Category: SEX and SUBSTANCES

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The Dangers of Recreational Viagra

— The risks of taking Viagra without erectile dysfunction range from mild side effects to dangerous drug interactions

By Raevti Bole, MD

Advertisements for erectile dysfunction (ED) medication are everywhere. Viagra® and Cialis® are enormously popular. And as the ads suggest, they’re highly effective at improving sexual performance in people with ED.< But the use of these medications is also booming in people who don’t have sexual problems. But know this: This “recreational” use of Viagra can be risky.

Why do people without ED take Viagra?

To understand why people experiment with Viagra and Cialis recreationally, it’s helpful to understand how these drugs work.

Viagra and Cialis belong to a category of drugs called phosphodiesterase type 5 (PDE5) inhibitors. These medications open blood vessels and can be used to treat pulmonary hypertension and urinary problems.

But most famously, medications like Viagra and Cialis are used to address erectile dysfunction. The reason? Increased blood flow from PDE5 inhibitors results in firmer, longer-lasting erections.

Now, it’s important to note that erection firmness can be subjective. Most people will notice temporary differences in the quality of their erection depending on stress, energy levels, time of day, alcohol consumption and many other factors.

But if someone can reliably get and keep an erection that’s rigid enough for penetrative intercourse, they probably don’t have ED or a real need to pop a Viagra or Cialis, explains Dr. Bole.

That said, people without ED have recreationally used Viagra or Cialis to increase blood flow to their penis because they want to:

  • Counteract the effects of alcohol or other drugs on their sexual performance.
  • Improve the chances of an erection lasting long enough for sex multiple times.
  • Increase their confidence by reducing anxiety about performance or premature ejaculation.

Does Viagra improve athletic performance?

People also use Viagra and Cialis recreationally to improve their exercise performance. But does it really work? To keep the answer simple: No.

“PDE5 medications can increase oxygen levels and heart function in people who have cardiac risk factors or cardiac disease,” says Dr. Bole. “For people who are healthy, there’s no good evidence that the medications significantly improve athletic abilities in a standard, sea-level environment.”

Why mention the altitude? Well, there’s some evidence that Viagra may make a difference for those doing activities in thin air at higher altitudes.

Researchers found that cyclists taking sildenafil, the medicine marketed as Viagra, improved cardiac output and exercise performance at higher altitudes. Another study focused on Mount Everest trekkers showed that sildenafil increased exercise capacity at high altitudes.

As noted, though, any benefits experienced closer to the clouds do not transfer to lower altitudes where most of us spend our time.

Five risks of recreational Viagra use

The potential consequences of taking Viagra and Cialis recreationally depend on medical, psychological and social factors. The risks range from mild to serious and include:

1. Dangerous interactions with other drugs

PDE5 inhibitors lower blood pressure. Mixing them with other drugs that also lower blood pressure can be potentially life-threatening, says Dr. Bole.

Be sure to review with your healthcare provider all supplements and medications you’re taking to check for potential interactions. Here are some examples of medications known to interact with Viagra or Cialis:

  • Amyl nitrate, which can also be misused as a street drug known as “poppers.”
  • Nitroglycerine, a medication used to treat angina (chest pain) in people with coronary artery disease.
  • Certain types of blood pressure medications, prescription drugs that lower high blood pressure. (Isosorbide mononitrate is one example.)

2. Uncomfortable side effects

The side effects of Viagra and Cialis are usually mild. Headache is a common side effect that can vary from mild to pounding. You may also experience:

  • Acid reflux.
  • Facial flushing.
  • Muscle aches.
  • Stuffy nose.
  • Vision changes.

One of the most severe adverse events is called priapism, a painful erection that lasts for several hours. “Luckily2, it is quite rare when using oral ED medications,” notes Dr. Bole. “But if this happens to you, seek emergency medical care immediately.”

3. Psychological dependency

Frequent use of Viagra or Cialis just to boost confidence can create psychological dependency — especially if you’ve never discussed the issue with anyone. You may eventually feel that you need it to have sex, creating a long-term issue for you and your partner.

“If you are having severe performance anxiety that’s affecting your erections, I recommend talking to your healthcare provider or a sex therapist,” says Dr. Bole.

“A medical professional can discuss your worries about sex; help you set personalized and realistic expectations; and develop strategies to improve your confidence without relying on medication alone.”

You may still choose to try a medication, but understanding the psychology behind sexual performance is a healthier strategy.

4. Unknown dosage and contaminants

ED drugs and supplements are easy to find without a prescription. People get them from friends, family members and online. You can even find them sold as vitamin or herbal supplements at gas stations.

But without a prescription from a reputable provider, you don’t know the dosage of active ingredients in the pills you’re taking or even what may truly be in the medication.

For example, the U.S. Food and Drug Administration (FDA) has issued advisories for “Rhino” male enhancement products. These products are available at gas stations, corner stores and online. Marketed as “dietary supplements,” tests show they may contain hidden PDE5 inhibitors.

Taking these sorts of fraudulent products can be dangerous for unsuspecting consumers, warns the FDA.

5. Association with high-risk behaviors

Combining Viagra or Cialis with alcohol or drugs can lower inhibitions. As a result, you may be more likely to engage in risky sexual behavior that could expose you to sexually transmitted infections (STIs).

“Using ED medications to enhance your sexual performance when you’re under the influence of alcohol or drugs can lead you to make choices that harm your sexual and overall health,” stresses Dr. Bole.

When to talk to your provider about Viagra use

If you’re taking Viagra or Cialis recreationally to improve your sexual or exercise performance, Dr. Bole recommends letting your provider know.

Long-term use could mask a real decline in erectile function due to underlying health problems such as:

“Some patients may feel reluctant or embarrassed to talk about their sex life,” recognizes Dr. Bole. “But we have these conversations all the time with patients. You are not alone. Our role is to help you understand the risks versus benefits and provide guidance without judgment.”

Complete Article ↪HERE↩!

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PrEP: What is the HIV prevention drug and how effective is it?

— PrEP has been hailed by sexual health experts as crucial in bringing the HIV epidemic to an end, but studies show that only 20 per cent of the British public even know it exists.

BY CONOR CLARK

Taking PrEP (pre-exposure prophylaxis) is one of the most effective ways to reduce the risk of getting HIV, but knowledge about it among the British public remains scarce. In fact, just 20 per cent of people in the UK know it exists, according to research conducted by YouGov on behalf of Terrence Higgins Trust, the country’s leading sexual health charity. A staggering 77 per cent were also unaware that England can end new cases of HIV by 2030, which sexual health experts have said PrEP is key to making a reality. So, what is the drug, how effective is it at preventing HIV and where can you get it?

What is PrEP?

PrEP (sometimes known as Truvada) is a medicine that drastically reduces the risk of getting HIV from sex or injection drug use when taken effectively. It typically comes in the form of a tablet containing tenofovir disoproxil and emtricitabine, both of which are used to treat HIV. Once there’s enough of the drug inside you, it works by blocking HIV from getting into the body and replicating itself.

Long-acting injectable PrEP also exists and has been approved by the Food and Drug Administration (FDA) in the US, though is not yet available in the UK. It can also exist as a vaginal ring, though this is also not yet available in the UK.

PrEP does not protect you against any other sexually transmitted infections (STIs).

How effective is it at preventing HIV?

When taken effectively, PrEP reduces the risk of getting HIV from sex by 99 per cent. When taking it daily, PrEP needs to be taken for seven days until it becomes fully effective.

The PrEP Impact Trial, which involved more than 24,000 participants across 157 sexual health services from October 2017 to July 2020, proved the real-world effectiveness of the drug and concluded that it should be used more widely to prevent the spread of HIV. John Stewart, National Director for Specialised Commissioning at NHS England and co-Chair of the PrEP Impact Trial Oversight Board, said: “Not only did the trial directly prevent many cases of HIV, help normalise the use of PrEP, remove stigma and pave the way for a routinely commissioned clinically and cost-effective PrEP service; but it also made a very real contribution towards our goal of ending new cases of HIV by 2030.”

How often should I take it?

Most people take it orally in the form of a tablet, either regularly (one a day) or ‘event-based’ (two tablets two to 24 hours before sex, then one 24 hours after sex and a further one 48 hours after).

Those who were assigned female at birth and trans people using hormone treatment are recommended to take PrEP daily due to the lack of data available in supporting other dosing options. More information about this is available here.

Do I still need to test for HIV if I’m on PrEP?

The short answer is yes. Sam, a doctor at the Dean Street sexual health clinics in London, which are world-famous for their services to LGBTQIA+ people, said: “PrEP is the most effective way of protecting yourself from HIV. However, mistakes can happen with taking your PrEP, so we still advise testing every three to four months for HIV and all the other STIs.”

Kidney tests are done before you begin taking PrEP and continue routinely while you are on it. This is because it can sometimes affect your kidneys, though this is incredibly rare and typically only happens in those aged 50 and older or those who already have kidney problems.

Are there any side effects?

Not everyone gets side effects from PrEP and those who do usually see them go away after the first few weeks of taking it. “This is one of the number one reasons for people not wanting to take PrEP, but actually only about one in 10 people get side effects from PrEP and these tend to be quite mild and not very severe,” Sam told GAY TIMES.

According to the NHS, the most common side effects some people experience are:

  • Headache
  • Nausea and/or vomiting
  • Diarrhoea
  • Feeling dizzy and/or weak
  • Trouble sleeping
  • Bloating and/or indigestion

Clinicians recommend that anyone experiencing side effects seek medical advice if they persist.

Complete Article ↪HERE↩!

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Cannabis Can Help Women Reach Orgasm

— But It’s ‘More Than Pleasure’

By Sarah Sinclair

Over half of women have faked an orgasm. Surprised? Probably not.

But while some women fake it from time-to-time, for others the lack of ability to reach orgasm is a far more debilitating issue.

Female orgasm disorder/difficulty (FOD), sometimes referred to as orgasm dysfunction, occurs when an individual has difficulty reaching orgasm, even when they are sexually aroused.

It affects millions of women worldwide and yet remains drastically under-studied.

“FOD is an under-recognized and under-treated serious public health issue,” says Dr Suzanne Mulvehill, founder of the Female Orgasm Research Institute, in written correspondence.

“The purpose of the Female Orgasm Research Institute is to identify proven pathways to female orgasm, conduct female orgasm research, bring awareness to the persistently high percentage of women affected by female orgasm difficulty, and provide an online female orgasm research library.”

According to Mulvehill’s research, the condition affects up to 41% of the female population, a statistic that has remained unchanged for 50 years.

She puts this down to a number of reasons that include “shame, stigma, lack of research, and lack of treatments”.

A quick search of clinicaltrials.gov and you’ll see that there are currently no clinical trials recruiting or in the early stages of development on FOD and only 13 completed studies.

This is compared to 363 completed studies on erectile dysfunction and 88 in the early stages.

Dr Mulvehill says: “When I was conducting my dissertation research, I was shocked to discover that there is only one empirically validated treatment for FOD and that is only for women who never orgasmed, or rather, have not yet orgasmed, and this is called directed masturbation and was developed in the 1970s.

“There are no empirically validated treatments for the largest group of women affected by FOD which is women who have what is referred to as Situational FOD, meaning women who can orgasm in some situations but not others, such as orgasm from masturbation but not during partnered sex.”

There is one potential treatment which is showing significant promise though.

While previous research has suggested cannabis could have therapeutic potential in a number of female sexual disorders and could enhance pleasure for both men and women, the latest study to be published by the Female Orgasm Research Institute is the first to specifically evaluate the effects of cannabis in treating FOD.

What The Study Found

The observational study conducted among almost 400 women between March-November 2022, evaluated baseline demographics, sexual behavior, mental health, cannabis use, and the orgasm subscale questions of the Female Sexual Function Index (FSFI), evaluating orgasm frequency, orgasm satisfaction, and orgasm ease, with and without cannabis before sex.

The majority of women in the study who reported difficulty reaching orgasm were between the ages of 25–34 (52%), reported their race as white (75%) and were married or in a relationship (82%).

Among those respondents reporting orgasm difficulty, cannabis use before partnered sex was found to increase orgasm frequency (72.8%) improve orgasm satisfaction (67%) or make reaching orgasm easier (71%).

According to the findings, the frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women with FOD, while orgasm response to cannabis depended on the reasons for use.

These findings echo 50 years of research, Dr Mulvehill says.

“I honestly do not know of any other condition that has more of a research history than cannabis and sex, and in particular female orgasm,” she continues.

“What we do know is that 50 years of research shows cannabis helps women orgasm and helps women who have FOD. In the 1970s Dr Eric Goode speculated that it helped women release sexual inhibition.

“Aldrich found that cannabis has been used since ancient times to enhance sexual pleasure, and extensively documented the tantric use of cannabis in India from the seventh century onward to aid sexual pleasure and enlightenment.

“In 2020, Kasman et al. found that for each step up in cannabis use, female sexual dysfunction declined by 21%.”

FOD: The Bigger Picture

It starts to make sense when you look at the bigger picture around FOD.

Dr Mulvehill’s study also examined the mental health difficulties experienced by women with FOD. Those with the condition reported 24% more mental health issues, 52.6% more PTSD, 29% more depressive disorders, 13% more anxiety disorders, and 22% more prescription drug use than women without FOD. Women with FOD were also more likely to report sexual abuse history than women without.

“Rabinak et al found that hypervigilance, anxiety, and PTSD are responses of the amygdala while studies from 2007 and 2015 found that trauma responses commonly impair sexual response,” she explains.

“We also know that orgasm difficulties are the number one sexual complaint of sexual abuse survivors. When we start to put the research puzzle together, we see cannabis medicine helping women overcome FOD.”

Dr Mulvehill and her research partner, Dr Jordan Tishler, have been trying for three years to secure the funding to conduct a randomized controlled trial to examine cannabis as a treatment for FOD in more depth.

Among as yet unanswered questions such as why it works first-time for some and not others, this is an issue about “more than just pleasure” and could have a much wider impact on health.

FOD has a well-documented link to anxiety, childhood sexual abuse, PTSD, and cognitive distractions.

Studies have shown that THC, one of the main cannabinoids found in cannabis, can significantly reduce rates of anxiety and traumatic memories related to trauma and PTSD by reducing activity in the amygdala and reduces cognitive distractions by inhibiting activity in the prefrontal cortex.“

“As it turns out, orgasm is way more than being about pleasure. It is about a human right, a sexual right, and mental and physical health,” says Dr Mulvehill.

FOD has been linked to heart disease and cardiovascular issues, while a 2009 study found that of the sexually active women with type 1 diabetes, 51% of women reporting female sexual dysfunction had problems with orgasm.”

“If we start to actually ask women if they orgasm or not when screening for medical conditions, we may find out that lack of orgasm is linked to other health conditions. We know that during orgasm massive amounts of oxytocin are released.

“And what condition is related to a lack of oxytocin? Alzheimer’s disease. We also know that women in their 60’s are twice as likely to develop Alzheimer’s. We will not know until we start asking the questions.”

FOD And Public Policy Changes

Dr Mulvehill began researching this area following her own experience of overcoming FOD with the help of cannabis. And she’s not alone.

The study comes as four U.S. states are now considering adding FOD to the list of qualifying conditions for a medical cannabis prescription.

This month, the Illinois Medical Cannabis Board approved adding FOD and endometriosis as conditions of treatment with medical cannabis and is now awaiting final approval from the state’s director of public health.

Dr Mulvehill’s personal testimony has been submitted as part of the Illinois public comments process, alongside that of other women.

Meanwhile, Ohio’s State Medical Board also recently announced that FOD, along with autism spectrum disorder, would move forward for expert review and public comment following petitions submitted online.

New Mexico and Connecticut are also reported to be considering the issue.

Dr Tishler, founder of the Association of Cannabinoid Specialists and president of inhaleMD, already prescribes cannabis for FOD and other sexual disorders, and has also submitted a letter of support to regulators in New Mexico.

He highlights the importance of women having access to legally prescribed cannabis and clinical guidance when using it to manage these conditions.

“Cannabis is a medicine and as such must be treated as a medication,” he comments over email.

“It has risks as well as benefits and best practices that lead to better outcomes. This is certainly true for the treatment of FOD. Using cannabis in a recreational manner is more likely to lead to no benefit and higher risk of misuse. Further, as cannabis overuse can worsen anxiety and depression, it can worsen FOD. Women who have FOD, like any other illness, deserve proper treatment from a knowledgeable and caring cannabinoid specialist.”

Despite the lack of robust scientific evidence through RCTs, Dr Mulvehill highlights how this hasn’t prevented other conditions being approved for medical cannabis treatment. PTSD was approved in New Mexico in 2009, with no published studies and only case reports.

“The 50 years of research, combined with doctors prescribing medical cannabis for FOD, therapists recommending it, and women using cannabis before sex, tells me there is enough evidence for FOD to become a condition of treatment with medical cannabis,” she says.

“Just google cannabis and orgasm and you will see all of the articles on it. It is not new news. What is new is getting a public policy change to add FOD as a condition of treatment with medical cannabis. Just like PTSD has dealt with stigma through awareness and education, the same can be said for FOD.”

Dr Mulvehill adds: “FOD is a medical condition that deserves proper medical treatment. It is not something that women should have to ‘figure out on their own’.”

Complete Article ↪HERE↩!

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Misinformation Is on the Rise.

— Here’s What You Need to Know About Birth Control.

Three Black reproductive experts discuss how to access birth control, navigate the misinformation online, and understand what’s unfolding politically.

By Margo Snipe

It’s been a tricky landscape since Roe v. Wade was overturned almost two years ago, as reproductive health care has become increasingly complicated to navigate — and misinformation is on the rise.

Not only are the attacks on abortion care merging with limits on the availability of infertility treatment, but the same court that reversed the constitutional protection for abortion will hear arguments this week on restricting access to mifepristone, one of two medications commonly used to induce an abortion. And on the state level, new bills are aiming to cut back contraception options.

In Oklahoma, one bill in the state legislature has sparked questions about whether it might ban emergency contraception — like the day-after Plan B pill — and intrauterine devices, or IUDs. Part of it targets contraception that prevents the implantation of a fertilized egg. At the same time, some birth control options are expanding. This month, Opill, the first over-the-counter birth control pill, began sales. And, under a new policy, New York pharmacists can dispense certain hormonal contraceptives without a prescription.

Capital B asked three Black reproductive health care experts some of the big questions about how to access birth control, navigate the misinformation online, and understand what’s unfolding politically. Here’s what you need to know.

What is the difference between abortion care and birth control?

Amid the uptick in misinformation, experts want patients to understand there is a distinct difference between abortion care and birth control. Birth control, like the pill and IUDs, is not abortion inducing, doctors say.

While both are considered a part of reproductive health care, birth control, also called contraception, is intended to prevent pregnancy before it occurs and is often discussed and prescribed by gynecologists, which are doctors who specialize in women’s reproductive health systems. 

“Birth control is acting to fundamentally prevent pregnancy,” said Dr. Alexandra Wells, an OB-GYN in Washington state. It works by stopping sperm from meeting the egg, she said.

Abortion care is separate. It terminates an already existing pregnancy, either out of patient choice up to a certain time period or medical necessity. It takes place after folks know they are pregnant and is typically managed by obstetricians, or doctors that focus on the pregnancy of patients. Many practitioners have their training in both gynecology and obstetrics.

Over the past year, how has the landscape over available birth control changed?

With so many different bills being introduced in states across the country, aiming to both limit and expand access to reproductive health care, the amount of misinformation spreading across social media platforms is surging.

While birth control and abortion care are different, the landscape in terms of access to both is shifting nationwide.

Soon after the 2022 Dobbs decision reversing federal abortion protections, when states began moving to restrict abortion, many physicians were concerned about the implications on birth control, said Dr. Yolanda Lawson, a Texas-based OB-GYN. It was not the first time. Several years prior, in the Burwell v. Hobby Lobby case, the U.S. Supreme Court decided that corporations run by religious families cannot be required to pay for insurance coverage for contraception care.

More recently, changes in abortion care have also trickled into changes in birth control access and infertility treatment for families. When reproductive health care clinics offering abortions close, other  services are impacted, said Wells, who’s also a fellow with Physicians for Reproductive Health. The good news is technology is making online access to birth control options more accessible. Many options can be mailed and are often covered by insurance, she said.

Opill is now available, adding to the many other options, including condoms, spermicide, the ring, IUDs, implants, patches and cycle tracking.

How do I know what’s happening with access to birth control in my state?

There is no comprehensive, central location for all of this information, said Jennifer Driver, senior director of reproductive rights at SiX, an organization that works with elected officials after they win office. The federal Title X family planning websites have a lot of information and resources for patients, said Driver. The best way to find out what is happening with legislation is directly through the state legislator. On each website, you can see what bills are being introduced and which representatives may have brought it forth.

Local news coverage from trusted outlets may also break down what bills are impacting your reproductive health care. Experts caution against relying on social media for health information, given the sheer amount of misinformation and myths.

Do IUDs induce abortions?

No. The devices work by thickening the mucus along the uterine wall, making it difficult for sperm to migrate and meet with the egg, preventing fertilization.

“It’s a simple mechanism, but it really works,” said Lawson, who’s also the president of the National Medical Association. It prevents conception. They are 99.9% effective at preventing pregnancy.

What birth control is now available?

Condoms, spermicide, contraceptive sponges, apps to track your menstrual cycle, emergency contraception like Plan B, and most recently Opill, are all birth control options that do not require a prescription from a doctor.

Some hormonal contraceptives require either a prescription or insertion by a medical provider. Those include the ring, IUDs, implants, contraceptive injections, and birth control pills. Sterilization is also an option regardless of the gender of the patient.

“It’s really amazing that women have so many contraception options,” said Lawson. There is some slight variation in how well each works, she said. “There are options that our grandmothers and even mothers did not have. I hope women are empowered by that.”

It’s also important to make sure you feel comfortable with your provider, said Wells. You should feel free to ask questions about how each contraceptive option works and might impact your body.

A lot of birth control options are covered by insurance, and many clinics and health centers may offer free condoms. Some birth control pill companies offer discounts on their websites.

If you’re uninsured, many freestanding health clinics offer sliding scale payment options based on your household income and ability to pay, which could bring the price down.

How do I know what my best birth control option is?

It’s important to understand your medical history, said Wells. In person or online, your provider may ask about your history with high blood pressure, blood clots, and conditions like lupus. Those conditions may preclude the use of certain forms of contraception.

People should also consider their lifestyle and goals, she said. For example, the IUD requires a one-time insertion every handful of years depending on the types, whereas the pill requires patients to take them at the same time each day. Each option offers a different level of independence. The pill can be stopped at any time. The IUD and implant require an appointment with a provider to remove.

Complete Article ↪HERE↩!

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What doctors wish patients knew about getting a vasectomy

By Sara Berg, MS

When discussing reproductive health choices, one procedure has been gaining attention—especially since the fall of Roe v. Wade—for its effectiveness: the vasectomy. As individuals and couples explore long-term contraception options, vasectomies have emerged as a popular choice for those seeking a permanent solution—rates have increased by 26% in the past decade. With its relatively low risks and high success rates, this procedure is reshaping conversations about family planning.

The AMA’s What Doctors Wish Patients Knew™ series provides physicians with a platform to share what they want patients to understand about today’s health care headlines.

In this installment, three physicians took time to discuss what patients need to know about getting a vasectomy. These AMA members are:

  • Jason Jameson, MD, a urologist and chief of urology at the Phoenix Veterans Affairs Medical Center, who serves as a delegate for the American Urological Association in the AMA House of Delegates.
  • Amarnath Rambhatla, MD, a urologist at Henry Ford Health and director of men’s health at the Vattikuti Urology Institute in Detroit.
  • Moshe Wald, MD, a urologist at the University of Iowa Hospitals & Clinics and an associate professor in the department of urology at Carver College of Medicine in Iowa City.

Henry Ford Health and University of Iowa Hospitals & Clinics are members of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

There are seasonal spikes in vasectomies

“We sometimes see seasonal spikes in vasectomies. We see it in March and then also in November and December before the end of the year,” Dr. Rambhatla said. “We think it spikes at the end of the year because everyone has met their deductible for the year.

“In March, it’s been loosely associated with March Madness, he added, noting “the running joke is that men get their vasectomy around the NCAA basketball tournament and ask their wives for permission to lay on the couch for four straight days so they can watch the basketball tournament.”

“The other interesting thing we’ve seen is with the Roe v. Wade reversal. There are studies showing an increase in Google trends, searches and consultations for vasectomies after that,” Dr. Rambhatla said. “So, it seems like some men are more inclined to be in control of their fertility status after that ruling.”

It’s a minor surgical procedure

“A vasectomy is a minor surgical procedure, which is aimed at eventually achieving permanent birth control,” said Dr. Wald, noting “the procedure is typically performed in a clinic setting under local anesthesia, which means injection of numbing medication into the area.

“However, in some cases, based on anatomy and on the patient’s preference it could also potentially be done in the operating room under sedation or general anesthesia,” he added. “But the vast majority are being performed  in the clinic under local anesthesia.”

“The procedure involves the surgical interruption of a tube called the vas deferens. The vas deferens is the tube that drains sperm from the testicle outwards and a man typically has two of them, one on each side,” Dr. Wald said. “So, the idea is to interrupt these tubes, and then allow enough time for  the sperm that at the time of the vasectomy was already beyond the vasectomy site to wash out.”

The procedure “usually takes about 20–30 minutes. One or two small cuts are made in the scrotum with a scalpel or no-scalpel instrument,” Dr. Jameson said, noting “the vas deferens are cut and tied or sealed with heat. The skin may or may not be closed with sutures.”

But “if the vas deferens are not easy to feel due to body characteristics—obesity, previous scarring—the procedure may be more challenging to perform,” Dr. Jameson noted.

It’s OK to drive yourself home

“Most of the time patients are OK to drive themselves home after the procedure. Occasionally I’ll have some patients who are a little nervous or anxious about getting a vasectomy,” said Dr. Rambhatla. “So, we can prescribe them medication to help calm down their anxiety for the procedure.

“In those situations, they need to have a driver with them because that medicine can alter their ability to drive,” he added. “Otherwise yes, you could drive yourself home.”

Don’t be nervous, it’s straightforward

Patients “should definitely relax. It’s a straightforward, easy procedure,” said Dr. Rambhatla. “The most common feedback I get from men after the procedure is: Oh, I thought it was going to be a lot worse than that.”

“Sometimes their friends will mess with them before the procedure and say it’s going to be a terrible experience and it is just good old fun,” he said. “But most of the time, people say it wasn’t so bad and they had nothing to worry about.”

Follow up requires a semen test

A vasectomy is “not immediately effective. If you can imagine a tube through which sperm is passing, the vasectomy is basically occluding that tube so sperm isn’t passing through anymore, but there’s still sperm on the other side of that tube we’ve occluded,” said Dr. Rambhatla. “And so, all that old sperm needs to be cleared out for men to become sterile.”

“We check a post-vasectomy semen analysis about three months after the procedure to make sure all that old sperm has been cleared out,” he said. “And sometimes some men may take longer, so it can take up to six months or so to clear out all the old sperm.”

Vasectomy is very effective

It is important to note that a “vasectomy would never provide a 100% guarantee. The only way to reach a 100% guarantee of no pregnancy is simply to avoid sexual intercourse altogether,” said Dr. Wald. “Even after a man gets a vasectomy and later gets a semen test that will show no sperm cells in the semen, there is still a very small risk for an unwanted pregnancy in the future.

“That risk is estimated in many studies at one in 2,000, which is, for example, much better than condoms. But it’s not zero and never will be,” he added. “That risk of roughly one in 2,000 by most series is after a man has a post-vasectomy semen test that showed no sperm. If somebody had unprotected sexual intercourse after a vasectomy before having such semen test at all, his chances for pregnancy could be close to 100%.”

This is meant to be permanent

“The best candidates for a vasectomy are couples who are done having kids or men who may be single and know that for sure they do not want any kids in the future,” said Dr. Rambhatla. That is “because we do consider it a permanent form of sterilization. It can be reversed, but really we want people going into it with the idea of permanent sterilization.”

Dr. Wald agreed, emphasizing that “If there’s any question about that, then I would advise against the vasectomy at that particular time.”

Vasectomies don’t always work

“There is a risk of failure. Even if done by an experienced physician, vasectomies could fail. Not necessarily due to surgical error—which is a possibility,” Dr. Wald said, noting “there have been multiple studies that showed the potential reconnection that can happen.”

“Sometimes there could be microscopic channels that can sprout from one end of the interrupted tube and at least in a transient manner allow for some sperm to sneak into the other side,” he said. “The risk varies a lot depending on if the patient had or did not have a semen test following the vasectomy that was negative for sperm. If he did that, his risk for such failure is very small.”

It may be covered by insurance

“Most private insurers cover some or all of the cost of vasectomies,” Dr. Jameson said. “For men without coverage, various self-pay options may be available in certain local facilities.”

“It’s a lot cheaper for insurance to pay for men to have a vasectomy than pay for them to have another child,” noted Dr. Rambhatla, emphasizing “most insurance companies are happy to cover a vasectomy.”

Vasectomy reversals are complicated

“Vasectomies are theoretically surgically reversible. The problem is that vasectomy reversals are a very different thing,” Dr. Wald said, noting that “vasectomy reversals are true surgery performed in the operating room. It is very expensive if not covered by insurance and it does not always work, even if done by an expert.”

The success of a vasectomy reversal “depends on various factors such as how long it’s been since the vasectomy, what your fertility status was prior to the vasectomy and what your partner’s fertility status is,” said Dr. Rambhatla. “Because sometimes we see men with new partners who may have different fertility potential than their previous partner or now their same partner is older, and her fertility potential has changed.”

“And the closer you are to the vasectomy period, the better success rates with the reversal,” he said. “Generally, if this is done within 10 years, there’s a good chance that we can get sperm back in the ejaculate. But sperm in the ejaculate doesn’t necessarily translate to a pregnancy.”

There is a risk of bleeding

“From the surgical standpoint, this is a fairly small procedure, so the risks are not to the magnitude of anything life threatening, but there are certainly risks that are worth mentioning,” Dr. Wald said. “There are the most obvious risks of bleeding and infection. Bleeding, if it happens, is not even close to being anything life threatening.

“Such bleeding happens not externally, but rather internally into the scrotal sac and it could cause bruising, swelling and patient discomfort, and it can take a few weeks to gradually absorb,” he added. “It typically involves the surgical wound or the skin, but sometimes can be deeper and even involve the testicle. These are almost always managed by antibiotics, but it’s a risk.”

“The risk of bleeding with vasectomy increases with blood pressure,” Dr. Jameson said. That’s why it is important to have blood pressure controlled before getting a vasectomy.

Watch out for abnormal pain

“What is not that obvious is the risk of chronic testicular pain. I’m not referring to the obvious post-procedural pain, but a chronic condition that can last months, years or even be there for life,” Dr. Wald said.

According to the American Urological Association, about 1% to 2% of men may experience ongoing pain or discomfort, explained Dr. Jameson. The pain is often treated with anti-inflammatory medications such as ibuprofen.

“This chronic type of pain is a treatable condition, but in some men such treatment could involve surgery that could be bigger in its magnitude than the original vasectomy,” Dr. Wald said.

Men can develop antibodies to sperm

“Not all, but most men who undergo a vasectomy do develop antibodies to sperm. This is because sperm is typically separated from the immune system,” Dr. Wald said. “However, a vasectomy is one of the most common causes where sperm is exposed to blood  and the immune system, and that could lead to the formation of anti-sperm antibodies.”

“This is not something that is posing a general health concern and patients will not feel it,” he said. “But the problem is that if somebody does seek fertility later in life and undergoes a vasectomy reversal, even if the vasectomy reversal works, these antibodies do not go away and can coat sperm, slow sperm down and impair its function.”

It should not affect sex

“A vasectomy does not change sexual function. It does not protect against sexually transmitted infections,” said Dr. Rambhatla. “It’s simply a way to prevent sperm from coming out in the ejaculate.”

Additionally, Dr. Jameson noted, according to the Urological Care Foundation, that a vasectomy should also not cause any erection problems—ejaculations and orgasms should feel the same. And while there is no sperm, the amount of semen does not decrease more than 5%.

Avoid extensive activity

“Typically, if the procedure is done towards the end of the week, then the patient can simply take a long weekend and then plan to go back to work Monday,” Dr. Wald said. “It’s not something that requires you to be in bed, but definitely avoid extensive physical activity.”

That means “no heavy lifting, running. Any gym type activities should be refrained from,” said Dr. Rambhatla, noting that “walking is OK. Just no strenuous activity.”

Additionally, “men with more activity and heavy lifting at work may need more time off as you should avoid heavy lifting for a week,” Dr. Jameson said.

Address pain control

“In terms of pain control, usually most people do well with alternating between Tylenol and ibuprofen as needed,” said Dr. Rambhatla, adding that icing for the first couple days also helps.

Patients can “resume sexual activity once the pain and swelling have resolved,” he explained.

Wear snug underwear and ice area

After a vasectomy, it is common to have swelling and minor pain in the scrotum for a few days, Dr. Jameson said, noting that “wearing snug underwear or a jockstrap can help ease discomfort and support the area.”

Additionally, “patients are typically asked to wear a jock strap with a pretty bulky dressing for 48 hours, and also to ice the area intermittently for 48 hours,” Dr. Wald said.

There are other forms of contraception

“Other birth control methods include condoms or birth control pills for females,” Dr. Jameson said, noting “both of these methods are effective but must be consistently used, and the one-time cost of a vasectomy may be cheaper over time than the cost of other birth control methods.”

Additionally, “tubal ligation in females is another surgical option for birth control and is performed by gynecologists,” he said.

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Female Orgasmic Disorder Could Become a Qualifying Condition for Medical Cannabis in Four States

— Science confirms what many of us discovered on our own.

By Sophie Saint Thomas

Four states—Ohio, Illinois, New Mexico, and Connecticut—are now looking into adding female orgasmic disorder (FOD) to the list of qualifying conditions for medical cannabis. There’s mounting research that suggests that cannabis can help women have more orgasms. For those with FOD, defined by the Merck Manuel as a “lack of or delay in sexual climax (orgasm) or orgasm that is infrequent or much less intense even though sexual stimulation is sufficient and the woman is sexually aroused mentally and emotionally,” medical marijuana could not only make having an orgasm easier, but more satisfying. 

Diagnosis criteria and scientific research aside, stoners have been boasting about the sexual properties of cannabis, probably since the herb was first smoked. Now, we know that cannabis, as a vasodilator, can increase blood flow to the genitals. Because it can also aid in anxiety, using some weed before sex can help people relax into the moment, which can be especially beneficial to those whose sexual dysfunction stems from trauma. After all, we know that cannabis has a well-documented ability to treat PTSD. It even enhances the senses, often making touching and even checking out your partner more fun. And as cannabis can also aid in creativity, it can help you consider and explore more variations in your sex life. 

“Women with FOD have more mental health issues, are on more pharmaceutical medication,” Suzanne Mulvehill, clinical sexologist, and founder and executive director of the nonprofit Female Orgasm Research Institute told Marijuana Moment. “They have more anxiety, depression, PTSD, more sexual abuse histories. It’s not just about pleasure, it’s about a human right,” adding that: “It’s a medical condition that deserves medical treatment.”

Ohio is currently evaluating a proposed amendment to add the condition. Earlier this month, the State Medical Board declared that both FOD and autism spectrum disorder are advancing to the stages of expert assessment and public feedback, following online petition submissions. Public comments will be accepted until Thursday.

In Illinois, regulatory officials are scheduled for a meeting next month to discuss the inclusion of FOD as an eligible condition. New Mexico plans to address the matter in May, as per the nonprofit Female Orgasm Research Institute. The organization also noted that Connecticut is exploring the possibility of adding FOD to its list of qualifying conditions, although a specific date for a meeting has not yet been determined.

Suzanne Mulvehill plays a leading role in the initiatives advancing the therapeutic advantages of cannabis for individuals with FOD. She says that this condition impacts as many as 41% of women globally. She filed a petition last year aiming to include this disorder among Ohio’s list of conditions eligible for medical marijuana.

Present studies suggest that approximately one-third of women who consume cannabis utilize it to enhance sexual experiences—a statistic Mulvehill notes has remained relatively consistent over the years.

She’s aware of the understanding surrounding cannabis’s ability to enhance sex. “It’s not new information,” Mulvehill said in her interview with Marijuana Moment. 

The novelty lies in the readiness of government bodies to address the matter. According to Mulvehill, Ohio appears to be the first state to evaluate FOD as a condition warranting medical marijuana. Moreover, she noted that Ohio’s meeting earlier in the month marked the inaugural instance, to her knowledge, of a public government entity discussing female orgasmic disorders.

A 2020 article published in Sexual Medicine discovered that frequent cannabis use among women correlates with improved sexual experiences. Additionally, various online polls have highlighted a positive correlation between cannabis consumption and sexual satisfaction. There’s even research indicating that the enactment of marijuana legislation correlates with a rise in sexual activity.

And research published last year in the Journal of Cannabis Research revealed that over 70% of adults surveyed reported an increase in sexual desire and enhanced orgasms when using cannabis before intercourse, and 62.5% noted improved pleasure during masturbation with cannabis use. Given previous data showing that women who have sex with men often experience orgasms less frequently than their male counterparts, the researchers suggested that cannabis might help bridge this orgasm equality gap.

For some people, having an orgasm is a challenge in a way that counts as a disorder that deserves treatment, and access to medical marijuana is paramount. For others, this new legal push is just a reminder that weed can make sex better and a reminder that you don’t need a diagnosis to have hot, stoned sex.

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Top 10 drugs that may contribute to sexual dysfunction

By Naveed Saleh, MD, MS

Key Takeaways

  • A variety of prescription medications, along with the conditions they treat, may contribute to sexual dysfunction.
  • Some of these drugs are known to interfere with sexual health, such as antidepressants and beta blockers; lesser known culprits include thiazide diuretics or opioids.
  • Clinicians can help by being aware of medications that may affect sexual function, having open discussions with patients, and adjusting medications where needed.

Sexual dysfunction can be an adverse effect of various prescription medications, as well as the conditions that they treat. Some of these treatments, such as antidepressants and certain antihypertensives, likely come as no surprise to the clinician. Others, however, are not as well-known.

Here are 10 types of prescription medicines that contribute to sexual dysfunction.

Antiandrogens

Antiandrogens are used to treat a gamut of androgen-dependent diseases, including benign prostatic hyperplasia, prostate cancer, paraphilias, hypersexuality, and priapism, as well as precocious puberty in boys.

The androgen-blocking effect of these drugs—including cimetidine, cyproterone, digoxin, and spironolactone—decreases sexual desire in both sexes, as well as impacting arousal and orgasm.

Immunosuppressants

Prednisone and other steroids commonly used to treat chronic inflammatory conditions decrease testosterone levels, thus compromising sexual desire in males and leading to erectile dysfunction (ED). 

Sirolimus and everolimus, which are steroid-sparing agents used in the setting of kidney transplant, can mitigate gonadal function and also lead to ED.

HIV meds

The focus of dolutegravir (DTG)-based antiretroviral therapy has been on efficacy, as measured by viral load. Nevertheless, these drugs appear to affect sexual health, which can erode quality of life, according to authors writing in BMC Infectious Diseases.[1]

“Sexual dysfunction following transition to DTG-based regimens is common in both sexes of [people living with HIV], who indicated that they had no prior experience of difficulties in sexual health,” the study authors wrote. “Our findings demonstrate that sexual ADRs negatively impact self-esteem, overall quality of life and impair gender relations. DTG-related sexual health problems merit increased attention from HIV clinicians.”

Cancer treatments

Both cancer and cancer treatment can impair sexual relationships. And cancer treatment itself can further contribute to sexual dysfunction.

For example, long-acting gonadotropin-releasing agonists used to treat prostate and breast cancer can lead to hypogonadism, resulting in lower sexual desire, orgasmic dysfunction, erectile dysfunction in men; and vaginal atrophy/dyspareunia in women.[2]

Hormonal agents given during the course of endocrine therapy in cancer care lead to a sudden and substantial decrease of estrogens via their effects at different regulatory levels. Selective ER modulators (SERMs) are used to treat ER-positive breast cancers and bind ERs α and β. These receptors are crucial in the functioning of reproductive, cardiovascular, bone, muscular, and central nervous systems. Tamoxifen is the most common SERM used.

In females, reduced estrogen levels due to endocrine therapy can lead to vaginal dryness and discomfort, pain when urinating, dyspareunia, and spotting during intercourse.

Antipsychotics

Per the research, males taking antipsychotic medications report ED, less interest in sex, and lower satisfaction with orgasm, with delayed, inhibited, or retrograde ejaculation. Females taking antipsychotics report lower sexual desire, difficulty achieving orgasm, anorgasmia, and impaired orgasm quality. 

“The majority of antipsychotics cause sexual dysfunction by dopamine receptor blockade,” according to the authors of a review article published in the Australian Prescriber.[3] “This causes hyperprolactinaemia with subsequent suppression of the hypothalamic–pituitary–gonadal axis and hypogonadism in both sexes. This decreases sexual desire and impairs arousal and orgasm. It also causes secondary amenorrhoea and loss of ovarian function in women and low testosterone in men,” they continued.

Antipsychotics may also affect other neurotransmitter pathways, including histamine blockade, noradrenergic blockade, and anticholinergic effects.

Anti-epileptic drugs

Many men with epilepsy complain of sexual dysfunction, which is likely multifactorial and due to the pathogenesis of the disease and anti-epileptic drugs, per the results of observational and clinical studies.[4]

Specifically, anti-epileptic drugs such as carbamazepine, phenytoin, and sodium valproate could dysregulate the hypothalamic–pituitary–adrenal axis, thus resulting in sexual dysfunction. Carbamazepine and other liver-inducing anti-epileptic drugs could also heighten blood levels of sex hormone-binding globulin, thus plummeting testosterone bioactivity.

Both sodium valproate and carbamazepine have been linked to disruption in sex-hormone levels, sexual dysfunction, and changes in semen measures.

Antihistamines

Allergic disease is commonly treated with antihistamines and steroids, with both drugs potentially interfering with sexual function by decreasing testosterone levels. In particular, H2 histamine receptor antagonists can disrupt luteinizing hormone/the human chorionic gonadotropin signaling pathway, thus interfering with the relaxation of smooth muscles at the level of the corpus cavernosum.[5]

ß-blockers

ß-blockers contribute to ED likely because they suppress sympathetic outflow.

“Non-cardioselective ß-antagonists like propranolol have a higher incidence of ED than cardioselective ß-antagonists which avoid ß2 inhibition resulting in vasoconstriction of the corpora cavernosa,” per investigators writing in Sexual Medicine.[6] “Nebivolol has the greatest selectivity for ß1 receptors as well as endothelial nitric oxide vasodilatory effects, and has been shown to have a positive effect on erections.”

The authors cite a double-blind randomized comparison in which metoprolol decreased erectile scores after 8 weeks, whereas nebivolol improved them.

As well, he selective β-blocker nebivolol inhibits β1-adrenergic receptors, which may protect against ED vs non-selective β-blockers.[7]

Opioids

The µ opioid receptor agonist oxycodone not only inhibits ascending pain pathways, but also disrupts the hypothalamic-pituitary-gonadal axis by binding to µ receptors in the hypothalamus, thereby resulting in negative feedback and resulting in ED, as noted by the Sexual Medicine authors.

Consequently, less  gonadotropin-releasing hormone is produced, which results in lower levels of  gonadotropins and secondary hypogonadism. 

Loop diuretics

Results of a high-powered study demonstrated that men taking thiazides were twice as likely to experience ED compared with those taking propranolol or placebo. It’s unclear whether furosemide also causes ED. It’s also unclear why thiazides cause ED. Nevertheless, the Sexual Medicine authors stress that prescribers should remain cognizant of the potential for thiazide to interfere with sexual function.

What this means for you

It’s important for clinicians to realize the potential for a wide variety of drugs to contribute to problems in the bedroom. If a patient experiences trouble having sex, they may discontinue use of the drug altogether. Consequently, physicians must tailor treatment plans with patients and their partners in mind.

The key to assessing sexuality is to foster an open discussion with the patient concerning sexual function and providing effective strategies to address these concerns.

Complete Article ↪HERE↩!

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Can Microdosing Help Heal Sexual Trauma?

— Sexual trauma poses unique challenges to clinical treatment. Psychedelic medicine can address healing from sexual trauma through a more holistic lens.

By Kiki Dy

A sexual assault at fifteen changed the contours of Australia-based artist Lydia’s* life. She blamed herself in a haze of adolescent confusion and hid the assault from her loved ones, even when they suspected something was amiss. The next ten years became a barbed loop of trying to forget and then remembering so vividly that she couldn’t sleep. Lydia tight-roped between extremes:— long periods of abstinence splintered by sprints of hypersexuality. In her early 20’s, she pursued therapy but ultimately found the experience “painful with no payoff.” She recognized she needed a spiritually profound route to recast her sense of self and shift the narrative of her assault–that’s when mushrooms entered the picture.

Psychedelics and Sexual Trauma: An Overview

On her podcast Inside Eyes–a series about using entheogens to ease the aberrations of sexual trauma–somatic psychotherapist Laura Mae Northrup describes sexual assault as a form of spiritual abuse. The impact of sexual violence on the survivor is subjective. However, many, like Northrup, would agree that experiencing sexual assault can change how we view humanity, making us question the morality of mankind and the meaning of our existence at large.

Objectively, sexual assault is unconscionable violence against humanity, resulting in feelings of dissociation and disembodiment that can last a lifetime (and even be passed down). As survivors grow up, they frequently learn to suppress the event and its aching emotions as a defense mechanism. But trauma can never truly be suppressed. Until trauma is addressed, one small trigger has the ability to open the gateway back to the grieving phase.

Given the prolonged spiritual distress sexual abuse spurs, western medicine and traditional therapy can often fall short. For some, exploring a more mystical method of healing provides better outcomes. After all, sexual assault is a complicating factor for mental wellness, with survivors displaying psychological responses such as depression, anxiety, and post-traumatic stress disorder (PTSD)—all of which psilocybin is proven to positively benefit.

As a seasoned psychedelic researcher and professor at Johns Hopkins University School of Medicine, Roland Griffiths reports that over 70% of people who took magic mushrooms to treat depression, anxiety, or PTSD cited their psychedelic experience as being among the most impactful events in their lifetime. Additional research echoes these praises, suggesting that psilocybin often induces emotional breakthroughs and profound shifts in perspective for those who choose to use it–and for Lydia, that shift in perspective was life-saving.

“I felt stuck. All my relationships were failing, even the one with myself. I was ready to give up,” she tells us at Retreat. “It felt like one person had stolen my happiness, and I couldn’t get it back, even ten years later.”

Then, a psilocybin retreat changed everything.

Lydia, who lived in Berlin at the time, made a convenient pilgrimage to attend a magic mushroom ceremony in Amsterdam. “The trip cracked me wide open,” she shares, “I was outside my body looking at myself. Which was trippy, but more important is that the filter changed, and suddenly I saw myself with softness and empathy. I sobbed.”

Like Lydia’s anecdotal evidence suggests, psychedelics hold great promise and potential to help people reprocess their trauma in a meaningful manner. In the words of psychedelic integration therapist Dee Dee Goldpaugh, psilocybin allows us to experience a “compassionate recasting of ourselves in the story [of a traumatic event].” By introducing her mind to new ways to think, psilocybin helped Lydia unglue herself from the decade of anguish the assault catalyzed. With the muck cleared off her mind’s windshield, she began to see and accept the truth: it wasn’t her fault, and it doesn’t define her.

The Therapeutic Potential of Microdosing

The heroic dose helped Lydia forgive and reopen herself to pleasure, but microdosing helped her cement her newfound perspectives.

“I didn’t want the trip to be this epiphany that didn’t stick,” she shares. “I was so relieved but also a bit anxious that I was placing a flimsy bandaid over a bullet hole.” So, after research and casual coaching by a seasoned psychonaut friend, she started a new routine three times a week: spiking her morning matcha with psilocybin powder.

Lydia enhanced her microdosing journey with daily journaling, affirmations, and a focused effort to allow the soft voice that spoke to her during the trip to reshape her internal monologue. She insists that microdosing rewired her brain in a way SSRIs failed to achieve.

But does the science behind microdosing support her experience?

While the conclusion is clear on the therapeutic benefits of large doses of psychedelics, such as increased empathy, openness, mood, and life satisfaction—the developing research on microdosing doesn’t allow us to draw any one conclusion. Research suggests that microdosing may lead to a positive mood, increased presence, and enhanced well-being.

However, the findings do not come from controlled trials where one-half of the participants take a microdose, and the other half take a placebo.  Current knowledge is mostly from vocal success stories like Lydia’s and surveys of people who have used microdosing as a tool for mental health and personal growth. (That said, that is changing, with a number of microdosing studies in the works across the industry.)

The Bottom Line

Though universally painful, healing from sexual trauma is personal. Whether you leverage traditional talk therapy, small amounts of psilocybin, or a guided heroic trip that sends you to an alternate reality for eternity and returns you a new person–one fact remains: addressing trauma is a meaningful step toward a happier future.

As for the potential of psychedelics to facilitate healing more holistically, the science is promising. Individuals that have suffered sexual trauma often close down as fear, anxiety, and anger shrink them. In one famously-cited psilocybin study, 61 percent of participants demonstrated a lasting and measurable change in openness after just one dose of mushrooms–a significant finding because lasting personality change is often out of reach with just talk therapy alone.

However you choose to heal, and whoever you choose to help you heal, Retreat wishes you the best and is here to offer a little psychedelic support and a lot of empathy.

*Name has been changed to protect privacy.

Complete Article ↪HERE↩!

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Why Viagra has been linked with better brain health

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Viagra can be a wonder drug for men with erectile dysfunction, helping them maintain their sex lives as they age. Now new research suggests the little blue pill may also be beneficial to aging brains.

The findings are based on a massive study of nearly 270,000 middle-aged men in Britain. Researchers at University College London used electronic medical records to track the health of the men, who were all 40 or older and had been diagnosed with erectile dysfunction between 2000 and 2017. Each man’s health and prescriptions were tracked for at least a year, although the median follow-up time was 5.1 years.

During the study, 1,119 men in the cohort were diagnosed with Alzheimer’s disease.

The researchers noticed a distinctive pattern. The men who were prescribed Viagra or a similar drug had an 18 percent lower risk of developing Alzheimer’s disease, compared with men who weren’t given the medication.

The researchers also found an even larger difference in men who appeared to use Viagra more often. Among the highest users, based on total prescriptions, the risk of being diagnosed with Alzheimer’s was 44 percent lower. (Men with erectile dysfunction are instructed to only take Viagra before sex, and no more than once a day.)

“I’m excited by the findings but more excited because I feel this could lead to further, high-quality studies in a disease area that needs more work,” said Ruth Brauer, a lecturer in pharmacoepidemiology at the University College London School of Pharmacy and the principal investigator of the study.

There’s a limit to how much we can conclude from the study results. The findings show an association between lower Alzheimer’s risk and Viagra use, but don’t prove cause and effect. For instance, it may be that Viagra use is a marker for better overall health, and that men who have more sex also are more physically active as well. Physical activity is independently associated with a lower risk of Alzheimer’s disease, Brauer said.

Why Viagra may be linked with a lower risk of dementia

Sildenafil, the generic name for Viagra, was never supposed to be a sex drug. Pfizer had developed the drug as a cardiovascular medication to treat hypertension and chest pain called angina. The company had been conducting clinical trials using sildenafil as a heart medication when some patients reported an unexpected side-effect — erections.

Viagra is part of a class of drugs known as phosphodiesterase Type 5 Inhibitors, or PDE-5 drugs. The drugs work by dilating blood vessels and increasing blood flow throughout the body, including to the penis. Since its discovery as an erectile dysfunction treatment, sildenafil also has been used to treat pulmonary arterial hypertension for both men and women.

The link between heart health and sexual health is strong. Erectile dysfunction can be an early warning sign of coronary artery disease. And an unhealthy vascular system is one of the reasons men start having problems with erections.

Vascular risk factors have also been linked to certain types of dementia, including Alzheimer’s disease, so researchers have been intrigued about whether erectile dysfunction treatments can affect brain health as well.

Animal studies of PDE-5 inhibitors have shown the drug may help prevent cognitive impairment by, in part, increasing blood flow in the brain, but researchers who conducted a review of the available research say the efficacy of the class of drugs “remains unclear.” And Brauer said the findings in animals are only “possible mechanisms” in humans.

“There is an idea that if we can help with improving blood flow in the brain, maybe we can also reduce the risk for Alzheimer’s disease,” said Sevil Yasar, an associate professor of medicine at Johns Hopkins University and the co-author of an editorial that accompanied the study in Neurology.

Other reasons for the effect

Stanton Honig, a professor of urology at Yale School of Medicine, said the newest study is far from definitive. “You can’t draw any conclusions” from the study because “there are so many other factors” at play besides whether a man takes a pill for erectile dysfunction.

“Someone who is more likely to take a pill like that at 70, they’re probably more active, they’re more likely involved with their partners, things like that,” Honig said. “There’s too many confounding variables to make a definitive statement that it’s the pills or it’s the patients that are taking the pills that are less likely to be neurologically impaired.”

Brauer said the average “pack” per prescription is four tablets. But it’s not clear if the men took all the tablets prescribed and, if so, how often.

“We do not know if people used the prescribed drugs as intended nor could we measure sexual activity or physical activity levels,” Brauer said. “We need further studies to show if our results would hold up in a group of men without erectile dysfunction and — even better — it would be better to run our study in a group of men and women.”

Previous studies on different populations have come to somewhat contradictory conclusions. A Cleveland Clinic study found a significantly reduced risk of Alzheimer’s disease among those using sildenafil, said Feixiong Cheng, the director of the Cleveland Clinic Genome Center and the principal investigator of the study. But a study by researchers at Harvard Medical School and the National Institute on Aging found “no association” between the use of sildenafil, or other PDE-5 inhibitors, and the risk of Alzheimer’s disease, said Rishi Desai, an associate professor at Harvard Medical School.

More study is needed

Rebecca Edelmayer, the senior director of scientific engagement for the Alzheimer’s Association, said in an email that it remains unclear whether Viagra and similar drugs have an effect on Alzheimer’s risk. “Further research and specifically designed, randomized clinical trials are a necessary step,” she said.

For now, the findings don’t suggest that men should start taking Viagra if they don’t need it. But we do know that Viagra is an effective treatment for erectile dysfunction, and men who are experiencing the problem should see a doctor and discuss both their sexual health and cardiovascular health.

“You should not take Viagra to reduce your risk,” Yasar said. “You should eat healthy. You should exercise. There’s plenty of evidence for that.”

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Psilocybin, LSD And Other Psychedelics Improve Sexual Satisfaction For Months After Use, New Study Finds

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Psychedelic substances, including psilocybin mushrooms, LSD and others, may improve sexual function—even months after a psychedelic experience, according to a new study.

The findings, published on Wednesday in Nature Scientific Reports, are based largely on a survey of 261 participants both before and after taking psychedelics. Researchers from Imperial College London’s Centre for Psychedelic Research then combined those responses with results of a separate clinical trial that compared psilocybin and a commonly prescribed selective serotonin reuptake inhibitor (SSRIs) for treating depression.

Authors say it’s the first scientific study to formally explore the effects of psychedelics on sexual functioning. While anecdotal reports and and qualitative evidence suggest the substances may be beneficial, the study says, “this has never been formally tested.”

“It’s important to stress our work does not focus on what happens to sexual functioning while people are on psychedelics, and we are not talking about perceived ‘sexual performance,’” said Tommaso Barba, a PhD student at the Centre for Psychedelic Research and the lead author of the study, “but it does indicate there may be a lasting positive impact on sexual functioning after their psychedelic experience, which could potentially have impacts on psychological wellbeing.”

“Both studies and populations reported enhanced sexual functioning and satisfaction following psychedelic use.”

Authors noted that sexual dysfunction is a common symptom of mental health disorders as well as a common side effect of certain medications, such as SSRIs.

“On the surface, this type of research may seem ‘quirky,’” Barba said in a statement, “but the psychological aspects of sexual function—including how we think about our own bodies, our attraction to our partners, and our ability to connect to people intimately—are all important to psychological wellbeing in sexually active adults.”

Co-author Bruna Giribaldi said that while most studies ask whether depression treatments cause sexual dysfunction, this study attempted to go further.

“We wanted to make sure we went deeper than that and explored more aspects of sexuality that could be impacted by these treatments,” Giribaldi added. “We were interested in finding out whether psychedelics could influence people’s experiences of sexuality in a positive way, as it appeared from existing anecdotal evidence.”

The team’s analysis found that respondents typically experienced improvement in sexual function for as long as six months after a psychedelic experience, observing upticks in reported enjoyment of sex, sexual arousal, satisfaction with sex, attraction to their partners, their own physical appearance, communication and their sense of connection.

“Naturalistic use of psychedelics was associated with improvements in several facets of sexual functioning and satisfaction, including improved pleasure and communication during sex, satisfaction with one’s partner and physical appearance.”

The most striking improvements were around seeing sex as “a spiritual or sacred experience,” satisfaction with one’s own appearance and one’s partner as well as the experience of pleasure itself.

“Sexuality is a fundamental human drive. For example, we know that sexual dysfunction is linked to lower well-being in healthy adults, can impact relationship satisfaction, and is even linked to subjective happiness and ‘meaning in life,’” Barba said.

The only marker of sexual function that did not go up significantly was “importance of sex,” which could be read to mean that psychedelics did not cause hypersexuality or an excessive focus on sex.

In the clinical trial portion of the study, which compared psilocybin therapy to the SSRI escitalopram, authors found that while both treatments showed “similar reductions” in depressive symptoms, “patients treated with psilocybin reported positive changes in sexual functioning after treatment, while patients treated with escitalopram did not.”

Barba said that’s especially significant because “sexual dysfunction, often induced by antidepressants, frequently results in people stopping these medications and subsequently relapsing.”

David Erritzoe, clinical director of the Centre for Psychedelic Research at Imperial College London, said the findings “shine more light on the far-reaching effects of psychedelics on an array of psychological functioning” but said more study is still needed, especially in light of the currently illicit nature of psychedelics.

“While the findings are indeed interesting, we are still far from a clear clinical application,” Erritzoe said in a release, “because psychedelics are yet to be integrated into the medical system. In future, we may be able to see a clinical application, but more research is needed.”

As the study itself says, “These findings highlight the need for further research utilizing more comprehensive and validated measures to fully understand the results of psychedelics on sexual functioning. However, the preliminary results do suggest that psychedelics may be a useful tool for disorders that impact sexual functioning.”

“Use of psychedelic drugs might foster an improvement in several facets of sexual functioning and satisfaction, including experienced pleasure, sexual satisfaction, communication of sexual desires and body image.”

The new study comes just a few months after a study published by the American Medical Association reported the apparent “efficacy and safety” of psilocybin-assisted psychotherapy for treatment of bipolar II disorder, a mental health condition often associated with debilitating and difficult-to-treat depressive episodes.

Both studies are part of a growing body of research demonstrating the potential of psilocybin and other entheogens to treat a range of mental health conditions, including PTSD, treatment-resistant depression, anxiety, substance use disorders and others.

A recently published survey of more than 1,200 patients in Canada, for example, suggested use of psilocybin can help ease psychological distress in people who had adverse experiences as children. Researchers said the psychedelic appeared to offer “particularly strong benefits to those with more severe childhood adversity.”

And in September, researchers at Johns Hopkins University, Ohio State University and Unlimited Sciences published findings showing an association between psilocybin use and “persisting reductions” in depression, anxiety and alcohol misuse—as well as increases in emotional regulation, spiritual wellbeing and extraversion.

A separate study from the American Medical Association (AMA) came out in August showing that people with major depression experienced “clinically significant sustained reduction” in their symptoms after just one dose of psilocybin.

As for other entheogens, a separate peer-reviewed study published in the journal Nature recently found that treatment with MDMA reduced symptoms in patients with moderate to severe PTSD—results that position the substance for potential approval by the Food and Drug Administration (FDA).

Another study published in August found that administering a small dose of MDMA along with psilocybin or LSD appears to reduce feelings of discomfort like guilt and fear that are sometimes side effects of consuming so-called magic mushrooms or LSD alone.

A first-of-its-kind analysis released in June, meanwhile, offered novel insights into the mechanisms through which psychedelic-assisted therapy appears to help people struggling with alcoholism.

At the federal level, the National Institute on Drug Abuse (NIDA) recently started soliciting proposals for a series of research initiatives meant to explore how psychedelics could be used to treat drug addiction, with plans to provide $1.5 million in funding to support relevant studies.

As for other research into controlled substances and sex, a report last year in the Journal of Cannabis Research found that marijuana could also enhance sexual enjoyment, especially for women—findings authors said could help close the “orgasm inequality gap” between men and women.

A 2022 study out of Spain, meanwhile, found that young adults who smoke marijuana and drink alcohol had better orgasms and overall sexual function than their peers who abstain or use less.

An earlier 2020 study in the journal Sexual Medicine also found that women who used cannabis more often had better sex.

Numerous online surveys have reported similar positive associations between marijuana and sex. One study even found a connection between the passage of marijuana laws and increased sexual activity.

Yet another, however, cautioned that more marijuana doesn’t necessarily mean better sex. A literature review published in 2019 found that cannabis’s impact on libido may depend on dosage, with lower amounts of THC correlating with the highest levels of arousal and satisfaction. Most studies showed that marijuana has a positive effect on women’s sexual function, the study found, but too much THC can actually backfire.

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Pleasure, Unwrapped

— How CBD Gummies Can Enhance Your Journey to Sexual Well-Being

Hey there, pleasure seeker! If you’re looking to spice up your journey to sexual well-being, we’ve got a sweet treat for you – CBD gummies. Yep, those delightful little gummies aren’t just for chillin’; they can add a whole new layer of pleasure to your intimate adventures. Let’s unwrap the secrets and explore how CBD gummies can enhance your sexual well-being.

A Calm Prelude: CBD Gummies for Relaxation and Intimacy

Picture this: You and your partner, bathed in soft candlelight, feeling the calming effects of CBD gummies, setting the mood. CBD is known for its relaxation properties, and incorporating it into your prelude can create a serene atmosphere, easing any tension or stress. It’s like a gentle melody playing in the background, preparing you for a symphony of pleasure.

CBD gummies for sex? Absolutely. The relaxation you experience from the CBD can help you be more present in the moment, heightening your senses and paving the way for a more intimate connection. So, before you dive into the passionate crescendo, consider incorporating CBD gummies into your prelude for a calm and collected overture.

Amplifying Sensations: CBD Gummies and Heightened Pleasure

Now, let’s talk about how CBD gummies can turn up the volume on pleasure. CBD enhances blood flow, increases sensitivity, and reduces discomfort. Translation? You might just experience more heightened sensations and a smoother ride to ecstasy.

The magic lies in how CBD interacts with your body, increasing blood flow to intimate areas and promoting relaxation. It’s like a gentle breeze, enhancing the natural rhythms of pleasure. Incorporating CBD gummies for sex can be your secret weapon, intensifying the sensations and elevating your journey to new heights of pleasure.

An Encore of Connection: CBD Gummies for Intimacy and Bonding

The encore is all about connection and bonding as the curtain falls on your intimate escapade. CBD gummies, with their potential to reduce anxiety and promote a sense of calm, can foster a deeper emotional connection after the act. It’s like a post-performance glow, creating a space for you and your partner to bask in the warmth of shared intimacy.

CBD gummies for sex aren’t just about the act itself; they contribute to the entire experience, from the build-up to the afterglow. As you savor the encore, you may find that CBD helps maintain a sense of relaxation and connection, strengthening the emotional bonds that make your intimate moments truly special.

Exploring Varieties: Finding the Right CBD Gummies for Your Pleasure Palette

When it comes to CBD gummies for sex, one size doesn’t fit all. Just like choosing the right wine for a meal, finding the perfect CBD gummies to complement your pleasure preferences is key. CBD gummies come in various formulations, each offering unique benefits. Some are crafted for relaxation, while others focus on heightened sensations. Before you embark on your journey to sexual well-being, take a moment to explore the varieties available and consider what suits your pleasure palette.

For those seeking a gentle intro, CBD gummies with a balanced blend of CBD and relaxation-promoting ingredients may be the perfect choice. On the other hand, if you’re aiming to amplify sensations, gummies with a higher concentration of CBD might be more in tune with your desires. It’s all about finding the right balance and flavor to enhance your intimate experience. Dive into the world of CBD gummies and discover the variety that speaks to your unique pleasure preferences.

Timing Matters: When and How to Integrate CBD Gummies into Your Intimate Routine

Timing is everything, especially when incorporating CBD gummies into your intimate routine. Think of it like preparing the stage for a grand performance – you want everything to align perfectly. The optimal time to indulge in CBD gummies for sex is about an hour before you plan to engage in intimate activities. This allows the CBD to take effect, promoting relaxation and enhancing sensations when needed.

Consider making it a ritual. Whether it’s before a planned romantic evening or a spontaneous rendezvous, take a moment together to enjoy the CBD gummies. It can become a shared experience, adding an extra layer of connection. As you anticipate the pleasure, CBD works its magic in the background, preparing both your minds and bodies for a harmonious and enjoyable experience. So, pay attention to the timing, make it a part of your intimate routine, and let the CBD-infused symphony unfold.

Beyond Pleasure: Exploring the Potential Health Benefits of CBD Gummies

While the focus is on pleasure, it’s worth mentioning that CBD gummies offer more than just a sweet enhancement to your intimate moments. CBD has various health benefits, and incorporating it into your routine may contribute to overall well-being. CBD is known for its anti-inflammatory and stress-relieving properties, which can indirectly support sexual health.

Beyond the immediate pleasure boost, regular use of CBD gummies might contribute to a more relaxed state of mind, reducing stress and anxiety – common factors that can impact sexual well-being. It’s like adding an extra layer of self-care to your routine, promoting pleasure and a holistic approach to your health. So, as you explore the potential of CBD gummies for sex, consider the broader spectrum of well-being that they may bring to your life.

The Sweet Symphony: Incorporating CBD Gummies into Your Pleasure Playlist

As we wrap up this exploration of pleasure, think of incorporating CBD gummies into your pleasure playlist as adding a sweet melody to your favorite tune. Whether you’re seeking relaxation, heightened sensations, or a deeper connection, CBD gummies can be the secret ingredient that enhances your journey to sexual well-being. So, why not unwrap a new level of pleasure? Your symphony of satisfaction awaits!

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How Alcohol Can Affect Your Sex Life

─ Time To Give It Up To Get It Up?

By Nina Smith

Alcohol has long had a close relationship with sex, from wild nights out meeting someone for the first time, to romantic evenings in with a glass of wine. But there is a boundary and alcohol can cause significant problems for a person’s sex life, particularly if their relationship with alcohol itself has become problematic.

But how exactly does alcohol affect our sex life? From relationships to performance, we run down what impact it may be having on you…

Alcohol and Sexual Performance

Although alcohol is often perceived as a social lubricant, its effects on sexual performance can be contradictory. While a small amount of alcohol may help lower inhibitions and increase confidence, excessive consumption can lead to a range of sexual problems as many studies have shown. In men, alcohol can affect erectile function, delay ejaculation, and reduce sexual desire.

For women, it can lead to decreased lubrication, diminished sensitivity, and difficulty achieving orgasm. Furthermore, chronic alcohol abuse may contribute to long-term sexual dysfunction, impacting both physical and psychological aspects of intimacy.

Relationships and Communication

Alcohol misuse can strain relationships and hinder effective communication between partners. Intoxication can lead to impaired judgment, altered perceptions, and decreased sensitivity to emotional cues, resulting in miscommunication and misunderstandings.

Alcohol-induced aggression or emotional instability may escalate conflicts, eroding trust and emotional intimacy within a relationship. Addressing these issues requires open and honest dialogue, seeking professional help when necessary, and creating a supportive environment for recovery.

The Role of Addiction

Addiction to alcohol presents a grave threat to one’s sex life and overall well-being. Alcohol addiction is a chronic disease and the presence of it intensifies the negative effects alcohol can have on sexual health.

Addiction often leads to neglect of personal relationships and increased secrecy, potentially driving a wedge between partners. Furthermore, substance abuse disorders can contribute to psychological disorders such as depression, anxiety, and low self-esteem, all of which can further exacerbate sexual dysfunction.

Seeking Help and Recovery

Recognizing the impact of alcohol on one’s sex life and acknowledging that alcohol guidance and possibly seeking advice from a mental health clinic London is required in order to get it back on track, as well as your own overall health. Professional guidance and support from healthcare providers, therapists, or support groups play a vital role in addressing alcohol-related sexual issues.

Treatment options for alcohol addiction typically involve a combination of medical interventions, counseling, and behavioral therapies. These approaches aim to help individuals break free from the cycle of addiction, restore physical and mental well-being, and improve sexual health.

For those who feel they aren’t suffering from addiction but feel like the substance could be harming their sex life, it is also worth considering the following…

  • Moderate alcohol consumption ─ Limiting alcohol intake can help maintain sexual function and enjoyment. Being mindful of one’s alcohol consumption and setting boundaries can prevent a negative impact on sexual performance.
  • Open communication ─ Honest conversations with your partner about sexual concerns and the impact of alcohol can foster understanding and create an environment of support and empathy.
  • Seek professional help ─ If alcohol-related sexual problems persist or are linked to addiction, seeking professional assistance from healthcare providers or therapists can provide valuable guidance and support for both individuals and couples.

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What to Know About the Sexual Side Effects of Antidepressants

— S.S.R.I.s, the most widely prescribed antidepressants, frequently cause sexual problems. Here’s what patients can do about it.

By Azeen Ghorayshi

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 certain drugs, 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.

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Alcohol Might Be Ruining Your Orgasm

— How much and how often you drink can affect your ability to climax during sexual activity.

By Catherine Pearson

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.”

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Are Aphrodisiacs Worth Trying?

— A complementary approach to improving libido

By Anna Giorgi

Aphrodisiacs include food, drinks, or drugs used to increase your libido or sex drive. They may also improve your performance or increase your pleasure during sex.

While some substances can impact your body, research often fails to prove their effect on desire. Others can have harmful or even lethal results. It is also thought that the increased libido you feel from these items may be tied to the placebo effect rather than physical changes.1

This article describes why people use aphrodisiacs and whether there is proof they work. It also includes foods, herbs, and other items that are thought to affect sexual desire.

Reasons People Use Aphrodisiacs

The reasons people use aphrodisiacs vary by individual. Generally, people hope to make sex more enjoyable by increasing their sexual potency and performance.
The motives people have for using aphrodisiacs typically include the following:2

  • Increase libido: Low libido can cause a decreased desire and interest in sex. Your libido is affected by internal and external factors such as hormonal changes, aging, relationship problems, changes in physical conditions, medication side effects, and depression, among other issues. Research suggests that sexual dysfunction (problems that prevent a person from enjoying sexual activity) affects 43% of women and 31% of men.3
  • Extend potency and stamina: Potency and stamina can affect your ability to become and remain aroused during sex. Men may seek aphrodisiacs to counter issues such as erectile dysfunction (ED) (the inability to achieve or maintain a penile erection) and premature ejaculation (ejaculation during sex before satisfaction). For women, problems with potency and stamina may be linked to issues such as vaginal dryness or pelvic pain.3
  • Increase sexual pleasure: Even if libido and potency are not problems, people may seek to improve their sexual experience. Your brain and physical actions work together to lead to the orgasmic phase of sex. People may seek to enhance sexual pleasure by trying aphrodisiacs that promise to act on these triggers.4

    • Do “Natural” Aphrodisiacs Work?

    With all the hype that some substances carry, it’s common to wonder whether aphrodisiacs are real. Generally, most “natural” aphrodisiacs don’t work. According to the Food and Drug Administration (FDA), no supposed over-the-counter (OTC) aphrodisiac is scientifically proven to be effective at meeting its claims.5

    While there is often no sound scientific proof for using these substances, there is some anecdotal and historical evidence that some plant-based substances may impact arousing desires and improving sexual performance.6

    • Support the production of sex hormones
    • Improve blood flow
    • Activate neural pathways that support sexuality

    One of the biggest impacts of natural aphrodisiacs is their impact on your psychological state. While the benefits you achieve may be related to a placebo effect (an improvement in a subject’s condition that can’t be attributed to the treatment itself), anything that makes you feel more relaxed, calm, and confident about your sexuality will likely elevate your libido, performance, and experience.7< Additional natural ways to improve your libido and sexual satisfaction include the following strategies:

    • Participate in regular exercise: Research indicates that regular exercise may lower the risk of erectile dysfunction in men and increase sexual arousal in women.8
    • Eat a healthy diet: Growing evidence supports the role of diet in sexual function. General dietary principles that emphasize a plant-forward diet, such as the Mediterranean diet, can offer many benefits to mental and cardiometabolic health, which support all aspects of reproductive health.9
    • Manage stress: When stressed, your body releases the stress hormone cortisol, intended to be delivered in short bursts of energy to relieve stressors. Chronic stress can suppress sex hormones and lower your sex drive. Stress management techniques like meditation, deep breathing, mindfulness, and massage, can help you de-stress before intimacy and improve your experience.10

    Possible Side Effects

    While so-called natural aphrodisiacs may be viewed as safer than medications because they are readily available without a prescription, that is not always the case.

    The mechanisms of action of many aphrodisiacs can cause a wide range of possible side effects. In addition, the fact that they are not regulated increases the risk of aphrodisiacs being mislabeled, unstandardized, or produced with multiple ingredients whose effects may not be known.11

    Your side effects and the intensity at which they occur depend on many factors, such as other medications you may be taking. In a review of the pharmacology effects of herbal sexual enhancers, researchers reported that interactions of aphrodisiacs with other substances and herbal formulas represent these substances’ most significant health risks.1

    Researchers report that side effects of aphrodisiacs can include many problems, many of which may not be known due to the lack of research and the variety of substances used. These side effects include the following:1

    Aphrodisiac Foods

    Aphrodisiac foods vary by geographic location and culture. While many foods are touted as improving sexual desire and/or performance, most claims are not backed by science and may just help you feel better. However, there is evidence that the following foods may help your sex life:

    • Oysters: While research is lacking to support the belief that oysters promote sexual arousal, oysters are rich in zinc, an essential mineral for men’s health, normal sperm function, and fertilization. This is the basis for the thought that oysters are effective aphrodisiac foods for males. In biology, zinc deficiency is linked with sperm dysfunction, low testosterone levels, and male infertility.12 Raw oysters also contain D-aspartic acid and N-methyl, which have been linked to higher sex hormone levels in animals.13
    • Watermelon: While evidence is lacking on the impact of watermelon on human sex drives, watermelon flesh has had an aphrodisiac effect on male rats. Researchers said the findings support using watermelon flesh for increasing potency and countering ED in men. The impact may be tied to the citrulline amino acid, which helps increase circulation in your sex organs.14
    • Maca root: Maca root is the root of a cruciferous vegetable, which comes from the same family as broccoli, cabbage, and cauliflower, and is rich in vitamin C, zinc, copper, and calcium. In one study, an increase in sexual desire was reported by half of all participants who consumed 3 grams of maca root for 12 weeks. Improvements in mood, energy, and health-related quality of life, which can promote a healthier sex life, were also reported.15
    • Apples: Apples are rich in quercetin, a type of flavonoid, a substance that has anticancer, antioxidant, antiviral, and anti-inflammatory properties. Research shows that quercetin can lower blood pressure, helping men avoid high blood pressure linked to erectile dysfunction.16 In one study, male participants with a higher fruit intake achieved a 14% reduction in erectile dysfunction, possibly due to their flavonoid content.17
    • Red wine: Research indicates that alcohol can increase sexual arousal in women. In one study, women who drank one to two glasses of red wine daily reported more sexual desire and better sexual function.18
    • Some meats: Certain high-protein foods like beef, chicken, and pork contain compounds that improve blood flow, a key element in sexual response among males and females. These compounds include L-carnitine, L-arginine , and zinc. Research indicates that arginine supplements significantly improved ED in participants who took these supplements vs. those who took placebo or no treatment.19

    Aphrodisiac Herbs

    The following herbs have been used as aphrodisiacs:

    • Ashwagandha: The Indian herbal remedy ashwagandha shows promise as a natural “female Viagra” (working like a drug prescribed to males for erectile dysfunction), based on the positive effects reported from studies of sexual dysfunction in both women and men. It is believed to have medicinal benefits in treating several conditions and as an aphrodisiac.20
    • Cannabis: Research indicates that cannabis has sexually stimulating effects. This herb can increase sexual desire and intensify sexual experiences for both men and women. It may also indirectly enhance sexual function by increasing relaxation and sensory focus. However, too much of it may inhibit sexual function and satisfaction.21
    • Fenugreek: Fenugreek is an annual plant whose seeds are used in South Asian cooking. It appears to contain compounds that your body can use to make the sex hormones estrogen and testosterone. In a small study that included women with low sex drives, participants who took a daily 600 milligram dose of fenugreek extract showed a significant increase in sexual arousal and desire in women.22
    • Ginseng: Ginseng is the root of a plant that is used as a dietary supplement, aphrodisiac, and in treatments in Chinese medicine. Ginseng is said to trigger the release of nitric oxide (NO), which promotes the dilation of blood vessels. This improves blood flow to the penis, improving an erection.23
    • Horny goat weed: Horny goat weed is a type of flowering plant used in traditional Chinese medicine. The results of animal studies indicate that this herb may have aphrodisiac properties by impacting hormone regulation and increasing blood flow to the penis.24
    • Chlorophytum borivliianum: Chlorophytum borivliianum can be useful for treating certain forms of sexual difficulties like premature ejaculation and oligospermia (low sperm count). Researchers attributed the observed effects to the testosterone-like effects of the extracts.25
    • Yohimbe: Yohimbe comes from the bark of certain trees that grow in India and Africa. In the United States, it is administered by prescription to treat sexual dysfunction. It is also included in some OTC supplements.

    However, whether over-the-counter Yohimbe products provide the same benefits as the prescription is uncertain. Research is lacking on whether its use as a dietary supplement is useful as an aphrodisiac. It has been linked with seizures and heart attacks.26

    Preparing Herbs

    Many herbs are consumed as a beverage after special preparation using an infusion or decoction technique. While an infusion is used for leaves, a decoction is usually reserved for harder herbs like roots, bark, and seeds. These brewing methods are performed using the following steps:27

    Infusion:

    1. Pour hot water over dried leaves, berries, or other plant matter.
    2. Wait to allow the matter to steep in the hot water (timing varies by ingredient).
    3. Remove the plant matter before drinking.

    Decoction:

    1. Grind or crush the root, bark, or seeds.
    2. Heat the required quantity of herbs with water for about 30 minutes, until about 50% of the water is lost.
    3. Remove the plant matter before drinking.

    Why Work With a Registered Herbalist?

    Herbs and other natural treatments are not regulated for content and quality the way drugs are in the United States. Working with a registered herbalist from the American Herbalist Guild can help you use these substances safely. Registered herbalists have completed professional training in the use of herbs and plants as aphrodisiacs and other treatments.

    Aphrodisiac Supplements

    The following natural substances are used are often used as aphrodisiac supplements:

    • Arginine: L-arginine is an amino acid that causes the dilation of tiny blood vessels and increases blood flow. In a study of men with ED and no underlying diseases, daily high doses of L-arginine caused improvement in sexual function.28
    • L-carnitine: L-carnitine is an amino acid present in many foods, especially those of animal origins like beef and chicken. Research shows that this substance may increase sperm maturation, sperm motility, and sperm production.29
    • Zinc: A study of 116 postmenopausal women with low zinc levels showed that zinc supplementation can improve testosterone levels and sexual function in postmenopausal women. Women who took zinc supplements reported improved sexual desire, arousal, satisfaction, vaginal moisture, orgasm, and less pain during intercourse vs. the control group.30

    Summary

    The use of aphrodisiacs involves a search for ways to increase sexual craving, performance, and pleasure that has lasted for thousands of years. While certain foods, herbs, and other products may affect the way you feel, most claims have little to no proof based on science.

    However, some products may have value. Those that work to increase blood flow may help improve blood flow to the genitals. This can be helpful for people who have problems with circulation.

    Other products may have value in the placebo effect. This can make you expect better sex and thereby achieve it.

    Consult your healthcare provider before using herbs or other new products. While these products may not have a big impact on your sex life, some can cause problems by mixing with prescribed drugs or other treatments.

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