School biology lessons can sometimes be a case of a teacher trying to impart the basic facts about sex to a group of giggly teenagers.
And while the trusty basics are a great place to start, there is so much more about penises and erections that we bet they didn’t teach you.
Our sexual health is something we should be all clued up about and our favourite Dr Danae Maragouthakis, from Yoxly, an Oxford-based sexual health start-up, is an Instagram doctor who knows all their is to know about our genitals.
We’ve already covered penis misconceptions, now it’s the time for the hard facts…
There are three types of erection
If you get an erection you may not think much about how you actually became aroused.
But, when your penis gets hard there are actually three different categories of erection it can fall into.
There are three different types of erections men can have
A subconscious erection is the first type. These hard ons usually occur when you’re dreaming – you won’t need physiological or physical stimulations.
Psychogenic erections are the result of sexual fantasies either fulfilled in reality or in porn, where your body responds to visual stimuli.
The third and final type of erection is the reflexogenic erection. This is an erection which happens because of direct physical stimulation to the penis.
You don’t need an erection to orgasm
We usually associate an orgasm with an erection but you don’t necessarily need to be hard to finish.
So if you can’t get it up, that doesn’t mean you can’t sometimes still have a satisfying end to getting it on.
Some people can experience an orgasm without being fully erect, while some men have reported being able to orgasm with just their prostate being massaged.
Penile stimulation isn’t always a necessity.
Up to half your erection is hidden
Your penis is actually a lot longer than it looks
Men, your penis is actually a lot longer than it looks.
About 30% of the tissues that make up the male erection are internal, so you can’t see it from the outside.
This means a third or even up to a half of your hard on is hidden.
Penises have penile spines
Don’t panic, your penis doesn’t actually have spines! But, while humans don’t have penile spines, plenty of closely related animals do.
These spines are pointed, keratinised structures found in the genitalia of several animals, which may help to induce ovulation or enhance sensation during sexual activity.
Our distant relative – the chimpanzee – has penile spines, as well as cats, bats and cute fluffy koalas down under.
Myth: The penis is a muscle
Wrong.
Danae tells Metro.co.uk: ‘Some people believe that the penis is a muscle that can be exercised to increase size or improve sexual performance.
‘The penis is not a muscle. It looks like muscle because it gets hard when it fills with blood when it gets an erection but it’s actually made predominantly of spongey tissue and blood vessels.
‘When someone fractures their penis, they break the blood vessels that run in the penis and tear the soft tissue. It’s incredibly painful and really dangerous, that’s a medical emergency.
‘Seek medical attention immediately because if you compromise the blood flow to those tissues, they can die.’
Beetroot and oysters could give you better erections
Dr Danae also said that consuming foods that are high in Nitric Oxide can help blood flow, thus improving your erections.
Foods high in Nitric Oxide are dark chocolate, beets, garlic, watermelon and leafy green veggies.
You might finally have a reason to try oysters too! Foods that are high in zinc are important for good testosterone levels and sperm production.
This includes the divisive shellfish, as well as beef, chicken, nuts and beans.
As seems to be the rule of thumb for every part of your body, drinking plenty of water means you’ll be hydrated and promote healthy blood flow, which can only be good for your erections.
Beetroot and leafy greens could help give you better erections
Smoking-related erectile dysfunction can be reversed
While there is a misconception that smoking can actually shrink your penis there is no scientific evidence to that point.
However, this doesn’t mean the effects of smoking on your body don’t take their toll on your sexual performance and satisfaction.
What you probably did learn in biology is that smoking constricts your blood flow, but they may not have touched upon the fact that means you won’t always get sufficient blood flow to your genitals.
Most people know the fundamental sportsmanship rule: hitting below the belt is illegal. The groin is highly sensitive, and a strike here can cause severe injury. While a man’s sexuality is off-limits for low blows, that doesn’t mean it’s off-limits for discussion with your doctor.
Too bad most men don’t see it that way.
Stats About Guys and Sexual Health
It’s not that men aren’t concerned about sexual health. In a 2023 survey, the Cleveland Clinic reported:
• 44% of men are worried about erectile dysfunction.
•39% of men are worried about loss of sex drive.
•36% of men are worried about low testosterone.
But of men surveyed, while 37% reported having experienced issues related to sexual health, only two in five sought professional help.
So, guys, let’s have a frank discussion about your most common sexual health concerns.
– Talking About ED
What is it? Erectile dysfunction is the inability to get or maintain an erection firm enough to have sex. Many men think ED only occurs in older men, but ED is not exclusive to getting older. There are men in their 40s and 50s who experience ED and men in their 70s, 80s, and 90s with great sex lives.
What are the symptoms? Failure to reach or sustain an erection more than half of the time, at any age, may indicate a condition that needs treatment. Other symptoms may include decreased sexual desire and less rigid erections.
Who is at risk? ED has a wide range of causes, from vascular issues and nervous system issues to hormone or psychological issues. Chronic health conditions, which about 1 in 4 guys face in the U.S., also impact erectile function. These include diabetes, heart disease and hypertension, obesity, high cholesterol, and smoking. Many medications that treat these conditions have side effects that contribute to ED. Bottom line: ED is a complex, common medical condition and not one to treat lightly or feel self-conscious about.
What is the most common myth about ED? That taking testosterone supplements will cure ED. Low testosterone may or may not be what is affecting your erections. Taking supplements with a normal testosterone level will not result in better erections and may cause side effects if not taken appropriately.
What treatments for ED are you most excited about? Low-intensity shock wave lithotripsy and platelet-rich plasma (PRP) therapy injections. There are also new oral therapies in clinical trials. ED is very treatable. It all comes down to which treatment is right for your lifestyle.
– Talking About Low-T
What is it? Testosterone deficiency syndrome or Low-T means that a man’s body is not making enough testosterone, the primary male sex hormone that regulates fertility, muscle mass, fat distribution, and red blood cell production.
What are the symptoms? Reduced sex drive, reduced erectile function, loss of body hair (including facial hair), loss of lean muscle mass, feeling tired all the time, obesity, and symptoms of depression are the specific symptoms most directly linked to Low-T.
Who is at risk? Data suggests that about 2.1% of men (2 in every 100) may have clinically Low-T, which is a low blood testosterone level of less than 300 nanograms per deciliter (ng/dL). It is more common in men over the age of 80, who have diabetes, or who are overweight. Don’t just assume you have Low-T and start popping pills. Talk to your doctor.
What is one of the most common misconceptions about Low-T? That it’s a normal part of aging, and nothing can be done about it. If you have clinically Low-T, it is essential to treat it. Testosterone is not just for sexual health. It aids in bone, cardiac, mental, and psychological health. Anyone whose testosterone is in the low-normal range may also benefit from treatment, but a physician should manage it.
What treatment for Low-T are you most excited about? Bio T Pellets because they quickly get testosterone into the normal and high normal range for men.
– Talking About Peyronie’s Disease
What is it? Peyronie’s disease is a condition by which a small scar forms in the lining of the penis resulting in penile curvature, loss of penile strength, indentation, or pain.
What are the symptoms? During the first 12 months of developing Peyronie’s disease, you may experience pain with erections, curvature of the penis, penile shortening, an abnormal shape to the penis, or a lump in the penis.
Many men are worried that Peyronie’s disease will cause issues with getting and maintaining erections. While there is some association between penile plaque and restriction of blood flow in the penis, this is not always the case.
Who is at risk? Peyronie’s disease typically forms from microscopic trauma that occurs during intercourse. The trauma leads to inflammation and then a penile scar or lump. It is most common in men over the age of 40.
What is the most common misconception about Peyronie’s That it is a rare condition. It can feel very isolating, since many men don’t talk about it or seek care because they find it embarrassing. In reality, it’s estimated that 6-10% of adult men have Peyronie’s disease.
What treatments for Peyronie’s disease are you most excited about? Introducing injectable collagenase into penile plaques has dramatically broadened the options for safe and effective office-based treatment of Peyronie’s. Surgery remains highly effective at correcting the curvature for more severe or bidirectional (S-shaped) curvatures.
The Physical/Mental/Sexual Health Connection
Men, your physical, mental, and sexual health are closely related. Changes in sexual health may indicate underlying medical conditions. Sexual health affects your quality of life and mental health.
A urologist can provide many management options, including observation, medication, injections, surgery, and more. Sexual health is a crucial component of overall health, so if you’re experiencing any issues, it’s time to consider seeking help from a physician.
Google has revealed the top sex questions people asked this year – and it’s made me slightly concerned for everyone who lived before the internet.
Honestly, what the hell did people do before its creation?
You’re telling me they nipped over to the local library and scanned the shelves to find out the answers to their explicit questions?
I don’t think so.
But of course, with the creation of the internet also comes data that can be stored and analysed, allowing Google to come up with the very list we’re reporting on today.
It might be embarrassing to think about how Google probably knows exactly whether you’re among the people asking these questions, but at least you’ll know you’re not alone.
So, let’s get on with it shall we?
10 – How do fish have sex?
I bet that’s not where you thought we’d be starting, is it? But it’s a valid enough question, even if it’s never crossed your mind before.
If you’re curious now, I can tell you that fish apparently aren’t so bothered about having sex as they are with reproducing.
Spawning fish get themselves into what’s known as a ‘nuptial embrace’, where the male wraps his body around the female and releases milt into the water, while the female releases eggs which are then immediately fertilized.
Fish are more bothered about having babies than getting busy.
9 – Why do I have no sex drive female
There are a number of things that can lower your sex drive as a woman, including relationship problems, stress, anxiety or depression, sexual problems, pregnancy, medicines and hormonal contraception.
If you’re worried about low sex drive, you can get in touch with your GP for advice.
8 – What is anal sex?
Loads of you might be clued up on exactly what anal sex is, but clearly there are a lot of people still out there wondering.
To put it simply, anal sex involves penetration of the anus, rather than the vagina.
You wouldn’t want to ask about anal sex in a library.
7 – How long after a miscarriage can you have sex?
As well as dealing with the emotional effects of miscarriage, there are also a number of physical effects which can impact sex.
People may bleed for a period of time following a miscarriage, during which time
the cervix is dilated wider than normal, making it more prone to infection.
To help ensure you can carry out healthy sex, doctors recommend waiting at least two weeks after miscarriage before inserting anything into the vagina.
6 – How many calories do you burn during sex?
Is it possible to really get a good workout from pleasure?
Research indicates that you can at least equate some fun in the bedroom to light exercise – with one study conducted by the University of Quebec at Montreal revealing that men burned an average of 101 calories in 24 minutes, while women burned 69 calories.
No, I’m not making that number up.
Sex can be considered light exercise.
5 – How many dates should you go on before having sex?
Ah, the age-old question. What is the perfect number? Some live by the three-date rule, while others want to wait until they hit four or five.
Ultimately, it comes down to your own preferences; when you’re ready, whether you actually still like the person after a few dates, and whether you actually want to have sex with them.
4 – Why do I bleed after having sex?
The NHS states there are a number of reasons women may bleed after having sex, including an infection, vaginal dryness or damage to the vagina.
In rare instances, bleeding after sex can be a sign of cervical or vaginal cancer.
If you’re concerned, contact your GP for advice.
3 – What is sex positivity?
There are varying definitions of sex positivity, but generally it’s about openness and appreciation of sex, including sexual orientations, interests, identities and expressions.
Embrace and enjoy it!
Sex positivity is about embracing and appreciating sex.
2 – Can you have sex when pregnant?
There have been a few jokes made on TV and in films about whether the baby could be impacted by the sudden appearance of an unexpected guest in the vagina, but I can assure you that, unless you’ve been specifically advised by a doctor or midwife to avoid sex, the baby will be fine.
A penis or toy wouldn’t penetrate beyond the vagina, meaning having sex is perfectly safe.
1 – What is speed bump sex position?
Here we are, at the most Googled sex question of 2023. I’m surprised positions didn’t come up sooner, but everyone’s clearly spent this year focused on one in particular.
So, what is the speed bump?
Popularized by Love Island star Tom Clare after he mentioned it on the show, the speed bump involves one person putting a pillow under their hips before lying face down.
The pillow forms the so-called ‘speed bump’, though I’m not sure how effective it is at getting people to slow down.
So there you have it, you’ve managed to learn the answers to the year’s top sex questions without becoming a Google statistic.
Sexual health is health — and, boy, did we learn a lot about it this year. After spending 2023 diving into studies, surveys and even pop culture moments that focused on all things sex, I’ve concluded that there’s always more to know about the more intimate side of our lives. Sometimes the things we learned may have felt a little TMI — like, say, the role Christmas ornaments have as potential sex toys. Most of the time, however, the stuff we learned about sex was pretty groundbreaking, such as how there are two types of desire, and neither is wrong.
Here’s a wrap-up of the top six things we learned about sex this year — and here’s to many more fun, sexy facts in the new year.
1. Many women keep a ‘sexual toolbox’
You may not find it at Home Depot, but more than half of menopausal women ages 50 and over who were asked about their sex lives in a September Kindra-Harris poll said that they kept a “sexual toolbox” to make intercourse more pleasurable. These products include lubricants, as well as vibrators, both of which can make sex more fun and comfortable, especially as many menopausal women experience vaginal dryness and other pain during sex, medically known as dyspareunia.
And speaking of lubricant — you may want to be careful about what you put in your own toolbox. If you are using condoms, whether that’s with a sex toy or partner, you should never use oil-based lube, as it can “destroy the integrity of latex condoms,” women’s health expert Dr. Jennifer Wider tells Yahoo Life.
You don’t have to be menopausal to benefit from lube either. “A myth surrounding lube is that people only use lube when something is not quite working correctly,” says Dr. Laura Purdy, chief medical officer at Wisp. “This couldn’t be further from the truth. Many people use lube to make things feel more natural, and lube can be your best friend during sex.”
2. There are 2 types of desire — and neither is wrong
In movies (and, of course, porn) all it takes is someone looking at their partner for Marvin Gaye’s “Let’s Get It On” to start playing. In real life, sexual psychologist Laurie Mintz says that’s not exactly how things work — at least, not most of the time, and especially not for people in long-term relationships. That’s because there are two types of desire: “spontaneous desire,” which is when you feel aroused pretty much immediately, and “responsive desire,” which means you need some kind of stimulation in order to put yourself in a sexy mood.
“With this type of desire, one doesn’t wait to be horny to have sex, but has sex to get horny,” Mintz says, which means that “the desire follows the arousal, versus the reverse.”
Obviously, there are times when sex is completely off the table between two consenting adults — headaches and new episodes of The Golden Bachelor do exist, after all. However, these two kinds of desire may take some of the pressure off people who may feel like they have a lower libido simply because they don’t feel spontaneously sexual.
Instead of making yourself feel bad because you can’t go zero to 60, try engaging in things that make you feel in the mood before you get to your sexual main event, whether that’s masturbating, kissing your partner or even just relaxing and thinking about sex in the hours leading up to a planned encounter.
3. Young people are having less sex than their parents did at their age
Teen rates of sexual intercourse are declining, according to a 2023 published survey from the Centers for Disease Control and Prevention. The survey found that only 30% of teens in 2021 said they ever had sexual intercourse, down from 38% in 2019. While, yes, the COVID-19 pandemic did likely have something to do with the declining rates (it’s a little hard to socially distance during sex), some experts think there may be other reasons for the decline, such as more teens identifying as LGBTQ and engaging in sex acts that don’t necessarily involve intercourse.
It’s also possible that young people just aren’t growing up as fast as they once did. Jean Twenge, a San Diego State University psychology professor who reviewed the data for her book Generations, told the Los Angeles Timesthat more young people are living at home longer and delaying things like getting their driver’s license and going to college — which may also affect their sex life.
“In times and places where people live longer and education takes longer, the whole developmental trajectory slows down,” she said. “And so for teens and young adults, one place that you’re going to notice that is in terms of dating and romantic relationships and sexuality.”
4. People are using strange seasonal things as sex toys
TikTokers love to review the holiday items at Target each year, but Dr. Adam Gaston, an internal medicine physician since 2021, went viral on the platform for a different reason: by reminding his followers not to put said Christmas decor any place it “doesn’t belong.” Sure, that Christmas tree ornament may not be shaped all that differently from a dildo, but spending the holidays in an emergency room because glass broke inside your rectum or vagina is ho-ho-horrific.
Of course, it’s not just the holiday season that gets people hot, bothered and making bad decisions about what to use for sexual gratification: A 2013 case study revealed that things like ballpoint pens, a tea glass and even an eggplant were found in the rectum of different men, so really, why wouldn’t a Christmas ornament be on deck too?
Place those ornaments on your tree and add a silicone-based sex toy on your holiday wish list.
5. Libido gummies (probably) don’t work — at least not how you think
Popping a supplement or chewing on a gummy won’t make you instantly hot and bothered, even as more and more companies are selling libido gummies that claim to put women in the mood for love.
The jury is out on these products, says Dr. Tiffany Pham, an ob-gyn and a medical adviser for female health app Flo Health, as there is “a lack of robust research into the claims behind these supplements,” even as some individual ingredients show promise.
But that’s not the only reason they’re unlikely to be the sole solution for low libido for women: Libido involves more than just physical function and can be affected by everything from stress to past trauma to the connection one has with a partner. If you’re really struggling with a lack of desire, talking with a sex therapist will likely do way more than an over-the-counter supplement. And if you are curious about taking something to boost your libido, make sure to talk to your doctor, who can tell you if it’s safe to explore.
6. Dry orgasms are a thing for men
And Just Like That may be lacking the sex part of its predecessor’s name, but there’s still plenty of sex in the city for Carrie Bradshaw and her friends. In a 2023 episode, Charlotte and her husband, Harry, are having sex when Harry orgasms — only for no semen to come out. After consulting with a doctor, the couple learns he experienced a retrograde orgasm, or a dry orgasm, which occurs when semen enters the bladder instead of exiting through the penis, leading to little to no ejaculation. While Harry is instructed to do kegels — leading to Charlotte training him in the famed pelvic floor exercise — urologist Dr. Fenwa Milhouse told Insider that advice won’t help. Dry orgasms are typically a nerve issue and often caused by certain medications, like ones taken for diabetes, as well as pelvic injuries.
“It’s not dangerous. It’s not detrimental to the person’s body, but it can interfere with fertility because the semen isn’t getting where it needs to be, which is being deposited into the partner’s vagina,” Milhouse told Insider.
Bonus: Here’s how you find your G-spot (which may not be a ‘spot,’ after all)
Ah, the G-spot. If you’re a person with a vagina and have always found this famed alleged center of pleasure elusive, Martha Kempner’s breakdown of the G-spot includes where to find it. The G-spot is on the front wall of the vagina, nearly two inches in. Also worth noting? The G-spot may not be a spot at all but more of a zone, as, according to a 2022 article, there are actually “five separate erotogenic tissues that function in a similar way to the G-spot.”
One theory why stimulating the G-spot feels so good is that people are stimulating the clitorourethrovaginal (CUV) complex, which includes interactions between the clitoris, urethra and uterus, says Debby Herbenick, director of the Center for Sexual Health Promotion at Indiana University and author of Read My Lips. A come-hither motion with two (well-lubed!) fingers should do the trick.
You’ve probably planned on coming out about your sexuality to essential family members like your mom and dad. But have you ever thought about the importance of coming out to your doctor?
An open and honest relationship with your doctor is essential to getting care. This is especially true since there are specific needs that you might have as part of the LGBTQ+ community. As health family medicine physician Rita Lahlou, MD, MPH, told UNC Health Talk, “It’s important for people who identify with historically marginalized communities to find a primary care provider who will be supporting, affirming and understanding of them.”
With that said, the thought of a discussion about your health can be downright nerve-wracking. Whether you’re seeing a new doctor or talking with the doctor you’ve been seeing for years, here are a few tips and strategies to ensure that all your healthcare needs are met for your sexual health.
And it’s not an area that many general practitioners might feel comfortable asking about. Research published in Sexual Medicine examined healthcare specialists’ avoidance of sex and sexuality. It stated that many specialists think that asking their patients about their sex life and sexuality could cause embarrassment, so it’s not something that might come up. However, creating the appropriate framework of trust and empathy between your doctor and you can make this discussion easier. Bringing the topic to the table first lets your provider know it’s not a taboo area to talk about.
If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat988lifeline.org
Look for an LGBTQ-friendly provider
Since your sexuality is a crucial area of your life and who you are, having a physician or specialist who understands how to support the LGBTQ+ community can make talking about your sexuality easier. Look for a provider with an LGBTQ+ designation. According to Henry Ford, doctors with this designation complete additional clinical training for patients within this community, making them more likely to be knowledgeable in documenting sexual orientation and understanding the specific needs.
Finding an LGBTQ+-friendly provider might take some looking around. Paula Neira, Program Director of LGBTQ+ Equity and Education, told Johns Hopkins Medicine that there are databases by groups such as GLMA: Health Professionals Advancing LGBTQ Equality, but they aren’t exactly comprehensive. Thus, setting an appointment with a healthcare provider might require asking about their experience caring for LGBTQ+ patients. You can also ask others in the community to find a doctor they trust or have had a positive experience with.
Neira adds that not being open and honest with your provider could lead to missed screens, like those for cancer, especially for transgender individuals. Johns Hopkins Medicine also pointed out that seven out of ten LGBTQ+ members have received negative care, and connecting with a healthcare specialist competent in this field can alleviate that.
Bring your partner to the appointment
It’s easier to talk about your sexuality when you have a loving person supporting you. Consider bringing your partner with you to discuss this with your provider. Not only can they hold your hand, but they might also be able to help you make sure you have all your bases covered.
Bringing your partner with you and introducing them to your doctor can quickly clarify your sexuality and cue your healthcare provider that it’s okay to broach the subject of your sexual orientation. According to family medicine physician Beth Careyva, MD, “By providing this information, we can make sure to offer preventative care screenings, as well as provide counseling on sexual health, lifestyle changes, and same-sex family planning” (via Lehigh Valley Health Network).
The Office of Disease Prevention and Health Promotion notes that having a support person during the visits can help ensure you keep track of your specialist’s advice and ask questions when something isn’t clearly explained.
Use techniques to calm nervousness
The Center for American Progress points out that discrimination in the healthcare setting for the LGBTQ+ community leads to delays and access to needed medical care. It can affect not only patients, but their parents as well. This is especially true for those trying to find care for their transgender children. Thus, it’s not surprising that this topic might be uncomfortable for some to discuss with their doctor, leading to nervousness.
Fortunately, there are several techniques to calm the nerves before talking to your doctor about your sexuality. One of the best calming methods is focusing on breathing (via NHS). Get yourself in a comfortable position and let your breath flow. Focus on nothing but the movement of your chest and the refreshing air coming into your lungs for a steady five-count. Keep repeating until the doctor comes in so that you can talk to them with a clear, relaxed mind.
The Baton Rouge Clinic AMC states that it can be helpful to close your eyes and count to ten as you wait for your healthcare provider to enter the room. You can also try counting to 20 backward. Other calming techniques include chewing gum, smelling lavender, and listening to calming music. Once the doctor comes in, you can bring up your sexuality as part of your casual health conversation.
Be straightforward and honest
It may be hard to be bold, but when it comes to your health, it’s not a time to be shy. Bring your sexuality to the table immediately. For example, introduce yourself to a new doctor with your name, preferred pronouns, and sexuality. Being matter-of-fact with your healthcare professional establishes honesty. With a current specialist, bring it up by saying, “I have a personal question…” states the National Institute on Aging.
Johns Hopkins Medicine also notes that you should set an agenda when talking to your doctor. It doesn’t have to be a long, intricate list, but outlining your sexuality and issues you would like to talk about will ensure that all your needs are met. According to Megan Moran-Sands, DO, a Geisinger pediatrician, “Your doctor and any healthcare professional you interact with will keep your information private.” Knowing this can help you not to feel so apprehensive.
And remember, your doctor wants honesty. Debra Roter, Dr.P.H., a professor at the Johns Hopkins Bloomberg School of Public Health, noted, “It’s important to share things about your lifestyle, social obligations and relationships at home and at work. Sometimes patients are fearful that the doctor isn’t interested or that it isn’t relevant.” But having this information gives them a better understanding of your overall health.
Use questions as your guide
If you’ve had a bad experience with a different healthcare provider regarding the topic of sexuality, you might be even more apprehensive about talking about it openly. In that case, using questions as your guide might be better. Giving your current provider hints about what you need to discuss allows them to bring the subject up and save you embarrassment.
For example, you might start off your conversation with your provider by discussing their knowledge of LGBTQ+ patients. During your initial interview with a new doctor, you might ask about their patient experience with sexuality and LGBTQ+ patients. Ask about their experience with transgender issues. LCMC Health states that it sets a tone with your provider, allowing them to draw the conversation toward your sexuality in a respectful manner. As the National Institute on Aging notes, asking questions is key to building open communication with your doctor to better understand medical issues, tests, and medications that can affect your sexual life.
Don’t put off talking about your sexuality
The World Health Organization says that your sexual health is essential not just to your personal well-being, but also to that of your loved ones. Don’t overlook being committed to your sexual health with your doctor, since it can influence screenings, family counseling, testing, and more.
Understanding your sexual health also plays a vital role in sexually transmitted disease prevention, practicing safer sex, and your body image, states Healthline. In addition, it’s a key area of mental and emotional health, particularly for members of the LGBTQ+ community who experience “discrimination or cultural homophobia.” Per data presented by the Substance Abuse and Mental Health Services Administration, sexual minorities such as the LGBTQ+ community are more likely to have substance misuse and mental health issues.
As Dr. Megan Moran-Sands notes (via Geisinger), “It’s beneficial to share your sexual orientation with your doctor so you can get the most personalized care. You can be more open about your life and your choices, and you and your doctor can work together to create a plan for staying healthy.” Don’t wait to talk to your doctor about sexual health. Bring it to the discussion immediately to set the bar for all future appointments.
Sexuality and sexual health should not be taboo topics, and are nothing to feel ashamed about. Remember that no matter what, your doctor is there to help. To make things a bit easier during your appointment, Willis-Knighton Health System suggests writing down the items you want to discuss on a phone or piece of paper to avoid forgetting what you want to say in case you suddenly feel uneasy.
Since talking about sexual health can be difficult face-to-face, you might also want to take advantage of telehealth consultations to discuss these issues. It might be easier for you to talk about sexual orientation, sexual problems, and gender in the comfort of your own home. Your provider can ask questions to get the necessary tests or medications (via the International Society for Sexual Medicine). Telehealth might also be the best way to connect with a doctor that is LGBTQ+-friendly.
Lastly, it helps to give your doctor a heads-up. For example, you can tell your healthcare provider during your initial appointment that you would like to speak to them about sexuality. You can also let them know that you’re nervous. This way, they can have questions ready to help you overcome your negative feelings.
Sexual dysfunction, a concern affecting millions worldwide, has long been shrouded in silence and stigma. However, new developments in 2024 are transforming how we approach and treat this sensitive issue. This change isn’t just about enhancing sexual pleasure; it’s deeply tied to self-esteem, mental health, and the quality of relationships.
Open Communication: The first significant trend is the shift towards open communication about sexual dysfunction. This growing openness is largely fueled by mainstream acceptance and the increasing awareness among healthcare providers of the interconnection between sexual and overall health. Online counseling and specialized sexual wellness apps are playing a crucial role in this transformation, offering accessible resources for those hesitant to discuss these issues in person.
Advancements in Technology: Sound wave technology, particularly the development of Cliovana, is a breakthrough in treating sexual dysfunction, especially in women experiencing menopause-related symptoms. This pain-free, non-invasive technology stimulates natural healing processes, leading to enhanced blood flow, sensitivity, and sexual responsiveness. The simplicity and effectiveness of treatments like Cliovana’s soundwave therapy are key drivers in changing the landscape of sexual health solutions.
Menopause Education: The destigmatization of menopause and its associated sexual dysfunctions is gaining momentum. With the global menopause market projected to reach $22.7 billion by 2028, there’s an increasing focus on educating and providing solutions for women. This includes hormone and testosterone replacement therapies, which are tailored to individual symptoms, offering rejuvenation and improved sexual experiences.
Normalization of Sex Toys and Lubricants: Once considered taboo, sex toys and lubricants are now recognized as essential elements of sexual wellness. The market for these products is expanding rapidly, reflecting a societal shift towards accepting these products as tools for enhancing sexual experiences. Retail accessibility, both online and in physical stores, underscores this trend.
Lifestyle Choices and Sexual Health: Finally, there’s a growing understanding of how lifestyle choices impact sexual health. Research linking low-grade inflammation to erectile dysfunction (ED) has encouraged a broader distribution of information from doctors and researchers. Lifestyle modifications like reducing smoking, increasing physical activity, maintaining a healthy weight, and moderating alcohol consumption are recognized as effective strategies for minimizing the risk of ED.
One promising treatment is Cliovana, a unique, patented procedure specifically designed to enhance women’s orgasm intensity and frequency. This innovation is particularly noteworthy considering the widespread issue of sexual dissatisfaction among women. Studies indicate that 60% of women are not satisfied with their sex life, highlighting a significant disparity in sexual fulfillment between genders.
What sets Cliovana apart is its use of sound wave technology. This non-invasive approach, steering clear of lasers or scalpels, significantly reduces the risk of side effects, making it a safer alternative for sexual wellness. The technology is focused on increasing arousal levels, orgasm frequency, and intensity, aiming at a core aspect of sexual satisfaction: the clitoral responsiveness.
The efficacy of Cliovana is backed by clinical trials, which consistently show heightened sensation and stronger orgasms among women who undergo the treatment. The results are not just immediate but also long-lasting. Women report a sustained enhancement in their sexual experience, which can last for over a year, with the option of annual revitalization sessions to maintain these benefits.
2024 is setting a new tone in the realm of sexual health and wellness. With advancements in technology, increased openness, and a holistic approach to treatment and education, the future looks promising for individuals struggling with sexual dysfunction. This year symbolizes a breakthrough in not only treating the physical symptoms but also in supporting the emotional and relational aspects of sexual well-being.
— The small blue pill helping end HIV transmission
Pre-Exposure Prophylaxis (PrEP) is used to prevent HIV transmission
By James W Kelly
Access to a preventative drug has led to a fall in the number of gay and bisexual men diagnosed with HIV, a leading sexual health clinic has said.
Health Security Agency (HSA) figures for London show the number of first diagnoses had fallen in this group by 3% from 2021 to 2022.
Pre-Exposure Prophylaxis (PrEP) is a “powerful tool” in ending transmission, 56 Dean Street clinic said.
However there was a rise of 17% in new HIV diagnoses in the capital.
The treatment which has been free on the NHS in England since 2020, involves taking the PrEP pill containing the drugs tenofovir and emtricitabine before having sex.
Uptake of the drug has been greatest in gay and bisexual men, the clinic said.
Consultant Dr Alan McOwan said: “Everyone should know about PrEP and its potential for preventing HIV.”
Dr Alan McOwan
Dr McOwan said it’s “really simple” to access PrEP
He encouraged anyone considered at higher risk of HIV to enquire about it at their local sexual health clinic.
Across England however, among gay and bisexual men, the overall reduced HIV transmission is not reflected across all ethnic groups.
Tarun Shah, who was diagnosed with HIV four years ago while trying to access PrEP, said the results were encouraging but more work was needed to target more at-risk people in accessing the drug.
He told BBC News: “A few months after enquiring about the PrEP trial, I ended up getting quite ill and it came out that I was HIV positive.”
Tarun said his experience accessing PrEP before his HIV diagnosis was “frustrating”
At the time, PrEP was only available on the NHS to a limited number of people during its trial and Tarun said he was unable to get onto it and could not afford the drugs privately.
He said he found it “frustrating” to think about his situation but added: “I’ve now been quite healthy ever since and it’s great to see that PrEP is now widely available to everyone.”
‘Many not being talked to’
The data for England shows new diagnoses fell by 17% from 2021-22 for white gay and bisexual men, while rises were observed among men of Asian (17%) and mixed or other ethnicity (25%).
Tarun, who is South Asian, said: “There are a lot of groups who don’t feel like they are being talked to in these conversations.
“The more people we can include, the better and I think it will be great that everyone has access to PrEP.”
While effective HIV treatment eliminates the possibility of transmission, Tarun said his partner taking PrEP provide them with a “double zero kind of safety”.
If you’re sexually active, taking the antibiotic doxycycline within 72 hours of sex might help prevent an STI
Syphilis cases are surging in the United States, making ‘Doxy on Demand’ a welcome weapon against the disease
Taking doxycycline shouldn’t be a substitute for condom use, experts say
Data showing that the antibiotic doxycycline might prevent a sexually transmitted infection (STI) if taken soon after sex made headlines earlier this year.
As surging numbers of cases of syphilis and gonorrhea affect more Americans, here’s what you need to know about using the drug.
“If you’re actively having sex and not using condoms 100% of the time, which is the reality out there, this strategy could be appropriate for you,” said Dr. Christopher Foltz, an infectious disease specialist at Cedars-Sinai in Los Angeles. “It comes down to each person’s individual risk level, something that you should discuss with your physician.”
He noted that syphilis, especially, has reemerged with a vengeance in recent years as a health threat.
“Syphilis has been climbing at the highest rate with a significant increase among pregnant women and men who have sex with men,” Foltz said in a hospital news release.
According to the U.S. Centers for Disease Control and Prevention, syphilis cases among gay and bisexual men in the United States rose by 7% between 2020-2021.
Rates of new cases of the disease rose even more steeply among women: a 55.3% jump between 2020 and 2021, and 217.4% rise between 2017 and 2021 overall. That means more babies potentially being born with syphilis, as well.
You may not even realize you are infected with syphilis, Foltz noted, since in many cases it can lurk symptom-free for years. But left undiagnosed, long-term syphilis can cause blindness and neurological issues.
“That’s what we’re trying to prevent — these kinds of catastrophic long-term complications from undiagnosed STIs,” Foltz said. “If we can prevent infections with a relatively safe and easy-to-take antibiotic, the overall number of new infections will ultimately decrease.”
That’s why the new data on doxcycycline is so promising. A trial found that one 200 milligram (mg) dose of the drug — which has been used to treat other ailments for years — could prevent infection with syphilis and chlamydia if taken within 72 hours of a sexual encounter.
The strategy has even gained a nickname: “Doxy on Demand” or “Doxy PEP” (post-exposure prophylaxis).
The method isn’t foolproof however, and it’s no reason to forgo the use of condoms, Foltz warned.
“We absolutely encourage condom use to prevent against other STDs and HIV as an added barrier of protection for prevention,” he stressed.
Doxycycline is not advised for certain groups: Pregnant women and anyone known to be allergic to a class of antibiotics known as tetracyclines. Always consult with your doctor before taking any antibiotic.
Plan B One-Step is a single-dose emergency contraceptive (EC) pill. It contains the active ingredient levonorgestrel, a synthetic hormone belonging to the progestin class. Plan B One-Step and its generic alternatives are available over the counter (OTC).
The Food and Drug Administration (FDA) has approved the use of Plan B One-Step to reduce the chance of pregnancy if taken within three days (72 hours) after unprotected sex.1
Taking Plan B One-Step may affect your period. Some females get their period about a week early or a week late after taking Plan B One-Step, and their bleeding may be lighter or heavier than usual. However, if your period is more than a week late, you could be pregnant.3
Keep reading to learn more about the link between taking Plan B One-Step and your period’s timing, along with basic safety and dosage information regarding its use.
Understanding the Morning-After Pill
Emergency birth control such as the morning-after pill, can help decrease your chance of becoming pregnant after unprotected sex. EC pills, like Plan B One-Step, work by preventing ovulation, the release of an egg from the ovaries.
By stopping this process, the sperm cannot fertilize the egg, thus avoiding a pregnancy.
It is important to note that EC will not have any impact if ovulation has already taken place. As a result, EC does not affect fertilized eggs or pregnancies already implanted.4
EC, including Plan B One-Step, differs from Mifeprex (mifepristone). Mifeprex is a medication given in combination with the drug misoprostol for medical termination of a pregnancy up to 70 days into the pregnancy.5
EC, on the other hand, only works as a preventive measure against pregnancy, with no effect after pregnancy begins.2
Some states restrict access or completely disallow the use of Mifeprex. Fourteen states have banned access to Mifeprex for medical termination of pregnancy, while another 15 states limit its use to certain situations.
In contrast, Plan B One-Step is legal and available in all 50 states.6
What Is Plan B One-Step?
The FDA approves Plan B One-Step for use in females to reduce the likelihood of pregnancy following unprotected sex. It comes as a single-dose oral tablet that you swallow. It is intended for use in females of reproductive age.
Plan B One-Step works up to 72 hours after unprotected sex to prevent pregnancy. Taking it as soon as possible increases its effectiveness and reduces the chances of getting pregnant.1
The sooner you take it after sex, the more effectively it works, though some research suggests that it may still work up to four days (96 hours) afterward.4
Levonorgestrel, the active ingredient in Plan B One-Step, is also available OTC as several other emergency contraceptive products, such as Her Style, Opcicon One-Step, and Fallback Solo.2
Plan B One-Step prevents or delays ovulation when the ovary releases an egg. As a result, sperm cells cannot reach or fertilize the egg, which helps prevent pregnancy.3
Plan B One-Step works by preventing or delaying ovulation. If you take it after ovulation has already occurred, it may be less effective.
However, since you may not know when you ovulated, you can still take Plan B One-Step at any time during your menstrual cycle to help prevent pregnancy within three days after having unprotected sex.8
Taking Plan B One-Step may result in changes to the menstrual cycle. After taking Plan B One-Step, your period may be earlier or later than expected. In most cases, individuals taking it will get their period within a week when expected.
However, if your period is more than a week late, this could be a sign of pregnancy; take a pregnancy test or talk to a healthcare provider for guidance.
Period flow and duration may be similarly affected by Plan B One-Step. Some individuals experience heavier or lighter bleeding than usual, and their period may be longer or shorter than usual.
Some people may notice spotting or light bleeding after taking Plan B One-Step, but this side effect may not be your actual period. You should still anticipate your period within a week before or after the expected time.
After taking Plan B, you may feel anxious while waiting to see if it was successful at preventing pregnancy. The most typical indication of its effectiveness is the arrival of your period. You can also take a pregnancy test if your period is late.
There is no other method to determine the effectiveness of Plan B One-Step if signs such as a negative pregnancy test do not occur.3
Why Does Plan B Affect Your Period?
Levonorgestrel, the active ingredient in Plan B One-Step, results in possible changes to the menstrual cycle. Levonorgestrel is a synthetic progestin hormone.
It is a lab-made version of a naturally occurring progesterone hormone and acts similarly.1
Because Plan B One-Step contains a more significant amount of hormone than the body naturally produces at various stages of the menstrual cycle, the medication can alter the flow, duration, and timing of the next period.
In general:9
Taking Plan B One-Step after the midpoint of the menstrual cycle (the time of expected ovulation) may result in extended periods and/or delays in period onset.
Taking Plan B One-Step before the midpoint of the menstrual cycle is more frequently associated with spotting and earlier period onset.
Dosing Guidelines
The table below shows the strength and dosage of Plan B One-Step:1
Plan B One-Step can be taken with or without food as long as you take it within 72 hours of unprotected sex. If you vomit within three hours of taking it, you may need to repeat the dose.2
Consult a pharmacist or healthcare provider for advice if you have questions about taking Plan B One-Step.
Precautions & Safety
The FDA advises pregnant individuals against using Plan B One-Step. However, the drug is not known to cause harmful effects if taken during pregnancy, and it does not affect an established pregnancy. Plan B One-Step will not terminate an existing pregnancy.
In addition, individuals should not rely on the morning-after pill as their primary form of contraception.
Other options, such as birth control pills or vaginal rings, are more effective when used as prescribed compared to Plan B One-Step or other emergency contraceptive pills.
Certain medications interact with Plan B One-Step and may lead to less effective results for Plan B One-Step when taken simultaneously.
If you’re experiencing severe abdominal pain after taking Plan B One-Step, contact a healthcare provider for evaluation and observation.
How Effective Is Plan B One-Step?
Plan B One-Step provides a practical option for preventing pregnancy. In a major clinical study, Plan B One-Step prevented 84% of expected pregnancies.
This was a drop from 8% to 1% in the expected pregnancy rate following unprotected sex without EC.1
However, other factors can alter the effectiveness of Plan B One-Step. Studies show that taking the medication as soon as possible after the time of unprotected sex increases the chances of effectively preventing pregnancy.
Furthermore, the point in the menstrual cycle when you take Plan B can affect how it works.11
An independent study of Plan B One-Step showed that while the medication may still be effective after ovulation, it is more effective if taken before ovulation.8
Summary
Plan B One-Step (levonorgestrel 1.5 mg oral tablet) is an OTC EC pill.1 It is taken to reduce the chance of pregnancy if taken up to 72 hours after unprotected sex.
After taking Plan B One-Step, it’s common for individuals to experience some changes to their normal menstrual cycle.2
Your period can come one week earlier or later than expected. Plan B One-Step may cause spotting and/or periods that are heavier, longer, or lighter than usual.
If more than a week has passed since you expected your period after taking Plan B One-Step, you may be pregnant. Take a pregnancy test; if the result is negative and another week passes without a period, take another test or reach out to a healthcare provider for medical advice.
Frequently Asked Questions
How can I safely store Plan B One-Step?
Store Plan B One-Step at room temperature (68-77 degrees F) and keep it away from any area susceptible to high levels of heat or moisture, such as the bathroom.
Keep Plan B out of the reach of children and pets.10
Will Plan B One-Step affect future fertility?
No. Plan B One-Step does not impact future fertility. The medication works quickly and only stays in your system for a few hours without making any lasting changes to hormones or fertility.12
What is the shelf-life of Plan B One-Step?
Plan B One-Step comes with an expiration date on the product packaging. It is usually four years after the date of manufacturing.
Once expired, the medication may be less effective, so dispose of any unused Plan B One-Step and replace it with a fresh supply if desired.13
How commonly used is EC?
EC has gained popularity over the last two decades.
According to a 2019 survey, more than 25% of females of reproductive age reported taking EC at least once; a similar survey from 2002 found that only 4% of females reported using EC.
This increase is likely because EC is now an easily accessible OTC product that had previously required a prescription.7
Age and the passage of time usher in many changes. But in all my years practicing medicine, one thing remains a constant: My patients want to continue having a fulfilling and pleasurable sex life, even if they’re dealing with health problems or chronic illness. One disease that can take a heavy toll on a couple’s sex life is diabetes. Fortunately, there are ways to manage it and reignite your sex drive. Don’t despair! Here’s how you can do it.
The role of glucose in your sex life
People with diabetes are more prone to sexual dysfunction than the rest of the population, according to the American Diabetes Association (ADA). Both men and women may experience little or no sex drive due to poor management of their diabetes. But only 47 percent of men and 19 percent of women with diabetes discuss this issue with their doctors, according to a study published by Diabetes Care. Controlling blood sugar levels with medication and regularly monitoring these levels is essential to maintaining a healthy sex life.
But even if blood sugar is kept under control, men and women with diabetes may feel sexual desire but have difficulty becoming physically aroused.
And a failure to control blood sugar will eventually lead to blood vessel and nerve damage, which can prevent arousal.
How does diabetes affect your sex life?
There are many reasons why people with diabetes lose their sex drive or their ability to orgasm. Obesity, high blood pressure, sleep apnea and depression are conditions that often accompany diabetes and can compromise your libido. Some of the medications used to treat these conditions can also adversely affect your sex life. Some treatments for high blood pressure, for instance, can cause erectile dysfunction.
According to a study published in the International Journal of Environmental Research and Public Health, the sexual disorders of patients with type 1 diabetes are directly linked to depression and are less severe in those who accept their diabetes. These disorders also affect men more than women, and they take a greater toll on patients with blood glucose levels above 6.5 percent.
Erectile dysfunction in men with diabetes
If a man’s blood vessels don’t function properly or he has a blocked artery, his penis will not receive enough blood flow to get an erection. Men over 50 with type 2 diabetes are 11 times more likely to experience erectile dysfunction than younger men, according to a study published in the Caspian Journal of Internal Medicine.
Men with diabetes-related erectile dysfunction are also at greater risk of developing Peyronie’s disease, where a type of scar tissue known as plaque forms under the skin of the penis. This causes a curvature that can make erections painful, difficult or impossible.
Sexual problems in women with diabetes
Nerve damage in women can cause vaginal dryness, a condition that is not unique to people with diabetes but, according to the ADA, is twice as common in this population. The neurovascular system plays a necessary role in arousal and orgasm. If the small nerves aren’t working properly due to damage from poorly controlled blood sugar, a woman can have sensation problems. The clitoris needs optimal blood flow and sensation to become engorged enough to achieve orgasm.
Women with diabetes are also at greater risk of urinary tract and vaginal infections, which can make sexual intercourse painful and unpleasurable. Middle-aged women with diabetes who take insulin are 80 percent more likely to have difficulty reaching orgasm than women without diabetes, according to a study published in Obstetrics & Gynecology.
How can you maintain a healthy sex life?
Here are some practical suggestions that anyone can follow:
1. Eat right
Eating healthy can make all the difference. Non-starchy vegetables, such as broccoli and carrots, and whole grains can help stabilize your blood sugar and give you the energy you need to have sex. These foods are also rich in fiber and nourish your gut microbiome — the bacteria and other organisms that keep your gut healthy. A snack before sex will help boost your stamina and keep your blood sugar under control.
2. Exercise
Sex, like any other form of exercise, requires energy. So how can you be prepared? Activities such as weightlifting and Zumba classes can help you build stamina and have more energy in bed. I recommend at least 150 minutes of exercise per week, which can include walking, swimming or even gardening. Exercise also makes the body more sensitive to insulin, which helps it control insulin levels more efficiently.
3. Take your medications
Strictly follow your doctor’s instructions and make sure you take your medications. If you have diabetes, controlling your blood sugar starts with taking your prescriptions. Talk with your doctor if you suspect that a medication prescribed to treat other conditions may be interfering with your sex life, so that you can work together to look for alternatives. I also recommend buying a weekly pill organizer, which has been shown to help increase compliance with medical treatment.
4. Manage stress
Learning that you have diabetes can be upsetting and can affect your mental health. Learn how to calm your mind and body in stressful moments, such as during a sexual encounter. Brush away negative thoughts. Be grateful for — and focus on — enjoyable moments. Meditation can be very helpful. Research shows that meditation may strengthen the parts of the brain that help you remain calmer in stressful situations. But my favorite tool for reducing stress and anxiety is cognitive behavioral therapy; check with your doctor to see if this is a good option for you.
5. Be consistent
Consistency is a bridge between dreams and reality. Follow these suggestions daily. Take it gradually at first. Don’t reach for gimmicky or drastic solutions; just stick to the basics and you’ll get results, especially over time. Remember that the key is consistency, not perfection.
Antidepressants have long been among the most widely prescribed drugs in the U.S. Their popularity only grew at the start of the coronavirus pandemic, when many people struggled with depression and anxiety. Some surveys have found a striking rise among adolescents, particularly teenage girls.
For many people, the drugs can be lifesaving or can drastically improve their quality of life.
But many of the most popular antidepressants, known as selective serotonin reuptake inhibitors, or S.S.R.I.s, come with sexual side effects. In many cases, the problems caused by the medications can be managed. Here’s what patients should know.
A wide variety of symptoms has been reported.
More than half of patients who take S.S.R.I.s report some problems having sex. They include low levels of sexual desire or arousal, erectile dysfunction, pleasureless or painful orgasms and loss of genital sensitivity.
Many people also report emotional blunting after taking S.S.R.I.s. This may make negative feelings less painful but also make positive feelings less pleasurable.
Don’t be shy about talking to a doctor.
When S.S.R.I.s went on the market in the late 1980s, patients began telling their psychiatrists that they were having sexual problems. Initially, doctors were perplexed: As far as they knew, older antidepressants had never come with these issues. But they had been wrong.
“Only in going back and looking more carefully and gathering more data did we realize that actually those serotonergic drugs, the older ones, also caused sexual dysfunction,” said Dr. Jonathan Alpert, head of the American Psychiatric Association’s research council. Doctors and patients just hadn’t been talking about it, he said.
As S.S.R.I.s boomed in popularity, and social stigmas about discussions of sex eased, researchers began documenting the problem in the scientific literature. But some patients found it easier to talk about than others did. Men were much more likely to report sexual side effects to their doctors than women were, even though women are almost twice as likely to be prescribed antidepressants.
“The charitable interpretation is that we simply have more treatments available for male patients, and so doctors are more likely to ask after things that they feel they can actually help with,” said Tierney Lorenz, a psychologist at the University of Nebraska-Lincoln who has studied antidepressant-induced sexual dysfunction in women. “The significantly less charitable interpretation is that we still live in a very sexist society that doesn’t believe that women should have sexual interest.”
Doctors may first recommend waiting it out.
For some people, the sexual side effects of S.S.R.I.s will show up almost immediately after starting the medications and then resolve on their own. So doctors may suggest waiting four to six months to see whether the patient adjusts to the drugs and the most distressing sexual effects subside.
But the odds of spontaneous resolution of sexual side effects are low, happening in an estimated 10 to 20 percent of patients who report the symptoms.
Other medications, including other antidepressants, can help.
One common way to manage sexual side effects is to try another S.S.R.I. Research suggests that certaindrugs, such as Zoloft and Celexa, come with a higher likelihood of causing sexual problems. Switching drugs, however, means enduring a trial-and-error period to try to find what works.
If a patient is otherwise doing well on an S.S.R.I., a doctor may be hesitant to drastically change the drug regimen. Instead, the doctor might recommend adding an additional drug to the mix that could help counteract the sexual side effects.
For example, adding the non-S.S.R.I. antidepressant Wellbutrin, which acts on norepinephrine and dopamine in the brain, has been shown to diminish sexual symptoms in many patients, Dr. Alpert said.
For erectile dysfunction, doctors may also suggest adding phosphodiesterase type 5 inhibitors like Viagra, which acts on the vascular system, he said.
‘Drug holidays’ can help. But be careful.
Another approach that should be used cautiously and under the close supervision of a physician is temporarily stopping the S.S.R.I. or lowering the dose for 24 to 48 hours before having sex.
But for many patients, this isn’t an ideal solution. Planning ahead can be annoying. And withdrawal from S.S.R.I.s can immediately cause other unpleasant symptoms, including dizziness, nausea, insomnia and anxiety. Some doctors are concerned that frequent use of drug holidays may make patients more likely to discontinue the medications altogether, which could lead to worsening mental health problems.
In rare cases, sex problems can persist after stopping the drugs.
A small but vocal group of patients is speaking out about sexual problems that have endured even after they stopped taking S.S.R.I.s. Some have reported low libido and numb genitals persisting for many years.
Though studies are scarce, the risk appears to be low. A recent study estimated that about one in 216 men who discontinued S.S.R.I.s were subsequently prescribed medications for erectile dysfunction, a rate at least three times as high as that among the general population.
But diagnosing this condition is tricky, in part because depression itself can dull sexual responses. Among unmedicated men with depression, 40 percent report a loss of sexual arousal and desire, and 20 percent struggle to reach orgasm.
Emma Schmidt, a clinical sexologist in Cincinnati, has lost track of the number of clients she’s seen for low libido and problems orgasming after they’ve first visited a doctor who advised them to “Just relax and have a glass of wine.”
That type of suggestion is not just dismissive, Dr. Schmidt said, but it highlights the gaps in our collective understanding about the interplay between alcohol and sex.
After years of contradictory findings, recent research has made it clear that even moderate drinking poses risks to your overall health. But the question of how alcohol affects sexual health — specifically, orgasms — can be a bit fuzzier.
“Society has long depicted alcohol as a crucial ingredient for romantic encounters,” said Catalina Lawsin, a clinical psychologist who specializes in sexuality. She added that people often mix sex and alcohol because it relaxes them and offers a sense of escapism — and because of a widely held belief that alcohol “elevates sexual prowess and pleasure.”
But the reality, she said, is much more complex.
What happens when you mix alcohol and sex?
“Essentially, there’s no research,” said Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine whose work focuses on sexual dysfunction in women.
The data that does exist — much of it from rat studies or small, qualitative investigations — suggests a pattern: Small amounts of alcohol seem to enhance arousal and decrease sexual inhibitions, Dr. Streicher said, but large amounts can suppress arousal and delay or prevent orgasm.
To understand why, it helps to look at the specific processes happening in your brain when you drink.
Alcohol releases dopamine, said Dr. Regina Krel, an assistant professor of neurology with Hackensack Meridian School of Medicine, who described it as “the feel good neurotransmitter.” Researchers believe it helps control desire.
At the same time, alcohol enhances the effects of gamma-aminobutyric acid, or GABA, a chemical messenger that inhibits impulses between nerve cells, essentially slowing the brain down and making a person feel more relaxed.
“It does make you think, ‘Oh, I feel hornier!’” because it lowers inhibitions, said Laurie Mintz, an emeritus professor of psychology at the University of Florida who focuses on human sexuality. “But the irony is that, in fact, it’s a central nervous system depressant.”
That means that alcohol has a dampening effect throughout the brain, Dr. Krel said, including in the prefrontal cortex (which is responsible for things like weighing consequences), the cerebellum (which controls coordination) and the autonomic nervous system (which regulates functions like heart rate and breathing).
Alcohol can hinder the brain’s ability to process sexual stimuli and coordinate muscle contractions, which are central to the orgasmic response, Dr. Lawsin added. “While it may contribute to relaxation and inhibition reduction initially, excessive consumption can interfere with the intricate processes that lead to the intense pleasure and satisfaction of orgasm.”
How much you drink matters.
The experts said that moderate drinking before having sex is usually OK. However, they also stressed that knowing whether alcohol will help lead to orgasm by reducing stress and inhibitions, or get in the way of orgasm by suppressing basic functions, has a lot to do with how often you drink and how much you drink on any given occasion.
Moderate drinking is usually defined in the United States as no more than two drinks a day for men or one drink a day for women. But the way alcohol affects you is determined by a host of factors, including genes, body size and composition, and your history with drinking.
Chronic, heavy use of alcohol has been linked to erectile dysfunction and premature ejaculation in men, Dr. Mintz said. Research has also connected alcohol consumption to sexual dysfunction (persistent problems with sexual response, desire and orgasm) in women.
“There isn’t a magic number of drinks that applies to everyone,” Dr. Lawsin said, adding that excessive alcohol use can hamper the connection between partners, as well as impair decision making and the ability to consent to sex.
How to find help with orgasm issues.
If you are experiencing anorgasmia (which is delayed or infrequent orgasms, or no orgasms at all), your first step should be to reach out to a primary care physician or sex therapist who can help determine the root cause or causes and connect you to the right type of specialist or treatment, Dr. Schmidt said.
There could be one or a number of underlying issues affecting your ability to orgasm, including certain health conditions or medications, relationship problems and trauma, as well as your alcohol consumption.
Many primary care doctors, and even some gynecologists and urologists, do not have a specific background in sex medicine, so it can help to ask if they do, she said, and if they have any experience working with patients with anorgasmia.
If alcohol seems to be hampering your orgasms, ask yourself how and why you use alcohol around sex, Dr. Schmidt said, noting that mental health professionals and sex therapists can be a valuable resource.
Do you often or always drink beforehand?
“If someone is using alcohol as a way to be able to have sex,” she said, “or if they feel scared, ashamed or vulnerable having sex without alcohol, then we might want to explore more.”
Regarding our overall well-being, it is crucial not to overlook sexual health. While physical and mental health often take the spotlight, we must not underestimate the importance of sexual health in maintaining a fully functional life. It impacts our physical well-being and plays a significant role in emotional stability. Therefore, prioritizing this aspect of our well-being is essential. In this blog post, we will delve into how good sexual health contributes to a healthier lifestyle.
1. Contributes to Longevity
Good sexual health can remarkably contribute to longevity. Regular sexual activity has been linked to an extended lifespan, promoting physical health in many ways. It works as a form of exercise, burning calories, and strengthening muscles, and it can also boost the immune system, helping the body fend off illness and disease.
Furthermore, it stimulates the release of endorphins and other hormones with myriad health benefits, such as reducing stress, improving sleep, and enhancing heart health. The doctors at Atlanta Men’s Clinic usually recommend regular sexual activity for their patients, which can significantly contribute to a longer and healthier life. Testosterone therapy, a treatment for low testosterone levels, is also known to improve sexual health and overall well-being.
2. Enhances Emotional Connection
Sexual activity can foster a deep emotional connection, especially with an intimate partner. During sex, our bodies release oxytocin, a hormone that promotes feelings of bonding and trust. This strengthens the bond between partners and helps improve overall mental well-being.
Moreover, regular sexual activity can boost self-esteem and confidence, leading to a more positive outlook. For individuals struggling with mental health issues, such as depression or anxiety, incorporating good sexual health practices can significantly impact their emotional well-being. It allows for a safe and intimate space to connect with another person, which can be incredibly therapeutic.
3. Prevents Sexual Dysfunction
Maintaining good sexual health plays a pivotal role in preventing sexual dysfunction. This is an umbrella term for conditions that prevent an individual from enjoying or participating in sexual activity. These conditions include erectile dysfunction, low libido, premature ejaculation among men, arousal disorders, orgasmic disorders, and sexual pain disorders among women.
Regular sexual activity can increase blood flow to the genitals, which can help prevent or alleviate erectile dysfunction. Moreover, maintaining a healthy lifestyle – incorporating exercise, balanced nutrition, adequate sleep, and reduced stress levels – can notably improve sexual performance and prevent dysfunction. Regular check-ups with medical professionals can also help identify and treat underlying issues.
4. Promotes Communication and Consent
Good sexual health practices also involve open and honest communication with sexual partners. Conversations about boundaries, desires, and consent can create a safe space for both individuals to express themselves freely. This not only leads to a more fulfilling sex life but also promotes healthy relationships.
Furthermore, being aware of one’s sexual health and practicing safe sex is crucial in preventing sexually transmitted infections (STIs). Regular STI screenings, protection, and vaccination can significantly reduce the risk of contracting or spreading infections.
5. Promotes Heart Health
Sexual activity serves as a form of exercise that promotes heart health. During sexual activity, the heart rate rises, increasing blood circulation throughout the body, including the heart itself, thereby strengthening the cardiovascular system. It also helps lower blood pressure, a key factor in heart disease prevention.
In addition, engaging in sexual activity releases hormones like oxytocin and endorphins, which can effectively alleviate stress and anxiety, thereby promoting heart health. Given that stress and anxiety are recognized as risk factors for heart disease, reducing these factors can significantly lower the likelihood of developing cardiac problems. Therefore, incorporating regular sexual activity into a well-rounded lifestyle can play a vital role in maintaining a healthy heart.
6. Improves Sleep Quality
Sexual activity has been linked to improved sleep quality due to the release of certain hormones. Post orgasm, the body releases prolactin, a hormone that contributes to feelings of relaxation and sleepiness. Moreover, the previously mentioned oxytocin, also known as the ‘love hormone,’ fosters emotional bonding and promotes better sleep.
This is because oxytocin counteracts the effects of cortisol, the stress hormone, thus helping the body to relax and enabling more restful sleep. Additionally, the physical exertion associated with sexual activity can contribute to better sleep, as it can help tire the body out, making it easier to fall asleep and stay asleep. Therefore, regular sexual activity can benefit good sleep hygiene, contributing to more restful and rejuvenating sleep.
Sexual health should not be overlooked when it comes to maintaining overall well-being. Incorporating good sexual health practices into our daily lives can improve physical, emotional, and relational well-being. Whether it is through regular sexual activity, communication, and consent with partners, or prioritizing medical check-ups, taking care of our sexual health can have a positive impact on our overall health and longevity. So, let us not underestimate the importance of sexual health and make it a priority in our self-care routines.
In a bid to stem the resurgence of sexually transmitted infections, the Centers for Disease Control and Prevention plans to recommend doxycycline, a widely used antibiotic, for use after an unprotected sexual encounter.
The antibiotic would be taken only by gay and bisexual men and transgender women who have had an S.T.I. within the previous year or who may be at risk for one. The scientific evidence is too limited to recommend the strategy, called doxy-PEP, to all people who might be exposed to infection-causing bacteria during sex.
The agency released draft guidelines on Monday and plans to finalize them after a 45-day public comment period.
“We need game-changing innovations to turn the S.T.I. epidemic around, and this is a major step in the right direction,” an official with the Centers for Disease Control and Prevention said.
Why It Matters: Rates of S.T.I.s are skyrocketing.
In 2021, there were 1.6 million cases of chlamydia, more than 700,000 cases of gonorrhea and nearly 177,000 cases of syphilis in the United States, together tallying up to $1.1 billion in direct medical costs. (Rates of babies born with syphilis also soared that year, with nearly 3,000 affected.)
All three S.T.I.s are caused by bacteria and are easily treated with antibiotics. But the closure of sexual health clinics across the country and a drop in public awareness has contributed to a sharp rise in infections.
Gonorrhea cases have increased 118 percent since a historical low in 2009, according to the C.D.C. Syphilis was nearly eliminated in the United States about 20 years ago, but cases have risen 74 percent since 2017.
On any given day in 2018, about one in five Americans had an S.T.I., the C.D.C. has estimated.
“We need game-changing innovations to turn the S.T.I. epidemic around, and this is a major step in the right direction,” Dr. Jonathan Mermin, director of the agency’s National Center for H.I.V., Viral Hepatitis, S.T.D. and TB Prevention, said in an emailed statement.
Background: Doxycycline is a powerful deterrent of infection.
The C.D.C.’s guidelines are based on studies that show that a single dose of doxycycline taken within 72 hours of unprotected sex dramatically cuts the risk of the infections.
Evidence from emerging research was compelling enough that clinics in some cities, such as San Francisco, have been offering doxy-PEP to those at high risk of infection for months. Generally, patients are given a supply of pills and told to take one within three days of an encounter during which they might have become infected.
But rates of S.T.I.s are highest among Black people and Native Americans, who are often those with the least access to health care. “No prevention tool — no matter how powerful — will change the S.T.I. epidemic if it doesn’t reach the people who need it most,” Dr. Mermin said.
What Critics Say: Wider antibiotic use may pose risks.
Doxycycline has been in use for decades, and there are few indications that bacteria have become resistant to it. Syphilis and chlamydia do not often develop resistance, but gonorrhea is another question: Those bacteria have become resistant to multiple classes of antibiotics.
Still, the picture may change depending on how many people take doxy-PEP and how often, some experts cautioned.
“At the population level, that does worry me,” said Antón Castellanos Usigli, a sexual health expert who is an adjunct lecturer at the Columbia Mailman School of Health.
In places like his native Mexico, Dr. Castellanos Usigli said, indiscriminate use of antibiotics has fueled the rise of drug-resistant bacteria, which can alter a person’s gut microbiome.
What Happens Next: The C.D.C. will finalize new guidelines.
Evidence so far supports doxy-PEP’s use only in men who have sex with men and in transgender women. In those groups, the antibiotic cut rates of syphilis and chlamydia by about 90 percent and gonorrhea by about 55 percent.
Men who have sex with men account for nearly half of reported syphilis cases, according to the C.D.C. If studies show the approach to be effective in heterosexual cisgender men and cisgender women, the guidelines may be expanded.
The agency said doctors should prescribe doxy-PEP as part of a comprehensive sexual health program that includes counseling, screening and treatment for the infections and for H.I.V.
“Doxy-PEP will be a good option for some patients,” Dr. Castellanos Usigli said. “But we will have to do a lot of education with medical providers and patients so that we target the best candidates and prevent misuse and overuse.”
Having new sexual partners can be fun and exciting, but it’s important to make responsible decisions. That includes having tough conversations. But luckily for you, September is Sexual Health Awareness Month! What better time to have an open and honest discussion about one of the most crucial aspects of any romantic relationship: sexual health.
Sexual health awareness empowers individuals to make informed decisions about their physical and emotional well-being. It also helps maintain trust and transparency in a relationship, whether long-term or just for the moment.
One of the most essential discussions with a new partner is getting tested for sexually transmitted infections. While this conversation may feel daunting, it’s necessary for any sexual dynamic to keep you and your partner safe. Here are some ways to have the conversation with ease.
Conversations About Getting Tested
Consider Timing
One of the most important aspects about initiating this type of conversation is choosing the best moment. Timing is everything. Avoid discussing this sensitive topic when you or your partner are stressed, tired, or in the middle of an argument. When introducing the conversation, make sure to make it as normal as possible. Begin by stressing that sexual health is a part of responsible adulting. Present the idea of getting tested as something you both do for each other’s peace of mind. Emphasize that it’s not about trust but rather about taking care of each other’s health.
Use “I”
As with any difficult conversation with a partner, using “I” statements is essential. This helps you avoid sounding accusatory. For example, say, “I think it’s important for both of us to get tested” instead of “You should get tested.” Creating a safe space should be one of the top priorities.
Remain Patient and Supportive
Although you are doing your best to create a calm conversation, you should always brace yourself for their reaction. Your partner could be entirely on board, or they could take offense to the conversation and need some time to think. No matter what, you should remain patient and supportive regardless of their initial response.
Respect Your Partner
Respect your partner’s decision, whatever it may be. Whether they agree to get tested immediately or need more time, continue to communicate openly and empathetically about your relationship’s health and well-being. Stand firm on your stance that this is important to you.
Lead With Confidence
Asking your new partner to get tested doesn’t have to be awkward. Remember to embrace it with confidence and compassion, knowing it’s vital to nurturing the dynamic between you.
You must be logged in to post a comment.