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Sexual pain after cancer treatment an unspoken affliction for many women, UC Davis oncologist says

Sexual pain is a common, but unspoken, aftermath of women’s cancer treatment. Doctors can be reluctant and patients too embarrassed to discuss it.

But it’s an all-too-real aspect of cancer treatment for women, according to Dr. Vanessa Kennedy, a gynecological oncologist for the UC Davis Health System.

Dr. Vanessa Kennedy, assistant professor in gynecological oncology, UC Davis Health System, Sacramento.

Dr. Vanessa Kennedy, assistant professor in gynecological oncology, UC Davis Health System, Sacramento.

“Some patients are two to three years out of treatment and they’re dealing with sexual pain and no one’s talked about it. Patients hesitate to bring it up because it’s a sensitive issue,” said Kennedy, who recently discussed the problem in the journal Obstetrics & Gynecology. Her co-author, Dr. Deborah Coady of New York University Langone Medical Center in New York, is author of the book, “Healing Painful Sex: A Woman’s Guide to Confronting, Diagnosing and Treating Sexual Pain.”

Kennedy estimates that about 50 percent of female patients with cancer – of any type – experience some form of sexual pain, due to physical changes caused by surgery, chemotherapy and radiation. It can range from vaginal dryness caused by early menopause to anatomical changes that can make sex uncomfortable.

Some women feel guilty they’re even concerned about their sex lives, given what they’ve been through battling cancer. “There’s some guilt that they should just feel lucky to be alive and shouldn’t ask about these other things,” she said. But when sexual health is addressed, “They’re actually relieved to know they’re not alone.”

Twice a month on Fridays, Kennedy holds a regular clinic, seeing UC Davis patients who’ve been referred for post-cancer problems with sex. She works with patients on a number of interventions, including physical therapy, lubricants (even coconut or olive oil), vaginal dilators and couples counseling to re-establish intimacy.

Kennedy said doctors and medical students need to learn to be comfortable broaching the topic. “A lot of students and providers are still a little bit nervous asking about sex,” she said. “How do you get comfortable talking about these things? You just do it. It’s just like asking a patient about changes in appetite or changes in sleep. Sex is another thing (on the list). Get over it and ask about it.”

There’s a difference in how men and women cancer patients deal with sexual health, Kennedy contends. For men who’ve undergone prostate cancer treatment, there’s an emphasis on restoring their sexual function. For women, there’s often physical pain and a loss of intimacy, along with the added fear by some that their partners view them as less desirable. In some cases, where sex has become nonexistent, patients confide that their partners have threatened to leave or cheat on them.

Kennedy, who did fellowship training at the University of Chicago, which has a sexual health program for women cancer patients, says research on women’s sexual health issues is lagging, compared with that for men with prostate cancer. Next April, she’s hosting a national gathering of the Scientific Network on Female Sexual Health and Cancer, which promotes research and information for women patients and their providers.

“Sex is a quality-of-life issue and a core of our well-being,” Kennedy concludes. “We have to bring back the intimacy and make this a part of the body that’s associated with pleasure, rather than an uncomfortable, negative place.”

Complete Article HERE!

A BDSM Game That Lets Me Explore A New Type Of Sexual Experience

By Heather Alexandra

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Ladykiller in a Bind is a visual novel by Christine Love. It’s about affection, sex, consent, manipulation, and expression. Video games can often be a vector for experimentation and escapism. Playing Ladykiller in a Bind has taught me a surprising amount about myself.

The core conceit of Ladykiller can feel a bit flimsy. You play as a woman impersonating her brother on a school cruise. There’s a contest going on; whoever gets the most votes will receive a heap of cash. This conflict ends up feeling largely secondary to the main interactions you have with many characters, which often focus more on sex and power dynamics.

There is a message at the title screen: “In real life, all power exchange must be negotiated. That is to say, there’s nothing more important than clearly communicating your desires and limits in advance, without either party feeling uncomfortable or pressured.

Mystic Messenger’s Jumin Han

Mystic Messenger’s Jumin Han

A focus on power dynamics is what makes me far more comfortable with Ladykiller in a Bind than my previous visual novel/otome game Mystic Messenger. While many of the routes in that game are tame, things escalate quickly during the route for Jumin Han. Jumin is a detached billionaire who gets very possessive once you start a relationship. At a later point in the route, he refuses to let you leave his apartment. You remain there for days.

In our discussion about the game, I mentioned my discomfort with this moment. My co-worker Cecilia D’Anastasio pointed out that some people might be into it. This is a completely fair point. Captivity and notions of ownership can be very powerful as a sexual fetish. Viewed in this light, Jumin functions as an incredibly commanding dominant.

The thing that made me uncomfortable with Jumin was my inability to approach the situation with nuance. My choices were to gleefully assent to his domination or largely equivocate and rationalize his possessiveness in a way that felt incredibly enabling. I felt forced into a role that I was not ready for and ill equipped to handle.

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Ladykiller in a Bind has a mechanic were you generate suspicion for acting differently than your brother might. A way to remove all accrued suspicion is to spend the night with another classmate. These liaisons are distinctly BDSM affairs. Unlike Mystic Messenger, I had much more ability to express myself. I could get greedy and press for kisses, I could struggle when tied, or I could completely submit. If I felt uncomfortable, I had the option to signal my discomfort. The power dynamics flowed in multiple directions. I was not helpless.

I eventually found myself submitting more and more often in these scenes. Safe within the confines of a virtual realm, I was free to experiment with sexual exchanges far different than any real world experience I’ve had. Without kissing and telling too much, it is enough to say that I’ve never particularly considered sexual submissiveness as a significant form of intimate expression. Yet here I was actively, excitedly, and consensually submitting in scenes. Game or no, I was engaging in a form of sexual exploration, sampling an experience previous foreign to me. I liked it.

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A notable thing about Ladykiller’s interactions is how much they still stress the act of being a sub as an active decision. To be submissive is to make a choice and it’s actually pretty remarkable how clear the mechanics of a visual novel make this. While video game systems can often feel reductive and lacking when it comes to simulating the real world, Ladykiller’s format makes decision making incredibly clear.

I had my character largely remain silent during these scenes. To do so I still had to make a conscious and continued decision to pass up dialog options up in favor of remaining passive. The process was still engaging and deliberate. I was never forced to do anything. I chose to play along. I trusted that the situation would never move beyond a point where I did not feel secure.

I’m not suggesting that my exploration in Ladykiller constitutes anything equal to real world experience but I do believe that the game provided a significant vector for me to experiment with certain sexual arrangements and behaviors while maintain a remarkably safe space for said experimentation. It was illuminating and respectful to me as a player. That respect is appreciated and I hope that more games might extend the same courtesy to me in the future.

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

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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.

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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!

Apple’s Health App Now Tracks Sexual Activity, and That’s a Big Opportunity

By Lux Alptraum

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It’s no secret that Apple has a fraught relationship with sex. Since the debut of the iOS App Store, the company’s made every effort to keep its wares “family friendly” (read: porn free), often employing a very, very broad definition of what, exactly, constitutes porn.

But as iOS has moved more and more into the health space, Apple’s had to contend with the reality that sex isn’t just some seedy business it can push into the corner, but instead an integral, and unavoidable, part of healthy human life. And that’s starting to change the way the company interacts with sex… at least a little bit, anyway.

Case in point: take a look at how HealthKit handles sex. Initially, the combination of health tracking app and developer tools was completely sex free, refusing to even acknowledge the existence of menstruation. After pushback from angry female users (who reminded Apple that, even though it involves a vagina, menstruation isn’t some pervy thrill), the Health app was updated to sync with period tracking and fertility apps. In its current iteration, it even allows users to track their sexual activity. Yes, your HealthKit is also a HumpKit.

At first glance, the sexual activity tracking function appears to be extremely limited. As one iPhone user noted, it only integrates with period tracking and fertility apps (in spite of the fact that there are plenty of apps specifically designed to track sexual activity itself). Viewed this way, the Health app assumes that boning is purely about reproduction—whether you’re trying to get pregnant, or trying to avoid it—and the only people who need to keep track of when and how and with whom they’re doing the dirty are people at risk of getting pregnant.

The updated Health app has more options for reproductive health.

The updated Health app has more options for reproductive health.

But there’s more to Apple’s sexual activity tracker than just app integration. Users have the ability to manually input every time they get down and dirty (noting date, time, and whether or not protection was used), allowing users to create a calendar of when, and how, they’re having sex. While this may seem like nothing more than a virtual bedpost for would-be Casanovas to etch notches into, it’s actually a great step forward for sexual health tracking—and, hopefully, for the tech world’s attitude towards sex.

Why would Health app users want to track their sexual activity (aside from the standard baby making or baby avoiding reasons)? Well, for starters, STIs. If your latest health check up turned up a chlamydia infection, it’s helpful to have access to data that allows you to pinpoint when you may have become infected—and how many partners you may have spread that infection to.

Although the app does not currently allow users to indicate who they were having sex with (perhaps due to privacy concerns, although existing sex tracking apps like Bedpost have been navigating that issue for almost a decade), having a baseline for when an infection might have occurred is at least a good start.

On the flip side of the STI equation, people managing chronic STIs might want to keep tabs on their sexual activity as part of their strategy for keeping partners safe (something that would be even more useful when combined with a log of herpes outbreaks, for instance).

And even users in committed, monogamous relationships where there’s zero risk of STI transmission can still find value to keeping tabs on their sexual activity. Just like mindfulness and nutrition and exercise and sleep, sex is an important part of life that has an impact on wellbeing and general health. If the frequency with which you’re having sex is affecting your stress level, or your emotional wellbeing, or your general health and happiness, that’s useful and important information to have.

The sex tracker is basic, but still useful.

The sex tracker is basic, but still useful.

As the app itself notes, “sexual activity can affect both physical and emotional health,” and keeping track of when you’re boning can provide a better, broader understanding of what, exactly, is affecting your health.

Apple has long viewed sex as something taboo—and when it comes to porn and sexual entertainment, that probably won’t change anytime soon. But the latest iteration of Health is a step in the right direction.

And while it could certainly benefit from a bit of expansion—recognition of the possibility of multiple partners, a more nuanced reflection of what “protection” might mean for different users, ability to indicate a partner’s gender, just for starters—it’s still a huge step forward from a historically-sex-unfriendly company. Much as we try to deny it, sexuality is a fundamental and important part of human life. It’s wonderful to see Apple finally allowing it to be truly integrated into our tech as well.

Complete Article HERE!

Heightened Awareness: Anxiety Can Lead to Pain During Sex

Clearly anxiety can be an obstacle to a healthy sex life and needs to be talked about.

By Carrie Weisman

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