A: Sleep orgasms happen to a lucky minority. I'd say relax and enjoy nature's bounty if it weren't causing such a problem at home. The anxiety attacks are another matter entirely. If they happen only when you have sex with your partner I'd look both to your own past and to your relationship. After four years together you may now be feeling secure enough to deal with some earlier sexual trauma that is now coming to the surface. Perhaps you may be rebelling against getting any more closely enmeshed with someone who wants to control even the pleasure you take while asleep. I can't know without a lot more information. In either case, the two of you need to have a long talk — perhaps several long talks — about your feelings, your relationship, sex, what's working and what isn't. If more comes up than you can handle, consider seeing a therapist to find both the cause of your anxiety and ways to deal with it.
Q: I have a very good friend, 26. He has been extremely depressed for several months. He recently told me that he has a really big secret that he needs to share with someone but does not feel ready to tell me yet, although he says I am the only person whom he feels he will ever be able to share this with. All he has said is that he has lived with this for several years now, and it haunts him every day, he can't stop thinking about it. He says it is something to do with him and it is something that will never go away, but will get worse. I honestly think he is going to tell me that he is HIV-positive. I don't know very much about HIV, but if I am right I would like to be able to offer him the best advice I can. I really care about him and would like to be a really supportive friend who can offer him sensible advice. Please can you tell me what the best thing would be for me to say to him if he is HIV-positive? What should I advise him to do?
A: Whatever his big secret, the best help you can give him now is to listen and assure him of your continuing affection and respect. If it's a medical condition that he tells you about — HIV or anything else — or some past personal trauma, you can inform yourself better by visiting a library or conducting a Web search on the topic. Help him find a group dealing with whatever it is by calling local hospitals or organizations and urge him to share his concern, not only with you, a friend who loves him, but with others who are struggling with the same issue and can provide education as well as mutual support. I assure you that there are support groups for every condition imaginable and many, not only for HIV carriers, but also for their HIV-negative loved ones.
Q: Is it distasteful or wrong to want to come on a lover's body or face?
A: It would be if wrong if pregnancy were your goal and it would probably be distasteful if the partner were not engaged in sex with you at the moment. (Only kidding here). The only ones to get to vote on this issue are you and your partner. What one person finds really hot is another's total turnoff … maybe even the same person at different times. Isadora Alman, author of Doing It: Real People Having Really Good Sex, is a board-certified sexologist and a California-licensed marriage-and-family therapist. Contact her at firstname.lastname@example.org. Her Sexuality Forum is at