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Cancer patients and survivors can have trouble with intimacy

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People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.

People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.(Photo: Getty Images/Comstock Images)

In the mirror, Kelly Shanahan looks normal, even to herself.

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Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health.

But she does not feel like herself.

The breasts she had reconstructed eight years ago look real, the nipples convincing. But her breasts have no sensation. The only time she feels them at all is during the frigid winters of her South Lake Tahoe, Calif., home, when they get so cold, she has to put on an extra layer of clothing.

“For a lot of women, breast sensation is a huge part of sexual pleasure and foreplay. That is totally gone,” says Shanahan, 55, who has lived with advanced breast cancer for three years. “It can be a big blow to self-image, even though you may look normal.”
Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health. (Photo: Kelly Shanahan)

Shanahan is part of a growing group of patients, advocates and doctors raising concerns about sexual health during and after cancer treatment.

“None of us would be here if it weren’t for sex. I don’t understand why we have such a difficult time talking about it,” she says.

Though virtually all cancer diagnoses and treatments affect how patients feel and what they think about their bodies, sex remains an uncomfortable medical topic.

Shanahan, an obstetrician herself, says that until her current doctor, none of the specialists who treated her cancer discussed her sex life.

“My former oncologist would rather fall through the floor than talk about sex,” she says.

Major cancer centers now include centers addressing sexuality, but most community hospitals still do not. The topic rarely is discussed unless the patient is particularly bold or the doctor has made a special commitment.

There’s no question that cancer can dampen people’s sex lives.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Weight gain or loss can affect how sexy people feel. Fatigue is unending during treatment. Body image can be transformed by surgeries and the idea that your own cells are trying to kill you. The constant specter of death is a sexual downer, as are the decidedly unsexy aspects of cancer care, like carrying around a colostomy bag. Then, there are the healthy partners, feeling guilty and terrified of causing pain.

And once people start to associate sex with pain, that can add apprehension and muscle tightness, which makes intercourse harder to achieve, says Andrea Milbourne, a gynecologist at the University of Texas MD Anderson Cancer Center in Houston.

There’s almost never a medical reason cancer patients or survivors shouldn’t be having sex, says Karen Syrjala, a clinical psychologist and co-director of the survivorship program at the Fred Hutchinson Cancer Research Center in Seattle. Even if there is reason to avoid intercourse, physical closeness and intimacy are possible, she says, noting that the sooner people address sexual issues the less serious those issues will be.

“Bodies need to be used and touched,” she says said. “Tissues need to be kept active.” Syrjala recommends hugging, romantic dinners, simple touching, “maybe just holding each other naked at night.”

There are ways to improve sexual problems, starting with doctors talking to their patients about sex. Milbourne and others say it’s their responsibility, not the patients’, to bring up the topic.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Communication between partners also is essential. “A lot of times, it’s unclear, at least in the mind of the other partner who doesn’t have a cancer, what has happened. ‘Why does this hurt? Why don’t you want to do anything?’ ” Milbourne says.

For women who have pain during sex, Milbourne says one study found benefit to using lidocaine gel to numb vaginal tissue.

Jeanne Carter, head of the female sexual medicine and women’s health program at Memorial Sloan Kettering Cancer Center in New York City, recommends women do three minutes of Kegel exercises daily to strengthen their pelvic floor muscles and improve vaginal tone, and to help reconnect to their bodies.

For women sent abruptly into menopause, moisturizing creams can help soften tissue that has become brittle and taut. Carter says she’s conducted research showing that women with breast or endometrial cancers who use moisturizers three to five times a week in the vagina and on the vulva have fewer symptoms and less pain than those who don’t. Lubricants can help smooth the way, too.

“We’ve got to make sure we get the tissue quality and pain under control or that will just undermine the whole process,” Carter says.

Sex toys also take on a different meaning after cancer treatment. Specialized stores often can offer useful advice and the ability to examine a product before buying. Rings and other equipment, in addition to medications such as Viagra, can help men regain erections.

Doctors and well-meaning friends also need to stop telling cancer patients that they should simply be glad to be alive, Shanahan says. Of course she is, but eight years after her initial diagnosis and three years after her disease advanced, Shanahan wants to make good use of the time she has left.

And that, she says, includes having a warm, intimate relationship with her husband of 21 years.

Complete Article HERE!

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Expert Shares Tips for Talking Sexual Health With Cancer Survivors

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by KATIE KOSKO

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Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer and survivors it can feel even more awkward. Nevertheless, sex ranks among the top 5 unmet needs of survivors, and the good news is, proactive oncology practitioners can help fill that void.

Sixty percent of cancer survivors—9.3 million individuals in the United States alone—end up with long-term sexual problems, but fewer than 20% get professional help, according to Leslie R. Schover, PhD, founder of the digital health startup, Will2Love. Among the barriers she cited are overburdened oncology clinics, poor insurance coverage for services related to sexual health, and an overall lack of expertise on the part of providers, many of whom don’t know how to talk to patients about these issues.

And, oncologists and oncology nurses are well-positioned to open up that line of communication.

“At least take one sentence to bring up the topic of sexuality with a new patient to find out if it is a concern for that person,” Schover explained in a recent interview with Oncology Nursing News. “Then have someone ready to do the follow-up that is needed,” and have other patient resources, such as handouts and useful websites, on hand.

Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for practitioners on the topic, has been a pioneer in developing treatment for cancer-related problems with sexuality or fertility. After decades of research and clinical practice, she has witnessed firsthand how little training is available in the area of sexual health for healthcare professionals.

“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” said Schover. “I submitted a grant four times before I retired, to provide an online interprofessional training program to encourage oncology teams to do a far better job of assessing and managing sexual problems. I could not get it funded.”

In her webinar, she offered tips for healthcare practitioners who want to learn more about how to address sexual health concerns with their patients, like using simple words that patients will understand and asking open-ended questions in order to engage patients and give them room to expand on their sex life.

Schover suggests posing a question such as: “This treatment will affect your sex life. Tell me a little about your sex life now.”

Sexual side effects after cancer treatment vary from person to person, and also from treatment to treatment. Common side effects for men and women include difficulty reaching climax, pain during sexual intercourse, lower sexual desire and feelings of being less attractive. Men specifically can experience erectile dysfunction and dry orgasm, while women may have vaginal dryness and/or tightness, as well as loss of erotic sensation such as on their breasts following breast cancer treatment.

Sexual dysfunction after cancer can often lead to depression and poor quality of life for both patients and their partners.

According to Schover, oncologists and oncology nurses should provide realistic expectations to patients when they are in the treatment decision-making process.

“Men with prostate cancer are told they are likely to have an 80% chance of having erections good enough for sex after cancer treatment,” Schover says. “But the truth is it’s more like 20 to 25% of men who will have erections like they had at baseline.”

To get more comfortable talking about sex with patients, Schover advises role-playing exercises with colleagues, friends, and family—acting as the healthcare professional and then the patient. When the process is finished, ask for feedback.

Brochures, books, websites and handouts are also good to have on hand for immediate guidance when patient questions do arise. But Schover is hoping for a bigger change rooted in multidisciplinary care and better patient–provider communication to find personalized treatments tailored to each individual’s concerns and needs.

Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, she explained. In addition, side effects like prolonged nausea, fatigue, and chronic pain also can disrupt a patient’s sex life.

“Simply to give medical solutions rarely resolves the problems because a person or couple needs to make changes in the sexual relationship to accommodate changes in physical function,” Schover stressed. “That kind of treatment is usually best coming from a trained mental health professional, especially if the couple has issues with communication or conflict.”

Schover wants to make sure that those resources are easily accessible to patients and survivors. Thus, she has created the startup, Will2Love, which offers information on the latest research and treatment, hosts webinars, and provides access to personalized services.

“Sexual health is a right,” concluded Schover, and both oncology professionals and patients need to be assertive in getting the conversation started.

Complete Article HERE!

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A slip through the back door does not a gay man make

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By JOACHIM OSUR

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When Risper met Tom, she was convinced that he was the Mr Right she had been waiting for. She was thirty-two years old and like any single woman of that age, there was enough pressure from her mum and aunties to get married as quickly as possible.

You see, there is this belief that if you do not marry by a certain age you will remain single forever and may not bear children, so the people who need to be named, those whose names your children should inherit will suffer extinction.

We believe that we live forever by giving our names to newborns from our children. Anyway, that is a story for another day.

And so it was that six months into the relationship Risper and Tom were already having sex. Plans were underway for a wedding.

Tom had already visited Risper’s parents and they were all too thankful to God for favouring their daughter with such a handsome and responsible man – Tom was a doctor, a cardiothoracic surgeon, who had delayed marriage to pursue his specialised medical qualification.

A month before the wedding Risper was seated in front of me at the sexology clinic, weeping. She was weeping because in discovering each other sexually, Tom had ventured into anal sex.

Risper was not psychologically prepared for it. All she could remember was that she heard Tom requesting in the heat of the moment to be allowed to try something new and adventurous. She said okay only to be caught unawares when he penetrated her anus!

“God forgive me, but I have to call off the wedding. I cannot marry Tom! I will not entertain homosexuality; it is evil, it is unacceptable, it is wrong!” Risper said, her eyes red and wet with tears.

NOT HOMOSEXUALITY

But anal sex is not synonymous with homosexuality. Homosexuality is sexual attraction to a person of the same sex. For women, it is called lesbianism (where a woman is attracted sexually to another woman.) Men who are attracted sexually to other men are gay. When a man is sexually attracted to a woman, like in Tom’s case, then he cannot be labeled homosexual.

“But tell me doctor, how do gay men have sex, is it not anal sex?” Risper asked not believing me.

Well, anal sex between men is gay sex but between a man and a woman it is heterosexual anal sex and it does happen. There are heterosexual couples who find it pleasurable and if they mutually enjoy it, they should be allowed to do it.

The scenario is different if one partner is uncomfortable with any type of sexual adventure in a relationship. There should be mutual discussion about it and if one party finds it unacceptable, just keep off.

“My anus hurts! I do not understand why he had to do this to me!” Risper said writhing in pain and ignoring my advice.

Of course if one chooses to have anal sex it must be understood that the anus does not lubricate (a vagina does). Applying a lubricant before penetration is important. Further, one has to be gentle and considerate of the partner’s feelings. It is insensitve to cause pain and injury to one’s partner during sex in the name of adventure.

“In fact, it is unchristian to do what Tom did to me! If I reported him to our pastor, the church would call for prayer and fasting for God to deliver us,” Risper interjected.

And yes, one’s values do matter as far as sexual adventures are concerned. If it is against your values it is better to keep off. There are people who cannot entertain anal sex, oral sex or other forms of sex other than the traditional intercourse where the penis goes into the vagina. This should be respected.

The next day I had a sit-down with both Risper and Tom and reiterated the etiquette of introducing new sexual moves to each other. Tom was saddened to hear that Risper had considered calling off the wedding.

“You know what, doctor? I did what I did to please Risper. I read somewhere that women enjoy it. In fact I forced myself into it and did not enjoy it at all,” Tom explained, gloom painted on his face.

“Well, you have learnt your lesson, in sex sometimes words speak louder than actions and you have to learn to use words more than your actions especially when introducing something new,” I explained, to which Tom nodded vigorously.

So the wedding plans continued and the couple is now married and living happily together. Two years into the marriage, Tom called and informed me that Risper had delivered a bouncing baby girl at dawn. The baby was named after Tom’s mother.

“Thank you for setting us straight on that fateful day, I cannot forget your intervention; it saved my marriage!” Tom said bursting into a loud staccato laughter.

Complete Article HERE!

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What is really afoot with the foot fetish?

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Why are some people attracted to the human foot and why is this particular fetish so misunderstood??

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The origins of the foot fetish

How the adoration of the human foot began is shrouded in mystery because it is so much more than what it seems; namely, an erotic trigger for sexual arousal. Although never traditional, since the dawn of time feet have been a stimulus for arousal. This is evidenced in the mythology, paintings, sculpture and sacred writings of many ancient civilizations including Egypt, Greece and the ancient rites of Judaism, Christianity, Buddhism and Hinduism.

The modern foot fetish

While the practice remains unchanged, the stimuli for the foot fetish in today’s world are vast and diverse because they include all forms of media; namely, art; movies; television and the Internet.

The Antebellum Art Gallery in Los Angeles recently celebrated foot worship with an exhibit entitled: Fools For Feet, which featured, among other things, a foot worship workshop, stained glass art, paintings, ceramic sculptures and drawings devoted to the human foot. There is even a foot karaoke session in which lovers of feet get a chance to sing about related songs such as These Boots Were Made For Walking and Blue Suede Shoes.

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Psychological Aspects

To Sigmund Freud, the erotic allure of feet was due to a physical resemblance to the penis, but modern psychological theorists have developed more scientific and sophisticated answers, such as early childhood imprinting and conditioning experiences, which occur when a child unconsciously connects a sexual response with a non-sexual object.

Some famous foot fetishists

The world is full of foot fetishists, some of whom are both famous and infamous. The caretakers of were known to screen women’s feet before they could have a romantic encounter Elvis Presley with him.

Pop artist, Andy Warhol, did many shoe portraits (Untitled Feet, 1958) and kept a human mummified foot by his bed. English novelist, Thomas Hardy had a fixation with women’s feet as well as talk show host, Jay Leno.  Foot fetishes affect all kinds of people, even those from the darkest side of human depravity, such as serial killer, Ted Bundy.

Why has the foot fetish survived ancient cultures and adapted to modern tastes and predilections? Well, my friends, the answer is not blowing in the proverbial, Bob-Dylan  wind, but lies rather in the words of an ancient adage that reads:

If the shoe fits…

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Complete Article HERE!

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How Finding Your Boyfriend’s ‘G-Spot’ Is The Secret To Unforgettable Sex

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There are various myths around the concept of prostate massage.

Interestingly, as more men and women become aware of the benefits of massaging the prostate area, the taboos surrounding this highly sensual experience are breaking down.

Despite what you may have heard, prostate massage is an extremely healthy activity that two people can enjoy in order to improve their intimacy and physical relationship.

If you like the idea of engaging in this pleasurable treatment, here is why your man may want a prostate massage, and how you can give him a mind blowing orgasm from it.

But first, you might want to know a little more about the prostate.

The prostate is a reproductive gland that’s located directly under the bladder, around 2 to 3 inches inside the anal passage. You may have also heard the prostate referred to as the male G-spot. There’s a very good reason for this. The prostate is part of the male orgasm cycle and stimulation of this area promotes erection and sensations of heightened pleasure.


Why should I give my partner a prostate massage?

Many men enjoy direct stimulation of the prostate due to the blissful sensations it brings. Furthermore, a prostate massage promotes an enjoyable sex life and increased sexual confidence. In a survey by a British tantric massage agency, around 33 percent of men experienced orgasms more intense than their usual ones, as well as benefiting from thicker, firmer erections.

Erectile problems are diminished with regular prostate massage as stimulation of this region increases blood flow to the area, encouraging an erection to occur. This improves your sexual energy and reduces any stress or frustration you may have been having about sexual activity.

By engaging in regular prostate massage, you’ll be relishing the thought of trying new experiences, feeling healthier and happier about the connection you have with a partner. You and your partner will feel completely relaxed during this erotic, sensual activity, increasing the sexual confidence of both of you.

Is prostate massage for everyone?

While many assume that prostate massage is an experience that only gay men participate in, it’s actually an activity that men of any sexuality enjoy. In the same survey by the massage agency, 80 percent of women said they would be happy to give their partner a prostate massage, demonstrating that this is an experience that can be shared by both sexes. It’s a very healthy activity for men and women to engage in, as well as being completely safe.

Using a prostate massager is an easy method of giving your partner a prostate massage and as stats show an increase in the sales of prostate massagers, you can be assured that it’s something that many couples are experimenting in, in order to boost their relationship and the intimate connection between them. A massage is a very erotic activity for a man and sharing this with a loved one can boost your relationship in both physical and spiritual form.

Prostate massage also has a vast number of health benefits, such as reducing the risk of contracting prostate cancer, eliminating infections and inflammation, minimizing painful ejaculation, lowering the risk of bladder infections and, of course, promoting a healthy sex life. As these benefits demonstrate, by massaging the prostate area, you’re encouraging good health and vitality. 

How can I give my partner an incredible prostate massage?

If you’re new to this activity, using a prostate massager is a straightforward method of ensuring your partner experiences the sensational effects of a massage. Many people assume that massaging the prostate is a messy experience, but the anal area is normally clean. However, its best if you ensure that the bowels have been recently cleared before participating in a massage.

During preparation of a prostate massage, ensure that your partner and any massagers are clean, and that you have lube at the ready. You may prefer to take a shower together before the massage to increase the intimacy between you.

During the massage, get your partner to sit up with his legs wide, or lie on his back with a pillow below his hips. Apply lots of lube and start to work inwards, slowly and gently.

Rock the massager back and forth in a nice rhythm and allow your partner to relax and relish in the mind blowing climactic sensations.

Complete Article HERE!

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