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Expert Shares Tips for Talking Sexual Health With Cancer Survivors



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!

The Thrills of Left-Handed Wanking

By Tom Usher

left hand

I’ve always been confused about my strongest hand. When I was knee-high to a grasshopper, I used to switch hands when writing or coloring in, when one or the other hand got tired. As a grew older I realized I was left-handed when I was writing but had an ambidextrous hangover because my stronger side was always my right.

But, I hear you ask, what does this mean for your preferred wanking hand of choice? Yes, a pertinent question. A little personal, as I barely know you, but it means in reality that I’ve always used both hands, and never really thought too much about it either way, you weirdo. After doing a bit of research I found that left-handed wanking, or “non-dominant hand masturbation,” is a thing.

“I wank with my left hand so I can browse porn using my mouse easier with the right,” is one excuse trotted out a lot by wankers. Others say the “orgasm is more intense and lasts longer when I wank with the left hand.” Finally, a lot of wankers seem to say that “wanking with the opposite hand makes it feel like someone else is doing it.” All good and valid reasons from people of an ‘ambisextrous’ nature (ZING). But to find out the real reasons why we may choose to bash off with our non-dominant hands I spoke to counselor, psychosexual, and sex addiction therapist Michael Stock, a member of the Association for the Treatment of Sexual Addiction and Compulsivity (ATSAC).

VICE: Why might you think guys might want to masturbate in different ways? What reasons have you heard so far?
Michael Stock: The key thing with internet porn is that the person, or teenager, watching it and masturbating separates sex from emotion. They’re short-circuiting—going straight to strong sexual arousal using porn, rather than putting in the effort from being with a man or woman. When they switch on their computer, they have more porn than they can shake a stick at their command—with anonymity and accessibility.

So you think people end up wanking in different ways because it’s become so easy to be aroused?
Yes. A typical guy will orgasm within about two minutes of starting to masturbate. Some people will say, ‘no that’s not me’ but most men masturbate roughly to porn, completely focused on the idea that they have to get to the orgasm—nothing pleasurable about it. Some of my clients play around for several hours and might sit there watching porn, stimulating but not allowing themselves to come, but most come quite quickly.

What mental or physical difference can non-dominant masturbation make, then?
I imagine it’s about variety, because the human brain craves excitement. If I were looking at porn, I’d start on the reasonably soft stuff and then I’d want more and more, which all has to do with dopamine. That’s when people get addicted. I’ve worked with clients who the only way they could come is masturbation—they couldn’t even do couple sex anymore. So I can imagine that non-dominant hand masturbation is another way to get some excitement and make wanking feel different.

I see a lot of stuff on the internet about the shape of people’s penises and how it affects things differently when masturbating. Have you come across anything like that?
I would say that’s unlikely to be true. I think there are a lot of rumours but, first of all, most of us are boringly normal, and secondly the size and shape shouldn’t matter. The only issue is if a man has been circumcised or not: circumcised men may find the head of the penis, filled with nerves, feels very sensitive. Unless the shape of the penis was absolutely extreme, it’s not relevant.

Have you seen any experiments or research done on the right and left hemispheres of the brain and how that impacts on masturbation?
I think that’s a red herring. Neuroscience says the right and left hemispheres talk to each other all the time—this idea is very overdone. You’re right in the sense that as someone right-handed, the left hemisphere of my cerebral cortex controls my right hand and the right side of my brain controls my left hand. But I wouldn’t think using one side of the brain or the other would be particularly important in masturbation. It would be different probably more realistically, if you think about it—and I’m going to assume you masturbate…

Assume away.
… If you were masturbating with one hand, your thumb and finger would be in a particular position, rubbing up and down the shaft of the penis. If you used your other hand, you’d stimulate other areas of the penis.


I’m ambidextrous, so this idea of right-handed people masturbating left-handed is a new thing for me.
You’ve made the case for me! You can be ambidextrous, able to do it either way around, and we can certainly learn to change. I’m strongly right-handed. I can write with my left but it’s extremely difficult; it feels like I’d get brain-ache after a while. I would say that for someone imasturbating with their non-dominant hand, the main effect would a different, and somehow novel physical stimulation of the penis.

Earlier you mentioned how porn may be desensitising us when it comes to our pleasure from masturbation.
I’ve had young men as clients, 18-year-olds, so hooked on porn that they’ve become uninterested in couple sex. We train our brain all the time, and I believe most of our behavior is learned. Young guys in particular—say 16-year-olds—who masturbate a lot are in the middle of a crucial time when their brains are growing in complexity, in neuropathological ways.

At 16, your brain did something called ‘pruning.’ It went in and got rid of lots of neural pathways it didn’t need, like a railway network over the UK that’s gone mad laying tracks everywhere until you say, ‘This is crazy I don’t need this track.’ And your brain rips up a track. Your brain goes from an overgrown weed at 16 to a nice tree structure two years later—you’ve pruned your brain. Today’s youngster are being exposed to more extreme porn when they’re young, in this pruning stage, and that’s where things have grown really interesting for someone in my line of work.

Complete Article HERE!

Sleeping with other people: how gay men are making open relationships work

A new study says non-monogamous couples can actually be closer, even as critics of open relationships argue humans are unable to separate love and sex

Non-monogamous relationships can lead to a happier, more fulfilling relationship, a study found.

Non-monogamous relationships can lead to a happier, more fulfilling relationship, a study found.

By Spencer Macnaughton

Hugh McIntyre, a 26-year-old music writer, and Toph Allen, a 28-year-old epidemiologist, are in love and have an “amazing” relationship of two and a half years. One of the keys to their success: sleeping with other people.

“We wouldn’t change a thing,” says Allen, who lives in New York City with McIntyre. “We get to fulfill our desire of having sex with other people. We avoid cheating and the resentment that comes in monogamous relationships when you can’t pursue sexual urges.” Their relationship is not unusual among gay men. In 2005, a study found that more than 40% of gay men had an agreement that sex outside the relationship was permissible, while less than 5% of heterosexual and lesbian couples reported the same.

McIntyre and Allen say the strength of their bond is built on clear and open communication. And while that assertion will be perplexing or even taboo to many monogamous couples, a new study into gay couples in open relationships suggests that this skepticism is unjustified. In fact, the study says, non-monogamous couples can actually be closer than their more faithful counterparts.

In June 2015, Christopher Stults, a researcher at The Center for Health, Identity, Behavior, and Prevention Studies at New York University, launched a qualitative study of 10 gay couples in open relationships. He conducted 45-minute, individual interviews with each of these men and their partners, who ranged in age from 19 to 43.

The study, funded by the Rural Center for Aids/STD Prevention at Indiana University, had multiple aims. “We wanted to see how these relationships form and evolve over time, and examine the perceived relationship quality, relationship satisfaction, and potential risk for HIV/STI infection,” says Stults, who finished coding the interviews this week at NYU and hopes to have the study published early next year.

So far, Stults says his finding is that non-monogamous relationships can lead to a happier, more fulfilling relationship. “My impression so far is that they don’t seem less satisfied, and it may even be that their communication is better than among monogamous couples because they’ve had to negotiate specific details,” Stults says.

And open relationships “don’t seem to put gay men at disproportionate risk for HIV and other STDs,” Stults says. “To my knowledge, no one contracted HIV and only one couple contracted an STD,” he says.

But despite Stults’s findings, there’s stigma associated with these kinds of relationships. In 2012, four studies from the University of Michigan found that participants’ perception of monogamous relationships were “overwhelmingly more favorable” than of open relationships.

“Gay men have always engaged more often in consensual non-monogamous relationships, and society has consistently stigmatized their decision to do so,” says Michael Bronski, a professor in the department of women, gender and sexuality at Harvard University.

McIntyre and Allen say they’ve experienced the stigma themselves but that an open relationship is the most honest way for them to be together. “We’ve run into gay and straight people who have assumed our relationship is ‘lesser than’ because we’re not monogamous. I think that’s offensive and ridiculous,” McIntyre says.

So what makes an open relationship work? Participants in Stults’ study emphasized that success is predicated on creating rules and sticking to them. For McIntyre and Allen, two rules are key: “Always tell the other person when you hook up with someone else, and always practice safe sex,” Allen says.

For David Sotomayor, a 46-year-old financial planner from New York, sticking to specific rules is fundamental to the success of his open marriage. “They’re built to protect the love of our relationship,” he says. “We can physically touch another man and have oral sex, but we can’t kiss, have anal sex, or go on dates with other guys,” he says. “We attach an emotional value to kissing – it’s special and unique.”

But sticking to the rules isn’t always easy. Sotomayor has broken them multiple times, which has caused conflict. “It creates a sense of doubt of whether someone is telling the truth,” he says.

Critics of non-monogamous relationships argue that humans are unable to separate love and sex. “Sex is an emotional experience,” says Brian Norton, a psychotherapist who specializes in gay couples and an adjunct professor at Columbia University’s department of counseling and clinical psychology. “There is emotion at play, and even in the most transactional experience someone can get attached,” Norton says.

Further, Norton believes that going outside the relationship for sex can lead to emotional insecurity. “I think it is a difficult pill to swallow that we cannot be all things to our partners,” he says. “A relationship is a constant balancing act between two conflicting human needs: autonomy and the need for closeness,” he says.

But Allen thinks it’s more complicated: “It’s true that love and sex are intertwined, but they aren’t the same thing. Love is about so much more than sex. [There’s] intimacy, friendship, mutual care and respect.”

That gay couples are leading the way in sexually progressive relationships shouldn’t be surprising, according to Bronski. “Because they’ve been excluded from traditional notions of sexual behavior, they’ve had to be trendsetters and forge their own relationship norms,” he says.

Norton believes the facility with which gay men engage in open relationships may be related to a fear of intimacy. “The experience of coming to terms with your homosexual identity can often be associated with emotional abandonment, shame and rejection,” he says.

“So our experience with love and intimacy at an early age is often broken and compromised, so when someone tries to get close to us as an adult, defenses get close,” he says. “It’s human nature to avoid revisiting feelings of abandonment, and open relationships may be a way of keeping a distance between another man.”

But Allen says that being open has strengthened his relationship with McIntyre and brought the couple closer together. “I feel a greater sense of connectedness with Hugh because I get to see him explore his sexuality with other people and I feel gratitude to him for giving me the same leeway,” he says.

Complete Article HERE!

I have a cold, sinking feeling in my stomach

Name: Scott
Gender: Male
Age: 20
Location: Kansas
I am a 20 year old virgin who has never even had phone- or cybersex. The reason for this is that when I am complimented in a sexual or sensual manner — for example “your voice is sexy” or “your intelligence is a major turn on” or even something as simple as “you’re cute (or adorable or whatever)” — I am aroused but I also have a very negative reaction. I have a cold, sinking feeling in my stomach, become slightly dizzy and even occasionally nauseous. I’ve been having these reactions since 7th grade, which was the first time I was propositioned. When I find the woman of my dreams I want to be able to satisfy her every want and need, but I won’t be able to if I continue to have these reactions. Can you help me get rid of this or at least give me an idea of where it comes from or what is causing it?

Sounds to me, pup, like you got yourself a bad case of sexphobia; an irrational fear of sex. This is classic: “I am aroused but I also have a very negative reaction. I have a cold, sinking feeling in my stomach, become slightly dizzy and even occasionally nauseous.” You should also know that this isn’t a particularly uncommon problem.

There’s probably a good reason why you’re experiencing this phobia. If you and I were working together I’d want to take a look at the incident you report happened to you in the 7th grade. You said you were propositioned. What does that mean? You were 12 and someone came on to you? A peer? Someone older? Was it someone inappropriate; say a family member, a clergy person, or a teacher? And why did you have such a negative response?stop

  • That being said, getting over a phobia, of whatever kind — fear of flying, snakes, spiders, public speaking, or sex — can be accomplished without dredging up the past. It may be as simple as:
    Identify the specifics of your fear as they play themselves out in your life now. What precisely frightens you about sex and/or intimacy?
  • Create a plan to take the edge off your fear in small steps. For example, start out with holding hands, move to embracing, then kissing. What behaviors push the panic button for you?
  • Address each and every thing that hampers your progress. For example, why does kissing push your buttons and holding hands and/or cuddling doesn’t?
  • Be firm in your resolve to push past your discomfort and stretch your limits. Sinking to the lowest common denominator will not do.
  • Address the emotional response you have to each aspect of your phobia before moving on to the next one. Build on your successes.

This is kinda hard to do on one’s one, but it’s not impossible. There are loads of books and programs on the market that help an individual move through a phobia. You might want to look online, look for something like: overcoming a phobia.

Some people have success with visualization techniques, for others hypnotherapy works. Basically, it’s simply a matter of desensitization — defusing the feared thing, and doing it incrementally.

Good luck

a pretty good looking guy, but a total wanker

Name: Anonymous
Gender: male
Age: 22
Location: Phoenix
Dear Dr. Dick, Im a pretty good looking guy, with a pretty average penis size, with a pretty average ego and confidence level. I am unable to make a first move. Whenever the situation rises, I become nervous as a little girl and the only thing I can think of is the awkwardness of rejection. Its really starting to throw me off balance when I cant get the physical attention I need, you know? It’s starting to make me think I’m gay also, which is totally fucking with my head. Help me out doc, what’s going on?

head up your ass

Well, anonymous, the fact that you couldn’t even bring yourself to put your own first name on this anonymous submission form, or even think up a plausible substitute marks you as a world-class wimp. And hey, here’s a tip, stop comparing your total lack of cojones to being a girl or being gay. You are neither — a girl don’t need no balls and gay men have ‘em. You, on the other hand, need to grow yourself a pair, pal!

So you’re 22, a pretty good-looking guy (or so you report) with an average sized dick (although I don’t see what that has to do with anything.), and yet you still are stumped on how to connect with a chick. Holy cow, did you miss junior high? Is there anything about you that women might find interesting? Are you intelligent, witty, fun to be with, a good conversationalist, sensitive, kind, a good cook, romantic…are you rich? Listen chum, you’re gonna need more to recommend you than bein’ pretty good lookin’ and a modest peanut.

“I can’t get the physical attention I need…” I’m gonna go way out on a limb here and guess you mean you can’t get laid, right? Maybe you need to work on your presentation. Because what self-respecting woman is gonna want to put out for someone as desperate as you. Start by getting off the pity-pot and learn to handle rejection. Don’t take it personal, rejection is just part of being a grownup. Also, jettison the notion that women are put here simply to satisfy men’s physical needs, that’s so freakin’ Neanderthal.

Put your pride aside and start connecting women as friends, not as potential sex partners. For most women, sex flows from intimacy. If you take the time to get to know a woman first, without that lean and hungry sex-starved look that I just know you have about you, you’ll find that, unless you are a totally dorky klutz, even you will get laid sooner or later.

Good luck