IN Toronto magazine

“I constantly gag when trying to give a blowjob. What can I do? It is embarrassing, and I am afraid I will throw up all over the guy.”

The pesky gag reflex — it’s a problem for many men. I agree: Unless you’re in a kinky situation that calls for it, or on a not untypical episode of Jerry Springer, vomiting on your man’s penis is not cool.

You gag when the sides and back of your throat are touched by something other than food. It is the body’s way of preventing you from choking unless you are eating; the nerve endings are triggered, the brain recognizes that swallowing is not occurring, and an involuntary muscle response is produced causing rejection of the “foreign invader” by reversing the process of digestion — food going back out instead of in. Thus the utility of sticking your fingers down your throat to vomit when you feel nauseous and you just want to get it over with. And like everything else, some people are more sensitive than others and have surprisingly strong gag reflexes while others have very small ones.

Avoiding contact with the trigger areas is one approach. Try repositioning first. Many guys, with great success, have tried lying on their backs with their head hanging over the edge of the bed, so that the neck and head are tilted backwards (a position similar to that used by sword swallowers!). Other positions may work too. You’ll have to experiment and find which ones are best for you. The important thing is to keep your partner’s penis centred in your mouth to avoid touching the gag areas at the sides and very back of your throat.

Lozenges and throat sprays with anesthetic in them, intended to treat sore throats, can also be useful. These work by numbing your throat, turning off the nerve endings so that your gag reflex isn’t activated. The down side is that you can’t feel or taste anything, two of the perks of blowing someone. Not to mention it makes your partner’s penis go numb too, which he may or may not appreciate.

There are some things which accentuate the gag reflex as well… particularly anxiety. If you are nervous, all of your body’s nerve endings are just begging for an excuse to fire, including the ones in the back of your throat. Relaxing and remaining calm will go a long way, trust me.

If all else fails, try doing other things besides deep-throating, concentrating on the part of the penis you can get into your mouth with no problem. This is the most sensitive part of the penis anyway, especially the head.

Kissing, sucking, nibbling, blowing, licking — all of these actions can be used to turn on your partner. Ask him what he likes. Use your hands, too. Following your hands up and down when taking him in and out of your mouth usually feels very nice and is essentially the same as deep-throating. You can invariably find some way to drive him crazy without having to swallow his whole erection.

Dr Keith Loukes works in emergency in a Toronto hospital. Send him your sexual health question at This e-mail address is being protected from spambots. You need JavaScript enabled to view it This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

This column should not be viewed as medical advice; always consult your physician.