36.319 repeating the addition of more lubricant, more 00:22:36.319 --> 00:22:38.900 lubricant, more lubricant. Because it will eventually 00:22:38.900 --> 00:22:40.740 get, the water will get absorbed into the body 00:22:40.740 --> 00:22:45.079 and then it'll stop having as much of a fluid 00:22:45.079 --> 00:22:48.119 lubricating effect. It's a little sticky too. 00:22:49.319 --> 00:22:51.079 Yeah, exactly. And it can get a little bit sticky 00:22:51.079 --> 00:22:54.609 too. And then there are silicone -based lubricants. 00:22:54.970 --> 00:22:57.829 And silicone -based lubricants are really just 00:22:57.829 --> 00:23:00.930 tiny, tiny, tiny beads that you can't see and 00:23:00.930 --> 00:23:03.950 that, as far as we know, don't get absorbed into 00:23:03.950 --> 00:23:08.069 the body, too. And those little beads just rub 00:23:08.069 --> 00:23:10.049 up against one another and roll around with one 00:23:10.049 --> 00:23:12.069 another. But because they're not absorbed into 00:23:12.069 --> 00:23:16.650 the body, they stay lubricating. So you don't 00:23:16.650 --> 00:23:19.630 really need to keep adding a lot of silicone 00:23:19.630 --> 00:23:22.119 -based lubricant. which is why generally people 00:23:22.119 --> 00:23:24.819 recommend a silicone -based lubricant if you're 00:23:24.819 --> 00:23:29.059 going to engage in anal play. And then the third 00:23:29.059 --> 00:23:32.319 option would be an oil -based lubricant. And 00:23:32.319 --> 00:23:34.400 generally, they're not recommended for anal play 00:23:34.400 --> 00:23:37.460 because oil can also collect bacteria, and so 00:23:37.460 --> 00:23:40.880 that may cause some issues in the rectum. But 00:23:40.880 --> 00:23:44.200 there are some oils that are naturally antibiotic, 00:23:44.819 --> 00:23:48.640 like coconut oil, so that may be able to be used 00:23:48.640 --> 00:23:51.970 in anal play. without any particular concerns. 00:23:53.210 --> 00:23:54.829 Remember what I said about, like, there's the 00:23:54.829 --> 00:23:57.509 stuff that we know for sure, the stuff we definitely 00:23:57.509 --> 00:23:59.009 don't know, and then there's the stuff in the 00:23:59.009 --> 00:24:00.670 middle. This is kind of the stuff in the middle. 00:24:01.109 --> 00:24:04.269 People certainly have been using oil -based lubricants 00:24:04.269 --> 00:24:06.869 for anal play. You have to experiment and see 00:24:06.869 --> 00:24:08.829 what works for you. But there are some words 00:24:08.829 --> 00:24:11.490 of caution about each of these different options. 00:24:11.509 --> 00:24:14.650 So if it's water -based lubricant, then you got 00:24:14.650 --> 00:24:17.650 to be sure that you're continuing to add it repeatedly. 00:24:18.430 --> 00:24:21.509 because it will start to wear off its lubricating 00:24:21.509 --> 00:24:24.250 effect. So using silicone -based lubricants, 00:24:24.710 --> 00:24:26.609 there are two things. One is it can stain your 00:24:26.609 --> 00:24:29.349 sheets. And also, if you're using any kind of 00:24:29.349 --> 00:24:33.789 silicone -based toy, then you can't use a silicone 00:24:33.789 --> 00:24:36.289 -based lubricant because it will wear away at 00:24:36.289 --> 00:24:38.910 the toy and cause it to wear down and fall apart. 00:24:39.349 --> 00:24:43.349 And then if you're using oil -based lubricants, 00:24:43.849 --> 00:24:47.170 then if you use a latex condom or glove or some 00:24:47.170 --> 00:24:50.700 kind of barrier, then oil will wear down on the 00:24:50.700 --> 00:24:54.240 latex. So you'd want to use water or silicone 00:24:54.240 --> 00:24:57.099 instead of that. And then you did mention the 00:24:57.099 --> 00:24:59.460 concerns with water -based. And this is specifically 00:24:59.460 --> 00:25:02.279 something I've seen a lot with the sugars and 00:25:02.279 --> 00:25:05.259 salt going into the anus. A lot of water -based 00:25:05.259 --> 00:25:08.839 lubricant contains glycerin, which is essentially 00:25:08.839 --> 00:25:11.799 the sugar. And that is one of those things that 00:25:11.799 --> 00:25:14.240 you said can cause that osmosis effect and dry 00:25:14.240 --> 00:25:18.279 out the anus. Exactly. So in the limited studies 00:25:18.279 --> 00:25:21.880 that have been done about lubricants, it's the 00:25:21.880 --> 00:25:24.319 ones that are high in sugars and salts that tend 00:25:24.319 --> 00:25:27.640 to wear out the lining, right? So exactly what 00:25:27.640 --> 00:25:30.460 you just said. And the only thing I'm going to 00:25:30.460 --> 00:25:32.579 add to it, which you may already know yourself 00:25:32.579 --> 00:25:37.339 too, is that lubricants for sex are not regulated 00:25:37.339 --> 00:25:40.740 by the Food and Drug Administration. So it's 00:25:40.740 --> 00:25:42.880 not like they have to go through extensive testing 00:25:42.880 --> 00:25:45.460 before they've been introduced to the market. 00:25:45.930 --> 00:25:49.529 And that also means that a formula, let's say 00:25:49.529 --> 00:25:54.569 you use IDLube, which is a brand of lube. This 00:25:54.569 --> 00:25:57.049 year, their ingredients could differ from what 00:25:57.049 --> 00:26:00.049 they had two years ago inside of them because 00:26:00.049 --> 00:26:01.849 they're not regulated by the Food and Drug Administration. 00:26:02.210 --> 00:26:05.349 So that's another area where we don't know some 00:26:05.349 --> 00:26:07.089 things, but what we do know is exactly what you 00:26:07.089 --> 00:26:10.420 said. All right. Well, that's all the time we 00:26:10.420 --> 00:26:13.059 have for today's episode. We will continue this 00:26:13.059 --> 00:26:15.539 conversation on our next episode of Prep and 00:26:15.539 --> 00:26:17.059 Play. See you next time.