Q: My question is about "A2M" vs. rimming. Why is my girlfriend fine with doing the latter but refuses to do the former? She said A2M can make people sick, but doesn't rimming pose the same risks?

A: Sometimes I can't believe I've been writing this column for nearly five years. This happens when I get a question, go back over my archives to see if I've answered it before, and am floored to find that not once has a reader ever asked me about the health risks of A2M and rimming. Kudos on your original question!

A2M (short for the crude if not quite accurate "ass-to-mouth") is the term for fellatio immediately following anal sex, with no washing up in between. It's a popular item on the Will Not Try list of many people, since the penis actually goes inside the pooper, potentially grabbing a fair amount of fecal matter in the process. The idea of putting poop in your mouth is a sizable turnoff for most of us, hence A2M's position on the grand chart of sexual fetishes (somewhere between saliva play and coprophilia).

Rimming, or anilingus, is tonguing your partner's anal opening. It's a more common practice, which some people consider to be part of oral sex. Feces stays in the colon until you're ready to expel it, so there isn't a whole lot of fecal matter around the anal opening (there's always some, though, which is why we always wash our hands even when we pee). That spot is also home to a lot of nerve endings, so some gentle stimulation tends to enhance the experience. Rimming is considered a more passive way to provide sexual pleasure, whereas A2M is generally an act of domination over a submissive partner.

Anytime your mouth is someplace where someone else's fecal matter is found, you run the risk of ingesting bad bacteria. Intestinal parasites, E. coli, salmonella and other bacteria that generally get along just fine in your own digestive system do not belong in the digestive systems of others, and they will react accordingly by causing diarrhea, vomiting and fever, or worse. E. coli can also cause urinary tract infections if you happen to transmit a little fecal matter from the anal opening to the urethral opening during oral sex. Chlamydia, HPV, hepatitis, herpes and other infections can be present in the rectal area, so a barrier protection such as a cut-open condom or latex glove is recommended during rimming.

OK, so what about you girlfriend receiving A2M? I hesitate to point this out, but the health risks associated with that are significantly lower. Those organisms and bacteria at home in her colon don't like being relocated to your upper digestive tract, so being on the receiving end of A2M can sometimes cause stomach upset and diarrhea. However, since they already reside in her own body, it's highly unlikely she'd experience anything worse than that. In a worst-case scenario, though, she could have an STD such as gonorrhea in her anal area, which then gets carried to her mouth and throat, causing strep-like symptoms.

Ingesting someone else's fecal matter during rimming, though, even a little bit, can pose significant health risks. This is how restaurants get shut down, after 100 people get sick because one employee neglected to wash his hands before returning to work. A2M -- as long as it's his or her own A and M -- is safer, but I'm sure you can understand your girlfriend's hesitation with taking something into her mouth that was just in her butt.

If you really want her to try it, then I suggest you go first, using a dildo or vibrator of your choice and letting her use it on you before you suck on it. If she's still not interested, then just let it go. She already puts her tongue on your rectum, so shut up and enjoy it.

  • Alexis McKinnis is taking your questions about sex, dating and relationships. Send them to advice@vita.mn or submit anonymously at www.vita.mn/alexis. Don't leave out the juicy details!