Dear Dog-ter,
Before I started getting high I would only let a guy screw me until I came, usually about 20 minutes or so. Since crystal has joined the party, I love to get screwed for hours.

Lately though, I’ve been having a lot of pain after I get topped. I’ve tried creams like Preparation H to help ease the pain but the only thing that really helps is to take it easy for a few days. The pain is slowly getting worse but I can’t imagine giving up anal sex. I have a doctor that I like but I am way too embarrassed to talk with her about it. What should I do?
Too Embarrassed

Over the years, I have used humor to address the sensitive topics and questions sent in. This topic requires a different kind of bedside manner. Too often, feelings of shame and embarrassment make it difficult for guys to seek proper medical care for “sexually related pain.” Feelings of shame are quite common.

As you know, it is difficult to ignore rectal pain. Many things can go wrong with your butt – it is important that you don’t try to diagnose and treat problems on your own. A good rule of thumb is that if you have rectal pain that lasts for more than two days, you must speak with a doctor about it and get an exam! For many folks, having a doctor that you “like” is important. What is more important is that you have established an open line of communication with her or him. Find out early in your relationship if they are someone you can trust. If you can’t talk openly with your doctor about your drug use and the sex you enjoy, you should find a different doctor.

Besides pain, other rectal signs and symptoms can include the presence of blood, mucus discharge, sores, incontinence (loss of shit when you aren’t trying to take a crap), and cramping. If you have any of these, it’s time to see your doctor.

As you pointed out, use of crystal (and other drugs) can lead to longer bouts of anal sex. Crystal can block the body’s “pain” signals that normally limit the amount of anal sex you have. Also, some crystal users like to get fucked “harder.” Having longer and harder screwing sessions will make it more likely that your butt will become damaged. It is important to recognize the limits of your body and your butt — unfortunately crystal can make it difficult to recognize and stay within your limits. Learn to listen to your body — if you’ve been having rectal pain it’s telling you to “lay off”.

Again, it is important to find a doctor or clinician that you feel comfortable with. Someone you can share your medically related “secrets” with. You should be able to discuss your drug use, sexual practices and any symptoms you are having in an open way. Before you go in to see your doctor, try writing down your symptoms on a piece of paper. That way, if you get nervous, you won’t forget. If you’re not comfortable going to your doctor, consider visiting the Harborview STD clinic (see insert) or call the HIV/STD hotline at 303-692-2777 or Toll-free: 877-478-3448 for a referral.

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