The way sex is portrayed in pop culture films and music could easily give you the idea that it, at least physically, should happen easily – particularly for men.
Sex may seem like a straightforward activity but it actually involves a high degree of coordination between the brain and body parts. Recent data suggests that erectile dysfunction affects around one in five UK men, with the figure rising to 50% for the 40-70 age group.
With this data in mind, we set out to explore how we could mathematically model the essence of sexual response in men and improve the experience. We found that too much psychological arousal before or during sexual stimulation can make it difficult to climax.
Until recently, little was known scientifically about physiology and psychology of what happens when people are having sex, partly because of the taboo around it. A breakthrough came in the 1960s with the work of US researchers William Masters and Virgina Johnson. They invited over 380 women and over 300 men to a lab and observed them having sex, taking notes of the physiological changes that happened.
Having collected data from over 10,000 sex acts, Masters and Johnson published their results in 1966 in their Human Sexual Response paper. It proposed a paradigm of the human sexual response cycle as a sequence of excitement, plateau, orgasm, resolution. For each of these stages Masters and Johnson described in minute detail physiological changes in genital areas, as well as more general reactions, such as hyperventilation, increased pulse and blood pressure, and involuntary sweating immediately after orgasm.
While sexual responses in women are less understood, the Masters-Johnson sexual response cycle for men has stood the test of time and is still the best representation of the stages men go through when having sex. Data collected by later studies showed that female sexual responses are more diverse and don’t follow the linear progression of excitement-plateau-orgasm-resolution of the Masters-Johnson model.
Practical insights
One of the criticisms of the Masters-Johnson framework was that it did not account for psychological component of sexual response. In our mathematical model, we wanted to capture interactions between physiological and psychological aspects of sexual response in men. Our model focused on how the levels of physiological and psychological arousal (turn-on) change during sexual stimulation.
We combined data about physiological responses from the Masters-Johnson study with insights from five functional magnetic resonance imaging (fMRI) studies of people having sex from 2003 to 2011. fMRI measures the small changes in blood flow that occur with brain activity.
Our model made two assumptions. First, that psychological turn on increases when someone is physically excited, from watching porn or from observing a partner and interacting with them. We also assumed that after sex, psychological excitement eventually subsides.
Getting over excited
The results of our model show that if a man becomes psychologically overly excited, either due to their initial level of psychological turn-on before, or during sex, this can be detrimental to their chances of achieving orgasm. One explanation for this is that when someone is overly excited they are too focused on their sexual performance or achieving an orgasm.
This can cause anxiety, which is itself a state of psychological overstimulation. As a result, people can come to a frustrating state of being agonisingly close to the point of climax yet not being able to reach it. The solution to this is to mentally switch-off and relax to allow your psychological arousal to decrease.
Another finding of our model is that the level of physical arousal decreases with psychological stimulation. Although this may seem counter-intuitive, it fits with the data from fMRI studies from around 15 years ago, in which 21 men were put inside an fMRI scanner and asked to bring themselves to orgasm either through self-stimulation or with the help of their partners.
The results showed that right before orgasm, many areas of the brain become deactivated. These include the amygdala (responsible for processing emotions and threatening stimuli) frontal cortical regions (controls judgement and decision making) and orbitofrontal cortex (integrates sensory input and takes part in decision making for emotional and reward-related behaviour).
So orgasm is associated with letting go – it’s a mental release as much as a physical one.
The same result follows from the Yerkes-Dodson law, which over 100 years ago established that for some tasks optimal physical performance is achieved with intermediate levels of psychological arousal. For example, difficult or intellectually demanding tasks may require a lower level of arousal (to facilitate concentration), whereas tasks demanding stamina or persistence need higher levels of arousal (to increase motivation).
Mathematical models have already helped us understand the dynamics of other physiological processes, such as blood circulation, heart disease, cancer, neural firing in the brain. Applying them to such complex phenomenon such as sexual response can provide insights that can help improve sexual performance and develop new approaches to treatment of sexual dysfunction.
Recent data suggests that while heterosexual men achieve orgasm about 95% of the time, the equivalent figure for heterosexual women is a measly 65%.
Our next step would be to explore how to develop a mathematical model to represent the dynamics of female sexual response using the latest Basson’s circular model, which will hopefully help close the orgasm gap.
Stella, 31 — The thing about lesbian sex is it takes a while
I’ve never found a sexual partner so attractive. When Satya gets naked I immediately feel weak. Soon after we started dating, I was sitting on her sofa after a night out and she put on a sexy, romantic song and gave me a really slow lapdance. She is an amazing dancer and held eye contact without laughing. I was really turned on, but I also felt very nerdy, like an undeserving teenage boy.
Feeling almost painfully desperate because you are so full of desire is a new experience for me and, unexpectedly, I love it.
In previous relationships I have been accused of wanting to have sex less than my partners, which is a bit of a self-fulfilling prophecy because it’s not a very sexy dynamic if your partner is always itching for it, and you’re the mean one, always withholding.
I often shut my eyes when boyfriends orgasmed because it gave me the ick.
Now often I feel the most turned on when I have to work for it a bit – when Satya doesn’t initially want it as much as me and I have to seduce her.
Satya can find it difficult to orgasm, so we’re working on that together. I get it, because I found it difficult for most of my 20s. For a long time I was convinced I was asexual. Partly that’s because I hadn’t realised I was a lesbian. When I had sex with boyfriends I suppose I got off on the mechanics of it, but I sometimes felt sickened by the closeness of it all. I often shut my eyes when they orgasmed because it gave me the ick.
Recently, Satya and I have started doing special exercises to try to make it easier for her to climax. I will set a timer for 20 minutes, and touch her, and I will stop when the timer goes off, no matter what. The point is to take the pressure off finishing, and concentrate on pleasure.
Most of the time we pencil in a session for the weekend because the thing about lesbian sex is it takes a while. You’re taking it in turns, so you need an hour, absolute minimum. You can’t have a quickie in the same way. If it’s 11pm on a weeknight you can’t get started: you’d be up all night! We like to give it a whole afternoon.
Satya, 33 — I really like that when Stella and I are having sex there’s no procreation, there’s just pleasure
I met Stella at a party and I remember noticing how self-possessed she was. She didn’t know that many people there but she was entirely at ease. A year on, sometimes I’ll look at her from across the room when we’re out and be struck by that quality all over again. I’ll watch her talking to someone and she’ll be all composed and beautiful, and I’ll think: I’m going home with you.
I’d had sex with one woman before I met Stella, but only had relationships with men. I find it difficult to orgasm with a partner, and I have tended to stop my exes concentrating on me in the bedroom because I worry I take too long. Stella won’t stand for that.
I used to make the kind of noises I’d heard in porn, mostly to reassure my male partner that he was doing well
She introduced this exercise where she sets a timer on her phone and my job is to just enjoy what she’s doing. I know it’s going to end so don’t panic about her getting bored or tired, which are my main concerns and turn me off. Before she puts the timer on, she reminds me I should stop her if I don’t like something and she will never be hurt or offended.
Another rule is her focusing on me, but I’m not allowed to make any sounds. That’s helpful because I used to make the kind of noises I’d heard in porn, mostly to reassure my male partner that he was doing well (even though he often wasn’t). One of the many wonderful things about being with a woman is they’re not so convinced by the fake noises other women make in bed. I also really like that when Stella and I are having sex there’s no procreation, there’s just pleasure. It makes things much more open and exciting.
The knowledge that I’m attracted to women didn’t strike me like a lightning bolt – it was a slow realisation. I go over it in my head a lot: how did this happen? Is everyone pansexual? Or are all women actually lesbians? Or is it just a random coincidence that I’ve fallen in love with Stella and she happens to be a woman? I think about how much I love her and how happy we are every day.
No, penis size doesn’t matter — at least not in terms of desirability or function.
Its size has zero bearing on its ability to give and receive pleasure or do any of what it’s supposed to do.
That’s not to say that some people don’t prefer a bigger or smaller one, but that’s a matter of perceived preference, kind of like pineapple on pizza. To each their own.
Need some reassurance — or better yet, proof? Read on.
Bigger isn’t necessarily better
Contrary to the bull you might hear in the locker room or media, a bigger dick isn’t everything.
Bigger-than-average penises have been associated with a higher risk of injury and infection.
Extra length can also make some positions especially painful.
Too much girth can cause tearing if you’re not careful, especially during anal sex. Then there’s the whole choking and gag reflex to contend with during oral.
Of course, there are ways around these things, but it just goes to show that having a huge D isn’t all that.
Smaller isn’t necessarily bad
A smaller D is automatically easier to handle, which means all involved can focus on pleasure rather than pain or trying to figure out how the eff you’re gonna get THAT in there.
It’s certainly easier for fitting in the mouth. And when it comes to anal, a smaller peen is basically top dog.
Like any size penis, any perceived shortcomings are easily — and enjoyably — rectified with the right position.
And average is, well, smaller than you probably think
Most people with penises — around 85 percent — overestimate what average is when it comes to dick size and are convinced everyone else is packing something a lot beefier.
Here’s a dose of reality based on the most recent stats on schlong size:
The average penis length is 3.6 in (9.1 cm) when flaccid and 5.2 in (13.1 cm) when erect.
Girth-wise, the average flaccid penis measures 3.66 (9.31 cm) around and 4.59 (11.66 cm) in while erect.
To be clear: Size has nothing to do with stamina
You can be hung like the proverbial stallion and still lack stamina in the sack.
A big dick won’t last longer than a smaller one or keep you from running out of steam or cumming faster than you’d like.
It doesn’t affect fertility, either
If you’ve got baby-making on the mind, the last thing you need to do is stress about your size.
For starters, sperm is produced in the testicles — not the penis. Plus, there’s evidence that stress can reduce sperm quality and affect fertility.
FYI, stress can also put a kibosh on sexual pleasure, boners, and negatively impact your overall health.
The only thing size can do is affect your game — for better or worse
Peen size can totally affect your game, but how comes down to you.
Learn how to make the most of what you’ve got and all the other ways there are to give pleasure and you’ll be a rockstar. Focus on size alone and you’ll flop — literally and figuratively.
For example, some folks neglect their skillset because they think a big dick is all they need to rock someone’s world… and it’s not.
Others may let worries of a small D drain their confidence, causing them to overcompensate in other ways.
All of these things can take a mental toll on the penis-haver and suck the fun out of a sex sesh for all involved.
How to maximize what you’re working with
Not to keep hammering away at it, but it’s not the size of your penis that matters as much as what you do with it.
There’s nothing quite like leaving your partner writhing in ecstasy to thrust your confidence sky high, which will serve you well, in and out of the bedroom.
Here’s how to max the crap out of what you’ve got and feel good about what you’re working with — whether you lean bigger, smaller, or fall someplace between.
If you’re more endowed
The key to working with a bigger-than-average penis isn’t even really about your penis — at least not at first.
Making sure your partner is super-aroused will make it easier for them to handle your beast of a boner, so some extra focus on foreplay is a must. And lube. Lots of lube.
Use your mouth, tongue, or fingers to tease their erogenous zones, focusing on all the usual suspects, like the nips and genitals, as well as some less explored but surprisingly erotic bits, like the inner arms of behind the knees.
If you’re both ready to move onto penetration, choose positions that allow your partner a little more control over the depth. Having them on top is always a good way to go.
First, they can take you in at a pace that feels good. Plus, you get a bangin’ view of all the action and easy access to their other parts for maximum arousal.
If you’re less endowed
If your penis falls to the smaller side of the spectrum, focus on positions that let you go deep, like doggy style. Take it deeper by having your partner lower their head and chest while arching their back.
If you have a thinner penis, choose positions that make for a tighter squeeze. This can be any sex position, really, so long as your partner keeps their legs tight together.
Missionary, face-down, and them-on-top positions all work with closed legs.
And don’t let your wang worries make you forget about other types of sex. Add oral sex to the menu as the appetizer or even the main course.
And when giving, incorporate your hands or a sex toy to increase the chances of a clitoral or anal orgasm.
And speaking of orgasms, know that the chances of having them increases greatly with manual or oral stimulation than with intercourse.
You may also find it easier to hit the G spot, A spot, or P spot using your fingers or a toy. Seriously. Give it a try. You can thank us later.
If you’re somewhere in the middle
Well look at you and your not-too-big and not-too-small D, Goldicocks!
In terms of sex positions, anything goes if you aren’t trying to accommodate a penis that falls outside the average range. This is your chance to experiment like mad and fine tune the positions that you and your partner enjoy the most.
Sensation play using sex toys, feathers, and ice cubes is a good start, especially if you’re BDSM-curious.
The bottom line
Being good in bed — or anywhere else you choose to get busy — isn’t about penis size, but how you handle it.
Figuring out what feels good for you and your partner and choosing moves that make the most of your penis type will serve you better than worrying will, so get to it!
— When thinking about orgasms, many of us associate them with feelings of pleasure. However, this isn’t always the case. Research has found that people experience bad orgasms, even during consensual sexual activity. Let’s explore how these orgasms can happen and the reasons they occur.
A study published in the Archives of Sexual Behavior found that many people had experienced a bad orgasm during consensual sexual activity, adversely affecting their sexuality, relationships, and mental health.
Reasons for bad orgasms included weak orgasms due to societal emphasis on orgasms, narrow gender roles and sexual scripts, poor intimacy, painful orgasms, shame and guilt about sex, gender dysphoria, and racial fetishization.
People can manage physical and emotional needs related to bad orgasms by seeking safety, using at-home treatments such as heat or ice packs, and communicating with their partners.
Do bad orgasms happen?
Although orgasms are typically thought of as pleasurable experiences, research published in the Archives of Sexual Behavior indicates that people engaging in consensual sexual activities can actually experience bad orgasms.
The study surveyed 726 participants about past sexual experiences where they may have felt pressure to have sex, pressure to orgasm, or agreed to sex they didn’t really desire. The findings revealed that around 55% of participants had experienced a bad orgasm in such situations.
These types of orgasms were found to have adverse effects on the participant’s sexuality, relationships, and mental health.
Reasons why people experience a bad orgasm
The study found that there were multiple reasons that people experienced a bad orgasm.
Weak orgasm
Some people in the study reported that their orgasms were weaker and less pleasurable than they had in the past. A reason for this occurring could be the emphasis that we as a society put on orgasms as the defining ending of sex, as well as an indicator of its success. Attempting to have an orgasm, even when we’re not really into it, could cause orgasms to be weaker.
Narrow gender roles and sexual scripts
Similar to the reasons above, some participants in the study found that narrow gender roles and sexual scripts led to negative orgasms. Some women within the study felt pressured to orgasm to please their partners, and men also experienced unpleasurable orgasms due to these narrow gender roles and sexual scripts.
Some participants stated that they felt pressured to perform and meet the unrealistic stereotypes of being able to orgasm easily or always wanting sex. Additionally, some bisexual men felt pressure to orgasm when having sex with a woman to not be perceived as gay, which resulted in a bad orgasm.
Poor intimacy
Other study participants claimed that orgasms with a partner without a close intimate connection were unpleasant. A bad physical and emotional connection with a partner may make it difficult for some to fully relax and let go during sexual activity, hindering the ability to reach orgasm or making it less pleasurable.
Painful orgasms
Some participants stated that the reason for their bad orgasms was pain. While pain during orgasms can indicate sexual dysfunction, many participants in the study attributed their pain to specific circumstances, such as their bodies not being sufficiently aroused for sex, being too tired, or the orgasm taking too long to occur.
Shame and guilt
Other participants attributed their bad orgasms to their shame and guilt about sex due to religious and sociocultural factors.
Gender dysphoria
Gender dysphoria, particularly for transgender individuals, was identified as another reason for unpleasant orgasms. For some, an orgasm served as an anxious reminder of the mismatch between their biological sex and their gender identity, leading to an unpleasant orgasm.
Fetishization
People of color who participated in the study reported that racial fetishization caused moral conflicts about the sexual experience, leading to negative orgasms.
Other reasons people may experience a bad orgasm
Aside from the reasons mentioned above, some sexual dysfunctions can cause an orgasm to feel bad or unpleasant.
Anorgasmia
Anorgasmia is characterized by delayed, infrequent, or absent orgasms or experiencing orgasms that are significantly less intense, even after being sexually aroused and adequately stimulated. It can happen to people of all sexes, although it is less common in people with penises.
For people with a vulva, it is a symptom of sexual dysfunction — female orgasmic disorder, while in penis owners, it is likely a symptom of delayed ejaculation. Anorgasmia is caused by several factors, including stress, depression, anxiety, relationship factors, menopause, and certain medications.
Anhedonia
Anhedonia is a rare condition characterized by the inability to experience pleasure from an orgasm. This phenomenon is commonly observed in individuals with penises and is sometimes referred to as “pleasure dissociative orgasmic dysfunction” or “ejaculatory anhedonia.” Despite being able to ejaculate normally, individuals with anhedonia do not experience any pleasure during the act.
While they may achieve an erection and recognize that they are having an orgasm, the neural pathways in their brain responsible for interpreting these sensations as pleasurable are absent. The cause of the disorder is unknown, but for most people suffering from sexual anhedonia, it is unlikely that it will be permanent.
What to do if you experience a bad orgasm?
Depending on the reason for your bad orgasm, there are different methods to help you manage any physical or emotional needs.
Seek safety. If you feel unsafe for any reason, it’s important that you seek safety as soon as you can do so safely.
Use at-home treatments. If the cause of your bad orgasm was pain, you could use at-home remedies such as an ice pack and a heat pack to help alleviate the pain. If you have a small tear on the genitals, place an ice pack on the affected area to help with the pain. If you experience pelvic pain, a heat pack on the lower part of the stomach will help.
Communicate. If you feel pressured into having an orgasm to please your partner, you should communicate this to them so that you can work on ways to increase pleasure in further sexual experiences.
Many people will experience a bad orgasm in their lifetime. However, if you consistently experience them, it’s an indication that you may need to speak to a doctor along with a mental health professional, such as a sex therapist, in order to understand why it’s happening, and work out an individual treatment plan, to prevent it from happening in the future.
At various points in our lives, orgasms can be the ultimate bliss and the ultimate frustration. Remember that our relationships with our bodies can be fluid and changeable, and sometimes, this can change the sex we have with our partners. For many women, achieving orgasm with a partner can be a challenge — even when achieving orgasm alone, or with the assistance of something akin to a handy-dandy vibrator, comes easily. We may start to blame ourselves, our partners may start to blame themselves, and the bedroom can start to feel anxiety-provoking, rather than a relaxing space to unwind and enjoy all the pleasures our bodies can feel.
Should you be looking for solutions to easier orgasms, but you’re having trouble honing in on what could be addressed, we have some ideas for you. Women spoke exclusively with Aliyah Moore, Ph.D., a certified sex therapist, to better understand what barriers might need to be broken to achieve orgasm with your partner. She said, “Sex is not a performance, and there’s no one-size-fits-all approach. Take the pressure off of yourself and focus on enjoying the moment. Don’t be discouraged if things don’t go as planned; it happens to the best of us.”
Put your body first
Whether you have recently been struggling to orgasm in the bedroom, or have been struggling for some time, the stress of wondering, “Am I going to orgasm this time?” could be enough to stop you from being in the moment. Speaking exclusively with Women, Dr. Aliyah Moore said, “Sometimes, our brains can get in the way of our bodies. If you’re too worried about whether or not you’re going to orgasm, you might end up putting too much pressure on yourself and making it harder to actually get there.” In order to combat this, remind yourself that when it comes to sex, there is no race to the finish; there is no “right” amount of time it “should” take to get to orgasm. Instead, feeling and embracing pleasure throughout the sex act is part of the experience.
Should you feel your mind racing during sex, and the anxiety over your orgasm has set in, try to redirect your thoughts to the physical sensations in your body. Remind yourself that it is okay to let go of the expectation of orgasm. Perhaps you will be surprised how far that can take you.
Prioritize quality stimulation
Remember also that, when engaging in sex with a new partner, it could simply take time to learn about each other’s bodies. And, of course, knowing your own body is key. “Masturbation can be a helpful way to learn what types of touch and stimulation feel good for you,” Dr. Aliyah Moore said, speaking exclusively with Women. “When you know what feels good for you, it can be easier to communicate that to your partner and guide them to provide the stimulation you need to reach orgasm.”
While you might feel self-conscious speaking up to your partner when you want them to do something different, keep in mind that your partner wants to please you. You can communicate before sex, or gently guide your partner through movements that feel good to you during sex as well. “Approach the issue with empathy and an open mind, and work together to find solutions that work for both of you,” Dr. Moore said. “Try to avoid blame or criticism and instead focus on finding ways to support each other and address the issue together.” Do not be afraid to tell your partner when a certain action does not feel good, either. Incorporating longer foreplay into your sexual encounters has also been shown to increase the rate of orgasm, according to a 2014 article published in Human Reproductive Biology.
Review your medications
Being on certain kinds of medications, namely antidepressants such as selective serotonin reuptake inhibitors, aka SSRIs, can also significantly impact one’s ease in having an orgasm. For those whose depression symptoms are significantly improving on medication, but are still having trouble in bed, there are some ways you can work around side effects that might include lack of sex drive, or difficulty reaching orgasm.
First, know that over time, the side effects of SSRIs on your libido can sometimes fade as your body adjusts to the medication. Should you have just started your treatment and feel frustrated with the changes in your sex life, do what you can to be gentle with yourself, and give the circumstances some patience. Should the issue persist, “Talk to your doctor,” Dr. Aliyah Moore suggested, speaking exclusively with Women. “If you’re experiencing difficulty reaching orgasm, it’s a good idea to talk to your doctor to rule out any underlying medical conditions or medication side effects that could be contributing to the problem. Your doctor may be able to suggest treatments or adjustments to your medication that could help,” she said. This could include anything from lowering the dose when appropriate, to switching medications to see if the issue continues.
Assess your physical health issues
A number of physical issues could also hinder your ability to orgasm in bed. One is anorgasmia. According to Mayo Clinic, “Anorgamsia is delayed, infrequent or absent orgasms — or significantly less-intense orgasms — after sexual arousal and adequate sexual stimulation. Women who have problems with orgasms and who feel significant distress about those problems may be diagnosed with anorgasmia.”
There are other issues, too. Speaking exclusively with Women, Dr. Aliyah Moore said, “Unfortunately, certain health conditions can impact our sexual function. Diabetes, multiple sclerosis, and spinal cord injuries are just a few examples. But even things like hormonal imbalances or thyroid issues can play a role.”
There are also several kinds of sexual dysfunction disorders that could contribute to issues with orgasming, where symptoms could include having pain during sex, perhaps caused by ovarian cysts or fibroids, and having a lack of sexual desire or arousal. Age does tend to be a factor in many sexual dysfunction disorders, however. For any number of these concerns, see a doctor or specialist for treatment plans and ideas.
Consider the role of past trauma
ƒsubPast trauma can also be a sensitive barrier to achieving orgasm. When you have had a traumatic experience surrounding sex, reclaiming your body can be a process that necessitates care, love, attention, and trust. Survivors of sexual assault, for example, might experience self-blame, disgust, or otherwise feel disconnected from their bodies, which can make sexual experiences hard to enjoy. Some may even have flashbacks of the traumatic incident. Know that it is possible to repair your relationship with your body and with sex, even when it feels challenging. Understanding your triggers and boundaries, as well as engaging in robust communication, are just a few ideas that can help shape what you want out of your sexual experiences.
Perhaps you might simply be having issues in your relationship that make having an orgasm difficult. “If past trauma or relationship issues are impacting your ability to orgasm, working with a therapist can be helpful in addressing these issues,” said Dr. Aliyah Moore, speaking exclusively with Women. She continued, “A therapist who specializes in sexual issues can help you work through any underlying psychological factors that may be impacting your ability to reach orgasm.” And where therapy is financially unfeasible, explore sexual education resources online. The sex exploration app Ferly, for example, offers expert guides, insight, and community for a small fee each month.
In the end, Dr. Moore advised, “Be gentle with yourself and your partner: It’s important to remember that sexual function can be impacted by various factors, and it’s not necessarily anyone’s fault.”
Boundaries are the latest buzzword in the mental wellness space, but with good reason: They allow us to express what we want, and feel safer in our relationships.
That being said, setting boundaries isn’t easy — especially in the bedroom. “In a culture that applauds people for being as easy-going and flexible, it can feel like we are inconveniencing people by setting clear sexual boundaries,” said queer sex therapist and expert for sex toy brand LELO, Casey Tanner.
In reality, however, setting boundaries builds trust between partners. If someone knows their boundaries will be respected, they’ll feel more confident taking risks and exploring with you, Tanner said. We asked experts like them to explain what boundaries even are, and how you can set them with your partner.
What are boundaries?
The word “boundary” gets thrown around a lot, and not always correctly. “I set a boundary for my partner,” for example, isn’t a boundary, said relationship, sex, and mental health therapist Rachel Wright. Why? “Boundaries are things that we set for ourselves that we are not available for,” she said. “‘I can’t talk tonight’ is a boundary. ‘I am not going to participate in this conversation if you’re talking to me like that’ is a boundary.”
With sexual boundaries, it’s the same thing: It’s our own preferences. Examples of sexual boundaries Wright said are: “I don’t like to be touched here,” and, “I’m not interested in anal sex.”
“Whatever the case is,” said Wright, “it has to start with ‘I.'”
Wright’s advice is to, first and foremost, figure out what these boundaries are for you. Acknowledge that they can and likely will change over time — just like our desires can change.
“You are the only person who can set your sexual boundaries,” echoed Tanner. After you communicate them to your partner(s), though, everyone involved is accountable to holding them and checking-in over time.
Sometimes, boundaries may be more nuanced than an absolute yes or no, and it may require self-exploration to figure out where you draw the line.
One challenge people face is being unsure where their boundaries lie, they continued. Sometimes, boundaries may be more nuanced than an absolute yes or no, and it may require self-exploration to figure out where you draw the line. “This is why it’s so important to embrace a consent practice that allows you to say ‘no’ halfway through trying something,” said Tanner. “You can always rescind your consent, even if initially you thought you were interested.”
If setting sexual boundaries feels scary, Tanner recommends setting non-sexual boundaries with people you know to be supportive. Try saying “no” to an event you don’t feel like going to, for example. By practicing boundaries in a lower-stakes setting, you’ll be more prepared to advocate for yourself in sexual situations.
Contain the boundary conversation
Once you establish what your boundaries are, the next step is to share them with your partner. “A beautiful way to do that is through asking for a container,” Wright said. A container, in this instance, means a specific time and place to have an important conversation. A way to ask for that is, “I would love to have a conversation with you about sexual boundaries. When would be a good time?”
“You can always rescind your consent, even if initially you thought you were interested.”
We may ambush our loved ones with these sensitive conversations and launch into them without consent, which doesn’t go over well. If someone had a bad day at work, for example, their mind will be elsewhere than what you want to talk about. This could leave you feeling rejected — but asking for a container can help this.
If such an in-person conversation is difficult for you — or you’re meeting someone for a hookup for the first time — you can discuss boundaries via text or dating app beforehand, Tanner said. Try initiating a conversation about limits and desires prior to meeting.
How to tell your partner your sexual boundaries
Once you establish a time and place (preferably private, say your living room), now you state your boundaries and have an open conversation.
Discuss any areas of your body that you prefer not to be touched, penetrated, or have contact with without a barrier (like a condom) — or at least without consent first each time, said sexologist and therapist Dr. Joy Berkheimer, LMFT.
Tell your partner any words or scenarios you may find uncomfortable, and ask them the same. Examples Berkheimer named are being too dominant or submissive, introducing toys, or refusing toys.
Discuss erotic possibilities that are on or off the table; read Mashable’s guide for discussing kink with your vanilla partner. If needed, introduce a safe word, or a prearranged word to stop a sexual activity in the moment.
Remember that you don’t owe anyone an explanation for why you have a boundary. If it feels good to share, by all means, do; if you don’t, however, that’s okay. “Even a gut feeling that says ‘this doesn’t feel right’ is a valid reason to set a sexual boundary,” Tanner said.
If you have multiple partners, you can also have different boundaries with different people! Boundaries with a longtime partner will look different than those with someone new.
Stay open when speaking about your intimate values, and embrace the fact that we’ve all absorbed varying narratives about sexuality and our bodies, Berkheimer said.
“We’ve been informed by our families culture, possibly personal trauma, past relationships or media,” Berkheimer continued. “There is so much messaging that happens way before we ever get physical, so to feel safe with intimate partners, they have to be willing to show us they will uphold the boundaries we request for our mental, emotional and physical health.”
Things seem to work well without really thinking about it. Then, when it starts going wrong, you don’t quite know how to talk about it, so the situation gets to a point where you’re stuck and you don’t know how to deal with it. The first stage in addressing this is for each person to spend a couple of days thinking about what they see the problem is, and then agreeing to sit down together for a discussion. Take turns saying: “This is what I think the problem is, and this is how it is affecting me.” Out of this comes the opportunity to really get to the heart of the matter and work out what is needed.
2. Look for the reasons why sex might have changed
How did sex use to be? What was intimacy like? What has changed? What are the blocks to sorting it out? There may have been occasions when you might not have wanted to be sexual or you might not have been in the mood, and that got misinterpreted, or there were a few times when you got rejected. And then you get into a pattern of not having sex or avoiding it.
3. Talk about how you first met. And make an effort to look nice
Spend an evening chatting about what you liked about the other person. You can remind each other of what drew you both together. Do that on the first night, then on the next night, dress up, go out for a meal and make an effort to feel and look special. What you’re likely to find is that you’re feeling much more connected and that can lead to noticing desire, feeling sexual, and you can reignite something that has perhaps been lost for a while.
4. Every time you leave the house (and come back) make a point of having a kiss or a cuddle
There is no intention that it is going to lead to sex, you just get used to the idea you can reclaim intimacy. Make a point of saying, “I like what you’re wearing”, send texts to each other throughout the day saying “missing you” and “look forward to seeing you”. In this way you’re recreating some of the behaviours you probably did at the beginning of your relationship and you are giving the message, “I’m noticing you and I like you”, so that the sense of feeling closer to the other person, the emotional intimacy, starts creeping back in.
5. Schedule regular time to be intimate
This is making a commitment to maintaining the relationship by saying: even though sometimes we don’t feel like it, we realise the importance of this and will try to be sexual. It is about not letting gaps appear so then it starts becoming more normal to not have sex. What your scheduling says is that Friday nights are your night, you’ll put some effort into making it special and this can lead to greater intimacy. Perhaps this means having a shower together, or maybe dressing up – above all it is about making a statement that your physical relationship is important, and you are prepared to put in the groundwork, instead of saying it is just about sex.
6. Write down on pieces of paper what really works for you both
Then fold them up and put all of the bits of paper in a jar. I encourage couples to sit down and work out some of the things that each person particularly likes when they are being sexual. Then, whenever you’re going to have some intimate time, pull out a piece of paper and whatever’s there, you’ve got the chance to try. It enables an element of fun and excitement to return into the relationship which can be helpful to maintain the spark.
7. If there is a high level of anxiety attached to sex, introduce mindfulness
I always suggest pelvic floor exercises, because this makes you focus on your genitals, so you become much more tuned into your body. For a man, this can increase the quality of his erection and the chances of more ejaculatory control. For a woman, it is likely to help her to regain a bit more feeling within the vaginal walls and it might help towards arousal.
8. For older couples, slow everything right down
Try having a bath together, so you feel good and in tune with each other. Pay more attention to what position feels comfortable. If there are issues of mobility and flexibility it can be useful to try out positions first. You might want to do this while you’re still dressed when it can feel easier (and warmer).
9. Take turns to be selfish
Say, “I’d really like it if you could give me a back rub”, or “I just really want the opportunity to touch you”. I often suggest couples go to bed and have a period of time when you’re both naked without needing to be sexual. Just lying next to each other, feeling the other person’s skin on your skin can be a very intimate and nourishing moment.
10. Rediscover how to be intimate with each other
There are many reasons why intimacy can change in a relationship. Pregnancy and birth, ageing, body shape, resentment, arguments not being resolved, anxiety, the menopause, erectile problems … It is important to understand why you’ve reached the point where things are dysfunctional, but it is always possible to make changes. I’ve worked with couples who haven’t had sex in six years and it has been a privilege to help them rediscover how to be intimate with each other.
Peter Saddington is a clinical supervisor and a relationship and sex therapist working for Relate.
— ‘I feel as if my body has betrayed me,’ one survivor says
Brenna Gatimu and her husband, Nimmo Kariuki, tend to their youngest son, Kylian, in Casper, Wyo. Gatimu was diagnosed with Stage 3 breast cancer in 2020.
By Netana H. Markovitz
Brenna Gatimu, 34, of Casper, Wyo., was diagnosed with Stage 3 breast cancer in 2020. She quickly had chemoradiation, and both her breasts and ovaries were removed. She now takes a medication that suppresses any remaining estrogen in her body.
“I feel as if my body has betrayed me, like all the things that make me biologically a woman — the estrogen, the progesterone, my ovaries and my breasts — everything had to be removed and stopped,” Gatimu said.
Gatimu’s experience is not uncommon. As cancer survival rates in the United States improve, many survivors are left with permanent changes to their body — outwardly and functionally. Some feel particularly unprepared for persistent changes in their sexual functioning.
“Sexuality is a very big issue, and unfortunately, the avenues to get help are often limited because people are concentrating on helping [patients] live through cancer, and really concentrating on quality of life but devoid of sexuality,” said Don Dizon, a professor of medicine and surgery at Brown University and the founder of the Sexual Health First Responders Clinic at the Lifespan Cancer Institute.
Sexual health and quality of life
In 2022, approximately 18 million people with a history of cancer were living in the United States. The number is expected to increase over time.
“As people live long lives after cancer … these questions on the permanent, long-term side effects of treatment are something we have to address,” said Sharon Bober, founding director of the sexual health program at the Dana-Farber Cancer Institute and an associate psychiatry professor at Harvard Medical School.
“I feel as if my body has betrayed me, like all the things that make me biologically a woman — the estrogen, the progesterone, my ovaries and my breasts — everything had to be removed and stopped,” Gatimu says.
“We are looking not just at what people do functionally, but we’re also thinking about people’s experiences of themselves being whole, having a sense of integrity in their body — even after things change,” Bober said. “We’re talking about an experience of how people relate to a partner, we’re talking about dating, we’re talking about emotional and sexual relationships that undergo changes themselves.”
“We’re also thinking about people’s experiences of themselves being whole, having a sense of integrity in their body — even after things change.” — Sharon Bober, founding director of the sexual health program at the Dana-Farber Cancer Institute
Some cancer centers have created programs dedicated exclusively to sexual health for patients with cancer — such as Massachusetts General Hospital and Memorial Sloan Kettering in Manhattan. These centers are still relatively rare, but their numbers are increasing.
Those without access to a comprehensive center should consider seeking out “specific practitioners who have relevant expertise, such as certified menopause specialists, urologists or urogynecologists who specialize in sexual medicine, pelvic floor physical therapists or certified sex therapists in the community,” Bober said in an email.
Gatimu holds some of the medications she takes while Kylian asks if he can have the pills, too.A family portrait on Gatimu’s wall shows husband Nimmo Kariuki, stepdaughter Paisley Grundhoffer, and sons Malcolm, James and Kylian. The family had the photo taken the day Gatimu completed chemotherapy.
Patients can also access a growing body of information.
“There are really more resources now than there ever have been and there are a lot of organizations that now have really good information and education on their websites,” Bober said. “I would just say people should feel free to access the growing amount of supports that are out there. And that’s the case both for patients and providers.”
For example, the Scientific Network on Female Sexual Health and Cancer has a host of resources, including webinars, a page with links to several online resources and a “find a provider” page to search for help by location. The American Cancer Society also has a fairly comprehensive overview of navigating sex and cancer.
Jacob Lowy in his living room in New York.
Even before intimate encounters, body image can be an issue. Jacob Lowy, 31, a fourth-year medical student at the University of Michigan, was diagnosed with metastatic sarcoma in 2021. Since then, he has had to deal with dating.
“It definitely messed with my psyche a lot to talk to people because it feels like you’re hiding something at first,” Lowy said. “But there’s no real advice for how to do it properly.”
Besides fatigue and surgical complications from his two abdominal surgeries, he has experienced decreased libido and erectile dysfunction.
“I went from feeling … invincible and very strong to my body feels like a wreck on the inside,” Lowy said.
Physicians often don’t discuss sexuality with patients for many reasons, Dizon said. “Partly it’s because I don’t think oncologists are trained in talking about sexuality,” he said.
Lowy spends time with friends on the Lower East Side in New York on March 4.
When sexuality is discussed, much of the talk often focuses on what’s safe — for example, when it is safe to have sex during chemotherapy. Bober said “potential sexual side effects and sexual rehabilitation really is not routinely incorporated into care. So a lot of people struggle on the other side of treatment and feel pretty isolated.”
“I went from feeling … invincible and very strong to my body feels like a wreck on the inside.” — Jacob Lowy
But when the topic is broached, doctors often have treatment recommendations.
Sarah E.A. Tevis, an assistant professor of surgery at the University of Colorado, recently started asking her patients about sex after a patient questionnaire she distributed flagged the issue.
“This wasn’t a common thing I talked to all of my patients about, and ever since I’ve started bringing it up, I feel like almost every single patient I talk to is having some problem that we can probably help with,” Tevis said.
Ask for help or a referral
Even if your oncologist does not know how to help, someone is probably out there who can.
“This is something that people should be empowered about — that as with other aspects of our health, if you’re having issues, give it voice, ask for specific assistance,” Dizon said. “And if your doctor doesn’t know or doesn’t want to discuss it, then ask for a referral.”
For Gatimu, she has done her best to adapt to a new normal but still struggles.
Since treatment, she has experienced vaginal dryness, difficulty achieving orgasm and lack of libido. She also has no sensation in her reconstructed breasts. Gatimu has sought advice through a combination of doctors and friends who are cancer survivors.
Gatimu helps Kylian wake up to get ready for day care on March 1.Gatimu’s son Malcolm walks past a photo wall his mom and dad put together of past family moments, photos and sayings as he gets ready for school on March 1.
“I still have times where I really struggle with the comparison or the wishful thinking of ‘Oh my gosh, if only this didn’t happen and I didn’t have to live through this, where would [I] be?’ On the positive side, I have gained such a self-awareness and such a self-confidence within myself,” Gatimu said.
One 44-year-old man who was diagnosed with Stage 3 rectal cancer in 2018 underwent chemotherapy and radiation before having surgery that resulted in an ostomy pouch, a bag that collects stool outside the body.
“It’s tough for me not to view my body as … broken,” said the man, who asked not to be named for privacy reasons.
For him, sex with his partner now involves going to the bathroom to empty out the ostomy pouch and ensuring that it is as flat as possible so it does not get in the way. He also takes Viagra for the erectile dysfunction he has had since treatment.
A photo of Gatimu and Kariuki attending an adult prom in Casper, Wyo., that raises money for childhood cancer research.
“I am very fortunate that I have a loving partner who loves me for who I am and we’ve adjusted, but now sex is really tough to have spontaneously,” said the man, who lives in Chapel Hill, N.C.
A common misconception is that only certain cancers affect sex.
“We tend to think of sexual health as an issue [only] for people treated for sex-related cancer,” Dizon said. “But that’s actually not true. There’s a growing literature that even people treated for, say, colon cancer and lung cancer — they actually have issues related to sexuality.”
He points out, for example, that chemotherapy itself can affect the vaginal mucosa, which can cause pain with sex.
Unfortunately, many cancer patients feel alone in their struggles.
No one mentioned sexuality to the Chapel Hill resident, except for a brief, awkward conversation with his radiation oncologist regarding the possibility of infertility after treatment.
“People often will equate sexuality and fertility, but those are very different conversations,” Dizon said.
Lowy organizes his pills for the week.
“Their goal is to save a life.” the Chapel Hill resident said. “And they were very good at doing that. I willingly put my life in their hands, but sex was an afterthought.”
Once he got the courage to broach the subject, he was prescribed Viagra, which has been working well.
“I think the biggest advice I would give is, do not be afraid to ask questions,” he said. “If something isn’t right, talk to the doctors about it.”
Advice on sex is available on myriad apps, sex toys are for sale on the high street, and the science of sexual fufilment is blossoming. Will this focus on sexual wellbeing have the desired effect?
Tina was 52 when her long-term relationship ended. She had experienced low libido throughout her perimenopause years, and her relationship had become “pretty much sexless by the end”, so reigniting her sex life felt like a daunting prospect.
But rather than closing the book on her sexuality, Tina turned to a sexual wellness app called Dipsea, and began listening to erotic stories, as well as learning about different self-pleasure and communication techniques.
“I’ve never hugely enjoyed visual pornography and this sounded like something different and worth trying out,” she says. “The app enabled me to explore my sexual wants and fantasies as well as use some of the wellness-focused content, which helped me to feel more confident when dating and navigating having sex again.”
She’s not alone. As attitudes to sex have liberalised, and people increasingly strive for greater physical, mental and social wellbeing, a growing industry in sexual wellness has sprung up. Whereas sex toys only used to be available from sex shops or porn magazines, they can now be bought from high street chemists. Subscription-based apps and websites are offering erotic content alongside relaxation exercises and relationship advice from trained sex counsellors. Sex is no longer taboo, but an integral part of our general wellbeing. But while investors in this industry may have hit the financial G-spot, what does it mean for the rest of us?
Precisely who conceived the term “sexual wellness” is hazy, but the actor Gwyneth Paltrow is credited with catapulting it into the mainstream. In 2015, her lifestyle website Goop.com recommended that women steam-clean their vaginas for extra energy and to rebalance female hormones. Since then, Goop has sparked debates about the pros and cons of jade vaginal eggs, an “aphrodisiac warming potion” called Sex Dust – not to mention the infamous “This Smells Like My Vagina” candle.
Gwyneth Paltrow’s Goop has been credited with initiating the sexual wellness trend – but claims made about the benefits of some of the expensive products it sells lack evidence.
“With the launch of things like Goop, there’s been a much broader, holistic sort of view on what sexual wellness means, and how it can benefit you to be a happier, more confident and satisfied human being,” says Mei-lin Rawlinson, chief of staff at OMGYes, an educational website about female pleasure.
Around the same time Paltrow was preaching the benefits of vaginal purification, OMGYes’s founders were setting out on a mission to use science to help crack a similar nut. Sparked by conversations between friends about how women like to be touched, they realised there was a dearth of academic research on the subject, and little vocabulary for the specific things women find pleasurable.
They partnered with sex researchers to conduct in-depth interviews with more than 3,000 women from across the US, using these insights to develop a trove of educational videos, infographics and how-to’s, designed to educate fee-paying members on how to access greater sexual pleasure.
“Sex is such a core part of life for many people, but it is also a really vulnerable, charged area of life, with lots of taboo. We think that if people can talk about it, learn more about it, learn more about themselves, they can flourish so much more,” Rawlinson says.
In the coronavirus lockdowns, sales of adult toys increased by 25%. Superdrug’s website promotes sex toys with the line: ‘Masturbation is self-celebration’.
Launched in 2015, OMGYes was one of the first sexual wellness platforms, and it now has more than a million users. Research conducted by the platform, in collaboration with Devon Hensel, a professor of sociology and paediatrics at Indiana University, suggests that the benefits of membership aren’t just physical.
They gave 870 women access to the website, and asked them to complete pre- and post-questionnaires to assess their sex-based knowledge and communication skills.
The research, published in the Journal of Sex Research, found that after a month, women reported they had developed a wider repertoire of ways to talk about what they liked sexually and that they felt more positive and confident about understanding what felt good. “These are skills not only important for sex, but also in the context of women’s everyday lives,” Hensel says. Indeed, some of the women also reported an increase in overall agency – such as voicing their thoughts or ideas at work – as a result of this training.
It’s not only educational platforms that are growing in popularity. The global sexual wellness devices market – industry speak for sex toys – was estimated to be worth $19bn in 2021.
With everybody stuck at home due to Covid restrictions, this market experienced a boost. During the first two weeks of UK lockdown alone, orders for adult toys reportedly increased by 25%. But while sales of other consumer categories, such as cycling products, that experienced a “Covid boost” have since fallen back, the sexual wellness market continues to experience accelerated growth.
“I think that’s a good data point to suggest that it is earlier in its life stage. There is more to go for in terms of the number of people who buy these products, and the number of products any one person uses,” says Jacqueline Windsor, UK retail leader for PwC.
She recently co-authored a report on the sexual wellness devices market, and believes several factors may be at play. Interest in general wellness has increased over the past decade, and sexual health and wellbeing are increasingly viewed as central to this. Attitudes to sex are also liberalising, and there has been a shift in sex-toy design away from explicit brands, and towards more discreet and ergonomic models primarily targeting women and couples.
“Commercially, it’s big business, but I think it makes a big statement when we see sex toys and pleasure products on high-street shelves like those in Boots and Selfridges,” says Kate Moyle, a psychosexual therapist and host of the Sexual Wellness Sessions podcast. “It makes the statement that sexual wellbeing should be there, and shouldn’t be taboo or hidden away, and this can have a huge forward impact on how we think and talk about sex, helping us to break away from its links to shame.”
Pleasure isn’t the only benefit: doctors are increasingly recommending vibrator use as a way of treating and preventing conditions such as vaginal dryness and atrophy. Some of these new generation products could go a step further and enhance scientific research into sexual health and orgasm.
Ergonomically designed, the Lioness vibrator is a modern iteration of the classic “rabbit” toy. What really sets it apart though, is the incorporation of sensors to measure pelvic floor movements, such as the rhythmic contractions that accompany orgasm. Paired with an app, this allows users – and (with users’ consent) sex researchers – to better understand how sexual function is affected by factors such as caffeine, alcohol, childbirth, menopause, or medical conditions such as concussion.
“I always tell people that knowledge is pleasure,” says Anna Lee, co-founder and head of engineering at Lioness. “It’s an empowering tool to be curious about your body, and to learn about things that might be changing our pleasure or sexual wellness.”
But the plugging of sexual wellness could also have some pitfalls. Lee worries about the potential for misinformation in the marketing of certain products, and their promotion by social media influencers. For instance, in 2018, Goop was forced to pay $145,000 in civil penalties for making the unsubstantiated claim that jade love eggs were used by women in ancient China to increase sexual energy and pleasure.
“Jade is a porous material that you should never insert [into] your body, and there’s no evidence to indicate that this technique was ever used in ancient China,” Lee says. “We have to be so mindful of how we create this information that so many people are desperately seeking – because they will grab on to anything, it is such a hard topic to talk about.”
Also, whereas novelty and exploration can be a turn-on for some people, for others, it can have the opposite effect. “Some people are much more comfortable with what’s familiar,” says Emily Nagoski, a sex educator and the author of Come As You Are.
Another risk is that the focus on sexual wellness mounts pressure on people to do things they don’t want to do. “Everywhere you look, whether it’s on social media, telly, movies, the emphasis seems to be on the importance of sex – everyone’s having great sex, and if you’re not having great sex there’s a problem,” says Ammanda Major, head of clinical practice at Relate and a trained relationship counsellor and sex therapist.
“Sex toys historically, and some of the new apps, are kind of promoting the idea that you should be having amazing sex. You should be having an orgasm. But having worked with clients for 25-30 years, what they are often asking for is they just need [the sex] to be good enough.”
What these clients are really seeking, Major explains, is intimacy: the emotional closeness and trust that ideally accompanies sex. “A lot of these apps and products focus on the physical stuff, as opposed to what sexual intimacy means for individuals. I think we sometimes put a lot of pressure on people to be sexual, when actually sex isn’t that important to them.”
In other cases, couples genuinely want to have more sex, but struggle to find the time and motivation to achieve this. Here, technology could help. In early 2022, Mark (not his real name) and his partner began using an app called Intimacy to track their sex life – logging both the number of encounters and their orgasm count. “We had reservations, but set ourselves a target of having sex 104 times in the year – or twice a week,” Mark says. “Rather than putting pressure on ourselves, and recognising it won’t be for everyone, we revelled in the experience – we are obviously both target-oriented.
“We rapidly found ourselves ahead of our target, and reset it to 2.5 times a week, or 130 times in the year – and we ended on 134. We had a good sex life before, but this gave us the motivation to be more intimate.”
Cannabis has the potential to boost a person’s sex life, small studies suggest.
Weed may lower anxiety and sexual shame and make for more satisfying orgasms.
Still, using weed could also lead to a partner being more critical in their relationships.
Weed is everywhere.
According to the CDC, an estimated 48.2 million people, about 18% of Americans, used weed at least once in 2019, the most recent year the government agency collected data on the matter.
Cannabis use could potentially impact your sex life and relationship too, whether you’re a regular user or just enjoy indulging in a vape or edible before a date or intimate experience.
Some findings suggest weed can lead to more mind-blowing orgasms and increased feelings of intimacy during sex, while others suggest the substance could kill an erection or make someone more likely to act irritable in their relationships. Still, cannabis isn’t widely studied yet, so research is often inconclusive.
For the study, published May 2020 in the journal Culture, Health & Sexuality, researchers interviewed men who were 15 to 30 years old about their experiences using cannabis before or during sexual encounters. Three of the men were transgender, 36 were cisgender, and the remainder didn’t identify with a particular gender.
Through interviews, researchers found that participants often reported that cannabis use lowered feelings of anxiety and shame during sex, particularly anal sex.
“I’m actually enjoying this for like the first time, solidly, like a nine out of ten [after taking the edible]! And then the next time I had sex without an edible, I was enjoying it as an eight out of ten. I’m like, ‘Huh?!’ So it changed something in me,” one the study participants said.
Stronger orgasms and better sex overall
Researchers in Spain found that using cannabis before sex could potentially lead to more satisfying orgasms compared to drinking alcohol before sex.
For the study, published in January 2022, researchers at the University of Almeria enlisted 89 male and 185 female volunteers who either used cannabis, alcohol, or neither in their personal lives.
Both male and female participants who used cannabis regularly were more likely to report better sexual function than those who didn’t use weed at all. When the researchers broke sexual function out into more specific categories of desire for sex, physical sexual arousal, and orgasms, they found cannabis users reported more arousal and better orgasms, but not more desire, than non-users.
He said that patients regularly ask him about how they can incorporate cannabis into their sex lives. Before treatment with him, they cite issues like difficulty with sex drive and arousal, pain on penetration, anxiety and PTSD, and difficulty achieving orgasm.
If you want to infuse weed into your sex life without losing your erection, it’s best to start with a small dose and see how your body reacts, said Tishler. Consider talking to your doctor about the best course of action before proceeding, he said.
Tishler suggests newbies start with 5 milligrams and choose a strain with between 15% and 20% THC. Any more could heighten your anxiety and ruin the experience, he said.
Less confrontational during fights, which could lead to unresolved conflict
When it comes to weed and relationships, a study published in June 2022 suggests it could make someone more irritable or avoidant during relationship conflicts.
To study this, researchers at Rutgers University interviewed 232 cannabis users and their partners who live together in Massachusetts, where recreational cannabis is legal. They asked them how often they use cannabis and how they felt about their overall commitment and satisfaction in their relationships. They also measured each participant’s resting heart rate and breaths per minute.
They also videotaped the couples while they discussed a relationship conflict for 10 minutes, then watched the videos back. They found that weed users were more likely than non-weed users to avoid disagreements or react to them negatively. When later questioned, cannabis users were also more likely to say they were satisfied with how they resolved the conflict than non-cannabis users.
“This suggests that users may be unaware, or perhaps unbothered by, negative relationship dynamics during and after conflict. This can be harmful to relationships in the long-run to have chronic, unresolved conflicts,” Salvatore told Insider.
But it can be easy to get into a bit of a sex rut – especially if you’re in a long term relationship – and foreplay can become monotonous.
If you feel like you and your partner(s) are just going through the motions, why not try something new?
This four-minute foreplay sex game can reginite some excitement in the early stages of intercourse.
All you have to do is spend four minutes each doing whatever foreplay you want to your partner, within their bounds of consent, of course.
Sex coach Vernita Griffith shared the tip on TikTok, explaining: ‘Set the timer on your phone for four minutes.
‘Then I want you to take turns, for four minutes each, to do whatever you want to your partner – you have to agree to do whatever you want to each other.’
She goes on to say that, hopefully, what you choose to do to your partner will also be pleasurable for them, but the excitement comes from the unknown.
Melissa Stone, sex and relationships expert at Joy Love Dolls, approves of this game.
‘Four minutes of foreplay can be beneficial because it gives both partners time to become aroused and can help to reduce the risk of premature ejaculation,’ she says.
‘Additionally, it can help to build anticipation and excitement and can help partners to connect emotionally and physically.’
This game, which focuses on building the heat, can be followed up with some good old-fashioned foreplay if four minutes isn’t enough to get your wheels turning.
Or, if you’re really into it, you could even set the timer for a little longer.
If you do try this game, be sure to try it with someone you trust, and make sure to let them know your sexual boundaries beforehand.
— Low sex drive in men linked to chemical imbalance
By Sandee LaMotte
While hanging out with his college roommates, Peter (not his real name) realized he felt differently about sex than other heterosexual men.
“I’ve never been somebody who was interested in pornography, but I’d laugh along with their jokes,” said Peter, now 44, who is British. “Of course I never mentioned that … as a man, you’d be kicked out of the herd.”
As he developed “proper, serious relationships” with women, Peter discovered he didn’t have the sexual drive many of his partners did.
“I would make excuses around getting tired or feeling stressed, that kind of thing,” he said. “It wasn’t an issue with attraction to my partner. It just didn’t enter my mind to initiate sex.”
In 2021, Peter saw an ad recruiting male volunteers for a new study on hypoactive sexual desire disorder, or HSDD. Researchers planned to inject the study’s participants with kisspeptin —a naturally occurring sexual hormone — to see if it increased their sex drive. Kisspeptin plays a key role in reproduction; without adequate levels of the hormone children do not go through puberty, for example.
In a long-term, committed relationship with a woman he says has a higher sexual appetite, Peter signed up, intrigued by the thought that a biological imbalance might help explain his behavior.
In the week after the final session, Peter said, something amazing occurred.
“All of a sudden, I wanted to initiate intimacy. I can only presume it was driven not by my mind remembering something, but my body wanting something,” he said. “I did initiate sex more and it improved things with my partner incredibly.”
Experts believe HSDD affects at least 10% of women and up to 8% of men, although those numbers may be low, said Stanley Althof, a professor emeritus of psychology at Case Western Reserve University School of Medicine in Cleveland, Ohio and executive director of the Center for Marital and Sexual Health of South Florida.
“Men are embarrassed to go to the doctor to begin with, and you’re supposed to be a macho guy,” said Althof, who was not involved in the kisspeptin study.
“So it’s difficult for men to say, ‘Hey, I’ve got a problem with my sex drive.’ That’s why the majority of male patients I see with HSDD are sent in by their partners.”
To be diagnosed with the disorder, a person must have no other issues that might cause a change in libido, such as erectile dysfunction or premature ejaculation.
“Losing interest due to performance issues is common, but HSDD is its own thing,” Althof said. “It’s an absence of erotic thoughts and a lack of desire for sex that has to be present for six months. It also cannot be better explained by another disorder or other stressors: It can’t be due to depression. It can’t be due to a bad relationship. It can’t be due to taking an antidepressant.”
One more key point: A man or woman must have clinically significant distress to have HSDD, said clinical psychologist Dr. Sheryl Kingsberg, a professor in reproductive biology and psychiatry at Case Western Reserve University, who was also not involved in the kisspeptin study.
“Some people aren’t bothered by their lack of interest in sex, so we wouldn’t treat them for HSDD,” said Kingsberg, who is also chief of behavioral medicine at MacDonald Women’s Hospital and University Hospitals Cleveland Medical Center.
“The women coming into my office are deeply distressed,” she said. “They tell me ‘I used to have desire but it’s gone. I could be on a desert island with no pressures, but I just don’t have the appetite. I want it back.’ Those women have HSDD.”
Dr. Waljit Dhillo, a professor in endocrinology and metabolism at Imperial College London, has been studying the relationship between low sexual desire and the hormone kisspeptin for years, first in animals, then in people.
Prior studies by Dhillo of healthy men with no libido problems found giving them kisspeptin boosted levels of testosterone and luteinizing hormone, which is important for gonad function.
His newest study, published in the journal JAMA Network Open in February, enrolled 32 men with verified HSDD. Peter was one of them.
“So many people say to themselves, ‘It’s just me. I’ve got a problem.’ But actually, HSDD may be how your brain is wired,” said Dhillo, who is a dean at the United Kingdom’s National Institute for Health and Care Research Academy in Newcastle upon Tyne.
“The biology is telling us there’s increased activation of inhibitory areas in the brain — the same areas that tell us it’s not OK to walk around in public naked — and those areas are switching off sexual desire. How can we tackle that? We give a hormone that would naturally give you increased sexual desire, essentially hijacking the normal system.”
The men participating in the new study visited Dhillo’s lab twice. On each occasion, they were fitted with a device to objectively measure arousal, given an injection and asked to watch pornography while their brains were scanned via functional magnetic resonance imaging (fMRI).
Neither the subjects or the researchers knew if that day’s injection was kisspeptin or a placebo.
“It was extraordinarily surreal, lying there with something resembling a hangman’s noose around your bits and watching a mixture of ’70s to modern-day pornographic images and videos,” Peter said. “You’d get about five or six seconds of one type of image or video, rate your arousal for the researchers, and then move on to the next.”
Brain scans showed a significant dual effect after the kisspeptin injection, Dhillo said. Activity in the areas of the brain that inhibit behavior slowed, while areas of the brain connected to sexual interest lit up.
“As a group, the men had a 56% higher sexual response to sexual images after the kisspeptin than the placebo,” Dhillo said. “And we found no side effects at the very, very small dose that we are using.”
Peter noticed a difference immediately after finishing the treatments. His sex life was so robust, in fact, that it wasn’t long before his partner was pregnant with their first child.
As published, the study did not follow the men long-term to see if the effects of kisspeptin lasted. For Peter, however, its impact has been life-changing.
“I have found there’s been a lasting effect for me,” he said. “I do find I have a much better sexual appetite even now some years after the treatment.”
Even the arrival of a baby boy didn’t deter his new interest in sex.
“The cliche is when you have kids, your sex life takes a bit of a hit,” he told CNN. “But that hasn’t been the case for us. In fact, we’re pregnant with our second child, due in July.”
While Peter had a positive long-term result, it’s too soon to say kisspeptin injections were the reason, Althof said.
“When you hear dramatic results like Peter’s, I would be cautious in saying that is the typical outcome. While it’s wonderful that it happened for him, these fMRI studies are difficult to interpret and not conclusive,” he said.
“Sexual desire is very complicated — I say it’s a combination of brain function, hormones and love, wine and roses,” Althof added. “This study is promising, but it needs replication in larger groups.”
And even if future research does confirm kisspeptin’s benefits, medical treatment is not a substitution for healthy communication about sex between partners and with health care providers, Dhillo said.
“These are society’s taboos, but actually, the more we talk about real (sexual) issues that affect real people, the more we find it’s actually quite common,” he said.”If you’re not troubled by low libido, it’s not an issue at all, but if you are troubled by it, this can lead to marital breakdown, unhappiness and reduced quality of life.”
As a renowned sexologist, Chantelle Otten is privy to people’s deepest desires, fears and insecurities. Here, she’s honest about her own.
I’m in bed with Chantelle Otten and she’s taking photos of her feet. It’s not as kinky as it sounds. We’re speaking over Zoom ahead of Otten’s Body+Soul cover shoot the next morning, and she’s sending the manicurist pictures of her nails so they know what to expect.
“This is very embarrassing, my nails are really, really bleak,” she says, with endearing honesty and an easy laugh.
There’s something about Otten’s voice. It’s soothing. And welcoming. Like the cosy blanket wrapped around her dachshund Sauce, who’s snuggled beside her in bed.
Chatting from her sunlit bedroom in Melbourne, Otten speaks with a warmness. She has a way of putting you at ease, making you feel comfortable and giving you the space to speak your truth. When Otten opens her mouth, you can’t help but bare your soul in return. It’s a gift – and sometimes a burden – and it’s something she was born with.
“For my entire life, I’ve always had people confide in me. I’m the person at the party sitting in the corner listening to someone’s life story,” explains Otten, who grew up in a “quirky” family in the Melbourne suburb of Murrumbeena with two younger brothers and an older sister with an intellectual disability.
“As a kid, I was always listening in on what was happening in my parents’, siblings’, grandparents’ and friends’ lives. That gave me an awareness and understanding of different personalities, and the complex nature of individuals.”
From then, Otten, now 32, has turned her skill into a successful career as a psycho-sexologist. What exactly does that involve, you may wonder? A sexologist is someone who studies the science of sex, human behaviour and sexual health and wellbeing. Their job is to help clients with their sexual concerns, and to empower them with the knowledge and the confidence they need to lead a healthy sex life.
At Otten’s sex therapy clinic in Melbourne, nothing is off limits. It’s a safe space to talk about intimate things: sexual identity, self-esteem, performance anxiety, trauma, pleasure and pain.
“I feel grateful that people trust me enough to be vulnerable with me.”
“My clinic is a place where people can be themselves; you can swear, cry, laugh and talk about things that upset you. Or not. Whatever you want,” she says. “My clients tell me that I make them feel at ease. Apparently, I’ve got a therapeutic voice.”
Soon, you’ll be able to listen to Otten’s voice in the Audible podcast Sex Therapy: Sessions with Chantelle Otten. The series promises to “take you under the covers and into the world of sex therapy”, and that’s quite literally what it does. Each episode features an anonymous recorded therapy session with real people dealing with real issues.
There’s the married couple looking for advice on opening up their relationship; the new mum trying to regain her sexual identity; the man experiencing erectile dysfunction; and the woman who has never reached orgasm. Their stories are fascinating – heartbreaking at times, oh-so relatable at others – and truly enlightening.
“We wanted for it to feel like being a fly on the wall,” says Otten. “We’re all going to have difficulties with sex at some point in our lives – all of us – so I hope this podcast can help to normalise talking about sex. I hope the episodes resonate with people, and that they take shame out of the conversation and help to alleviate any apprehension they might have around sex therapy.”
The podcast is the latest move in Otten’s mission to increase pleasure and remove shame from the bedroom. After studying psychology and undertaking a masters in sexual health, Otten worked under Dr Ingrid Pinas in a women’s sexual health clinic in the Netherlands.
Upon returning to Melbourne from Amsterdam, she founded the Australian Institute of Sexology and Sexual Medicine in 2016, followed by her namesake clinic in 2018. In the five years since her clinic has opened, Otten has grown from being a one-woman show (and disguising her voice on the phone to pretend she had a receptionist) to having a dedicated team of 20.
“I tend to only take on patients with very specialised cases, so I am dealing with a lot of complex trauma,” she says. “That’s very rewarding for me. I don’t charge my patients; I make money from my sponsorship work. So, my client work is pro bono, which is my way of giving back.”
With Otten – and many other sex educators – leading the way, times are a-changin’. As her business has grown, Otten has seen vibrators go from being ‘dirty little secrets’ to being stocked in major department stores and promoted by influencers all over Instagram. She’s watched the sexual wellness industry grow by $16.8 billion from 2017 to now. And she’s been a part of important discussions about consent and reproductive health, with her 2021 book The Sex Ed You Never Had. But as far as we’ve come, there’s still a way to go.
In the last five years, we’ve witnessed Roe v Wade overturned in America, threatening the future of reproductive rights in the country. We’ve heard shameful stories of sexual harassment and assault within Australian politics. And we’ve learned that Instagram has been censoring sex education accounts – Otten’s included.
“Oh, I think I’ve been shadowbanned on Instagram for five years. It’s problematic that so many people are being silenced, because sex education should be accessible to everyone,” she says. “The main thing I want people to know is that sex should be fun, pleasurable and free of pain and shame. I think we need to make sex sexy again!”
That’s where Sex Therapy: Sessions with Chantelle Otten comes in. Apart from the all-important destigmatising and empowering stories, perhaps the best part of the podcast is getting to listen to Otten’s silky voice in situ.
Today Otten’s voice is raspier than usual. She’s been battling a sinus infection, she tells me, and is trying to recover from the physical fatigue of taking on people’s trauma.
“The challenges that come with this line of work are heavy. When you hear someone’s trauma, it does affect you,” she says. “I am constantly doing work on myself to make sure that I’m there for my patients.”
As well as the emotional toll there are other – more, er, unique – challenges that come with being a sexologist. Namely, people confusing sexology with sex work. Remember when Otten was starting out in her business and put on a fake voice to make out she had a receptionist? Yeah, that didn’t end well.
“I had a guy call wanting to book in a session with his wife for relationship therapy. He was talking and asking questions, and I was answering as the ‘receptionist’. Then he asked me if he could watch. ‘What?’ I asked. ‘Can I watch you and my wife having sex together,’ he said. ‘Oh, no, no, this isn’t the place for that,’ I explained. ‘Just keep talking,’ he said, and I realised that he was masturbating over the phone listening to my receptionist voice,” recalls Otten, with amusement rather than horror. “That’s when I realised I really needed to get an actual receptionist.”
Otten is quick to find the humour in her work. What’s the saying? If you don’t laugh, you’ll cry. That’s the approach Otten takes with life and work. Once again, this is a trait she’s had since childhood.
After Otten’s older sister left their primary school to attend a school that provided support for her disability, she had to find her own voice. “When my sister went to a different school, I felt left behind. I had no friends, so I had to learn how to make friends. I learned how to make people laugh, and became an extroverted introvert,” she says.
Learning how to make friends has paid off. Today, it’s Otten’s friends who keep her grounded. They’re the ones she turns to when she’s struggling with the pressures of her profession and running a 20-person business.
“My best friends are all amazing, deep thinkers. When I’m with them, I’m not the therapist, I’m their friend. I feel very lucky for the community I have around me,” she admits. That community includes Otten’s partner of four years, Dylan Alcott.
As the meet-cute story goes, Otten first laid eyes on Alcott, the champion tennis player and 2022 Australian of the Year, at the launch of his book at the North Fitzroy Library in 2019. It was love at first sight. “I still remember that moment so clearly. I remember looking at him and thinking, ‘That’s my person.’ I didn’t know anything about Dylan – or that he was famous – I just knew that he’d written a book because I was at his book signing. I realised this guy wants a big life, and I was excited to live a big, wonderful life together,” she says.
The feeling was mutual. When Otten had to slip away from the book launch without speaking to Alcott, he found her on Instagram after she posted about the event, and slid into her DMs: “Where the hell did you go?” They’ve been together ever since.
“Dylan has taught me so much about life, about having a purpose and being in a long-term relationship. When you love someone so much, you need to look at yourself and your flaws and consider what you’re bringing to the table. Dylan’s a lot of fun, and sometimes I can be a bit serious, so we’ve taught each other about balance,” says Otten. “There’s no one else out there who makes me feel so excited and passionate about life.”
Alcott, also 32, shares his partner’s passion for breaking down taboos, especially when it comes to changing the misconceptions around disabled people having – and desiring – sex. “A lot of people think that people with a disability don’t have sex, but I’m having the best sex of my life and it’s important for me to say that,” Otten told Stellar magazine in 2020.
Clearly, sex is a big part of her life. But does she ever get tired of talking about it? “Of course I get sick of talking about sex,” admits Otten. “There are times when I’ve been inundated with work and under a lot of pressure, and I’ve hated my job. I’ve had to put a lot of boundaries up.”
When people recognise Otten and come up to her on the street to tell her that they love her work, she feels grateful: “That’s beautiful.” But when people approach her and ask intimate questions or unload their personal issues, Otten takes a step back. She thanks them for wanting to open up to her and suggests they book a session through her clinic.
“There’s a time and place; I can’t give good advice when I don’t know all the details of their situation or medical and sexual history. It’s very complex,” she says. “I was once recognised by a girl on the dance floor at a club in Amsterdam at 3am, and I ran off into the darkness.”
Otten can be blunt. “I’m Dutch,” she explains. “I can be direct, but that’s how I speak, and sometimes I have to be that way. I don’t mind if people don’t like me because I hold boundaries with them. That’s more on them than it is on me.” When Otten speaks about boundaries, her voice is steady and unwavering.
There’s a knowing beneath her words. It’s the voice of someone who’s heard, seen and done some sh*t – and lived to tell the tale. The thing that keeps Otten going through it all is her innate curiosity.
“The best piece of advice I was ever given was to remain curious. My mum gave it to me and I’ve held onto it. People are so complex and I’m forever curious about them,” she says. “They have such amazing private lives – you have no idea about – and they come to share it with me. How lucky am I that I get to hear people’s secrets, and hold those secrets? It’s unbelievable.”
How to have better sex
Four surprisingly simple Chantelle Otten-approved ways to improve your intimacy.
Keep learning
“I want people to remain open to learning more about their sex lives and their partner. We often make the mistake of assuming we know everything about our partner, but there’s so much that goes on behind our outer shells. That mystery is a beautiful thing.”
Get playful
“Toys can add spice to your sexual experience, making it more pleasurable and adding variety for both you and your partner. I like to think of toys like salt and pepper – they might not be needed, but they make everything better.”
Book it in
“OK, this one might seem a little bit naff, but scheduling sex once a week has been shown to increase sexual satisfaction. Even if it’s the same sexual menu every time, it still improves satisfaction. Our sex lives are something we need to work at.”
Talk it out
“When you’re stuck in a sexual rut – and we all get stuck sometimes – don’t be shy to talk about it with someone who can help. That’s what sexologists are here for, to provide a different perspective and give advice on getting more pleasure.”
— Anna Richards is the founder of ethical porn platform FrolicMe, which portrays sex in a positive, female-focused light. Believing we’re all capable of having great sex, she says the secret is losing your inhibitions and getting comfortable with what turns you on. From the importance of switching up your stimuli to why dropping expectations in the bedroom can be liberating, here are her tips…
By Tor West
Enjoy It
“Sex is supposed to be fun, and feel good, but in a long-term relationship it can be easy to forget who we are having sex for. This means we don’t stop to look at what sort of sex we enjoy. Remember, we aren’t having sex for anyone else. Too often, we are overly focused on the man’s experience, convinced we need to affirm to him that we are ‘good in bed’ by bringing him to orgasm. However, for sex to be great, we need to have sex for ourselves. Plus, there’s no more of a turn-on for a man than being in the presence of a woman losing herself to her own pleasure.”
Keep The Brain Stimulated
“The brain is our biggest sexual organ, and it needs stimulating to have great sex. In a long-term relationship, it can be easy to slip into maintenance sex to get the job done, but to keep it fresh, you need to change the dynamic. Taking sex out of the bedroom is a good start or try having sex at a different time of the day, like before dinner, so you can relish in the afterglow together earlier in the evening. It’s okay to need to work at reviving your libido as it can be a struggle to put yourself in the mood. Turning to sex-positive ethical erotica sites like FrolicMe or engaging in erotic stories is a great way to stimulate your desire by liberating your erotic imagination.”
Create Your Own Pleasure
“Just because you’re single doesn’t mean you can’t revel in the sexual highs and pleasures of sex. Being single is a great time to explore your own body and learn what it is you enjoy and desire. By exploring your own body through solo masturbation, you will learn so much more about what turns you on for when you are in a partnered relationship. We don’t always know what we like until we give it a try. Get involved with a clitoral stimulator – the choice has never been better, and they can help you reach orgasm. Watch masturbation erotica and learn new techniques – you can even film yourself talking to your phone as you enjoy some solo time. Explain how you feel and what’s turning you on as your body responds to your touch. If you’re in a relationship, you can even send it to your partner – it can feel mind-blowing to know you are thinking of them as you pleasure yourself, as well as being watched.”
If you’re confident in bed KNOWING WHAT YOU WANT, that’s a HUGE TURN-ON for your partner.
Talk About It
“Sex is about pleasure and connection with yourself and your partner. It’s important to communicate and be open with your partner about what you enjoy and what you want. Help each other achieve this desired satisfaction – if it’s reaching an orgasm, talk about what would help and how you can achieve it together. Perhaps you need to incorporate some toys and accessories into your play to help with more sexual stimulus. Take time to explore what you enjoy and let your lover know. If you’re confident in bed knowing what you want, that’s a huge turn-on for your partner.”
Experiment With Joint Masturbation
“It’s a very sexy way to quickly understand and learn how and where your partner stimulates themselves, and what it is they enjoy to reach climax. You can then apply these techniques during partner play in the knowledge of how much it turns them on. Plus, it increases the excitement to know you’re being watched. It can feel great to let your partner hold a toy on you as you masturbate. You can tell and guide them to what you like and where you like it.”
Listen To Audio Porn
“Explore stimulating and arousing your mind by tapping into audio porn, which will fuel your mind with erotic thoughts – you’ll be surprised at how quickly you will feel aroused. Audio porn allows the listener to feel part of a shared fantasy, setting the scene as you may wish to imagine it, creating your personal erotic porn of choice to stimulate pleasure.”
Get Spooning
“Spooning is a classic and simple sex position that’s great for when you’re feeling lazy but crave intimacy. The partner behind you can penetrate you deeply while reaching around and holding you in their arms or touching your genitals and nipples. It’s a great position for new parents who may barely have the energy to move at the end of the day but still want to feel intimate. To level up, try going side by side, which is like spooning. Both lie on your sides but facing each other – the partner being penetrated will wrap their legs above the other partner’s legs to create room for them both and allow deeper penetration. This can feel intimate as you can look into each other’s eyes.”
Penetrative sex SHOULDN’T ALWAYS BE THE FOCUS – sex is about pleasure, which can take many forms.
Go Slow
“If you struggle to have an orgasm during sex, you’re not alone. Don’t forget that less than 25% of women are capable of achieving orgasm through penetration alone and, as clitoris owners, we rely on additional sensations to help us achieve climax. Take the foot off the expectation pedal when it comes to climax, too, as the expectation of an orgasm can put pressure on and hinder your chances. Don’t forget that your partner could be the one to blame – not you. Perhaps they aren’t stimulating you in the right way. Remember you are responsible for your own orgasm, so communication on what you enjoy is important. Take it slow, play and arouse your body, and know that orgasms aren’t based on the clock. Taking your time doesn’t mean you’ve missed your chance. Being more mindful of the moment and letting your mind loose can be a great turn-on.”
Be Intimate
“Don’t think sex is all about penetration. Penetrative sex shouldn’t always be the focus – sex is all about pleasure, which can take many forms. Be creative and look at how you can be intimate with each other. Sex accessories can turn up the dynamic when it comes to sexy fun – blindfolds are good for kinky play while a bullet vibrator can help you achieve incredible orgasms. We still have expectations of sex where penetration is seen as the end of the game with a male ejaculating, and this needs to change. Bodies, pleasure and sexuality need to be equally discussed and normalised.”
Give Erotica A Chance
“Porn gives us the opportunity to expand our ideas, experiment and fantasise, and can inspire us to new forms of play. The problem is, mainstream porn is made for men. Woman-made and woman-centred ethical sites like FrolicMe can be a good place to start, allowing you to feel comfortable and safe. However, make sure you are not rushing into watching porn together until you are able to communicate your sexual needs. Certainly, you can’t get to watching threesomes and consensual BDSM if you are struggling to convey what turns you on. Be clear why you are wanting to share watching some porn with your partner and how you feel it might help with your own adventures. This will also help guide you to what sort of erotic films you should be viewing. Don’t try to be too ambitious in your viewing and build up your preferences through experience. Chat about what turns you on and what you would like to see but also what you wouldn’t.”
Don’t Overthink It
“Sometimes we feel sex is a much bigger issue than it really is. Sex is a part of our life, not our whole life. Rather than thinking of sex, think of it as pleasure and explore what you enjoy and what gets you off. This will help to remove the noise around sex and enable you to focus on yourself, exploring your body and revelling in the euphoria it can offer you. You don’t need someone else to help you evolve sexually – you can work on your own sexual evolution, so that when you have a partner, you can teach them exactly how to please you.”
Attention to sexual health in people with epilepsy is often lacking.Sexual dysfunction, however, is a side effect of epilepsy and the medications that treat it.
Although not fully understood, epilepsy can also cause endocrine disorders that negatively impact the reproductive system, leading to infertility. People with epilepsy need to talk to their healthcare providers about ways to prevent sexual problems when diagnosed with the condition.
This article addresses the cause of sexual problems in people with epilepsy and how to treat them.
What Is the Connection Between Sexual Problems and Epilepsy?
Sexual problems like decreased libido or inability to orgasm are more likely to occur in people with epilepsy compared to those who don’t have the disease. Because the brain is responsible for both epilepsy and sexual behavior, there is a connection between the two, which includes:
Brain excitability: Sexual dysfunction in people with epilepsy sometimes depends on the part of the brain from which the seizure originates. People with right-sided temporal lobe epilepsy have the highest rates of sexual dysfunction. People with partial epilepsy suffer from sexual dysfunction more than those with idiopathic generalized epilepsy.
Sex hormones: Abnormal secretion of sex hormones is common in people with epilepsy. Low testosterone and estradiol levels are associated with epilepsy and sexual dysfunction.
Endocrine disorders: People with epilepsy have fluctuating hormone levels that are either complicated by endocrine disorders or cause them. The hormonal instability and endocrine diseases further worsen sexual problems in men and women, including the ability to conceive.
Psychological effects: People with epilepsy often complain of poor self-esteem and stigma around their illness. A limited ability to work, drive, or attend school can lead to depression and anxiety. The added fear of having a seizure during sex can also inhibit the desire for intimacy.
Do Drugs That Treat Epilepsy Cause Sexual Problems?
Not only do seizures, hormones, and psychological issues diminish sexual function, but the medications that treat epilepsy also impact sexual health. Some anti-epileptic drugs (AEDs) cause elevated liver enzymes that lead to suppressed sex hormones. Other AEDs have a depressive effect on the brain that can leave people feeling sedated and uninterested in sex.
AEDs known for increasing liver enzymes and decreasing sex hormones include:
Speak to your healthcare provider about how anti-epileptic drugs could affect your sexual health.
How Are Sexual Problems Due to Antiepileptic Drugs Treated?
Some AEDs effectively treat seizures and have minimal sexual side effects. Changing medications may be an option depending on the type and severity of the seizure disorder. AEDs that have a decreased implication for sexual dysfunction are:
Reducing the dose of the AED, building up a tolerance to the medication, and taking the drug after sex may improve sexual ability. It may take various approaches to find the best solution for improved sexual health, but keeping an open dialogue with your healthcare provider is essential.
Symptoms and Gender Differences
Sexual problems in people with epilepsy can affect up to 60% of men and 50% of women. Although men and women with epilepsy may experience decreased libido, other sexual problems manifest differently in each gender.
Men
In addition to decreased testosterone levels and the side effects of AEDs, performance anxiety can cause the following sexual problems in men with epilepsy:
Endocrine disorders, low levels of female hormones, menstrual irregularities, and psychiatric conditions have been linked to sexual and reproductive dysfunctions in women with epilepsy.
Epileptic women often experience the following sexual problems:
Treating sexual problems associated with epilepsy begins by telling your healthcare provider. Various methods can help improve sexual dysfunction in people with epilepsy. Some options that may help include:
Medications: Drugs are available to help increase sexual desire and treat conditions like premature ejaculation.
Improving mental health: Treating underlying depression and anxiety can help with intimacy.
Lubrication: Vaginal pain and dryness during sex can be relieved with water-based lubrication.
Erection management: Prevent or reduce penile flaccidity by placing an elastic band at the base of the penis, using vacuum devices, or using an intracavernosal injection of vasodilators.
Brain surgery: Research found anterior temporal lobectomy resulted in being seizure-free in 60% of patients. Those patients also reported significant improvement in sexual function.
Summary
People with epilepsy often experience sexual problems. Hormonal abnormalities, endocrine disorders, fear, and side effects of treatment may lead to sexual dysfunctions. Depression, loneliness, and anxiety can occur if sexual health is not seriously addressed. There are various methods available for improving sexual impairments in people with epilepsy. Talk to your healthcare provider about ways to prevent sexual problems if you have been diagnosed with epilepsy.
A Word From Verywell
Sexual health plays a valuable role in the quality of life; many people feel unsatisfied and disconnected when it’s poor. If you’ve been diagnosed with epilepsy and are struggling with libido, the ability to orgasm, infertility, or depression, you are not alone. Speaking to your healthcare provider about these symptoms so they can help you feel better is essential.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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