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Female Sexual Dysfunction, Another Perspective

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Hey sex fans,

It appears that my posting of last week, Female Sexual Dysfunction Is A Fictional Disorder, caused quite a stir.  As you recall, I was answering a question from a woman who asked if FSD, or female sexual dysfunction is real or a fictitious “ailment” that is being promulgated to sell pharmaceuticals to unsuspecting women.  I replied; “I think that, for the most part, female sexual dysfunction, or FSD, is a fictional disorder. I also think pharmaceutical companies are trying to hit on a female version of Viagra to treat this imaginary disorder so they can make a bundle, just like they did with as the male version.”

Well, that didn’t sit well with some friends and colleagues. One among them, Dr. Serena McKenzie took the most exception. She sent me a little note: “Your blog on female sexual dysfunction being fictitious is – respectfully – fucking bullshit sir.” Ok then!

I invited Serena to make her case not only to me, but to all my readers. What follows is Serena in her own words.

Flibanserin, the first and only medication available for use in reproductive aged women with low libido, becomes commercially available this week after a rocky and controversial road that led to its FDA approval Aug. 18. The view on the medication whose brand name is Addyi (pronounced ADD-EE) ranges from a historical achievement in women’s health care to an epic failure of commercialized medical propaganda. Despite the lengthy debate that has surrounded flibanserin, what most people want to know is whether it will help their sex life or not now that it is here.

addyi


First Things First

While sexual concerns can be difficult to discuss for many women and their partners, it is important to acknowledge that sex and intimacy are some of the great extraordinary experiences of being human. When sex goes badly, which statistically it does for 43 percent of U.S. women, the consequences can devastate a relationship and personal health. One of the biggest applauds I have for the FDA is their statement of recognition that female sexual dysfunction is an unmet clinical need.

Sexuality Is Mind-Body But Not-Body?

Sexuality is usually complicated, and problems with sex such as loss of libido are multifactorial for most women. Antagonists to flibanserin cite psychosocial contributions such as relationship discord, body image, or history of sexual abuse to be the most pinnacle causes of a woman who may complain of problematic lack of sexual desire, and that sex is always a mind-body phenomenon. While these factors often implicitly correlate to loss of sexual interest for a woman, they don’t always, and you cannot advocate that women’s sexuality is all inclusive of her mind, body, and spirit — and assert simultaneously that a biochemical contribution which flibanserin is designed to address in the brain to improve satisfying sexual experiences does not exist.

(c) Myles Murphy; Supplied by The Public Catalogue Foundation

(c) Myles Murphy; Supplied by The Public Catalogue Foundation

The Biochemistry of Sex

Antidepressant medications that alter brain biochemistry are notorious for having sexual side effects which can be prevalent up to 92 percent of the time, and are known to decrease sexual interest, disrupt arousal, and truncate orgasm in some women. Ironically, flibanserin was originally studied as an antidepressant, and while the exact mechanism of how a medication can impair or improve sexual interest is unknown, it should not be difficult to consider that if biochemical tinkering can crush sexual function, it may also be capable of improving it.

Efficacy Data Dance

Flibanserin is a pill taken once nightly, and has been critiqued as showing only modest increases in sexual desire, with improvements in sexually satisfying events rising 0.4 to 1 per month compared with placebo. However just because flibanserin has lackluster efficacy data, that does not mean it is ineffective, and even small improvements in sexual function can be life altering for a woman struggling with disabling intimate problems. If only 1 percent of women with low libido were to improve their sexual function with use of flibanserin, that equates to 160,000 women, or the population of Tempe, Arizona.

Blue Sky Side Effects

Flibanserin has side effects, and the sky is blue. All medications have pro and con profiles, and for flibanserin the most common consequences of use include fatigue, dizziness, sleepiness, and a rare but precipitous drop in blood pressure. Women may not drink alcohol while taking this medication. Providers who will prescribe it and pharmacies that will dispense flibanserin must be approved through what is called a Risk Evaluation and Management Strategy, or REMS, which means they are educated on advising women on how to take flibanserin safely. While a REMS program is arguably overkill compared to numerous higher risk, common prescriptions which do not require a REMS, it is an excellent opportunity for clinicians who have a background in sexuality to be the main applicants since they are far more qualified to assess proper candidates for treatment as well as continue to endorse holistic measures alongside flibanserin. Women who are interested in trying flibanserin should only obtain it from sexuality trained professionals.

The Proof Is In The Sexy Pudding

If flibanserin is worthless, the marketplace will bury it in a shallow grave quickly. Women will stop paying for it, and conscientious medical providers will stop prescribing it. Yet 8,500 women taking flibanserin were studied, over a 1,000 of them for one year, and the data suggests it will help some. Women deserve to be educated on their options, because sexual health is worth fighting for.

Changing The World, One Orgasm At A Time

We simply cannot overlook how astronomical of an achievement it is to even have a mediocre medication approved for female sexual dysfunction. Women’s sexuality has been ignored by medicine for most of history. At least now we have something to fight over.

The controversy about flibanserin is in fact magnificent, and frankly, the entire point. We must talk openly about sexuality and sexual concerns to improve them, personally for one woman at a time, but also uniformly to embrace female sexuality as a vastly larger societal allowance.

A satisfying sexual life is far more than the restoration of sexual dysfunction, it’s a thriving, multi dimensional, ever evolving weave of psychology, relationships, life circumstances, and yes can include a milieu of biochemistry and neurotransmitter pools.

Is a pill ever going to replace the vastly complicated arenas that fuse into our sexual experience? Of course not — it’s absurd and lazy-minded for anyone to suggest that is even being proposed. But it is necessary and inherently responsible to allow for all possible puzzle pieces to be utilized through the ever evolving navigation of sensuality, intimacy, and erotic fulfillment.

So will flibanserin make your sex life better? Maybe. But considering the conversation about it valuable as well as its use as merely one tool among many options to improve sex and intimacy would be the better bet. Ultimately, we “desire” sex that is meaningful, erotic, and dynamic. The journey of seeking sexual vitality deserves every key, crowbar, heathen kick, graceful acrobatics, or little pink pill that lends its part to the process, no matter how small or big, for the opportunity to discover and embrace a sexual aliveness.

Holistic physician, certified sexual medicine specialist, sex counselor, medical director of the Northwest Institute for Healthy Sexuality

What Happens To Men Who Stay Abstinent Until Marriage?

by Sarah Diefendorf

Russell Wilson and his girlfriend Ciara

Seattle Seahawks quarterback Russell Wilson and his girlfriend Ciara arrive at a White House State Dinner in April.

Seattle Seahawks quarterback Russell Wilson and his girlfriend, the singer Ciara, recently announced plans to remain sexually abstinent until marriage.

It was a vow that came as a surprise to many. After all, sexual purity is a commitment that is historically expected of, associated with – even demanded of – women. However, sexual abstinence is not something assumed of men, especially men like Russell Wilson.

Wilson, an accomplished, attractive athlete, embodies contemporary ideals of masculinity, which include style, wealth and, yes, sexual prowess.

So how does a man like Russell Wilson navigate a commitment to abstinence while upholding ideals of masculinity? Wilson’s status as an athlete and heartthrob is likely giving him what sociologist CJ Pascoe calls “jock insurance.” In other words, due to his celebrity status, he can make traditionally nonmasculine choices without having his masculinity questioned.

But what does it mean for a man who isn’t in the limelight, who makes a similar type of commitment to abstinence? And what does it mean for the women they date, and might eventually marry?

I’ve been researching men who pledge sexual abstinence since 2008, work that comes out of a larger scholarly interest in masculinities, religion and sex education.

While men make this commitment with the good intentions for a fulfilling marriage and sex life, my research indicates that the beliefs about sexuality and gender that come hand in hand with these pledges of abstinence do not necessarily make for an easy transition to a married sexual life.

Who’s Pledging “Purity?”

Comedian Joy Behar recently joked that abstinence is what you do after you’ve been married for a long time. Here, Behar makes two assumptions. One is that sexual activity declines both with age and the time spent in a relationship. This is true.

The second is that abstinence is not something you do before marriage. For the most part, this is true as well: by age 21, 85% of men and 81% of women in the United States have engaged in sexual intercourse.

purity ringIf we compare these numbers to the average age of first marriage in the United States – 27 for women, and 29 for men – we get the picture: most people are having sex before marriage.

Still, some in the United States are making “virginity pledges,” and commit to abstinence until marriage. Most of the data that exist on this practice show that those who make the pledges will do so in high school, often by either signing a pledge card or donning a purity ring.

Research on this population tells us a few things: that those who pledge are more likely to be young women, and that – regardless of gender – an abstinence pledge delays the onset of sexual activity by only 18 months. Furthermore, taking a virginity pledge will often encourage other types of sexual behavior.

Virgins In Guyland

But little is known about men who pledge and navigate this commitment to abstinence.

I was curious about how men maintain pledges in light of these statistics, and also balance them with expectations about masculinity. So in 2008, I began researching a support group of 15 men at an Evangelical church in the Southwest. All members were white, in their early to mid-20’s, single or casually dating – and supporting each other in their decisions to remain abstinent until marriage.

The group, called The River, met once a week, where, sitting on couches, eating pizza or talking about video games, they’d eventually gravitate toward the topic that brought them all together in the first place: sex.

On the surface, it would seem impossible for these men to participate in what sociologist Michael Kimmel calls “Guyland” – a developmental and social stage driven by a “guy code” that demands, among other things, sexual conquest and detached intimacy.

Rather, the men of The River approach sex as something sacred, a gift from God meant to be enjoyed in the confines of the marriage bed. At the same time, these men struggle with what they describe as the “beastly elements” – or temptations – of sexuality. And it is precisely because of these so-called beastly elements that these men find each other in the same space every week.

The men of The River grappled with pornography use, masturbation, lust and same-sex desire, all of which can potentially derail these men from their pledge.

It raises an interesting dilemma: to these men, sex is both sacred and beastly. Yet the way they navigate this seeming contradiction actually allows them to exert their masculinity in line with the demands of Guyland.

Group members had an elaborate network of accountability partners to help them resist temptations. For example, one had an accountability partner who viewed his weekly online browsing history to make sure he wasn’t looking at pornography. Another accountability partner texted him each night to make sure that he and his girlfriend were “behaving.”

While these behaviors may seem unusual, they work in ways that allow men to actually assert their masculinity. Through what sociologist Amy Wilkins calls “collective performances of temptation,” these men are able to discuss just how difficult it is to refrain from the beastly urges; in this way, they reinforce the norm that they are highly sexual men, even in the absence of sexual activity.

The River, as a support group, works largely in the same way. These men are able to confirm their sexual desires in a homosocial space – similar to Kimmel’s research in Guyland – from which Kimmel notes that the “actual experience of sex pales in comparison to the experience of talking about sex.”

A ‘Sacred Gift’ – With Mixed Returns

The men of The River believed that the time and work required to maintain these pledges would pay off in the form of a happy and healthy marriage.

Ciara, in discussing her commitment to abstinence with Russell Wilson, similarly added that she believes such a promise is important for creating a foundation of love and friendship. She stated that, “if we have that [base] that strong, we can conquer anything with our love.”

So what happened once after the men of The River got married? In 2011, I followed up with them.

All but one had gotten married. But while the transition to married life brought promises of enjoying their “sacred gift from God,” this gift was fraught.

Respondents reported that they still struggled with the beastly elements of sexuality. They also had the added concern of extramarital affairs. Furthermore – and perhaps most importantly – men no longer had the support to work through these temptations.

There were two reasons behind this development.

First, respondents had been told, since they were young, that women were nonsexual. At the same time, these men had also been taught that their wives would be available for their pleasure.

It’s a double standard that’s in line with longstanding cultural ideals of the relationship between femininity and purity. But it’s a contradiction that leaves men unwilling to open up to the very women they’re having sex with.

These married men and women were not talking to each other about sex. Rather than freely discussing sex or temptation with their wives (as they had done with their accountability partners), the men simply tried to suppress temptation by imagining the devastation any sexual deviations might cause their wives.

after marriage

After marriage, the men felt left to their own devices.

Second, these men could no longer reach out to their support networks due to their own ideals of masculinity. They had been promised a sacred gift: a sexually active, happy marriage. Yet many weren’t fully satisfied, as evidenced by the continued tension between the sacred and beastly. However, to open up about these continued struggles would be to admit failure as masculine, Christian man.

In the end, the research indicates that a pledge of sexual abstinence works to uphold an ideal of masculinity that disadvantages both men and women.

After 25 years of being told that sex is something dangerous that needs to be controlled, the transition to married (and sexual) life is difficult, at best, while leaving men without the support they need. Women, meanwhile, are often left out of the conversation entirely.

So when we urge abstinence in place of healthy conversations about sex and sexuality, we may be undermining the relationships that are the driving goal of these commitments in the first place.

Complete Article HERE!

No, Scientists Have Not Found the ‘Gay Gene’

By Ed Yong

The media is hyping a study that doesn’t do what it says it does.

A woman works with human genetic material at a laboratory in Munich May 23, 2011. On May 25, 2011 the ethic commission of the German lower house of parliament (Bundestag) will discuss about alternative proposals for a new law on the use of preimplantation genetic diagnosis (PGD). Preimplantation genetic diagnosis (Praeimplantationsdiagnostik) is a technique used to identify genetic defects in embryos created through in vitro fertilization (IVF) before pregnancy, which is banned by German legislation.

This week, a team from the University of California, Los Angeles claimed to have found several epigenetic marks—chemical modifications of DNA that don’t change the underlying sequence—that are associated with homosexuality in men. Postdoc Tuck Ngun presented the results yesterday at the American Society of Human Genetics 2015 conference. Nature News were among the first to break the story based on a press release issued by the conference organisersOthers quickly followed suit. “Have They Found The Gay Gene?” said the front page of Metro, a London paper, on Friday morning.

Meanwhile, the mood at the conference has been decidedly less complimentary, with several geneticists criticizing the methods presented in the talk, the validity of the results, and the coverage in the press.

Ngun’s study was based on 37 pairs of identical male twins who were discordant—that is, one twin in each pair was gay, while the other was straight—and 10 pairs who were both gay. He analysed 140,000 regions in the genomes of the twins and looked for methylation marks—chemical Post-It notes that dictate when and where genes are activated. He whittled these down to around 6,000 regions of interest, and then built a computer model that would use data from these regions to classify people based on their sexual orientation.

The best model used just five of the methylation marks, and correctly classified the twins 67 percent of the time. “To our knowledge, this is the first example of a biomarker-based predictive model for sexual orientation,” Ngun wrote in his abstract.

The problems begin with the size of the study, which is tiny. The field of epigenetics is littered with the corpses of statistically underpowered studies like these, which simply lack the numbers to produce reliable, reproducible results.

Unfortunately, the problems don’t end there. The team split their group into two: a “training set” whose data they used to build their algorithm, and a “testing set”, whose data they used to verify it. That’s standard and good practice—exactly what they should have done. But splitting the sample means that the study goes from underpowered to really underpowered.

001

There’s also another, larger issue. As far as could be judged from the unpublished results presented in the talk, the team used their training set to build several models for classifying their twins, and eventually chose the one with the greatest accuracy when applied to the testing set. That’s a problem because in research like this, there has to be a strict firewall between the training and testing sets; the team broke that firewall by essentially using the testing set to optimise their algorithms.

If you use this strategy, chances are you will find a positive result through random chance alone. Chances are some combination of methylation marks out of the original 6,000 will be significantly linked to sexual orientation, whether they genuinely affect sexual orientation or not. This is a well-known statistical problem that can be at least partly countered by running what’s called a correction for multiple testing. The team didn’t do that. (In an email to The Atlantic, Ngun denies that such a correction was necessary.)And, “like everyone else in the history of epigenetics studies they could not resist trying to interpret the findings mechanistically,” wrote John Greally from the Albert Einstein College of Medicine in a blog post. By which he means: they gave the results an imprimatur of plausibility by noting the roles of the genes affected by the five epi-marks. One is involved in controlling immune genes that have been linked to sexual attraction. Another is involved in moving molecules along neurons. Could epi-marks on these genes influence someone’s sexual attraction? Maybe. It’s also plausible that someone’s sexual orientation influences epi-marks on these genes. Correlation, after all, does not imply causation.

So, ultimately, what we have is an underpowered fishing expedition that used inappropriate statistics and that snagged results which may be false positives. Epigenetics marks may well be involved in sexual orientation. But this study, despite its claims, does not prove that and, as designed, could not have.

In a response to Greally’s post, Ngun admitted that the study was underpowered. “The reality is that we had basically no funding,” he said. “The sample size was not what we wanted. But do I hold out for some impossible ideal or do I work with what I have? I chose the latter.” He also told Nature News that he plans to “replicate the study in a different group of twins and also determine whether the same marks are more common in gay men than in straight men in a large and diverse population.”Great. Replication and verification are the cornerstones of science. But to replicate and verify, you need a sturdy preliminary finding upon which to build and expand—and that’s not the case here. It may seem like the noble choice to work with what you’ve got. But when what you’ve got are the makings of a fatally weak study, of the kind well known to cause problems in a field, it really is an option—perhaps the best option—to not do it at all. (The same could be said for journalists outside the conference choosing to cover the study based on a press release.)As Greally wrote in his post: “It’s not personal about [Ngun] or his colleagues, but we can no longer allow poor epigenetics studies to be given credibility if this field is to survive. By ‘poor,’ I mean uninterpretable.”

“This is only representative of the broader literature,” he told me. “The problems in the field are systematic. We need to change how epigenomics research is performed throughout the community.”

Complete Article HERE!

Mistress Matisse is Doing the Lord’s Work on Behalf of Sex Workers

By Noah Berlatsky

Mistress Matisse

At the end of July, Neal Falls booked an appointment with a sex worker named Heather in West Virginia. He planned to kill her, as police believe he may have murdered as many as nine other sex workers in Ohio, Illinois and Nevada. But with Heather he failed. But with Heather, finally, he failed. When he attacked her, she fought back, got his gun and killed him.

Falls’ death was national news but, as such things do, it soon faded out of the headlines. Heather, though, was still bruised and traumatized, unable to work and in difficult financial straits.

Luckily, not everyone forgot about Heather. Mistress Matisse, a writer and dominatrix in Seattle, heard about Heather’s experience and was determined to help. Through other sex workers she tracked Heather down, called her and booked a flight to West Virginia. She showed up at Heather’s door and hasn’t really left. She’s organized fund-raising, lined up medical assistance and connected Heather with nonprofit help.

This isn’t a new role for Matisse. She’s worked as a sex worker in various capacities since she was 19. But as she’s gotten established in Seattle, she says, “I have gotten to the point in my career where it is in many ways self-sustaining.”

As a result, she’s had more time to devote to activism. Matisse was there to help Heather because she’s made it her business to help sex workers who are in crises.

I talked to Matisse about her activism, her work with Heather and why sex workers are the best ones to help sex workers.


Most of your activism is independent, rather than directly working with non-profits or sex worker organizations. Why is that?

I get a lot out of sex worker organizations as a participant. I couldn’t be who I am without the sex work community. At a certain point it became clear to me that I should do sex work activism the way I do business.

I play well with others, but I’m also an introvert, and I don’t do well in people’s systems. I do well in my own system.

As a dominatrix, my work is creative. Someone is going to walk in, and you have a very short time where you sit and talk to them and kind of go, ‘What is it that you want and that you need? And how can that fit into things that I do, or am willing to do, in a way that’s creative and sexy and fun?’ In like five minutes, OK we’re doing that thing. It’s a very quick assessment. Make a plan. Make it happen. And that’s a dynamic that I do well with, and I enjoy it.

So for me what happens a lot is that I hear or see that there’s a sex worker who’s in a crisis, and I just reach out to her and say, ‘What do you need? How can I help you?’ And there’s a connection with her, and then I begin to address her needs at an individual level.

Working with an organization, you’re committed to working at a certain pace. They’re writing policy changes they want, or they’re lobbying in a very directed way to an elected official. They are process-oriented things, and I really want people to do them. It’s just that I’m not good at doing them. It just feels like slogging through mud to me.

So you’re working directly with Heather now?

Heather’s a case that moves me. My heart’s always very involved. And that’s why I like working the way I do. It’s emotionally very rewarding for me. Some people get rewarded from having written a really great policy, but that’s not rewarding for me.

I saw Heather on the news and I immediately knew — every woman who works alone, like I do, that’s the worst fear, is that you open the door to a murderer. And every time you see a new client, that thought is in your mind. I mean, I’ve opened thousands of doors over my career, to thousands of men, and crossed my fingers and hoped to God that it wouldn’t be one of those guys.

I’ve never been harmed by a client, but there have been a few cases where I have been very frightened, and that fear that you feel when you think, ‘Oh my god, is this guy going to hurt me? Am I going to be one of those girls?’ You never forget how that feels. So when I read this story…

This guy had a list of names of who he’s going after next. So Heather saved all those women’s lives. And it’s only sheer luck that the guy decided to go to West Virginia instead of Seattle. As far as I’m concerned, Heather saved my life and the lives of all the people I know in sex work, just as surely as she saved her own and the women on that list. This guy had been at it for a while. He’s a professional. So this is very emotional for me and very personal for me, and I decided that I was going to take care of it and make sure that she got everything she needed.

I started to call people (in the sex worker community) on the East Coast asking, ‘Who knows this girl? Who knows who she is? Who has met her?’ After a couple of days of calling around we came up with her phone number, so I called her and said, ‘You don’t know me, but I saw what you did and I’m a sex worker, too, and I would like to help you.’

Is it important that sex workers be the ones to reach out to help sex workers in need?

Well, for Heather, she was having a problem because there were some people local to her who had started a fundraiser for her, they said, but they were being really weird and controlling about the money. They weren’t going to let her have it unless she fulfilled certain things that they thought they should do.

They wanted her to give interviews, when she was clearly in no shape to give interviews. She told me they had bought her this dress they wanted her to wear. They wanted her to look like a nice respectable girl. They wanted to rescue her in the way, ‘We’re going to change your life. We’re going to change who you are, and we’re going to save you from this life.’

The reason that sex workers are the best people to help other sex workers is that we do it from a place of respect for the individual, and we understand that someone has to consent to being helped, at every stage of the way.

Trying to force ‘solutions’ on us that aren’t solutions just makes our lives more difficult. And most of the time, when you get a non-SW trying to help a sex worker who’s in trouble, they focus on sex work BEING the problem.

If someone wants to stop doing sex work, then we want options made available to them. But even in that situation, it’s crucial that you not shame someone who’s done sex work to survive. Like calling them a victim, even if that’s not how they identify, and focusing on how awful it must have been, asking for horror stories instead of just saying, ‘OK, so what do you want to be doing, and how can we get you there?’

I approach helping someone like I approach the BDSM scene. There’s a person here who I think wants me to take control of the situation. But you have to get consent for that. So I can say to you that I see that you’re having some trouble here, if you allow me to, I can do anything I can to alleviate these problems. Do you give me your consent to do that? Yes. You have to get the consent, and you have to go on getting the consent throughout the process.

These people wanted to get money for Heather, that’s great, but she didn’t even know them before they started doing that. And they were talking about her on the news and stuff. And they were going to hold onto the money until she did all these things they wanted her to do. What you’re doing to her she’s not consenting to, so it’s not really help.

I can look at Heather’s house, and say, moving out of here should be your first priority because a terrible thing happened here, and she’s like, ‘No, it’s not my first priority. X is my first priority.’ So that’s what we’ll do.

Do you consider your activism —helping sex workers— to be feminist activism?

The concept of feminism is kind of like the concept of God. There’s all this doctrine and dogma and stuff. And then there’s what people do. And everyone’s version of God is a little different. I’m very much in favor of a lot of the stated goals of feminism, just as I’m in favor of many of the stated goals of religion, which is be kind to other people, don’t lie and murder. It’s those ten commandment style things that I think we’re all on board with.

But mainstream feminism rejects sex work as an acceptable choice. So for me being a sex worker and being a feminist is kind of like being an immigrant who votes Republican. Even if you happen to agree with the rest of the party platform, there’s the small issue that they want to kick you out of the country. So I don’t describe myself as an adherent to a political philosophy that wants to eliminate me.

What can people do to help Heather if they’d like to contribute?

We’ve put together a crowdfund specifically to cover medical expenses; people can contribute to that here.

Complete Article HERE!

The Thrill Is Gone

Name: Billy
Gender: Male
Age: 46
Location:
I have heard it’s normal for sex drive to diminish as you age. I’ll run this by you. I’m a 46 year old male and the last time I was at a strip club with bare boobs bouncing around me, you may as well have rolled a grapefruit across the floor. Actually, I can see more use from the grapefruit. I don’t recall the last time I did it, and jerking off was almost disgusting. My tool has shrank to nothing. I barely touch it and it just dribbles, it doesn’t fire off anymore. I don’t even like to touch it to go piss anymore. I’ve had to shave around it, so I actually find it, to keep from pissing my pants. Is this normal?

No, Billy, this isn’t normal. I think you already know that too, right?

andropauseDo you know anything about andropause? If not, you ought to. Here’s what I suggest. Use this site’s search function in the sidebar. Type in the key word: “andropause” and you will come up with a wealth of information about this issue.

You can also use the CATEGORY pull down menu. Look for the subcategory: Sex and Aging, under the main category: Aging. Everything is alphabetized.

But for the time being, here’s a typical question and response —

Name: Wilson
Gender: male
Age: 58
Location: Lancing MI
I’m a successful entrepreneur, in decent health (I could stand to lose a few pounds.) I have just about everything a man could want in life, but I’m miserable. I have no energy and I feel like I’m sleepwalking through my life. I have no sex drive at all; my wife thinks I’m having an affair…I wish. Even Viagra doesn’t do the trick anymore. Is this just old age, or what?

Old age, at 58? Middle age, perhaps! Regardless what we call it, you sound like you’re in the throws of andropause — male menopause — ya know, the change of life!

Never heard of such a thing? You’re not alone. It’s only been recently has the medical industry has begun to pay attention to the impact changing hormonal levels has on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!andropause-1

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.

While most all of us have heard of a mid-life crisis, and it’s tragic consequences — red convertible sports cars, comb-overs, and the trophy wife or lover — fewer have heard of andropause. A mid-life crisis is essentially a psycho-social adjustment to aging — bored at work, bored at home, bored with the wife or partner — that sort of thing. Andropause, although it may coincide with a mid-life crisis, is not the same thing. Andropause is a distinct physiological phenomenon that is in many ways akin to female menopause.

Unlike women, men can continue to father children after andropause, but like I said, the production of testosterone diminishes gradually after age 40. I suppose you know that testosterone is the hormone that stimulates sexual development in the male infant, bone and muscle growth in adult males, and is responsible for our sexual drive. But did you know that by the age of 55, the amount of testosterone secreted into our bloodstream is significantly lower than at 45. And by age 80, most male hormone levels have decreased to pre-puberty levels.

Men, are you over 50? Are you feeling weak, lethargic, depressed, and irritable? Do you have mood swings, hot flashes, insomnia, and decreased libido, like our buddy Wilson, here? Then you too may be andropausal. You need to get some lead back in your pencil!

mutateAll kidding aside, andropausal men might want to consider Testosterone Replacement Therapy (TRT). Ask your physician about this. Just know that some medical professionals resist testosterone therapy, mistakenly linking Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. However, before starting a testosterone regiment, insist on a complete physical, including blood work and a rectal examine. Mmmm, rectal exams!

Testosterone is available in many forms — oral, injectable, trans-dermal and by way of implants. The oral form is not recommended because of the high risk of liver damage. But injections, patches, pellets, creams and gels might be just the answer. I encourage you to be informed about TRT before you approach your doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Good luck

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