Category Archives: Health Concerns

Sexuality and Illness – Breaking the Silence


(This is a Companion piece to yesterday’s posting. You’ll find yesterday’s posting HERE!)

By: Anne Katz PhD

Sexuality is much more than having sex even though many people think only about sexual intercourse when they hear the word. Sexuality is sometimes equated with intimacy, but in reality, sexuality is just one way that we connect with a spouse or partner we love (the true meaning of intimacy). Our sexuality encompasses how we see ourselves as men and women, who we are attracted to emotionally and physically, what turns us on (eroticism), our thoughts and fantasies, and yes, also what we do when we are sexually active, either alone or with a partner. Our sexuality is connected to our image of ourselves and it changes over the years as we age and face threats from illness and disability and, eventually, the end of life.seniors_men

Am I still a sexual being?

Illness can affect our sexuality in many different ways. The side effects of treatments for many diseases, including cancer, can cause fatigue. This is often identified as the number one obstacle to sexual activity. Other symptoms of illness such as pain can also affect our interest in being sexually active. But there are other perhaps more subtle issues that impact how we feel about ourselves and, in turn, our desire to be sexual with a partner or alone, or if we even see ourselves as sexual beings. Think about surgery that removes a part of the body that identifies us as female or male. Many women state that after breast cancer and removal of a breast (mastectomy), they no longer feel like a woman; this affects their willingness to appear naked in front of a partner. Medications taken to control advanced prostate cancer can decrease a man’s sexual desire. Men in this situation often forget to express their love for their partner in a physical way, no longer touching them, kissing them, or even holding hands. This loss of physical contact often results in two lonely people.  Humans have a basic need for touch; without that connection, we can end up feeling very lonely.

Just talk about it!

seniors_in_bedCommunication lies at the heart of sexuality. Talk to your partner about what you are feeling, how you feel about your body, and what you want in terms of touch. Ask how you can meet your partner’s needs for touch and affection. The most important thing you can do is to express yourself in words. Non-verbal communication and not talking are open to misinterpretation and can lead to hurt feelings. Our sexuality changes with age and time and illness; we may not feel the same way about our bodies or our partner’s body that we did 20, 30 or more years ago. That does not mean we feel worse – with age comes acceptance for many of us – but we do need to let go of what was, and look at what is and what is possible.

The role of health care providers

Health care providers should be asking about changes to sexuality because of illness or treatment, but they often don’t. They may be reluctant to bring up what they see as a sensitive topic and think that if it’s important to the patient, then he or she will ask about it. This is not good. Patients often wait to see if their health care provider asks about something and if they don’t, they think that it’s not important. This results in a silence and leaves the impression that sexuality is a taboo topic.senior intimacy02

Some health care providers are afraid that they won’t know the answer to a question about sexuality because nursing and medical schools don’t provide much in the way of education on this topic. And some health care providers appear to be too busy to talk about the more emotional aspects of living with illness. This is a great pity as sexuality is important to all of us – patients, partners, health care providers. It’s an important aspect of quality of life from adolescence to old age, in health and at the end of life when touch and love are so important.

Ask for a referral

If you want to talk about this, just do it! Tell your health care provider that you want to talk about changes in your body or your relationship or your sex life! Ask for a referral to a counselor or sexuality counselor or therapist or social worker. It may take a bit of work to get the help you need, but there is help.

Complete Article HERE!

Sexuality at the End of Life

By Anne Katz RN, PhD

In the terminal stages of the cancer trajectory, sexuality is often regarded as not important by health care providers. The need or ability to participate in sexual activity may wane in the terminal stages of illness, but the need for touch, intimacy, and how one views oneself don’t necessarily wane in tandem. Individuals may in fact suffer from the absence of loving and intimate touch in the final months, weeks, or days of life.head:heart

It is often assumed that when life nears its end, individuals and couples are not concerned about sexual issues and so this is not talked about. This attitude is borne out by the paucity of information about this topic.

Communicating About Sexuality with the Terminally Ill

Attitudes of health care professionals may act as a barrier to the discussion and assessment of sexuality at the end of life.

  • We bring to our practice a set of attitudes, beliefs and knowledge that we assume applies equally to our patients.
  • We may also be uncomfortable with talking about sexuality with patients or with the idea that very ill patients and/or their partners may have sexual needs at this time.
  • Our experience during our training and practice may lead us to believe that patients at the end of life are not interested in what we commonly perceive as sexual. How often do we see a patient and their partner in bed together or in an intimate embrace?
  • We may never have seen this because the circumstances of hospitals and even hospice may be such that privacy for the couple can never be assured and so couples do not attempt to lie together.

intimacy-320x320For the patient who remains at home during the final stages of illness the scenario is not that different. Often the patient is moved to a central location, such as a family or living room in the house and no longer has privacy.

  • While this may be more convenient for providing care, it precludes the expression of sexuality, as the patient is always in view.
  • Professional and volunteer helpers are frequently in the house and there may never be a time when the patient is alone or alone with his/her partner, and so is not afforded an opportunity for sexual expression.

Health care providers may not ever talk about sexual functioning at the end of life, assuming that this does not matter at this stage of the illness trajectory.

  • This sends a very clear message to the patient and his/her partner that this is something that is either taboo or of no importance. This in turn makes it more difficult for the patient and/or partner to ask questions or bring up the topic if they think that the subject is not to be talked about.

Sexual Functioning At The End Of Life

Factors affecting sexual functioning at the end of life are essentially the same as those affecting the individual with cancer at any stage of the disease trajectory. These include:go deeper

  • Psychosocial issues such as change in roles, changes in body- and self-image, depression, anxiety, and poor communication.
  • Side effects of treatment may also alter sexual functioning; fatigue, nausea, pain, edema and scarring all play a role in how the patient feels and sees him/herself and how the partner views the patient.
  • Fear of pain may be a major factor in the cessation of sexual activity; the partner may be equally fearful of hurting the patient.

The needs of the couple

Couples may find that in the final stages of illness, emotional connection to the loved one becomes an important part of sexual expression. Verbal communication and physical touching that is non-genital may take the place of previous sexual activity.

  • Many people note that the cessation of sexual activity is one of the many losses that result from the illness, and this has a negative impact on quality of life.
  • Some partners may find it difficult to be sexual when they have taken on much of the day-to-day care of the patient and see their role as caregiver rather than lover.
  • The physical and emotional toll of providing care may be exhausting and may impact on the desire for sexual contact.
  • In addition, some partners find that as the end nears for the ill partner, they need to begin to distance themselves. Part of this may be to avoid intimate touch. This is not wrong but can make the partner feel guilty and more liable to avoid physical interactions.

Addressing sexual needs

senior intimacyCouples may need to be given permission to touch each other at this stage of the illness and health care providers may need to consciously address the physical and attitudinal barriers that prevent this from happening.

  • Privacy issues need to be dealt with. This includes encouraging patients to close their door when private time is desired and having all levels of staff respect this. A sign on the door indicating that the patient is not to be disturbed should be enough to prevent staff from walking in and all staff and visitors should abide by this.
  • Partners should be given explicit permission to lie with the patient in the bed. In an ideal world, double beds could be provided but there are obvious challenges to this in terms of moving beds into and out of rooms, and challenges also for staff who may need to move or turn patients. Kissing, stroking, massaging, and holding the patient is unlikely to cause physical harm and may actually facilitate relaxation and decrease pain.
  • The partner may also be encouraged to participate in the routine care of the patient. Assisting in bathing and applying body lotion may be a non-threatening way of encouraging touch when there is fear of hurting the patient.

Specific strategies for couples who want to continue their usual sexual activities can be suggested depending on what physical or emotional barriers exist. Giving a patient permission to think about their self as sexual in the face of terminal illness is the first step. Offering the patient/couple the opportunity to discuss sexual concerns or needs validates their feelings and may normalize their experience, which in itself may bring comfort.

More specific strategies for symptoms include the following suggestions. senior lesbians

  • Timing of analgesia may need to altered to maximize pain relief and avoid sedation when the couple wants to be sexual. Narcotics, however, can interfere with arousal which may be counterproductive.
  • Fatigue is a common experience in the end stages of cancer and couples/individuals can be encouraged to set realistic goals for what is possible, and to try to use the time of day when they are most rested to be sexual either alone or with their partner.
  • Using a bronchodilator or inhaler before sexual activity may be helpful for patients who are short of breath. Using additional pillows or wedges will allow the patient to be more upright and make breathing easier.
  • Couples may find information about alternative positions for sexual activity very useful.
  • Incontinence or the presence of an indwelling catheter may represent a loss of control and dignity and may be seen as an insurmountable barrier to genital touching.

footprints-leftIt is important to emphasize that there is no right or wrong way of being sexual in the face of terminal illness; whatever the couple or individual chooses to do is appropriate and right for them. It is also not uncommon for couples to find that impending death draws them much closer and they are able to express themselves in ways that they had not for many years.

Complete Article HERE!

One Of The Willie Worrisome

Name: lup92
Gender: Male
Age: 15
Location: England
I’m 15 and masturbate often but have had no form of sex although my girlfriend wants to start. However my penis and scrotum have extremely small lumps all over. I also have a purple red large lump on the rim of my bellend. What do I do? Should I start? Or do I risk giving something to my girlfriend?

A quick note before we begin. I’m a Ph.D. kind of doctor. not MD type of doctor. You know that, right? While I know my way around the human body, I never offer medical advice of any sort. And, just so you know, no self-respecting physician, MD kind of doctor, is gonna offer you medical advice online either without seeing you in person first. Which, if you ask me, is a real good thing.

teen intimacy

Here’s the thing about lumps and bumps and discolorations of the skin anywhere on your body, especially on your precious willie, pup. They are signs that all is not well. Do us all a big favor and have your johnson looked at by a physician. Your health is nothing to fool around with. Everything you describe could be completely harmless, but you don’t want to take the chance that it isn’t, right? And here’s a tip: don’t do it for your girlfriend. DO IT FOR YOU! It’s your dick, you gotta lean how to take care of it. And there’s no time like the present to start properly lookin’ after it.

willy_worryJust so you know, I’m not suggesting that your have a STI (Sexually Transmitted Infection). I mean, how could you? You’ve only been wanking, right? Still, if you’re concerned enough to write to me about it, you should take yourself in for a look-see. Since you are underage, you’ll probably need one of your parents to arrange the appointment. But if you are typical teenager, you’ll probably be embarrassed to discuss this with your parents. Still, there’s no getting around this. I think your parents will be proud of you for being proactive about your health and wellbeing. Besides, there’s nothing to be ashamed about.

Another option is to contact a sex-positive resource near you. Check out the folks at FPA. Surely they’ll have a resource for you.

Please take care of this ASAP.

There is one more thing. And I’m gonna be as blunt as I know how. If you think you’re old enough to fuck, you’re old enough to know all about condoms and how to use them. If ya don’t, you’re just a dumb kid who may function like a grown-up, but doesn’t know how to behave like one. And I don’t want to believe that about you.

What it is with young people (old people too) who are still fuckin’ clueless about unprotected sex in this day and age? I have nothing against younger people being sexual. That pretty much is to be expected. But I am totally opposed to kids having kids! Like I said, if you’re old enough to swing it around, you’re old enough to know how to swing it responsibly.

Good luck

What a pain in the ass!

Name: Garth
Gender: Male
Age: 44
Location: South Africa
Hi, I fissured my butt sometime ago and I think it has healed. I have undergone a Lateral Sphincterotomy twice – inner and outer. Unfortunately the area is now VERY sensitive and when I defecate the area ‘screams’ in pain. The softer my stool the worse the pain. When my stool is firm, the pain is less. Will this go away? Is there any medication that I can use?

Everyone in my audience please listen up! I am not a medical doctor, nor do I play one on the internet. The Dr Dick moniker I use refers to my Ph.D. I am a clinical sexologist or a sex therapist if you prefer, not a physician. Get it? Got it? Good!

That being said, anal fissures are a common proctological problem, especially for the heavy ass play crowd. An anal fissure is a tear at the anal tissue. The most common complaint is pain in the anal region during and after taking a dump, itching and possibly some bleeding. Pain and irritation result in spasm of the internal anal sphincter muscle, which then fails to relax during defecation further aggravating the condition.ass-pain

The lateral sphincterotomy you mention is a surgical procedure that removes the fissure. This operation remains the primary form of treatment for chronic anal fissure.

From all that I could learn from my medical consultants, if your surgeries healed properly you shouldn’t be experiencing pain, let alone “screaming pain” when you shit. We all understand that the area will continue to be sensitive, but the pain you describe is not a good sign. You may very well have an infection. You need to have that looked at ASAP. This is nothing to roll around with.

Here’s a tip for all everyone in my audience: pain, of any sort, is one way our body talks to us. Its message is: things are not as they should be; get it fixed NOW. Sometimes the pain will subside when we stop doing something…like holding our hand too close to a flame, or being flogged senseless by Christian Grey. Some pain will only subside when a condition is fixed…like getting a cavity in one’s tooth filled. Other pain, like the emotional pain that come with depression is harder to soothe, but it is important to try. Finally, pain like Garth is experiencing means something is very wrong. And if not attended to immediately, things will only get worse.

Good luck

Intimate Workout

Hello sex fans,

And now for something completely different… It’s Product Review Friday all right, but we’ve seen nothing like this before. Today I, Dr Dick, will do the honors and tell you about a unique product for men. It’s a brand new product that will, I believe, change your life for the better. And in the process we welcome another new manufacturer to our review effort, Adult Fitness Concepts.

The Private Gym —— Basic $59.99  Advanced $99.99

Dr Dick
There are a handful of things that I have been very passionate about throughout my long career as a sexologist. Each of my passions revolve around two simple principles: the importance of knowing and owning who we are as sexual beings and an knowing about how our body works. These are the basic building blocks of sexual health and wellbeing.

Sexual wellbeing means a whole lot more than simply being able to perform. It also means taking responsibility for one’s eroticism as an integral part of one’s personality and involvement with others. But being unfamiliar with the basics of how our body works will surely short-circuit even our ability to perform.

My aim has always been to provide information, guidance, and resources that will help people approach their unique sexuality in a realistic and responsible manner. That’s what Dr Dick’s Sex Advice and Dr Dick’s Sex Toy Reviews are all about. So when a representative of Adult Fitness Concepts contacted me via email to tell me about their new product (actually, it’s more of a program than a product), the first FDA registered Kegel exercise program for men, my interest was piqued. I was told that the Private Gym was created after 3 years in development with several leading urologists, physiotherapists, and sexual health experts.

I have been an avid proponent of pelvic floor musculature toning for both women and men for my entire career in sexology. I write and speak about this topic so often that sometimes I feel like a broken record. Don’t believe me? Look for yourself. Use the search function in the sidebar of either of my sites, Dr Dick’s Sex Advice and Dr Dick’s Sex Toy Reviews, type in pelvic muscles, and BANG!home_hero_image

Women tend to know more about Kegel exercises, the exercises that tone and strengthen one’s pelvic floor musculature because doctors encourage them to do their Kegels during pregnancy. But here’s a tip for all you guys out there who are reading this and rolling your eyes and getting ready to turn the page because you think this is some kinda Oprah — vagina moment. Listen up you monkeys; kegel exercises aren’t just for the ladies. Us men folk have pelvic muscles too. So pay attention, you’re gonna want to know about Kegels too.

What are Kegels, you may be asking. They’re muscle contraction and relaxation exercises designed help restore, tone, and strengthen the muscles that surround the opening of the urethra (see guys, we have one of those), vagina (ok, we don’t have one of those, but we do have a penis and we get erections), and anus (we sure as hell have one of those). Since this includes the muscle that you use to stop and start the flow of urine, you can check if you’ve identified the right muscle by testing your kegel technique while peeing — if you can stop the flow of urine when tightening, then you know that you’re contracting the correct muscle group. BTW, the main muscle is call the pubococcygeus muscle, or PC muscle for short.

There are several “toys” on the market that are designed to help women tighten and tone their pelvic floor muscles, Ben Wa balls, and all their modern incarnations, for example.  Now, thanks to the Private Gym us men folk have our own exercise program. A program that promises stronger, more rigid erections, a reduction in premature ejaculation, heightened orgasms, improvement in urinary control all while supporting prostate health.

I know what you’re thinking, if I can do Kegels on my own, why do I need a program? Good question. The best answer I can come up with is it will help you stray on track and achieve your goals. I mean, isn’t that the reason we go to a gym? Surely we can workout on our own, but the support and encouragement we get from being part of and involved in a program makes the effort more rewarding. It’s all about psychology, right?

PG-TrainingKitOnly-PromoThe Private Gym is the first interactive, follow-along exercise program that helps men strengthen the muscles that support and control our cock. As men approach age 30, the muscles that support erectile function begin to weaken. By age 40, more than 50% of men experience some form of erectile dysfunction and this number increases to more then 66% as men approach 60 years of age. And for all you bottoms out there, you know how important it is to keep anal muscles in tip-top, pardon the pun, shape.

There are two parts to the Private Gym program — 1) the Basic Training Program (available on DVD or through digital download) and 2) the Complete Training Program, which involves resistance training.

As we all know, resistance training is key to building strong muscles. Imagine doing bicep curls or a bench press without weights. The Private Gym Complete Training Program resistance equipment is basically a weighted high-quality, latex-free, nonporous, phthalate-free, and hypoallergenic silicone cuff for your dick. How amazing is that? You slip this puppy around your stiffy and do your Kegels. The cuff is also waterproof, so it cleans us easily with mild soap and warm water.

Just like all weight training, muscle contractions increase blood flow and increased blood flow to your johnson will…wait for it…produce harder, larger, and longer-lasting erections. Your pelvic musculature is also responsible for the strength of your ejaculation. Do you dribble instead of shoot? Well, my friend, you have some important exercisin’ to do.

While the Private Gym is a practical tool for any guy at any age, I have a few extra words for those men—friends, clients, and correspondents—who are living with and through prostate cancer. I get how difficult things can be after an invasive and life altering surgery. I also know that, for the most part, oncologists are not inclined to walk each of their patients through the emotional and physical minefield that is life after these often devastating medical interventions. But that doesn’t mean you have to sink to the lowest common denominator and shut down as a sexual being.

I believe that the Private Gym Basic Training Program can be helpful in regaining a sense of your sexual self after surgery and radiation. I’m currently working with two clients and we are using the Basic Training Program to rehabilitate their traumatized pelvic musculature. While it is too early to tell what kind of success rate we will have, I can say for certain that the effort involved in this program, as well as both of them knowing that someone really cares about their sexual performance issues, is making a huge psychological difference in terms of outlook and confidence. And that is huge!

My own experience with the program has been very positive. I’m 65 years old and I’ve been dealing with prostate issues, bladder control issues, and erection issues for some time now. I’ve also been doing Kegel exercises for decades, so I conclude that I am as functional as I am because of my efforts to keep my pelvic musculature toned and strong. The Private Gym is helping me be more conscientious about my workouts. And that is a real good thing.
Full Review HERE!


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