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How do women really know if they are having an orgasm?

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Dr Nicole Prause is challenging bias against sexual research to unravel apparent discrepancies between physical signs and what women said they experienced

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It’s not always clear if a woman is really having an orgasm, as Meg Ryan demonstrated in When Harry Met Sally.

It’s not always clear if a woman is really having an orgasm, as Meg Ryan demonstrated in When Harry Met Sally.

In the nascent field of orgasm research, much of the data relies on subjects self-reporting, and in men, there’s some pretty clear physiological feedback in the form of ejaculation.

But how do women know for sure if they are climaxing? What if the sensation they have associated with climax is actually one of the the early foothills of arousal? And how does a woman know when if she has had an orgasm?

Neuroscientist Dr Nicole Prause set out to answer these questions by studying orgasms in her private laboratory. Through better understanding of what happens in the body and the brain during arousal and orgasm, she hopes to develop devices that can increase sex drive without the need for drugs.

Understanding orgasm begins with a butt plug. Prause uses the pressure-sensitive anal gauge to detect the contractions typically associated with orgasm in both men and women. Combined with EEG, which measures brain activity, this allows for a more accurate picture of a woman’s arousal and orgasm.

Dr Nicole Prause has founded Liberos to study brain stimulation and desire.

Dr Nicole Prause has founded Liberos to study brain stimulation and desire.

When Prause began studying women in this way she noticed something surprising. “Many of the women who reported having an orgasm were not having any of the physical signs – the contractions – of an orgasm.”

It’s not clear why that is, but it is clear that we don’t know an awful lot about orgasms and sexuality. “We don’t think they are faking,” she said. “My sense is that some women don’t know what an orgasm is. There are lots of pleasure peaks that happen during intercourse. If you haven’t had contractions you may not know there’s something different.”

Prause, an ultramarathon runner and keen motorcyclist in her free time, started her career at the Kinsey Institute in Indiana, where she was awarded a doctorate in 2007. Studying the sexual effects of a menopause drug, she first became aware of the prejudice against the scientific study of sexuality in the US.

When her high-profile research examining porn “addiction” found the condition didn’t fit the same neurological patterns as nicotine, cocaine or gambling, it was an unpopular conclusion among people who believe they do have a porn addiction.

The evolution of design of the anal pressure gauge used in Nicole Prause’s lab to detect orgasmic contractions.

The evolution of design of the anal pressure gauge used in Nicole Prause’s lab to detect orgasmic contractions.

“People started posting stories online that I had falsified my data and I received all kinds of sexist attacks,” she said. Soon anonymous emails of complaint were turning up at the office of the president of UCLA, where she worked from 2012 to 2014, demanding that Prause be fired.

Does orgasm benefit mental health?

Prause pushed on with her research, but repeatedly came up against challenges when seeking approval for studies involving orgasms. “I tried to do a study of orgasms while at UCLA to pilot a depression intervention. UCLA rejected it after a seven-month review,” she said. The ethics board told her that to proceed, she would need to remove the orgasm component – rendering the study pointless.

Undeterred, Prause left to set up her sexual biotech company Liberos, in Hollywood, Los Angeles, in 2015. The company has been working on a number of studies, including one exploring the benefits and effectiveness of “orgasmic meditation”, working with specialist company OneTaste.

Part of the “slow sex” movement, the practice involves a woman having her clitoris stimulated by a partner – often a stranger – for 15 minutes. “This orgasm state is different,” claims OneTaste’s website. “It is goalless, intuitive, and dynamic. It flows all over the place with no set direction. It may include climax, or it may not. In Orgasm 2.0, we learn to listen to what our body wants instead of what we think we ‘should’ want.”

Prause wants to determine whether arousal has any wider benefits for mental health. “The folks that practice this claim it helps with stress and improves your ability to deal with emotional situations even though as a scientist it seems pretty explicitly sexual to me,” she said.

Prause is examining orgasmic meditators in the laboratory, measuring finger movements of the partner, as well as brainwave activity, galvanic skin response and vaginal contractions of the recipient. Before and after measuring bodily changes, researchers run through questions to determine physical and mental states. Prause wants to determine whether achieving a level of arousal requires effort or a release in control. She then wants to observe how Orgasmic Meditation affects performance in cognitive tasks, how it changes reactivity to emotional images and how it compares with regular meditation.

Brain stimulation is ‘theoretically possible’

Another research project is focused on brain stimulation, which Prause believes could provide an alternative to drugs such as Addyi, the “female Viagra”. The drug had to be taken every day, couldn’t be mixed with alcohol and its side-effects can include sudden drops in blood pressure, fainting and sleepiness. “Many women would rather have a glass of wine than take a drug that’s not very effective every day,” said Prause.

The field of brain stimulation is in its infancy, though preliminary studies have shown that transcranial direct current stimulation (tDCS), which uses direct electrical currents to stimulate specific parts of the brain, can help with depression, anxiety and chronic pain but can also cause burns on the skin. Transcranial magnetic stimulation, which uses a magnet to activate the brain, has been used to treat depression, psychosis and anxiety, but can also cause seizures, mania and hearing loss.

Prause is studying whether these technologies can treat sexual desire problems. In one study, men and women receive two types of magnetic stimulation to the reward center of their brains. After each session, participants are asked to complete tasks to see how their responsiveness to monetary and sexual rewards (porn) has changed.

With DCS, Prause wants to stimulate people’s brains using direct currents and then fire up tiny cellphone vibrators that have been glued to the participants’ genitals. This provides sexual stimulation in a way that eliminates the subjectivity of preferences people have for pornography.

“We already have a basic functioning model,” said Prause. “The barrier is getting a device that a human can reliably apply themselves without harming their own skin.”


 
There is plenty of skepticism around the science of brain stimulation, a technology which has already spawned several devices including the headset Thync, which promises users an energy boost, and Foc.us, which claims to help with endurance.

Neurologist Steven Novella from the Yale School of Medicine uses brain stimulation devices in clinical trials to treat migraines, but he says there’s not enough clinical evidence to support these emerging consumer devices. “There’s potential for physical harm if you don’t know what you’re doing,” he said. “From a theoretical point of view these things are possible, but in terms of clinical claims they are way ahead of the curve here. It’s simultaneously really exciting science but also premature pseudoscience.”

Biomedical engineer Marom Bikson, who uses tDCS to treat depression at the City College of New York, agrees. “There’s a lot of snake oil.”

Sexual problems can be emotional and societal

Prause, also a licensed psychologist, is keen to avoid overselling brain stimulation. “The risk is that it will seem like an easy, quick fix,” she said. For some, it will be, but for others it will be a way to test whether brain stimulation can work – which Prause sees as a more balanced approach than using medication. “To me, it is much better to help provide it for people likely to benefit from it than to try to create fake problems to sell it to everyone.”

Sexual problems can be triggered by societal pressures that no device can fix. “There’s discomfort and anxiety and awkwardness and shame and lack of knowledge,” said psychologist Leonore Tiefer, who specializes in sexuality. Brain stimulation is just one of many physical interventions companies are trying to develop to make money, she says. “There’s a million drugs under development. Not just oral drugs but patches and creams and nasal sprays, but it’s not a medical problem,” she said.

Thinking about low sex drive as a medical condition requires defining what’s normal and what’s unhealthy. “Sex does not lend itself to that kind of line drawing. There is just too much variability both culturally and in terms of age, personality and individual differences. What’s normal for me is not normal for you, your mother or your grandmother.”

And Prause says that no device is going to solve a “Bob problem” – when a woman in a heterosexual couple isn’t getting aroused because her partner’s technique isn’t any good. “No pills or brain stimulation are going to fix that,” she said.

Complete Article HERE!

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Vaginismus: solutions to a painful sexual taboo

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Many women use terms such as ‘failure’ or ‘freak’ to describe themselves

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Vaginismus is often a problem from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences

Vaginismus is often a problem from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences

Vaginismus is a very common but rarely discussed problem. Most women I see with this difficulty will not have discussed it with anyone else, not even female members of their own family or girlfriends. The silence that surrounds the issue and the sense of shame experienced sometimes serves to compound the difficulty itself. Many women with whom I have worked will use terms such as “failure” or “freak” to describe themselves, wishing they were “normal” just like every other woman.

Before seeking therapy, they will often have suffered this distress over a long period of time, not feeling able to embark on or enjoy sexual relationships. The thought that they may not be able to conceive through intercourse is frequently a huge anxiety for these women.

What is vaginismus?
Vaginismus occurs when the muscles around the entrance to the vagina involuntarily contract. It is an automatic, reflexive action; the woman is not intending or trying to tighten these muscles, in fact it is the very opposite of what she is hoping for. Often it is a problem right from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences. In most cases, the woman is unable to use tampons or have a smear test.

What are the symptoms?
The main symptom of vaginismus is difficulty achieving penetration during intercourse and the woman will experience varying degrees of pain or discomfort with attempts. Partners often describe it like “hitting a wall”. This is as a result of spasm within the very strong pelvic floor or pubococcygeus muscle group. Spasm or tightening may also occur in the lower back and thighs.

What are the causes?
Vaginismus is the result of the body and mind developing a conditioned response to the anticipation of pain. This is an unconscious action, akin to the reflexive action of blinking when something is about to hit our eye. This aspect of vaginismus is one of the most distressing for women as they really want their bodies to respond to arousal and yet find it impossible to manage penetrative sex. The more anxious they become, the less aroused they will feel and the entire problem becomes a vicious cycle.

Vaginismus can occur as a result of psychological or physical issues. Often it is a combination of both. Psychological issues centre around fear and anxiety; worries about sex, performance, negativity about sex from overly rigid family or school messages.

Inadequate sex education is often a feature in vaginismus, resulting in fears about the penis being able to fit or the risk of being hurt or torn. There can also be anxiety about the relationship, trust and commitment fears or a difficulty with being vulnerable or losing control.

Occasionally a woman may have experienced sexual assault, rape or sexual abuse and the trauma associated with these experiences may lead to huge fears around penetration. There are physical causes too – the discomfort caused by thrush, fissures, urinary tract infections, lichens sclerosis or eczema and the aftermath of a difficult vaginal delivery can all trigger the spasm in the PC muscles. Menopausal women can sometimes experience vaginismus as a result of hormonal-related vaginal dryness.

Treatment
Vaginismus is highly treatable. Because every woman is different, the duration of therapy will vary but, with commitment to the therapy process, improvement can be seen quite rapidly. Therapy is a combination of psychosexual education, slow and measured practice with finger insertion and/or vaginal trainers at home and pelvic floor exercises. Women with partners are encouraged to bring them along to sessions so that the therapist can work with them as a couple towards a successful attempt at intercourse.

Vaginismus can place huge stresses on a couple’s relationship as well as their sexual life; therapy can help the couple talk about and navigate these stresses. This is particularly important for a couple wishing to start a family.

What do I do if I think I have vaginismus?
Make an appointment with the GP. It will be helpful to have an examination to out rule any physical problem and have it treated if necessary. The GP is likely to refer you to a sex therapist, a psychotherapist who has specialised in sex and relationships through further training. They have specific expertise in working with this problem on a regular basis. You can also refer yourself to a sex therapist but, because of the very complex and sensitive nature of sex and sexuality, it is important to ensure that they are qualified and accredited. Sex therapists in Ireland may be found on www.cosrt.org.uk

GEMMA’S STORY
Robert was my first boyfriend. We waited six months to try sex, mostly because I was a virgin and very nervous. My mother had always warned me about not getting pregnant and I think I was too scared to try. When we did try, it didn’t work, it was disastrous. We tried again and again but he could not get in.

Every time we tried, I ended up in tears and over time I started to avoid sex. Robert was really patient but I know that it was very tough for him and I felt guilty. We thought it was a phase and it would improve with time. It didn’t stop us getting engaged because we knew we were right for each other.

Eventually I got the courage up to go to the doctor who diagnosed vaginismus – the relief of having a name to put on it was huge. She referred me to a sex therapist. I was embarrassed even talking about it, but quite honestly it was a relief to finally discuss it all. She explained everything about my problem and started me practising with vaginal trainers. I even got to start using tampons, something I never thought I would be able to do.

Robert also came to the sessions and that was a big help. We were given exercises to do at home together that helped me relax a lot. I made a lot of progress over a couple of months and, finally, last Christmas we got to try intercourse again. Success! Our sexual relationship is completely different now, no more worries and lots more fun.

I feel as if a huge worry has been lifted off my shoulders.

Complete Article HERE!

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Bad sex award 2016: the contenders in quotes

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Games of tennis, muddy fields, knocking knees – it’s time to get intimate with the challengers for the Literary Review’s 2016 Bad sex in fiction prize

 ‘I slide my hands down his back, all along his spine, rutted with bone like mud ridges in a dry field, to the audacious swell below.’

‘I slide my hands down his back, all along his spine, rutted with bone like mud ridges in a dry field, to the audacious swell below.’

A Doubter’s Almanac by Ethan Canin

The act itself was fervent. Like a brisk tennis game or a summer track meet, something performed in daylight between competitors. The cheap mattress bounced. She liked to do it more than once, and he was usually able to comply. Bourbon was his gasoline. Between sessions, he poured it at the counter while she lay panting on the sheets. Sweat burnished her body. The lean neck. The surprisingly full breasts. He would down another glass and return.

The Tobacconist by Robert Seethaler

He closed his eyes and heard himself make a gurgling sound. And as his trousers slipped down his legs all the burdens of his life to date seemed to fall away from him; he tipped back his head and faced up into the darkness beneath the ceiling, and for one blessed moment he felt as if he could understand the things of this world in all their immeasurable beauty. How strange they are, he thought, life and all of these things. Then he felt Anezka slide down before him to the floor, felt her hands grab his naked buttocks and draw him to her. “Come, sonny boy!” he heard her whisper, and with a smile he let go.

Men Like Air by Tom Connolly

The walkway to the terminal was all carpet, no oxygen. Dilly bundled Finn into the first restroom on offer, locked the cubicle door and pulled at his leather belt. “You’re beautiful,” she told him, going down on to her haunches and unzipping him. He watched her passport rise gradually out of the back pocket of her jeans in time with the rhythmic bobbing of her buttocks as she sucked him. He arched over her back and took hold of the passport before it landed on the pimpled floor. Despite the immediate circumstances, human nature obliged him to take a look at her passport photo.

The Butcher’s Hook by Janet Ellis

When his hand goes to my breasts, my feet are envious. I slide my hands down his back, all along his spine, rutted with bone like mud ridges in a dry field, to the audacious swell below. His finger is inside me, his thumb circling, and I spill like grain from a bucket. He is panting, still running his race. I laugh at the incongruous size of him, sticking to his stomach and escaping from the springing hair below.

Leave Me by Gayle Forman

Once they were in that room, Jason had slammed the door and devoured her with his mouth, his hands, which were everywhere. As if he were ravenous.

And she remembered standing in front of him, her dress a puddle on the floor, and how she’d started to shake, her knees knocking together, like she was a virgin, like this was the first time. Because had she allowed herself to hope, this was what she would’ve hoped for. And now here it was. And that was terrifying.

Jason had taken her hand and placed it over his bare chest, to his heart, which was pounding wildly, in tandem with hers. She’d thought he was just excited, turned on.

It had not occurred to her that he might be terrified, too.

The Day Before Happiness by Erri De Luca

She pushed on my hips, an order that thrust me in. I entered her. Not only my prick, but the whole of me entered her, into her guts, into her darkness, eyes wide open, seeing nothing. My whole body had gone inside her. I went in with her thrusts and stayed still. While I got used to the quiet and the pulsing of my blood in my ears and nose, she pushed me out a little, then in again. She did it again and again, holding me with force and moving me to the rhythm of the surf. She wiggled her breasts beneath my hands and intensified the pushing. I went in up to my groin and came out almost entirely. My body was her gearstick.

Complete Article HERE!

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How did evolution change our sexual organs? It’s time to learn the history of sex

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Porn images are everywhere but we need better ways to teach children about love, intimacy and yes, masturbation

evolution

At the start of this third millennium, sex seems to be all around us – within easy reach, on our screens, constantly talked about in the media. What used to be concealed, shameful and forbidden only a century ago is today regarded as evidence of progress in the freedom of thought. Artists use sex to push the limits of creativity: Paul McCarthy’s “butt plug” sculpture, for example, was installed at the Place Vendôme in Paris in 2014, even though it provoked outrage among residents.

The sexual metaphor is ever-present. Paradoxically, however, sex is rarely explained and almost never taught. Do you know how our sexual organs changed when we evolved from animal to human? When did the first couple show up? Where does our sense of modesty come from? Or eroticism? Or love, that most momentous of human concerns? What about our earliest customs? Which ancient civilisation championed equality between men and women? And why was masturbation frowned upon?

Sex is one of those realities that for a long time we neither wanted to see nor hear about. The sexual liberation of the 1970s – which was, in my opinion, the biggest social revolution in the history of humanity – signalled the transition from a traditional male-dominated society to one in which sex with all its nuances could finally be examined openly and understood. But as sex has dared to uncover itself, to live, to speak, we face the challenge of expressing what for so long has been kept under wraps. How are we to communicate what so recently caused so much shock and outrage?

In the west, the union of two individuals is in complete flux, with a drop in those getting married (in France 57% of births now happen outside marriage); same-sex marriage; and the option of “slices of life”, relationships with different partners in the course of a lifetime. But however free our customs may be, censorship persists when it comes to the communication of sex, the words, the particular way of defining sexuality and the idea of sensuality. Literature and fiction have always attempted to push the boundaries of this censorship: in the 18th century we had Pierre Choderlos de Laclos’s Dangerous Liaisons; and in the 21st, EL James’s Fifty Shades of Grey. But mostly our discussions fall somewhere between sincerity and provocation as we attempt to understand intimacy and the fullest expression of sexual pleasure.

intimacy

No history book will delve too deeply into the sexual realm, yet it’s clear that history is a timeline of instructions and condemnations about sexuality. Each culture, each religion, each era has defined its own normality.

But without learning the history of love and intimacy, how can we understand the extraordinary evolution in customs that has led us from an existence ordered by family and society, and reinforced by religion, to the freedoms we know today? In his collection of aphorisms, Monogamy, the psychoanalyst Adam Phillips says that “most people would not live as a couple if they had never heard of it”. In this, he is reflecting the artificial nature of our customs and the need for a way to express our thoughts on sex, intimacy and being with other people.

We know today that human sexuality is not innate: it is learned and constructed through the images that society offers us. Even among our cousins, the primates, who live in a natural habitat, sexuality is learned through experience – young monkeys witness the courting and frolicking of the adults. The need for a model is evident: a young chimpanzee isolated from its peers is incapable of mating when it reaches adulthood.

Yet there is a fundamental difference: we invented modesty. Humans always make love away from the group. This is one of the great problems with sexuality: on the one hand it requires education; on the other, culture and religion collude to suppress sexual education.

The physician Thomas Beddoes was probably the first person to teach a course in sex education, complete with public demonstrations on the differences between men and women, in the early 19th century. But in the following two centuries, sex education failed to gain ground. Opposition was widespread and aggressive, on the part of the church as well as among teachers.

Sex education classes were subsequently written into law, but, in reality, rarely delivered. Sex education is today well established in Quebec and the Scandinavian countries, where primary school-age children are educated about gender differences and roles, as well as sexual orientation. In the Netherlands, where a complete programme of sex education is delivered from primary school, the rates of teenage pregnancies and abortions are among the lowest in the world.

But other western countries such as France and the UK provide little more than a perfunctory discourse on contraception and safeguarding against STDs. In France, a 2001 law stipulates three classes of sex education a year in middle and secondary school. However, as teachers have no training in this very particular field, it is often organisations such as those devoted to family planning that ensure these classes go ahead. In most cases, they rarely take place at all, and when they do they are limited to the three Ps: “prevention, pill, protection”, in other words, information on fertility and STDs. In this educational void the internet and porn offer themselves as models.

This is quite evidently the worst possible model, and the reason why a more reliable source of knowledge is indispensable, from primary school through to the last year of secondary. The average age at which children are first exposed to pornography is 11. Such an artificial vision of sex has altered our most intimate behaviour and has become the frame of reference not just for our teenagers but for us all. It makes us ask ourselves: am I sexy enough, am I the best lover?intimacy2

Nothing could be more damaging than these images devoid of explanation. We can’t stop young people from encountering porn, but a formal, educational approach would allow our society to explain its context and prevent misunderstandings that could otherwise compromise a fragile or still developing personality.

A genuine sex education should take the bio-psychological, emotional and social aspects of sexuality into account, should allow children to understand differences between the sexes, interpersonal relationships, the importance of developing critical thinking, an open mind and respect for the other. We must banish negative terms (sin, adultery, prostitution, Aids and STDs) in favour of positive schooling that allows children to understand desire, pleasure and excitement; the importance of sensitivity in love; the importance of masturbation, even. We must understand that everything can be taught, even the practicalities of how people live together, and we should start in primary school with discussions not only of genital differences but about the variations between boys and girls, the significance of love and of respect that may help with later relationships, notions of gender equality and domestic violence.

Only by speaking frankly, lightheartedly and wide-rangingly about sex, love and intimacy can we provide an education that enables adolescents, both boys and girls, to begin their lives with a better understanding of human relationships.

Complete Article HERE!

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Is casual sex bad for your wellbeing?

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Up to 80% of undergraduates have hookups.

Up to 80% of undergraduates have hookups.

Casual sex, hookups or one-night stands: whatever you call it, more than half of us will have sex with someone we barely know or don’t expect to date in the future. We’re most likely to do this at university, where up to 80% of undergraduates have hookups. Sex within relationships is said to improve cardiovascular health, reduce depression and boost immunity, but social science research has often linked casual encounters to feelings of sexual regret, low self-esteem and psychological distress, especially among women. Studies show that while men regret the sexual opportunities they missed, women often regret some of the casual sex they did have.

The solution

A Canadian study of 138 female and 62 male students who had casual sex found that men selected physical reasons for regret – such as their partner being insufficiently attractive. Women’s regrets focused on shame and self-blame. But the evidence as to whether casual sex, when done with protection against sexually transmitted diseases, is actually bad for anyone is unclear. The studies are overwhelmingly on heterosexual American university students and have varying definitions of hookups – from knowing someone for less than 24 hours, to sex in a “friends with benefits” relationship. Some show both men and women feel depressed, used and lonely after hookups; others find casual sex promotes more positive emotions than negative ones. In a study of 832 university students, only 26% of women compared with half of men felt positive after a hookup. Nearly half of women and 26% of men felt negatively about the experience.

Some factors are associated with an increased risk of feeling bad afterwards – these include having sex with someone you have known for less than 24 hours, drinking heavily or taking drugs beforehand, feeling you ought to rather than you want to, and hoping for a relationship afterwards. Interestingly, the Canadian study found that high-quality sex rarely led to regret.

Zhana Vrangalova, a professor of psychology at Cornell University, New York, who runs the Casual Sex Project – a website where people graphically share their encounters – argues that casual sex can improve wellbeing by increasing confidence, sexual pleasure and making people feel desirable. She points out in a TEDx talk that a study of 20,000 college students found that only 42% of women, compared with 78% of men, had an orgasm in their last hookup. This “pleasure gap” may partly explain the difference between men and women’s feelings about casual sex. But however pro-casual sex she is, Vrangalova warns that you shouldn’t hook-up if you care about seeing them again. Casual sex is not, she says, like doing the laundry.

Complete Article HERE!

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