Category: Health Concerns

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Let’s Talk About (Depressed) Sex

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

By Allison Stubblebine

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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

By Barbara Sadick

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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

By Chrissy Sexton

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The study is published in the journal Annals of Epidemiology.

Complete Article ↪HERE↩!

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Orgasmic dysfunction:

Everything you need to know

By Jenna Fletcher

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

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

What is orgasmic dysfunction?

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

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

There are several different types of orgasmic dysfunction, including:

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

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

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

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

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

Symptoms

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

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

Causes

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

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

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

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

Diagnosis

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

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

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

Treatment

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

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

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

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

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

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

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

Summary

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

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

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

Complete Article ↪HERE↩!

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How Alcohol Impacts Your Sex Life

By GiGi Engle

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

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

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

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

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

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

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

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

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

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

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

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

Alcohol complicates consent

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

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

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

Complete Article ↪HERE↩!

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Yes, Depression Can Disrupt Your Sex Life

— But The Reason Is Not What You Think

By Kelly Gonsalves

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

One other potentially major exacerbating factor? Mental health.

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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The 4 Worst Things About Sex After Cancer

By Annmarieg

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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Erectile dysfunction: exercise could be the solution

By , &

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

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

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

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

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

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

Hardening of the arteries

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

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

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

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

Take-home message

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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Sexual rehab could have benefits for men with heart disease

By Carolyn Crist

A sexual rehabilitation program could help with erectile dysfunction in men who have heart disease, a study from Denmark suggests.

Men assigned to the rehabilitation program had improved erectile function and better exercise capacity after 16 weeks compared to those who just got usual medical care, the study team reports in the journal Heart.

“Sexual problems have a profound negative impact on several aspects such as quality of life, general wellbeing, relationship problems and psychological outcomes such as depression and anxiety,” said lead study author Pernille Palm of Copenhagen University Hospital Rigshospitalet.

For some cardiovascular issues such as ischemic heart disease, erectile dysfunction is a problem in up to 80 percent of men, she said.

“Patients hesitate to seek help because it’s still a taboo,” Palm told Reuters Health by email. “They want health professionals to address the topic, but health professionals in general don’t feel they have the competence or correct intervention to offer.”

In the CopenHeart trial, Palm and colleagues randomly assigned 154 men either to just continue with their normal outpatient follow-up visits or to also take part in a 12-week sexual rehabilitation program that included physical exercise and psychoeducation around sexual health and dysfunction.

The men had either ischemic heart disease – meaning blocked or narrowed arteries – or a heart rhythm disorder that required an implanted defibrillator. Half were older than 62. Those assigned to the rehab program followed a cardio and strength-training regimen, as well as stretching and pelvic floor exercises, plus a tailored counseling program that covered each man’s specific issues and concerns.

The men answered questionnaires about their sexual functioning and their level of wellbeing at the start of the study, and the research team measured exercise capacity at the outset and again after four months and six months. Measurements of erectile function included questions about erection quality, orgasmic function, sexual desire and intercourse satisfaction. Another set of questions gauged quality of life related to having a disease.

The research team found that sexual rehabilitation, as compared with usual care, improved physical sexual function at four months and six months. The rehabilitation program also improved exercise capacity and pelvic floor strength. However, there was no difference between the groups in the psychosocial component of the assessments or in their self-reported health or mental health.

“What stuck out the most was the fact that so many men had this problem for so long and hadn’t sought professional help,” Palm said. “But also, the ones seeking help weren’t able to get sufficient advice.”

As part of the trial, the study authors elicited feedback from the men’s partners regarding erection function, yet only 10 percent of partners responded. Future studies should find other ways to engage partners and build the social aspect of the program, Palm said.

In fact, during the trial, some of the patients “teamed up with peers and met up after training sessions for a beer, thereby creating a special place for discussing their life with heart disease, including sexual issues,” she said.

Palm and colleagues are planninga larger study with different types of patients who may require different treatments, she explained. Other studies are specifically focused on sexual outcomes for women, too.

“Although the clinical guidelines recommend counseling of women and men about sex after a heart attack, women are far less likely to receive this counseling,” said Dr. Stacy Lindau of the University of Chicago, who wasn’t involved in the study.

Lindau directs WomanLab, a website that provides information about female sexuality and health conditions, especially with regard to menopause, cancer and heart disease. This week, WomanLab launched a new resource (bit.ly/2FNxEHj) with questions to ask doctors about sex after a heart attack.

“Both men and women should ask their heart doctor when it’s safe to start having sex again and, if possible, include their partner in the conversation,” Lindau told Reuters Health by email. “A life-threatening illness can be a wake-up call where couples reset their thinking about their life priorities and renew their commitment to caring for and loving each other each day.”

Complete Article ↪HERE↩!

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Puberty for the Middle-Aged

Forty-five-year-old women need a version of “the talk,” because our bodies are changing in ways that are both really weird and really uncomfortable.

By Lisa Selin Davis

If only, on your 45th birthday, a doctor would sit you down, look you squarely in the eyes and say, “Here’s what’s going to happen: Eventually, your pubic hair is going to thin out everywhere but on the bikini line, exactly the opposite of what you’ve always wanted. The fat on your body will redistribute so that each of your thighs is the shape of Grimace, the McDonald’s blob monster. You will develop those wings of loose skin below your arms. You just will, no matter what you do. Also: Everything about your periods will change. They may become shorter, more frequent, more painful. And they’ll just get weirder until they desist.”

If only, in other words, someone told you, “You need to really prepare, emotionally and physically, for middle age.”

But of course, no one does.

We put a lot of time and effort into preparing teenagers for what changes puberty will wreak, but for women, midlife brings another kind of puberty — perimenopause, a road that we in our 40s navigate blind, without enough information from our doctors or often other women, wondering in silent shame at the intensity and seeming endlessness of the changes.

What is perimenopause, you might be asking? For one thing, it’s a term so underused that Microsoft’s word-processing program is telling me it’s not a word, a term that was new to many when Gwyneth Paltrow uttered it last month in a Goop video. “Peri” is Greek for “near,” and menopause is the ceasing of menstruation. So perimenopause is all the crazy stuff that happens on the way to that cessation.

We need to have The Talk, but for 45-year-olds. Doctors should speak to their patients about the changes that could lie ahead and how to prepare for them. And we perimenopausal women need to talk to one another, and the rest of the world, about what’s happening. Because a lot of it, to me, is really weird, really surprising and really hard to sit comfortably through, from the stray chin hair — O.K., hairs — to the decreasing bone density. Some 40 percent of women have interrupted sleep during perimenopause. Between 10 percent and 20 percent have mood swings. Some have uterine bleeding or vaginal dryness and even that hallmark of actual menopause, hot flashes.

My desire to know the full story goes beyond my health: How am I going to make jokes about these symptoms if I don’t know what they are? (I will always fondly recall Joan Rivers joking about the surprising number of things that sag as you age, starting with your genitals

Recently I asked friends on Facebook what no one had told them about middle age. No post of mine has ever garnered so many responses, so equally divided between sad and funny. Or both.

There are the physical issues — the random acne, the skin tags, the cough that causes a little bit of pee, the long recovery time from minor injuries and how easy it is to get those injuries. “Doing something really banal like reaching for the remote can put my back out and leave me wailing like a child for a day,” one friend wrote.

And then there are the emotional issues: How will I feel differently about myself as my hormonal profile shifts, as I lose estrogen in the years just before my young children surge with it?

The Talk doesn’t have to be all bad. Among the things my Facebook friends noted was that they felt better and stronger than they did in their 20s and 30s, and that they had become much less vain. One friend wrote, “I prioritize the things that are important to me and people I care about.”

She has arrived at the still-mythical (to me) moment when people stop caring so much what others think, the beginning of the upswing of the U-shaped happiness curve, which shows that people get happier as they grow old (often the 40s are the curve’s nadir). Older people are the bearers of wisdom earned by their years, or by the sheer fatigue that has overtaken them, forcing them to pick their battles more carefully. Along with those chin hairs, solace may come.

So your doctor might also say, “You will most likely find that you no longer sweat the small stuff (except at night, when you will sweat uncontrollably), that you care less about the approval of others and feel less attached to an iteration of your life that you haven’t achieved. And invisibility is a superpower that can be used to your advantage.”

If your doctor won’t go there, you can take it from me.

Complete Article ↪HERE↩!

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Talking sexual health with older patients

Dr Sue Malta and her research team want to promote more positive social perceptions of older people’s sexuality, in general practice and beyond.

By Amanda Lyons

It is no secret that Australia’s population is ageing.

But that doesn’t mean older Australians are leaving the pleasures of the bedroom behind – and nor should they, argues Dr Sue Malta.

‘Having a healthy sex life when you’re older, even when you do have disability and disease, is actually really good for your health and wellbeing, and also your overall cognition and cognitive function,’ the Melbourne School of Population and Global Health research fellow told newsGP.

‘So there’s lots of reasons for people to remain sexually active in later life, and for GPs to encourage them to be so, if that’s what the older patient wants.’

Our culture contains many deeply embedded stereotypes about older people, and one of the strongest is that they are asexual. But, as shown by Sex, Age & Me, a national study conducted on the sexual and romantic relationships of over 2000 Australians aged 60 and older, this is very far from the case: almost three-quarters (72%) of respondents reported having engaged in a variety of sexual practices in the preceding year, ranging from penetrative intercourse to mutual masturbation.

Despite this kind of eye-opening data, stereotypes about older people’s sexuality – or lack of – persist, even among older people themselves and the health professionals who treat them.

The Sexual Health and Ageing, Perspective and Education (SHAPE) project, for which Dr Malta is a researcher and project coordinator, also revealed these stereotypes could cause significant barriers in discussion of sexual health between GPs and older patients.

‘GPs don’t want to initiate these conversations, they want them to be patient-led,’ Dr Malta said.
‘But older patients won’t talk to GPs because they are embarrassed, and for reasons that go back to an historical lack of sex education when they grew up: the context and eras these patients were born into, they just didn’t talk about sex.

‘So it leads to this Catch-22 situation.’

The SHAPE team wanted to further investigate the reluctance of GPs to raise sexual health issues with older patients, so they conducted semi-structured interviews with 15 GPs and six practice nurses throughout Victoria. The resulting paper, ‘Do you talk to your older patients about sexual health?’ was published in the most recent edition of The Australian journal of general practice (AJGP).

Dr Malta explained that semi-structured interviews allowed the researchers to access richer and more detailed information from their GP respondents.

‘It’s very easy to say ‘“yes, no” in a survey. We don’t really find out people’s underlying or unconscious views and attitudes,’ she said.

Researchers ultimately found many of the GPs feel uncomfortable broaching the subject of sexuality with older patients, and some found it difficult to reconcile sexuality with ageing.

As one GP said, ‘It’s a bit like you don’t really want to know your mum and dad have sex, you know? Because that’s just gross’.

However, as Australia’s ageing population grows, and divorce, online dating and sexually transmissible infections (STIs) become more common among older people, neglecting issues of sexual health can lead to harms.

There’s a whole issue around [the fact that] they’re not practising safer sex, so the STI rates are going up,’ Dr Malta said. ‘It has gone up 50% in five years, but from a low base.

‘But if we continue in this vein, with more and more single older adults coming into the population, this could potentially be more of an issue in the future.’

Furthermore, if GPs and other health professionals are unaware that they should be looking out for sexual health issues in older patients, they may miss important signs.

‘A lot of the symptomology [of STIs] actually mimic diseases of ageing,’ Dr Malta said. ‘So if there is a stereotype of the asexual older person in the GP’s mind, and an [older patient] has a symptom that might or might not be an STI, which side do you think the GP is going to err on? Not the possible STI.’

A vivid anecdote that Dr Malta encountered during her teaching work is a telling illustration of the importance of not making assumptions.

‘One of the registrars at a presentation I gave had a consultation with an older man, a gentleman on a walking frame, who was 90 or so, and presented with what looked like an STI,’ she said.

‘The consultant the registrar was working under said, “No, it wouldn’t be an STI, just look at him, he’s past it. That’s ridiculous.” But the registrar decided she would ask him.

‘So she asked and he said, “Yes, actually, it could be an STI. I went to see a prostitute last week and it was the best thing I’ve done in ages”.

‘So the registrar then had the opportunity to have that discussion about safer sex and give him some treatment.’

Many of the GPs interviewed for Dr Malta’s paper felt they would appreciate interventions designed to help facilitate discussions about sexual health during consultations with older patients.

Dr Malta agrees this would be helpful, but believes it would also be useful to start earlier, with better information about ageing and sexuality provided during general practice (and other medical) training.

‘In training, you learn about ageing, but in the context of disease and dysfunction,’ she said.

‘So the only thing about sex and ageing you might learn is about erectile dysfunction, how beta blockers affect your ability, vaginal dryness, menopause, prolapse. You don’t actually learn about positive sexuality in later life.’

Dr Malta has found that most older patients would like sexual health screening to become a normalised part of routine care in general practice. She also believes it is necessary to make changes in overall health policy to make it more inclusive.

‘There is no sexual health policy targeting older adults,’ she said. ‘They get lumped into general sexual and reproductive health policy, and the only mention that’s made of them is about menopause and the like.

‘There should be a specific sexual health policy for older adults because the issue is more involved than we think.’

Complete Article ↪HERE↩!

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Encourage teens to discuss relationships, experts say

BY Carolyn Crist</a

Healthcare providers and parents should begin talking to adolescents in middle school about healthy romantic and sexual relationships and mutual respect for others, a doctors’ group urges.

Obstetrician-gynecologists, in particular, should screen their patients routinely for intimate partner violence and sexual coercion and be prepared to discuss it, the Committee on Adolescent Health Care of the American College of Obstetricians and Gynecologists advises.

“Our aim is to give the healthcare provider a guide on how to approach adolescents and educate them on the importance of relationships that promote their overall wellbeing,” said Dr. Oluyemisi Adeyemi-Fowode of Texas Children’s Hospital and Baylor College of Medicine in Houston, Texas, who co-authored the committee’s opinion statement and resource for doctors published in Obstetrics & Gynecology.

“We want to recognize the full spectrum of relationships and that not all adolescents are involved in sexual relationships,” she said in an email. “This acknowledges the sexual and non-sexual aspects of relationships.”

Adeyemi-Fowode and her coauthor Dr. Karen Gerancher of Wake Forest School of Medicine in Winston-Salem, North Carolina, suggest creating a nonjudgmental environment for teens to talk and recommend educating staff about unique concerns that adolescents may have as compared to adult patients. Parents and caregivers should be provided with resources, too, they write.

“As individuals, our days include constant interaction with other people,” Adeyemi-Fowode told Reuters Health. “Learning how to effectively communicate is essential to these exchanges, and it is a skill that we begin to develop very early in life.”

In middle school, when self-discovery develops, parents, mentors and healthcare providers can help adolescents build on these communication skills. As they spend more time on social networking sites and other electronic media, teens could use guidance on how to recognize relationships that positively encourage them and relationships that hurt them emotionally or physically.

Primarily, healthcare providers and parents should discuss key aspects of a healthy relationship, including respect, communication and the value of people’s bodies and personal health. Equality, honesty, physical safety, independence and humor are also good qualities in a positive relationship.

As doctors interact with teens, they should also be aware of how social norms, religion and family influence could play a role in their relationships.

Although the primary focus of counseling should help teens define a healthy relationship, it’s important to discuss unhealthy characteristics, too, the authors write. This includes control, disrespect, intimidation, dishonesty, dependence, hostility and abuse. They cite a 2017 Centers for Disease Control and Prevention study of young women in high school that found about 11 percent had been forced to engage in sexual activities they didn’t want, including kissing, touching and sexual intercourse. About 9 percent said they were physically hurt by someone they were dating.

For obstetrician-gynecologists, the initial reproductive health visit recommended for girls at ages 13-15 could be a good time to begin talking about romantic and sexual health concerns, the authors write. They also offer doctors a list of questions that may be helpful for these conversations, including “How do you feel about relationships in general or about your own sexuality?” and “What qualities are important to someone you would date or go out with?”

Health providers can provide confidentiality for teens but also talk with parents about their kids’ relationships. The committee opinion suggests that doctors encourage parents to model good relationships, discuss sex and sexual risk, and monitor media to reduce exposure to highly sexualized content.

“Without intentionally talking to them about respectful, equitable relationships, we’re leaving them to fend for themselves,” said Dr. Elizabeth Miller, chief of adolescent and young adult medicine at Children’s Hospital of Pittsburgh of UPMC, who wasn’t involved in the opinion statement.

Miller recommends FuturesWithoutViolence.org, a website that offers resources on dating violence, workplace harassment, domestic violence and childhood trauma. She and colleagues distribute the organization’s “Hanging Out or Hooking Up?” safety card (bit.ly/2PQfxEM), which offers tips to recognize and address adolescent relationship abuse, to patients and parents, Miller said.

“More than 20 years of research shows the impact of abusive relationships on young people’s health,” Miller said in a phone interview. “Unintended pregnancies, sexually-transmitted infections, HIV, depression, anxiety, suicide, disordered eating and substance abuse can stem from this.”

Complete Article ↪HERE↩!

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How to have the talk with your partner

Since the most common symptom is actually having no symptoms, talking to any partners about sexual health is even more important than it is awkward. The good news is talking about sexually transmitted infections (STIs) and getting tested leads to more honesty, open communication and better relationships (and health) in the long run. Here’s how to start that particular conversation.

Taking the lead

“Just so you know, I got tested for STIs last month…” is a strong start. Taking the initiative yourself to get tested, get treated if necessary and know your status keeps you and your partner safer. Then, when you’re ready to have the conversation, you can open by sharing your results and normalizing getting tested for your partner.

If they respond that they haven’t been tested or it’s been a while since their last appointment, encourage them to do it, too, so you can be on the same page. This also is a good time to remind them that getting tested doesn’t mean they do have an STI, and if they do, most are curable and all are treatable (and having one doesn’t say anything about them).

Jumping in together

If you haven’t been tested recently either, start a conversation with your partner about both of you getting tested. You can even introduce it as something uncomfortable if that’s where you are, i.e., “This is awkward, but I care about our health and I think it’s time for us to get tested for STIs. Would you want to go get tested together?”

This kind of conversation lets you share an awkward experience while empowering you both to take care of yourselves and each other, creating stronger communication in the long run. It’s also a quick way to hear from your partner if they have recently been tested, and if so, they can serve as your support system in taking on your health.

Sharing results

Talking about an STI you had or have, or hearing about one from your partner, can be a stressful situation. A few things to keep in mind: STIs don’t define people or behaviors, many are curable and all are treatable, millions of people contract STIs every year and even in monogamous relationships an STI doesn’t necessarily mean someone cheated (in some cases, it can take years for symptoms to show up, if at all).

Start a conversation like this one in a safe place where you won’t be interrupted and practice what you’d like to say ahead of time. “I had chlamydia and took medicine, so I don’t have it anymore, but it made me realize we should be getting tested more…” or “I was just diagnosed with gonorrhea and my doctor said you can also get a prescription for the antibiotics…”

Sometimes people need time to process this information, and that’s okay—let them know you’d like to continue talking about it when they feel ready.

If your partner is disclosing an STI to you, remember these facts and consider how you’d want to be treated on the other side. Be compassionate, avoid judgment and take on your health as a team. If you have questions or would like to get tested, Medical Services offers STI testing by appointment with a health care provider and on a walk-in basis through the lab.

Free safer sex supplies (condoms, lubricant, etc.) are available through Health Promotion on the first floor of Wardenburg Health Center. For general information on sexual health and sexually transmitted infections, visit beforeplay.org

Complete Article ↪HERE↩!

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Men, like women, can have post-sex blues

By Cheryl Platzman Weinstock

After sex, men can sometimes experience a myriad of confusing negative feelings, a phenomenon called post-coital dysphoria (PCD), which can interfere with relationships, researchers say.

The research team analyzed responses from over 1,200 men to an anonymous international online survey that asked whether they had ever experienced symptoms of PCD, which can include tearfulness, sadness or irritability following otherwise satisfactory consensual sex.

The men, aged between 18 and 81 years, were primarily in Australia and the U.S., but the sample also included men in the UK, Russia, New Zealand, Germany and 72 other countries.

The study team, led by Joel Maczkowiack, a master’s student at Queensland University of Technology in Brisbane, Australia, found that 41 percent of the men reported having experienced PCD in their lifetime, with 20 percent saying they had experienced it in the previous four weeks. Between 3 percent and 4 percent of the men reported experiencing PCD on a regular basis.

“I would like to think that this study will help males (and females) reflect on their experience of sex, as well as encourage communication between partners about their experience,” Maczkowiack told Reuters Health by email.

“In addition, we hope that this type of research will help people whose experience of sex is dysphoric (or dysphoric at times) to know that they are not the only ones who feel this way. In this sense, we hope this study normalizes a variety of human experiences following sex,” he said.

Past research has found that PCD is common among women. This is the first time it has been documented in men, Maczkowiack said.

PCD can occur despite satisfying and enjoyable sex. One man in the study reported that PCD made him feel “self-loathing.” Another reported, “I feel a lot of shame.” One participant said, “I usually have crying fits and full on depressive episodes following coitus that leave my significant other worried . . . .”

The study, published in the Journal of Sex and Marital Therapy, found that PCD may be related to previous and current psychological distress and past abuse, including sexual, emotional and physical abuse in childhood and adulthood.

Emotional abuse was the most common form of abuse reported by the men both before and after age 16, researchers found. Sexual abuse in childhood was reported by 12.7 percent of the men and sexual abuse in adulthood was reported by 3.5 percent of the men. Their most common reported mental health concern was depression (36.9 percent), followed by anxiety (32.5 percent) and bipolar disorder (3 percent).

Current psychological distress was the strongest variable associated with lifetime and four-week PCD. Higher levels of psychological distress were more strongly associated with PCD.

The data for this study was collected from February to June 2017 and drawn from a larger questionnaire that examined the post-coital experience of men and women.

“While this research is interesting, the study of PCD needs psychometrically valid instruments, said Rory Reid, an assistant professor of psychiatry and research psychologist at the University of California, Los Angeles, who was not involved in the study.

The study used a few questions to measure PCD, but there is ambiguity in those items, Reid said in a phone interview. “They lack precision and there was no specificity about frequency in responses as to exactly how often was ‘a little’ or ‘some of the time’,” he noted.

“Future studies of PCD need to utilize qualitative approaches where participants are interviewed about their PCD experiences so we can further understand this phenomenon, why people might experience it, the extent to which it is causing individuals psychological distress, and whether it is negatively impacting their romantic relationship,” Reid added.

One of limitations of the study was that the men self-reported their emotional response to previous sexual experiences. “This information can be difficult for participants to recall,” Maczkowiack, said.

“The findings of this study could influence marital therapy by normalizing different responses. In addition, it may open up communication between partners,” he said.

Complete Article ↪HERE↩!

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What Do You Do If You Have An STI?

Stay Calm, Here Are 3 Steps To Take

By Laura Moses

Years ago, a friend raged into my apartment with bad news: the guy she had been hooking up with had given her an STI. She knew he was seeing other people, but he had just written her a lovey-dovey email from his business trip, asking about her upcoming schedule, and saying how much he missed her. She was gobsmacked about what to do. I mean… what do you do if you have an STI? Like a good friend, I made her a drink and then we made a plan. She wrote a nice email back to him saying she’d check her schedule, hoped he had a nice trip, and ended with “P.S. We have gonhorrea.” Boom.

Although we still laugh about that to this day, your sexual health is something to take very seriously. If you think you might have an STI, you probably feel anxious, scared and pretty physically uncomfortable. I connected with Dr. Gillian Dean, Senior Director of Medical Services at Planned Parenthood Federation of America, about this topic. She observes, “The reality is that there are 20 million new STI cases each year. Getting an STI or having a partner with an STI is extremely common — it’s the result of intimate contact with other people and not something to be embarrassed about. It doesn’t make you any less valuable or worthy of love, and your STI status doesn’t make you “clean” or “dirty.” So take a deep breath, you got this, and read on for steps to take to address what might be going down… down there.

Step One: Get Tested

It’s important to note what your specific symptoms are and when they first occured. While a girl’s gotta pay attention to everything going on below her belt, keep in mind that not every itch or sore spot is caused by an STI. Dr. Dean explains, “painful or frequent urination could be a symptom of an STI — or it could be caused by a urinary tract infection or vaginitis. Both yeast infections and pubic lice cause itching. Is that bump a wart or a pimple? It can be hard to tell sometimes.”

While noting and keeping track of your symptoms is important, most common STIs out there — chlamydia, gonorrhea, HPV — often don’t have any symptoms, Dr. Dean says. That’s why there’s no accurate way to tell if you have an STI without being tested. STI testing is quick, easy and painless. All STIs are treatable, while many are curable — but you have to know your status before you can get treated. So go.

Step Two: For Real, Get Tested

Let’s say you feel fairly fine, just a little irritation down south, but you would rather wait it out and hope it goes away than trek to your gyno’s office and do the whole pelvic exam thing. Most of the time, STIs have no symptoms or may be so mild that they don’t bother you, but that doesn’t mean they’re not harmful.

Dr. Dean cautions, “Just because you don’t have physical symptoms doesn’t mean you can’t pass it [an STI] to a partner or that it can’t lead to more serious health problems in the future. If you’ve had vaginal, anal, or oral sex with a new sexual partner or multiple sexual partners, you should talk with a nurse or doctor about getting tested.”

Now, if you have physical symptoms such as sores or bumps on and around your genitals, burning or irritation when you pee or flu-like symptoms like fever, body ache, and swollen glands… then please put your phone in your bag and go right to the doctor. (You can finish reading this later!) You can also get rested — often for a reduced rate or even for free — at Planned Parenthood or a sexual health clinic.

Once you’ve been tested and you know exactly what you’re dealing with, the treatment your doctor prescribed to you will get to work. Going forward, be sure you take all precautions to protect your precious health, like using protection and getting tested regularly. Dr. Dean explains, “At a minimum, sexually active people should get tested once a year — but it also depends on your personal risk factors, such as if you use protection or if you have a new sexual partner since you last got tested.” She suggests talking with your doctor about what makes sense for your life.

Also, you should talk to your sexual partner or partners about this. If you’re unsure how to have this super fun talk with a sexual partner about STI testing and protection, or that you have an STI, Planned Parenthood created a set of videos to help you out. If you truly don’t want to have a face-to-face chat, you can always do it in an email postscript, like my dear friend once did. Your sexual health is part of your physical, emotional and mental health, so being able to communicate with your sexual partners is key.

Complete Article ↪HERE↩!