Dear Carol,

I saw on the Good Vibrations Web site that there is a Kegelcisor for women. I’m curious if there is one for men. I’m interested in the health benefits mentioned on your site for exercising the PC muscle but am not aware of how to do this short of using a catheter which, from what I understand, increases the risk of urinary infection. And since the PC muscle is just in front of the bladder in men, I am not sure how one could exercise it. Any ideas? –Curious

Dear Curious,

I’m sure there are things you could do with a catheter that would allow you to exercise your pubococcygeal muscle–but I wouldn’t recommend that method. It’s not just the question of urinary infection; it also has to do with ease of exercise, and there are two much more accessible ways for men to do Kegels. The PC muscle actually has a figure-eight shape in men as well as women. It attaches at the pubis and the coccyx (hence its name), and crosses at the floor of the pelvis–basically, at the perineum, the spot between the penis (or vagina) and the anus. You don’t need to isolate the part of the muscle that’s near the bladder. It’s true that men as well as women can benefit from exercising these muscles–benefits include better blood flow to the genitals and stronger orgasms. One method, which you can do without using any sort of device, simply involves tensing and relaxing the muscles. You can find which muscle to isolate and exercise by stopping a stream of urine in midflow; the one you used to stop the urine is the muscle you’ll want to tense. Do this repeatedly, twenty to one hundred times–you can do it more than once a day if you really want to tone the muscle, but make sure you relax it, too, not just tighten. One way to make sure you’re doing the "relax" part of the cycle is to imagine you’re breathing out through the floor of your pelvis, or through your anus.

The other method involves using a device like the Kegelcisor to resist against, and many people prefer this because it helps them focus on the exercise (plus, it can feel good). It’s true that the Kegelcisor is designed for vaginal use, and men using a device for PC exercise will need to insert it anally. As a woman, you could use the Kegelcisor, which is shaped something like a barbell, anally–but it’s not recommended, since it has no base to prevent it from slipping all the way in. If you do use the Kegelcisor, take care not to let this happen. However, you could also use the S-curve-shaped lucite wand, which happens to also be recommended for men with prostatitis; you could also use anal beads or a slender dildo or an anal plug. The important thing is that the toy or device used gives you something to squeeze against. In the case of the beads, you can pull them gently–that will provide some extra resistance. The weight of the Kegelcisor serves the same function. No matter how you choose to do the exercises, PC strengthening will improve your genital health–and your access to pleasure.

Dear Dr. Queen,

I read with interest this week’s column in the East Bay Express; it sounds like much is known about the relative risk of AIDS transmission under various circumstances. What is known about the risk of sexual transmission of Hepatitis C? For example, is the virus present in saliva? Or, more specifically, is it present in semen? Could an infected man transmit the virus to a female partner during unusually vigorous (non-condom) sex which causes some blood to appear in his semen? In the event of such a happenstance, would there be any immediate measures (i.e. douching) which could reduce the risk of transmission? –Geo

Dear Geo,

Hepatitis B is definitely sexually transmissible, as is Hepatitis A under certain conditions–especially oral-anal. Just a few years ago Hep C went by the moniker "Non-A, Non-B"–which tells you about how much was known about it. The medical text at my side states gravely that B and Non-A, Non-B are "present in virtually all body fluids and excreta of carriers"–but that was back when Dr. Science hadn’t even identified the virus. B and C are primarily blood-borne, meaning that blood contact is the most efficient route of transmission, and hepatitis C is thought to be rarely sexually transmitted.

So I can’t be as specific as you would like about your (and your partners’) risk; it’s a little early to say with certainty what you can and cannot do. Phrases like "thought to be rarely sexually transmitted" aren’t guaranteed to completely soothe the unquiet mind. In your shoes I would definitely consider condom use as a backup to the less-than-perfectly-clear reassurance cited above, although I would probably relax about saliva.

However, even very vigorous intercourse does not often result in bloody semen; is this something that happened once, has happened more than that, or that you merely thought of as a worst-case scenario? Unless it’s the latter, I would recommend a visit to a good urologist. Blood in the semen would certainly make the chances of hep transmission a little higher, though the virus would still have to access your partner’s bloodstream. Douching is something I don’t typically recommend, as it can drive potentially infective material deeper into the vagina as well as rinse it out. And though you didn’t ask about it, consider unprotected anal intercourse problematic.