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Some drugs can cause unwanted sexual side effects in men

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

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

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

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

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

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

What you can do

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

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

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

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

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

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

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

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Sex, Drugs, and Alcohol

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8 Things Doctors Wish You Knew About Dyspareunia, AKA Painful Sex

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Yup, we mean the bad kind of pain.

Pop culture’s depictions of sex typically focus on the romantic, the salacious, and (in some refreshing cases) the embarrassing.

But one thing that’s still rarely mentioned—both on screen and IRL—is pain during sex (also known as dyspareunia), or the shame, confusion, and stigma that often accompany it. (And we’re not talking about the good, consensual kind of pain during sex, FYI, we’re talking about sex that hurts when you don’t intend it to.)

While dyspareunia may be absent from many sexual-health discussions, it’s not rare, and it’s certainly nothing to be ashamed of. Here, doctors walk us through what they wish more people knew about painful sex:

1. Unfortunately, pain during intercourse isn’t that rare. In fact, it’s really common.

Nearly 75 percent of women will experience pain during sex at some point in their lives, according to the American College of Obstetrics and Gynecologists (ACOG). Sometimes, this pain will be a one-time thing. Other times, it will be more persistent.

2. The thing is, sex isn’t supposed to hurt unless you want it to.

Some people accept painful sex as the norm, but it shouldn’t be. “The most crucial thing for women to know is that pain during or after intercourse is never really OK,” Antonio Pizarro, M.D., a Louisiana-based gynecologist specializing in pelvic medicine and reconstructive surgery, tells SELF. There are, of course, some circumstances in which someone might seek out some level of pain during sex. But there’s a difference between a sexual kink and undesired, severe, or persistent pain in the vulva, vagina, or pelvis.

3. Minor soreness during or after sex and intense, chronic pain are not the same thing.

There are tons of reasons you might be sore after sex, Natasha Chinn, M.D., a New Jersey-based gynecologist, tells SELF. They include inadequate lubrication, penetration with a particularly large object or body part, and sex that was especially rough or fast.

If these are minor issues you only encounter every now and then, Dr. Chinn says you can usually pinpoint the cause of the problem and address it on your own (use more lube, seek out smaller sex toys, or have slower, more gentle sex). (Of course, you can go straight to seeing a doctor if you prefer.)

But what if your problem isn’t an every-now-and-then thing? If these issues are happening every time you have sex, happening more frequently than they used to, or if they’re not going away after you try to address them on your own, your painful-sex cause might be more complicated.

4. Unfortunately, there are a ton of health conditions—like endometriosis, cervicitis, and vaginismus—that can lead to painful sex.

Some of these include:

  • Contact dermatitis: a fancy medical name for an allergic reaction on the skin—and yes, that includes the skin on your vulva. This can happen if, say, the delicate skin around your vagina doesn’t react well to a soap, body wash, or detergent you’re using. Contact dermatitis can leave your skin cracked and uncomfortable, and chances are that any kind of sex you’re having while you’re experiencing this reaction is going to be pretty painful.
  • Cervicitis: a condition where the cervix, or lower end of the uterus connecting to the vagina, becomes inflamed, typically due to a sexually transmitted infection. While it often presents without symptoms, Dr. Pizarro cautions that it sometimes causes pain during urination or intercourse.
  • Endometriosis: a condition associated with pelvic pain, painful periods, and pain during or after sex. While the exact cause of endometriosis is not well understood, it seems to be the result of endometrial tissue (or similar tissue that’s able to create its own estrogen) growing outside of the uterus, which can cause pain, scarring, and inflammation. This can lead to pain that’s sometimes worse around your period, when going to the bathroom, and even during sex.
  • Ovarian cysts: fluid-filled sacs found in or on the ovaries. Sometimes they don’t cause any symptoms, but other times they rupture, causing pain and bleeding, including during sex.
  • Pelvic inflammatory disease (PID): this condition is typically caused when bacteria from a sexually transmitted infection spreads to the reproductive organs. PID can cause pain in the abdomen or pelvis, pain during urination, pain during intercourse, and even infertility if left untreated.
  • Uterine fibroids: noncancerous growths in or on the uterus. Fibroids often don’t cause symptoms, but they can make themselves known via heavy menstrual bleeding and pelvic pressure or pain, during sex or otherwise.
  • Vaginismus: a condition that causes the muscles of the vagina to spasm and contract. This can lead to pain during sex—or even make any form of vaginal penetration impossible, whether it’s sexual or just inserting a tampon.
  • Vaginitis: an umbrella term for disorders that inflame the vaginal area. Examples include bacterial vaginosis and yeast infections, both of which occur when the balance of microorganisms in the vagina gets thrown off, causing some kind of bacterial or fungal overgrowth. Other forms of vaginitis are sexually transmitted infections such as trichomoniasis (an STI caused by a parasite), chlamydia, and gonorrhea. All three of these infections are characterized by changes in vaginal discharge, vaginal irritation, and, in some cases, pain during intercourse.
  • Vulvodynia: a condition charactized by chronic pain at the opening of the vagina. Common symptoms include burning, soreness, stinging, rawness, itching, and pain during sex, Dr. Chinn says, and it can be devastating. According to the Mayo Clinic, vulvodynia consists of pain that lasts for at least three months that has no other identifiable cause.

Dr. Chinn says that women going through menopause might also experience pain during sex as a result of vaginal dryness that happens due to low estrogen levels.

People who recently gave birth may also grapple with discomfort during sex, Dr. Chinn says. It takes time for the vagina to heal after pushing out a baby, and scar tissue could develop and make sex painful.

5. There are so many other things that can mess with your sexual response, making sex uncomfortable or legitimately painful.

Any negative emotions—like shame, stress, guilt, fear, whatever—can make it harder to relax during sex, turning arousal and vaginal lubrication into obstacles, according to ACOG.

Of course, the source of these negative emotions varies from individual to individual, Dr. Pizarro says. For some, it’s a matter of mental health. Feeling uncomfortable in your body or having relationship issues might also contribute.

In an unfair twist, taking care of yourself in some ways, like by using antidepressant medication, blood pressure drugs, allergy medications, or some birth control pills, can also cause trouble with lubrication that translates into painful sex.

6. You shouldn’t use painkillers or a numbing agent to try to get through painful sex.

This might seem like the best way to handle your pain, but Dr. Pizarro cautions against it. Your body has pain receptors for a reason, and by numbing them, you could end up subjecting your body to trauma (think: tiny tears or irritation) without realizing it—which can just leave you in more pain.

7. If you’re not ready to see a doctor yet, there are a few things you can try at home, first.

According to ACOG, a few DIY methods might mitigate your symptoms:

  • Use lube, especially if you feel like your problem is caused by vaginal dryness.
  • Apply an ice pack wrapped in a towel to your vulva to dull a burning sensation when needed.
  • Have an honest conversation with your partner about what’s hurting and how you’re feeling. Let them know what hurts, what feels good, and what you need from them right now—whether that’s a break from certain sex acts, more time to warm up before you have sex, or something else.
  • Try sex acts that don’t involve penetration, like mutual masturbation and oral sex, which may help you avoid some of the pain you typically experience.

It’s totally OK to experiment with these things, Dr. Pizarro says, especially if they help you associate sex with something positive. But these tactics cannot and should not replace professional care.

8. If you’re regularly experiencing painful sex, you should talk to a doctor.

It’s really up to you to decide when to see a doctor about painful sex. “It’s like a cold,” Dr. Pizarro says. “If you’ve got a little cough, you might be all right. But if you have a cough and fever that haven’t gone away after a few days, you might want to see a doctor.” When in doubt, mention your concerns to your care provider, especially if any of these sound familiar:

  • Sex has always been painful for you
  • Sex has always been painful but seems to be getting worse
  • Sex is usually pain-free but has recently started to hurt
  • You’re not sure whether or not what you’re experiencing is normal, but you’re curious to learn more about painful sex

When you see your doctor, they’ll likely ask questions about your medical history and conduct a pelvic exam and/or ultrasound. “It’s important for doctors to ask the right questions and for patients to voice concerns about things,” Dr. Pizarro says.

From there, your doctor should take a holistic approach to treatment to address the possible physical, emotional, and situational concerns. “You really have to look at the total person,” Dr. Chinn says. Treatment options for painful sex vary wildly since there are so many potential causes, but the point is that you have options. “Many people think that it’s acceptable to experience pain during intercourse,” Dr. Pizarro says. “Use your judgment, of course, but it probably isn’t acceptable. And it can probably be made better.”

Complete Article ↪HERE↩!

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Why hasn’t the gay community had a #MeToo moment?

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The conversation around consent for gay men has been stifled. We must recognise the culture of sexual assault that exists

‘Sex is something to be celebrated – whatever your gender, sexuality or preference.’

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Most gay men can remember the first time they set foot in a gay bar: the awkwardness as they walked up to the bouncer, ID (fake or otherwise) in hand, clasped tightly. Discovering others with a specific experience similar to your own, finding community, is a powerful feeling. But as the #MeToo movement rolls on, and the conversation turns to consent and dating dynamics between men and women, there’s an uncomfortable reality on the gay scene that also needs to be confronted.

According a survey by gay men’s health charity GMFA, some 62% of British gay men have been touched or groped in a bar without consent. In the US 40% of gay and 47% of bisexual men have experienced sexual violence other than rape, compared with 21% of heterosexual men.

There’s a culture of silence, and it’s not difficult to understand why. Recognising the sexual violence you have experienced isn’t always easy, especially when these are some of your earliest sexual encounters, or when memories are clouded by alcohol and drugs.

The conversation around consent for gay men has been stifled: most of us were never taught the language with which to explain or understand the experiences of our youth. Inclusive same-sex education in schools isn’t mandatory, being LGBTQ+ doesn’t often run in the family, and there are fewer role models to learn from. Instead, we navigate sex blindly. For many young gay men, the boundaries and the logistics of sexual contact are an unknown.

It wasn’t long ago that our relationships were looked down on by both society and the state, with our sex lives taboo and criminalised. To criticise now how some of our sexual practices have developed bears a risk: the bigots will say they were right all along, and our sexual relationships will be further stigmatised.

But fear is no excuse for avoiding difficult questions. When the types of intimacy we engage in deviate from “lights off, in bed, with a long-term monogamous partner every other Friday” – which, of course, can have its own problems – it’s not an act of betrayal to point out that there are more opportunities for things to go wrong.

Take, for instance the “dark room” – a space few people will speak of outside the confines of the gay scene’s sweaty, hedonistic heart. To the uninitiated, the concept is simple: it’s a room in a club, it’s dark and you have sex. When it comes to consent, though, the situation is more complex.

Much of gay dating revolves around hookups and clubs fuelled by alcohol and drugs. Gay and bisexual men are seven times more likely to use illegal drugs, according to a 2012 study, and twice as likely to binge drink than heterosexual men.

Is taking a step into such a dark room consent to all sexual contact? Can two (or more) people consent to sex when they’re both off their face? Is whispering “do what you want with me” a green light for whatever happens next? When others join in – do they need explicit permission – what if you don’t even notice? There aren’t necessarily right or wrong answers to all of these questions, but in the context of #MeToo these are conversations that need to be had.

It’s would be easy to write this off as universal; of course, heterosexuals also get wasted and look for sexual partners under the cover of night. Unlike our straight counterparts, however, it’s often only in bars and clubs that many gay men learn the rituals of love, sex and seduction – having to come out, rather than your sexual identity be seen as normal, means many of us do not innocently experiment and reflect during adolescence. We find our norms on the scene. For most of us, there were few other places to turn.

It’s not just gay men who have woken up next to someone they barely remember taking home, but when there are multiple sexual partners involved – in drug-filled rooms and dark, public spaces – the risks are multiplied. Having no recollection of who you had sex with, or where, means you may not have had the capacity to consent in the first place.

For younger gay men, the landscape is changing: the internet has revolutionised how we look for sex. Apps have provided a way to find partners away from nightlife, but these hookups aren’t always safe and forgiving environments either. Some men feel a sense of entitlement when you turn up at their door with a single, prearranged purpose. The number of crimes reported as a result of online hookups is rising. Casual sex is all well and good, but these interactions don’t teach teenagers about intimacy and relationships.

Reckless behaviour in adulthood can be linked to self-hatred, abuse and violence – it’s a coping mechanism in a world that continues to see us as victimised, isolated and abused.

Of course, it is possible to tackle these problems: the introduction of same-sex sex education in schools would be a start. Community support, once publicly funded and now decimated by local government cuts, would be another useful step. LGBTQ+ spaces away from drugs and alcohol are also sorely needed, as are effective mental and sexual health services.

At the same time, predatory gay men need to take responsibility for their actions. Drugs, darkness and the thrill of the moment are no excuse for exploiting vulnerable men. We need to recognise and highlight the culture of sexual assault and violence that exists in our community, as it does in others, and hold perpetrators to account. Assault is assault, and rape is rape. That isn’t the “freedom” our community fought for.

But neither do we need moralising from high horses, homophobic or otherwise. People of all genders and sexualities take drugs, and it can be done healthily. Putting your fingers in your ears and pretending it’s not happening serves no purpose to anyone. Ours is a community that has long been persecuted and made to feel ashamed. It’s important to talk about liberation, and to embrace sexuality in all its glorious forms. Sex is something to be celebrated – whatever your gender, sexuality or preference – as long as the all of those involved can and do consent.

Complete Article HERE!

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What is good sex?

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Here are six sexual health principles to follow

by Silva Neves

Sex is one of those topics that everybody talks about and everybody has opinions about.

What I mostly hear in my consulting room is that people don’t have good sex education and they compare themselves to what they think others do in bed.

In the absence of good sex education, what we have left to rely on is pornographic films, which is entertainment and not an accurate depiction of everyday sex, or your friends lying about their sex life being amazing.

Deep down, many people are confused about what good sex really is, and many people wonder if their sex life is good enough.

Some people criticise their sex life as ‘healthy’ or ‘unhealthy’. Some people ask me questions like: ‘Am I normal for having a fetish?’, ‘Am I unhealthy for having lots of sex?’, ‘Do I masturbate too much?’, ‘Should I feel more sexual?’, ‘Am I strange for not liking penetration?’ And so on and so forth.

When we talk about sex, we tend to focus on the particular acts rather than on the broad view of sexuality: human sexuality is rich and varied and there are thousands of ways to have sex and be sexual. One person’s favourite sexual activity can be another person’s repulsion. How can we even begin to identify what is good or bad, healthy or unhealthy without falling into the trap of being opinionated, judgemental, critical and shaming?

I invite you to think about your sex life differently. If you want to know if the sex you’re having is good or bad, stop focusing on sexual acts and instead think about sexual health principles. There are six of them:

1. Consent: Consent can only be expressed from a person aged 16 or over, with a fully functioning brain. Consent cannot be expressed from a person who has impaired thinking under the influence of drugs or alcohol, for example. Consent to exercise your sexual right to have sex with whomever you choose should be unambiguous. If there is doubt, take some extra time to have a conversation with your sexual partners to make sure the cooperation between you is clear.

2. Non-exploitation: This means to do what you and your partner(s) have agreed to do without any coercion using power or control for sexual gratification.

3. Protection from HIV, STIs and unwanted pregnancy: It is your responsibility to make sure that you are at low risk of contracting a sexually transmitted infection. Often it requires a honest conversation with your partner, and an explicit agreement on how you are going to protect each other. If you have a STI that is infectious, it is your responsibility to put protection in place that won’t knowingly infect your partner(s).

4. Honesty: Being honest and upfront with your sexual desires and sexual needs is important. Everybody is different, and human sexuality is diverse. It is likely that your partner may not know all of what you like, need or want sexually. In fact, some people are not in touch with their own sexual landscape and all the parts of their body that is erogenous. Being able to express to your partner what you want or need is important. It can be difficult and it is a courageous conversation to have, because you can risk hearing your partner saying that they don’t like what you like. When couples stay in a place of honesty and truth, often they can work some things out between them to achieve a fulfilling sex life.

5. Shared values: It is important that you and your sexual partner are ‘on the same page’ about what is acceptable and what is not. Our values are important to us because it informs us on what specific sexual acts means to us and contributes to our motivation for having sex. Conversations about values can clarify important aspects of your sexual health which will help with giving consent to have sex.

6. Mutual pleasure: Pleasure is an important component of sex. For good sexual health, it is crucial that you make sure that what you do bring you pleasure and at the same time, to be able to hear what your partner finds pleasurable. It is a good idea to talk about it with your partner because it is not possible to assume. We usually feel good when we bring pleasure to our partners and we also feel good when we feel pleasure ourselves.

You can stop thinking about being a ‘good bottom’ or a ‘good top’. You can stop worrying about your kinky sex life being healthy or not. If you move away from opinions about specific sexual acts, there is no judgments to be made and you can ensure your sexual life to be good by meeting the six principles of sexual health.

Complete Article HERE!

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