Better Sex Starts in your Gut

Share

By Dr. Edison de Mello

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

What are the most common causes of low libido?

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

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

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

“All disease begins in the gut.”  Hippocrates

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

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

10 Reasons Why you may not have a healthy gut?

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

5 initial Steps to Take to Have Better Sex

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

5 Ways how your partner can help you get there:

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

Other 10 possible causes of low libido:

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

Complete Article HERE!

Share

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

Share

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!

Share

How Alcohol Impacts Your Sex Life

Share

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!

Share

What Do You Do If You Have An STI?

Share

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!

Share

Gay men: Finally, sex without fear

Share
PrEP is effective as a protection against HIV – though condoms can still be used to prevent STDs. Why can’t we celebrate the idea that men can have sex without fear of death?

By

Have you heard of the anti-AIDS drug PrEP? Most straight people are unaware of it. In 2015, the World Health Organization said “the efficacy of oral PrEP has been shown in four randomized control trials and is high when the drug is used as directed.

PrEP (Pre-exposure Prophylaxis) is a drug that allows you to have as much sex as you want, without a condom, and remain HIV-negative. If you use it, you probably won’t catch HIV. POZ magazine says that it has “100 per cent efficacy for those who stick to the treatment.”

Doctors recommend everyone use condoms, because although PrEP is very effective as a protection against HIV, it does not guard against the transmission of other sexually transmitted diseases.

Recently, Patrick William Kelly — a gay academic from Northwestern University who is writing a “global history of AIDS” — sounded the alarm about PrEP. For many straight people, Kelly’s discussion of PrEP may be the first they have heard of this revolutionary drug.

Kelly’s concern is that the popularity of PrEP will cause gay men to stop using condoms. He worries:

“An entire generation of gay men has no memory or interest in the devastation [AIDS] wrought. AIDS catalyzed a culture of sexual health that has begun to disintegrate before our eyes. What is there to be done to bring it back?…The nonchalant dismissal of the condom today flies in the face of the very culture of sexual health that gay men and lesbians constructed in the 1980s.”

Doctors still recommend that everyone use condoms because although PrEP is effective as protection against HIV, it does not guard against the transmission of other sexually transmitted diseases.

There is one sentiment that is missing from Kelly’s article. Why doesn’t he celebrate the fact that gay men — and everyone else — can now have sex without fear of death? PrEP makes sex safer for everyone. It is just one new tool in the “safe sex arsenal.” Why not be happy about the fact that PrEP will undoubtedly save many lives?

Not a lethal illness anymore

Some might ask — isn’t AIDS still a lethal illness? Not so much.

The gold standard in HIV treatment” (highly active antiretroviral therapy or HAART) was first introduced at the 1996 Vancouver International AIDS Society (IAS) Conference. According to Dr. Julio Montaner, director of the British Columbia Centre for Excellence in HIV/AIDS, “this was a pivotal moment, when HIV infection became a chronic manageable condition.

In 2014, The Globe and Mail reported that worldwide deaths from AIDS were massively decreasing:

“In 2013, 1.5 million people died from AIDS-related causes worldwide, compared with 2.4 million in 2005, a 35 per cent decrease.”

This state of affairs seems particularly significant when one considers hysterical early predictions concerning the effects of the disease. In 1987, Oprah Winfrey stated confidently that “research studies now project that one in five — listen to me, hard to believe — one in five heterosexuals could be dead from AIDS at the end of the next three years.”

This never happened.

It’s absolutely true that AIDS affects different demographics,

In this 1989 photo, protesters lie on the street in front of the New York Stock Exchange in a demonstration against the high cost of the AIDS treatment drug AZT. The protest was organized by ACT UP, a gay rights activist group.

ethnicities and geographies differently, and that gay men are not the only population to be affected by it worldwide. But the improvement in the lives of HIV-positive people everywhere is only in part due to the tireless efforts of doctors, researchers and health-care workers.

It is also due to the tireless efforts of gay men everywhere — many of whom became safe-sex activists during the last 35 years, distributing pamphlets, marching and just generally spreading the news.

So why would a gay professor characterize PrEP as a bad thing? Why is he worried that gay men — en masse — will suddenly start practising unsafe sex?

Kelly is the victim of another kind of infection — the notion that gay men are criminals whose desires must be controlled.

This criminalization of homosexuals goes back as far as the notion of sodomy.

Viewing homosexuality as criminal

In the England of Henry VIII, the punishment for sodomy was death; India today is still struggling to legalize same-sex encounters.

In 1972, gay liberation theorist Guy Hocquenghem flatly stated in his book Homosexual Desire: “Homosexuality is first of all a criminal category.”

Hocquenghem went on to suggest that even though the late 19th century brought a tendency to view homosexuality through the more “tolerant” lens of illness, the human need to view homosexuality as criminal is persistent.

“Certainly as we shall see later, psychiatry tends to replace legal repression with the internalization of guilt. But the passage of sexual repression from the penal to the psychiatric stage has never actually brought about the disappearance of the penal aspect.”

Both the sexuality of gay men and the sexuality of women are a threat to the primacy of patriarchal male heterosexual desire. Heterosexist culture believes this threat must be controlled. The LaBouchere Amendment in England (1885) was used to incarcerate Oscar Wilde for his homosexuality as a crime of “gross indecency.”

But Labouchere was an amendment to legislation designed to control female prostitution — a law that angered many 19th-century trailblazing feminists.

When AIDS appeared in the early 1980s, some heterosexuals saw it as primarily a gay disease (AIDS was first called GRID — gay-related immune deficiency). They worried that gay men might infect straight people, especially children.

In his influential book of essays, Is The Rectum A Grave?, Leo Bersani suggests that when small-town Americans wanted to ban HIV-positive hemophiliac children in schools, what they actually feared was the spectre of “killer gay men” acting too much like women:

Women and gay men spread their legs with an unquenchable appetite for destruction. This is an image with extraordinary power; and if the good citizens of Arcadia, Florida could chase from their midst a very law-abiding family it is, I would suggest, because in looking at three hemophiliac children they may have seen — that is unconsciously represented — the infinitely more seductive and intolerable image of a grown man, legs high in the air, unable to refuse the suicidal ecstasy of being a woman.

AIDS was not the first thing to make straight people think gay men

A doctor holds Truvada pills, shown to help prevent HIV infection.

had to be controlled. It simply fit like a glove on a fear of homosexuality that was already culturally endemic.

Our society seems addicted to the notion that homosexuality is something uncontrollable and potentially lethal. So when AIDS came along, as the long-time AIDS worker Simon Watney wrote, it was “effectively being used as a pretext throughout the West to justify calls for increased legislation and regulation of those who are considered to be socially unacceptable.”

The concern over gay male imagined libidinal insanity is a throwback to an old trope. Gay men don’t need to be controlled; at least not any more than anyone else. And if you think otherwise? Well, it’s based on prejudice. Not fact.

Complete Article HERE!

Share

Gay or bi men who disclose sexual history may get better healthcare

Share

By Anne Harding

Young men who have sex with men (MSM) who disclose their sexual orientation or behavior to a health care provider are more likely to receive appropriate healthcare, new data suggest.

Dr. Elissa Meites of the Centers for Disease Control and Prevention (CDC) and her colleagues studied 817 MSM, ages 18 to 26, who had seen a healthcare provider in the past year.

Men who had disclosed were more than twice as likely as those who had not to have received the full panel of recommended screenings and vaccines, the researchers found.

The CDC and the Advisory Committee on Immunization Practices recommend that MSM be screened for HIV, syphilis, gonorrhea and chlamydia at least once a year, and immunized against hepatitis A and B and human papillomavirus (HPV), Meites and her colleagues note the journal Sexually Transmitted Diseases.

Overall, 67 percent of the study participants had received all four recommended STI screenings, but that was true for only 51 percent of the MSM who had never disclosed.

Nine percent overall had received all vaccinations, compared to six percent of those who hadn’t disclosed.

The pattern was similar when researchers looked to see how many participants received all seven recommended services. The rate was just seven percent for the overall study population, but it was even lower – at less than four percent – for the MSM who hadn’t disclosed.

About two-thirds of study participants (64.2 percent) said they had disclosed their sexual behavior or orientation to a healthcare provider, while roughly nine in 10 (91.7 percent) said they would do so if it was important to their health.

“This shows us that the patients are doing all the right things. They are going to the doctor regularly and they are willing to speak about their sexual behaviors,” Meites told Reuters Health in a telephone interview. “It looks like health care providers may be missing some opportunities to provide the best health care to these young men.”

Doctors can encourage disclosure among MSM by asking about sexual history, and “fostering a clinical environment where people can be comfortable revealing their sexual behavior,” Meites said. And doctors should be aware of the panel of health care services that are recommended for MSM, she added.

Share

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

Share

By

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

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

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

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

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

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

mental distress
health behaviors such as

  •       tobacco use
  •       binge drinking
  •       diet
  •       exercise

biological risk factors such as

  •       obesity
  •       hypertension
  •       diabetes
  •       cholesterol.

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

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

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

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

Complete Article HERE!

Share

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

Share

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

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

By Michael O. Schroeder

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

Share

The End of Safe Gay Sex?

Share

By Patrick William Kelly

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

Share

Sex and gender both shape your health, in different ways

Share

By

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

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

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

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

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

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

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

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

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

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

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

Femininity can affect your heart

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

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

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

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

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

A tool for researchers

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

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

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

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

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

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

Complete Article HERE!

Share

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

Share

You deserve sensitive, comprehensive care.

By Nathan Levitt, FNP-BC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

Share

Doctors Are Failing Their Gay Patients

Share

by Liz Posner

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

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

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

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

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

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

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

Complete Article HERE!

Share

STI symptom checker: Do I have gonorrhoea, chlamydia or syphilis? Signs of sex infections

Share

STIs – or sexually transmitted infections – can be passed on via unprotected sex. These are the symptoms of gonorrhoea – commonly misspelt gonorrhea – chlamydia and syphilis to look out for.

STI symptom checker: Unprotected sex risks sexually transmitted infections

By Lauren Clark

[S]TIs – the common abbreviation for sexually transmitted infections – can be passed on via unprotected sex.

Common STIs include chlamydia, syphilis and gonorrhoea, and they are on the rise, according to recent figures.

In 2016 there were 420,000 diagnoses of sexually transmitted infections in England, including a 12 per cent increase nationwide in cases of syphilis.

Rates of gonorrhoea are also soaring particularly in London, which earlier this year was revealed to be the city with the highest STI levels in the UK.

Failing to get a diagnosis and treatment for an STI can cause pelvic inflammatory disease in women, and infertility in both men and women.

But do you know the symptoms of gonorrhoea, chlamydia and syphilis? The NHS has revealed the signs to look out for.

Gonorrhoea

They usually develop within two weeks of an infection, but can sometimes take months to appear. The signs vary between men and women.

Women:
– an unusual vaginal discharge, which may be thin or watery and green or yellow in colour

– pain or a burning sensation when passing urine

– pain or tenderness in the lower abdominal area (this is less common)

– bleeding between periods, heavier periods and bleeding after sex (this is less common)

Men:
– an unusual discharge from the tip of the penis, which may be white, yellow or green

– pain or a burning sensation when urinating

– inflammation (swelling) of the foreskin

– pain or tenderness in the testicles (this is rare)

Syphilis

The first signs usually develop within two to three weeks of infection, and can be split into early symptoms and later symptoms.

Early symptoms:

– the main symptom is a small, painless sore or ulcer called a chancre that you might not notice

– the sore will typically be on the penis, vagina, or around the anus, although they can sometimes appear in the mouth or on the lips, fingers or buttocks

– most people only have one sore, but some people have several

– you may also have swollen glands in your neck, groin or armpits

Later symptoms:

– a blotchy red rash that can appear anywhere on the body, but often develops on the palms of the hands or soles of the feet

– small skin growths (similar to genital warts) – on women these often appear on the vulva and for both men and women they may appear around the anus

– white patches in the mouth

– flu-like symptoms, such as tiredness, headaches, joint pains and a high temperature (fever)

– swollen glands

– occasionally, patchy hair loss

Chlamydia

This is one of the most common STIs in the UK, and, worryingly, it often doesn’t trigger any symptoms. If signs do appear, however, they may include the following.

– pain when urinating

– unusual discharge from the vagina, penis or rectum (back passage)

– in women, pain in the tummy, bleeding during or after sex, and bleeding between periods

– in men, pain and swelling in the testicles

If you think you may have an STI, you should visit your GP or local sexual health clinic. Find out more information here.

Complete Article HERE!

Share

Some drugs can cause unwanted sexual side effects in men

Share

 

[Y]ou might assume that erectile dysfunction, or ED, is a normal problem that men face as they age. But because men (and women) take more medications as they age, the experts at Consumer Reports’ Best Buy Drugs report that side effects from those drugs are a little-known yet common cause of ED.

“Many medications can affect things like erectile dysfunction, desire and ejaculation in different ways and through different mechanisms of action,” says J. Dennis Fortenberry, former chair of the board of the American Sexual Health Association and the Donald Orr Professor of Adolescent Medicine at Indiana University School of Medicine.

Medications that can have these effects include high blood pressure drugs such as beta blockers, including atenolol (Tenormin), clonidine (Catapres), metoprolol (Lopressor) and methyldopa (Aldomet), and diuretics such as hydrochlorothiazide (Hydrodiuril).

Popular antidepressants and anti-anxiety drugs such as alprazolam (Xanax), diazepam (Valium), duloxetine (Cymbalta), fluoxetine (Prozac) and paroxetine (Paxil) can cause sexual problems such as delayed ejaculation, reduced sexual desire in men and erectile dysfunction. Lesser-known drug types that can also cause such sexual problems include antihistamines such as diphenhydramine (Benadryl) and antifungal drugs such as ketoconazole (Nizoral).

Surprisingly, heartburn drugs, including famotidine (Pepcid) and ranitidine (Zantac) are known to reduce sexual desire in men. In addition, reduced desire and erectile dysfunction have been reported in men taking the powerful painkillers oxycodone (OxyContin) and hydrocodone (Vicodin), muscle relaxers such as baclofen (Lioresal), and even over-the-counter ibuprofen (Advil, Motrin).

And perhaps not surprisingly, the more drugs a man takes, the greater his odds are of experiencing an issue. For example, in a 2012 study of men ages 45 to 69, those who took three to five drugs were 15 percent more likely to have erectile dysfunction than men taking two or fewer. Men who took six to nine drugs were 51 percent more likely to have erection problems.

What you can do

Before making any change to your medications, talk with your doctor, says David Shih, a board-certified emergency medicine physician and executive vice president of strategy on health and innovation at CityMD, a network of urgent care centers in the New York metro area and Seattle.

If appropriate, your physician can make changes such as “lowering the medication dose, switching to a new medication or a combination therapy of lower doses each,” notes Shih.

Your doctor may also suggest temporarily stopping a medication — often referred to as taking a “drug holiday” — before having sex, if that is possible.

If you’ve just started taking a new drug, sexual side effects may disappear as your body adjusts. But if after a few months they don’t, discuss it with your physician. He or she will want to rule out other conditions that could cause your sex drive to take a nose-dive.

“The prescribing physician will need to explore if these symptoms are from cardiovascular disease, depressive disorder, diabetes, neurological disease and other illnesses,” says Shih.

Even suffering from sleep apnea is known to affect sexual interest or response.

That’s why, if you experience ED, it’s important to get to your doctor’s office for a detailed discussion about what could be causing it.

Share

These scientists say you’ll probably never have heart-stopping sex

Share

[H]eart patients have worried that they may die suddenly from having sex, but a new study suggests they probably won’t.

Researchers found that less than 1 percent of people who experienced sudden cardiac arrest were having, or just had, sex. Now Sumeet Chugh, one of the study’s authors, has some “happy news” to tell his nervous patients.

“As a cardiologist, from time to time, in an awkward way, patients would ask me, ‘You know doc, what’s my risk of dying suddenly with sexual activity?’ We could say to them it’s probably low, but we never had data,” Chugh said. “Now we have data to answer that question.”

Researchers described sudden cardiac arrest as a “mostly lethal condition” that manifests as “an unexpected collapse and loss of the pulse.”

More than 300,000 people die of sudden cardiac arrest every year in the United States, yet about 1 in 100 men and 1 in 1,000 women experience sudden cardiac arrest relating to sexual activity, according to the study, which was presented at the American Heart Association’s Scientific Sessions and published in the Journal of the American College of Cardiology.

The community-based Oregon Sudden Unexpected Death Study examined data on more than 4,500 sudden cardiac arrests in the Portland, Ore., metropolitan area from 2002 to 2015. Of those, 34 were related to sex, and most were men with a history of heart diseases.

Researchers collected medical records, autopsy data and details of what the person was doing when sudden cardiac arrest occurred. Any cases that occurred during sex or within one hour of having sex were considered related to sexual activity.

Sudden cardiac arrest occurred during sexual activity in 18 cases and within minutes of it in 15 cases. In one case, the timing could not be determined.

“We were pleasantly surprised to see how low it was,” said Chugh, the associate director of the Heart Institute for Genomic Cardiology at Cedars-Sinai in Los Angeles.

This study is an opportunity to reassure patients that they can return to a good quality of life, including sexual activity, said Nieca Goldberg, who is the medical director for the Joan H. Tisch Center for Women’s Health at New York University. She is also an AHA spokeswoman and was not involved with the study.

“These are real concerns of our patients,” she said. “We have so many tools to prolong people’s lives. We want them to have a good quality of life, returning to exercise, eating a healthy diet and returning to sexual activity.”

The study also shows that sex “obviously isn’t as strenuous as we thought,” Chugh said, and Goldberg agreed. Sex, in general, is equivalent to walking up two flights of stairs, she said.

But a concerning result of the study, Chugh and Goldberg noted, is that it seems to suggests that sexual partners aren’t very willing to perform CPR, or don’t know how to do it, if a partner goes into sudden cardiac arrest.

Within 10 minutes of sudden cardiac arrest, a person is likely to die, and only one-third of those who experienced sudden cardiac arrest relating to sexual activity received bystander CPR, according to the study.

“We would think that if the witness is right there, everybody would get CPR,” Chugh said. “But it turns out only a third of the subjects got CPR. And since most of the subjects were men it seems like two-thirds of the women really didn’t do the CPR.”

“It’s a good idea to be aware of CPR, know how to do CPR, and do CPR even if it’s as awkward and difficult a scenario as cardiac arrest during sexual activity,” Chugh said.

On average, those who went into sudden cardiac arrest related to sexual activity were five years younger and more likely to be African American than the rest of the cases, the study states. Sudden cardiac arrest in relation to sexual activity was also more likely to have ventricular fibrillation, when the heart pumps little to no blood, according to the study.

Researchers did not examine how often patients in the study had sex, the type of intercourse, or how long it lasted. In any case, the results show that there isn’t a high risk associated with sex and sudden cardiac arrest, Chugh said.

Complete Article HERE!

Share