Ask Debby Herbenick | I am a 35-year-old gay man having sex with a woman for the first time

Q I recently had symptoms similar to herpes. As you can imagine, I was horrified and confused since I always wore condoms with my last girlfriend. I saw my doctor, who performed a viral culture, which came back negative. However, I’m still concerned. The symptoms went away after I started taking Valtrex and, from what I’ve read, viral cultures are not always accurate. I’m also unsure if my doctor had done a culture before, because he had problems doing the lancing. I’m left with a few panicked questions: Is there a different kind of doctor I should see if I have symptoms again? If I do have herpes, are there support groups in the Chicagoland area I could attend? Is it true that if I have HSV 2 that I can still get HSV 1?

A There’s nothing like fear of a sexually transmissible infection (STI) to prompt “a few panicked questions,” so good for you for asking what is on your mind—and I’m sure on the minds of other readers, too. People have many questions about herpes. First, there is the herpes simplex virus-type 1 (HSV-1; also called cold sores). HSV-1 is usually found on the lips but can be spread from mouth to genitals during oral sex. Then there’s HSV-2 which tends to “prefer” (or more easily be transmitted to and show symptoms on) the genitals—when this happens, we often say someone has “genital herpes” (as does 20–25% of the adult population). HSV-2 can be spread from genitals to mouth during oral sex, too. Because HSV-1 and HSV-2 are spread from contact with the skin or mucosal area—and condoms only cover a small amount of skin—they’re not a guarantee against what a reader once called “The Big Herp” [In&Out, TOC 92]. STI tests, particularly for herpes, are not perfect but they are reasonably good. If you’d like a second opinion, the Chicago Department of Public Health (among others is the Lakeview Specialty Clinic, 2861 N Clark St, 312-744-5507) routinely tests for STIs, as do Planned Parenthood clinics (plannedparenthood.org; and yes, most treat men) and the Howard Brown Health Center (howardbrown.org). You mentioned that you took Valtrex (an antiviral prescription that can reduce the risk of herpes outbreaks and transmission) but it’s unclear whether your symptoms coincidentally cleared on their own or as a result of treatment. Finally, yes, there are support groups (chicagohelp.org) and yes, if you do have HSV-2, you can still acquire HSV-1 from an infected partner.

Q I am a 32-year-old woman, and ever since I can remember, I have had inverted nipples and, since getting pubic hairs, hair around my areola. When I was younger, my sexual escapades were reduced as a result of my worry about it. Now that I’m older, I’m less concerned, but still wondering: How common are inverted nipples, and are there any medical risks involved? Also, I don’t like having hair on my breasts. I have been waxing on my own, and have noticed some additional hairs in some places. The last thing I want is more hair! I was considering laser but heard that it is a painful option and I worry that lasers might put me at risk for breast cancer. What recommendations do you have for removing hair on the breast?

A Ah, the gifts of quirky body parts. Some estimates suggest that about 10 percent of women have inverted nipples—there are no health risks. Many women also have hair around their areola (the roundish pigmented area around the nipples). Some women go natural with their breast hairs and, like you, learn to chill out about it over time. An old boyfriend once said to me, “every hair that’s growing on your body knows exactly what it is doing,” which made me feel he was cool with any hairs that I chose to keep. Though we didn’t stay in love, I stayed in love with that line. I used to think that if we were lucky, we found partners who were cool with our hairs . Now I’m more of the mind that we either choose partners who are accepting of us, or else we can help them learn to accept. If you decide to keep some or all of your hairs, then cool. If not, check in first with a dermatologist who can advise you on hair removal or hair reduction options, including laser hair reduction (not as scary or painful as you may think, but not appropriate for all skin types), electrolysis and medications (yes, some meds now treat certain hair growth issues). If nothing else, there is always waxing, which you’ve been doing and seem comfortable with.

Q I am a 35-year-old gay man and I am about to have sex with a woman for the first time. That’s right, unlike a lot of the gays, I never did a girl in high school. The woman I’m going to have sex with is a good friend of mine and wants to get pregnant the old-fashioned way, but has not found the right relationship partner. We have talked about the issues around friendship and emotions and have had lawyers draw up appropriate documents related to parenting rights. I feel prepared on all fronts except the sex part. I know that vaginas are not scary, and yet they are still foreign to me. With an anus, I can be rough. How gentle or rough should I be with her vagina? We will probably have to do it more than once. How much is too much? Are there any other vagina things I should know about before going in for the first time?

A So she wants a penis rather than a turkey baster. Well, good for you for calming your vagina anxieties prior to penetration. After all, you only have a limited amount of time to try to impregnate your friend each month and if you’re too nervous, the anxiety could cause erection loss and defeat the purpose. Sometimes I do a brief Vagina 101 for gay men (and by the way, there is actually a great video online that you might like called Cunts for Fags; find it at iamfivestar.com). After all, gay men find themselves facing a vagina for many reasons including impregnating friends, providing health education or learning to perform medical exams. First, the word “vagina” refers to the inside part (the birth canal), whereas the word “vulva” refers to the outside parts: the clitoris, clitoral hood, labia majora (outer lips), labia minora (inner lips), and vestibule (opening to the vagina). The vagina itself is warm and wet, thanks to natural lubrication. You don’t usually need much lube for vaginal intercourse, but have some water-based or silicone-based lube on hand—just not a lube with chlorhexidine in it such as the original version of K-Y, as some research suggests that ingredient may be toxic to sperm (K-Y’s other lines, and many other lubes, are free of this chemical). Some lubes can cause sperm to swim more slowly, so if pregnancy is your primary goal, consider going without. Like men and anal sex, some women like vaginal sex rough and some like it gentle; some are fine with one round and others (especially when making babies) may hold frequent call-backs. My best advice is, since you have covered the emotional and legal issues, get together and talk sex. Have her use the old “in and out” finger motions to show you how fast or slow she wants it, have her pound your thigh with her hand to give you a sense of roughness or gentleness. Through talking—and a little practice—you two should figure it out.