Dear Carol,

Can you draw blood from a hickey (just by sucking)? I have a friend who asked me about this and she believes her partner did, but some of our other friends think it was his gums bleeding (he's a drug user, so he has weak gums). Can you shed any light on this?
--Curious, Concerned Friend

Dear CCF,

A hickey happens when, due to sucking and sometimes chewing or biting, subcutaneous cells lose their ability to keep their cellular contents inside. It's sort of like a bruise created by suction, or actually, by a vacuum, which is a special kind of suction -- the kind you'd find a penis or clit pump creating. The mouth can be an even more efficient source of suction than these devices, plus it has teeth.

The skin has several layers -- the epidermis, which is keratinized (that is, its layers of cells are basically dried out, and form the part of the skin that protects the outside of our bodies. Under that there are live cells -- you can see this next layer when you get a mild scrape -- and these are filled with cellular fluid and fed with blood by tiny capillaries. The capillaries are so fine that the suction of a hickey can break them -- hence the blood that blooms under the skin of our necks or wherever a hickey is caused. Suction, of course, will bring blood to the surface anyway -- if you suck on an area, it will get pinker or redder than usual as extra blood is drawn to the surface -- but a hickey is typically a prolonged form of suction.

Unless the outer skin had been broken by teeth, however, it should be enough of a barrier to keep the blood inside. If there was visible, wet blood on the surface but the skin was not disturbed, I would suspect your friend's friends are right and the force of her boyfriend's suction actually made his gums bleed. If there *was* any noticeable skin breakage, it's possible (though not terribly likely) that the blood on the surface was hers. That chance increases, of course, the greater the damage to the skin. If her hickey later scabs over or the skin feels dryer than the surrounding skin, it means she *did* sustain some skin damage.

A note about safety -- Boyfriend with bleeding gums should be aware that whenever he used his mouth for sexual purposes, he's taking more risk than a person whose gums are intact. The few cases of oral-sex-related HIV that are pretty positively documented are likely the result of infected blood, semen, or vaginal fluids getting direct access to the bloodstream through the broken skin of the newly infected person's gums. I am personally aware of at least one such case. So if Boyfriend is as oral all the time as he is while he's playing vampires, he should be cautious. Does she run any risk being bitten by him? If he's an IV drug user, the possibility exists that he could be infected with something like HIV or hepatitis C. However, it would have to be a pretty gory hickey-fest, one that definitely broke the skin and drew blood, to put her at risk during this specific sexual activity -- and even then the risk to her would likely be very small. In general, surface skin sucking and licking are among the safest forms of safe sex.

Dear Queen of Hearts,

What is the throbbing sensation I feel after an orgasm? Is it blood flowing back into the body, small spasms of the pc muscle, strong pulse from increased heart rate...? Or what?
--Chris

Dear Chris,

It could be all or any of the above. Among other things, the process of sexual arousal and genital stimulation to orgasm involves the circulatory system, as blood rushes to the genitals and fills all the engorgeable tissue there (the longer and more perfect the stimulation, the more engorgement you'll probably experience). This blood does indeed gradually ebb out of the pelvic region after stimulation stops, and if this happens with an orgasm to climax the process, the pelvic muscles will have just given some pretty strong squeezes or pulses. (This part is dependent on how strong the pubococcygeal muscles are, and it's one reason why sex therapists, and we at Good Vibrations, recommend PC exercises -- stronger muscles make the orgasm feel stronger and more climactic.) Have you ever exercised to the point where your legs felt fluttery? Some people, especially those whose PC muscles really squeeze down hard, may experience something parallel.

In addition, the nerves in the area have been awakened and are sensitive to stimulation, perhaps much more so than usual. And blood pressure may have been raised quite a bit. It is certainly possible to tune in, in your sensitive yet relaxed post-orgasmic state, to your heart beating -- and in fact the circulatory system may be working so hard that you can feel your pulse in the femoral artery, which comes quite near the genitals on its way to your lower extremities. If, tuning in to your whole body, you feel this pulse all over, that's the cause of your throbbing.

All these elements will be present, by the way, in people of all genders. They may not be as present in orgasms that do not come from direct genital stimulation, as in the case of nipple stimulation resulting in orgasm, for example -- because some of these effects are related to friction. No matter what kind of an orgasm one has, though, it will involve nerves, muscle tension, and probably an increase in heart rate and respiration.

In addition, each of us is built roughly alike but also may have individual responses that are not common to everyone, in the same way that some of us are more easily orgasmic than others, and some of us do throb and others don't (or it's so subtle that we don't notice it). So I can't say with certainty what *your* throbbing is, especially without knowing more specifics -- exactly where is this throb? How long does it last? Does it feel more muscular or more circulatory? But the body systems described above are your most likely candidates, and if you try tuning in to your body, you may well be able to detect the source of your own personal throbbing.