Themes of the Week

HIV prevention with PEP, PrEP, and ART medications

Dear Alice,

If my husband takes antivirals or post-exposure prophylaxis can we still have sex with a condom and still complete the process like normal? It is affecting our sex life because he does not want to infect me. I don't want to be infected but I knew what I was getting into from the start. I might start PrEP as it is now available to me. What are your thoughts?

Cleaning shared needles?

Alice —

Recently, my boyfriend began injecting cocaine. I've noticed that he and his friends share their needles, but "clean" them first with bleach and water. Is this a valid way to avoid contamination?

— Worried and Wondering

HIV transmission risks from anal fingering

Dear Alice,

Can you contract HIV from anal fingering your partner if you had cuts/scratches on your fingers?

Can blood donations be used to test for HIV?

Dear Alice,

My boyfriend claims he is HIV negative based on the fact that his blood donations have not been rejected. Is this a safe assumption? Is each and every pint of donated blood really tested for HIV and other blood-transmittable diseases? Do they really contact the donor if the blood is rejected because it tested positive for a blood-borne disease?

How effective are at-home HIV testing kits?

Dear Alice,

I got tested for HIV a year and a half ago. Since then, I've been with two other people. One guy was a virgin but we had unprotected sex sometimes. He was tested in December (after us being together for one year) and it came back negative. I'm afraid to get tested again because I heard that the guy I was with two years ago before I was tested is HIV positive. I was already tested after I heard this and it came back negative. But, people around campus just won't stopped talking and I'm starting to panic. So, I thought about doing an at-home test because I'm too scared to go to the clinic. I found an at home test that says that you can get at home results in 15 minutes.

It's called the HOME ACCESS and it says it's FDA-approved. Is this accurate? Also, I have another question: with the information I provided you, do you think I'm at risk?

HPV screening and treatment for men

Dear Alice,

I am aware of the effects of HPV in women such as cervical cancer, but if there are no signs and symptoms how will a male know that he has HPV and how is it treated in men?

Family history of breast cancer: When do I need to get a mammogram?

Dear Alice,

If there is a strong family history of breast cancer in the family on the mother's side (including the mother), then how often should the daughters get mammograms and when should they start?

How do I get tested for lupus?

Dear Alice,

Is there free testing for diseases like lupus? It is in my family and I'm scared that I may have it.

Feeling Crummy

How long does an HIV test take?

Dear Alice,

How long does it take to get results from an HIV test?

— Wondering

What's a colposcopy?

Dear Alice,

I was just wondering what a colposcopy is? Something irregular turned up on my pap smear. My gynecologist gave me sulfa-based creams, but the irregularity on the cells from my cervix was still there on my next exam. Now, I have to have a colposcopy, and I was wondering what that entails. My doctor said that it was just to see if further action needed to be taken. Could you tell me, if at all possible, what purpose colposcopies serve and what is wrong with the cells? In other words, do you have any idea, from a vague description, what could be wrong? Thanks.

Quitting smokeless tobacco


How can a person get help quitting the use of smokeless tobacco? All of the resources in this general area are geared toward helping smokers stop smoking, but a smokeless tobacco nicotine addict does not have a similar usage ritual as a smoker, but does have a similar, or worse, addiction than a smoker because the nicotine absorption levels are many times greater. Any suggestions as to how a smokeless tobacco user can get help stopping this addiction would be greatly appreciated.

— Snuff head

Can't stop chewing Nicorette (nicotine gum)!

Dear Alice,

I have a very addictive personality. Fortunately, I am married and have a family and because of the added responsibility of taking care of my family I stay away from a lot of the harmful vices. However, for some stupid reason I decided to try out nicorette. I quit smoking about 12 years ago and thought I would just try out nicorette to see if I could get a buzz. Well two years later I am totally hooked on the stuff and wondering if I should start smoking/chew/patch to get off the stuff. How bad is nicorette for you and is it better than smoking?

— The idiot.

Alcohol and cigarettes — Quitting both at the same time?

Dear Alice,

I have been a smoker for about 8 years and smoke about a pack per day. I am also an alcoholic and now drink about 7 to 10 beers a day, and have been for the past 2.5 years. Last night I decided to quit drinking beer every day and today I am already shaky, nervous, and can't concentrate. I want to quit smoking also so I can join the army. Is it dangerous to quit both at once? Would it be too much stress on my body and mind? And also, would having just one beer a day for the next couple days help with the withdrawal symptoms?

— Aria

Smoking withdrawal symptoms

Hi Alice...

I would like to know all the withdrawal symptoms of quitting smoking. Also how long do these symptoms last and do they come all at once or one by one? Without using nicotine replacements, how does one deal with them? Plus, any suggestions to avoid weight gain?

How long does it take to get rid of withdrawal symptoms? What do you do if you have a headache — have a normal pain killer or what?

E-cigarettes — Effects on health? Smoking cessation tool?

Dear Alice,

Can you tell me about electronic cigarettes and their effects on health? Pros and cons, and a comparison to actual cigarettes? How do they compare to the patch and gum for someone who wants to quit smoking?

— E-Cig

The downsides of sleep deprivation

Dear Alice,

What are the long-term effects of sleep deprivation?

What position is best... for sleeping?

Dear Alice,

Is there a "correct" way to sleep? Position wise? And if so, is it possible to change your current sleep habits to conform to the correct way?

Waking up in fetal position

Bruxism bites: I'm grinding my teeth in my sleep

Dear Alice,

My mom tells me that when I'm sleeping, I grind my teeth... is this serious? Is it caused by stress? How can I stop this from happening?

Can't wake up in the winter


I have always been a poor "getter-upper" in the mornings, but lately I haven't even awakened when the alarm goes off. I just sleep right through it and wake up at around noon. I have been missing classes regularly and it's very distressing! I haven't been going to bed any later (I go to sleep at around 2:30 or 3 AM and have since the beginning of school and I used to wake up at around ten for my class). I haven't been eating or exercising differently. Could this be a result of the shift in weather or in the clocks? Does it take time for the body to adjust to the new season?

— Sleepyhead

When cuddling and sleeping don't mix

Dear Alice,

I would like to be able to cuddle up to my partner at night, but I can't sleep if anyone is touching me even a little bit. I'm very prone to insomnia as it is, so it's hard to practice. Is there a way I can learn to sleep differently?


One side of the divide

Do I have bulimia and will it interfere with my birth control pills?

Hello Alice.

Once a day, after meals — whenever my roommate isn't around, I stick my fingers down my throat and throw up most of the food that I had just eaten. I do not binge — I only purge. I understand from my Psychology professor that the diagnosis of bulimia nervosa requires that the person binge and then purge. I am curious, then, what I have — do I have a form of anorexia nervosa or what? Also, I am on birth control pills and I am afraid that I might hurt their effect by throwing up. How long does it take for the pill to get absorbed into my system? I usually don't throw up until about 5 or six hours after I have taken the pill. Will this hurt the effect of the pill?

— Curious

Recovering from bulimia and looking to gain weight

Dear Alice,

I was bulimic for about four or five months and went from 5'6.5" at 115 pounds to 95 pounds. I have not told anyone, and will not, so please don't ask me to, but I am back up to 110 to 112 pounds and pretty much graze throughout the day so I don't throw up. I mostly snack on white bread, fruit, potatoes, and cereal in large portions, but want to stop and eat a healthy, more balanced diet. The problem is, I am not sure what a healthy weight should be. Charts say I am too skinny, but I don't believe it because I know girls in the media are thinner than me and they seem fine. I want to be as small a weight as possible without being unhealthy. I skipped my period for three months but did get it in January. I have not lost any weight since then though, and I should have gotten my period about a week ago but didn't. I don't understand, it is so confusing, can you help me?


Men with eating disorders?

Dear Alice:

Is it possible for a male to have an eating disorder? I mean, I know it's possible, but I've never heard of any documented cases. All I've seen are connected to females.


Is it possible for a Black woman to have an eating disorder?

Dear Alice,

Is it possible for a black woman to have an eating disorder?

— Curious

No period—Is it because of my weight?


What should my normal body weight be? I am 4 feet 11 inches tall and I weigh 75 pounds presently. I think that I am underweight because I haven't had my period in almost a year. If I were of normal weight, what percentage of my calories should come from fat?

— Weight conscious

How much alcohol a day?


How much alcohol is too much to consume per day?

— Boundaries

Does drinking milk before alcohol coat your stomach?

Dear Alice,

If someone drinks milk before consuming alcohol, will it help you from getting drunk by "coating your stomach"? Why or why not?

Alcohol enemas?

Hello Alice,

I have been living an "alternative" lifestyle for many years now which leads to a lot of well...alternative situations. I have read about enemas consisting of things like champagne being used and it helps to make a person drunk faster. I do not think it would affect a person and I think the alcohol would probably lead to major discomfort or burning, even low proof stuff like champagne. I thought I should ask and see what you know before trying it.


Is it okay to drink alcohol while on Zoloft?

Dear Alice,

I just started taking Zoloft today. I am going on vacation next week and am wondering if it is safe to drink while on this medication. I can't seem to get a straight answer from anyone. I'm not talking about drinking to oblivion; I'm talking about having a couple of drinks by the campfire. Is this okay?

Suddenly, drinking alcohol makes me sick!

Dear Alice,

I have never had a problem with alcohol tolerances in the past. I could drink at least four or five drinks and be fine that night and the next morning. Now, I find myself getting violently sick after drinking just one or two. Even after a glass of wine I want to puke it up. Is there something physically wrong with me? I know the obvious solution is to stop drinking entirely. But, I shouldn't be this sick after drinking just one drink. Have you ever heard of this before? Can you help me figure out the problem?

Number one cause of stress and how to relieve it

Dear Alice,

I was wondering what the number one cause of stress is and the best way to relieve it?

— Worried Already

Sleep or physical activity?

Dear Alice,

I would ideally love to maintain a consistent exercise routine. However, there are stretches of time during which I get very little sleep, due either to a hectic schedule or a lot of stress. During these times (sometimes one or two weeks), I find it almost impossible to go work out. I'm simply too fatigued (I don't drink caffeine because it disrupts my sleep — even one cup in the morning!). The result is that I start to get flabby and untoned, and I then I tend to fluctuate between almost-toned to back-to-flabby.

My question is, what is the relationship between sleep deprivation and exercise? When you are very tired and have been getting little sleep for several days, is it better to just take it easy and let your exercise program go, or is it better to persist and work out anyway, albeit at a lower intensity?

I have bouts of insomnia, so it's not too helpful to just say "try to get more sleep." Sometimes I just can't.

— Tired and Flabby

Sleepy from oversleeping

1) Dear Alice,

I am in my second year at college and I have found myself falling into an unhealthy sleeping pattern. I sleep mostly at night (I don't nap too much) and don't go to bed too late (usually between 12 a.m. to 2 a.m.). But, unless I have some huge incentive to get up in the morning (class, etc.), I can sleep extremely late (1 p.m. to 2 p.m.). This makes me end up feeling even sleepier throughout the rest of the day. How can I keep myself from oversleeping?

— Sleepy

2) Alice,

Since final exams, I have been sleeping way more than I did during the semester. Normally, I can get by on six to eight hours a night, with maybe one morning to sleep late, if I've been leaning to the six-hour end for too many nights. And I would sometimes even wake up in the a.m. before any alarm clock and just get up since I would be wide awake. (Which was a good thing... )

But lately, I've been sleeping for eight to twelve hours a night, and still feel groggy when I do get up. I'm not doing anything noticeably different now than during the spring semester and don't think I'm depressed about anything. I would like to get up at 7 a.m. or 8 a.m. like I'm used to doing, but I just can't drag myself out of bed.

— Any suggestions?

Are short sleeps and long naps healthy?

Hi Alice,

I find that I'm most alert late at night, and at school I'll stay up till three or four in the morning. Since I've had morning classes in the past, I've tried to form a habit of going to bed earlier — around midnight or one — but realistically, I don't think this is ever going to happen. I was thinking of trying, when I go back to school this fall, to go to bed around three or four and sleep for four hours, and then also take a four-hour nap during the day. Is this a good solution, or will I be more tired than if I sleep eight hours straight at night? Thanks!

Noisy dorms — Help, I can't sleep!

Hi Alice,

I cannot sleep in my dorm room. It is always loud. I have read many articles about sleep hygiene, but no matter how healthy and relaxed I am before trying to sleep, I will wake up whenever there is noise.

I sleep with earplugs, but they do not block out the noise well enough. I wake up exhausted every day and it is seriously interfering with my ability to study, participate in activities, and otherwise enjoy life. I was very happy at my school until I had to move into this noisy room. After a visit to the campus health service, they diagnosed my insomnia as "situational" (due to the room) and recommended that I sleep in a quiet location, but that is not an option as I cannot prevent the noise.

I was not experiencing much stress at all in life until I moved into the room where I could no longer sleep. When I am stressed, I am always able to sleep fine as long as it is quiet; if it is noisy, I cannot sleep no matter how relaxed I am.

Family meets faith

Dear Alice,

I have been with my partner for almost six years. We are both from different religions (I'm Muslim and he's Hindu). I would like to raise my children as Muslims. He says we should raise them with both, but I completely disagree with this as I disagree with the religion of Hinduism. I have read a lot about Hinduism and asked him to do the same about Islam for 1 year now—I even gave him the Quran, but he just can't be bothered.

I'm due to go abroad for three months in two months' time, and I think that we should break up because we can't agree on our future. My parents are completely against this marriage, and so is his family. If I marry him, I risk losing my family completely. We are great together because we hardly argue unless it's about religion. I thought, perhaps, if he started reading and asking questions about my religion, he might convert (because then we would not have a problem) or even start to see things in a new light. He is brought up only believing what his parents told him about religion—he does not actually have any proof or evidence telling him what they have been telling him is correct about Hinduism.

I am just tired of this as we are going around in a circle and cannot seem to agree. I already am taking a big step by marrying him even though he is of a different faith. Please help.

Conservative Christian considering sex before marriage — What to do?

Dear Alice,

I'm a Christian, very conservative in upbringing, and I'm having difficulties in discussing sex in an open and casual manner. I told my male friends that sex should be done within the parameters of marriage. But they told me that I should have a first sexual experience so as to satisfy my wife or maybe a girlfriend (I don't have one yet). Should I follow their opinion regarding this? Should I first know the sexual dynamics of sexual intercourse before doing it with her?

I would appreciate your kind response.

Thank you.


Catholic and atheist consider marriage

Dear Alice,

I know that this isn't exactly your province, but I was wondering if maybe you could direct me to another website that might be able to help us. My boyfriend and I are both college students. We have been together for quite a while and are starting to think about becoming engaged, but there is something that disturbs us. He is a religious Catholic, and I am an equally devout atheist. This is not an issue now (we're both very respecting of each other), but we're afraid that if we become more serious, it might be a problem. Are there any resources you could suggest to us for ways to handle this? Or stories of couples that have faced similar issues? Thanks!

Change of faith: What if my religious parents find out?

Dear Alice,

I need some good advice. All my life, I've been raised as a Catholic. Both my parents are fairly religious, but I have completely lost interest in Catholicism as a religion because I feel it does nothing for me but preach and tell me how to live my life. It has now gotten to the point that I have become very interested in alternative religions, so much so that I want to change faiths. However, I'm terrified my parents will find out. What should I do?

— Regardless Faithless?

Falling from faith?

Dear Alice,

I came to college in a big city from a small town in Nevada. I came on the suggestion of one of the elders in the church, partly as a means of becoming a stronger voice of the church and partly to become more familiar with my own faith. Over the past couple of months, I have begun to question many things the church says and does, and many of the things I believe. I find myself doing things that I never would have dreamt of doing only six months ago. I'm not sure that this process is reversible or where it is headed. I am really confused and not sure what I want. I am afraid that relations with my family will become difficult if they find out how much I have been questioning my faith. I am really confused and don't know what I want. Are there any organizations on campus that I can talk to about this? Do you have any advice?

Falling from faith

How to find a therapist

Dear Alice,

I am trying to find a therapist. I have to go in-network for my health insurance to cover it, so I have this long list of therapists, but I don't know anything about them. Do you have any suggestions as to how to go about choosing one and/or questions to ask? Is there a "Go Ask Alice!" answer I could read for this info? I found my last therapist through the recommendation of a colleague at work and another through my school's counseling service. Now I need to spread my wings and find a professional therapist on my own! Yikes!

Thanks for any help you can give me!!!!!!!!!!!

Depression, bulimia, and Zoloft

Dear Alice,

Over the past year that I spent abroad, my cyclic depressions turned into a general depression, which has more or less left me incapable of doing anything. Along with the depression, I deal with bulimia, which expresses itself in my finest moments of despair. While abroad, I recognized that the depression I was feeling was no longer normal and asked my parents to please arrange some counseling for me upon my return home. So, for the months of July and August, I went to a therapist twice a week. I have not followed up with therapy back in New York, but feel that I must do something. Actually, I did do something, I went to the university's shrink, who promptly wrote me a prescription for something called Zoloft. What can you tell me about this drug?

In the meantime, I skip 2 - 3 classes a week and couldn't keep the small job I got to help cover the cost of therapy, which I see in the future. I constantly feel paralyzed, trapped, as if there is "no way out." I can't go on like this. Suicide is not an option for me, NEVER, but THIS ain't living.

— Signed,
Extremely unhappy


Dear Alice,

I'm worried that I might be manic-depressive, or bipolar-depressive, though I'm not quite sure what the exact medical definitions of those terms are. From time to time — sometimes over a couple of hours, sometimes over a couple of weeks, I can get very depressed, and everything in my life seems like it's going wrong — school, work, relationships, etc. These happen at night and during the winter more often than usual, but they happen fairly regularly all year round, for at least the last three to four years. Other times, even for weeks at a time, I'll feel fine; get really happy with certain things; not ecstatic, but happy. I also find that these depressive states can be brought on by certain things, like an argument with someone or just something that pissed me off. But then they get better, usually before I have a chance to see a counselor, and I feel silly for having felt that way at all; things seem much rosier at those times. I've seen counselors some before, but never wanted to bring it up — I was hoping they'd guess at it on their own; I did describe all my feelings, just not that I thought I might be manic-depressive. I always thought that I was just being a hypochondriac. What do you think?


I think my boyfriend's depressed — what do I do?


What do I do about suspected depression?

My boyfriend is a Columbia student; I am not. For quite some time, I have suspected he is depressed. Just last week, it got so bad that he's finally come round to admitting maybe it would be a good idea to go see someone about it. He made an appointment at Columbia's CPS office on the Morningside campus — they couldn't fit him in for another 2 weeks, and his schedule means he can't get to the walk-in hours.

But I'm wondering if that's who he should be seeing at this stage. Actually, he's not even sure whether his appointment is to see a counselor or a psychiatrist or what. If the suspicion is that he's depressed, should his first stop be at his internist? Who can diagnose him? Who can determine whether he needs anti-depressants, and give him a prescription if necessary? I always read that depression is an actual illness, and given this, I don't want him to waste time just talking with a therapist, if what he really needs is to see a doctor. I've never dealt with any of this before, and I'm just not familiar with how it works. And when he goes to his appointment, should he basically just walk in and say, "Hi, I think I might be depressed?"

He's in such a terrible state, and I'm so worried about him, and this has been so long in coming — I know there won't be a quick fix, but I really want him to get started as soon as possible.

Clueless and Concerned

Dissociative disorders--unable to recognize myself

Dear Alice,

I look at my reflection time and time again, and I ask myself: "Is that me?" At some point during the past 3 years or so of my life (throughout which there has been no specific traumas I can name, recall, or otherwise), I have lost the ability to recognise my own reflection. Looking at recent photographs, I often have to take a few moments to recognise myself then. Older photographs are even harder to recognise, especially if I was unaware of the photo being taken. Do I suffer from some kind of neurological pattern-matching disorder? It reminds me of dissociative identity disorder, but I have no referential 'other identity(ies)' to work this from. Is this a common problem for 16-year-olds like myself, or am I going insane faster than I thought?


P.S.: I am almost certain I suffer from schitzotypal disorder — is this connected in any way?

Masturbating stats: Are there gender differences and why?

Dear Alice,

I have searched your files for the answer to a question that has long been bugging me. It has to do with masturbation. I can see by the questions there are many men who masturbate, but I don't see many from women. Do many women masturbate? Are they just more shy about talking about it? Can you give any specifics on the percentage of women, versus the percentage of men, who masturbate?

— Wants to learn more

Masturbation while being sick?

Hi, Wondering if there are any negative effects to masturbation while being sick. I hear it could be a cause of lower immunity levels, is that true? Thanks, R

Female masturbation optimization

Dear Alice,

Your masturbation section is overflowing with male inquiries, so I thought I'd throw my question in to add some variety. What are ways to optimize female masturbation? I often read dirty books to get things going, but I don't always reach my intended destination. I have trouble reaching orgasm while flying solo, and I'd really like to learn more about the female erogenous zones and how to optimize my masturbation experience. Basically, how can I best bring myself to pleasure through self-stimulation?

Can masturbation or using a sex toy desensitize the clitoris? And would my partner prefer her sex toy over me?

1) Hi Alice,

I heard that masturbation causes desensitization of the clitoris and that after a while, a lady who masturbates a lot will not be able to have an orgasm by normal sexual intercourse. Is that true? And if it is, is there a way to fix that? Thank you.

2) Hi Alice,

My girlfriend and I bought her first sex toy, a 9" dildo for her, and I'm about an average size. My question is I'm worried about it taking over our sex life. The interesting thing is this is something I wanted at first as a fantasy come true, but now I'm wondering if she could be desensitized or want the plus size over me? Is this an item I should be concerned with?

Showerhead fun: Safe?

Dear Alice,

Recently I have discovered if I change the settings on my shower head so the water pressure is harder and faster it works wonderfully as a tool for masturbation. My question is, is there any health risks for using water for self pleasure? My main concern is getting water in my vagina...could that cause issues? Thank you so much!

— Fun in the Shower

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