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Sexuality at the End of Life


By Anne Katz RN, PhD

In the terminal stages of the cancer trajectory, sexuality is often regarded as not important by health care providers. The need or ability to participate in sexual activity may wane in the terminal stages of illness, but the need for touch, intimacy, and how one views oneself don’t necessarily wane in tandem. Individuals may in fact suffer from the absence of loving and intimate touch in the final months, weeks, or days of life.head:heart

It is often assumed that when life nears its end, individuals and couples are not concerned about sexual issues and so this is not talked about. This attitude is borne out by the paucity of information about this topic.

Communicating About Sexuality with the Terminally Ill

Attitudes of health care professionals may act as a barrier to the discussion and assessment of sexuality at the end of life.

  • We bring to our practice a set of attitudes, beliefs and knowledge that we assume applies equally to our patients.
  • We may also be uncomfortable with talking about sexuality with patients or with the idea that very ill patients and/or their partners may have sexual needs at this time.
  • Our experience during our training and practice may lead us to believe that patients at the end of life are not interested in what we commonly perceive as sexual. How often do we see a patient and their partner in bed together or in an intimate embrace?
  • We may never have seen this because the circumstances of hospitals and even hospice may be such that privacy for the couple can never be assured and so couples do not attempt to lie together.

intimacy-320x320For the patient who remains at home during the final stages of illness the scenario is not that different. Often the patient is moved to a central location, such as a family or living room in the house and no longer has privacy.

  • While this may be more convenient for providing care, it precludes the expression of sexuality, as the patient is always in view.
  • Professional and volunteer helpers are frequently in the house and there may never be a time when the patient is alone or alone with his/her partner, and so is not afforded an opportunity for sexual expression.

Health care providers may not ever talk about sexual functioning at the end of life, assuming that this does not matter at this stage of the illness trajectory.

  • This sends a very clear message to the patient and his/her partner that this is something that is either taboo or of no importance. This in turn makes it more difficult for the patient and/or partner to ask questions or bring up the topic if they think that the subject is not to be talked about.

Sexual Functioning At The End Of Life

Factors affecting sexual functioning at the end of life are essentially the same as those affecting the individual with cancer at any stage of the disease trajectory. These include:go deeper

  • Psychosocial issues such as change in roles, changes in body- and self-image, depression, anxiety, and poor communication.
  • Side effects of treatment may also alter sexual functioning; fatigue, nausea, pain, edema and scarring all play a role in how the patient feels and sees him/herself and how the partner views the patient.
  • Fear of pain may be a major factor in the cessation of sexual activity; the partner may be equally fearful of hurting the patient.

The needs of the couple

Couples may find that in the final stages of illness, emotional connection to the loved one becomes an important part of sexual expression. Verbal communication and physical touching that is non-genital may take the place of previous sexual activity.

  • Many people note that the cessation of sexual activity is one of the many losses that result from the illness, and this has a negative impact on quality of life.
  • Some partners may find it difficult to be sexual when they have taken on much of the day-to-day care of the patient and see their role as caregiver rather than lover.
  • The physical and emotional toll of providing care may be exhausting and may impact on the desire for sexual contact.
  • In addition, some partners find that as the end nears for the ill partner, they need to begin to distance themselves. Part of this may be to avoid intimate touch. This is not wrong but can make the partner feel guilty and more liable to avoid physical interactions.

Addressing sexual needs

senior intimacyCouples may need to be given permission to touch each other at this stage of the illness and health care providers may need to consciously address the physical and attitudinal barriers that prevent this from happening.

  • Privacy issues need to be dealt with. This includes encouraging patients to close their door when private time is desired and having all levels of staff respect this. A sign on the door indicating that the patient is not to be disturbed should be enough to prevent staff from walking in and all staff and visitors should abide by this.
  • Partners should be given explicit permission to lie with the patient in the bed. In an ideal world, double beds could be provided but there are obvious challenges to this in terms of moving beds into and out of rooms, and challenges also for staff who may need to move or turn patients. Kissing, stroking, massaging, and holding the patient is unlikely to cause physical harm and may actually facilitate relaxation and decrease pain.
  • The partner may also be encouraged to participate in the routine care of the patient. Assisting in bathing and applying body lotion may be a non-threatening way of encouraging touch when there is fear of hurting the patient.

Specific strategies for couples who want to continue their usual sexual activities can be suggested depending on what physical or emotional barriers exist. Giving a patient permission to think about their self as sexual in the face of terminal illness is the first step. Offering the patient/couple the opportunity to discuss sexual concerns or needs validates their feelings and may normalize their experience, which in itself may bring comfort.

More specific strategies for symptoms include the following suggestions. senior lesbians

  • Timing of analgesia may need to altered to maximize pain relief and avoid sedation when the couple wants to be sexual. Narcotics, however, can interfere with arousal which may be counterproductive.
  • Fatigue is a common experience in the end stages of cancer and couples/individuals can be encouraged to set realistic goals for what is possible, and to try to use the time of day when they are most rested to be sexual either alone or with their partner.
  • Using a bronchodilator or inhaler before sexual activity may be helpful for patients who are short of breath. Using additional pillows or wedges will allow the patient to be more upright and make breathing easier.
  • Couples may find information about alternative positions for sexual activity very useful.
  • Incontinence or the presence of an indwelling catheter may represent a loss of control and dignity and may be seen as an insurmountable barrier to genital touching.

footprints-leftIt is important to emphasize that there is no right or wrong way of being sexual in the face of terminal illness; whatever the couple or individual chooses to do is appropriate and right for them. It is also not uncommon for couples to find that impending death draws them much closer and they are able to express themselves in ways that they had not for many years.

Complete Article HERE!

Some of the Most Incredible Facts About the Human Body


That’s right; most of you isn’t even really you. In fact, between 2 and 6 pounds of your weight is actually just bacteria. Feel free to factor that in next time you’re on a diet.

Scientists have discovered that there are small deposits of magnetite in human brains. While they’re not 100% sure why, a leading theory is that the magnetic crystals aid our sense of direction by drawing upon Earth’s natural magnetic fields. Similar deposits can be found in the brains of homing pigeons, dolphins and bats, who all use magnetic fields to navigate.

The muscle that moves your jaw up and down (called the masseter) exerts more pressure than any other muscle in your body — up to 200 psi on your molars! However, we still wouldn’t recommend trying to chomp through a jawbreaker.

You might not be able to run faster, but you can run farther! Human bodies are perfectly engineered for running long distances, and it’s believed we evolved this way in order to hunt more efficiently. In fact, this type of hunting — called Persistence Hunting — is still practiced by hunter-gatherers in Southern Africa. You can see a video of the process here.

There are a few other primates who can toss objects, but humans are the only animals who excel at accurate, high-momentum throwing. Some scientists argue that our ability to throw is very much responsible for our success as a species, as it gave us a way to kill strong animals from a distance. Today it comes in handy as a way to play fetch with your dog.

That’s right, GOLD! However, it’s only 0.2 milligrams of gold, which by today’s standards will net you…less than a cent. But still. It’s real gold. In fact, there are a lot of valuable chemical elements floating around your body, including Rubidium, Boron and Scandium (all valued at thousands of dollars per kilogram). All together, the chemical elements of an average human body are worth about $160.

Of course you know that your fingerprints are unique but, as it turns out, the shape of your ears is, too! Biometrics developers are working on ways of implementing this knowledge in order to easily identify individual people in crowds from CCTV footage or to take attendance in a classroom. If you’re looking for a way to evade this new technology, we recommend wearing a hat, or maybe investing in some Spock ears.

Both the shape and the pattern of bumps on your tongue are entirely unique to each individual. In fact, both your teeth and the bacteria in your mouth are also unique between people — even identical twins! So the next time someone calls you unoriginal, just stick your tongue out at them and show ’em how special you are!

A baby has over 300 bones at birth, but adults have only 206. So what gives? Did you just lose some bones and not realize it? Nope! Actually, many of the bones in a baby’s body fuse together to create bigger, mega-bones (not a medical term), and that’s how you end up with only 206 in adulthood.

Babies are born exhibiting a number of fascinating reflexes, including the ability to walk on a flat surface (as long as the baby’s body and head are supported). Another baby superpower is called the Palmar Grasp, which allows the baby to grab onto an object with surprising strength. In fact, some babies can even support their own weight (although we don’t advise trying to recreate the picture above).

And speaking of superpowers, here’s a shout out to your liver, which is basically the superhero organ of the human body. Your liver performs over 500 functions, including producing bile and cholesterol, removing bacteria from the bloodstream and — of course — clearing the blood of toxins from drugs and alcohol. Keep that in mind next time you complain about working overtime.


And if that’s not impressive enough for you, it’s recently been discovered that your nose can smell at least 1 trillion scents, making it the most sensitive organ in the body by a large margin. However, I think we can all agree that there are some scents you might be better off forgetting.

It’s called the Mammalian Diving Reflex, and it is seriously one of the coolest things your body is capable of. When you splash cold water on your face, your body thinks it’s going for a swim, and prepares accordingly. First, your heart rate slows down 10-25%. Then the blood vessels in your extremities constrict and send more blood to your lungs. As a result, you use up less oxygen and — if you were swimming — would be able to stay underwater longer.

Maybe the Mammalian Diving Reflex is what the people in face wash commercials are actually demonstrating…

Ounce for ounce, human bones can withstand a lot more pressure than steel. In fact, a cubic inch of human bone could bear a load of 19,000 pounds! Bones are also a lot lighter, less dense and more flexible than steel, which makes them a great material for, you know, supporting your entire body. Steel wins when it comes to building materials, though, because using bones would be a little too spooky.

Like, a lot of saliva. In fact, throughout the course of your lifetime, the amount of saliva you produce could fill the Olympic-size swimming pool pictured above…twice. Maybe even more if you spend a lot of time thinking about Warhead candies.

A single strand of hair can support about 100g (which is equal to about two candy bars). But twisted together, one person’s entire head of hair (consisting of about 150,000 individual strands) could support 12 tons of weight — that’s the weight of 2 elephants!

Not only is hair very strong, it’s also virtually indestructible. Aside from being flammable, hair won’t break due to extreme temperatures, and it’s also resistant to a lot of acids and other corrosive chemicals.

Although hair doesn’t easily break, you still lose between 60 and 100 strands of it every day. Think of how many elephants you could be lifting if you didn’t!

This reflex, known as the Photic Sneeze Reflex, is present in 18-35% of the population, and it causes people to sneeze when exposed to a change in light intensity (such as leaving a dimly lit building on a sunny day). Sneezing can also occur in some people after eating spicy foods, or even when they’re full after eating. This phenomenon is not completely understood, but we’re pretty sure it’s the lamest superpower ever.

While your eyes remain the same size throughout your entire life, your ears and nose will continue growing as you get older. This is partially due to the fact that they are made out of cartilage (rather than bone), but is mostly as a result of gravity. So they’re not actually growing as much as sagging. Regardless, you’ll be able to tell your grandkids “all the better to hear you with,” so that’s pretty cool.

Since fat is essentially an endocrine organ, it needs a supply of blood to function. So, as fat is added to your body, your body in turn constructs blood vessels and capillaries to provide blood to the fat cells. For each pound of fat, your body creates 7 miles of blood vessels, and that means your heart has to work harder to pump blood throughout your body. This is part of the reason why obesity is often linked to heart disease, and is also part of the reason why we’re having a salad for lunch.

Complete Article HERE!

Why I’ll miss Candida Royalle – the feminist porn queen

Candida Royalle – the legendary feminist porn director and animal rights activist – has died after long battle with ovarian cancer. Fellow porn director Petra Joy explains what she did for women everywhere

By Petra Joy

Candida Royalle former porn star and film-maker in her New York flat in 1997

Today is a very sad day for many women, feminists and erotic artists around the world. As the news spread that yesterday morning Candida Royalle died at her New York home aged just 64, her Facebook page is being transformed into a colourful kaleidoscope of an amazing life. Every few minutes someone new leaves a tribute for this truly exceptional woman that paved the way for porn from a female perspective and opened doors to the many feminist pornographers – myself included – that followed in her footsteps. All the pictures posted show a radiant woman with a smile that said “I love live, will live it to the full, let’s go and have an adventure!”

Candida was born Candice Vadala on the October 15 1950 in New York. The daughter of a jazz musician, she too was drawn towards a creative lifestyle. She studied music, art and dance and was a flamboyant and beautiful young woman. Experimenting with her sexuality and being drawn to filmmaking, she decided in the seventies to become a porn performer. In the ‘Golden Age’ of porn she starred in over 25 adult films, including titles such as “Kinky Tricks” and “Hot & Saucy Pizza Girls”.

Candida prioritised women’s pleasure and orgasms

As time went on, she grew tired of portraying female sexuality through the eyes of the men that directed her and craved taking the reins of production. In 1984, at a time where the first feminist porn movement was at its peak and when “feminist porn” was also the ultimate oxymoron, she founded her own adult film company, Femme Productions. The old boys club that ran the porn industry at the time was bemused and did not expect what was to come: Candida produced and directed 17 award-winning films, including her debut “Femme”, the “Eyes of Desire” series and “Stud Hunters”. She was way ahead of her time and proved to be right – women were voyeurs too and the moment was ripe and ready to produce porn from a female perspective.

So what made her porn different from mainstream porn, created by men and for men? Put simply – Candida prioritised women’s pleasure and orgasms. And she didn’t end every scene with the male ejaculation – the so called “money shot”. She featured a variety of sensual and sexual play rather than shooting what she used to call “predictable and soulless porn painted by numbers”. Her films showed hot men who were skilled lovers, ran credible storylines that were full of humour and spoke to a large audience who were tired of soulless wham-bam-thank you-mam porn. She was a very skilled business woman but was never motivated by financial gain. She created her films because she had a burning desire to put female sexuality on the map, inspire other women to live out their fantasies, and bring pleasure to people’s bedrooms.

As an activist for feminism and female sexual liberation, she branched out in 1999 when she developed the “Natural Contours” line of body massagers. Candida brought innovation to the sex toy market that was then saturated with giant plastic phallic rods by developing ergonomically shaped toys that hit just the right spots to make a woman orgasm. In 2004 Candida moved into writing – penning “How To Tell A Naked Man What To Do”, encouraging women to ask for what they want long before Nicki Minaj said women should demand orgasms.

Candida Royalle was all about female pleasure long before Nicki Minaj

That was also the year I started shooting my version of porn from a female perspective. In Europe back then, feminist porn was still unheard of. My style is different from Candida’s as I do not feature dialogue, but we shared the vision of porn as art and using is as a vehicle of sexual empowerment for women. It was through the legendary ‘ecosex’ artist Annie Sprinkle that I met Candida Royalle in 2008. Candida kindly viewed my first full length feature “Female Fantasies” and was full of praise. I was humbled by the amount of time she gave me and genuine support when she suggested publishing my films under her coveted “Femme” line in America. Our professional co-operation continued over the years. I published some of Candida’s classic films on my “Her Porn” anthology series and was chuffed when she agreed to be a jury member for the Petra Joy Awards I had set up for up- and coming filmmakers. To discover and mentor new talent was very close to her heart.

We shared many magic moments such as in 2009 when we were both honoured with the first Poryes award in Berlin and then two years ago when we met at the Dusk Porna Award in Amsterdam. I was baffled to win it and asked Candia onto the stage to join me. After I handed her a bunch of flowers to thank her for all she had done for the sisterhood, I walked off stage, only to be called back by her with these words: “I am very happy to step aside and just honour you and all these wonderful filmmakers who are picking it up and doing it now.” I was speechless and we hugged to thundering applause – a moment I will never forget. She was, as someone said on Facebook, the Grace Kelly of porn – a sophisticated and beautiful woman of incredible integrity, big enough to allow others to shine.

Candida was not just a colleague but became a close friend. In September 2013 I was very happy to entertain her in my home for several days where we shared beach walks, cream teas, and spoke at length about nature and environmental issues, issues close to both of our hearts which served to strengthen our bond even further. Her last post on Twitter was: “Icelandic whalers are about to start harpooning endangered fin whales again but we can stop them! Act now”.

Snettisham Bird Reserve lies on the edge of 'The Wash', one of the most important bird estuaries in the UK, supporting over 300,000 birds. A few times every year higher than average tides force thousands of waders including Knot, Oystercatchers, Sanderlings, Black and Bar Tailed Godwit and Plover to take flight, and advance up the mud flats in search of food. The event is one of the most incredible wildlife spectacles in the UK

She loved her wildlife too and was a passionate animal rights campaigner

We also both loved to feed the wildlife in our gardens and that was always a big concern to her – who would feed her birds when she was gone? She did not want to go and fought over five years a very hard fight against ovarian cancer. Only two weeks ago she was full of optimism and we emailed about her bringing my new film to America and she loved a picture of the starlings in my garden I had sent her.

So how to pay tribute to the feminist icon, animal rights activist and inspirational woman that was Candida Royalle?

Maybe it could be an apt one to start feeding your local wild birds. Alternatively, simply enjoy one of her films or toys and have an amazing orgasm in her name. I think she would like that.

Complete Article HERE!

I’m just along for the ride

Dear Dr Dick,
My husband (34) and I (31) are coming up of ten years of marriage, and for the most part our sex life has been what I would consider average. He’s pretty much been the aggressor in our relationship, which has worked out fine until now. I guess after ten years my husband would like it if I occasionally expressed interest and initiated and told him what I like/don’t like etc. I really have no idea how to do that! I told him that and his comment was that maybe I wasn’t even sure what I liked/don’t like and that I’ve pretty much just been going along for the ride all these years. He’s probably right.
We used to kiss and cuddle etc. to work up to sex and now it’s, “hey, you wanna have sex?” which completely turns me off (which he knows). I’m sure this is partly due to his work schedule and having a four year old so by the time we get to bed we’re wiped out most of the time, but I’m so not into the, “hey, you wanna…” approach.
Anyway, I guess my question is how do I get started in figuring out what I like and don’t like, how do I work up to feeling comfortable enough to verbalize it and especially verbalize or show him that I’m in the mood, and then how do I tell him I don’t like something without shutting him down. There are times, I know I don’t like something but I go along with it because I don’t want to shut him down.
I should preface by saying I’m not a very confident person and tend to be a people pleaser?

You’re husband’s right. It is fuckin’ time you started lifting your share of the sexual initiation load. I mean come on! Most women would kill for a man in their life that would show an interest in what they like and don’t like. This going along for the ride stuff has got to end, darling.

female nude159How do you get started in figuring out what you like and don’t like? Masturbation! That’s the shortest and most to the point answer I can think of. Once you discover what turns your crank through masturbation you will have loads of very important information to share with you man. And hey, don’t forget toys, vibrators in particular.

How do you work up to feeling comfortable enough to verbalize what turns you on and verbalizing or showing him that you are in the mood? The answer to this question is as simple as the previous question. You masturbate for him.

Now I know that a lot of people, and that includes most women, have been socialized to think that masturbation is wrong, or at least it’s a private affair that one should keep to herself. But I’m her to tell you that’s just bull-hockey. And this is true for both women and men, gay and straight and everyone in between.

How do you tell him you don’t like something without shutting him down? Well, it’s probably much easier to tell him what you like and how you like it rather than approaching the tutorial from the negative. If he’s not completely brain dead, he WILL get the message. If, however, he starts to do something that is rubbing you the wrong way, so to speak, simply tell him as calmly as possible that he will get a much bigger and better rise out of you if he did it THIS way. And then show him…again.masturbation001

That fact that you sometimes don’t like something but that you often if not always go along with it tells me that you’ve socialized your man into thinking he’s an adequate lover when he perhaps isn’t. Its time for a confession, girlfriend! Be as gentle as you can, but for god sake, it’s time to come clean.

Take responsibility for keeping him in the dark about his lack of sexual prowess. Then tell him that there’s a very easy and fun fix for the problem and show him what you need and how you need it.

If you indeed lack the confidence you need to be honest with the one you love and who loves you back, then frankly Brandi, you deserve what little you get. But if you can muster up the gumption to throw off the tyranny of that whole people pleasing bullshit you’ve been laboring under all these years, then you have a real shot at some happiness and sexual fulfillment. It’s gonna be up to you to make this happen. If you need some support find a sex positive therapist who will help you grow some balls.

Good luck

I’m confused

Name: sexdout
Gender: Male
Age: 28
Location: Toledo
My wife wants to have sex every night, but it’s been three years and I just can’t fuck like I used to. What do I do?

REALLY? You’re 28 and you can give up the bump at least once a day? Holy cow; what’s up with you? Are you stressed out; sleep deprived; or overweight? Are you on any medications like antidepressants or antihistamines?sexual-enrichment

If you can’t fuck like you usta; what can you fuck like? Is this a libido thing? Is it an interest thing? Or is it a boredom thing? Would you know how to pleasure your wife without taxing your pathetic worn-out peanut? If not, that’s where I think you oughta start looking for answers to your question; “What do I do?”

There’s so much more to sexual satisfaction for both women and men than the old in and out. Here’s where your biggest sex organ, the one between your ears, will come in handy. Try some sex toys, read some erotica, look into some kinky stuff. Check out the category pull-down menu in the sidebar to your right. Scroll down till you see the ENRICHMENT category. There’s a subcategory under that called Sexual Enrichment. Choose that and you will be presented with a treasure trove of ideas in both written and podcast form. There are tons of topics under the LIFESTYLE/RELATIONSHIPS Category and the SEX THERAPY Category too. Check ‘em out; you’ll be glad you did.


Gender: Male
Age: 21
Location: NEW YORK

facialThis is called a facial, pup and it’s completely safe. Unless, of course, you get your partner gets his spunk in your eyes. THAT STUFF WILL BURN LIKE CRAZY.

Good luck you guys!

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