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Adolescents with autism need access to better sex education

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Intimacy is part of being human. There are well-documented benefits to positive relationships, from emotional security to good mental health1. Those who want relationships and can’t develop them face low self-esteem, depression, loneliness and isolation from the wider society2.

For adolescents, learning how to navigate sex and sexuality can be a minefield. How do you figure out the nuances of sexuality without experience? How do you approach a potential partner? And once you do, how do you communicate with him or her?

This path is especially fraught for adolescents with autism. For example, people with autism tend to report higher levels of sexual abuse and sexual exploitation than their neurotypical peers3. And yet there is a gap between what these young people need and what schools provide. According to a 2012 study, adolescents with autism know less about sex than do their peers and have less access to sex education4.

My team of researchers and I are documenting the experiences of adolescents with autism in relation to sex, sexuality and their schools’ sex education requirements. Our research suggests schools should provide sex education tailored to the needs of young people with autism.

These classes should include both the standard fare — from human development to safe sex — and additional instruction on topics such as how teens can express themselves to their potential partners and how to decode innuendos and other language used to describe sex. This education is vital to ensure that these adolescents can approach relationships in a way that is safe, confident and healthy.

Role play:

One common misconception about individuals with autism is that they prefer to be alone. My research suggests this simply isn’t true.

In an ongoing study, for example, my team conducted interviews related to sex and relationships with 40 adults with autism. Only three expressed ambivalence about relationships, mostly due to worries about coping with the needs of another person. Nearly half of the respondents had not yet had a relationship but expressed a strong desire for one.

Despite the desire to form relationships, this group expressed limited knowledge about how they would meet someone or show their interest. They found the idea of going out to a pub or club frightening, and socializing with groups of people provoked high anxiety. Some of them expressed a disdain for small talk, and others admitted they had little idea of how to engage in general conversation. They also found the use of dating apps unappealing and said they thought there was an inherent danger in meeting strangers.

Sex education could help these individuals feel confident in approaching others using role-play. For example, they could use techniques created by the late Augusto Boal, a Brazilian theater director who created plays in which audiences could participate.

In the context of sex education, an actor would play the part of the individual with autism and re-create one of that person’s real-life experiences, such as trying to talk to someone new in a bar. The individual with autism would then give the actor new directions — such as “What if I offer to buy her a drink?” — allowing the person with autism to try out many approaches, and witness potential consequences, in a safe environment.

Advice network:

Although instructors may help with some aspects of communication, it’s profoundly difficult to teach someone how to read the intentions and desires of others. Most teenagers rely on peers to work through some of these social complexities.

Teens get feedback from their peers on how to interact, meet new people and gauge the appropriateness of a relationship. Teens with autism struggle with close relationships, but sex education classes could facilitate that learning.

Our research suggests that they desire this guidance. For example, one individual in our study commented that schools should provide students with the “skills on how to find the right sort of partner.” To accomplish this goal, a school could provide an advice network, including regular group meetings in which young people with autism share and reflect upon their experiences. Social networking could extend this support.

For most adolescents, peers also fill in gaps such as helping to define sexual slang. In our study, another participant commented that hearing “dirty talk” from other students made her feel left behind. She was also unsure how to decode the words she heard, and said her school should explain what people might say in a sexual context and what these terms mean. With this context, she could decide to get involved or not.

Moderated discussions in a peer network could help address such slang and provide a safe space for students to ask questions about unfamiliar words.

Different sexualities:

To be effective, sex education in schools must take into consideration that some individuals with autism do not conform to traditional sex roles. When we interviewed 40 young adults with autism as part of an ongoing study, we found that 20 percent identified as gay or bisexual — more than is reported in national surveys of the general population. Gender fluidity may also be more common in individuals with autism: In a study we conducted this year (but is not yet published), we found an unusually high incidence of autism and autism traits in individuals who identify as transsexual or non-binary.

Despite these high numbers, some people with autism find it hard to accept different sexualities. As one male participant explained: “I have a rigid way of seeing the world, and this prevented me from accepting my sexuality. I sort of denied it to myself because I have very concrete black-and-white thinking and it didn’t quite fit in.” This early inability to accept his sexuality and identify as a gay man led to severe depression and admittance to a psychiatric ward.

In some ways, people with autism may even fall outside the ever-expanding range of sexual identities we see today, such as gay, straight, bisexual, pansexual and asexual. For example, one of our participants explained that her wonderful relationship with another girl with autism often involved sitting together for up to 10 hours reading in silence, or spending hours discussing Greek history.

Autism represents a profoundly different way of seeing and being in the world, and individuals with autism often expend great mental and physical effort just trying to appear ‘normal.’ Sex education in school needs to move away from suggesting that people with autism should fit in, and instead explore alternatives to traditional types of romantic relationships.

Awareness gaps:

Our work also suggests that individuals with autism aren’t always aware that they are sexual beings. This lack of self-awareness manifests both in the sexual cues they give off and how they may be perceived by others.

For example, two participants in our study reported behavior that could be perceived as stalking, such as continually following strangers, although they didn’t indicate that they understood how this could seem threatening. One described it this way: “I literally just saw him on the street. And then pretty much just stalked him.”

Not having a sense of one’s own sexuality can be harmful in other ways. For example, individuals with autism are three times as likely to experience sexual exploitation as their peers5. In our study, participants spoke of times when they had been extremely vulnerable and open to abuse. One woman reported that others had gotten her drunk and encouraged her to have sex with girls even though she doesn’t identify as gay. In the interview, she did not appear to be aware that these incidents could be perceived as someone taking advantage of her.

Sex educators need to understand these gaps in awareness to build confidence in young people with autism and to protect them from harm and from unintentionally harming others. For example, young people with autism need to be aware of the law on issues such as stalking, which they themselves may not see as a problem. Their education needs to include lessons on the language of sex and draw distinctions between playful and threatening behavior. It also needs to address issues of abuse and signs that a relationship or encounter is abusive.

Research such as ours can offer insight into this area and provide the tools for effective sex education for people with autism. With the right support, adolescents with autism can feel more comfortable building relationships and exploring their sexuality. This support will help them develop healthy relationships and experience their benefits to well-being, self-esteem and happiness.

Complete Article HERE!

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Are you a pervert? Challenging the boundaries of sex

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Are you a pervert?

I believe you are.

This statement might offend you. Perhaps you wonder what would compel me to say something like that about you, especially since we’ve never met. However, a voice deep down inside of you might wonder if I am right. Maybe that voice is telling you that thing you did or liked may make you abnormal.

Whatever your take on this may be, I invite you to open your mind and explore what might be beyond your comfort zone. Let me entice you with a little bit of what I research as a neuroscientist of sexual behaviour.

Throughout history, those who have not lived under the conformity of social standards of sexuality have been tortured, ostracized, convicted and, in general, have lost their social standing.

In fact, non-conventional sexual practices – and fetishes – are not deviant. Yet there’s a well-established tradition of judging them as if they are. The repercussions of this societal judgment cause the social stigmatization of people we most likely don’t know at all.

One of the most common targets is the Bondage, Domination/Submission, Discipline and Sado-Masochism (BDSM) culture.

Why has society condemned certain intimate practices between consenting adults but not others? The answer possibly lies in wherever our society sets moral standards — generally biased, limited and sometimes political. Instead, normality should be derived by scientific and quantified results.

The Victorian church set sexual standards

The word pervert did not originally mean sexual deviant, but atheist. Pervert described someone who would not ascribe to the normal (church) rules. People who resisted the morality dictated by the church were people who debauched or seduced.

Additionally, the word contains the suffix ‘vert’, meaning to turn, as in, convert. Therefore, pervert described a person who turned away from the right course. The word changed from the moral heretic to the immoral sexual deviant in the Victorian era, when scholars used it to describe patients with “atypical” sexual desires. I imagine in the Victorian era that even a foot fetish would have been considered a perversion.

When it comes to bedroom activities, we often believe that most things we don’t do are wrong and sick. We often judge other people’s realities and behaviours from our limited and biased scope and experience.

Let’s talk about sex and bondage

BDSM is an umbrella term that encompasses a wide range of consensual sexual or erotic practices. BDSM communities commonly welcome anyone who identifies with their practices. Consider it akin to a book club if you like to read, or like an orchestra if you want to play classical music.

You may imagine or know some of the BDSM practices. But what makes you part of the BDSM culture? Well, there are no rules, but there are three fundamental principles that guide any BDSM practice: consent, safety and respect.

Physical and psychological well-being are a priority over anything: There is no pleasure in a sexual act when one of the parties is not enjoying it.

BDSM practices may require painful and risky stimulation carried out with extreme care. Just as in several other fun activities, such as playing a sport, practice makes perfect. There is only one way of doing things — the right way — and anyone who engages in these practices within the community knows health and safety comes first.

A vintage illustration from the 1950s for an erotic tale, Bizarre Honeymoon.

Normal and sexually satisfied

BDSM and other non-conventional sexual practices are more familiar than you may know. Research has shown that fetishes and BDSM-like practices are very common in the general population. Normal, everyday people commonly fantasize about BDSM-like experiences.

As well, BDSM practitioners and submissive-identified females in particular appear to be more sexually satisfied than the general population. Other studies have revealed increased pleasure, enjoyment and positive effects during BDSM versus non-BDSM sexual experiences.

Although BDSM practitioners were previously believed to have a history of sexual abuse and trauma, studies by medical researcher and professor Norman Breslow in the Journal of Social Behavior and Personality showed these initial ideas were based on hypothetical case studies and not empirical evidence.

As well, more recent studies show that BDSM practitioners do not generally report sexual abuse or childhood trauma. BDSM practitioners also display less depression, anxiety and post-traumatic stress symptoms compared to “normal” population standards. Furthermore, BDSM practitioners also report significantly less benevolent sexism, rape myth acceptance and victim-blaming attitudes compared to college students and the general population.

Even male and female rats have been known to develop fetishes.

A universe of possibilities

All these differences do not necessarily mean one needs to embrace more BDSM-like practices. Instead, it’s an invitation to stop judging others, and instead, embrace and enjoy our sexual lives. Fetishes can simply be the expression of our experiences and versatile sexuality in terms of practices, toys or objects that can be incorporated into our intimacy.

It’s up to each individual to choose what is right for themselves. The notion of abnormality in sexuality — with its medical and psychological labels of illness — came about to explain a deviant pattern in the reproductive aspects of mating. But humans, in general, engage in sex because they like it, not necessarily because they want to reproduce. Thus, in the eyes of those who may believe sex only serves for reproduction, any “deviation from reproductive sex” may be abnormal.

There is a universe of possibilities out there to which only you should set the boundaries. Our time in this world is too short and uncertain to deprive ourselves of the pleasures of the flesh and senses simply because someone has a negative opinion about it.

So, let me ask again, are you a pervert?

Complete Article HERE!

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What it’s like to be a male sexual surrogate

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The Sessions looked at the work of sexual surrogates

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For most adults, sex is an activity that can bring joy, frustration, contentment or disappointment – the full range of human responses. But for a few people, the very thought of sexual contact with another human being causes such anxiety that they can never get close to the act.

For them, psychosexual therapy is usually a good choice. And in a few cases, this can involve a particular form of therapy: use of a sexual surrogate.

Sexual surrogates are trained and professional stand-in partners for men and women who have severe problems getting to an intimate/sexual relationship. Normally, the client will be undergoing counselling with a psychosexual therapist, and then, in parallel with that, will have ‘bodywork’ sessions with a surrogate partner.

Andy, 50, is a psychosexual therapist who also worked as a surrogate for a number of years. Clients tend to be aged from their mid-thirties to around fifty and most came to him through word of mouth. “Some people have never experienced sexual intimacy,” he explains. “I had one client who had never gone beyond kissing.” Others have experienced abuse and have negative connotations around sex or have physiological problems.

“I would usually do between six and ten monthly sessions of three hours each. The first sessions would be about getting comfortable being in a room with a man. So I will say, ‘So you’re in a room with a man, how does that feel for you?’ And perhaps it reminds them of being a teenager so we’ll talk about what that teenage part of them needs – to be more confident, say.”

Although the sessions would build towards penetrative sex, it would be a long way down the line. But some clients want to take things too quickly, he says. “If they want to rush into sexual intimacy or penetration then I’ll slow them down and ask them where that comes from. Most of them do need to slow down because they’re rushing into what they think is the goal of sex.”

After a few sessions, Andy would bring touch into the sessions. “I would ask them what sort of touch they would want to receive. And they might like to receive some sort of massage, fully clothed or partly unclothed. Sometimes we would sit opposite each other on the sofa and find out what happens in her system if one of us leans closer. Does she get excited? Does she want to run away? Does she want to reach out and have more contact?”

Once the client was comfortable with touching, nudity would be introduced. “I might do an undressing process where I would invite them to take off one piece of clothing and each time to name a limiting belief that stops them really enjoying and celebrating their body and allowing pleasure in it. ‘One thing that stops me is my belief that I’m unattractive and my bum’s too big.’ They would take off that piece of clothing and that belief. Then I would offer feedback about what I see, so, ‘Your breasts feel very sensual and feminine to me’.”

Sexual surrogacy has been operating in Britain for a few decades, introduced from America, where it was also the subject of the Oscar-nominated film The Sessions, based on the true story of partially paralysed polio survivor Mark O’Brien and Cheryl Cohen-Greene, the surrogate he worked with to overcome his problems.

While most surrogates are female working with male clients, there are a handful of male surrogates in Britain who work with female clients. Male surrogates tend to be mid-thirties and older.

For many men, being hired to act as an intimate partner for a woman they barely know would be a strange situation. So how did Andy feel during these sessions? “Sometimes it was quite challenging, sometimes engaging, sometimes arousing,” he recalls. “And client reactions were very varied too. Some would feel ashamed, sometimes emotional or physical discomfort. Or they would feel excitement and confidence. It was moment to moment – it’s like how you feel in a relationship, you feel many things.

“It’s an interesting line to walk. There are many clients that I have worked with who I really liked and I enjoyed the work with them both sexually and emotionally but I’m also aware that I’m not there to be in a relationship with them.”

He is glad he did the job but it did cause him difficulties, not least in relationships with his own partners, whom he always made aware of his work. “I supported many women through a very challenging and sometimes life-changing process,” he says. “But I found that ultimately it took too great a toll – energetically, physically and emotionally. I was putting myself in situations of intimacy with a client that I wouldn’t necessarily have chosen. And I found that draining. I would sometimes ask, ‘Why did I do that to myself?'”

Overall he believes they key to sexual surrogacy involves being realistic about what will come of it.

“I think surrogacy is to be entered into with as much self-awareness as the client can muster,” he says. “While it can point them in the right direction, it’s not the answer. Ultimately, they have to find confidence within themselves. It can be a step on that journey.”

Complete Article HERE!

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A new way to love: in praise of polyamory

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Polyamory isn’t monogamy and it isn’t swinging, it’s being open to having loving relationships with different people of different sexes at the same time, and in that way learning to love yourself, too

‘It’s like any normal relationship, except with more time management’: Elf Lyons.

By Elf Lyons

I have never enjoyed typical monogamy. It makes me think of dowries and possessive prairie voles who mate for life, and historically all monogamous relationship models have owned women in some way, with marriage there for financial purposes and the ownership of property.

For the last few years I’ve defined myself as a polyamorist. Friends before defined me as a “friendly philanderer”. I love to kiss people. Friends usually, or women who wear polo-necks. Polyamory is consensual non- monogamy. It’s a philosophy. Rather than the active pursuing of multiple partners in a lascivious way, it’s the embracing and understanding that it’s possible to fall in love, and have relationships, with more than one person at the same time.

Alongside developing CEO-worthy skills in multitasking, polyamory is the most empowering way of loving that I have encountered. It gives women more autonomy than other relationship models ever have. Although monogamous relationship models work for many, they’re not the only way to have relationships in society. In non-monogamous relationships, their success relies on everything being on the table from the start. I believe that it could be the huge relationship revolution that the feminist movement needs.

Many think it’s about sex – it’s not. It’s not swinging. It’s not Pokémon Go, you don’t have to catch them all. It’s about the freedom to be honest about the evolving ways you feel. It opens up the boundaries between friend and lover in a safe and transparent way.

‘As a teen I questioned what it was to be adulterous. I saw infidelities on a different level to other friends’: Elf Lyons.

As a teen I questioned what it was to be adulterous. I saw infidelities on a different level to other friends. When partners mentioned they found other people attractive, I never minded. It made sense. “Why wouldn’t you want to kiss Stephanie? She’s a legend!” Apparently that was not considered a normal way to react.

If I had known as a teenager it was possible to love more than one person, it would have saved so much anxiety, guilt and time spent writing awful poetry. I spent years beating myself up about it. It often caused me to end relationships rashly, giving excuses like “I’m not ready to be in a relationship,” or “I have commitment issues,” or “I’m not into Warhammer as much as you think.” I didn’t want to end the relationships, but admitting how I felt seemed a worse betrayal, so I would lie, breaking friendships in the process.

I discovered polyamory when I was 23. I met a parliament of poly performers at the Adelaide Festival who were hippyish, liberal and kind. These performers spoke about their partners, children, poly-families. There were ex-couples who were working together on shows while their other poly families toured elsewhere, married couples who had live-in partners, triumvirates where they all balanced an equal partnership. I was entranced by their openness. It seemed symbolic of our changing global world, and most peoples developing nomadic lifestyles where we travel for work and find love with others on the way.

So when I went to study at theatre school in Paris (fresh out of a relationship with a 45-year-old French father of three), I decided to embrace my inner Barbarella. And the reality? Non-monogamy is rather ordinary and occasionally dull. Stereotypes of weird Eyes Wide Shut sex parties and Sartre/de Beauvoir/Olga ménages à trois aside, it’s like any normal relationship, except with more time- management, more conversations about “feelings” and more awkward encounters with acquaintances at parties who try to use you as their “Sexual Awakening Friend Bicycle”, ie that shy girl from book club will get drunk and put her hand on your leg, before leaning in to kiss you, hiccuping: “I really loved Orange Is the New Black…”

‘Sexual awakenings do not mean the absence of consent’: Elf Lyons.

There are misconceptions – a date once grabbed me for a kiss unexpectedly despite the fact I had made it clear I was in no way interested (my words were exactly: “This is not going to work. We have entirely different opinions on the EU and you have just told me I am ‘very funny for a woman’.”) When I pushed him away he was shocked. He believed because I was “sexually awakened” he could do what he liked. Luckily my experiences have meant that I am more vocal and confident, and able to stand up for myself. Yes I am open about my relationships and desires, but that doesn’t mean anyone’s allowed to touch me without my permission. Sexual awakenings do not mean the absence of consent.

I must admit, when I first dipped my toes into polyamory I misunderstood, went overboard with Tinder. The experience was stressful and would involve me asking awkward questions like: “Do you think crabs think fish can fly?” while wandering around the National Gallery for the third time that month. (There is no denying that polyamory suits the self-employed schedule). I learned that when people don’t know what polyamory is, they misunderstand it as another term for “hook up”, which it’s not. So previous partners have usually been friends I trust.

People often ask: “How can you truly love someone if you want to be with someone else?” and “Don’t you get jealous?” I think these statements enforce unhealthy relationship ideals. I feel it’s dangerous to think that you’re the only person that can complete someone else’s life, and be their confidant, their friend, their support network and their sexual partner. It’s too much pressure! When you take a step back, drop your ego and realise you’re one unique component of someone’s life, it’s liberating and freeing. Jealousy ebbs away and you realise that, of course, they may find another person attractive, because we’re all different pieces of a puzzle. This has made me more comfortable about myself – I am not holding myself up to standards about traditional female beauty, because I can experience it in a hundred different ways.

Of course, there have been tears, heartbreaks, existential crises and moments when I felt left out. I’ve wondered if it was actually making me more free, or more insecure, with jealousy popping up at the most inconvenient times. I’ve dated people who have lied and I’ve had relationships that have ended because they didn’t trust or believe in polyamory.

But, despite the downs, non-monogamy has revolutionised the way I view love. First, it made me less ashamed of my sexuality. I fancied girls way before I fancied boys. But as a teenager at house parties I remember being made to think that female sexual relationships were purely to turn men on. We’d all seen that scene in Cruel Intentions. I remember girls kissing at parties and the guys cheering. It was performative. Except, I wanted to kiss girls because I liked girls.

When I started getting to know people in the poly community it was as liberating as taking off an underwired bra. I have had partners of both genders. I didn’t have to “choose”: the people I met understood that it was possible to give infinite, equal love to both sexes. My confidence soared. I wasn’t hiding. Men and women had equal place in my life. I no longer felt like a pendulum, swinging from one to another. This refreshing awakening did result in many awkward conversations with my mum and dad though, which would go something like this:

Elf: “Mum and Dad, I am queer.” [Mum puts the hummus down.]

Mum: “What does that mean?”

Elf: “It means I have relationships with men and women”. [Mum picks the hummus up.]

Mum: “Oh! Well, I’m queer. Your father’s queer, your grandmother’s queer, we’re all queer darling!”

Elf: “No you don’t understand. I mean I have sex with men and women.” [Mum drops the hummus.]

Mum: “Oh Elfy… No wonder you’re so tired.”

Although I love sex, because of past unpleasant experiences I’m also mildly afraid of it. So when I started experimenting with non-monogamy the idea of being intimate emotionally as well as physically with more than one person was a challenge. But, the choice gave me a power and ownership over my wants which I felt I had lost and been made to feel ashamed about. I’m not saying I jumped in the sack with everyone I met. God no. I’m too busy. But through being less judgemental on myself, I relaxed, opened up to the people I trusted and started loving myself again. It forces you to be really honest, to live life with an undefended heart.

It’s not been plain sailing. But to quote RuPaul: “If you can’t love yourself, how the hell can you love anyone else” – this is integral to non-monogamy. You can’t use multiple relationships to fill the void and give you the gratification that you should be able to give yourself. More love doesn’t mean better love. If you are dating multiple people in order to enhance your self-worth, you end up feeling like out-of-date hummus, feeling jealous anytime anyone chooses to spend time with anyone else, resulting in you treating your partners badly and without respect.

We shouldn’t feel ashamed about being socially and sexually confident. Women have been made to feel embarrassed for their desires for too long. It’s about having the trust to speak our minds and behave the way we want to. The moment you start to crumble you need to stop and ask exactly what it is you want and if it makes you happy. Being loved and loving multiple people should make you feel stronger, not weaker.

In a time of censorship on women, increases in assault and constant critiques on how we should behave, polyamory and its manifesto of embracing our evolving feelings, sharing responsibility and communicating and working effectively with people from all around the world could help revolutionise the way we tackle privilege, inequality and control of women’s rights.

I have an authority and a voice that I didn’t feel I had before. My friendships are better, my health is better. Through being polyamorous and being a part of the community I have been made aware of issues, both personal and political, that need to be uncovered and addressed.

The world would be a better place if everybody was more open to polyamory. As well as that traditional idea, that it takes a village to raise a child, it would mean we’d all love more, and love better. Loving different people at the same time is like learning a different language. There are different rules every time and it’s always open for discussion. You start to realise that love is infinite. Every time you say “I love you” to someone it takes on a new meaning. It’s retranslated, and it’s wonderful.

Complete Article HERE!

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Who’s avoiding sex, and why

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By Shervin Assari

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

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