Gay, Straight, Or Bisexual – Which Group Of Men Are More At Risk Of Heart Failure?

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Can your sexuality increase or decrease your risk of heart failure?  A new study released by the NYU Rory Meyers College of Nursing states that Bisexual men have a higher risk for heart disease compared with heterosexual men.

Now, of course it is not because you’re sleeping with men, but it’s because of everything else that may come with it.

In a new study published online in the journal LGBT Health, Billy Caceres, the study’s lead author, states:

Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of men and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in bisexual men.

More than 30 percent of men in the US have some form of heart disease making it a leading cause of death for American men. Not many studies have been done to understand the impact of sexual orientation on heart disease risk for men.

In this study, NYU researchers examined differences in modifiable risk factors for heart disease and heart disease diagnoses in men of different sexual orientations. Risk factors measured included:

mental distress
health behaviors such as

  •       tobacco use
  •       binge drinking
  •       diet
  •       exercise

biological risk factors such as

  •       obesity
  •       hypertension
  •       diabetes
  •       cholesterol.

Responses from 7,731 men ages 20 to 59 were part of the National Health and Nutrition Examination Survey (2001-2012). Differences were analyzed across four groups based on their sexual identities: gay men, bisexual men, heterosexual men who have sex with men, and heterosexual men.

The researchers found no differences in heart disease diagnoses based on sexual orientation, but risk for heart disease was more complicated.

  • Gay men, heterosexual men, and heterosexual men who have sex with men had similar heart disease risk.
  • Gay men reported lower binge drinking compared with heterosexual men, but otherwise few differences in health behaviors were noted.
  • Bisexual men, however, had higher rates of several risk factors for heart disease relative to heterosexual men: mental distress, obesity, elevated blood pressure, and three different measures of diabetes (medication use, medical history, and average glycosylated hemoglobin level).

“Poor mental health is a recognized risk factor for the development of heart disease,” said Caceres. “Clinicians should be educated about sexual minority health and should routinely screen bisexual men for mental distress as a risk factor for heart disease. This is particularly important as healthcare organizations increasingly include sexual orientation as part of demographic questionnaires in electronic health records.”

Complete Article HERE!

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Do You Have Sexual Side Effects From Antidepressants You Stopped Taking?

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From low libido to erectile dysfunction, some people report suffering from enduring sexual problems.

From low libido to erectile dysfunction, some people report suffering from enduring sexual problems.

By Michael O. Schroeder

Antidepressants are widely prescribed, commonly used for depression and recommended to treat a range of other issues, from anxiety disorders to pain. But the medications aren’t without risk – and some potentially serious side effects start, or continue, after a person has stopped taking them.

These effects vary by the individual and the drug, but for the most commonly prescribed antidepressants – selective serotonin reuptake inhibitors, or SSRIs, and serotonin-norepinephrine reuptake inhibitors, or SSNIs – side effects, or adverse events reported by patients, range from headache, nausea and fatigue to paresthesia, or an abnormal sensation that can feel, to some, like electrical shocks, to insomnia to seizures. And though less widely recognized, some patients also report another enduring effect of SSRIs and SSNIs: sexual dysfunction.

To be sure, sexual side effects ranging from lower libido to erectile dysfunction are known and detailed in drug labeling information. But though online support groups have cropped up for people who experience persistent sexual dysfunction after going off antidepressants – post-SSRI sexual dysfunction, or PSSD – it’s not clear how common the concern is.

However, one recent paper co-authored by researchers linked with an independent drug safety website RxISK.org that collects reports of side effects – including after people stop medications – recently reported on 300 cases of enduring sexual dysfunction. These were reported by people from around the world who were taking SSRIs, SSNIs and tricyclic antidepressants, as well as drugs called 5α-reductase inhibitors and isotretinoin. which are used to treat male hair loss (baldness) and benign (non-cancerous) prostate enlargement, and acne respectively. Reports by patients who’d taken 5α-reductase inhibitors and isotretinoin to RxISK of enduring problems with sexual function after stopping these medications appeared to have similar characteristics to those related to antidepressants, notes co-author Dr. Dee Mangin, the David Braley and Nancy Gordon Chair in Family Medicine at McMaster University in Hamilton, Ontario, and chief medical officer for RxISK.org.

“We were really looking at sexual dysfunction both on and after taking medication, because some of the reports we were getting were suggesting that sexual dysfunction, which is a known side effect of a number of drugs, seemed to be persisting once the drugs were stopped,” Mangin says.

As noted in the paper published in the International Journal of Risk & Safety in Medicine, there have been limited references to the potential for such issues to occur after patients stopped antidepressants. In the U.S., the product information for Prozac (fluoxetine) – the oldest of the SSRIs – was updated in 2011 to warn, “Symptoms of sexual dysfunction occasionally persist after discontinuation of fluoxetine treatment.” What’s more, the authors noted, “The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, states that ‘In some cases, serotonin reuptake inhibitor-induced sexual dysfunction may persist after the agent is discontinued.'”

But the authors go further in detailing reports of enduring sexual dysfunction such as the onset of premature ejaculation and persistent genital arousal disorder (whereby a person becomes aroused without any stimulation) as well as losing genital sensation, or genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. “Secondary consequences included relationship breakdown and impaired quality of life,” the authors note.

The individuals weren’t independently evaluated before, during or after taking the medication, and more study is needed. Still, Mangin asserts, “The study provides the strong signal that there is a group of people who seem to experience enduring side effects that affect their sexual function after they’ve stopped taking the drug.”

Experts say just as patients should never stop antidepressants abruptly, or without consulting with their provider – since doing so is known to increase side effect risk and worsen those effects – patient and provider should discuss any adverse effects that start or continue after stopping a medication.

Dr. Eliza Menninger, who directs a behavioral health program at McLean Hospital in Boston, says she hasn’t heard from patients voicing serious concerns about sexual side effects after stopping their medication. For the most part, sexual side effects seem to go away after patients stop taking the medication, Menninger says. “Some will indicate it’s still an issue, but they don’t seem as bothered by it – and I don’t know if it’s as bad an issue as when they were on the SSRI,” she says.

However, clinicians say, it would be helpful to have more clarity on the issue – including how likely it may be that patients could experience enduring sexual side effects. In part due to the sensitive nature of sexual complaints, experts point out, these effects often go unacknowledged in patient-provider conversations.

One problem is that sexual side effects aren’t tracked in a systematic way like other drug side effects – even though they can be severely damaging to intimate relationships and undermine a person’s overall quality of life and well-being. “There’s no requirement, for example, for drug companies to track sexual side effects. They’re not considered serious adverse events, although the potential for them to continue post-medication I would consider extremely serious – even a disability,” says Audrey Bahrick, staff psychologist at the University of Iowa’s counseling service.

Bahrick recently signed onto a petition, along with Mangin and others who’ve researched enduring sexual side effects, asking the U.S. Food and Drug Administration and other regulatory bodies to require makers of SSRIs and SSNIs to update drug labeling to warn that such legacy effects can occur and continue for years or even indefinitely.

Sandy Walsh, a spokesperson for the FDA, said it would review the petition and respond to the petitioner, but declined to comment further regarding the petition. Drugmakers who responded to a request for comment say they work closely with regulatory agencies to keep information updated.

Mads Kronborg, a spokesman for pharmaceutical firm Lundbeck, notes that summary production information for its SSRIs, citalopram (Celexa) and escitalopram (Lexapro), “already states that side effects can occur upon discontinuation, and that such side effects may be severe and prolonged.” Specifically, it’s stated that “generally these events are mild to moderate and are self-limiting, however, in some patients they may be severe and/or prolonged.” The side effects listed for citalopram and escitalopram “include sexual side effects,” he says, though he adds that sexual side effects are not among the most commonly reported reactions to discontinuation. “So information about potential enduring side effects is actually already included.”

But the petition asserts drug companies aren’t going far enough to acknowledge these concerns.

Bahrick says though the prevalence of enduring sexual side effects remains unknown, “My own impression clinically is that it’s not at all uncommon, and that it can range from subtle – not returning to sexual baseline – to really a complete sexual anesthesia, where a person who has been without any significant sexual problems prior to taking the medication might be rendered unable to experience sexual pleasure, unable to have sensation in the genitals, having orgasms that are not associated with pleasure,” she says. “These are clearly, I think, drug effects. [Issues] like genital anaesthesia and pleasureless orgasm – these are not symptoms that are associated with any sexual problems, say, that are commonly associated with depression. We can see these as legacy effects of the SSRIs.”

In the absence of prevalence data, clinicians continue to debate the potential extent of enduring sexual side effects for those who have stopped antidepressants. Some worry about unnecessarily scaring patients away from antidepressants who may benefit from taking the drugs.

“These medications are used to treat symptoms of illnesses that are potentially quite debilitating and can be lethal, so while I want to encourage a discussion of side effects, the intent is to use medications to help improve significant symptoms,” Menninger says. She points out, as the petition notes, that to date no prospective studies have been done assessing sexual dysfunction prior to SSRI and then during and after SSRI use. Though certainly side effects are real and concerning, she says, “there is clinical evidence the medications make a significant difference in helping [and/or] saving a life.” That’s something some clinicians emphasize shouldn’t get lost in the discussion.

But Bahrick says for patients, not having information that these effects may occur undermines their ability to make a fully informed decision when deciding to go on antidepressants, and deciding whether to try alternative treatment options first. “It’s so important to get this information out there on the front end. Because these injuries are very real and can be lifelong and seriously limit intimacy and create a lot of shame and isolation and despair,” she says. While for some the side effects go away on their own, for others they persist – and Bahrick says there’s no known cure for PSSD. “So this is in service of informed consent that is quite lacking at this time.”

Complete Article HERE!

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The End of Safe Gay Sex?

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By Patrick William Kelly

June is Pride Month, a ripe time to reflect on one of the most startling facts about our sexual culture today: Condom use is all but disappearing among large numbers of gay men.

Many rightly attribute the condom’s decline to the rise of PrEP — an acronym for pre-exposure prophylaxis, a two-drug cocktail that inoculates a person from contracting H.I.V. But another crucial component is the fading memory of the AIDS crisis that once defined what it meant to be gay.

After tracking the sexual practices of 17,000 gay and bisexual Australian men from 2014 to 2017, a team of researchers this month unveiled the most convincing evidence to date. While the number of H.I.V.-negative men who are on PrEP increased to 24 percent from 2 percent, the rate of condom use decreased to 31 percent from 46 percent. More troubling, condom use among non-gay men is also down significantly</a

Although public health advocates have been sounding the alarm on condom use for the last decade, their calls have gone largely unheeded. Part of that is because of a shift in how we talk about risky sex: The Centers for Disease Control and Prevention has replaced “unprotected” with “condomless” sex.

The dangerous implication is that PrEP alone may ward off all sexually transmitted infections. Indeed, studies have shown a strong correlation between PrEP use and the contraction of S.T.I.s. PrEP enthusiasts counter that PrEP mandates testing for S.T.I.s every three months, a practice that promotes rather than discourages a culture of sexual health.

But a 2016 study by the University of California, Los Angeles illustrated that PrEP users were 25.3 times more likely to acquire gonorrhea and a shocking 44.6 times more likely to develop a syphilis infection (other studies have found no significant uptick in S.T.I. rates, however).

More than the specific public-health risks of declining condom use among gay men is the shocking speed with which a sort of historical amnesia has set in.

The very idea of “safe sex” emerged from the gay community in the early 1980s, in response to the AIDS crisis. Drag queens once ended performances with catchy one-liners like, “If you’re going to tap it, wrap it.”

AIDS indelibly shaped what it meant to be gay in the 1980s and 1990s. When I came out at the tender age of 14 in 1998, I recall my mother’s reaction. As tears welled up in her eyes, she buried her face in her hands and said, “I just don’t want you to get H.I.V.” No stranger to controversial allusions, the AIDS activist and author Larry Kramer famously called it a homosexual “holocaust.” Condom use, therefore, was never a negotiating chip.

Until it was. PrEP, which the Food and Drug Administration approved in 2012, replaces the condom’s comforting shield. Liberated from the stigma of AIDS, gay men, many people think, are now free to revert to their carnivorous sexual selves. In this rendering, the condom is kryptonite, a relic that saps the virile homosexual of his primordial sexual power.

AIDS is no longer a crisis, at least in the United States, and that is a phenomenal public-health success story. But it also means that an entire generation of gay men has no memory or interest in the devastation it wrought. AIDS catalyzed a culture of sexual health that has begun to disintegrate before our eyes. What is there to be done to bring it back?

One answer is to recall the gay culture of the 1970s that gave rise to the AIDS crisis in the first place. The myth of a world of sex without harm is not new. The 1970s were a time of unprecedented sexual freedom for gay men, during which diseases were traded rampantly, fueled by a libertine culture that saw penicillin as the panacea for all ills.

The nonchalant dismissal of the condom today flies in the face of the very culture of sexual health that gay men and lesbians constructed in the 1980s. If a hyper-resistant strand of another life-threatening S.T.I. develops, we will rue the day that we forgot the searing legacies of our past. We might also recognize that PrEP has not proved nearly as effective a prevention strategy for women as it has for men, and that some strains of H.I.V. have developed resistance to the drug.

While we debate the utility of latex, what are we to think about the millions of sex workers, injecting-drug users and marginalized populations (in particular, black men who have sex with men) without adequate access to costly and coveted drugs like PrEP? If they develop AIDS, they also struggle to acquire the triple drug therapies that have since 1996 turned AIDS into a manageable if chronic condition. Millions have died from lack of access while pharmaceutical companies rake in billions every year.

We might also pivot away from the individualistic and privileged approach of our dominant L.G.B.T. organizations — what one scholar called the “price of gay marriage.” We might, then, regain a radical sense of queer community that we lost in the wake of AIDS.

Complete Article HERE!

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Embrace And Then Move Past Your Scaring

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Name: NIta
Gender: female
Age: 40
Location: South Africa
I recently had abdominal surgery to remove a cancer. I’m recovering pretty well, and the prognosis for my future is also pretty good. But I am noticing two problems. The surgery left a really big scar. It’s still not fully healed yet, but I can tell it’s always going to be ugly. And my belly is really misshapen now. I felt pretty okay about my body before hand, but this scar really makes me look really unattractive. Also, my sex drive has completely gone away. I used to be a pretty sexual person, but now nothing excites me. Would you say this is normal?

How long ago was your surgery, I wonder? It’s got to be pretty recent, if you say the incision is still healing.

Darlin’, may I suggest that you’ve been through quite a trauma — a cancer diagnosis, recent surgery and all. This would throw anyone for a loop. I’d be willing to guess you’ve not had the proper time to process all of this. It comes as no surprise to me that your libido has gone south. I wouldn’t expect otherwise.

If you’re still healing on the outside, you know for sure your insides have a much longer way to go. You’re probably still feeling some discomfort, right? That’s enough to put the kibosh on sexual interest right there. You’re body is consumed with the job of healing itself. It probably hasn’t any energy to spare for sex. And why have a libido if ya can’t be sexual, right? So you see, your body is actually protecting itself and concentrating on the task at hand.

Maybe at this point in your recovery a little pampering would be better for you than a pursuit of sexual pleasure. Long luxurious baths will help soothe the tension, as well as giving your easy access to your fine pussy. Even folks with no discernable libido find touching themselves enjoyable. And just to keep your head in the game, even though you’re sitting on the sidelines, you could read some erotica or watch some sexy smut.

Some modest exercise like walking or swimming can perk up the libido too. Treat yourself to an erotic massage. Let a pro get his or her hands on you and make you glow. This may also help bring back some of the sensitivity to areas effected by the surgery. One things for sure, doing something is better than doing nothing but sitting there wondering what’s up.

An invasive and disfiguring surgery will always have a profound effect on one’s body image, which goes without saying. Feeling unattractive because of a scar? No doubt about it, it’s a bummer. But consider for a moment that you are here writing to me about it, instead of napping six-feet under. So I guess the scar is not the worst thing that could have happened, right? As you probably know, I hear from a number of my country’s war vets returning home with shattered bodies and lives. My advice to them is what I offer you now. Move through the scar’s impact…with a therapist if need be. And find within yourself the other things that make you beautiful, attractive, alluring and desirable. Who knows, you might luck out and find a scar fetishist out there who will worship you for what you find loathsome.

Embracing and then moving past your scaring will open you to find the myriad pleasures your body can still provide you and others. So while your body works on healing itself, your mind can do likewise. No need to have two scars, on one your belly and another one on your psyche. In the end you may find that flaunting your scar, like some women do with their mastectomy scars, will liberate you from feeling unattractive. After all, that scare and misshapen abdomen are your red badges of courage, honey. Not only do they make you distinct, but also they testify to you being a survivor.

Good luck

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Sex and gender both shape your health, in different ways

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When you think about gender, what comes to mind? Is it anatomy or the way someone dresses or acts? Do you think of gender as binary — male or female? Do you think it predicts sexual orientation?

Gender is often equated with sex — by researchers as well as those they research, especially in the health arena. Recently I searched a database for health-related research articles with “gender” in the title. Of the 10 articles that came up first in the list, every single one used “gender” as a synonym for sex.

Although gender can be related to sex, it is a very different concept. Gender is generally understood to be socially constructed, and can differ depending on society and culture. Sex, on the other hand, is defined by chromosomes and anatomy — labelled male or female. It also includes intersex people whose bodies are not typically male or female, often with characteristics of both sexes.

Researchers often assume that all biologically female people will be more similar to each other than to those who are biologically male, and group them together in their studies. They do not consider the various sex- and gender-linked social roles and constraints that can also affect their health. This results in policies and treatment plans that are homogenous.

‘Masculine?’ ‘Cisgender?’ ‘Gender fluid?’

The term “gender” was originally developed to describe people who did not identify with their biological sex. John Money, a pioneering gender researcher, explained: “Gender identity is your own sense or conviction of maleness or femaleness; and gender role is the cultural stereotype of what is masculine and feminine.”

There are now many terms used to describe gender — some of the earliest ones in use are “feminine,” “masculine” and “androgynous” (a combination of masculine and feminine characteristics).

Research shows that gender, as well as sex, can influence vulnerability to disease.

More recent gender definitions include: “Bigender” (expressing two distinct gender identities), “gender fluid” (moving between gendered behaviour that is feminine and masculine depending on the situation) and “agender” or “undifferentiated” (someone who does not identify with a particular gender or is genderless).

If a person’s gender is consistent with their sex (e.g. a biologically female person is feminine) they are referred to as “cisgender.”

Gender does not tell us about sexual orientation. For example, a feminine (her gender) woman (her sex) may define herself as straight or anywhere in the LGBTQIA (lesbian, gay, bisexual, transgender, queer or questioning, intersex and asexual or allied) spectrum. The same goes for a feminine man.

Femininity can affect your heart

When gender has actually been measured in health-related research, the labels “masculine,” “feminine” and “androgynous” have traditionally been used.

Research shows that health outcomes are not homogeneous for the sexes, meaning all biological females do not have the same vulnerabilities to illnesses and diseases and nor do all biological males.

Gender is one of the things that can influence these differences. For example, when the gender of participants is considered, “higher femininity scores among men, for example, are associated with lower incidence of coronary artery disease…(and) female well-being may suffer when women adopt workplace behaviours traditionally seen as masculine.”

In another study, quality of life was better for androgynous men and women with Parkinson’s disease. In cardiovascular research, more masculine people have a greater risk of cardiovascular disease than those who are more feminine. And research with cancer patients found that both patients and their caregivers who were feminine or androgynous were at lower risk of depression-related symptoms as compared to those who were masculine and undifferentiated.

However, as mentioned earlier, many health researchers do not measure gender, despite the existence of tools and strategies for doing so. They may try to guess gender based on sex and/or what someone looks like. But it is rare that they ask people.

A tool for researchers

The self-report gender measure (SR-Gender) I developed, and first used in a study of aging, is one simple tool that was developed specifically for health research.

The SR-Gender asks a simple question: “Most of the time would you say you are…?” and offers the following answer choices: “Very feminine,” “mostly feminine,” “a mix of masculine and feminine,” “neither masculine or feminine,” “mostly masculine,” “very masculine” or “other.”

The option to answer “other” is important and reflects the constant evolution of gender. As “other” genders are shared, the self-report gender measure can be adapted to reflect these different categorizations.

It’s also important to note that the SR-Gender is not meant for in-depth gender research, but for health and/or medical studies, where it can be used in addition to, or instead of, sex.

Using gender when describing sex just muddies the waters. Including the actual gender of research participants, as well as their sex, in health-related studies will enrich our understanding of illness.

By asking people to tell us their sex and gender, health researchers may be able to understand why people experience illness and disease differently.

Complete Article HERE!

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6 Things Every Transgender Person Should Know About Going to the Doctor

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You deserve sensitive, comprehensive care.

By Nathan Levitt, FNP-BC

[T]ransgender patients often experience tremendous barriers to health care, including discrimination and an unfortunate lack of providers who are knowledgeable about and sensitive to this population. As a result, many transgender and nonbinary people avoid seeking care for preventive and life-threatening conditions out of fear.

According to a report from the National Transgender Discrimination Survey of more than 6,450 transgender and gender nonconforming people, nearly one in five (19 percent) reported being refused care because they were transgender or gender nonconforming. Survey participants also reported very high levels of postponing medical care when sick or injured due to discrimination and disrespect (28 percent). Half of the sample reported having to teach their medical providers about transgender care.

As a transgender person myself, I know how difficult it can be to access sensitive care.

That’s why it’s essential for trans and gender nonconforming people to be empowered with the knowledge and information that will help them find the best providers they possibly can, who are knowledgeable and sensitive, and will advocate for their gender nonconforming patients.

It can be hard to know where to start, so I’d recommend looking into the following resources online to help you find trans-friendly medical care near you:

And here are a few questions you might want to consider when looking for a doctor or health care provider who is accessible, inclusive, and who can responsibly and knowledgably care for you:

  • Do they have signs or brochures representing the transgender community?
  • Have the care providers been trained on issues specific to transgender health?
  • Does the organization have a nondiscrimination policy that covers sexual orientation and gender identity?
  • Do they have experience caring for transgender patients? Specifically, are they able to provide medical advice on how to manage hormones, after-surgery care, and health screenings in the trans population?
  • Are they able to provide the necessary accommodations you need to feel comfortable (For instance: a gender-neutral bathroom, a safe and comfortable waiting room environment, willingness to use your requested name and pronoun, etc.)?
  • Has their staff (including the office staff) received training on transgender sensitivity?

Even after you’ve found a medical provider, the reality is that transgender patients often still have to teach them about transgender care.

It’s your responsibility to communicate your medical history and needs so that you can get the best, most appropriate care. That can be intimidating and overwhelming, so I’ve outlined a few of the most important things you should go over with your doctor or medical provider.

1. Make sure your provider has a baseline medical history for you.

Once you find a transgender-sensitive health provider, think of this person as your medical ally—someone who can help you with any changes your body is experiencing. In that vein, you’ll want to tell them about your family and personal health history so they can better manage your health care screenings, such as cardiovascular, bone health, diabetes, and cancer screenings.

Cancer screening for transgender people can require a modified approach to current mainstream guidelines. If your provider isn’t sure what that looks like, you can point them towards UCSF Center of Excellence for Transgender Health.

Unfortunately, I know from professional experience that transgender people are often less likely to have routine screenings and cancer screenings due to discomfort with health care providers’ use of gendered language, providers’ lack of knowledge about surgery and hormones, gender-segregated systems, and insensitive care.

2. Discuss your goals and expectations around medical transition, whether it’s something you have done, are in the process of doing, or are interested in pursuing.

Of course, not all transgender and gender nonbinary individuals are interested in medical transition—including surgery and/or hormones—but for those who are considering these options, it’s important to select health care providers who understand how to administer and monitor hormones and who are knowledgeable about what is needed for pre- and post-operative care.

So it’s a good idea to ask your provider about their experiences with transition-related medical care or if they can refer you to someone who is experienced in that field. You’ll want to talk with your provider about your goals of hormone therapy, any lab work needed, and any relevant information from your and your family’s medical history.

There are many different surgeries that transgender individuals may undergo to align their body with their gender identity. Share with your medical provider any gender affirming surgeries you have had or are interested in. You deserve to feel comfortable with your surgeon and feel that your health care team is working together.

As your body changes, stay informed about what additional screenings may be needed. For instance, although the data linking hormone therapy to cancer is inconclusive (when taken correctly and monitored by a medical provider), it is still important to discuss risks with your provider.

For patients who currently have hormone-dependent cancers, it is imperative that you discuss with your oncologist and your primary care provider any past history or current use of hormones.

I know that some cancer screenings such as Pap smears and prostate screenings can be incredibly uncomfortable for some transgender and gender nonbinary people. Finding sensitive providers is essential to not delay important screenings.

3. As awkward as it may be, discuss your sexual history and activity in a way that allows your medical provider to accurately assess your sexual health needs.

It’s unfortunately not uncommon for transgender men to skip pelvic exams (whether they fear discrimination, think they don’t need them, or avoid them for dysphoria-related reasons). It’s also not uncommon to forego preventive health care, such as STI screenings, out of fear of discrimination or disrespect. This can hurt the transgender population’s health.

Of course it can be awkward, but your sexual health is an important topic to discuss with your provider, so they shouldn’t make you feel too uncomfortable to talk about it. If you feel your provider is not conducting transgender-sensitive sexual histories, you should feel empowered to give them this feedback. You can even ask your provider to use the language you feel most comfortable with to describe your and your partner’s bodies. This is important because they can help you to understand how to have sex that is safe, affirming, and specific to your body and identity.

It’s also important to tell your provider the nitty gritty details about your sex life and history (like: how many sexual partners you have had, whether you’re using condoms or dental dams during sex, what kind of sex you are having, and if and when you were last tested for STIs and HIV).

Unfortunately, surveys tell us that transgender people are less likely to get tested for STIs because of the discrimination and fear they face when talking about their bodies and identity. According to the CDC, in 2015, the percent of transgender people who were newly diagnosed with HIV was more than three times the national average. Trans women are at an especially high risk for HIV; in particular, African American trans women have the highest newly diagnosed HIV rates within the transgender community.

Be proactive and ask what you should be doing to reduce your risk of STIs and HIV. One option your physician may discuss with you is pre-exposure prophylaxis (PrEP), which is a daily pill that can greatly reduce your risk of HIV infection, and may be appropriate for some patients

I know it can be uncomfortable to have these conversations with a medical provider, and it can be just as difficult to have them with your partner. To help get you started, here are some helpful resources on sexual health for trans women and trans men.

4. If you’re using substances, ask your medical provider for trans-sensitive resources and referrals for substance support services.

Substance and tobacco use can often be the result of depression and anxiety associated with discrimination by the community. In fact, the National Transgender Discrimination Survey showed that 26 percent of transgender individuals use or have used alcohol and drugs frequently, compared with 7.3 percent of the general population according to a National Institute of Health’s report. In addition, 30 percent of the transgender participants reported smoking regularly compared with 20.6 percent of U.S. adults.

There are many risks associated with substance and tobacco use, especially in combination with hormone therapy. Smoking can cause an increased risk of some cancers, blood clots, and heart disease, and it may negatively impact the outcome of hormone therapy, among other complications. Talk to your provider about resources to help decrease substance dependency.

5. If you’re experiencing anxiety, depression, or any other mental health symptoms, bring it up to your health care provider.

When it comes to getting help or making that first call, you don’t have to wait until things get “bad enough.” Unfortunately, mental health issues can be prevalent in the transgender community as a result of isolation, rejection, lack of resources, and discrimination. Share with your provider any feelings of depression or anxiety you may be having. They can help manage your care and recommend a trans-sensitive mental health professional, which can be challenging to navigate on your own.

If you are in crisis, contact Trans Lifeline at 877-565-8860.

6. Tell your physician if you’re interested in potentially having children someday.

Transgender populations have fertility concerns that are often unaddressed by providers. If you are interested in potentially starting a family someday, make sure to talk to your provider about your reproductive health and fertility options early on, especially if you’re considering medical transition or have transitioned.

Transgender men may need to discuss cessation of testosterone if they are interested in becoming pregnant. And if transgender women are interested in having children using their own sperm, they may need to use sperm banking services because of estrogen’s potential effect on sperm production.

Finding trans-sensitive ob/gyn care, birth control resources specific to the trans population, and trans-sensitive fertility support can be difficult, but there are resources that can make it easier, like the ones listed at the beginning of this article.

Finally, remember that you are deserving of a responsible, knowledgeable health care team.

While patients often initially come into a medical office nervous, when they find a healthcare team they trust, they are able to open up more—sharing more information and asking more questions.

As a healthcare provider, I’ve witnessed that those patients who become increasingly empowered to take control of their own health have lasting positive effects, including better overall wellness and greater confidence and self-esteem. Everyone deserves that level of care.

Complete Article HERE!

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Can You Get An STI From Anal Sex?

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That itch in your butt? It may not just be a harmless rash.

By Isadora Baum

[W]hen you think of sexually transmitted infections, symptoms like vaginal itching and pelvic pain probably come to mind. But the same STIs that threaten your health down below can infect other body areas. They’re typically transmitted through oral sex or anal sex, but some can be picked up after direct skin contact.

The scary thing about getting an STI in another part of your body is that you’re less likely to recognize signs, so you don’t seek the right treatment—and the infection potentially gets worse. Here are four body areas that can play host to an STI, plus the symptoms to look for.

On your face

You already know that genital herpes can spread to your lips if you have oral sex with someone who has this STI. What you may not know is that the same type of herpes that shows up below the belt can infect other parts of your face, such as around your mouth, Amesh Adalja, MD, an infectious disease physician and senior scholar at Johns Hopkins Center for Health Security, tells Health. Herpes can also appear on your tongue or nose.

How do you know if a sore on your face is herpes? Early signs are the same as genital herpes: tingling and itching, and then as the sore develops, it blisters and scabs over. If you’re unsure, check in with a dermatologist. You can treat herpes with over-the-counter cold sore remedies; your doctor can also prescribe antiviral meds that cut the duration of an outbreak.

In your butt

Yep, we have to go there. Chlamydia, gonorrhea, and syphilis can be transmitted to the rectum if you have anal sex with an infected partner, Karen Brodman, MD, a gynecologist in New York City, tells Health. Your risk of one of these backdoor STIs increases if you develop small tears or nicks in the thin skin of the anus, through which the bacteria can get into your system.

STIs transmitted through skin contact, such as genital herpes or HPV, can develop in or outside the anus and rectum, says Dr. Brodman. Herpes may also show up as sores on the skin of the buttocks. And of course, HIV is spread via anal sex, as are blood-borne viruses such as hepatitis B and C.

Signs of an STI in your behind include rectal burning, unusual discharge, bleeding, pain, or a fissure, says Dr. Brodman. You might also notice blisters or achiness in the groin, she adds. If any of these develop, let your doctor know. And don’t be embarrassed—she’s seen it all before.

In your eyes

STIs that trigger eye infections include herpes, gonorrhea, chlamydia, and syphilis, says Dr. Adalja. The signs of many of these conditions mimic pink eye: think pain, swelling, redness, and discharge.

An eye herpes infection, however, can present differently. If the herpes virus is in your eye, it may result in an outbreak of one or more lesions on the eyelids or even the cornea, triggering pain and sensitivity that could jeopardize your vision by causing scarring. If you have any symptoms, see your ophthalmologist promptly, says Dr. Adalja.

In your throat

STI infections in the soft, moist tissues of the back of the mouth and throat are more prevalent than you might think. Chlamydia and gonorrhea (including the drug-resistant strain known as “super gonorrhea”) can set up shop here if a person contracts either of these infections during oral sex. Scarily, you may not even know it; sometimes the only symptom is a sore throat, according to the Centers for Disease Control.

HPV is another infection that invades the throat—and it’s thought to be behind the recent rise in cases of head and neck cancers, especially among men. While there are more than 100 types of HPV, the type that causes many cases of cervical cancer, HPV 16, is also responsible for most head and neck cancers. Though HPV of the throat is becoming more common, a 2017 study emphasizes that the overall lifetime odds of cancer is low. Still, if you think you might be at risk, talk to your doctor.

Complete Article HERE!

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Sexual side effects of prostate treatments include ejaculatory dysfunction

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Even if patients are 100 percent satisfied with the treatment and can urinate perfectly, they may be unhappy that they can’t ejaculate.

[M]edications that treat lower urinary tract symptoms and enlarged prostates may cause sexual dysfunction, but some urologists don’t discuss this with patients, according to a survey of doctors.

Although more than half of the physicians said they discuss ejaculatory dysfunction when prescribing the most common treatments, most don’t routinely offer alternatives, the study authors report in World Journal of Urology.

“We need to think about the entire picture as doctors. Even if patients are 100 percent satisfied with the treatment and can urinate perfectly, they may be unhappy that they can’t ejaculate anymore,” said lead study author Dr. Simone Giona of King’s College Hospital in London.

Lower urinary tract symptoms and prostatic hyperplasia – an enlarged prostate – cause difficulty with urination, urgency and leaking. Patients sometimes wait until symptoms worsen before seeking treatment, often because they know treatments could affect sexual function, Giona said.

“That’s very important for some men, even if they’re 75 or 80 years old,” Giona said in a telephone interview. “We need to talk to patients about their expectations and offer the treatments that will help them, including new alternatives.”

Giona and colleagues surveyed 245 urologists attending the 2015 World Congress of Endourology in London. They asked what prostate treatment options the urologists offered their patients, how often they discussed the different types of treatments available, how often they discussed ejaculatory dysfunction with patients and how often they discussed alternative treatments based on the risk of sexual dysfunction.

About 70 percent of survey participants said they discuss erectile dysfunction before prescribing alpha blockers, although there’s no evidence currently that these medications impair sexual function. Most urologists said they discuss treatment-related erectile dysfunction, but those with the busiest practices and higher caseloads were most likely to discuss sexual side effects.

On the other hand, most respondents said they don’t routinely discuss alternative therapies based on the risk of sexual dysfunction, and those with the highest caseloads were least likely to offer alternatives.

“We’d expect that a urologist with more experience would have a wider picture of the best treatment, but maybe they don’t discuss options other than what they prefer or know best,” Giona said. “We need to make sure patients have options and we’re not missing the rest.”

A limitation of the study is that the responses were not analyzed according to the participants’ region or country of origin, which might highlight differences in what’s available. Some countries don’t yet offer some of the treatment options, but few survey respondents marked “not applicable” while answering the questions, the study authors note.

“Patients should mention all their worries and discuss their sex life concerns,” Giona said. “Urologists should get a full picture of what will make their patients happy.”

Current guidelines recommend lifestyle modification, medication or surgery for enlarged prostates. All options can impact sexual function, but some affect libido, erection, ejaculation and semen volume more than other options. In this study, the most common treatments were medications such as alpha blockers and 5alpha-reductase inhibitors, followed by surgical options such as Transurethral Resection of the Prostate (TURP) and laser procedures such as Holmium Laser Enucleation of the Prostate (HoLEP) and GreenLight Photoselective Vaporisation of the Prostate (PVP).

“Patients didn’t previously have choices about their treatments and accepted the side effects,” said Dr. Tobias Kohler of the Mayo Clinic in Rochester, Minnesota, who wasn’t involved in the study.

“But now, we’re seeing minimally invasive treatments that offer excellent improvement and low risk of sexual side effects,” Kohler said in a telephone interview.

“Now the conversation needs to be whether patients should take a pill or treat the problem definitively and prevent the progression of bladder dysfunction,” Kohler said.

“Patients should educate themselves on the risks and benefits of prostate treatments,” he said. “Upfront procedures could offer little risk and a lot of reward.”

Complete Article HERE!

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For Menopause Sex Discomfort, Gel Worked as Well as Estrogen

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Study find gels worked as well as prescription hormone tablets at reducing symptoms of menopause-related sexual discomfort.

By Lindsey Tanner

[I]n a study of women with menopause-related sexual discomfort, gels worked as well as prescription hormone tablets at reducing symptoms.

The researchers say the results suggest low-cost, over-the-counter moisturizers might be the best option.

Most women in the study reported some relief from their most bothersome symptoms — painful intercourse, vaginal dryness or itching — regardless of treatment. Still, not quite half the women experienced what researchers considered a meaningful decline in symptom severity.

The problems are linked with declining levels of the hormone estrogen, which happens to all women when they reach menopause.

What baffles researchers is why only about half of women experience bothersome symptoms. Without that answer, pinpointing the cause and finding the perfect solution is difficult, said Dr. Caroline Mitchell, the study’s lead author and a researcher at Massachusetts General Hospital.
Continue reading the main story

“Until we know why, our treatments are really just pretty broad attempts,” Mitchell said. “We’re not targeting the true biological root cause.”

Researchers enrolled 300 women at a Kaiser Permanente research institute in Seattle and at the University of Minnesota. Women were randomly assigned to one of three treatments: prescription vaginal estrogen tablets and a gel with inactive ingredients; placebo tablets and Replens over-the counter moisturizer; or placebo tablets and the inert gel. Treatment lasted 12 weeks.

The results were published Monday in JAMA Internal Medicine. The National Institutes of Health paid for the study and the researchers have no financial ties to the products studied.

A journal editorial says there have been few similar studies and most were too small to reach conclusive results.

The latest results show that prescription treatment that can cost $200 is no better than over-the-counter moisturizers costing less than $20. The researchers noted that some women may prefer tablets to creams, which can be messy, but the extra money won’t buy extra relief.

Women with troublesome symptoms “should choose the cheapest moisturizer or lubricant available over the counter — at least until new evidence arises to suggest that there is any benefit to doing otherwise,” the editorial said.

Complete Article HERE!

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Consensual sex is key to happiness and good health, science says

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[I]t’s not just that sex is fun – it’s also good for your physical and mental health.

Some of my research is focused on how men and women differ in the links between sexuality, mental and physical health, and relationship quality. In this article, I write from my findings and that of others on how sex is important to our love, mental health, relations and survival. At the end, I suggest a solution for individuals who are avoiding sex for a common reason – chronic disease.

Good sex makes us happy

Good sex is an inseparable part of our well-being and happiness. Those of us who engage in more sex report better quality of life. Sexual intercourse is linked to high satisfaction across life domains. In one of my studies on 551 married patients with heart disease, individuals who had a higher frequency of sexual intercourse reported higher marital quality, marital consensus, marital coherence, marital affection expression and overall marital satisfaction. These results are replicated in multiple studies.

In a study by another team, partners who both experienced orgasm during sex were considerably happier. These findings are shown inside and outside of the United States.

Sex keeps us alive

Although early initiation of sex such as during adolescence is a risk factor for mortality, having a sound sexual life in adulthood is linked to low mortality. In a seven-year follow-up study of men 17 years old or older, erectile dysfunction and having no sexual activity at baseline predicted increased mortality over time. Similar findings were shown in younger men. This is probably because more physically healthy individuals are sexually active.

No sex and forced sex makes us depressed

There is a two-way road between bad sex and depression. Depression is also a reason for bad sex, particularly for women. And, men who are depressed are more likely to sexually abuse their partners.

And it’s important to note, in the wake of continuing news of sexual assault and abuse, that forced sex in intimate relations make people depressed, paranoid, jealous, and ruins relationships. Couples who experience unwanted sex have a higher risk for experiencing other types of abuse, as bad habits tend to cluster.

Sex different for men and women?

Men and women differ in the degree to which their sexual act is attached to their physical, emotional, and relational well-being. Various reasons play a role among both genders, but for women, sexual function is heavily influenced by mental health and relationship quality.

By contrast, for men sexual health reflects physical health. This is also intuitive as the most common sexual disorders are due to problems with desire and erection for women and men, respectively.

Reasons for avoiding sex

As I explained in another article in The Conversation, sexual avoidance for those who have a partner or are in a relationship happens for a long list of reasons, including pain, medications, depression and chronic disease. Common diseases such as heart disease interfere with sex by causing fear and anxiety of sexual intercourse.

Aging should not be considered as a sexless age. Studies have shown that older adults acquire skills and strategies that can buffer age-related declines in their sexual life, particularly when they are in a positive relationship. This is called seniors’ sexual wisdom.

Back on track

Because people avoid sex for a variety of reasons, there is no single answer for those who want to become sexually active again. For many men, physical health problems are barriers. If they suffer from erectile dysfunction, they can seek medical help for that.

If fear of sex in the presence of chronic disease is a problem, there can be medical help for that as well. For many women, common barriers are relational dissatisfaction and mental health. For both men and women, the first step is to talk about their sexual life with their physician, counselor or therapist.

At least half of all medical visits do not cover any discussion about sexual life of patients. Embarrassment and lack of time are among the most common barrier. So make sure you make time to talk to your doctor or health care provider.

Neither the doctor nor the patient should wait for the other person to start a dialogue about their sexual concerns. The “don’t tell, don’t ask” does not take us anywhere. The solution is “do tell, do ask.”

Complete Article HERE!

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Vaginismus: a major psychological reason women experience pain during sex

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If you have never heard of vaginismus, it’s time to get it on your radar.

Don’t suffer in silence

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[A]ly Dilks, sexual health expert and clinical director at The Women’s Health Clinic, says: ‘It is the term used to describe recurrent or persistent involuntary tightening of muscles around the vagina whenever penetration is attempted,’

According to Vaginismus Awareness, the condition affects at least two in every 1,000 women at some point in their lifetime.

Approximately 10% of adult women have experienced painful intercourse in the past six months.

‘It’s not fully understood why the condition happens [but] factors can include thinking the vagina is too small, negative sexual thoughts – thinking sex will be painful and cause damage – and previous sexual abuse,’ says Ms Dilks.

She also lists damage to the vagina – common during childbirth or an episiotomy, a painful first sexual experience, relationship problems, and fear of pregnancy as other potential triggers.

Pain is not limited to sex.

Some women find inserting tampons or fingers painful; others find any type of penetration intolerable.

Unlike other causes of vaginal pain, such as an infection, vaginismus is a psychological problem that cannot be cured with a straightforward prescription.

There’s effective treatment

Help is available beyond search engine suggestions

This is not to say it can’t be treated: Vaginismus Awareness reports a 95% chance of treating this psychological condition effectively, and many women receive referrals to a sex therapist as a first port of call.

Colin Richards is a relationship and sex mentor and the founder of Intimacy Matters.

He says: ‘As a practitioner who works with both the psychological and physiological, about 20% of female clients that come to me for treatment around sexual performance come with some level of vaginismus.

‘The psycho-sensual treatment I offer involves talking through the psychological influences, followed by sensual massage that is given in controlled, professional space.

‘It allows the new emotional tools to emerge in an authentic, non-judgemental way.’

Both Ms Dilks and Mr Richards also suggest vaginal trainers: four, smooth, plastic penis-shaped objects in different sizes.

They can be used in the privacy of your own home, at your own pace. Ms Dilks says: ‘Once you feel comfortable inserting the smallest one, you can move on to the second size, and so on.’

‘It doesn’t matter how long it takes – whether it’s days, weeks, or months.’

Vaginismus is just one of many types of sexual frustrations and fears women face but, says Mr Richards, it is probably the most challenging for the sufferer.

That challenge is perpetuated by a lack of awareness and the taboo that still surrounds female sexuality, even when women talk to one another.

Yet it can have major implications on a woman’s sex life, self-esteem, body image and her relationships.

Hope for sufferers

Women can be reluctant to talk about their sex life, even with other women

If you have pain during sex, during your period, or if there’s anything that concerns you about your sexual health, don’t suffer in silence; women have been doing that for too long, and vaginismus is something for which there is a proven treatment.

Mr Richards says: ‘In my experience, if one can get to the root psychological cause of the anxiety or fear, then the vaginismus can be removed completely.

‘I have seen improvement over a period of three to six appointments.

‘As the mind learns that sexual penetration is not painful or wrong, and is, in fact, pleasurable, the body soon responds and lets go of the need to tense up.

‘[The woman] remains calm, and feels familiar with the situation, and so confident that everything should be fine.’

Complete Article HERE!

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7 Reasons Why Your Crotch Itches

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[I]t may not be the most couth move men make, but there are occasions when guys grab at their balls for a quick scratch or adjustment. There are also times, however, when the urge to scratch is intense because you are experiencing a serious itching sensation, perhaps one that keeps recurring. Should you be concerned? Would you like to know why your crotch itches and what you can do about it?

Here are seven reasons why your crotch itches and, thankfully, ways you can stop itchy balls in their tracks. Some fixes are quick while others take a bit more time, but follow the suggestions and you should have your hand out of your pants in no time.

Chafing

Running and other athletic activities that can cause your thighs to rub together are typical causes of chafing. The rubbing can result in inflammation and minute cracks in the outer skin layer, resulting in a burning or itchy rash. You can protect your skin and eliminate the itching and burning by using a moisturizing cream that contains colloidal oatmeal along with one that provides zinc oxide. Natural remedies include aloe vera gel or olive oil rubbed into the affected area.

Contact dermatitis

This super itchy condition is caused when your skin makes contact with an allergen, which could be the material in your underwear, a new laundry detergent, fabric softener, or soap, or towels. Contact dermatitis usually looks like a bumpy red rash that may be accompanied by an oozing fluid. The effective treatment is to eliminate the cause, which may take a little detective work. If you recently started using a new soap, laundry detergent, or fabric softener, return to your old one. If you have new underwear, you may need to wash it several times (in your tried-and-true) detergent before wearing them. If you have contact dermatitis, you should notice results within 10 to 14 days or sooner.

Fungal infections

If a fungal infection is the cause of your itchiness, you likely will also have a rash or other noticeable skin condition. A yeast infection, for example, is usually accompanied by moist, shiny skin on the penis as well as white deposits in the skin folds and an itchy red rash. Other fungal infections may appear slightly differently. All fungal infections can be treated with antifungal cream (e.g., clotrimazole). A natural alternative is coconut oil, while other remedies (e.g., tea tree oil, oregano oil), when mixed with an appropriate amount of carrier oil, can be helpful as well. Discuss the best mixture of oils with a knowledgeable practitioner.

Genital warts

The human papillomavirus (HPV) is characterized by the presence of genital warts, which are usually soft, skin-colored growths that may even look like tiny florets of cauliflower. Fortunately, these itchy warts don’t cause any other symptoms, but they also are merely a visible representation of a systemic virus. You can successfully treat genital warts with topical medications available over the counter (e.g., imiquimod, podofilox, sinecatechins) or by prescription (e.g., podophyllin, trichloroacetic acid) or have the warts frozen or burned off by your doctor. However, the virus will remain in your system, and the warts may return at a later time.

Herpes

Sometimes itching is the first symptom of an infection with the herpes virus, a sexually transmitted disease. The itching quickly turns into burning, after which blisters can develop. If the blisters break, they can result in painful ulcers. The best treatment strategy is to see your physician, who can prescribe an antiviral medication such as acyclovir or valacyclovir hydrochloride. You also should inform any sexual partners of your infection so they can treated as well.

Intertrigo

Intertrigo is an inflammatory condition that forms in the folds of the skin. It is usually chronic, and along with itching you can experience burning, pain, and stinging. Intertrigo is caused and aggravated by exposure to friction, heat, moisture, and lack of air circulation. In some cases, intertrigo is complicated by a fungal, bacterial, or viral infection. Men who are obese and/or who have diabetes are frequently affected.

Treatment includes keeping the affected area as clean and dry as possible. Avoid wearing tight clothing that restricts air circulation. Use a barrier cream to help prevent irritation. Your doctor may suggest short-term use of a topical steroid to manage inflammation. If you have an infection, an antifungal or antibiotic ointment may be necessary.

Pubic lice

If you notice tiny yellowish or white specks near the roots of your pubic hair and the itching is intense, there’s a good chance you have eggs belonging to pubic lice (aka, crabs). Once the eggs hatch, the parasites are gray-white or tan and can cause quite a bit of itching and irritation as they crawl. You should see your healthcare provider as soon as possible for an accurate diagnosis.

Treatment of pubic lice typically includes use of a lotion or shampoo that contains either permethrin or pyrethrins with piperonyl butoxide, which kills lice. Natural remedies include holding a soft cloth soaked with equal amounts of apple cider vinegar and water on the affected area for about 30 minutes. Repeat daily as needed. Both peppermint and tea tree oils, mixed with an appropriate amount of carrier oil, can help eliminate pubic lice as well.

Complete Article HERE!

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Same-sex couples experience unique stressors

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Study by SF State professor finds that institutionalized discrimination has lasting effects

Professor of Sociology Allen LeBlanc

By Lisa Owens Viani

[S]tressors faced by lesbian, gay and bisexual (LGB) individuals have been well studied, but San Francisco State University Professor of Sociology Allen LeBlanc and his colleagues are among the first to examine the stressors that operate at the same-sex couple level in two new studies conducted with support from the National Institutes of Health. “People in same-sex relationships are at risk for unique forms of social stress associated with the stigma they face as sexual minority individuals and as partners in a stigmatized relationship form,” said LeBlanc.

In the first study, recently published in the Journal of Health and Social Behavior, LeBlanc and colleagues conducted in-depth interviews with 120 same-sex couples from two study sites, Atlanta and San Francisco, and identified 17 unique pressures that affect LGB couples. Those range from a lack of acceptance by families to discrimination or fears of discrimination at work, public scrutiny, worries about where to live and travel in order to feel safe, and experiences and fears of being rejected and devalued. The researchers also found that same-sex couple stressors can emerge when stress is contagious or shared between partners and when stress “discrepancies” — such as one partner being more “out” than the other — occur.

“We wanted to look beyond the individual, to look at how stress is shared and how people are affected by virtue of the relationships they’re in, the people they fall in love with and the new ways couples experience stress if they’re in a stigmatized relationship form,” said LeBlanc. “One of those is feeling that society doesn’t value your relationship equally.”

“Changing laws is one thing, but changing hearts and minds is another.”

That perception is the focus of a second study just published in the Journal of Marriage and Family. LeBlanc found that feelings of being in a “second-class” relationship are associated with mental health issues — such as greater depression and problematic drinking — even after taking into account the beneficial impact of gaining legal recognition through marriage. In 2015, the U.S. Supreme Court legalized same-sex marriage, but the effects of long-term institutionalized discrimination can linger, according to LeBlanc.

“Our work is a stark reminder that legal changes will not quickly or fully address the longstanding mental health disparities faced by sexual minority populations,” said LeBlanc. “Changing laws is one thing, but changing hearts and minds is another.”

Even though people in same-sex relationships experience many unique challenges, research also shows that having a good primary intimate partnership is important for a person’s well-being, which is true for both heterosexual and LGB couples. “The unique challenges confronting same-sex couples emanate from the stigma and marginalization they face from society at large, not from anything that is unique about their relationships in and of themselves,” said LeBlanc. LeBlanc’s study builds on an emerging body of research suggesting that legal recognition of same-sex relationships is associated with better mental health among LGB populations — as has long been suggested in studies of legal marriage among heterosexual populations. “This new research suggests that legal marriage is a public health issue,” said LeBlanc. “When people are denied access in an institutionalized, discriminatory way, it appears to affect their mental health.”

LeBlanc said transgender individuals were not included in the studies because of other stressors unique to them; he noted that another study focused specifically on trans- and gender-nonconforming individuals is underway. He hopes his research will help people better understand and support not just same-sex couples but also other stigmatized relationships, including interracial/ethnic relationships or partnerships with age differences or different religious backgrounds. “It’s not just about civil rights for LGB persons,” he explained. “It’s about science and how society can be more supportive of a diversity of relationships that include people from all walks of life.”

Complete Article HERE!

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How to enjoy sex even when your mental ill-health is working against you

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Anxiety and low self-esteem can seriously impact your sex life

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[E]ver had one of those days when your brain seems to be dead set on working against you?

You’re planning a nice bit of sexy time – whether with a partner or simply some solo fun – but your head’s just not in it.

However much you might want to get jiggy with it, your brain is skipping around elsewhere and you just can’t concentrate, let alone roll around in orgasmic delight.

So what causes your head to seemingly separate from your body at just the moment you want to be able to focus on fun times?

All too often it boils down to lack of confidence in yourself and what you’re doing.

If you have problems with self esteem, it can trickle into all areas of your life – and that includes the bedroom.

The saying ‘first you have to love yourself’ is bit of a cliche – but like most cliches, it’s actually true. Many things can sap your confidence, both mental and physical.

For my friend Amy, the problem is a lack of confidence caused by physical issues.

The problem has grown over the years, to the stage where it’s such a big issue that she’s unsure how to even start working through it.

‘I was born with cerebral palsy and I also have ME and fibromyalgia,’ Amy says.

‘I’ve gone from being moderately active and social to spending most of my time at home and sleeping a lot.

‘I was never particularly confident with guys because I have always been overweight.

‘I’ve had four sexual partners so far, three men and a woman. All were basically one night stands that were pretty unsatisfactory for me (and probably them too).

‘I’ve not had sex in years now and have never really dated anyone.

‘I’m pretty fed up of that to be honest but I feel quite isolated socially and wary of anyone who might take an interest because I feel so unattractive.’

You need to learn to love yourself

My personal suggestion in any situation like this always boils down to that same cliche – you have to learn to love yourself first.

Mirrors, masturbation and practice is the key.

Look at yourself so that you’re used to what your own body looks like and learn what really turns you on.

If you practice this alone then you’ll have all the more confidence when it comes to getting down to it with someone else in the room.

Amy’s story is just one of many I hear all the time from people whose sex lives have become unsatisfactory through no fault of their own.

I spoke to relationship and sexuality counsellor Jennifer Deacon and asked for her general advice on separating sex from anxiety.

‘When you’re anxious it’s often hard to feel turned on – or even have any desire at all.

‘That in turn can feed the anxiety more, particularly if you’re in a relationship where you might feel you’re letting your partner down, bringing up a whole heap more anxiety.

‘As with any anxiety the first thing is to try and find that tricky balance between reflecting on what’s going on with your thoughts and over-analysing.

‘What’s stopping you – is it the thought of being naked with someone else? The physical acrobatics that you might feel you ought to be performing?

‘Or is your sexual desire being suppressed because of meds that you’re taking?

‘Try to reflect on what’s going on, and then work through the ‘what ifs’ and ‘shoulds’ that often make up a huge part of anxious thoughts.

‘If you have a partner, try to communicate with them what you need – for example if you’re missing intimacy but are scared of initiating hugs or cuddles because you’re not sure you want full sex, then try to find a way to talk about this with them.

‘If your anxiety has roots in a trauma that you’ve experienced then communication becomes even more important – both communicating with yourself as to what you need and want, and communicating with your partner so that they can support you.

‘Lack of libido can be a common side effect from medication so if you notice that your sexual desire has waned since you started a new medication or changed your dose, consider discussing this with your GP or specialist.’

Many prescription drugs do indeed have side effects that affect the libido – and doctors aren’t always up front about explaining the risks.

Okay, so ‘losing interest in sex’ might be a long way down the list of worrying potential side effects, but given that antidepressants often cause this issue, I’m always amazed that it isn’t discussed more.

Sex is a healthy part of life and if you still want it but struggle to get any joy out of it, that’s going to affect your happiness levels.

After literally decades of living with chronic anxiety, I’ve been through endless different drugs in the hope of finding one that will help without ruining the rest of my life.

The problem is that drugs affect everyone differently – what works brilliantly for one person can potentially have drastically negative effects on another.

The first antidepressant I was given was Prozac.

Back then it was the big name in drug therapy and widely considered to be suitable for everyone.

And yes, it helped my depression – but it also completely removed my ability to orgasm.

I still wanted to – my sex drive itself wasn’t affected in any way – but I simply couldn’t ‘get there’.

I still regale people about ‘that time I gave myself RSI through too much w*nking’ – it’s a funny story now, but at the time it was utterly true and completely miserable.

I went back to the doctor and had my meds changed.

At the last count, I think I’ve tried about thirteen different anxiety meds and I still haven’t found one that I can cope with.

Ironically, if I was happy to lose my libido then several of them would have been perfect – but why should we be expected to go without one of the most enjoyable life experiences?

Personally, that makes me just as miserable as being anxious or depressed, so it invalidates the positives anyway.

Currently I’m med-free – and not very happy about it – but at least I still have my sex life.

For some people, finding the right medication without it affecting their libido will be easy.

But everyone has to find their own balance – some might prefer to take the meds and sacrifice their physical enjoyment.

But it’s okay to want both.

Complete Article HERE!

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Doctors Are Failing Their Gay Patients

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by Liz Posner

[Y]ou’re supposed to be able to tell your doctor anything. But how are patients supposed to know what to tell their doctors if the doctors don’t ask the necessary questions in the first place? When it comes to sexual health screening, many doctors either missed the class in medical school that was supposed to teach them to ask patients about sexual health questions, or their lack of attention to sexual health is a conscious choice. Bespoke Surgical recently conducted a study of 1,000 Americans of various ages and sexual identities to hear what they’ve been asked by their doctor on the topic. The results suggest few doctors are asking questions about sexual health at all, and that LGBTQ patients, in particular, are being neglected.

The survey asked participants what kinds of questions their primary care physician focused on when they brought up sexual health during physical exams. The results varied based on the sexual orientation of the patient, as the graph below shows.

There are some outliers here that should be noted, but first, take a second to note how low these numbers are overall. Over half of heterosexual respondents said they were never asked about basic sexual health questions like HPV and STD exposure—a number that’s surprising, especially since 79 million Americans have HPV, a condition that can lead to cancer in both men and women. In general, it seems like doctors aren’t asking patients the right questions about sexual health.

But consider the shocking numbers revealed in the chart above. Of the physicians who saw homosexual patients last year, only 13 percent asked their patients if they had received the PrEP HIV prevention drug. Nearly half of all gay and lesbian respondents said their doctor had not asked them about HPV/Gardasil, anal pap smears, PreP/Truvada, or prior STD exposure. Only 40 percent of patients gay, straight and bi said they were asked if they used any kind of protection during sex.

When they do ask the right questions, the survey suggests doctors are asking them of the wrong people. In all but one of the above sexual health categories, bisexual patients were more likely to be asked about sexual health conditions. This could be because, as the Advocate explains, there’s a myth that bisexual people are more promiscuous than other people. The survey authors affirm this: “the ‘B’ in LGBTQ+ is often misrepresented in a variety of settings, including sexual promiscuity.”

Undoubtedly, doctors aren’t asking their patients a full range of questions because they aren’t able to spend enough time with them in the first place. People of all sexual orientations have experienced the rotating door model of doctor visits. Some primary care doctors say they treat 19 patients a day. With a full roster of 2,500 patients total, the Annals of Family Medicine says each doctor would have to “spend 21.7 hours per day to provide all recommended acute, chronic and preventive care” for that many patients. A 2016 study found that most doctor’s office visits only last 13-16 minutes. Professor Bruce Y. Lee at Johns Hopkins calls the average crammed doctor’s visit “archaic” in an article for Forbes, and says, “there is little time to actually listen or talk to patients and maybe not enough time to carefully examine them.”

The LGBTQ population seems to be catching on to the fact that primary care physicians may not know the right questions to ask their patients. That would explain why gay, lesbian and bisexual respondents were 20-30 percent more likely than straight respondents to rate having a doctor with the same sexual identity as them as “very important.” LGBTQ people are especially vulnerable to discrimination and may face barriers to health care that heterosexual people don’t. Some technology, like the entrepreneurs who launched an app to connect LGBTQ patients to gay-friendly doctors, is helping to make this easier. But it’s a quick fix to a much more systemic problem, considering so many primary care physicians don’t ask about sexual health problems at all.

Complete Article HERE!

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