Some men may not know as much about their own sexual health because women’s health dominates that public conversation.
That could be important because the Centers for Disease Control and Prevention recently reported that sexually transmitted diseases like syphilis, chlamydia and gonorrhea — all of which can be cured with antibiotics — are spreading more than ever. Gay and bisexual men and young people were particularly affected by the infection increases.
Dr. Arik Marcell, a professor of pediatrics at Johns Hopkins and the paper’s first author, said in the statement that it shows “no one particular factor is responsible for young men’s lack of engagement” in getting sexual and reproductive health care. “We need to think about working at multiple levels to effect change rather than focusing solely on the individual level, which may place undue blame on the individual.”
Study results show that the young men surveyed talk to people in their lives, like their mothers and friends, about their health but didn’t always know where to go for care. Self-consciousness also played a role in their care: “Some participants also discussed needing greater self-confidence when asking and answering questions about their health in general, especially about their sexual health,” the university said.
The authors suggest that a lack of knowledge or health care could have a gender basis: According to the study, the culture around health care in the U.S. is “focused on women’s health” and males are influenced by “traditional masculinity scripts.”
“Few men also have received sexual and reproductive care because historically, few clinical guidelines have outlined care that providers should deliver to this population, and few public health efforts have focused on engaging this population,” Johns Hopkins said.
Care is not the only way men lag behind women when it comes to sexual and reproductive health. Another recent study showed that men don’t know a lot about their own fertility. A survey of hundreds of Canadian men found they were generally not aware of many of the factors that could reduce their sperm counts. And the authors of that study suggested one of the reasons could be that men are not are likely as women to ask questions about their own health.
Although the new study shows men have less knowledge and receive less care than women when it comes to their sexual health, some are getting a level of care. According to Johns Hopkins, about half of the men they surveyed had health insurance and a regular source of health care, and a majority had received a physical exam in the last year. Additionally, 35 of the 70 were tested for HIV.
Q: I’m a larger lad than I was a few years ago. Even though my boyfriend still says he finds me attractive and wants to sleep with me, I no longer have any interest. How can I learn to be confident in the bedroom?
A: Carrying extra weight can dent a person’s sexual self-confidence, regardless of their gender and sexual orientation, but the precise nature of the negative self-talk can vary from person to person.
Melbourne sex therapist Dr Christopher Fox (sexlifetherapy.com.au) says gay men are often confronted with cultural images of svelte, muscular, hairless young men. “This is not the only image in the gay community. ‘Bears’ [hairy, and often larger men] also feature. Yet, like the straight community, youth and beauty is still a focus.”
When we carry a mental template of what a “sexy” person looks like, even if we know, intellectually, that it is an unrealistic and unachievable ideal, we cannot help feeling we fall short by comparison, which causes us to feel ashamed of our bodies.
Carrying weight can impact on your self-esteem, Dr Fox says. “The self is an important aspect of us feeling sexy. The way we view our bodies also impacts on our feeling sexy. When our sense of self [esteem] and our body are both challenged, our levels of desire, and of feeling sexy, are also challenged.”
Once low self-esteem and negative self-talk have become entrenched, they can lead to a general feeling of ennui, and a shutting down of the senses. That sluggish, dulled mindset makes it difficult to truly enjoy all of life’s pleasure, but it particularly affects the libido. One of the first challenges you face is to find the motivation to make any changes, no matter how small. So make yourself move your body.
I am not talking about going to the gym, taking up yoga, or doing anything with a view to losing weight. Simply get your system turning over, like warming up the engine of your car. Research has shown that physical activity, even merely going for a walk, releases the feel-good hormones, endorphins. You will start to feel a little more positive, which will help you to take another step.
Fox warns that learning to accept our bodies and ourselves is not an easy process. “It is an achievable process though,” he says. “On an immediate level I think it is important for you to challenge your thinking about yourself. Your boyfriend says he finds you attractive and he wants to sleep with you. Consider how he looks at you. Maybe he sees something you don’t. This is important to consider.”
When we feel bad about ourselves we often react to compliments with “deflection”. We challenge every compliment, or counter a positive observation by drawing attention to a perceived flaw, “but what about my gut!”. This can feel like rejection to your partner, and, if you do it too often, he might either give up, or start to agree with you.
Practise accepting compliments and endearments graciously, with a simple “thank you”, even if that inner voice is screaming out objections. Let the positive words land, and allow yourself to enjoy them.
It can be difficult to make changes without support, and another good way to begin would be to seek professional assistance. Fox suggests finding someone who has experience in working with gay men, body image and sexuality.
“Through therapy we would explore how your changing body impacts on your sense of self and your body image,” he says. “We would explore how you could develop tools and strategies to challenge your own perceptions.”
Remember that although sex and arousal involve elements of fantasy, the true enjoyment comes from the lived experience in the moment. Car lovers might drool over images of unattainable Ferraris and Bugattis, but the pleasure of enjoying the car that belongs to them, that they can drive, and polish, and experience, is the real pleasure.
Whether you’re in a new relationship or a well-established one, there’s every reason to introduce toys for your mutual sexual happiness. Put simply, the couple that plays together are more likely to stay together – and there’s some science behind that.
First of all, the excitement of trying out sex toys stimulates the production of dopamine – the chemical that plays a big role in both sexual arousal and pleasure in general. Meanwhile, for the large majority of women the simple in-and-out of vaginal penetration alone isn’t usually the route to orgasm, but add some clitoral stimulation and you’re far more likely to score a “Yes!”. Having an orgasm produces oxytocin – also known as the ‘bonding’ hormone – which has the long term effect of making people feel closer to and more supportive of their partner.
So, the science is great – but if you’re not yet using sex toys together, how do you get past any potential embarrassment, and avoid either partner being made to feel defensive about their bedroom technique? Here are some possible dilemmas and corresponding suggestions that could help you set off on a new adventure together.
I’ve just started a new relationship. How do I admit to my partner that I already use sex toys?
It’s always best to be honest, but be sensitive and approach the subject in a casual manner outside of the bedroom. Maybe mention that you recently saw lubricant for sale in your local supermarket and how it made you smile! Judging by your partner’s reaction, you’ll know right away if you could immediately let on about your sex toy collection, or whether to stick to a more subtle hint such as, “Do you think we should pick up some lube next time we’re out?” By keeping the conversation light-hearted and jovial, you can easily disperse any tension and it will be easier to gauge what they think of the idea. It’s always a good idea to be honest from the beginning.
My partner says that if I was satisfied with them, I wouldn’t need a sex toy. How do I convince them this isn’t the case?
The trouble is that people who aren’t familiar with sex toys are often thinking of huge dildo vibrators that are, quite frankly, intimidating! But these are really just a fraction of what’s available. The most popular toys are actually things like small bullet vibrators for clitoral stimulation, or stretchy cock rings for happy erections, and they’re far from scary.
Reassure your partner that you find your sex life fulfilling but that you don’t want them to feel under pressure to be responsible alone for bringing you to orgasm. Using a mini vibrator or a cock ring can provide pleasure for you both.
A great way to turn a man’s prejudices on their head might be to buy a male toy for you both to enjoy using on him first. A textured stroker sleeve adds a whole new dimension to a hand job, and could prove to be the path to his sex toy enlightenment…
It should be noted that toys are not supposed to replace nor detract from what your partner brings to your play time in the bedroom. If anything, toys should be seen as a treat designed to enhance the experience and discover more about each other.
We do both want to use sex toys together, but we don’t know where to start
It’s a great idea to choose something together. Cuddle up with a glass of wine on a weekend evening and browse the Lovehoney website – you’re sure to find something you both like. There’s lots of advice in the ‘Help’ section to assist you, too.
If you’re in a male/female couple you could start with a toy that stimulates you both at the same time. The Tracey Cox Supersex Twin Vibrating Love Ring is great for getting you both off, for example. The stretchy cock ring part can give him a bigger, harder erection and more powerful orgasm, while the vibrating bullet in the top provides vibrations to both her clitoris and his testicles.
Same sex relationships benefit from toys just the same as hetero relationships. And strap ons aren’t just for the girls! Guys are also both using and allowing their partners to please them with these helpful and amazing tools to enhance their experience between the sheets..and anywhere else!
Or why not go for a vibrating wand massager? Originally created for soothing tired muscles, wands are also great for stimulating erogenous zones such as inner thighs or the nape of the neck, plus intimate parts such as the labia, testicles and more.
The most important part of using sex toys together is to communicate. Go ahead and experiment, and if at any point you start to feel numb or uncomfortable, speak up – your partner won’t know unless you tell them. By the same token, if you especially enjoy something, let your partner know – the joy of discovering a new favourite sensation together is what sex toys are all about!
What was your sex education like? Did you get any at all past the age of 16? Given that only a quarter to a third of young people have sex before they are 16, but most will have had sex at least once by the age of 19, it seems remiss not to provide high-quality sex education for the 16-25 age range (especially since that is the age group most at risk of contracting STIs such as chlamydia).
Unfortunately, sex education hasn’t moved on much from puberty, plumbing and prevention, and is often reported as being too little, too late and too biological. In the new internet world order where porn and internet hook-ups prevail, and the use of dating apps by perpetrators of sexual violence was reported last week to have increased sharply, it is time we provided sex and relationships education fit for the 21st century, to help us to enjoy our bodies safely.
So if you missed out on quality sex education, or could do with a top-up, here are five things relating to sex and relationships you might want to think about:
1. Sexuality – We live in a heteronormative world, where gender binary and heterosexual norms prevail. Fixed ideas about sexual identity and sexuality can be limiting. We all need to understand sex as something more than a penis in a vagina and recognise that sex with all sorts of different body parts (or objects) in all sorts of wonderful configurations can be had. That’s not to say you have to experience kinds of sex outside your own comfort levels and boundaries. Be aware of how media, cultural background, gender and power dynamics influence sexuality. Monogamous heterosexuality does not have to be your path.
2) Consent – what it looks like, what it sounds like, what it feels like. Enthusiastic consent should be a baseline expectation, not an aspiration. Without enthusiastic consent then sex is no fun (and quite feasibly rape). If consent is in any doubt at all, you need to stop and check in with your partner. You might even want to think about introducing safe words into your sexual interactions and ensuring you and your partner are confident using them.
‘Taking time to challenge and explore ideas around pleasure will help with your sex education.’
3) Pleasure – sex can be one of the most awesomely fun things you do with your body. All sorts of things can affect your ability to give and receive pleasure, including your upbringing, self-confidence, physical and mental health, and communication skills. If sex isn’t pleasurable and fun for you, what needs to change? It is worth noting that male pleasure is generally prioritised over female pleasure. Consider, for example, when you would consider a penis-in-vagina sexual interaction to be finished – at male orgasm or female orgasm?
Taking time to challenge and explore ideas around pleasure as well as deepening your understanding of your own body (in other words, masturbation) will help with your sex education. Always remember, you don’t have to have sex if you don’t want to.
4) Health and wellbeing – Love your body and know what is normal for you. Bodies come in all shapes and sizes. There are all sorts of pressures on us to make our bodies look a certain way, but take some time to appreciate the non-photoshopped, non-pornified variation in our bodies. Your shape and size (of penis, or breasts) do not matter – sex can be the best jigsaw puzzle, and genuine confidence in your body can help you figure out how to use it as an instrument for pleasure.
Knowing what is normal for you is also really important. There are women who continually get treated for thrush bacterial vaginosis and cystitis because they do not understand vaginal flora and the natural discharge variation in their monthly cycle. Nobody told them that having a wee shortly after sex is a good idea.
5) Safety – We are often taught to override our gut feelings. This sometimes stems from childhood, when adults have ignored our bodily autonomy. However it is vital we remember to tune into our gut instincts, especially given the rise in internet dating and internet dating-related crime. Being aware of your own personal safety and sexual boundaries when internet dating is essential.
Remember that no matter how you have been socialised, you do not need to be polite to someone who is making you feel uncomfortable. No is a complete sentence. If someone does not respect your right to bodily autonomy and violates your consent, it is never your fault; the blame lies entirely with them. Always trust your “spidey” sense – if it is tingling, it is trying to tell you something isn’t right, be that a relationship with unhealthy elements, or plans to meet up for a blind date. If a situation doesn’t feel right, think about what needs to change.
It’s not always clear if a woman is really having an orgasm, as Meg Ryan demonstrated in When Harry Met Sally.
In the nascent field of orgasm research, much of the data relies on subjects self-reporting, and in men, there’s some pretty clear physiological feedback in the form of ejaculation.
But how do women know for sure if they are climaxing? What if the sensation they have associated with climax is actually one of the the early foothills of arousal? And how does a woman know when if she has had an orgasm?
Neuroscientist Dr Nicole Prause set out to answer these questions by studying orgasms in her private laboratory. Through better understanding of what happens in the body and the brain during arousal and orgasm, she hopes to develop devices that can increase sex drive without the need for drugs.
Understanding orgasm begins with a butt plug. Prause uses the pressure-sensitive anal gauge to detect the contractions typically associated with orgasm in both men and women. Combined with EEG, which measures brain activity, this allows for a more accurate picture of a woman’s arousal and orgasm.
Dr Nicole Prause has founded Liberos to study brain stimulation and desire.
When Prause began studying women in this way she noticed something surprising. “Many of the women who reported having an orgasm were not having any of the physical signs – the contractions – of an orgasm.”
It’s not clear why that is, but it is clear that we don’t know an awful lot about orgasms and sexuality. “We don’t think they are faking,” she said. “My sense is that some women don’t know what an orgasm is. There are lots of pleasure peaks that happen during intercourse. If you haven’t had contractions you may not know there’s something different.”
Prause, an ultramarathon runner and keen motorcyclist in her free time, started her career at the Kinsey Institute in Indiana, where she was awarded a doctorate in 2007. Studying the sexual effects of a menopause drug, she first became aware of the prejudice against the scientific study of sexuality in the US.
When her high-profile research examining porn “addiction” found the condition didn’t fit the same neurological patterns as nicotine, cocaine or gambling, it was an unpopular conclusion among people who believe they do have a porn addiction.
The evolution of design of the anal pressure gauge used in Nicole Prause’s lab to detect orgasmic contractions.
“People started posting stories online that I had falsified my data and I received all kinds of sexist attacks,” she said. Soon anonymous emails of complaint were turning up at the office of the president of UCLA, where she worked from 2012 to 2014, demanding that Prause be fired.
Does orgasm benefit mental health?
Prause pushed on with her research, but repeatedly came up against challenges when seeking approval for studies involving orgasms. “I tried to do a study of orgasms while at UCLA to pilot a depression intervention. UCLA rejected it after a seven-month review,” she said. The ethics board told her that to proceed, she would need to remove the orgasm component – rendering the study pointless.
Undeterred, Prause left to set up her sexual biotech company Liberos, in Hollywood, Los Angeles, in 2015. The company has been working on a number of studies, including one exploring the benefits and effectiveness of “orgasmic meditation”, working with specialist company OneTaste.
Part of the “slow sex” movement, the practice involves a woman having her clitoris stimulated by a partner – often a stranger – for 15 minutes. “This orgasm state is different,” claims OneTaste’s website. “It is goalless, intuitive, and dynamic. It flows all over the place with no set direction. It may include climax, or it may not. In Orgasm 2.0, we learn to listen to what our body wants instead of what we think we ‘should’ want.”
Prause wants to determine whether arousal has any wider benefits for mental health. “The folks that practice this claim it helps with stress and improves your ability to deal with emotional situations even though as a scientist it seems pretty explicitly sexual to me,” she said.
Prause is examining orgasmic meditators in the laboratory, measuring finger movements of the partner, as well as brainwave activity, galvanic skin response and vaginal contractions of the recipient. Before and after measuring bodily changes, researchers run through questions to determine physical and mental states. Prause wants to determine whether achieving a level of arousal requires effort or a release in control. She then wants to observe how Orgasmic Meditation affects performance in cognitive tasks, how it changes reactivity to emotional images and how it compares with regular meditation.
Brain stimulation is ‘theoretically possible’
Another research project is focused on brain stimulation, which Prause believes could provide an alternative to drugs such as Addyi, the “female Viagra”. The drug had to be taken every day, couldn’t be mixed with alcohol and its side-effects can include sudden drops in blood pressure, fainting and sleepiness. “Many women would rather have a glass of wine than take a drug that’s not very effective every day,” said Prause.
Prause is studying whether these technologies can treat sexual desire problems. In one study, men and women receive two types of magnetic stimulation to the reward center of their brains. After each session, participants are asked to complete tasks to see how their responsiveness to monetary and sexual rewards (porn) has changed.
With DCS, Prause wants to stimulate people’s brains using direct currents and then fire up tiny cellphone vibrators that have been glued to the participants’ genitals. This provides sexual stimulation in a way that eliminates the subjectivity of preferences people have for pornography.
“We already have a basic functioning model,” said Prause. “The barrier is getting a device that a human can reliably apply themselves without harming their own skin.”
There is plenty of skepticism around the science of brain stimulation, a technology which has already spawned several devices including the headset Thync, which promises users an energy boost, and Foc.us, which claims to help with endurance.
Neurologist Steven Novella from the Yale School of Medicine uses brain stimulation devices in clinical trials to treat migraines, but he says there’s not enough clinical evidence to support these emerging consumer devices. “There’s potential for physical harm if you don’t know what you’re doing,” he said. “From a theoretical point of view these things are possible, but in terms of clinical claims they are way ahead of the curve here. It’s simultaneously really exciting science but also premature pseudoscience.”
Biomedical engineer Marom Bikson, who uses tDCS to treat depression at the City College of New York, agrees. “There’s a lot of snake oil.”
Sexual problems can be emotional and societal
Prause, also a licensed psychologist, is keen to avoid overselling brain stimulation. “The risk is that it will seem like an easy, quick fix,” she said. For some, it will be, but for others it will be a way to test whether brain stimulation can work – which Prause sees as a more balanced approach than using medication. “To me, it is much better to help provide it for people likely to benefit from it than to try to create fake problems to sell it to everyone.”
Sexual problems can be triggered by societal pressures that no device can fix. “There’s discomfort and anxiety and awkwardness and shame and lack of knowledge,” said psychologist Leonore Tiefer, who specializes in sexuality. Brain stimulation is just one of many physical interventions companies are trying to develop to make money, she says. “There’s a million drugs under development. Not just oral drugs but patches and creams and nasal sprays, but it’s not a medical problem,” she said.
Thinking about low sex drive as a medical condition requires defining what’s normal and what’s unhealthy. “Sex does not lend itself to that kind of line drawing. There is just too much variability both culturally and in terms of age, personality and individual differences. What’s normal for me is not normal for you, your mother or your grandmother.”
And Prause says that no device is going to solve a “Bob problem” – when a woman in a heterosexual couple isn’t getting aroused because her partner’s technique isn’t any good. “No pills or brain stimulation are going to fix that,” she said.