• What is an Orgasm?
• What is the Difference Between a Male and Female Orgasm?
• What is the Fluid on the Tip of His Penis Before he Ejaculates (Comes)?
• How Long Does Sperm Live After Ejaculation?
• Can a Guy Hold His "Come" Inside During Sex, or is an Orgasm Uncontrollable?

What is an orgasm?

Orgasm is an emotional and physical experience that occurs during a normal sexual response cycle. During this cycle, pleasure peaks and is then accompanied by a sense of release from sexual tension. During orgasm, both men and women experience involuntary, rhythmic contractions of the pelvic muscles. The mind senses these contractions as pleasurable, but the intensity of these sensations differs from person to person. Each orgasm can also differ in intensity from one time to the next for the same person. For example, an orgasm could feel like warm, gentle throbbing in the genital area one night, and then tomorrow it could feel like an explosion that causes the whole body to become rigid and the mind to momentarily black out.

The four phases of sexual response are as follows: Arousal, Plateau, Orgasm, and Resolution. Arousal, or feeling "turned on," is a combination of mental arousal and physical changes, such as a racing heart, rapid breathing, flushing, increased sensitivity in the genital area, erection of the penis, and swelling and lubrication of the vagina. During the plateau phase, sexual and muscular tension intensifies. During orgasm, sexual pleasure peaks and sexual tension is released. The fourth stage is resolution, during which there is a gradual return of the body to its baseline state accompanied by a sense of warmth, pleasure, and relaxation. After orgasm and ejaculation, most males are unable to have another orgasm for a period of time. This refractory period depends on age (younger men can need only minutes to fully "recover" and older men may need an hour or more) and differs widely between men.

What is the difference between a male and female orgasm?

The most obvious difference in orgasms is that male orgasms are usually accompanied by the ejaculation of semen. Ejaculation involves the secretion of semen into the urethra (urinary tube) and a rhythmic contraction of pelvic muscles that forces the semen out of the urethra. In males, however, orgasms can occur with or without ejaculation. When men have orgasms without ejaculation, the pelvic muscles contract and you feel like you're having an orgasm, but the semen is prevented from being secreted into the urethra. Less commonly, the semen is pushed backward into the bladder during orgasm and appears as milky fluid that comes out during urination after sex. This is called retrograde ejaculation and happens occasionally when men try to prevent ejaculation during orgasm and is usually not a sign of a disorder. However, retrograde ejaculation does happen more frequently in people with diabetes or after surgery, causing damage to the nerves around the penis.

During orgasm for a female, the rhythmic contractions take place within the pelvic muscles as well as the walls of the vagina. In most women, there is no fluid ejaculated, but they often experience vaginal wetness when they are sexually aroused. Another difference between male and female orgasm is that women do not experience a refractory period and may have multiple orgasms with continued or additional stimulation.

What is the fluid on the tip of his penis before he ejaculates (comes)?

The pre-ejaculatory fluid or pre-come is a clear fluid that is secreted from the Cowper's glands (bulbourethral glands), which are two pea-sized glands near the prostate gland. This fluid's primary purpose is to serve as a lubricant during sexual intercourse. Not everyone produces pre-ejaculatory fluid, however. If you don't produce this fluid, it doesn't necessarily mean there won't be adequate lubrication during intercourse. Although Cowper's glands do not contain sperm, pre-ejaculatory fluid may contain some sperm, which have mixed in from the secretions pooled within the inner urethra. Therefore, there is always the risk of getting pregnant from pre-come, which can be prevented by the proper use of condoms and other forms of contraception.

How long does sperm live after ejaculation?

Although sperm can live for many weeks while in the testicle, sperm remains capable of fertilization only 24 to 48 hours after ejaculation. The woman's egg can probably only be fertilized for 12 to 48 hours after ovulation.

People often use this information to determine when it is least possible to get pregnant with unprotected sex. These methods are called the rhythm methods of contraception. Rhythm methods are not reliable methods of contraception. Pregnancy rates in some field studies using these types of methods were as high as 20 percent. Furthermore, they do not prevent the transmission of STDs such as HIV.

Can a guy hold his "come" inside during sex, or is an orgasm uncontrollable?

Male sexuality is extremely variable. Most men ejaculate within two minutes of penetration during sexual intercourse, then lose their erection and experience a refractory period. Some men can prevent ejaculation and experience multiple orgasms without ejaculation and without losing their erection. Although most men who experience multiple orgasms develop that ability naturally, some men are able to develop it with training. This is accomplished by a combination of interrupting sexual intercourse before a point when ejaculation is inevitable, deep breathing to reduce the building excitement, and contraction of pelvic muscle to inhibit the secretion of semen. A helpful guide on this matter is one called "The Multi-Orgasmic Man," and a guide for a wide range of questions on human sexuality is "The Kinsey Institute New Report on Sex."

When telling someone you self-injure, self-harm, there are many things to take into consideration. Consider revealing your self-injury to someone you trust.

Telling someone that you are a self-injurer is scary. You don't know how they will react to your self-injury disclosure. In a way, it can be viewed as similar to coming out as gay or lesbian. Although it is very common, it may not be considered "acceptable" to others. Be careful whom you choose to tell. Choose someone you really trust. You can disclose your self-harm in a conversation, or in a letter that you present to them, or by e-mail. If you choose the last two, be ready to follow it up with a face-to-face conversation or phone call.

Disclosing You Self-Injure

When telling someone you self-injure, keep these points in mind:

• Be willing to give the person some time to digest what you have told them. You may have caught them by surprise and first reactions are not always the best indicators of their feelings. Give them some space, but be ready for their questions. You may even have to respond to self-injury myths they may have heard or something they saw in movies about self-injury.
• Be as open as you can and give them as much information about what self-harm is as you can. Give them internet addresses like this one. Providing them with self-injury, self-harm books to read can also be helpful. People are afraid of things that they don't understand.
• Try to anticipate what questions they might ask. If they ask you something that you are not ready to talk about yet, tell them that.
• Realize that it can be as difficult for them to hear what you have to say, as it is for you to say it. Anyone that you are that close to will not want you to hurt, and will want to help. They may wonder where they went wrong and feel guilty that they did not notice. Be sure to tell them that this is a choice you made and you were not ready for their self-injury help and support earlier, but need it now.
• You do not have to accept their value judgments about your self-injury.
• Let the person know you are telling them because you trust them, not because you are trying to punish, manipulate or guilt-trip them.
• Never tell someone in anger. ("You made me cut/burn/hit.") Do not blame the person for their behaviors which may have triggered you or for not seeing your pain. They'll get defensive and angry. You want their understanding, not their guilt and besides, self-injury is always your choice.
• If you have a friend or a counselor that you trust, you may want them to be present to give you support, but do not expect them to tell the other person for you.
• It's usually best to avoid graphic descriptions of your injuries or ways you self-injure. Do not share self-harm pictures or photos. You are not trying to freak them out. They probably don't need a technicolor description of your worst incident. If they have any questions later or ask for signs and symptoms of self-injury, then you can give them the details in another conversation once they have had a chance to absorb what you told them.

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Inspiring Stories of People Living with HIV and AIDS

One of the most devastating epidemics in human history began with little fanfare in 1981 when the U.S. Centers for Disease Control and Prevention quietly released a nine-paragraph report detailing five cases of an unusual disease in gay men.

The disease in the report, which came to be known as AIDS, soon would grab headlines nationwide. In the years since it's never let go. Shortly after the report's release, doctors and scientists worldwide rapidly realized they were up against a new and little-understood viral foe with an almost sinister ability to outwit that most powerful of disease fighters--the human immune system. In turn, public fears mounted as news reports detailed the lack of medical weapons with which to assault this new, frightening disease and its potential to spread to those previously not thought to be at risk.

In the past two decades, many of these fears have been realized. AIDS has indeed become a 21st-century plague. Fifty-eight million people worldwide have been infected with HIV, the virus that causes AIDS, according to the Joint United Nations Program on HIV/AIDS. Twenty-two million have died after the virus rendered their immune system nearly defenseless, leaving them open to some types of cancer, nerve degeneration and opportunistic infections such as tuberculosis and pneumonia that physicians once thought were under control.

We wanted to put a human face on AIDS. On the following pages are just a few of the stories of people living with HIV and AIDS and the impact AIDS has had on their lives.

Self-injurers, people who self-injure, do share some common personality traits. Who are these people who self-harm? Read on to find out.

Self-injurers are spread across races, genders and come from different social classes. There are not many unifying factors among people that self injure. Most of them are women, but not all, and most of them begin to self-injure in their early teenage years, but not all. (Yes, there are adults who self-harm) Chances are that more men self injure than we know about, but are less likely to seek medical and emotional support for self-injury. It is not easy to spot the signs of self-injury, as many who engage in the practice are very adept at hiding them.

Personality Traits of the Self-Injurer

People who self-injure generally share these characteristics:

• strongly dislike/invalidate themselves
• are hypersensitive to rejection
• are chronically angry, usually at themselves
• tend to suppress their anger
• have high levels of aggressive feelings, which they disapprove of strongly and often suppress or direct inward
• are more impulsive and more lacking in impulse control
• tend to act in accordance with their mood of the moment
• tend not to plan for the future
• are depressed and suicidal / self-destructive
• suffer chronic anxiety
• tend toward irritability
• do not see themselves as skilled at coping
• do not have a flexible repertoire of coping skills
• do not think they have much control over how/whether they cope with life
• tend to be avoidant
• do not see themselves as empowered

Unfortunately, many people don't understand self-injury. Many think self-harm is simply about getting attention. However, this is rarely ever the case and, generally, not one of the causes of self-injury. People self-injure to relieve tension and unwanted emotions. If someone is committing self-injury for attention, they are probably asking for help and need the attention.

Here are some alternatives to self-harm (aka self-injury, self-mutilation). These tools are designed to relieve the desire to self-injure the next time you feel like self-harming.

Self-Harm Alternatives

Understand Yourself

What is causing your desire to self-injure? If you can get to the root of the problem, you can find alternative methods to absolve the pain and ways to avoid getting into a similar situation in the future. Go ahead, examine your emotions the next time you feel like self-injuring and try one of the following suggested alternatives to self-harm instead.

Do you feel Angry, Frustrated, Anxious?

• Violence is the key, as long as it is not directed at a living thing:
  As an alternative to self-harm, you can rip up or punch a pillow, scream your lungs off, jump up and down, or cut up a soda bottle or some other miscellaneous, irrelevant item. Break something that you won't regret breaking, like sticks.
  Mark on or tear up a picture of yourself. It's better than doing it to the real thing!
• Positivity can also be good. You could clean your room or house. Get some exercise! Dance, walk, jog, or run until you're exhausted. Play a sport or go swimming.

Do you feel Depressed, Down, Sad, generally Unhappy?

• Wash your problems away with a soothing bath is another good alternative to self-injury. A slow, relaxing dip in a warm tub filled with bath oil or bubbles is a good idea. Pamper yourself. You'll be surprised by what it can do for your mood. When you get out, try massaging body lotion into your arms and legs, or the places you'd like to cut.
• Relaxing is the best way to alleviate feelings of unhappiness. You can curl up in bed with a book and escape to an alternate reality or light some incense and just kick back listening to calming music. Call a friend and chat about nothing in particular. Eat yummy snacks and spend the evening watching TV or surfing the web.

Do you feel Unreal, Inhuman, Alone?

• Hurt yourself in a relatively harmless way, like holding ice, or rubbing ice on the spot you would normally cut or burn. Chew up a hot pepper or rub liniment under your nose. Snap your wrist with a rubber band. Another good alternative to self-harm, take a cold bath. Jump around, stomping your feet on the ground. Focus on something, like breathing or your heart beat. Notice the way your body feels and moves.

Do you need Focus?

• Working on something is a good way to focus your mental and physical energy. Do something on the computer, like playing Tetris writing a computer program, or creating a personal homepage. You can also pursue any other hobby you may have that is fulfilling and requires concentration.
• Attentively eat a raisin, or any other snack. Weigh it in your hand, feel it, look at the little details of it, including the texture. Describe it to yourself. How does it feel? How does it smell? Is it sweet or tart? You could also choose any object in the room and examine it. Then write a detailed description of it, including size, weight, texture, shape, color, uses, feel, etc. Include all of your senses. Choose a random object and try to list 30 different uses for it.
• Pick a subject and research it on the web. This can get your mind going and give you a new project to work on.

Do you need to see Blood, pick Scabs, or see Scars?

• Draw on your wrist with a red felt-tip pen. Pour red food coloring over the area you want to cut. This self-injury alternative may be more effective if you warm it up first. Paint on yourself with red paint.
• Tattoo yourself using henna. The henna goes on as a paste. After you've left it on overnight, you can pick it off as you would a scab and it leaves an orange-red mark behind.

If you're wanting to gain some insight into why you self-harm or what triggers your self-injury behaviors, take this self-injury test.

About the author: Vanessa, is a self-injurer and started the self-injury website, "Blood Red."

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It's not easy to talk about self-injury; especially if you're the self-injurer. Here are some suggestions.

To stop your self-injurious behavior, you have to first realize that you have a problem, and then you have to communicate with others. Relationships, in any form, are extremely important. They are your structure, your foundation. You can get support from them which can help you overcome self-injury. I know it seems difficult to disclose your self-injury to others, but perhaps these tips on how to talk to someone about self-injury will make the process a little easier.

Talking to Someone About Self-Injury

Telling someone you self-injure is not a spur of the moment conversation. It takes careful planning and consideration BEFORE talking to a friend or family member about your self-harm behaviors.

• Locations, Location, Location!
  When talking to someone about your self-injury, make sure that you are in a comfortable, safe place. Plan for it. Set aside a lot of time, and make sure the person you're going to be disclosing to has plenty of time to talk as well. It is important that the conversation is not rushed or interrupted by other people. If this means leaving your house and going somewhere more private, do so, but make sure it is a place that you both will feel comfortable talking.

• Express yourself!
  Make sure the person that you are talking to understands that you are disclosing this information to them because you trust, love, and want to share every aspect of yourself with them. Also, make it clear from the beginning that you are not looking for pity or using your self-injurious behavior as a manipulative tool. Letting someone know how you feel from the beginning will set a good foundation for your discussion.

• Compassion counts!
  Hearing that someone you care about is suffering from self injury can be a shock to many people, especially if they don't understand what self injury is. You need to be understanding of their feelings. They may feel inadequate because they somehow allowed you to do this to yourself.
• Think before you speak!
  The way you choose to broach this issue will play a large role in the way the person you are talking to reacts. If you try to use your self-injury as a weapon against them in an argument, you will probably receive a bad reaction - not the sympathetic, understanding reaction that you want.
• Everything in moderation!
  If you have been seeing a therapist or counselor about your SI, you might want them to sit in on your discussion. They already understand your behavior and may be able to explain it in a way the other person can understand. If they act as a moderator or intermediary, they may fend off possibly miscommunications or misunderstandings.
• Be prepared!
  You've almost certainly dealt with the prejudices people have concerning SI. Many of these prejudices revolve around myths concerning what SI is. Before you begin discussing your self-injurious behavior with this person, gather as much information on it as you can, and be prepared to dispel their preconceived notions about self-injury. Printing up websites or getting pamphlets on the subject can be helpful reading material for the person you are going to talk to.
• Be open!
  You wanted them to be understanding and accepting, but they also may need you to be willing to talk more about the self-injury than you had originally intended. Be prepared to answer their questions, even if the questions seem harsh and judgmental. They may ask if you want therapy, what they can do to help you, or why you self injure to begin with. Thinking about these questions, coming up with your own, and answering them before you sit down to talk can help get all your bases covered. Also, be open to their reactions, and let them know that it's okay to discuss their feelings as well as yours during the conversation.
• Less is more!
  It's best to let them come to terms with your self-harm through a basic conversation. Don't shock them with the morbid details of emergency room trips or blood getting everywhere. If they are curious about the ways you self injure, try telling them in simple statements. For example, "I make cuts on my arms and legs," "I hit things with my fists," or "I burn myself."
• Instincts!
  Feel the people out as you go. Disclose, but make sure to keep your wits about you. Do what you think is right. Discuss what you think they can handle.

About the author: Vanessa, is a self-injurer and started the self-injury website, "Blood Red."

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Take this self-injury test. Examine your mind and why you feel the need to self-injure.

Self-Injury Test Questions

If you feel the need to self-injure, try asking yourself these questions first. Write them down so you can refer to them later and really analyze your reasoning.

• Why do I self-harm? Why do I feel I must self-injure? What has driven me to cut, burn, etc.?
• Have I done this before? How did I cope then? Did I feel the same way?
• What other paths have I pursued to ease my pain before now? Is there something else I can do, a self-harm alternative, that won't hurt?
• How am I feeling now?
• How will I feel later, when I am self-injuring?
• How will I feel afterward? How will I feel tomorrow morning?
• Can I avoid the problem that has driven me to this point? Is there a better way I can handle it next time?
• Must I self-injure?

If you'd like, print out this self-injury test and your answers and share them with your doctor or therapist. Your insights into why you self-injure and how you feel about self-injury could prove very helpful in your self-injury treatment and recovery.

Self-Harm Treatment and Self-Help:

• Self-Injury Treatment: What are the Treatments for Self-Harm?
• Self-Injury Help, Self-Mutilation Help and Support
• How to Stop Self-Harm, Self-Injury Behaviors
• Self Injury Self Help: Self Help Coping Skills for Self Harm
• Alternatives to Self-Harm
• Cutting Help and Treatment
• Stop Cutting Yourself. Here's How.

Self-help for self-injury does exist and can be effective in curbing self-harm behaviors. Learn more about self-harm, self-help coping skills.

Most people who self-harm want to stop hurting themselves and they can do this by trying to develop new ways of coping and communicating. However, some people feel a need not only to change their behavior but also to understand why they have resorted to harming themselves. (Discover why people self-injure.)

There are a number of self-harm, self-help techniques that can reduce the risk of serious injury or minimize the harm caused by self-injury. This list is not exhaustive - different people find different things useful in various situations. So if one self-help tool doesn't work, try another. You might also find these suggestions become more effective if you are getting professional self-injury treatment; working with a mental health professional.

Self-Injury Self Help Techniques

• Stop and try to work out what would have to change to make you no longer feel like hurting yourself (take our self-injury test for insight)
• Count down from ten (nine, eight, seven)
• Point out five things, one for each sense, in your surroundings to bring your attention on to the present
• Breathe slowly - in through the nose and out through the mouth.

If you still feel like cutting yourself or using other ways to self-harm, try:

• Marking yourself with a red water-soluble felt-tip pen instead of cutting
• A punch bag to vent the anger and frustration
• Plunging your hands into a bowl of ice cubes (not for too long, though)
• Rubbing ice where you'd otherwise cut or harm yourself

(Helpful information on Self-Harm Alternatives and Cutting Help and Treatment)

Self-Harm Self Help Coping Tools

There are several other self-injury, self-help ideas you can implement to help yourself better cope with self-injury:

• Acknowledge that this IS a problem, that you are hurting on the inside, and that you need professional assistance to stop injuring yourself.
• Realize that this is not about being bad or stupid - this is about recognizing that a behavior that somehow was helping you handle your feelings has become as big a problem as the one it was trying to solve in the first place.
• Find one person you trust - maybe a friend, teacher, minister, counselor, or relative - and say that you need to talk about something serious that is bothering you.
• Get help in identifying what "triggers" your self-harming behaviors and ask for help in developing ways to either avoid or address those triggers.
• Recognize that self-injury is an attempt to self-sooth, and that you need to develop other, better ways to calm and sooth yourself.

Sources:
Helpguide.org

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Cutting help and cutting treatment is available and is effective. Self-injury cutting is a possibly lethal form of self-harm that injures many people per year.

Cutting treatment can be provided in residential facilities, in outpatient programs, in groups or even one-on-one. Anyone who wants to stop self-harm can do it by engaging with cutting help and treatment for cutting.

Cutting is any form of self-harm that breaks the skin and causes bleeding. Any form of cutting should be taken seriously because while likely not a direct suicide attempt, self-harm is correlated with a higher-than-average risk of suicide. (More on self-harm and suicide and the effects of self-injury)

Inpatient Cutting Help

Some facilities offer inpatient (live-in) cutting help and treatment. This type of cutting treatment might be a good idea for someone who has previously tried and had unsuccessful treatment or for someone who frequently cuts and believes they cannot stop without direct supervision. An inpatient cutting treatment program may include:¹

• Different types of therapy such as individual, group and family
• Self-injury evaluation
• Impulse control management classes
• Education on self-harm
• Medication management (where needed)
• Case management
• Collaboration with other professionals
• Planning for care after leaving the facility

Programs that offer cutting treatment often involve multiple professionals to aid in care. Part of the program might be:

• A psychiatrist
• A psychologist
• A registered nurse
• Support staff
• Specialized therapists

Inpatient programs can be very expensive ($20-30,000/month) and intense and so require a commitment on the part of the patient that they do want to stop cutting and will try their hardest during cutting treatment.

Outpatient Cutting Treatment

Some cutting treatment programs are still very intensive but operate on an outpatient basis; where the patient attends treatment during the day but continues to live at home. This type of cutting help often includes similar types of services to inpatient cutting treatment but requires greater individual responsibility over not cutting due to the lesser oversight.

When attending cutting treatment, the patient is often asked to sign a document promising they will not harm themselves while in the program. A patient may also be asked to identify alternative self-injury coping methods up-front and be expected to use these instead of self-harming. (Self-Injury Self-Help: Self Help Coping Skills for Self Harm)

Therapeutic Cutting Help

A person may instead elect to seek out less intensive cutting therapy. This may be in the form of group therapy or individual counseling. Therapists who are licensed and specialize in self-harm are the best choice for cutting help. This type of therapy might be found through a treatment center but can also be found in the community or through mental health organizations. Common forms of therapy for cutting treatment include:

• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Interpersonal psychotherapy

Medication Cutting Help

Medication is rarely prescribed for cutting treatment, when cutting or self-harm is the only problem present. Many people who cut, however, also have underlying mental illnesses and so those must be treated when undergoing treatment. These underlying illnesses, such as bipolar disorder, depression or borderline personality disorder, may require the use of psychiatric medication and other specialized treatment.

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Self-harm is, by its very nature, isolating, so it's very hard for someone to admit, "I cut myself." Most often people work very hard to hide that they cut themselves and keep their self-harm secret. People tend to cover up self-harm scars and marks and lie about any signs or symptoms of self-injury that people may spot, or evidence someone else may find. Part of the reason for this is shame about self-harm. Clinically, it has also been found that those with greater shame are more likely to self-harm.¹

I Cut Myself – Shame About the Reasons for Self-Harm

Often times, one of the self-harm secrets is why the person is cutting him or herself to begin with. Often times, the self-harm secret has to do with severe trauma. People don't want to say, "I cut myself," as that may lead to people finding out about this hidden trauma.

For example, people who have suffered sexual abuse are more likely to self-harm than those who haven't. Many people who have lived through sexual abuse keep it secret and feel great shame around it having happened. They may even think that they are to blame for the abuse and need to be punished. This shame, then, gets translated into self-harm where the shame is felt even more strongly.

I Cut Myself – Shame About Self-Harm

Many people feel shame about the self-harm acts themselves. People feel "stupid" or "weak" because they cut themselves. They feel the need to keep their self-harm secret because of this shame. People who self-injure also worry that:²

• Others will judge them for their self-harm behaviors
• People will look down on them
• People will be shocked and disgusted at what they've done

These worries breed further shame and forces the person who self-harms into an isolated position where they must hide the self-harm and the evidence of the behavior too. Scars and other evidence of self-harm carry the same shame, as they are reminders of the shameful acts that created them. You can gain more insight on this by reading self-injury stories and cutting stories by real people.

I Cut Myself – There is Nothing to Feel Shameful About

But the truth is, admitting that, "I cut myself," is nothing to feel ashamed about. Cutting and other ways of self-harm are common and are behaviors that are used to deal with stress. While cutting and self-injury are negative actions, they are likely the best the person can do at the time and there is no shame in that.

By not keeping the self-harm a secret, by opening up and talking to others, better ways of dealing with the problems of life can be learned and the self-harming can stop. Moreover, this openness and self-injury help can take away the shame that has plagued the person who self-harmed.

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