Coronavirus and Sex: Questions and Answers


These are not sexy times.

As an obstetrician and gynecologist in the Bay Area, I’ve been caring for my patients via telemedicine for the past three weeks because of the new coronavirus pandemic. When I ask patients about new sex partners — a standard question for me — the answer is a universal “no.” They are taking California’s shelter-in-place very seriously.

In fact, many of my patients are more interested in updates about the virus than the medical (and often sexual) problem for which they were referred.

The pandemic has most of the world practicing exceptional hand hygiene and social distancing. This coronavirus is so new that we don’t know what we don’t know, and while fresh information is coming at an incredible pace, one medical recommendation has remained constant: the need for social distancing.

This time has been an exercise in prioritizing needs from wants. So where does sex fall on that spectrum?

It’s hard to know yet. While some people may turn to sex for comfort or as a temporary distraction, these are unprecedented times and we don’t have much data.

Depression and anxiety have a negative effect on libido. Some people are out of work, too, and unemployment can affect sexual desire. The kind of worry people are experiencing crosses so many domains: job security, health, friends’ and family’s health, retirement and the ability to have access to medical care, to name a few.

One study that looked at the effect of the 2008 Wenchuan earthquake in China on the reproductive health of married women found sexual activity decreased significantly, and not just in the week after the earthquake.

Before the earthquake, 67 percent of married women reported they were having sex two or more times a week. One week after the earthquake, that number fell to 4 percent. By four weeks, only 24 percent reported they were having sex two or more times a week, well below the baseline.

While this study is retrospective data — women were asked to recall their sexual activity eight weeks after the earthquake — and an earthquake isn’t the same thing as a pandemic, it seems unlikely that sexual activity overall will increase.

We don’t know if the new coronavirus is present in vaginal secretions or ejaculate, but it has been identified in stool. Based on what we currently know about transmission of coronavirus, penetrative vaginal or anal sex or oral sex seem unlikely to pose a significant risk of transmission.

It’s best to limit sex to your household sex partner (HSP), who should also be following recommendations for hand hygiene and social distancing. The World Health Organization currently lists the risk of household transmission as 3 to 10 percent, but this is based on preliminary data. We don’t know what role kissing or sexual activity plays in transmission.

The idea of limiting sexual contact to your household partner and social distancing in general is about ending the chain of transmission to your household should one person become infected.

If your HSP is sick with symptoms of Covid-19, or has been exposed, definitely don’t have sex. They may be too fatigued anyway, but your risk of being infected will likely go up in close, intimate contact. Sleep in separate bedrooms if possible.

If you have more than one bathroom, designate one for the sick or exposed person. Try to stay six feet apart and be fastidious about cleaning surfaces. If they were exposed, living as separate as possible in your home for 14 days is recommended.

Credit…Illustration by Claire Milbrath

Many labs are overwhelmed with coronavirus testing, so you may not get results for some S.T.I.s — like gonorrhea, chlamydia and herpes — as fast as before. Given the short supply of test kits for Covid-19, many medical centers and labs are taking swabs and liquid from other test kits to jury-rig testing kits for the new coronavirus, so sampling kits for genital infections may be in short supply.

Ask your health provider because work flows may vary locally and may change day to day. But if you are at risk of an S.T.I., you should still seek out a test as soon as possible.

Yes, I’m sorry to say, those are the recommendations. For now.

But this doesn’t mean you can’t meet people online — start talking on the phone, have video chats, sext or have phone sex if that’s your thing.

And if someone you meet online is encouraging you to meet in person? That not only tells you how they view their own safety, but, even more important, how they view yours.

I’ve heard people talk about this: a sexual partner who agrees to socially distance with everyone else, but the two of you will hook up for mutual release.

I really discourage this (for now): Social distancing means limiting contact with people outside of your household. Each additional person added to the household increases risk. And of course, you are depending on this person to be as vigilant with social distancing as you are — not to mention the risk during transportation between your home and your partner’s. At the moment, the risk is too high.

Paying electronically is safer than an in-store purchase: Paying online means no one is physically handling a credit card or cash.

As for the delivery itself, there is lab data suggesting the new coronavirus is viable up to 24 hours on cardboard. Washing your hands after opening and throwing away the delivery box seems like an appropriate mitigation strategy. Letting that box sit for a day (if possible) before opening may be a good idea, although we don’t know how the lab data of the virus survival on surfaces translates to the real world.

Does your online purchase of a nonessential (as much as it pains me to say this, a vibrator is a “want,” not a “need”) put someone else at increased risk? Workers at large warehouses where social distancing isn’t possible may be at increased risk, especially if they don’t have sick pay, so taking time off if exposed isn’t possible.

One option is to consider a local small business that can take your payment over the phone or online and arrange a curbside pickup.

Right now the only safe sex is no sex with partners outside your household.

If you or your HSP are at high risk, should you take extra precautions to further reduce the risk of transmission — giving up sex and kissing, sleeping in separate bedrooms — in case one of you has an asymptomatic infection? Asking your doctor for guidance here is probably wise.

But what about when we emerge from our homes again — which may be some months away — and start thinking about in-person dating, and even mating?


Source link