DEAR DR. NERDLOVE: My girlfriend and I have been together for a year and a half. I love her and the sex is ok, could be great except for her fear of germs. She keeps a bottle of hand sanitizer next to the bed. She stops in the middle of changing positions and goes for the sanitizer. After I finger her ass or clit or vagina, she stops everything to clean it up. After I give her head or analingus, she makes me use a strong mouthwash before I can kiss her.

It’s quite frustrating and I’ve tried to talk to her but she’s scared of infection.

This constant stopping and going really puts a damper on enjoying the moment and keeping up my erection. If we have anal sex, I don’t go back into the vagina… I will go wash but she insists on smothering the cold gel on me anyway. After we’re done, she runs to shower. She’s not a germ freak except in bed. I don’t know what to do.

Hand Sanitizer Isn’t Lube

DEAR HAND SANITIZER ISN’T LUBE: Quick question, HSIL: has your girlfriend ever had a urinary tract infection before? People with vaginas are especially prone to them, and they can be incredibly painful — like, “take me to the hospital right the hell now” levels of pain. One of the most common causes of UTIs is sexual intercourse — bacteria gets transferred from hands, mouths, penises and barriers and end up in the urinary tract, leading to an infection. I’ve personally taken several friends — men and women both — to the emergency room because of these and helped nurse them through the early stages of recovery. I’ve heard about just how unpleasant and painful the experience is from folks who were going through it in that moment. Trust me when I tell you: if she’s had a UTI before, it is entirely understandable that she might be mortally terrified of ever going through that again.

Whether your girlfriend has had a UTI or not, she’s right that keeping things clean is an important part of sexual health. The only real issue is that some of what she’s doing is taking things a little too far. Hand sanitizer isn’t really a substitute for old-fashioned soap and water, and it can bring on its own problems if it gets used excessively.

And to be honest, constantly using the hand sanitizer isn’t the best practice in terms of preventing UTIs — or of avoiding other bacterial infections for that matter. Washing your hands thoroughly with unscented soap before sex, while urinating afterwards and taking a post-sex shower work perfectly well for keeping things clean and avoiding infections. I don’t think you need to stop to clean things off just because you’ve switched positions… with one exception.

She is right to have you clean your hands and mouth after any sort of anal play; going from her anus to her mouth or her vagina without washing your hands thoroughly is a great way to transfer a number of nasty organisms, including e.coli. If you’re incorporating some form of anal play during sex or your fingers or mouth are coming in contact with her anus while rolling around, then yeah, you’re going to want to clean things up. I also can’t necessarily blame her for wanting you to rinse your mouth after rimming her. If she’s keeping things clean and douching before anal, then the odds that you’ve come in contact with any fecal matter is very low… but I can absolutely understand why she’d want to be sure.

The same goes for any form of anal penetration.I don’t think you need to slather sanitizer on your junk after anal, but you do want to give it a very thorough cleaning, especially if you intend to have sex again soon.

(Also: I’d think that the sanitizer would sting like a motherf--ker on your balls…)

So, while I think some of this is a little over the top — possibly for very understandable reasons — she does have the right idea. I think there are areas where you and she could find a certain amount of compromise, like not requiring hand washing between every change of positions or slathering sanitizer on your penis even after you’ve cleaned up, but for the most part, this isn’t entirely unreasonable. You can also help avoid transferring bacteria after anal rimming or oral sex by using a dental dam or other barrier methods that keep your mouth and tongue from coming in direct contact with her anus or vulva and clit.

I think it may help to talk about how you can streamline things so that there aren’t as many hard (as it were) interruptions. Similarly, demonstrating that you’re being diligent about cleaning before and after sex may help ease her worries.

I’d also suggest picking up a copy of The Vagina Bible by Dr. Jenn Gunter. This is an excellent no-nonsense resource about vaginal and vulval health that separates myth from science and demystifies a lot of mistaken ideas about what is or isn’t healthy for vaginas. Both of you reading this may go a long way towards helping your girlfriend not be as terrified of possible infections and help you find some best practices to help her avoid painful infections.

Good luck.

Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com

DEAR DR. NERDLOVE: I am writing to you about my husband, who is dealing with some serious mental health challenges. I don’t really feel like I have anyone else to talk to about this, because everyone I know is going through equally stressful problems.

Some background, my husband and I have been married for 3 years. When I first met him, he was starting to get seriously ill, and his worsening health was a constant backdrop during our initial friendship and then our dating relationship. After months of terrifying and agonizing symptoms, he almost died and was hospitalized. While in the hospital, he was diagnosed with a lifelong debilitating disease. He started treatment, his health stabilized, and we later married.

During our first year of marriage, we lived with his mom. I was in school, and his disease is disabling enough that he cannot work, so this living situation was our only option. Unfortunately, he grew up in a severely dysfunctional and abusive home, and I experienced some of this during that year. It is what pressured me to get a higher paying job and insist that we move out. I also insisted that my husband start therapy, because he was showing symptoms of mental illness, even then.

While moving out of the dysfunctional home was great for me, it has been very hard for my husband. It has been a shock for him to live in a place where there isn’t daily yelling, fighting, child abuse, drug abuse, and hoarding…  All that was normal in his daily existence. He was the person in the family who was expected to “fix” the results of everyone else’s dysfunction, and he surrendered all his aspirations and dreams to do so.

Now that he doesn’t have to be the fixer anymore, he feels worthless. He hates himself and tries to punish himself by refusing medicine and food. He says he knows this is illogical, but he feels like resources should not be “wasted” on a worthless person like him. His therapist says he has depression, anxiety, and PTSD. Sometimes, he is even afraid to leave our bedroom and be seen by our roommates (who love him and would never hurt him), because he spent most of his childhood locked in his room, and would be beaten if he came out. His self esteem problems are worsened because, on top of all this, his physical illness is a disability that keeps him from working. He calls himself a “bum” because I bring in the money, and he calls himself “lazy”, “weak”, and “worthless” when he can’t help around the house on days his illness flares up.

My husband is a smart, funny, enjoyable, and worthwhile person, but he cannot see it. He is an incredible spouse who treats me wonderfully, but whenever I tell him so he doesn’t believe me. I thought he would be happier, once we moved away from the dysfunction, but he has only gotten more unhappy. Without the constant distraction of his family’s drama, he is having to unpack years and years of suppressed trauma and abuse… and it’s causing him to fall apart.

He is still going to therapy, but it is clear this will be a years-long battle for him.

In the meantime, I’m struggling a lot. I am afraid and I don’t feel like I have many outlets for those fears. It is awful to watch my husband have panic attacks and say horrible things about himself. I hate not being able to have a quick solution to make him feel better. I suppose this letter is more of a vent session then a question but, if you have any advise, I would appreciate it.

Feeling Helpless and Worried

DEAR FEELING HELPLESS AND WORRIED: My heart sincerely aches for you FHW; you and your husband are in an incredibly rough place and one that sounds incredibly painful for the both of you. It’s made all the worse because — in a real way — you and your husband have similar worries: you’re both feeling lost and helpless because you’re facing situations where you feel like you both have little to no control.

That’s a really hard thing for people to deal with in general. When we feel like we have no agency and no influence, it’s very easy to fall into despair. When that happens, we often turn inward. Your husband, for example, feels worthless because he can’t “fix” things. That family dynamic was toxic as hell, but it gave him a perverse sense of purpose. He felt like he could do something — be the “fixer” — even though on some level he knew this was hopeless. What’s worse is that there’s likely a part of him that associates “being the fixer” with “here’s how I justify being deserving of love”. I suspect that part of why he’s having this crisis is because he’s coming to the realization of just how f--ked up that whole situation was. When feeling like his “job” was tied to being the fixer, then he could at least rationalize any mistreatment as not being good at his job. It’s an incredibly irrational and harmful belief but it makes a twisted sort of sense because it means that his parents love and care for him and this is his fault. As long as the reason for their mistreatment of him was tied to his “failure”, then it was still possible to say his parents loved him. Realizing that no, what his parents did to him was horrific and abusive can be incredibly hard to accept. Parents are supposed to love and care for their children. Harming them like this is an incredible betrayal and facing that realization is the sort of pain that can shake people to their very core.

If that’s the case — and to be sure, this is just my read on things based on what you’ve written here — then it’s not surprising that he’s feeling worthless and that he’s punishing himself. Not only does it keep up the idea that he “failed” his parents, but it gives the illusion of control. He can’t make his parents’ abuse go away, nor can he make them love him. That’s out of his sphere of influence. He can, however, affect himself. It’s perverse, it’s masochistic and it’s harming him and you… but it may well be something that brings a strange sort of comfort.

I’m very glad to hear that he’s still going to therapy; this is something that’s going to require a lot of love, support and the dedication of the work of trained mental health professionals. And it’s going to take a lot of work and a lot of strength to heal. It sounds like his depression is particularly stubborn and resistant to treatment. If that’s the case, there are potential therapy options that he could discuss  with his therapist and see what they think, whether they would be a good match for him or whether they’re even available as an option. These can include more experimental therapies like MDMA or psilocybin, transcranial magnetic stimulation or ketamine infusion; if he qualifies for these studies, they may provide relief that would make it easier for him to deal with his trauma and PTSD. And to be 100% clear: these are therapies that are still under study, performed under specific guidelines and standards, and they have varying levels of success. Initial studies are promising, but they aren’t a miracle cure and they’re sure as s--t not something that you can do yourselves. But looking into them and talking them over with his therapist (who, unlike Dr. NerdLove, IS a trained medical professional) may provide options that could make a difference for his recovery.

Here’s the thing you need to understand: as hard as this is, you can’t fix him. I know that you know this on an intellectual level, but on an emotional level, when we see our loved ones in pain, we want to do something. We want to believe that we can make things better, no matter what, because they’re hurting and damn it we love them and we should be able to fix this. And the fact that we can’t, being forced to admit that we’re not gods, is very, very hard because it feels like the worst practical joke in the world. What the f--k good is it when we love someone that much and we can’t take that love and make them better if only through sheer willpower alone?

But the fact that you can’t fix him doesn’t mean that you are powerless to do anything. In fact, I don’t know if you give yourself enough credit for the fact that you have gotten him to this point in the first place. The fact that you pulled him out of the nightmare that was his f--ked up family situation is huge. I know it feels (illogically) like you’ve made things worse because of the way he’s been spiraling, but the truth is that I think you saved his life. I think that if you hadn’t busted ass and gotten yourselves out of there, you wouldn’t have a husband. Yes, he’s dealing with a lot of pain right now, but the reason why he’s in the position to do so is that you pulled him out of hell. He’s only in the position to face this damage and begin the healing process because you got rid of the thing that was harming him. So I think you need to take a moment to realize that you are, without exaggeration, a goddamn superhero.

Just as importantly though… you also need to pay attention to your own mental and emotional health too. He’s not the only person dealing with trauma right now, you are as well. I realize that it can sound absurd or even self-indulgent to say “I’m hurt by this situation too”, but it’s the truth. Secondary trauma is a very real thing. Caretakers get post-traumatic stress disorder too. It’s all too easy to dismiss your own pain as lesser, that calling what you’re experiencing trauma somehow diminishes what your husband has gone through, but the fact is that you’ve been harmed by this as well. It’s just as important that you take care of yourself as it is to take care of your husband. It doesn’t do him any good if you break yourself to pieces trying to help him. Frankly, I don’t think there’s any way he wouldn’t want you to be hurt like this, so in a very real way, taking care of yourself means that you’re taking care of him, too.

You need a support system of your own. That means friends who can give you love and support when you need it and provide you with breaks so that life isn’t just about how hard you both are fighting to heal. It also means finding an outlet where you can express these feelings without worrying about judgement. If you aren’t already, I think that it’s very important to find a therapist of your own who can help you process these very real, very valid feelings of pain, stress and despair. They’re going to be a very important part of taking care of your own mental and emotional health, so that you can help your husband take care of his. As the saying goes: be sure to put your own oxygen mask on first before helping others with theirs.

And while it certainly isn’t going to change his feelings of worth or undo the f--ked up dynamic his parents had forced him into, one thing that might help your husband is to make it clear that right now the way he can be of use is to get better. It’s time for him to focus on fixing himself. If he needs to believe he’s fixing someone then by taking care of himself and focusing on healing, he’s helping you too. The better care he takes of himself, the more it helps the both of you. That’s the best way he can be of use right now, the best way he can give back for all that you’ve done. His love for you can be the motivation to learn to love himself enough to heal.

Of course, that goes both ways:

This s--t is hard. It’s grueling and it’s left you both with scars. You’ve dragged yourselves out of the fires of hell and you’ve got the ashes to prove it. Take care of yourself so that you can help your husband take care of himself.

You’re both incredibly strong to have survived this. You both clearly care about each other more than words can say. Be strong for each other and for yourselves.

You’ve got this.

All will be well.

Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com

DEAR DR. NERDLOVE: I have an issue of, I guess, becoming less of a nerd. Let me explain: I (31f) have been married to my partner (35m) a few years now. When we started dating 7 years ago, we shared a lot of traits. Our best year together was when we lived abroad, worked in the same company so that our ”together-time” was during the lunch break, so then after work both of us played games for the rest of the day, separately or together.

Something changed after we bought an apartment though. Because it was ”my own nest”, I wanted to become more organized. I started pursuing more hobbies and dreamed of travel. You can see where this is going. I feel we have grown apart and there is nothing to talk about anymore. I guess my question is… how do I know when to break up? Or am I just being selfish?

There are a few things that make it difficult. On the one hand, he is the type to always be loyal and not let me go. I tried breaking up once and he just scoffed it off. Our day-to-day life together is good to ok. But I’ve started to feel better when I’m alone or with friends. He is also bad at communicating or being vulnerable; in important discussions he will become anxious and mix words up, and take multiple minutes to form words. He’s not very self-reflective either. I feel stuck. If I knew he’d get better at communicating it would be different. I’ve also thought of having a family in the future, but with him? I don’t know.

NerdLess 

DEAR NERDLESS: On occasion, I’ll hear from folks whose relationship early on was founded on loving a lot of the same things. Of course, over time, people grow, people change and their interests change… but when their tastes in pop culture or hobbies or games start to diverge, they begin worry that this says something bad about their relationship.

But while shared interests and commonalities are part of what bring us together, they’re not what keep us together. Or at least, not exclusively. In fact, relationships can often be strengthened by partners having different interests, different social circles, even separate vacations. Part of what sparks that passion and desire for togetherness in the beginning of a relationship is novelty and mystery… things that are difficult to keep in a long-term relationship, particularly when you both live together. Having separate lives, where you both are able to do your own thing on occasion, can have a huge benefit to your relationship. Not only does it keep the spark alive by helping maintain that feeling of “can’t see enough of you, there’s always something new to discover,” it also means that you have less pressure to love all the same things… or to worry about what it means if and when you start to have interests your partner doesn’t share and vice versa.

However, I don’t think becoming less of a nerd is your issue here, NL. The problem seems to be about communication and feeling connected to one another. If you’re always together, then it’s very easy to start feeling smothered or to want time to yourself. Having space of your own can be vitally important in a relationship, especially during the COVID pandemic. Being able to feel like you have a life that isn’t defined by what your husband wants or enjoys is important, just as it is for him. There’s no reason, for example, that you couldn’t travel with friends, even if your husband would rather stay and keep the home fires burning.

Similarly, there’s the lack of communication and vulnerability. I have to wonder if whether the issue is that he isn’t bad at communicating and more that his way of communicating is frustrating you. Sometimes there can be a disconnect when our partners don’t necessarily have the same communication style that we do. Some people get heated and vehement, even when they aren’t actually upset or angry. Others get flustered and tongue-tied when they’re dealing with strong emotions and react badly when they feel like their partner’s being overly aggressive. That doesn’t mean that either of them are bad communicators, just that their style of communication is in conflict.

You say that he starts to get anxious, mix up words and needs to take time to collect his thoughts. That leads to an obvious question: have you been giving him that time? If you’re having important discussions, especially about things that are vital to you or to him, then it can be important to factor his communication style into the discussion. If someone, for example, tears up when they feel strong emotions, that doesn’t mean that their partner can’t get upset at them or have those tough conversations. It just means that both parties have to take that into consideration as part of the discussion.

All of this is part of why when I tell people to have an Awkward Conversation, that they should carve out time specifically for it and to take turns while the other listens without interrupting. Amongst other things, this gives everybody the opportunity to focus their thoughts without feeling like they need to reply right away. Knowing you won’t be interrupted takes a little of the anxiety out of trying to express yourself and makes it easier to be clear and ensure that you’re understood. And, of course, easing that anxiety means that people who get flustered are better able to keep their cool and not rush into a response.

There are a couple things that strike me as a little odd; you say that he scoffed off your breaking up with him. What exactly does that mean? Did he just not accept the break up and you went along with it? Or was it that because he didn’t immediately end things, you had time to think about things and realized that maybe you didn’t want to break up? The way you phrase it as a complication is confusing; it’s a little hard to tell whether you mean that this is a good thing, or you’re worried that he’ll be able to somehow veto your decision to divorce him.

Now it does need to be said that it sounds like you’ve already decided that you’re ready to end things and you’re just looking for the reason to pull the trigger. If that’s the case… well, again, there’s not really anything else to be said. All 50 states and the District of Columbia have no-fault divorce laws, which means that you don’t really need a casus belli; you just need to decide that you’re ready to not be married any more. And honestly, if you’re just asking for permission to do what you already want to do, then hey, permission granted. It doesn’t really sound like it’s warranted yet from what you say, but I’m also not the marriage police. If you want out, then the kindest thing to do would be to end things, as quickly and cleanly as possible. It’s better for the both of you; you don’t feel trapped in a marriage you want out of and he’s no longer married to someone who doesn’t want to be with him any more. Ending it quickly means that he doesn’t have to wonder what happened as your dissatisfaction curdles to into contempt, which will end up hurting even more than a speedy end to the marriage.

But if you aren’t standing there with your hand hovering over the relationship eject button… consider talking to a couple’s counselor. Having a third party help mediate some of your issues can make it easier for you both to hear and understand each other, as well as bridge the communication gap the two of you seem to have. And if it does turn out that no, you really are ready to leave, a counselor can also help you negotiate the end of your relationship and make it as painless as possible.

Good luck.

Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com