When Sex Workers Do the Labor of Therapists

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BY Carrie Weisman

Sky is a professional escort. She’s been working at Sheri’s Ranch, a legal brothel located in Pahrump, Nevada, for a little under a year. A few months back, a man came in asking for a group session with Sky, who prefers to be identified by her professional name, and one of her colleagues. He had come around a few times before. He made it a point to keep in touch through Twitter. This time, however, the session took a dark turn. He came in to tell them he was planning on killing himself.

“We see a lot of clients who have mental health issues,” she tells In These Times. Though, this experience was markedly more dramatic than her usual run in with clients who going through a depressive episode. She and her colleague were eventually able to talk the guy down. They sent him home with a list full of resources that specialize in matters of depression. They asked that he continue to check in with them through social media. 

Research suggests that upwards of 6 million men are affected by depression every year. Suicide remains the seventh leading cause of death among men in America. While it’s impossible to gauge exactly what percentage of that demographic frequents sex workers, the experiences of those in the field can offer some insight. During Sky’s last tour at the Ranch, she scheduled about seven appointments. Out of those bookings, only one involved sex. “We do a lot of companionship and intimacy parties,” she says. “The clients who sign up for those bookings are the ones struggling with loneliness.” 

And people with depression aren’t the only neurodivergent individuals sex workers encounter on the job. Those suffering from anxiety, a common accompaniment to depression, show up frequently. They also see a lot of people who fall on the autistic spectrum. In fact, Sky says she sees men who fall into the latter demographic relatively often. 

Sky first got her start in the industry working as a professional dominatrix. While she has since pivoted her position in the industry, she’s found ways to incorporate that expertise into life at the brothel. Sure, she offers standard escort services, but she also books sessions dedicated to BDSM, an acronym that can be broken down into three sub categories: Bondage/Discipline, Dominance/Submission and Sadism/Masochism. Each dynamic refers to a specific form impact play that participants can find deeply pleasurable. That kind of tactile experience, she suspects, might offer a certain special appeal to men with autistic spectrum disorder (ASD). And she might be right.

Among the many symptoms of those diagnosed with ASD is a resistance to physical contact. According to the CDC, early signs of the disorder may present in the form of an aversion to touch. At the same time, touch is an important sensation to experience. A lack thereof can lead to loneliness, depression and even a more secondary immune system. Researchers have determined that therapies designed to nurture regular sensory integration can help in this regard. 

Goddess Aviva, who also prefers to be referred to by her professional name, is a lifestyle and professional dominatrix based in New York City. Like Sky, she sees a good amount of clients with autism spectrum disorder (ASD), and also men dealing with depression and anxiety. She takes certain measures to screen clients. After all, violence against sex workers is an ongoing issue in the United States, and the wavering legality of the trade doesn’t exactly help combat the issue. In the wake of new federal legislation that has largely kicked sex workers offline, and with them, the ability to vet clients from afar, sex workers must be more vigilant than ever about whom they decide to take on. The clients who are neurodivergent or live with mental health conditions don’t seem to be the ones sex workers are worried about.

“You don’t have to be diagnosed with a mental illness to be a shitty person, and some of my clients who do deal with mental illness are wonderful, kind people with good intentions,” says Aviva. “I’ve never felt unsafe with a client that makes it all the way to a session. What matters most to me is that someone is respecting my boundaries, time and protocol.”

Sky, too, has encountered a number of undesirable clients throughout her career in the industry. But, similar to Aviva, these experiences don’t seem to be driven by those suffering from mental health or neurodivergent conditions. “My most uncomfortable moments in the industry have always come from men who would be told by a professional that they were completely sane,” she explains.

Fortunately, for Sky, it’s much easier to weed out problematic clients in places where prostitution is legal. According to her, the brothel has a security team monitoring the property. She also says there’s a sophisticated screening mechanism in place. Before booking a session, all clients have to provide ID and agree to an intimate screening to rule out immediate potential health risks. These aren’t typically privileges those operating independently have access to.

Throughout her career, Sky has encountered clients who have been pointed to the brothel by concerned friends, or family. She even knows of a few who have come by at the suggestion of a therapist. Though, not all mental health professionals would advise that kind of thing.

“Certainly, there are individuals that struggle with social anxiety, which prevents them from finding a real-life partner, and in those cases engaging with a sex worker can be both therapeutic and pleasurable,” says Dr. Michael Aaron, a sex therapist, writer and speaker based in New York City. “But the best option for a therapist that is looking to provide a patient with real-life experience is to seek out surrogates, who are trained and certified by the International Professional Surrogates Association.” The organization he’s referring too, also known as IPSA, operates around a triangular model of therapy involving a patient, a surrogate and a trained therapist. Together, the three work to improve the patient’s capacity for emotional physical intimacy through a series of structured, sexual experiences. The legal status of the practice is largely undefined in most of the United States. 

And maybe it’s not just in the interest of clients to see someone trained to provide the level emotional support they may be after. “It can be heavy,” says Sky. “I’ve had days where I have to take a minute for myself and get myself back together.”

Still, it seems as though few in the field shy away from providing the emotional labor that clients demand. “There’s this huge misconception that at the brothel we just have sex all day,” Sky explains. “But there are a lot of people who come in to work out some serious emotional issues. It’s really a good chunk of what we do.”

“I love my job,” she adds. “But there are certain parties that make us feel like we’re actually making a difference in the world – that we’re actually doing good things and not just providing a good time. And that can be super fulfilling.”

Complete Article HERE!

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Better Sex Starts in your Gut

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By Dr. Edison de Mello

“There’s a Connection Between Your Gut Health and Your Sex Life”

What are the most common causes of low libido?

Libido and sexual arousal is, for the most part, grounded on intimacy involving the interaction of several components, including physical trust, belief system emotional well-being, previous experiences, self-esteem, physical attraction, lifestyle and current relationship.

In addition, a wide range of illnesses, such as thyroid disease, arthritis, diabetes, neurological disorders, hormonal changes and physical changes, such as High blood pressure, cardiovascular disease, menopause in women, andropause in men and pain during intercourse can cause low sex drive and/or inability to reach an orgasm. Medications, prescribed or over the counter, can also kill one’s libido.

What’s one cause that’s really surprising?  Great Sex too starts in Your gut!

“All disease begins in the gut.”  Hippocrates

Although most us do not necessarily think of our intestines or bad gut bacteria when we think of possible causes of low libido, an imbalance of Gut bacteria (microbiome) is more often than not, a significant cause of decreased sexual arousal. This is in addition to the more commonly known GI related causes, such as bloating, gas, acid reflux, bad breath, diarrhea, etc. In fact, because the gut contains billions of bacteria, the gastrointestinal tract, also known as the gut system, plays a major physical factor that has many unexpected effects on our ability to respond and perform sexually. The truth is that “gut bacteria is to our digestion and metabolism what a beehive is to honey”: Good working hive = great honey; well balanced gut bacteria = optimized gastrointestinal function and better sex! Gut bacteria are also responsible for producing hormones, enzymes, and neurotransmitters such as serotonin, which are essential for sexual health.

And then there is lifestyle…. although a glass of wine can get both men and women in the “mood” for sex, too much alcohol can actually have the opposite effect and not only kill your libido, but make you sleep, which can be devastating to intimacy.

10 Reasons Why you may not have a healthy gut?

  1. Bad diet (sugar and processed food based diet)
  2. Digestive Health: Unbalanced gut bacteria and lack of good probiotics
  3. Overuse antibiotics and other medications
  4. Sedentary life style
  5. Disease, including autoimmune.
  6. Mental Health and Mood.
  7. Low/ unbalanced Hormone.
  8. Vaginal Health/prostate issues
  9. Weight proportionate to height issues
  10. Decreased physical, mental and emotional energy

5 initial Steps to Take to Have Better Sex

  1. Balance your gut health,
  2. Eat a healthy diet and moderate your alcohol intake
  3. Exercise more often
  4. Do you inventory of your relationship: Are you really happy or just pretending that you are?
  5. Work on your self-esteem and body image, if applicable.

5 Ways how your partner can help you get there:

  1. Love you unconditionally
  2. Help you feel that intimacy is more than just having sex
  3. Encourage you to make the changes outlined here –  free of judgment, and instead assuring you that yes, you can.
  4. Be the change that he/she expects of you
  5. Not make sex so serious… have fun with it.

Other 10 possible causes of low libido:

  1. Mental health problems, such as anxiety or depression
  2. Stress, such as financial stress or work stress
  3. Poor body image
  4. Low self-esteem
  5. History of physical or sexual abuse
  6. Previous negative sexual experiences
  7. Lack of connection with the partner
  8. Unresolved conflicts or fights
  9. Poor communication of sexual needs and preferences
  10. Infidelity or breach of trust

Complete Article HERE!

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Let’s Talk About (Depressed) Sex

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What to do when you have trouble maintaining a healthy romantic life while dealing with depression

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For people who have depression, even the most basic activities can seem daunting—and that includes sex. But because both depression and sexual problems are things that are difficult to talk about, even with intimate partners, the issues surrounding having sex while dealing with depression often wind up being ignored. As mental health advocate and writer JoEllen Notte puts it: “It’s the intersection of two taboo topics.” And it can lead to even more problems relating to a person’s mental and physical well-being.

Notte breaks the negative sex experience that comes with depression into two categories: loss of interest and side effects of medication. Notte says about the former: “I tend to reinterpret [it] as ‘everything seems incredibly hard and not worth doing’… Not wanting to be touched, and not wanting to deal with people.” While that applies to people who have depression and both are and aren’t on medication, the side effects specific to medication are a significant problem, too, and include, Notte says, “erectile dysfunction, vaginal dryness, genital numbness, delayed orgasm, and what’s usually referred to as ‘lost libido.'”

This loss of libido is symptomatic of a larger problem of depression: anhedonia, which Dr. Sheila Addison, a licensed marital and family therapist, tells me is “a loss of pleasure in ordinary things.” One of the things people with depression do to combat anhedonia is try to self-medicate and force pleasure, including through sex. Addison explains, “People with depression sometimes wind up chasing ‘peak’ experiences, little bursts of endorphins that seem to cut through the depression for a moment, but it’s a short-term fix for a long-term problem. And if it turns into having sex that they don’t really want, hoping to feel better, it can contribute to feelings of emptiness and self-loathing.”

The best thing to do when dealing with depression is to seek out a doctor, but even if you are comfortable seeking out help for depression, it can be difficult to broach the topic of sexual health, without feeling anxious. As Notte points out, “So many people have had bad experiences with doctors not wanting to deal with [sex] or prioritizing it as a topic.” My own doctor’s flippancy toward the subject was enough to shut me down for months, and it seems like this is all too common, leading to further stigmatization of this sensitive topic. Notte says, “All of the data that says these [sexual] side effects don’t happen is skewed, because people aren’t reporting them.”

Nevertheless, each person I talked to stressed that even though it’s difficult, if you are having issues with sex and experience depression, talk to a doctor first. Addison says that online forums can be the source of “a lot of unsolicited advice, pseudoscientific ‘cures,’ and supposed remedies that will lighten your wallet more than your mood.” And if you find the first doctor to be unsympathetic to your problems, then look for another one.

But how to find the right doctor? Notte recommends looking for keywords like “sex-positive” and “trauma-informed,” as it often means they’ll be more willing to discuss sexual issues or at least be able to point you in the right direction to someone who could. Addison herself is a member of LGBTQ Psychotherapy organization GAYLESTA and listed amongst kink-friendly professionals. These keywords tend to suggest the doctor has a more nuanced, whole-body approach to understanding and treating mental illness, but, of course, it may take a bit of searching to find someone whose methods you are comfortable with.

Once you find a doctor with whom you’re comfortable talking, you can also utilize them when you want to talk with your partner about any problems you might be having with regards to sex. “People often don’t know that you can bring anyone with you to your doctor visit if you want,” Addison points out. “Sometimes it’s easier to have the doctor talk directly to your partner because it’s not so personal.” Addison advises that the partner who isn’t experiencing depression seek care as well, saying, “Get support for yourself, from a therapist or from a group for partners of people with mental illness. Take good care of yourself, physically and emotionally

The main theme here, as with any taboo topics, is that talking about them is key, and the only way to remove the stigma. It’s particularly apt in this situation, though, as conversation, and communication in general, are also at the core of maintaining healthy romantic and sexual relationships no matter what your mental state.

But even though we know we should communicate openly, it can be difficult to get started. That’s why Allison Moon, sex educator and author of Girl Sex 101, recommends beginning conversations with “I statements” when breaching the topic of sexual issues. “It’s easy for people to catastrophize when partners bring up sexual issues, and they may be tempted to take responsibility for the issues of their partners,” Moon says. “It’s a good idea to use extra care when explaining one’s own experience, and be clear that the partner isn’t at fault or causing anything.” When considering the problem as a whole, Notte advises a team mentality for couples. She says, “What happens a lot is it gets treated as an issue of the healthy partner versus the other partner and their depression, and if we can be couples who are working on one team while the depression is on the other team, it’s a much healthier dynamic.”

Moon also recommends “speaking in concretes” when describing the ways depression affects your life and sexual experience to your partner. “Because mental health is so individuated, saying something like, ‘I have depression’ doesn’t always convey what one intends. Instead, I suggest discussing how something like depression manifests in a way the partner can understand. For instance, rather than saying ‘Depression makes me insecure,’ you could say, ‘Sometimes I need extra verbal validation from you. Can you tell me you find me sexy and wonderful? Can you remind me that I’m a good person?'”

Describing symptoms associated with depression can be difficult, though, and Notte often advises individuals to use what she refers to as “accessible” resources (“things that are not scary, that are not medical journals”) to work on coming to a mutual understanding of what you are going through. “Find things that are the language you and your partner speak,” she says; she sends her own partner comic strips and had them play Depression Quest, a role-playing game in which you navigate tasks as a person with depression.

We treat mental health very different than physical health,” Notte points out, adding, “If I were dating somebody and I had diabetes and wanted them to know I’d have to inject myself with insulin at some point, I wouldn’t have to be embarrassed to tell them that.” As with any disease, depression shouldn’t be treated as a liability in dating, and people who would treat it as such are not worth your time. Addison tells me, “Anybody who’s going to make you feel bad or weird about how your body works, does not deserve access to it. Disability rights folks have taught me, don’t apologize for how your body works or feel like you need to make someone else feel okay with you. If they can’t handle you, they can’t get with you.”

But that doesn’t mean it will always be easy—for either of you. So being present with your feelings and communicating them to your partner is vital. Moon says, “When you notice something coming up for you, whether it’s an emotion, a sensation, or a memory, practice giving it attention and letting it give you information.” Perhaps there is a “need attached to the emotion that you can turn into a request,” like needing more lube, or a moment to process your feelings before hooking up, etc. “If you notice that you’re going to cry, for instance, you can mention that so it doesn’t scare your partner,” Moon suggests. “Saying something like, ‘I’m having a great time, but I’m noticing some sadness come up. So if I start to cry, that’s okay, you’re not doing anything wrong. I’ll let you know if I want to stop, but I don’t want to right now.'”

Likewise, Addison recommends acknowledging the experience in the moment in a way that reassures your sexual partner that you don’t blame them for what’s happening. You can do this, she suggests, by saying something like: “This is just a thing my body does sometimes, and I”m not worried about it, so you shouldn’t worry about it either. Thanks for understanding. And I’m really enjoying [kissing you] so let’s do more of that.”

While the physical manifestations of depression in sexual relationships cannot be solved by medication, Notte recommends “workarounds” to address your specific sexual issue. Notte recommends using lubricants and not shying away from toys if experiencing anorgasmia, genital numbness, or erectile dysfunction. Exploring these types of options are especially great for people whose depression-related sexual problems manifest as specifically physical.

While all of this information is important for people with depression, it’s also essential for the partners who don’t have depression to understand how to respond in these situations. Addison tells me the best way is the simplest—nothing more than a “thanks for letting me know.” She explains, “Viewing someone as broken, or suffering, or in need of special treatment, is actually a poor way to approach sexual intimacy. If someone trusts you enough to let you know what’s going on with them, appreciate the gift that has been given to you, and treat it accordingly, with respect. [If your partner says,] ‘I don’t come through intercourse, and I might or might not finish myself off afterward,’ it is not an invitation for you to try to complete the Labors of Hercules to prove what an awesome lover you are. It’s information for you to let you know how this person’s body works, so be grateful that they trusted you enough to share something private with you, and act accordingly.”

And, she points out, “There’s nothing wrong with enjoying your climax when you’re with someone who’s said, ‘I probably won’t get off, but it’s still fun for me.'” Above all, Addison states, “Treat them like the expert on their own body, and you’ll be on the right track.”

Of course, finding people who will do that, especially at the beginning of a relationship or when dating around, can be difficult, but Addison advises to “decide what you’re looking for and what you’re willing to do or not do in order to get it… then screen your dates accordingly.” Finding someone who is comfortable with and respectful of your depression and sexual issues is a trait that can be filtered right in with your usual set of dating criteria. Addison says, “If you say, ‘Hey, I have medication that means I probably won’t come, and I’m looking for a partner who won’t be hung up about it—are you cool with that?’ and they try to inform you about how they’re going to be the one who makes you scream down the rafters, that’s a good reason to swipe left.” After all, she explains, “You can’t fuck somebody out of depression with your Magic Penis or Magic Vagina.”

If you or a loved one are seeking out further information about experiencing the sexual side effects of depression, seek out a psychologist or psychotherapist near you, and remember, as Addison says, “The only people who deserve to get close to you are people who can understand your needs and treat you with appropriate respect and care.”

Complete Article HERE!

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How To Navigate 6 Common Sexual Health Conversations With Your Partner

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By Jen Anderson
The pillar of any good relationship is open communication — and that doesn’t stop at being honest about whose turn it is to do the dishes. Opening up about sex with your partner, whether it’s about your birth control options, the positions that make you feel best, or the need to take emergency contraception, is essential to truly enjoying your sex life.

That’s why, in partnership with Plan B One-Step, we created a handy guide to the most common sex conversations you might encounter, tapping Katharine O’Connell White, MD, MPH, and Rachel Needle, PsyD, for their best advice on how to navigate each. No matter if it’s a new Hinge fling, a veteran booty call, or a long-term relationship, you should feel empowered to have these conversations — especially when they help ensure safe sexual health practices and more enjoyment to help you reach that O. Read ahead to see how Dr. White and Dr. Needle break it all down. A better sex life awaits you

The Birth Control Conversation

Before you engage in sex at all, it’s crucial that you and your partner are transparent with each other about what contraception you plan to use to protect against sexually transmitted infections (STIs), sexually transmitted diseases (STDs), and unintended pregnancies. This means talking about the methods you might already be using, like the pill or the IUD, plus barrier methods like condoms or a diaphragm. Be open and honest about your prior experience so that you’re both on the same page.

“The condom discussion is paramount, for the safety of all involved,” Dr. White says, and she suggests always having a supply of condoms on hand. This way, both parties can feel more comfortable going into sex knowing that you’re taking precautions to reduce the risk of STIs and STDs.

The Frequency Conversation

While you may feel like you’re the only couple that struggles with differing opinions on how often you want to have sex, the truth is that it’s very common. The key here is to bring up your feelings about frequency when you’re not hot and heavy. “Start off with something positive about your relationship, including your sexual relationship,” Dr. Needle advises. Then, “use feeling words and ‘I’ statements, [so you don’t put] your partner on the defensive.” Use the conversation to establish the factors that are contributing to either party’s decrease in sexual desire, and make plans to work on them, either on your own, together, or with a professional. Just remember: “There is not really a ‘normal’ amount or an amount of sex that is good or correct to have. Each couple is different.”

The Emergency Contraception Conversation

So the condom broke during sex, or it never got used. There’s no need to skirt around the issue. Dr. White suggests bringing up the emergency contraception conversation by saying something like, “Whoops, I think we forgot something,” if you and your partner forgot to use your preferred birth control method. If it broke, just say so, point blank. It’s likely that your partner is thinking the exact same thing as you are — someone just needs to break the ice and bring it up.

Make arrangements to buy Plan B One-Step for emergency contraception together, or, in the case of a fleeting one-night stand or a FWB-gone-awry, the conversation might not be necessary, and you should still feel empowered to get your emergency contraceptive on your own. It’s easier than ever, with Plan B available on the shelf at all major retailers without a prescription, age restriction, or ID. Just keep in mind: You have 72 hours after unprotected sex to take it, and the sooner you take it, the more effective it will be at helping prevent pregnancy.

The Sexually Transmitted Infections (STIs) & Sexually Transmitted Diseases (STDs) Conversation

When it comes to asking your partner to get tested, Dr. White advises keeping the convo friendly and factual. Try telling them your plans to get tested, and suggest they do the same. “That way, getting tested is a joint venture and not a one-way request,” she explains. If you already have an STI or STD, it’s important to chat about this prior to any sexual encounters — your partner has a right to know about their own risks. “Pick the right time and place for a serious conversation, and try [saying something like], ‘I like you a lot, so there’s something you need to know.'”

The Period Sex Conversation

Period sex isn’t for everyone. But for some, it can be just as enjoyable as non-period sex and even bring couples together in a new way. According to Dr. White, the best way to approach this topic is with a casual conversation that signals you’re not embarrassed and allows your partner to follow your lead. “Mention [upfront] that you’re on your period, so [you can] throw down a towel on the bed to protect the sheets,” she says — especially those white cotton sheets. Not only is this conversation important to have for transparency, but it could introduce a favorite new time of the month to get intimate. “Sex during your period has a lot of advantages,” she adds. “The blood can act as a [secondary] lubricant, and the endorphins released with orgasm can help soothe period cramps.”

The Painful-Sex Conversation

Plain and simple, painful sex isn’t good sex for anyone. “Any decent human will not want to cause you pain and will work with you to make it more comfortable,” Dr. White says. So use your voice to tell your partner immediately if something isn’t feeling quite right — even if this means stopping sex early. If the pain persists, “Trust your body… You should not keep doing the same thing that hurts. This will only teach your body to associate pain with sex, which can be a brutal cycle to break,” she adds.

Complete Article HERE!

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For survivors, breast cancer can threaten another part of their lives: sexual intimacy

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By Barbara Sadick

Jill was just 39 in July 2010 when she was diagnosed with stage 2 breast cancer. Her longtime boyfriend had felt a lump in her right breast. Two weeks later, she had a mastectomy and began chemotherapy. The shock, stress, fatigue and treatment took its toll on the relationship, and her boyfriend left.

“That’s when I began to realize that breast cancer was not only threatening my life, but would affect me physically, emotionally and sexually going forward,” said Jill, a library specialist in Denver who asked that her last name not be used to protect her privacy.

When someone gets a breast cancer diagnosis, intimacy and sexuality usually take a back seat to treatment and survival and often are ignored entirely, said Catherine Alfano, vice president of survivorship at the American Cancer Society. Doctors often don’t talk with their patients about what to expect sexually during and after treatment, and patients can be hesitant to bring up these issues, she said.

Among the common problems that the cancer treatment can cause are decreased sex drive, arousal issues and pain when having sex, and body image issues (if there has been such surgery as a mastectomy), Alfano said. Many of these problems are treatable, but only if a patient speaks up. That way, the clinician can refer the person to specialists versed in physical or psychological therapy for cancer survivors or health specialists familiar with the useful medications and creams.

According to the National Cancer Institute, about 15.5 million cancer survivors live in the United States. Of those, 3.5 million had breast cancer.

Sharon Bober, a Dana-Farber Cancer Institute psychologist and sex therapist, said the biggest problems couples and single women face after breast cancer are the surprises that unfold sexually. She said chemotherapy and hormone suppression therapy can send women abruptly into menopause or exacerbate previous menopausal symptoms, such as vaginal dryness, pain with intercourse and stinging, burning and irritation. Many women are also surprised to discover that breasts reconstructed after a mastectomy have no sensation.

Betty and Willem Bezemer. Betty, 72, had been diagnosed with breast cancer at age 50. Throughout her treatment, her husband kept her spirits up. The couple maintained their intimacy by continuing their habits together, such as dancing and soaking in bubble baths.
Couples, Bober said, often can benefit from working with a sex therapist trained in breast cancer issues. “It takes time and practice, especially in the face of permanent changes such as loss of sensation or body alterations,” she said. “Women need to become comfortable in their bodies again.”

Amber Lukaart, 35, was diagnosed in 2016 with invasive ductal carcinoma in her right breast. She had no family history of the disease and found the lump herself. She had been working at the Center for Women’s Sexual Health in Grand Rapids, Mich., helping survivors navigate their sexual issues — work that turned out to help her, too.

Her treatment was 16 rounds of chemotherapy, a partial mastectomy of her right breast, 20 rounds of radiation that left the skin on her chest raw and inflamed, and six months of a hormone blocker to protect her ovaries so she could have children in the future.

These treatments affected her sexuality and marriage. The first time she and her husband had sex after the treatments was horribly painful because of dryness. The pain, plus fear of cancer recurrence and death, put a halt to their attempt to reconnect emotionally. At the same time, the partial mastectomy and radiation left her breast looking malformed. She said she felt self-conscious and uncomfortable about it.

She turned to people she knew from her work and felt lucky to have the support.

“I understood immediately that I was in a unique position to help myself and my husband understand and communicate to each other the questions and concerns we both had about our sexual relationship,” Lukaart said.

Yet even with access to sex therapists, sex counselors and treatments, Lukaart said she still felt frustrated with the relative lack of data regarding hormone use for someone like her with estrogen-receptor-positive breast cancer — which about 80 percent of all breast cancer patients have, according to the National Cancer Institute. This type of the disease causes cancer cells to grow in response to the hormones estrogen and progesterone. Hormone treatments that are standard for dryness usually cannot be used after this time of cancer. And over-the-counter remedies didn’t seem to help Lukaart.

She and the co-founder of the women’s center, Nisha McKenzie, researched nonhormonal options. They came across a laser therapy that increases the thickness and elasticity of the vaginal walls. It took three sessions but eventually Lukaart said it gave her back the ability to have a sexual relationship with her husband. Three treatments cost about $3,000 and are not covered by insurance. (Lukaart’s work at the center, which now provides laser treatment, allowed her to get the therapy for free.).

McKenzie and Lukaart are focusing their efforts to help survivors recognize that they may need to do more than just ask their doctors for advice if they want to find ways to get their lives back on track sexually.

McKenzie said several organizations can provide the names of experts who can help, including the American Association of Sexuality Educators, Counselors and Therapists and the International Society for the Study of Women’s Sexual Health.

“Women need to know,” said Lukaart, “that they have to advocate for themselves and that it’s okay to want more than just to survive cancer — it’s ok to thrive, too.”

In Jill’s case, after exhausting the help of her oncologist and other physicians, she joined a clinical study run by Kristen Carpenter, director of Women’s Behavioral Health at Ohio State University, that looks at ways of improving sexual and emotional health after breast cancer.

The study of 30 women used mind-body techniques, such as progressive muscle relaxation to help with sexual intimacy, Kegel exercises to improve pelvic floor muscle tone and cognitive behavioral therapy to help them rethink negative, self-directed thoughts.

The group also had discussions about assertiveness training, communication techniques to use with partners, sexual positions, and aids that may improve comfort and pleasure.

“We laughed, cried and learned from each other’s struggles and stresses in a warm and understanding environment,” Jill said. “and it helped give me the tools for communicating my needs and challenges and to be aware that psychological and physiological interventions are available.”

A supportive partner can ease the problems of breast cancer survivors.

Betty Bezemer, 72, had been diagnosed with breast cancer at age 50. Throughout her treatment, her husband kept her spirits up. The couple maintained their intimacy by not only discussing what was happening but also continuing their habits together, such as dancing and soaking in bubble baths.

Bezemer said their relationship never suffered. And, with the help of lubricants and other remedies, they found ways to be closer sexually and otherwise.

“My husband always made me feel that he had fallen in love with my head and heart and not just my breasts,” said Bezemer, who now serves on the Houston board of the breast cancer organization Susan G. Komen.

“Obstacles may not be easy to overcome, but women need to understand and accept that problems of intimacy and sex will often follow breast cancer treatment,” said Julie Salinger, a clinical social worker at Dana Farber. “But there are solutions, and the sooner people start to ask about them, the better, as they will only get worse by waiting.”

Complete Article HERE!

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LGB people face higher risk of anxiety, depression, substance abuse

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By Chrissy Sexton

Researchers at Penn State are reporting that individuals who identify as gay, lesbian, or bisexual are at a higher risk for several different health problems. The experts found that sexual minorities were more prone to anxiety and depressive disorders, cardiovascular disease, and drug and alcohol abuse.

Study co-author Cara Rice explained that stress associated with discrimination and prejudice may contribute to these outcomes.

“It’s generally believed that sexual minorities experience increased levels of stress throughout their lives as a result of discrimination, microaggressions, stigma and prejudicial policies,” said Rice. “Those increased stress levels may then result in poor health in a variety of ways, like unhealthy eating or excessive alcohol use.”

Professor Stephanie Lanza said the findings shed light on health risks that have been understudied.

“Discussions about health disparities often focus on the differences between men and women, across racial and ethnic groups, or between people of different socioeconomic backgrounds,” said Professor Lanza. “However, sexual minority groups suffer substantially disproportionate health burdens across a range of outcomes including poor mental health and problematic substance use behaviors.”

It has been previously documented that sexual minorities have an increased risk of substance abuse or anxiety disorders, but Rice said that studies have not yet established whether these health risks remain constant across age.

“As we try to develop programs to prevent these disparities, it would be helpful to know which specific ages we should be targeting,” said Rice. “Are there ages where sexual minorities are more at risk for these health disparities, or are the disparities constant across adulthood?”

The investigation was focused on data from over 30,000 participants in the National Epidemiologic Survey of Alcohol and Related Conditions-III, who were between the ages of 18 and 65. The survey collected information about alcohol, tobacco, and drug use, as well as any history of depression, anxiety, sexually transmitted infections (STIs), or cardiovascular disease.

To analyze the data, the researchers used a method developed at Penn State called time-varying effect modeling.

“Using the time-varying effect model, we revealed specific age periods at which sexual minority adults in the U.S. were more likely to experience various poor health outcomes, even after accounting for one’s sex, race or ethnicity, education level, income, and region of the country in which they reside,” explained Professor Lanza.

Overall, sexual minorities were found to be more likely to experience all of the health outcomes. For example, these individuals had about twice the risk of anxiety, depression, and STIs in the previous year compared to heterosexuals.

The experts also determined that risks for some health problems were higher at different ages. An increased risk for anxiety and depression was highest among sexual minorities in their early twenties, while an increased risk for poor cardiovascular health was higher in their forties and fifties.

“We also observed that odds of substance use disorders remained constant across age for sexual minorities, while in the general population they tend to be concentrated in certain age groups,” said Rice. “We saw that sexual minorities were more likely to have these substance use disorders even in their forties and fifties when we see in the general population that drug use and alcohol use start to taper off.”

Rice said the results of the study could potentially be used to develop programs to help prevent these health problems before they start.

“A necessary first step was to understand how health disparities affecting sexual minorities vary across age,” said Rice. “These findings shed light on periods of adulthood during which intervention programs may have the largest public health impact. Additionally, future studies that examine possible drivers of these age-varying disparities, such as daily experiences of discrimination, will inform the development of intervention content that holds promise to promote health equity for all people.”

The study is published in the journal Annals of Epidemiology.

Complete Article HERE!

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Orgasmic dysfunction:

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Everything you need to know

By Jenna Fletcher

Orgasmic dysfunction is when a person has trouble reaching an orgasm despite sexual arousal and stimulation.

In this article, learn about the causes and symptoms of orgasmic dysfunction and how to treat it.

What is orgasmic dysfunction?

Orgasmic dysfunction is the medical term for difficulty reaching an orgasm despite sexual arousal and stimulation.

Orgasms are the intensely pleasurable feelings of release and involuntary pelvic floor contractions that occur at the height of sexual arousal. Orgasmic dysfunction is also known as anorgasmia.

There are several different types of orgasmic dysfunction, including:

  • Primary orgasmic dysfunction, when a person has never had an orgasm.
  • Secondary orgasmic dysfunction, when a person has had an orgasm but then has difficulty experiencing one.
  • General orgasmic dysfunction, when a person cannot reach orgasm in any situation despite adequate arousal and stimulation.
  • Situational orgasmic dysfunction, when a person cannot orgasm in certain situations or with certain kinds of stimulation. This type of orgasmic dysfunction is the most common.

Orgasmic dysfunction can affect both males and females but is more common in females. Researchers estimate that female orgasmic disorder, which is recurrent orgasmic dysfunction, may affect between 11 to 41 percent of women.

The North American Menopause Society report that 5 percent of all women have difficulty achieving orgasm.

Research from 2018 found that 18.4 percent of women could reach an orgasm through intercourse alone. However, the same study indicated another 36.6 percent of women needed clitoral stimulation to reach orgasm during intercourse.

Orgasmic dysfunction can affect the quality of people’s relationships, as well as a person’s self-esteem and mental health.

Symptoms

Orgasmic dysfunction is when someone has difficulty or the inability to reach an orgasm. For some people, reaching a climax can take longer than normal or be unsatisfying.

The way an orgasm feels or how long it takes to have an orgasm can vary widely. When someone has orgasmic dysfunction, climax can take a long time to reach, be unsatisfying, or be unattainable.

Causes

Scientists are not sure what causes orgasmic dysfunction, but believe the following factors may contribute to the problem:

 
  • relationship issues
  • certain medical conditions, such as diabetes
  • a history of gynecological surgeries
  • some medications, including antidepressants
  • a history of sexual abuse
  • religious and cultural beliefs about sex and sexuality
  • depression
  • anxiety
  • stress
  • low self-esteem

Also, women over 45 years of age are more likely to have trouble orgasming than women under this age. This may be due to menopause-related hormonal shifts and vaginal changes.

Once someone experiences difficulty reaching an orgasm, they may experience increased stress in sexual situations. Stress and anxiety during sex can make it even more difficult to reach an orgasm.

Diagnosis

Before diagnosing orgasmic dysfunction, a doctor will likely ask about a person’s symptoms and how long they have existed.

The doctor will also note any factors that could contribute to orgasmic dysfunction, such as underlying health conditions or the medications a person is taking.

A doctor may do a physical examination as well. In some cases, they may refer a person to a sexual medicine specialist or a gynecologist.

Treatment

Treatment for orgasmic dysfunction varies, depending on the underlying cause. A doctor may recommend treating any other conditions or adjusting any medications that may contribute to sexual health problems.

In many cases, a doctor may recommend a person who has orgasmic dysfunction try sex therapy or couples counseling.

A certified sex therapist can offer psychotherapy that focuses on concerns related to sexual function, feelings, or dysfunctions. Sex therapy can be done on an individual basis or with a partner.

Couples counseling focuses on relationship issues that may be affecting an individual’s sexual function and their ability to orgasm.

In some cases, a doctor or therapist may suggest a person try other forms of sexual stimulation to reach orgasm, such as masturbation or increased clitoral stimulation during intercourse. For others, they may recommend over-the-counter oils and warming lotions.

Hormone therapy may be effective for some females, particularly if the inability to orgasm coincided with the start of menopause.

In these cases, a doctor may suggest the woman tries an estrogen cream, patch, or pill. The estrogen may alleviate some menopause symptoms and improve sexual response.

Summary

Orgasmic dysfunction is the medical name for the inability to reach orgasm. Some people may experience orgasmic dysfunction when it takes too long to reach orgasm or when their orgasm does not feel satisfying.

Many factors can contribute to orgasmic dysfunction. To remedy orgasmic dysfunction, a person can speak to a doctor, a certified sex therapist, and other medical professionals to find the cause.

People can take steps to treat orgasmic dysfunction and improve their sexual health once they know the cause.

Complete Article HERE!

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11 Sex Tips for Guys Just Coming Out of the Closet

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By Zachary Zane

A few pointers for people who are just starting to explore their sexuality!

Right after coming out as gay/bi, the idea of having sex with another man can be nerve-wracking. The mechanics, while simple, aren’t necessarily intuitive. It also can be tough to really connect to another guy sexually right after sashaying out of the closet. Well, as we begin 2019, let’s make a New Year’s resolution to explore having better and more meaningful sex. With that in mind, here are 11 sex tips for guys who’ve just come out as queer.

1. There will always be cute guys

Cute guys are a dime a dozen. There will always be cute guys, so don’t be upset if one rejects you. Seriously, it’s not the end of the world! Don’t do anything stupid just to have sex with one. Relax. You have the rest of your life to sleep with cute guys.

2. Use condoms (even if you’re on PrEP)

If you just came out and are just starting to get comfortable with your sexuality, the last thing you’ll want to be doing is getting an STD or STI. Honestly, it’s just going to bum you out and make you never want to have sex again. So wear condoms. (Even if you’re on PrEP!)

3. Tell him what you’re into beforehand

Sex shouldn’t be a guessing game. If you’re into something, let him know beforehand that you like X, Y, Z, and it would really turn you on if he did that to you. That’s one of the (few) things that’s great about apps like Grindr. You can explicitly state what you’re into before meeting up without any judgement.

4. Be vocal during sex

In addition to saying what you’re into before things start heating up, you should also be vocal about what you like during sex. If that position isn’t doing anything for you, tell him you want to change positions. He isn’t a mind reader. Let him know what’s up!

5. Have sex with guys who are outside your normal “preference”

We all have men who we are attracted to and not attracted to. I’m not saying that you should sleep with men you’re not attracted to, but I am saying that you should broaden your horizons. Often, societal norms dictate to us what’s attractive. If we’re able to break away from societal standards of beauty, it opens us up (metaphorically and physically) to a wider range of sexual and romantic partners. 

6. Be vers

It’s 2019. Being a top or bottom only is so passé. Do it all. Be a millennial, renaissance man! Besides, being vers makes you a better lover because you’re aware of the mechanics of both types of sex.

7. You can say “no” anytime before or during sex

You can always say no anytime before or during sex without an ounce of shame. If you don’t feel comfortable, you have a right to stop having sex at anytime. Is it awkward to kick guys out of your house? Yes, it is, but it is worth the awkwardness. If you’re not into it, and he’s being aggressive, tell him to GTFO.

8. Figure out your own method of cleaning your butt

There are plenty of ways to get a deep clean. Figure out if a douche (or some other way) is the right way for you! While I douche, I’ve heard of some folks using ear syringes to clean out because it’s less forceful.

9. Never feel embarrassed, ashamed, or awkward about asking a guy’s status

You should never get uncomfortable or feel bad for asking a guy what his status is, as well as asking him to use a condom. In the era of PrEP, there is definitely a little bit of condom-shaming, but while you shouldn’t judge them for not wearing a condom, they shouldn’t judge you for wanting to wear one.

10. Use lube

Lube is your best friend. The more lube the better. You want to be turning that bed of yours into a Slip ‘N Slide! Additionally, it’s important to see what type of lube feels best for you. Some guys prefer water-based, whereas others prefer silicone or a hybrid mix of both. 

11. Explore your kinks

We all have some form of kink. Something a little more exciting that we’re into. Explore them now. There’s literally no reason to wait. And no matter how “weird” you think your kink is, there are literally thousands (if not millions) of guys who have the same one. You’re definitely not alone.

Complete Article HERE!

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How Alcohol Impacts Your Sex Life

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By GiGi Engle

The situation looks something like this: You’re out with on a date, the drinks are flowing and you’re feeling decidedly frisky. Somewhere between your third drink and that Cardi B song you love, you decide your date is definitely coming home with you.

Once you get there, you are both ready and willing to get in the groove. Unfortunately, your body is not as enthusiastic as your brain. You still want to have sex, but no matter how much you rub your clitoris, it is not down for the count. You’re on an endless plateau and no orgasms can be found.

Alcohol has loosened your inhibitions, but it has also taken the wind out of your sails. The situation is … not great.

So, why do we drink when we’re out partying, on dates, or with hanging with friends? What impact does alcohol have on sex, orgasm, and libido? Here is what we know.

Alcohol can act as social lubricant
While alcohol and sex don’t always mix well, it can act as a social lubricant, easing tension in social situations. When you’re trying to get some action, a couple of drinks can make the initial awkwardness less overwhelming, “The only possibilities for positive effects is for alcohol to create a feeling of less self-consciousness and to reduce inhibitions,” says Felice Gersh, M.D., OB/GYN, and founder/director of the Integrative Medical Group of Irvine, CA.

This is why we often feel sexy and in the mood after we’ve had a couple glasses of wine, our nerves are settled and we feel freer. “For women, moderate alcohol intake may increase libido and reduce anxiety or inhibitions toward sex,” addes Dr. Anika Ackerman, MD, a New Jersey based urologist.

Boozy vaginas are dry vaginas
Have you ever heard of Whiskey Vagina? This charming term (popularized by yours truly) refers to when you’ve had too much to drink. You start fooling around, and suddenly realize your vagina is not in on this game. Your drunk brain might be saying, “YES! I WANT TO GET IT!” but your vagina is not having it.

“Alcoholic beverages do have a negative impact on the development of sexual health,” Gersh says. “[It] can impact vital female sexual functions, such as the creation of vaginal moisture, by impacting the autonomic nervous system.”

In short, alcohol might calm you down by affecting the nervous system, but it will also dry you out for the same reasons.

Alcohol can inhibit orgasm
Drinking is all fun and games until you can’t have an orgasm. Not only has alcohol been shown to decrease natural vaginal lubrication, it increase issues with erection in men and destroys orgasm. “Alcohol can increase impotence and reduce the ability to orgasm and their intensity,” Gersh tells us.

Again, this is due to the negative impact alcohol has on the nervous system, a vital component in orgasm. Gersh says that without a normally functioning nervous system, orgasm might be off the table entirely.

Not to mention, the drunker you get, the sloppier and less coordinated you become. “The more inebriated a person becomes the more impaired they become,” Gersh says. This is both not particularly cute and overall super dangerous, especially if you’re going home with someone for the first time.

Alcohol complicates consent

Another critically important factor in this situation is consent. When you’re drunk, you don’t have ability to consent to sexual activity, according to the law. What’s more, you may be too impaired to even remember what happened the night before at all. Perhaps you didn’t even want to have sex, but were too drunk to say no. These are dark implications, but ones that need to be addressed. Sex an alcohol are a dangerous combination. And consent is an ongoing conversation.

It’s about moderation
If you want to have a glass or two of wine, that’s perfectly OK. Having a drink won’t harm you. It’s when you start pounding shots or take a bottle of wine to the face that your sex life (and life in general) will suffer consequences. So keep tabs on your intake and don’t overdo it. If you have issues with controlling your alcohol intake or have had struggles with abuse, it’s best stay away from alcohol altogether

In the end, alcohol is a big part of our social system, but when it comes to sex, the negative effects seem to outweigh any positive aspects. If you’re trying to have a screaming orgasm tonight, it might be an idea to not go overboard on the booze.

Complete Article HERE!

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Father-Son Talks About Condoms Pay Health Dividends

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By Steven Reinberg

Here’s some straight talk about the value of “the talk.”

Fathers who talk with their teenage sons about condom use can help prevent sexually transmitted infections (STIs) and unplanned pregnancies, researchers say.

Condoms are the only contraceptive method that can prevent pregnancy and the spread of sexually transmitted infections, including HIV. Yet, recent U.S. government data showed that condom use among teens steadily declined over the last decade.

And as condom use dropped, the number of sexually transmitted infections increased, researchers found. In 2017, the number of STIs reached an all-time high for the fourth year in a row, with teens and young adults accounting for about half of the cases, according to the U.S. Centers for Disease Control and Prevention.

Two out of three new HIV infections in young people are among black and Hispanic males, and more than 200,000 births a year are to teens and young adults, the study authors noted.

For the new study, researchers interviewed 25 black and Hispanic fathers and sons (aged 15 to 19) from New York City. The research was led by Vincent Guilamo-Ramos, a professor at New York University and a nurse practitioner specializing in adolescent sexual and reproductive health at the Adolescent AIDS Program of Montefiore Medical Center, in New York City.

The interviews made it clear that fathers talking to their sons about using condoms consistently and correctly is not only possible, but acceptable. The sons said they wanted their dads to tell them how to use condoms and problems with them, such as breakage and slippage, as well as incorrect use.

Fathers also saw these conversations as a way to improve their own condom use, the study authors said.

The findings showed that communicating about condom use can be a powerful way to help prevent teen pregnancies and sexually transmitted infections, the researchers concluded.

“Helping fathers teach their sons about the consistent and correct use of condoms by addressing common communication barriers — and focusing specifically on strategies to avoid condom use errors and problems — is a promising and novel mechanism to increase the use of male condoms and to reduce unplanned pregnancies, STIs, and sexual reproductive health disparities among adolescent males,” the study authors said in a New York University news release.

The report was published online Dec. 17 in the journal Pediatrics.

More information

For more about sexually transmitted infections, visit the American Sexual Health Association.

Complete Article HERE!

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Yes, Depression Can Disrupt Your Sex Life

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— But The Reason Is Not What You Think

By Kelly Gonsalves

When a couple finds themselves in a sexual rut, it can be hard to even pinpoint what got them there in the first place, let alone figure out a way to climb out. Oftentimes it’s a series of accumulated factors that have contributed to a slower or stagnant intimate life—a particularly time-consuming project at work, paired with the kids just entering a challenging new grade level, plus residual tension between the two partners after a recent argument, and then add in any health trouble that might be making physical touch difficult.

One other potentially major exacerbating factor? Mental health.

Depression can lower a person’s libido, both as a symptom of the chemical imbalances present in a depressed person’s brain and as a side effect of certain kinds of treatment. But additionally, a recent study published in the Journal of Social and Personal Relationships suggests there might be another explanation for how depression can disrupt a couple’s sex life: a phenomenon that researchers call interference, which refers to the small but consistent ways being in a relationship can affect someone’s daily life.

“Interference focuses on the ways partners can disrupt day-to-day routines and individual goals. It happens because our relationships have interdependence—our lives overlap with our partners’ lives,” Amy Delaney, Ph.D., a Millikin University assistant communication professor and lead author of the study, tells mbg. “The example I always give my students is my husband putting his socks on the floor instead of in the laundry basket (which is right there). Because our lives are interdependent, when he doesn’t get his laundry in the basket, he’s interfering with my goal of not having dirty socks on the floor.”

Past research has posited that relationship turbulence is triggered by two qualities: relational uncertainty (that is, the degree to which each party feels confident or uncertain about the status of the relationship and each person’s investment in it) and interference from a partner.

All this in mind, Dr. Delaney surveyed 106 different-sex couples where one or both people in the relationship had been diagnosed with depression, asking them about their depressive symptoms, their sexual intimacy challenges, their levels of relational uncertainty, and the ways each partner interfered with the other’s daily life. Her findings? People with more depressive symptoms also tended to report more relational uncertainty and increased perceptions of interference. But it was the latter—perceiving interference from a partner—that predicted sexual intimacy challenges.

In other words, even just one partner’s depression was associated with both partners feeling like their lives were being disrupted by the other person, and feeling this interference was associated with more stress on the couple’s sex life.

“For couples with depression, interference could really damage partners’ connection,” Dr. Delaney explains. “First of all, interference means that couples are having trouble coordinating routines and goals. If two partners aren’t working well together to accomplish their day-to-day goals, they probably won’t feel very connected in a way that allows them to connect sexually. Second, the relational turbulence model says that interference prompts negative emotions, like frustration. If, for example, one partner is dealing with a lot of interference because their spouse won’t take their medication, doesn’t clean up their dishes, and keeps bailing on plans for date night, that is likely to cause some frustration! And if frustration is added to the already negative emotional climate of depression, partners probably have lots of barriers to creating a positive emotionally and physically intimate connection.”

Interestingly, this effect was particularly significant for men with depression: Men with more depressive symptoms perceived more interference, as did their partners. Dr. Delaney’s theory posited in the paper: “Perhaps men notice goal blockages when they are cognitively and emotionally taxed by depression, whereas women perceive interference when their partners are limited by depressive symptoms.”

So why is this all important? Dr. Delaney believes these results highlight the relational effects of depression and the relational causes of intimacy challenges.

“Lots of existing research really dismisses sex problems as either a symptom of the depression or a side effect of treatment,” she says. These two things can definitely be true, but her findings suggest the qualities of the relationship itself can also be important contributing factors. “Sex problems aren’t just a lack of interest or difficulties with physical function; they’re more nuanced than that.”

If you and your partner are currently in a sexual slump and one or both of you struggle with mental health difficulties, it might be worth it for each of you to consider how your behaviors, habits, and lifestyle might be affecting the other’s day-to-day life and energy. The effects of mental health difficulties, particularly depression, will not be solved over the course of one conversation, but just opening up that dialogue can be a good way to begin working toward improving your life together and minimizing the feelings of tension, disruption, and discordance between you.

“Approach rather than avoid,” writes sex therapist Jessa Zimmerman at mbg. “I recommend that you come from a positive place, making it clear that you’re interested in creating your best possible relationship. Express how you’ve been feeling about the cycle you’re in and specifically acknowledge your own contribution, in thought and in deed, to keeping the two of you stuck.”

Difficulties in the bedroom can indeed be one step in a frustrating cycle—life’s struggles lead to less sexual energy and less sex, less sex can create turbulence in your relationship, and relationship turbulence just adds to more overall struggles, and then the cycle just spirals on and on. Having a healthy and satisfying sex life, on the other hand, can actually improve your mental health and your overall relationship well-being. That’s an equal and opposite kind of cycle, one with so many ongoing positive benefits that it’s certainly worth trying to set it in motion.

Complete Article HERE!

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The 4 Worst Things About Sex After Cancer

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By Annmarieg

After having cancer, a person’s sensitivities to touch, intimacy, and physical activities like sex, can be complicated. The things you wanted before may be different now.

I will not claim to have been a crazy sex kitten before cancer because I was not. My husband and I were a normal married couple of 15 plus years with 4 kids. While we did not have wild sex nightly, we were active and I certainly was not self conscious. I am not going to beat around any bushes here – this post is about trying desperately to get back what was robbed from so many us after cancer: sex.

If you have read anything I write, you know that I am not a doctor, rocket scientist or even a pharmacist so that is not where I am going here. I want to talk mental and why this is such a sexual mind fuck. I hope you don’t mind my use of the phrase, but that’s just the best way I can put it.

1. It’s hard to feel sexy after cancer.
My husband loves me, supports me and cherishes me like the princess I am. Tells me I am gorgeous, even hot. He does not care a freaking damn about my scars or how much weight cancer has made me gain. Why do I have a problem feeling sexy as he touches me? In my head I wonder how can he feel that way when I can not even stand to see myself. I do not even want to touch myself, why on earth would he want to? What does he find beautiful in these extra 15 pounds of scared ragged doll? I just do not see it. I am self conscious as he touches me- even pulling away because I am afraid that if he touches my scars (and there are many) he will realize how ugly and broken I am. I am nervous that he will realize that under the clothes I really am what I see: a mess. Not the women he has created in his eyes. I want to keep my tank-top on and not show him what I see in the mirror. How can he feel sexy when I look like this? Better yet, how can I feel sexy? I want this part of me back.

2. Cancer stole my sex drive.
I should fall his arms and be thrilled to have sex with my adoring husband…but I have no drive. None. I cannot even feel his hand under my shirt. I have no idea what part of my breast he is touching and it makes me mad. I try hard to push that anger aside and focus on how it used to feel but I want to cry. Tears of sadness and anger mixed together while I should be feeling lust and desire to be with the man I love so much. FUCK YOU, cancer. You did this to me and took my sense of feeling along with everything else. My nipples are gone too. Now I am a clean slate with no erotic zone- it makes me feel empty and for lack of creative terms: plain.

3. It hurts like hell.
Now I am honest to a fault, I had a little filter once but cancer broke it right off. When you mess with a women’s hormone’s you then take not just her desire but her lubrication. Vaginal dryness is a HUGE factor. The pain of sex is massive – like grabbing the sheets, “OMG when is this over” type of pain. Yes we have tried different gels but the issue is that you have check and make sure they are safe – some contain estrogen in them, which is a no no. So, now on top of all of the mental pain, there is physical pain too. I know what you are thinking reading this, “there are other things to do”. Tell me would you want to do any of it after everything I just wrote? He does not want to hurt me so I mask the pain and push through. I miss orgasms so terribly bad. This is not something I lost with old age – I am 43 not 93. Cancer took this from me too. We need to be discussing this with our doctors to get help, don’t you think? But talking to them can be embarrassing and make you feel even more broken. It is a vicious cycle.
 

4. Sometimes I hate being touched.
Wanting human touch is in our DNA but after all the poking, testing, prodding and surgeries, it almost makes me flinch now. At doctors appointments I feel like I am in a straight jacket and I need out of this body that I now have to live in. Every time I am touched it reminds me that I am in it with no way to get out.

I miss the touch so bad yet at the same time I hate it because I can not feel it. I want to shove my husband’s hand away like he is violating me which makes no sense but all the sense in the world. To see him touch me but not feel it is mentally painful. And to tell him breaks his heart and mine. This part is just not fair.

Learning how to embrace this body is new and figuring out how to adjust is a challenge. It takes adults years to be self confident right? So how can we expect someone who just went through all this shit cancer gives us to adjust to this body over night? Cancer happens fast. After the treatment, surgeries, and the dust settles you are left staring in the mirror trying to understand this new you. There seems to be lack of support on how to proceed and cope with the aftermath. All the while your spouse just wants to get their groove back, wanting you to “get over it”. It is not as easy as sexy lingerie (and for the record that is HARD to find) and high heels. It is about getting outside your own head and grasping the reality of where you are now, who you are now and how you feel in this new changed body.

I just want to straighten my tiara, get into bed, have my husband hold me and feel it. Is that too much to ask?

Complete Article HERE!

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Erectile dysfunction: exercise could be the solution

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By , &

Men with erectile dysfunction can improve their sexual function with 40 minutes of aerobic exercise, four times a week, according to our latest review of the evidence.

We reviewed all international studies carried out over the past ten years where inactive men with erectile dysfunction received professional help to become physically active. The results showed that most of the time it is possible to reduce erection problems with exercise.

Erectile dysfunction is the most common male sexual dysfunction. It is defined as a consistent or recurring inability to get and maintain an erection sufficient for sexual activity. In other words, persistent problems in getting it up or keeping it up during intercourse or masturbation.

Erectile dysfunction, including weakened night and morning erections, may be an early sign of health problems and, sometimes, a symptom of early-stage atherosclerosis (stiffening and narrowing of the arteries).

We know that erection problems are more common in smokers and in men who are physically inactive or overweight. It is also more common in men with high blood pressure, cardiovascular diseases and diabetes. So erection problems may be the first sign of vascular disease.

About 23% of inactive men and about 23-40% of obese men suffer from erectile dysfunction, as do 40% of men receiving treatment for high blood pressure and 75% of men with cardiovascular disease. By comparison, 18% of men in the general population have, or have had, erectile dysfunction.

Hardening of the arteries

When a man becomes sexually aroused, blood flows to his penis and the increased blood in the erectile tissue results in an erection. But in men with atherosclerosis the penile artery walls become thick and lose their elasticity. Three-quarters of erection problems are linked to atherosclerosis, a condition typically triggered by lifestyle factors, such as obesity, physical inactivity and smoking.

We already knew that lifestyle modifications, including physical activity, improved vascular health, sexual health and erectile function. Exercise is the lifestyle factor most strongly associated with erectile function and widely recognised as the most important promoter of vascular health, as physical activity improves blood circulation in the body, including the penis. We also knew that there is strong evidence that frequent physical activity significantly improves erectile function.

For our study, we wanted to know how much physical activity is needed to improve erectile function. We saw that physical activity of moderate to high intensity for 40 minutes, four times a week for six months resulted in an improvement or even a normalisation of the person’s erection. After six months of physical activity, men who could not masturbate or have sex for a long time were able to resume sexual activity.

The figure below shows, on a scale of 0-30 points, the average erectile function of men in different studies before and after the intervention (exercise). In all studies, men had improved erectile function.

Take-home message

If you are physically inactive and in bad shape, it’s important to not push yourself into a fitness regime that is beyond you, otherwise, you risk injury, which could make exercising difficult and reduce your motivation to continue.

The best approach is to start with simple aerobic activity. Walk every day, swim or cycle, and increase the pace and distance week by week. After a few weeks, you could add jogging, dancing, tennis or football into the mix. Or, if you prefer, you could join a gym.

To strengthen blood circulation – throughout the body and also the penis – exercise intensity must be moderate to high. This means that you warm up your body and produce sweat, your face turns red, your pulse increases and you become slightly breathless – breathless enough to make it difficult to have a conversation.

If your erectile dysfunction is caused by early stages of atherosclerosis, 160 minutes of physical activity weekly for six months will probably improve your ability to get an erection.

A physically active lifestyle should be considered as the beginning of more permanent lifestyle changes. If you are overweight, the effect of the physical activity can be further increased by losing weight. And if you smoke, the effect of physical activity becomes even stronger by quitting.

But changing your lifestyle from being physically inactive to being physically active is easier said than done, so it is best to seek professional help. Physiotherapists can help to evaluate your fitness level and potential. Also, they can provide you with a personalised training programme and guide and support you as you gradually increase your level of physical activity.

And exercise is much more enjoyable when you do it with others. So why not invite your partner or friends to join you? After all, training is healthy, but it should also be fun.

Complete Article HERE!

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Americans Were Quizzed on Sexual Health:

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What The Results Say About the State of Sex Ed

by LeAnne Graves

There’s no question that offering consistent and accurate sexual health information in schools is important.

Providing students with these resources not only helps to prevent unwanted pregnancies and the spread of sexually transmitted infections (STIs), but it can also help to ensure the overall well-being of an individual.

Yet the state of sexual education and awareness in some areas of the United States ranges from medically inaccurate to virtually nonexistent.

At present, only 20 states require that sex and HIV education be “medically, factually, or technically accurate,” (while New Jersey is technically the 21st state, it’s been left out since medical accuracy isn’t specifically outlined in state statute. Rather it’s required by the NJDE’s Comprehensive Health and Physical Education).

Meanwhile, the definition for what’s “medically accurate” can vary by state.

While some states may require approval of the curriculum by the Department of Health, other states allow materials to be distributed that are based on information from published sources that are revered by the medical industry. This lack of a streamlined process can lead to the distribution of incorrect information.

Healthline and the Sexuality Information and Education Council of the United States (SIECUS), an organization dedicated to promoting sexual education, conducted a survey that looked at the state of sexual health in the United States.

Below are the results.

Access To Education

In our survey, which polled more than 1,000 Americans, only 12 percent of respondents 60 years and older received some form of sexual education in school.

Meanwhile, only 33 percent of people between 18 and 29 years old reported having any.

While some previous studies have found that abstinence-only education programs don’t protect against teen pregnancies and STIs, there are many areas in the United States where this is the only type of sexual education provided.

States like Mississippi require schools to present sexual education as abstinence-only as the way to combat unwanted pregnancies. Yet Mississippi has one of the highest rates of teen pregnancies, ranking third in 2016.

This is in contrast to New Hampshire, which has the lowest rate of teen pregnancies in the United States. The state teaches health and sex education as well as a curriculum dedicated to STIs starting in middle schools.

To date, 35 states and the District of Columbia also allow for parents to opt-out of having their children participate in sex ed.

Yet in a 2017 survey, the Centers for Disease Control and Prevention (CDC) found that 40 percent of high school students had already engaged in sexual activity.

“When it comes to promoting sex education, the biggest obstacle is definitely our country’s cultural inclination to avoid conversations about sexuality entirely, or to only speak about sex and sexuality in ways that are negative or shaming,” explains Jennifer Driver, SIECUS’ State Policy Director.

“It’s hard to ensure someone’s sexual health and well-being when, far too often, we lack appropriate, affirmative, and non-shaming language to talk about sex in the first place,” she says.

STI prevention

In 2016, nearly a quarter of all new HIV cases in the United States were made up of young people ages 13 to 24, according to the CDC. People ages 15 to 24 also make up half of the 20 million new STIs reported in the United States each year.

Which is why it’s concerning that in our survey — where the age bracket 18 to 29 made up nearly 30 percent of our participants — when asked whether HIV could be spread through saliva, nearly 1 out of 2 people answered incorrectly.

Recently, the United Nations Education, Scientific, and Cultural Organization (UNESCO) published a study that states comprehensive sex education (CSE) programs not only increased the overall health and well-being of children and young people, but helped to prevent HIV and STIs as well.

Driver cites the Netherlands as a prime example of the payoffs from CSE programs. The country offers one of the world’s best sex education systems with corresponding health outcomes, particularly when it comes to STI and HIV prevention.

The country requires a comprehensive sexual education course starting in primary school. And the results of these programs speak for themselves.

The Netherlands has one of the lowest rates of HIV at 0.2 percent of adults ages 15 to 49.

Statistics also show that 85 percent of adolescents in the country reported using contraception during their first sexual encounter, while the rate of adolescent pregnancies was low, at 4.5 per 1,000 adolescents.

Though Driver acknowledges that the United States cannot simply “adopt every sex education-related action happening in the Netherlands,” she does acknowledge that it’s possible to look to countries who are taking a similar approach for ideas.

Contraception misconceptions

When it comes to contraception, and more specifically emergency contraception, our survey found that there are a number of misconceptions about how these preventive measures work.

A whopping 93 percent of our respondents were unable to correctly answer how many days after intercourse emergency contraception is valid. Most people said it was only effective up to two days after having sex.

In fact, “morning-after pills” such as Plan B may help stop unwanted pregnancies if taken up to 5 days after sex with a potential 89 percent reduction in risk.

Other misunderstandings about emergency contraceptives include 34 percent of those polled believing that taking the morning-after pill can cause infertility, and a quarter of respondents believing that it can cause an abortion.

In fact, 70 percent of those surveyed didn’t know that the pill temporarily stops ovulation, which prevents the releasing of an egg to be fertilized.

Whether this misconception about how oral contraception works is a gender issue isn’t clear-cut. What’s understood, however, is that there’s still work to be done.

Though Driver cites the Affordable Care Act as one example of the push for free and accessible birth control and contraception, she’s not convinced this is enough.

“The cultural backlash, as exemplified by several legal fights and an increase in public debates — which have, unfortunately conflated birth control with abortion — illustrates that our society remains uncomfortable with fully embracing female sexuality,” she explains.

93 percent of our respondents were unable to correctly answer how many days after intercourse emergency contraception is valid.

Knowledge by gender

When breaking it down by gender, who’s the most knowledgeable when it comes to sex?

Our survey showed that 65 percent of females answered all questions correctly, while the figure for male participants was 57 percent.

Though these stats aren’t inherently bad, the fact that 35 percent of men who participated in the survey believed that women couldn’t get pregnant while on their periods is an indication that there’s still a ways to go — particularly when it comes to understanding female sexuality.

“We need to do a lot of work to change pervasive myths, specifically surrounding female sexuality,” explains Driver.

“There is still a cultural allowance for men to be sexual beings, while women experience double standards regarding their sexuality. And this long-standing misconception has undoubtedly contributed to confusion surrounding women’s bodies and female sexual health,” she says.

Defining consent

From the #MeToo movement to the Christine Blasey Ford case, it’s clear that creating dialogue around and providing information about sexual consent has never been more imperative.

The findings from our survey indicate that this is also the case. Of the respondents ages 18 to 29, 14 percent still believed that a significant other has a right to sex.

This specific age bracket represented the largest group with the least understanding as to what constituted as consent.

What’s more, a quarter of all respondents answered the same question incorrectly, with some believing that consent is applicable if the person says yes despite drinking, or if the other person doesn’t say no at all.

These findings, as concerning as they might be, shouldn’t be surprising. To date, only six states require instruction to include information on consent, says Driver.

Yet the UNESCO study mentioned earlier cites CSE programs as an effective way “of equipping young people with knowledge and skills to make responsible choices for their lives.”

This includes improving their “analytical, communication, and other life skills for health and well-being in relation to… gender-based violence, consent, sexual abuse, and harmful practices.”

Of the respondents ages 18 to 29, 14 percent believed that a significant other has a right to sex.

What’s next?

Though the results of our survey indicate that more needs to be done in terms of providing CSE programs in school, there’s evidence that the United States is moving in the right direction.

A Planned Parenthood Federation of America poll conducted this year revealed that 98 percent of likely voters support sex education in high school, while 89 percent support it in middle school.

“We’re at a 30-year low for unintended pregnancy in this country and a historic low for pregnancy among teenagers,” said Dawn Laguens, executive vice president of Planned Parenthood.

“Sex education and access to family planning services have been critical to helping teens stay safe and healthy — now is not the time to walk back that progress.”

Moreover, SIECUS is advocating for policies that would create the first-ever federal funding stream for comprehensive sexuality education in schools.

They’re also working to raise awareness about the need to increase and improve the access of marginalized young people to sexual and reproductive healthcare services.

“Comprehensive school-based sex education should provide fact and medically-based information that complements and augments the sex education children receive from their families, religious and community groups, and healthcare professionals,” explains Driver.

“We can increase sexual health knowledge for people of all ages by simply treating it like any other aspect of health. We should positively affirm that sexuality is a fundamental and normal part of being human,” she adds.

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