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How To Talk To Your Doctor About Sex When You Have Cancer

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More people are surviving cancer than ever before, but at least 60 percent of them experience long-term sexual problems post-treatment.

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So you’ve survived cancer. You’ve endured brutal treatments that caused hair loss, weight gain, nausea, or so much pain you could barely move. Perhaps your body looks different, too—maybe you had a double mastectomy with reconstruction, or an orchiectomy to remove one of your testicles. Now you’re turning your attention back to everyday life, whether that’s work, family, dating, school, or some combination of all of those. But you probably aren’t prepared for the horrifying side-effects those life-saving measures will likely have on sex and intimacy, from infertility and impotence, to penile and vaginal shrinkage, to body shame and silent suffering.

More than 15.5 million Americans are alive today with a history of cancer, and at least 60 percent of them experience long-term sexual problems post-treatment. What’s worse, only one-fifth of cancer survivors end up seeing a health care professional to get help with sex and intimacy issues stemming from their ordeal.

Part of the challenge is that the vast majority of cancer patients don’t talk to their oncologists about these problems, simply because they’re embarrassed or they think their low sex drive or severe vaginal dryness will eventually go away on their own. Others try to talk, but end up with versions of the same story: When I went back to my doctor and told him I was having problems with sex, he replied, ‘Well, I saved your life, didn’t I?’ And many oncologists aren’t prepared to answer questions about sex.

“Sex is the hot potato of patient professional communications. Everyone knows it’s important but no one wants to handle it,” says Leslie Schover, a clinical psychologist who’s one of the pioneers in helping cancer survivors navigate sexual health and fertility. “ When you ask psychologists, oncologists and nurses, ‘Do you think it’s important to talk to patients about sex?’ they say yes. And then you say, ‘Do you do it routinely?’ They say no. When you ask why, they say it’s someone else’s job.”

Schover spent 13 years as a staff psychologist at the Cleveland Clinic Foundation and nearly two decades at the University of Texas MD Anderson Cancer Center. After retiring last year, she founded Will2Love, a digital health company that offers evidence-based online help for cancer-related sex and fertility problems. Will2Love recently launched a national campaign called Bring It Up! that offers three-step plans for patients and health care providers, so they can talk more openly about how cancer treatments affect sex and intimacy. This fall, the company is collaborating with the American Cancer Society on a free clinical trial—participants will receive up to six months of free self-help programming in return for answering brief questionnaires—to track the success of the programs.

Schover spoke to Newsweek about the challenges cancer patients face when it comes to sex and intimacy, how they can better communicate with their doctors, and what resources can help them regain a satisfying sex life, even if it looks different than it did before.

NEWSWEEK: How do cancer treatments affect sex and intimacy?
LESLIE SCHOVER: A lot of cancer treatments damage some of the systems you need to have a healthy sex life. Some damage hormone levels, and surgery in the pelvic area removes parts of the reproductive system or damages nerves and blood vessels involved in sexual response. Radiation to the pelvic region reduces blood flow to the genital area for men and women, so it affects erections and women’s ability to get lubrication and have their vagina expand when they’re sexually excited.

What happens, for example, to a 35-year-old woman with breast cancer?
Even if it’s localized, they’ll probably want her to have chemotherapy, which tends to put a woman into permanent menopause. Doctors won’t want her to take any form of estrogen, so she’ll have hot flashes, severe vaginal dryness and loss of vaginal size, so sex becomes really painful. She’ll also face osteoporosis at a younger age. If she’s single and hasn’t had children, she’s facing infertility and a fast decision about freezing her eggs before chemo.

What about a 60-year-old man with prostate cancer?
A lot of men by that age are already starting to experience more difficulty getting or keeping erections, and after a prostatectomy, chances are, he won’t be able to recover full erections. Only a quarter of men recover erections anything like they had before surgery. There are a variety of treatments, like Viagra and other pills, but after prostate cancer surgery, most men don’t get a lot of benefit. They might be faced with choices like injecting a needle in the side of the penis to create a firm erection, or getting a penile prosthesis put in to give a man erections when he wants one. If he has that surgery, no semen will come out. He’ll have a dry orgasm, and although it will be quite pleasurable, a lot of men feel like it’s less intense than it was before. These men can also drip urine when they get sexually excited.

Why are so many people unprepared for these side-effects?
If you ask oncologists, ‘Do you tell patients what will happen?’ a higher percentage—like in some studies up to 80 percent—say they have talked to their patients about the sexual side-effects. When you survey patients, it’s rare that 50 percent remember a talk. But most of these talks are informed consent, like what will happen to you after surgery, radiation or chemotherapy. And during that talk, people are bombarded by so many facts and horrible side-effects that could happen, they just shut down. It’s easy for sex to get lost in the midst of this information. By the time people are really ready to hear more about sex, they’re in their recovery period.

Why is it so hard to talk about sex with your oncology team?
It takes courage to say, ‘Hey, I want to ask you about my sex life.’ When patients get their courage together and ask the question, they often get a dismissive answer like, ‘We’re controlling your cancer here, why are you worrying about your sex life?’ Or, ‘I’m your oncologist, why don’t you ask your gynecologist about that?’ Patients have to be assertive enough to bring up the question, but to deal with it if they don’t get a good answer. Sexual health is an important part of your overall quality of life and there’s nothing wrong with wanting to solve or prevent a problem.

What’s the best way for people to prepare for those conversations?
First, because clinics are so busy, ask for a longer appointment time and explain that you have a special question that needs to be addressed. At the start of the appointment, say, ‘I just want to remind you that I have one special question that I want to address today, so please give me time for that.’ Bring it up before the appointment is over.

Second, writing out a question on a piece of paper is a great idea. If you feel anxious or you’re stumbling over your words, you can take it out and read it.

Also, some people bring their spouse or partner to an appointment. They can offer moral support and help them remember all the things the doctor or nurse told them in answering the question.

So you’ve asked your question. Now what?
Don’t leave without a plan. It’s easy to ask the question, get dismissed, and say, I tried. Have a follow-up question prepared. For example, ‘If you aren’t sure how to help me, who can you send me to that might have some expertise?’ Or, ‘Does this particular hospital have a clinic that treats sexual problems?’ Or, ‘Do you know a gynecologist or urologist who’s good with these kinds of problems?’ If you want counseling, ask for that.

What happens if you still get no answers?
I created Will2Love for that problem! It came out of my long career working in cancer centers and seeing the suffering of patients who didn’t get accurate, timely information. When the internet became a place to get health info, it struck me as the perfect place for cancer, sexuality and fertility. Sex is the top search term on the Internet, so people are comfortable looking for information about sex online, including older people or those with lower incomes.

Also, experts tend to cluster in New York and California or major cancer centers. I only know of six or seven major cancer centers with a sex clinic in the U.S. and there are something like 43 comprehensive cancer centers!

We offer free content for the cancer community, including blogs and forums and resource links to finding a sex therapist of gynecologist. We also charge for specialized services with modest fees. Six months is still less than one session with a psychologist in a big city! We’re adding telehealth services that will be more expensive, but you’re talking to someone with expert training.

What can doctors do better in this area?
For health care professionals, their biggest concern is, ‘I have 40 patients to see in my clinic today and if I take 15 extra minutes with four of them, how will I take good care of everybody?’ They can ask to train someone in their clinic, like a nurse or physician’s assistant, who can take more time with each patient, so the oncologist isn’t the one providing sexual counseling, and also have a referral network set up with gynecologists, urologists and mental health professionals.

 

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Bats and BALLS

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Today, we have a follow-up question from a fellow with a ball problem.

Last week this guy writes me to tell me he thinks he might have an abnormality in his nut sack. I wrote back to him: “I applaud you taking note of your balls in an inquisitive sort of way. Good for you! But you should also have at least a rudimentary understanding of your testicular anatomy. So that when you do your self-exam, you can have some sense about what it is you are examining.” To that purpose, I offered a medical diagram for him to look at. Despite my promptings to take his huevos to a doctor for a look see, he decided to write to me once again. D’oh!

Name: anoras
Gender:
Age: 47
Location: Northridge CA
Hey doc,
Thank you so much for your previous reply and for the diagram. Yes, I’ve seen it before but really didn’t look at it precisely — Ooops. So let’s see, the thing that goes into the testicles and that gangs up to the top of the testicle, that must be what I am referring to. Feeling my balls now I realize that it is at the top and not the bottom. Can I conclude that maybe I did feel it at that time on the top and thought it at the bottom, and/or that at that time maybe I my testicle turned around for some reason? Next, at the area where it is globulous, if pressure is placed on it, would it have a pain feeling rather than applying pressure anywhere else on the testicle? That is the question I’m asking, whether there are any areas on the testicle that you would naturally feel lumps and/or pain with any pressure. The next question would be if there are ways that the testicles can be turned around and when they do can they be readjusted. Thanks in advance for your understanding and great responses.

Sheesh, darling, take your nuts to a freakin’ doctor already, why don’t cha? Since I’m not there, while you root around in your groin, to see what you’re referring to, I’m not sure what you’re referring to. And even if I were there watching you poke and prod and I could feel what you feel, I wouldn’t hazard a guess about what’s going on with you. Ya know why? Because I am not a physician, that’s why!

You ask again about lumps. Here’s a rule of thumb for us all: If you got lumps of any sort see a doctor. You ask again about pressure and pain. Since I have no way of knowing what kind of pressure you are applying, all I can say is, if you’re applying lots of pressure, it’s probably gonna hurt. If your applying only light pressure and it hurts, I’d guess there’s a problem — see your doctor.

And no, I’ve never heard of inverted testicles — see your doctor!

Ok, audience, what have we learned in today’s lesson? If any of us has a concern about what we think might be an abnormality in our naughty parts…or any other part for that matter, don’t write me…especially more than once…go see the doctor. Get it? Got it? GOOD.

Good luck

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The Gender Myth

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About five years ago, I was in a psychology class at a local university. I was the oldest student in the room then at 55. We had a guest speaker who was one of the most intelligent, courageous, articulate, enlightened individuals I have ever encountered. Her name was Sarah.

Sarah was my age and she was a transgender woman. I use the past tense because I have never seen nor spoken with her since though I have often shared some of the things she taught me.

Sarah taught me one fundamental truth that seems obvious in retrospect but seemed revolutionary to me at the time. She said there are three distinct aspects of human beings that often get conflated. These three aspects are sex (our physical biological plumbing), gender (the continuum ranging from the feminine to the masculine) and sexuality which is who we are sexually attracted to and which may vary from no sexual attraction (asexual) to same-sex attraction, opposite sex attraction and both sex attraction.

Every human being has a different construct of the combination of these three factors. It’s easy to look at your own body and see your sex. Unless of course you are like Sarah and your body doesn’t reflect the sex you identify with. Sarah did have the sex change surgery long before I met her and she was quite pleased with the results. This physical plumbing is important to most of us in that it contributes to our identities, that understanding of who we are and how we want to be perceived by the world.

The second factor Sarah spoke of is gender, that feminine / masculine thing, and that is where I am the most grateful for her wisdom. Sarah taught me that maleness and masculinity actually have little to do with each other. Nor is the feminine the domain of females. Rather both genders are equally available to both sexes except as constrained by the cultures in which they live.

If this is true, and I believe it is, then our culture is stealing part of our human birthright by suggesting that as men we are not allowed to play on the feminine end of the spectrum. We must be masculine in order to be accepted. The only place for the feminine in men is if a man is gay. This is just so obviously wrong, false, and unreasonably limiting, I can’t imagine we haven’t rebelled against it sooner. Thank God we straight men have our gay brothers to lead the way in breaking down these detestable barriers.

And then there is the denial of the masculine in women. No one needs testicles to manifest masculinity. We all know women that show up with powerful masculine energy and this has absolutely nothing to do with their sexuality. And too often they pay dearly for it by being called dykes, ball busters, or worse. Again we are conflating sex with gender. Vaginas and penises are not determinates for the masculine and feminine. The sooner we learn what Sarah understood so clearly, the sooner we can move on to a culture of appreciation for who a person is as an all inclusive being with a sex, an ever-shifting gender and a sexual orientation that is not dependent on anything other than what turns us on.

Thank you, Sarah.

Complete Article HERE!

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Mouthwash Helps Kill Gonorrhea Germs in Mouth, Throat: Study

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Listerine’s maker has long made the claim, and new Australian research seems to confirm it

by Robert Preidt

A commercial brand of mouthwash can help control gonorrhea bacteria in the mouth, and daily use may offer a cheap and easy way to reduce the spread of the sexually transmitted disease, a small study from Australia contends.

Gonorrhea rates among men are on the rise in many countries due to declining condom use, and most cases occur in gay/bisexual men, researchers said.

The maker of Listerine mouthwash has claimed as far back as 1879 that it could be used against gonorrhea, though no published research has ever proved it.

In laboratory tests, the authors of this new study found that Listerine Cool Mint and Total Care (which are both 21.6 percent alcohol) significantly reduced levels of gonorrhea bacteria. A salt water (saline) solution did not.

The researchers then conducted a clinical trial with 58 gay/bisexual men who previously tested positive for gonorrhea in their mouths/throats. The men were randomly assigned to rinse and gargle for one minute with either Listerine or a salt solution.

After doing so, the amount of viable gonorrhea in the throat was 52 percent in the Listerine group and 84 percent among those who used the salt solution. Five minutes later, men in the Listerine group were 80 percent less likely to test positive for gonorrhea in the throat than those in the salt solution group.

The study was published online Dec. 20 in the journal Sexually Transmitted Diseases.

The monitoring period after gargling was short, so it’s possible the effects of Listerine might be short-term, but the lab findings suggest otherwise, according to the researchers.

A larger study is underway to confirm these preliminary findings.

“If daily use of mouthwash was shown to reduce the duration of untreated infection and/or reduce the probability of acquisition of [gonorrhea], then this readily available, condom-less, and low-cost intervention may have very significant public health implications in the control of gonorrhea in [men who have sex with men],” Eric Chow and colleagues at the Melbourne Sexual Health Center wrote in the study. Chow is a research fellow at the center.

Gonorrhea, which is common in young adults, is spread by vaginal, oral or anal sex with an infected partner. It often has mild symptoms or none at all. If left untreated, it can cause problems with the prostate and testicles in men. In women, it can lead to pelvic inflammatory disease, which causes infertility and problems with pregnancy, according to the U.S. National Institutes of Health.

Complete Article HERE!

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How To Get Your Partner Into Sex Toys

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By Jess McIntyre

Whether you’re in a new relationship or a well-established one, there’s every reason to introduce toys for your mutual sexual happiness. Put simply, the couple that plays together are more likely to stay together – and there’s some science behind that.

First of all, the excitement of trying out sex toys stimulates the production of dopamine – the chemical that plays a big role in both sexual arousal and pleasure in general. Meanwhile, for the large majority of women the simple in-and-out of vaginal penetration alone isn’t usually the route to orgasm, but add some clitoral stimulation and you’re far more likely to score a “Yes!”. Having an orgasm produces oxytocin – also known as the ‘bonding’ hormone – which has the long term effect of making people feel closer to and more supportive of their partner.

So, the science is great – but if you’re not yet using sex toys together, how do you get past any potential embarrassment, and avoid either partner being made to feel defensive about their bedroom technique? Here are some possible dilemmas and corresponding suggestions that could help you set off on a new adventure together.

I’ve just started a new relationship. How do I admit to my partner that I already use sex toys?

It’s always best to be honest, but be sensitive and approach the subject in a casual manner outside of the bedroom. Maybe mention that you recently saw lubricant for sale in your local supermarket and how it made you smile! Judging by your partner’s reaction, you’ll know right away if you could immediately let on about your sex toy collection, or whether to stick to a more subtle hint such as, “Do you think we should pick up some lube next time we’re out?” By keeping the conversation light-hearted and jovial, you can easily disperse any tension and it will be easier to gauge what they think of the idea. It’s always a good idea to be honest from the beginning.

My partner says that if I was satisfied with them, I wouldn’t need a sex toy. How do I convince them this isn’t the case?

The trouble is that people who aren’t familiar with sex toys are often thinking of huge dildo vibrators that are, quite frankly, intimidating! But these are really just a fraction of what’s available. The most popular toys are actually things like small bullet vibrators for clitoral stimulation, or stretchy cock rings for happy erections, and they’re far from scary.

Reassure your partner that you find your sex life fulfilling but that you don’t want them to feel under pressure to be responsible alone for bringing you to orgasm. Using a mini vibrator or a cock ring can provide pleasure for you both.

A great way to turn a man’s prejudices on their head might be to buy a male toy for you both to enjoy using on him first. A textured stroker sleeve adds a whole new dimension to a hand job, and could prove to be the path to his sex toy enlightenment…

It should be noted that toys are not supposed to replace nor detract from what your partner brings to your play time in the bedroom. If anything, toys should be seen as a treat designed to enhance the experience and discover more about each other.

We do both want to use sex toys together, but we don’t know where to start

It’s a great idea to choose something together. Cuddle up with a glass of wine on a weekend evening and browse the Lovehoney website – you’re sure to find something you both like. There’s lots of advice in the ‘Help’ section to assist you, too.

If you’re in a male/female couple you could start with a toy that stimulates you both at the same time. The Tracey Cox Supersex Twin Vibrating Love Ring is great for getting you both off, for example. The stretchy cock ring part can give him a bigger, harder erection and more powerful orgasm, while the vibrating bullet in the top provides vibrations to both her clitoris and his testicles.

Same sex relationships benefit from toys just the same as hetero relationships. And strap ons aren’t just for the girls! Guys are also both using and allowing their partners to please them with these helpful and amazing tools to enhance their experience between the sheets..and anywhere else!

Or why not go for a vibrating wand massager? Originally created for soothing tired muscles, wands are also great for stimulating erogenous zones such as inner thighs or the nape of the neck, plus intimate parts such as the labia, testicles and more.

The most important part of using sex toys together is to communicate. Go ahead and experiment, and if at any point you start to feel numb or uncomfortable, speak up – your partner won’t know unless you tell them. By the same token, if you especially enjoy something, let your partner know – the joy of discovering a new favourite sensation together is what sex toys are all about!

Complete Article HERE!

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