Dear Carol,

I've been searching all over the Internet for information, and cannot find one stinking thing pertaining to my condition. Two days ago, my boyfriend and I had... er, how do you say? Very "abrasive" sex. We had been to a party earlier that night, and I was rather intoxicated at that point. Therefore, I was not lubricated as normal. But at the time I was too inebriated to feel it or care.

I am paying for that now.

The next morning, urination was painful, and my entire vulva was (and is) tender to the touch. VERY tender... I can also feel small lesion-like injuries in the area, and there is a small amount of discharge... Friction injuries, perhaps??

I've been using a peri-bottle to cleanse the area frequently throughout the day, and while there has been some improvement (it doesn't hurt so much to pee anymore), I wonder if I should be doing something else? It's been more than 48 hours, dammit!

PLEASE don't tell me just to see a doctor. I am petrified of going to see a physician about this. Compound that with the fact that I have a really crappy medical plan that covers almost nothing, and an ex-husband who doesn't pay child support, and I'm downright adamant against going.

I thank you for any advice you can throw my way!

--Jenn

Dear Jenn,

Owwww! I feel your pain! This is one more argument against having sex while inebriated, huh? First you can’t feel enough to come worth a damn, and then this. I have some good news for you, though – you’re on the right track. Your discomfort might not resolve right away, but if you add a few changes to your routine for dealing with it, you may be able to avoid the dreaded doctor.

I suspect you are right about what’s troubling you – unless your boyfriend got up to something unusual while you were feeling no pain, like using some really untoward substance as lube, most likely your injuries are the result of a very vigorous fuck with way too little lubrication. This would indeed give you the vulvovaginal equivalent of rug burn. The big difference between this and a friction injury sustained on your knees or elbows is the type of skin you have abraded. Epidermis – the skin on the rest of your body – and mucosal tissue act rather differently when subjected to too much friction. Here’s what I’d add about your regimen.

First, you don’t say what you’re putting in your peri-bottle (for those of you who don’t keep up with these things, that’s a perineal irrigation bottle – a fancy name for a squeeze bottle when you use it to sploosh your genitals, basically). You want to sploosh with not just plain water initially, but with saline. You can use the expensive drugstore kind, or you can mix a teaspoon of salt into tap water – although it’d be better if you filtered the water first, unless your tap water is quite unadulterated and pure. Warm this up a little – it shouldn’t be too hot, but a bit better than body temperature will feel soothing, most likely, and won’t shock your sensitive tissues with cold. Squirt yourself good three or four times a day. You might also, for the next couple of days or until the condition feels like it’s resolving, take warm sitz baths – just sit in a few inches of water, clean tub, no soap.

In both cases – squirting and sitz bathing – pat yourself dry, don’t rub. And pat with a clean cloth. When you pee, rinse with water afterwards – then pat, don’t rub. You don’t want to add any more abrasion right now.

That means, no sex for a few days, until you feel you’re better. It might also mean you should go without panties, give the air a chance to get at your vulva. If the discharge hasn’t stopped and going panty-less is actually causing more discomfort, take a handkerchief-sized square of clean gauze, fold it into the shape of a sanitary napkin, and wear that against your irritated skin. Change it as frequently as you pee or do lavage (that’s French for “sploosh with the peri-bottle full of warm saline”). You could probably also just wear a sanitary napkin – one with a smooth surface, please – but this would block air getting to your vulva, so the gauze is a better bet.

And finally, attack the pain with urination by drinking cranberry juice or other very-high-in-Vitamin-C beverages, ideally not too dosed with sugar. You may also be battling a bacterial infection or bruised urinary tract from being banged like a rag doll. I am guessing your boyfriend was equally drunk and was not exactly a sensitive new age guy during this rollicking bout of intercourse, and being banged like crazy can result in painful urination. You may in fact have two separate things going on – this, and the abrasion. If the pain increases, you may have to see a doc – but try calling to say that you think you have a urinary tract infection, and ask whether the doc can just prescribe what s/he usually does for that condition. It is so common that your doctor might possibly be willing to treat it without seeing you, so maybe you can get away with skipping the office visit. I know you don’t want to go, but believe me, if it is a urinary infection and it worsens, you’ll perhaps undergo a temporary attitude adjustment about Western medicine. Anyway, hit the cranberry juice before it gets to that.

And make a deal with your boyfriend that next time you’re that juiced, he should at least use some lube. The only problem with this sort of negotiation, of course, is that if you’re both drunk, it’s awfully easy to forget what you decided on while sober. And really that’s a whole other column. Good luck!

Dear Carol,

Is vaginal fisting without gloves safe? I am in a monogamous relationship and we have been doing this.

--Skin to Skin

Dear S2S,

Here are the elements that might make vaginal fisting without gloves unsafe:If the fist-ee has HIV or a similar sexually transmitted condition and thefister has broken skin on her or his hand, then there is a risk (probably not super-large, but some risk) of transmission. The more broken the skin, thegreater the risk. If you want a trick to help you decide whether you have broken skin, squeeze a lemon into some water and dunk your hand in -- if you feel stinging from the lemon, glove up. (If your skin is intact enough toserve as its own barrier, you shouldn't feel the sting.)

There is also an element of safety for the fist-ee in glove use: namely,that gloves cover up any raggedy nails and hard hangnails that might pokeor scratch the vaginal mucosa. This is less a big deal than HIV transmission, but still is worth noting.

However, if the fist-ee is sensitive to latex, it would be important to cover up using another kind of glove – denatured latex, sometimes called Nitrile, might work, and some people use vinyl, though that is not as stretchy.

And having said all this, many people choose to fist without using gloves and it is often quite a safe practice -- at least, when it's done with care in the first place. That includes using enough lube, trimming the nails, going slow.

You didn't ask about it, but let me tell you one of the biggest dangers with vaginal fisting. It's moving the hand from side to side while the fist is in, which can stretch the ligaments that hold the vagina in place within the pelvic cavity. This is not a good idea -- ligaments aren't elastic enough to resume their prior shape when stretched.

There’s one book on vaginal fisting that I can recommend -- A Hand in the Bush, which Good Vibes carries. If you haven’t seen it, perhaps it will prove helpful.