Ask Debby Herbenick | How long is it okay to be on the pill?

Q Whenever I masturbate I get really close to orgasm and then have to stop. I’ll get very close (I think, anyway), but it’s like I can’t get all the way there because I always make myself stop because of all these bad feelings I have about masturbation, like that it’s wrong to do, and girls aren’t supposed to do that. I have all these memories of my mom catching me when I was a little kid and telling me how dirty it was and how wrong it was, and that I had to pray and ask for forgiveness for doing that. I’m old enough to get that the religious guilt was wrong of her to put on me, but these memories still get in the way. Don’t tell me to go out and have sex, either—that guilt is even worse. I want to do that someday, too, but it’s not in the cards for me right now.
A Quite a few women and men have felt separated from orgasmic sex by memories of rosary beads, confessional booths or parental insistence that masturbation, sex or genitals are bad/dirty/sinful. Then again, others find that their arousal is actually enhanced thanks to taboos about sex. Unfortunately, parents sometimes instill difficult, guilty thoughts in their children—usually without meaning any harm. Parenting is a tough job, and moms and dads typically do the best that they can, given how they were raised, what they learned as adults and how they experienced the world. I’ve heard so many different stories about people’s experiences with religious, familial or cultural guilt—one guy told me about a friend whose parents hung a poster of Jesus in his shower after they determined that the reason his showers had grown so long was due to his masturbation. Whatever the root causes of your masturbation guilt, you’re finding that it’s time to deal with the effects so that you can enjoy touching your body in pleasurable ways. Good for you! Two books are perfect for the job. Both are old-school but both are truly fantastic, and both deal with religious and family-related guilt around masturbation. They are For Yourself: The Fulfillment of Female Sexuality (Signet, $7.99) and Becoming Orgasmic (Fireside, $15). If one of these doesn’t do the trick, consider meeting with a sex therapist (aasect.org) who can offer more personalized support as you work through the ideas ingrained in your mind. Learning to orgasm is best supported by relaxation, patience and openness to experience, and those can easily feel stifled by guilt. The previously mentioned books, by the way, might help to start you on a path toward enjoying partnered sex, too.

Q I’m 24 years old and have been on the pill for six years. I have heard that it’s not good to take the pill for more than a few years and I’d like to get off. At the same time, I don’t want to get pregnant! I heard somewhere that there is a birth-control pill for men. Is that true? If so, where can we get one?
A Those pesky male birth-control pills are, sadly, just teasing little rumors. We still don’t have any effective means of hormonal birth control for men (though there are various pills, sprays and other possible preparations being studied), which leaves many women feeling as though they have few choices for birth control that don’t involve them popping synthetic hormones. I know, it sucks to have fewer choices than you want. The good news is that it’s not bad to take birth control pills for years on end—at least for most women (if you smoke cigarettes and are 35 or older, your risks for heart problems and stroke are significantly raised by the pill). If you are in generally good health, however, many health-care providers would point out the health benefits of being on birth control pills, such as the markedly lower risk of ovarian cancer for pill users—even (get this) for years and years after you stop taking the pill. All that said, maybe you feel as if you’ve devoted six years of your life to the pill and it’s time for a change. If that’s true, talk to your doctor about other options. If you’re still open to hormones, you might find that the vaginal ring (NuvaRing) is a decent choice, since you don’t have to take a pill every single day to make it work (NuvaRing involves a once-monthly insertion and removal of a flexible vaginal ring). If you’re done with popping hormones for a while, maybe you’re ready to return to condoms or natural family-planning methods (the latter are quite challenging to use correctly, so if you go that route, get detailed info from a nurse or health educator). To learn more about birth-control options, check out plannedparenthood.org.

Q I don’t know what to do. A lot of my friends are starting to settle down and get married. Me, I’m the perpetual single guy. I’m alone or with a dwindling number of single friends on weekends (I’ve given up being the “third wheel”—no more hanging out with married friends on weekends). At weddings, I’ve never taken a date. In fact, I don’t go out on many dates at all. I’ve only had two girlfriends in my life, even though I’m in my thirties. Neither one of them worked out. I’ve never had sex. It’s not that women don’t want to have sex with me. They do. Some have even been overly aggressive at trying to get me to have sex with them. My problem is that I am intensely disgusted by the idea of germs. Getting close with women has always been a horrible experience for me. I try not to kiss them, but you have to do it sometimes. I thought about having sex with condoms, but I’ve heard that you can pass herpes even if you use a condom. That nixed that. I don’t want to be single forever. I want a relationship. I just don’t know how to get over this.
A You’re like a younger (maybe even hotter?) Jack Nicholson looking for his Helen Hunt in As Good As It Gets. While it’s good that you’re cautious about germs and sexually transmissible infections (STI), when it gets to the point where your concern gets in the way of establishing meaningful, comfortable romantic relationships, that’s a problem. I guess if you wanted to spend your whole life alone, then fine. But you’re a guy who wants a relationship! As such, continued germ phobia won’t do for you. Please consider meeting with a counselor or therapist, or even talking to your primary care physician about your extreme worries about germs. In some cases, prescription medications offer enormous relief to people with similar anxieties, at least enough that they can live their lives in a less anxious way that makes it easier to meet people, date and—yes—even make out. As in, kiss with saliva and wetness and the possibility of catching the common cold. Or oral herpes. (But don’t let that stop you from kissing—many people find kissing to be one of the most connecting experiences of their lives.) Counselors also find great success working with patients through the use of cognitive-behavioral therapy, or systematic desensitization, which you can Google to learn more about (basically it involves thinking, step by step, about something anxiety-provoking, like kissing a woman, and each time you feel yourself getting anxious, you replace those thoughts with a happier, calming thought until—eventually—you can get through the entire thought process without anxiety). You can find a counselor through apa.org.