Positioning for safer sex


  • Putting Dr G On The Spot
  • Sunday, 22 Mar 2020

Dear Dr. G,

I hope you are keeping well during the movement control order (MCO) in Malaysia, I'm grateful that I'm spending with my lovely wife, as we were just married about two months ago.

Most people imagine how lucky we are that this "lockdown" is imposed during our honeymoon months. However, I have a confession to make: Our real honeymoon didn’t exactly go swimmingly well.

My wife and I are not exactly experienced in sex prior to the wedding. As I usually just go on top, my wife suggested we try something more adventurous during our wedding night. My wife decided to go “cowgirl” on me.

Perhaps she was a bit overzealous, but she caused a sudden a snap in my private parts. It was initially painful, naturally my erection collapsed and this was followed by a nasty bruise at the base of the penis.

We were both shocked and ended up in accident and emergency unit.

The doctors attending to me performed some tests. He said I was lucky I didn’t “fracture” my penis. However, I sustained a torn ligament. I was relieved the injury was not permanent. The doctor asked me to rest and be more cautious and to position better for safer sex!

I would like to put Dr. G on the spot on the issues of injury to the penis during sex. What exactly is a “fractured” penis? I didn’t even know the little “Johnny” had a bone to be fractured. Also, what is this torn ligament of penis? Is it dangerous?

On the issue of positioning for safer sex, can you clarify the normal positions couples adopt, and which ones are safer and ensure pleasure? Please help.

Yours truly,

Bruised Brain

First of all, I just want to clarify that human penis is not “blessed” with an internal bone. The erect penis is termed a “boner” because the entrapment of blood within a tough fibrous covering that envelops the penis’s corpora cavernosa makes it hard.

The outer layer of tunica albuginea in turn enforces the hardness during arousal to sustain erection for vigorous penetrative sex. A rapid blunt force to an erect penis, usually during vaginal intercourse or aggressive masturbation, can induce the rupture of the fibrous tissues, causing penile fracture.

Sufferers typically describe a cracking sound, accompanied by significant pain, followed by flaccidity.

Within the penis, accumulation of blood clots comes with instant swelling that typically looks like a “sorry” eggplant, which is medically described like an “aubergine sign”!

On the other hand, the traumatic rupture of the ligaments of the penis is a lesser degree injury to the penis. The penis harbours a triangular-shaped suspensory ligament that fixes the penis to the pubic bone. The structure secures a fixation of the penis at an angle about thirty degrees to the plane of abdominal wall, ensuring stabilisation of penis.

(Of course, such a structure cannot prevent other forms of wondering penis!).

The rupture of the suspensory ligament results in a similar manifestation as penile fracture, with the injury to the ligament usually requiring only conservative intervention. There's usually minimal long-term complications.

The famous sexologist, Alfred Kinsey analysed the exact roles of different sexual positions in heightening sensual pleasure. The categorisation of primary positions was only made in the 1950s, to scrutinize the importance of the maneuver in sexual pleasure.

However, the exact role of positions to enhance pleasure and safety obviously varies between individuals.

The most well-recognised maneuver is perhaps penetrating partner on top with front entry, the classic missionary position. The widening of the lower limbs, allowing the partner’s legs to straddle the body, permits mutual genital contacts in a comfortable position.

Comfort in this position can be enhanced when a pillow is placed underneath the pelvis to enhance support. The partner in the lower position can bend the knees, opening up the pelvis upwards to minimise painful thrusting.

This is perhaps the safest and most comfortable position to adopt.

On the other hand, the erogenous zone of the female genitalia is believed to be located at the frontal vaginal wall, one-third the length of the vagine. The repeated contact stimulations of the zone can lead to heighten waves of intense sensation. The position to achieve such contact would be the woman on top.

Apart from the slight curvature of the penis to reach the zone, the woman on top taking charge of the depth, by leaning slightly backwards and pacing the rhythm can help in reaching the G spot. Although such “cow girl” position may be pleasurable for the female partner, the vigorous thrusting can risk the fracture of the tunica albuginae or the rupture of the suspensory ligaments of the penis.

The founding father of the United States, Benjamin Franklin, famously said: “They who can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety!”.

I guess in the era of MCO for the prevention of the spread of Covid-19, we all should stay home and “Give up a little temporary liberty to obtain essential safety in the future.”

Dr. G is often put on the spot by inexperienced couples experimenting with different sexual

positions to enhance pleasure and maintaining safety and comfort. His view is that sex is journey of loving discoveries to ensure pleasure and comfort.

Therefore, this GENTLE exploration of each other perhaps is the only way to ensure couples “deserve the essential liberty of pleasure, and positioning for safety during sex!”

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Dr George Lee

Dr George Lee

Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at askdrg@thestar.com.my

   

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