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Who’s avoiding sex, and why

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By Shervin Assari

Sex has a strong influence on many aspects of well-being: it is one of our most basic physiological needs. Sex feeds our identity and is a core element of our social life.

But millions of people spend at least some of their adulthood not having sex. This sexual avoidance can result in emotional distress, shame and low self-esteem – both for the individual who avoids sex and for the partner who is rejected.

Yet while our society focuses a lot on having sex, we do not know as much about not having it.

As a researcher of human behavior who is fascinated by how sex and gender interact, I have found that sexual avoidance influences multiple aspects of our well-being. I also have found that people avoid sex for many different reasons, some of which can be easily addressed.

People who have more sex report higher self-esteem, life satisfaction and quality of life. In contrast, lower frequency of sex and avoiding sex are linked to psychological distress, anxiety, depression and relationship problems.

In his landmark work, Alfred Kinsey found that up to 19 percent of adults do not engage in sex. This varies by gender and marriage status, with nearly no married males going without sex for a long duration.

Other research also confirms that women more commonly avoid sex than men. In fact, up to 40 percent of women avoid sex some time in their lives. Pain during sex and low libido are big issues.

The gender differences start early. More teenage females than teenage males abstain from sex.

Women also are more likely to avoid sex because of childhood sexual abuse. Pregnant women fear miscarriage or harming the fetus – and can also refuse sex because of lack of interest and fatigue.

The most common reasons for men avoiding sex are erectile dysfunction, chronic medical conditions and lack of opportunity.

For both men and women, however, our research and the work of others have shown that medical problems are the main reasons for sex avoidance.

For example, heart disease patients often avoid sex because they are afraid of a heart attack. Other research has shown the same for individuals with cerebrovascular conditions, such as a stroke.

Chronic pain diminishes the pleasure of the sexual act and directly interferes by limiting positions. The depression and stress it causes can get in the way, as can certain medications for chronic pain.

Metabolic conditions such as diabetes and obesity reduce sexual activity. In fact, diabetes hastens sexual decline in men by as much as 15 years. Large body mass and poor body image ruin intimacy, which is core to the opportunity for having sex.

Personality disorders, addiction and substance abuse and poor sleep quality all play major roles in sexual interest and abilities.

Many medications, such as antidepressants and anti-anxiety drugs, reduce libido and sexual activity, and, as a result, increase the risk of sexual avoidance.

Finally, low levels of testosterone for men and low levels of dopamine and serotonin in men and women can play a role.

For both genders, loneliness reduces the amount of time spent with other people and the opportunity for interactions with others and intimacy. Individuals who are lonely sometimes replace actual sexual relations with the use of pornography. This becomes important as pornography may negatively affect sexual performance over time.

Many older adults do not engage in sex because of shame and feelings of guilt or simply because they think they are “too old for sex.” However, it would be wrong to assume that older adults are not interested in engaging in sex.

Few people talk with their doctors about their sexual problems. Indeed, at least half of all medical visits do not address sexual issues.

Embarrassment, cultural and religious factors, and lack of time may hold some doctors back from asking about the sex lives of their patients. Some doctors feel that addressing sexual issues creates too much closeness to the patient. Others think talking about sexuality will take too much time.

Yet while some doctors may be afraid to ask about sex with patients, research has shown that patients appear to be willing to provide a response if asked. This means that their sexual problems are not being addressed unless the doctor brings it up.

Patients could benefit from a little help. To take just one example, patients with arthritis and low back pain need information and advice from their health care provider about recommended intercourse positions so as to avoid pain.

The “Don’t ask, don’t tell” culture should become “Do ask, do tell.”

Complete Article HERE!

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A Sexless Marriage

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Name: Tammy
Gender: Female
Age: 36
Location: Springfield IL
My parents were Laurel Canyon hippies of the first order, free love, drugs and all that stuff. I used to be disgusted by all the sex my parents were having with other people. I just couldn’t understand why they didn’t just want to be with one another or divorce and remarry someone else. As soon as I could, I left the west coast for the Midwest. Now all these years later my own marriage is in trouble. My husband unilaterally ended our sex life after the birth of our last child three years ago. I haven’t let myself go. I’m still very attractive and have even improved my body after the babies. But nothing I do brings him back to bed. He said that we have children now, and people with children don’t do that sort of thing!

To spite him for shutting me out, I turned to another man for sex. I just wanted to feel desirable again. I fear my affair will be found out and it will destroy my marriage. Funny thing, my parents with all their multiple sex partners remained happily married for 51 years till my father’s death two years ago. They were honest about their lives; I am not! I feel ashamed, but I am also having the best sex of my life and I won’t give it up.

My husband is a decent man and a good father. How can I continue to live this lie? If I come clean it will likely break up my family and I’ll look like a cheating slut. Is there any other option? I wish I could have been more accepting of my parent’s lifestyle; maybe the karma wouldn’t be so rough now.

Ahhh, bad luck doll! That karma thing sure enough can be a bitch.

If I had a nickel for every time I’ve heard this same story from a frustrated and desperate man or woman trapped in a sexless marriage, I’d have enough money to lay down my keyboard, give up my status as the most fabulous and revered sexpert in the universe and retire to Maui. Unfortunately, by the time I hear from most of the people they have already suffered through years of abstinence, all the while begging and pleading for the sex they want and need. By the time they write to me it’s often way too late. The die is cast. They’re married with kids and often have a stray affair workin’ on the side. As you suggest, Tammy, it’s a pretty unbearable situation.

My first thoughts are that by the time things get to the point of sheer desperation, a happy ending is virtually impossible. A lot of people are gonna get hurt regardless of how this resolves it self. If that’s a given, maybe you should be asking yourself; what can be salvaged from the impending wreck?

Tammy, you write something very telling in your message when talking about your parents. You say, “They were honest about their lives; I am not!” In the end, if you can reclaim your integrity, regardless if it means the demise of your marriage and family, as you currently know it, you will have regained something of inestimable value.

I also want to address your comment: “If I come clean it will likely break up my family and I’ll look like a cheating slut.” Perhaps, but at least you’ll no longer be a lyin’, cheatin’ slut. Come on, how could what others think of you trump what you already think of yourself. You are down on yourself because you expect sex in your marriage. And when that disappeared, you didn’t shut down as a sexual being. Does that equation make you so bad, a slut even?

I wholeheartedly believe that married people deserve a rich and fulfilling sex life, unless there’s mutual agreement for another arrangement. Unilaterally depriving a spouse of a rich and fulfilling sex life is an act of sexual violence. It’s the kind of sexual violence that will cause frustration, anger and desperation. And inevitably lead to infidelity, which in turn destroys the marriage and traumatizes the kids. So Tammy, if you are a cheating slut, what does that make your husband? Neither you nor your old man is without blame. So time to buck up, darlin’, and do the right thing. Regardless of how the chips fall.

And one more thing, you say you were disgusted by your parent’s hippy, free love lifestyle — at least they were open an up-front with you about who they were. Consider the trauma your kids will experience when they learn dear old mom was bumping someone other than dear old dad. What kind of example are you setting for them? You see where the honesty thing is a good idea right from the get go, huh?

Ok, so I think there’s a consensus that the truth must be told. I suggest that you generously offer your husband the first right of refusal. He may not deserve it, but that’s the way to go nonetheless. Offer to stay with him and raise your kids together, but not in a sexless marriage. If he can’t bring himself to bone you the way you need it, when you need it, with vigor and passion; then he needs to free you up to find that bone in someone else’s drawers. And if he can’t live the cuckold life he ought at least to be man enough to leave the marriage with as little stink as possible.

Good luck

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The New Gay Sexual Revolution

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PrEP, TasP, and fearless sex remind us we can’t advance social justice without including sex in the equation.

By Jacob Anderson-Minshall

The sexual revolution of the 1960s and ’70s came to an abrupt and brutal end for many gay and bi men the moment AIDS was traced to sexual contact. In the early days of the epidemic, sex between men was equated with AIDS, not just in the mainstream media, but also in prevention efforts by other gay men. Since AIDS in those days was seen as a death sentence, for men who had sex with men, every sexual interaction carried the risk of death. Indeed, tens of thousands died of AIDS-related conditions.

“I was alive when homosexuality was [still] considered to be a psychological illness,” David Russell, pop star Sia’s manager, recently told Plus magazine. “The two generations ahead of mine, and a good portion of my generation, were completely decimated by AIDS. They’re gone.”

While some men with HIV outlasted all predictions and became long-term survivors, the widespread adoption of condoms is credited with dramatically reducing HIV transmissions among gay and bi men in subsequent years. Yet reliance on nothing but that layer of silicone — a barrier some complain prevents true intimacy and pleasure — couldn’t erase the gnawing dread gay men felt that every sexual encounter could be the one where HIV caught up to them.

There have been, of course, moments when nearly every gay or bi man has allowed their passions to override their fears and enjoyed the skin-on-skin contact that opposite-sex couples often take for granted. Thinking back on those unbridled and unprotected moments of passion filled many of these men with terror, regret, and guilt.

“Shame and gay sex have a very long history,” acknowledges Alex Garner, senior health and innovation strategist with the gay dating app Hornet. “And it takes much self-reflection — and often therapy — to feel proud and unashamed of our sex when everything around us tells us that it’s dirty, immoral, or illegitimate.”

Since the late 1990s and the advent of lifesaving antiretroviral drugs, some of the angst around sex between men faded — and with that came changes in behavior. Condom use, once reliably high among gay and bisexual men, has dropped off in the past two decades. According to a recent study published in the journal AIDS, over 40 percent of HIV-negative and 45 percent of HIV-positive gay and bi men admitted to having condomless sex in 2014. Researchers found the decrease in condom use wasn’t explained by serosorting (choosing only partners believed to have the same HIV status) or antiretroviral drug use. And despite what alarmists say, condom use had been declining long before the introduction of PrEP.

Garner, who has been HIV-positive for over two decades, says he’s almost relieved he acquired the virus at 23, because “My entire adult life I have never had to worry about getting HIV.”

The Rise of PrEP

Now there’s hope the younger generation may also experience worry-free sex lives — without the side effects of living with HIV.

The use of the antiretroviral drug Truvada as pre-exposure prophylaxis, or PrEP (it’s the only medication approved for HIV prevention), has been shown to reduce the chance of HIV transmission to near zero. Since the medication was first approved as PrEP in 2012, only two verified cases of transmission have been documented among those who adhere to the daily schedule (a third, according to HIV expert Howard Grossman, could not be confirmed). New, longer-lasting PrEP injectables should reach market in the next few years. Studies suggest that on-demand PrEP (such as taking it before and after sexual activity) may also be effective.

“This is a revolution!” Gary Cohan, MD, who prescribes PrEP, told us in 2016. “This should be above the fold in The New York Times and on the cover of Time magazine. A pill to prevent HIV?”

Undetectable Equals Untransmittable

Those who are already HIV-positive also have a sure-fire option for preventing the transmission of HIV that doesn’t rely on condoms. It’s called treatment as prevention, or TasP. Those who are poz, take antiretroviral medication, and get their viral load down to an undetectable level, can’t transmit HIV to sexual partners. Last year, The New England Journal of Medicine published the final results of HPTN 052, a study that proved antiretroviral medication alone is enough to prevent HIV transmission among serodiscordant couples. In a Facebook Live interview for AIDS.gov, Dr. Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, noted, “The chance of transmitting [HIV] if you are virally durably suppressed is zero.

Since Dieffenbach’s statement, a number of HIV organizations and medical groups have joined the “Undetectable Equals Untransmittable” bandwagon, including GMHC, APLA Health, and the Latino Commission on AIDS.

The Centers for Disease Control and Prevention recommends the use of condoms in addition to PrEP or TasP, primarily because neither biomedical approach prevents other sexually transmitted infections like gonorrhea or syphilis. Still, PrEP and TasP make it safer to have condomless sex — and that could jump-start the new sexual revolution. “When the threat of HIV is removed from sex there is a profound sense of liberation,” Garner says. “Sex can just be about sex.”

One hurdle is PrEP stigma, furthered by the myth of “Truvada whores,” and AIDS Healthcare Foundation’s Michael Weinstein’s deliberate efforts to portray the HIV prevention pill as “a party drug.”

“Fear and shame have been ingrained in gay sex for decades,” Garner admits. “And it will take time and a great deal of work to extricate those elements.” But he remains optimistic that “together negative and poz men can shift the culture away from fear and toward liberation.”

He argues that what’s at stake is far more than just a better orgasm.

“Our sexuality is at the core of our humanity,” Garner says. “Our sexuality is as integral to us as our appetite. We can’t advance social justice without including sex. As queer people and as people of color, our bodies have been criminalized, our sexuality has been pathologized, and structures continue to dehumanize us. It’s a radical act of resistance when, as gay men, we choose to find pleasure and intimacy in our sex. Our sex has been, and will continue to be, intensely political. It can change our culture and our politics if we embrace it and run to it instead of away from it.”

Complete Article HERE!

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Following in the footsteps of Viagra, female libido booster Addyi shows up in supplements

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By Megan Thielking

Following in the footsteps of its predecessor Viagra, the female libido drug Addyi has snuck into over-the-counter supplements that tout their ability to “naturally” enhance sexual desire.

The Food and Drug Administration announced a recall Wednesday of two supplements marketed to boost women’s sex drive. The supplements Zrect and LabidaMAX — both manufactured by Organic Herbal Supply — actually contained flibanserin, a medication approved by the FDA in late 2015 to treat hypoactive sexual desire disorder in women. It’s the first time federal officials have recalled a product contaminated with the drug.

“It’s the latest example of brand-new drugs being found in supplements,” said Dr. Pieter Cohen, a physician at Harvard Medical School who studies dietary supplements.

The problem has long plagued the male sexual enhancement supplement market. Viagra has turned up in dozens of over-the-counter pills that never declared they contained the drug. The FDA regularly checks supplements shipments for the presence of Viagra, and has added flibanserin into their scans since the drug was approved.

“FDA lab tests have found that hundreds of these products contain undisclosed drug ingredients,” said Lyndsay Meyer, a spokesperson for the agency.

The massive dietary supplement industry is largely unregulated. The products can be sold without a prescription in supermarkets, supplement stores, and, increasingly, online. The products currently being recalled were sold on Amazon through February.

And while supplement makers are not allowed to claim that their products cure or treat a particular condition, they are allowed to make general claims that their products support health or, in this case, promote sexual desire.

“There’s nothing that you can actually put into the pill that lives up to advertised claims, so there is this temptation to introduce a pharmaceutical drug that attempts to meet those claims,” said Cohen. Organic Herbal Supply, which is recalling its products, did not respond to a request for comment.

The FDA said it has not received any reports of adverse events tied to either of the supplements. But Cohen said they are far from safe — and argued a lack of regulation will allow those risks to remain.

“We have no idea the harms being caused by these products. As long as these products can be sold as if they improve your sexual health, there’s going to be no stopping this,” he said.

The amount of undeclared flibanserin in a supplement could vary widely from one pill to the next, as has been the case with Viagra. It’s also possible the drug could be introduced into a supplement along with other potentially libido-boosting compounds, exacerbating those effects.

“We don’t know what danger this poses because these combinations have never been studied before they’re sold to unsuspecting consumers,” Meyer said. Consumers can report adverse events tied to these or other dietary supplements to the agency online.

Cohen said the message from the recall is clear: “Consumers should just completely avoid sexual enhancement supplements. They either might be safe and don’t work, or they might work but are likely to be dangerous.”

Complete Article HERE!

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