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you typically with an infection that has been getting
worse for quite a while. If you treat many members of
sexual minorities, it might be worth while to learn more
about body modifications and their ramifications, and
perhaps to form affiliations with some of your local body
modification studios.

A relatively common activity for both men and

women is handballing or fisting, placement of a hand in
the partner's anus or vagina. After the hand is inserted,
it is curled into a loose fist, hence the name. Oral-anal
contact is called rimming. A butt plug is a sex toy for
insertion into the rectum. A strap-on is a dildo (artificial
phallus), worn in a harness that allows one to engage in
coitus with one's partner despite anatomy or physiology.
An individual who enjoys butt fucking or pumping the
poop shoot (anal coitus) is called a back door betty or an
anal slut. Felching is the act of sucking one's cum (semen)
out of a partner's rectum, and sometimes sharing it orally
with the original recipient.

Not all the most "shocking" sexual activities are the

most dangerous, and vice versa. If your patient trusts
you enough to tell you that s/he is engaging in some of
these behaviors, s/he wants and deserves nonjudgmental
consultation on the possible health ramifications (HIV,
Hepatitis, other STDs, as well as physical injury to the rectum
or colon) of what s/he is doing. Some of these activities
are not particularly risky from a health standpoint, and
many of the risks that do exist can be easily mitigated
with latex barriers and other prophylactic strategies.

When your partner is aware that you have or

could have more than one partner, you have an open
relationship. Many people in open relationships have an