Dear Readers,

Something’s been nagging at me for the two weeks since I answered the question about urinary tract infections: Here’s an addendum. Using a diaphragm for birth control may also be associated with UTIs in women. Not all women with UTIs wear diaphragms–in fact, does anyone use ‘em anymore? Cartoonist Nicole Hollander had her character Sylvia recommend them as rain hats for cats, and that was about fifteen years ago.

For those of you who didn’t come of age in the diaphragm era, it’s a shallow latex cup that fits in the vagina, blocking sperm’s access to the cervix. Its edges are highly flexible (indeed, I seem to remember there was a metal spring inside an old one I dissected as a youth)–this facilitates insertion of the device, as it can be squeezed together into a sort of taco shape. (When squeezed thus and covered with contraceptive gel, it’d make a fine Frisbee for cats. Talk about your un-suave sexual moments! Gooey diaphragms flying through the air are some of my fondest memories. Not.)

Anyway, this spring makes the diaphragm fit tightly, and it presses up against the back of the urethra. Especially during the sort of "longer, harder, faster, more" bouts I referred to in the previous column, the diaphragm’s rim will exert even more pressure. The Student Health Center doc who prescribed mine didn’t tell me there might be any associated UTI risk when I used it–but some years (and UTIs) later, a kindly feminist clinician mentioned the link. Presumably the diaphragm’s rather unforgiving rim does on the vaginal side essentially what the pubic bone can do on the anterior side–irritate the urethra and increase by some factor the risk of UTI.

This is ancient history to most of you. But there’s a menstrual product on the market that is shaped just like a diaphragm – the "Instead"–which is structured with a flexible rim and a poly- plastic cup. The rim doesn’t hide an unforgiving metal spring, though, so the likelihood of this device being associated with UTIs is probably a good deal lower. As a kitty rain hat, it looks like it’d do just as well.

Dear Carol,

I’m looking for a mate and have just met a fantastic woman – but I’m not comfy with the way she looks. Yes, feminists, start your chainsaws–I don’t blame you. But I’m not Barbie/bimbo/cheerleader-hunting. I’m trying to be progressive. The best relationship in my life was with someone who was big–I loved her like crazy, and we separated very amicably for other reasons. But I have to admit that her wide body was a private source of uneasiness for me: I’d wrestle with the nagging voices in my head about it. I don’t want to be a victim and perpetrator of cultural programming, i.e. Playboy–I don’t want to fall for the pictures in my head. On the other hand, one has a right to aesthetic tastes: Some guys love wide women, and maybe they’re just not a fit for me. If I was her, I would want to be with someone who really appreciated her looks.

Spirituality tells me the heart is where it’s at. Indeed, I’ve found that intimacy, an ongoing mind-emotions-spirit connection with someone, is the ultimate aphrodisiac. However, there’s still that body thing. I’ll keep going out with this woman and see what arises. But I’m uneasy about it. Any suggestions or comments regarding what you’ve seen about looks and lasting, positive relationships? Anywhere online you’d suggest going where people can dialogue about such things? –D.H.

Dear D.H.,

Readers, any online suggestions? I don’t have any up my sleeve today. But I do think you might want to check out Hanne Blank’s new book Big Big Love, which addresses all kinds of issues about love, sex, and body size. I bet your honey would appreciate it too–if it’s not gracing her coffee table already.

I’m not going to state that looks are irrelevant–although they are less relevant to some of us than to others. I do think it’s possible to have, ah, catholic tastes, appreciating a wider range of age and size than our culture tends to eroticize commercially, and I think it’s very much worth encouraging yourself to appreciate this range. When it comes to erotic response it’s possible to go for the whole body or a favorite zone, or even just the look in their eyes–I know, since you are so fond of this woman now, that there is something about her that lights you up, and that’s the part you will continue to focus on in a long-term context.

Sure, almost every woman wants her body to be appreciated–but more women than not say they want love and appreciation for the whole self. The intimacy that you value and can provide is a great gift and can be the basis for a lasting erotic connection. And, to borrow a page from lesbian therapist JoAnn Loulan, sexual connection in an ongoing couple doesn’t have to be based in active passion and horniness: It can be based on willingness to share erotic time together. This sort of willingness is fundamentally based in intimacy–another signal that if you feel emotionally and spiritually happy with this woman, you can maintain erotic happiness as well. An erotic connection is certainly important to long-term happiness (and some couples would rate it higher than others), but many other aspects of interpersonal compatibility are also vital–a shared worldview and goals, ability to communicate, flexibility. Don’t forget those less "sexy" things when thinking about sexiness–they’re really the emotional bed upon which you will continue to make love.