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How to Have a Sex Life on Antidepressants

When quitting isn’t an option, is it possible to overcome the sexual side effects that come with an SSRI?

By Shannon Holcroft

So, you’ve finally filled the antidepressant prescription that’s been acting as a bookmark for the most recent novel you’re feigning interest in. Somewhere between missing your own birthday party and watching everyone else have fun without you, you gave in. After a few medicated weeks, things are starting to look up. Except for your sex life, that is.

Just last week, you were tied to a kitchen chair enjoying an amazing (albeit rather mournful) few minutes of escape through sex. Today, getting naked seems less appealing than all the other pressing tasks you have new-found energy to complete.

“Is it the meds, or is it just me?” you wonder as you deep-clean the fridge with new vigour. After some soul-searching, it becomes clear that you’re still the same person—just with fewer festering foodstuffs and a lot less crying.

“It must be a side effect,” you decide. But months after filling your prescription, your genitals are still giving you the physiological equivalent of 8d2cc2c1a43108301b149f7f33e1664d.png

Why Antidepressants May Be a Downer for Your Sex Life

“[Sexual dysfunction] is a difficult, frustrating, and very common issue with this class of medications,” says Jean Kim, M.D., clinical assistant professor of psychiatry at George Washington University.

Twelve percent of American adults reported filling an antidepressant prescription in the most recent Medical Expenditure Panel Survey. Not just for clinical depression, but for all kinds of off-label conditions like chronic pain and insomnia.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant class. And between 30 percent and 50 percent of individuals taking SSRIs experience sexual dysfunction. Desire, arousal and orgasm may be affected by changes in function of neurotransmitters like serotonin and dopamine; the very mechanisms through which SSRIs treat depression.

How to Work Around the Side Effects

When fighting to survive a potentially fatal mental illness, there are often more important concerns than getting it on. It’s frequently not an option to stop taking life-saving medication to avoid side effects. So what’s a sexual being to do?

Despite SSRIs being pretty pedestrian, there’s no concrete answer to addressing sexual side effects. “Unfortunately, not much is reliably effective to deal with this [sexual dysfunction],” Dr. Kim notes.

This may sound pretty gloomy, but there are plenty of things you can try to bring sexy times back around. “Don’t hesitate to bring up the issue with your prescribing clinician, as there might be some helpful interventions available,” says Dr. Kim.

Here are other ways to work around the sexual side effects of antidepressants:

1. Time It Right

“Some literature advises trying to have sexual activity when the serum level of a daily antidepressant might be lowest in the bloodstream,” says Dr. Kim. In other words, the ideal time to get it on is right before you take your next daily dose.

If your dosing schedule makes it tough to pencil in sexual activities, chat with your clinician about changing the time of day you take your meds. In many cases, there’s room for flexibility.

“This would not work much with some SSRIs that have a longer half-life like fluoxetine (Prozac),” Dr. Kim adds. Those taking antidepressants that exit the body quickly, like Paxil and Zoloft, could be in luck.

2. Switch It Up

Switching to a different medication, with the support of your prescribing clinician, may make all the difference. Certain antidepressants have a greater incidence of sexual side effects than others. Commonly prescribed SSRIs associated with a high frequency of sexual dysfunction include paroxetine (Paxil), sertraline (Zoloft) and fluoxetine (Prozac).

Besides exploring the SSRI class, venturing into atypical antidepressant territory is another option. Buproprion (Wellbutrin) is an atypical antidepressant observed to present the lowest sexual side-effect profile of all antidepressants.

It may take some trial and error, mixing and matching to identify what works best for you, but it will all be worth it when you can [insert favorite sex act here] to your heart’s content again.

3. Augment

Some treatment add-ons may act as antidotes to SSRI-induced sexual dysfunction. “Supplementing with other medications that have serotonin blocking effects (like cyproheptadine [Peritol] or buspirone [Buspar]) or enhance other neurotransmitters like dopamine (like Wellbutrin) might help,” says Dr. Kim. She is quick to note that these findings are yet be confirmed by “larger-scale randomized controlled clinical trials.”

“Another common strategy is to prescribe erectile dysfunction drugs like sildenafil (Viagra) and the like for as-needed use before activity,” says Dr. Kim. Viagra has been found to reduce sexual side effects, even if you’re not in possession of a penis. In Dr. Kim’s clinical experience, “[Viagra] seems to help in more than a few cases.” Discuss with your doctor before adding any more medications to the mix.

4. Exercise

Now’s the time to take up aquacycling, indoor surfing sans water or whatever fitness fad tickles your fancy. Keeping active could be the key to preventing sexual dysfunction caused by SSRIs.

“Sometimes sexual dysfunction is not just a primary SSRI drug side effect but part of underlying depression/anxiety as well,” Dr. Kim explains. “Anything that helps enhance overall blood circulation, mood and libido might be helpful, such as exercise.”

Complete Article HERE!

Married LGBT older adults are healthier, happier than singles, study finds

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Same-sex marriage has been the law of the land for nearly two years — and in some states for even longer — but researchers can already detect positive health outcomes among couples who have tied the knot, a University of Washington study finds.

For years, studies have linked marriage with happiness among heterosexual couples. But a study from the UW School of Social Work is among the first to explore the potential benefits of marriage among LGBT couples. It is part of a national, groundbreaking longitudinal study with a representative sample of LGBT older adults, known as “Aging with Pride: National Health, Aging, Sexuality/Gender Study,” which focuses on how historical, environmental, psychological, behavioral, social and biological factors are associated with health, aging and quality of life.

UW researchers found that LGBT study participants who were married reported better physical and mental health, more social support and greater financial resources than those who were single. The findings were published in a February special supplement of The Gerontologist.

“In the nearly 50 years since Stonewall, same-sex marriage went from being a pipe dream to a legal quagmire to reality — and it may be one of the most profound changes to social policy in recent history,” said lead author Jayn Goldsen, research study supervisor in the UW School of Social Work.

Some 2.7 million adults ages 50 and older identify as lesbian, gay, bisexual or transgender — a number that is expected to nearly double by 2060.

Among LGBT people, marriage increased noticeably after a 2015 U.S. Supreme Court ruling legalized same-sex marriage nationwide. A 2016 Gallup Poll found that 49 percent of cohabiting gay couples were married, up from 38 percent before the ruling.

For the UW study, more than 1,800 LGBT people, ages 50 and older, were surveyed in 2014 in locations where gay marriage was already legal (32 states and Washington, D.C.). About one-fourth were married, another fourth were in a committed relationship, and half were single. Married respondents had spent an average of 23 years together, while those in a committed, unmarried relationship had spent an average of 16 years. Among the study participants, more women were married than men, and of the respondents who were married, most identified as non-Hispanic white.

Researchers found that, in general, participants in a relationship, whether married or in a long-term partnership, showed better health outcomes than those who were single. But those who were married fared even better, both socially and financially, than couples in unmarried, long-term partnerships. Single LGBT adults were more likely to have a disability; to report lower physical, psychological, social and environmental quality of life; and to have experienced the death of a partner, especially among men. The legalization of gay marriage at the federal level opens up access to many benefits, such as tax exemptions and Social Security survivor benefits that married, straight couples have long enjoyed. But that does not mean every LGBT couple was immediately ready to take that step.

According to Goldsen, marriage, for many older LGBT people, can be something of a conundrum — even a non-starter. LGBT seniors came of age at a time when laws and social exclusion kept many in the closet. Today’s unmarried couples may have made their own legal arrangements and feel that they don’t need the extra step of marriage — or they don’t want to participate in a traditionally heterosexual institution.

Goldsen also pointed to trends in heterosexual marriage: Fewer people are getting married, and those who do, do so later.

“More older people are living together and thinking outside the box. This was already happening within the LGBT community — couples were living together, but civil marriage wasn’t part of the story,” she said.

The different attitudes among older LGBT people toward marriage is something service providers, whether doctors, attorneys or tax professionals, should be aware of, Goldsen said. Telling a couple they should get married now simply because they can misses the individual nature of the choice.

“Service providers need to understand the historical context of this population,” she said. “Marriage isn’t for everyone. It is up to each person, and there are legal, financial and potentially societal ramifications.” For example, among the women in the study, those who were married were more likely to report experiencing bias in the larger community.

At the same time, Goldsen said, single LGBT older adults do not benefit from the marriage ruling, and other safeguards, such as anti-discrimination laws in employment, housing and public accommodations, are still lacking at the federal level.

Over time, Goldsen and colleagues will continue to examine the influence of same-sex marriage policy on partnership status and health.

The study was funded by the National Institutes of Health and the National Institute on Aging. Other researchers were Karen Fredriksen-Goldsen, Amanda Bryan, Hyun-Jun Kim and Sarah Jen in the UW School of Social Work; and Anna Muraco of Loyola Marymount University.

Complete Article HERE!

Reality Check: Anal Sex

First it was shocking, then it was having a cultural moment, now it’s practically standard in the modern bedroom repertoire—or so a quick scan of any media, from porn to HBO, will tell you. But the reality about anal is not, actually, that everyone’s doing it, says research psychoanalyst and author Paul Joannides, Psy.D., whose comprehensive book on sexuality, The Guide to Getting it On!, is used in college and medical school sex-ed courses across the US and Canada. The book is amazing not just for its straight-up factual information on practically any aspect of sex you can think of, but also for its easy, nonjudgmental, at-times humorous tone.

The CDC reports that the number of heterosexual men and women who’ve tried it vacillates between 30 and 40 percent (oddly, the CDC doesn’t report on how many homosexual men have tried it, except in a statistic that weirdly combines it with oral). If anal turns you on, you are definitely not alone, but its prevalence doesn’t change the fact that it’s the riskiest sexual behavior in terms of HIV and other STDs. Here, Joannides talks us through the realities of making anal both as safe and as pleasurable as possible.


A Q&A with Paul Joannides, Psy.D.

Q

When did heterosexual anal start to become a thing?

A

In the 80’s, I remember hearing from a friend that he had a videotape of anal porn. This seemed shocking at the time. (This was pre-Netflix: Everything was on videotape, from porn to Disney movies to highlights from the Olympics. Video rental stores were everywhere.) I’m not sure there are too many middle schoolers today who would be shocked or even surprised to watch anal sex on Pornhub or Xhamster.

Since porn became as easy to access as YouTube, porn producers have had to fight for clicks, and so porn has become more extreme. I’d say that by 2005, porn had totally blurred the distinction between a woman’s anus and vagina. This wasn’t because women were begging their lovers for anal, it’s because porn producers were afraid you’d click on someone else’s porn if they weren’t upping the ante in terms of shock value.


Q

Does the popularity of anal in porn reflect reality in both homosexual and heterosexual couples?

A

No. There are some couples who enjoy anal sex a lot, maybe 10 percent to 15 percent of all straight couples. But if you ask them how often they have anal vs. vaginal intercourse, they’ll say maybe they have anal one time for every five or ten times they have vaginal intercourse. We occasionally, as in once a year, hear from women who say they have anal as often as vaginal, but that’s unusual.

As for gay men, statistics vary widely, and studies aren’t always consistent in how they collect data—some might be looking at different levels of frequency, i.e. have you had anal once in the past year, or do you have it regularly? I’ve seen studies suggesting that 65 percent of men have anal sex, and others that suggest the figure is less than 50 percent. So, I don’t have exact figures for hetero or homosexual couples, but there is data suggesting that a good percentage of gay men would rather give and receive blowjobs than have anal sex.


Q

How should we modify the anal sex we see modeled in porn to best suit an in-real-life couple?

A

The way the rectum curves shortly after the opening tells us we need to make a lot of adjustments for anal to feel good. Also, the two sets of sphincter muscles that nature placed around the opening of the anus to help humans maintain their dignity when in crowded spaces (to keep poop from dropping out) mean there’s an automatic reflex if you push against them from the outside.

So one of the first things a woman or man needs to do if they want to be on the receiving end of anal sex is to teach their sphincter muscles to relax enough that a penis can get past their gates. This takes a lot of practice.

Also, unlike the vagina, the anus provides no lubrication. So in addition to teaching the sphincters to relax, and in addition to getting the angle right so you don’t poke the receiver in the wall of the rectum, you need to use lots of lube.

They show none of this in porn. Nor do they show communication, feedback, or trust. Couples who do not have excellent sexual communication, who don’t freely give and receive feedback about what feels good and what doesn’t, and who don’t have a high level of trust should not be having anal sex.


Q

What are the health risks of anal?

A

A woman has a 17-times-greater risk of getting HIV and AIDS from receiving anal intercourse than from having vaginal intercourse. So your partner needs to be wearing a condom and using lots of lube, unless both of you are true-blue monogamous, with no sexual diseases. Any sexually transmitted infection can be transmitted and received in the anus. Because of the amount of trauma the anus and rectum receive during anal intercourse, the likelihood of getting a sexually transmitted infection is higher than with vaginal intercourse.

Unprotected anal sex, regardless of whether it is practiced by straight or gay couples, is considered the riskiest activity for sexually transmitted diseases because of the physical design of the anus: It is narrow, it does not self-lubricate, and the skin is more fragile and likely to tear, allowing STDs such as HIV and hepatitis easy passage into the bloodstream.


Q

Are those risks all mitigated by the use of condoms and lube, or are there still issues, even beyond that?

A

The risks are substantially reduced by the use of condoms and lube as long as they are used correctly, but you won’t find too many condoms that say “safe for anal sex” because the FDA has not cleared condoms for use in anal sex. That said, research indicates that regular condoms hold up as well as thicker condoms for anal sex, so there’s nothing to be gained from getting heavy-duty condoms.

As for using the female condom for anal sex—studies report more slippage and more pain than with regular condoms.

Do not use numbing lube, and do not have anal sex while drunk or stoned. Pain is an important indicator that damage can occur if you don’t make the necessary adjustments, including stopping. If there is pain, perhaps try replacing a penis with a well lubed and gloved finger. The glove will help your finger glide more easily, and might be more pleasurable for the person on the receiving end. Also, this allows a woman to do anal play on a male partner. (When it comes to anal sex, what’s good for the goose should be good for the gander.)


Q

Are there known health consequences of anal practiced over the long-term? Can you do it too much?

A

One of the urology consultants for my book believes that unprotected anal sex can be a way for bacteria to get into the man’s prostate gland. He prefers the person with the penis that’s going into the other person’s butt use a condom.

Also, small chunks of fecal matter can lodge into the man’s urethra. So if the couple has vaginal intercourse following anal intercourse without a condom, the male partner should pee first in addition to washing his penis with soap and water.


Q

Do pre-anal enemas make a difference in terms of health safety? What about preventing accidents?

A

I know of no studies on the relationship between pre-anal enemas and health outcomes. As for its general wisdom, people seem as divided on that as on politics in Washington. So I would say, to each her own. Also, some people use a “short shot,” which is a quick enema with one of those bulb devices instead of using a bag and going the full nine yards. In any case, accidents are likely to happen at one time or another.


Q

What tests should people be getting if they practice anal?

A

There’s “should” and there’s reality. If I were on the receiving end of anal sex, I would want to be sure my partner did not have HIV before I’d even let him get close to my bum with his penis.


Q

Probably more people try anal today than in the past—are there ways to make a first experience a good one?

A

Both of you should read all you can about it first. Spend a few weeks helping the receiving partner train her/his anal sphincters to relax. Make sure you and your partner have great sexual communication, trust, and that you both want to do it, as opposed to one trying to pressure the other, or not wanting to do it but doing it because you are afraid your partner will find someone else who will. Do not do it drunk or stoned, and do not use lube that numbs your anus. If it doesn’t feel good when it’s happening, stop.


Q

Do people orgasm from anal stimulation? Is it common or uncommon?


A

Some women say they have amazing orgasms from anal, but usually they will be stimulating their clitoris at the same time.


Q

Does it usually take a few tries to enjoy anal? Are there positions that make it easiest?

A

It depends on how much you are willing to work on training the receptive partner’s anal sphincters to relax, how good your communication is, how much trust there is, and probably on the width or girth of the dude’s penis. Common sense would tell you it should go way better if a guy is normal-sized as opposed to porn-sized.


Q

What should we be telling our kids about anal?

A

We don’t tell them about the clitoris, about women’s orgasms, about masturbation, about the importance of exploring a partner’s body, and learning from each other. We don’t tell them that much of what they see in porn is unreal, and we don’t talk to them about the importance of mutual consent. So I don’t see anal being at the top of most parents’ “should talk to our kids about” lists. There are more important things we need to be talking about first.

Paul Joannides, Psy.D. is a psychoanalyst, researcher, and author of the acclaimed Guide to Getting it On!, which is now in its ninth edition and is used in college courses across the country. He’s also written for Psychology Today Magazine and authors his own sex-focused blog, Guide2Getting.com. Dr. Joannides has served on the editorial board of the Journal of Sexual Medicine and the American Journal of Sexuality Education, and was granted the Professional Standard of Excellence Award from The American Association of Sex Educators, Counselors and Therapists. Joannides also lectures widely about sex and sexuality on college campuses.

Complete Article HERE!

Everything You Need to Know About Cuckolding

Western, puritanical values have informed almost every aspect of our daily lives. Although many people nowadays do not consider themselves religious in the traditional sense, it’s hard to deny the influence of long-held Christian values on our everyday lives (at least in the Western world).

The one aspect of our lives that we often deny is rooted in religion (but actually turns out to be perhaps the most influenced by our shared cultural values) is what goes on in the bedroom. The idea that “one man and one woman” is the only way to get down is 100% a byproduct of the Judeo-Christian belief systems—and I know this because 1) Romans and Greeks were wild, 2) polyamory, sexual fluidity, and other alternatives to heteronormative monogamy are hugely appealing to many, and 3) cuckolding is one of the most popular fetishes around (and has been for a long time)

So, what iscuckolding?”

On the surface, it’s getting off on the idea of your committed partner having sex with someone else while you stand by, unable to participate.It’s a bit different than “liking to watch” or other sexual activities that center around voyeurism, in that the turn-on for most people who enjoy being cuckolded is the humiliation that accompanies the experience—”being fully aware that the sex is happening, but unable to participate,” as Rebecca Reid puts it in an article for MetroUK.

The terms from which the fetish derives, “cuckold” and “cuckquean,” are nothing new—at least not semantically.

They were used as far back as Middle-English (first known use is 1250 CE) to refer to men and women respectively whose spouses were adulterous—without their consent, of course. The evolution of the terms become fairly obvious after that, as… Well, that’s what the fetish is: getting turned on by watching (or hearing about) your significant other committing adultery.

As for why people enjoy being cuckolded, Mistress Scarlett (a professional dominatrix) spoke to MetroUK to explain:

“Cuckqueaning and cuckolding are both just fetishes that are part of the wider BDSM spectrum. It’s a fetish that centers around humiliation. Humiliation is one of the most frequently requested services that I encounter.”

Although the fetish has been around for a long, long time, the visibility of this type of sexual act has tangibly increased over the past few years. It’s even shown up in some television shows (notably on the recent season of You’re The Worst)!

So, why is cucking gaining popularity and visibility?

Spoiler alert: it’s not because of the feminists making men weak as many “mens’ rights”  activists (LOL) would have you believe.

While she can’t reveal too much, Mistress Scarlett assured MetroUK that the renewed visibility has nothing to do with actual changes in sexual desires.

“This fetish has been around for as long as people have been having sex. It’s got nothing to do with a lack of masculinity. In fact most of the men I see who want this kind of humiliation and control are hugely powerful in their day-to-day careers.”

She also emphasized that plenty of women also engage in cuckqueaning, so to imply that it’s a men’s only fantasy is to misunderstand the basic appeal of the experience.

She explains that, rather than feminism breaking down “masculinity,” the popularity of cuckolding fantasies indicates a positive turn towards more openness in the bedroom between partners, no matter their gender or kinks. Mistress Scarlett actually credits 50 Shades of Grey with our modern willingness to explore different aspects of our sexuality.

“Once women started talking about having darker desires in the bedroom, men began to feel that they could express themselves,” she explained in the article. According to Miss Scarlett, it’s not that people didn’t want to do try things like cucking and other BDSM play—it’s just that they couldn’t talk about it until now. That’s a win for everyone, in my book!

Anyway, there you have it. Cuckolding is the newest-oldest thing to try in the bedroom. I don’t know if I would try it, but seriously, human sexuality is super interesting and, so long as everyone is a consenting adult, go forth and play out whatever fantasies you’ve got.

It’s 2017, folks. Live a little.

Complete Article HERE!