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Is there a doctor in the house?

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Hey sex fans,

I know I promised you a Q&A podcast for today, but I’m afraid I must disappoint. I’ve been experiencing technical difficulties all weekend long, so this charming exchange between me and a nervous mother will have to satisfy you till I can pull together the next podcast…this coming Wednesday, 12/05/12, I hope.

Name: Nora
Gender: female
Age: 26
Location: Mane
My husband and I are having a little problem with our 5-year-old son. He’s very bright and inquisitive and we encourage that in him. However, we’ve caught him playing doctor with playmates, twice in two months. Once with a 4 year old neighbor girl and most recently, a 6-year-old boy from his school. How do we handle this? We don’t want to stifle his inquisitive nature, nor do we want to send him the message that sex is bad or dirty. We weren’t raised like that and we don’t want to raise our son like that either. At the same time, he can’t continue to do this. If other parents discover this, there could be trouble. What do you think? Thanks.

Ya gotta love the curiosity and innocence of children, but I certainly understand your concern.

Reading your message took me back to one of my earliest memories. I must have been about the same age as your son at the time. A neighborhood boy, who was slightly younger than me, and I were playing in a vacant lot near our homes. We made a little fort in the tall grass. And there, out of the blue, I suggested that he, the neighbor boy, pull down his pants so that I could take his temperature with this little stick I was holding. He was perfectly compliant and, like it was an everyday thing, he bent over and I stuck the twig in his bum. I remember taking careful note of his little peepee in the process. He had one, just like me, which was a totally different configuration than my baby sisters. I had taken note of that when I watched my mother change their diapers. I remember thinking to myself, my god that is so weird. But I digress. The gist of the story is that I was a very inquisitive lad, just like your son. And the opportunity check out the neighbor kid was, just that…an opportunity to satisfy my curiosity.

A couple days later, pretty much out of the blue, my dad took me aside for a little chat. He asked me about my play with the neighbor kid. I wasn’t quite sure what he was referring to. Ya see the “doctor” incident didn’t register with me as particularly significant, or all the memorable. It just was what it was. But it sure did register with a nosy neighbor lady who witnessed the whole thing. Apparently she told my mother, my mother told my father and now he was telling me. You have to remember, this was the mid-1950s, so sexual experimentation at any age was a lot more taboo than it is today, or even when you and your hubby were kids.

To my father’s credit he wasn’t hysterical, but he was very firm. I got the unambiguous message that this sort of behavior was not OK. It’s funny, had no one seen me and the neighborhood kid in our innocent play, the incident wouldn’t have registered with me at all. I probably had the same level of interest in the kid as I would have seeing an interesting bug, or catching a glimpse of a rabbit or raccoon. It filled the moment, and then it was gone.

Like I said, despite my father’s mild manner, I did get the clear message that what I did crossed some line, a line that I didn’t even know existed beforehand. My father’s talk managed to instill a sense of shame where there was none before. And I remember realizing that my behavior wasn’t just wrong, like if I had hit someone, but it bad, like sinful. And even at that age, I understood to some degree what sin was. I had visions of Jesus and his blessed mother up in heaven crying their little hearts out over my indiscretion. So now, along with the shame I began to feel guilt.

Of course, even if my “doctor” play hadn’t been discovered at age 5 there certainly were dozens of subsequent opportunities for me to get the hardball message that sex was dirty and sinful — not just touching but even dwelling on the subject was enough to send one to hell. There simply was no escaping that fifty some years ago. Are things fundamentally different today? Probably not fundamentally! There are, no doubt, more parents these days who, like yourselves, are more enlightened than when I was a kid. But let’s face it; the predominant culture is still very sex-negative.

One of the biggest mistakes parents make when they are faced with the kind of situation you refer to, Nora, is they impose adult motivations onto their kid’s behavior. For the most part, young children don’t have a sense of shame about their bodies, nor do they have a highly developed sense of the personal space of another person. When their curiosity about their body and the bodies of others, both children and adults, turns to touching and exploration, it has no sexual connotation like we grown-ups understand.

Some years ago, I said much the same thing at a church sponsored workshop for parents. A mother in the audience stood up to tell me that I was all wet about this. She said she knew for sure that her pre-adolescent son had a sense of guilt about fondling himself, because when she caught him doing it one day he looked very guilty. Well, duh! But when we discussed the occurrence further, we were able to discover the truth. I asked her, to describe the situation. She said, “I happened to see my son, through the partially open door to his room. It was just after his bath. He was sitting on his bed touching himself impurely.” I had to chuckle at her vocabulary, but I asked her to proceed with her story. She said, “naturally, I threw open the door and said; ‘what in the world are you doing?’” I said, in a somewhat mocking tone; “Yes, naturally!”

I wasn’t hard to imagine the scene she was describing, because she was pretty agitated by just retelling the story. I could visualize the bedroom door flying open, her stomping into the room, hands on her hips, eyes glaring, nostrils flared, her voice pitched high. What she saw in her young son’s face was not shame; it was fright. I told her that she was the cause of the panic in his face. I explained that if she had barged in to his room that way, with her threatening body language and her “what in the world” screech while he was on his knees saying his bedtime prayers, the kid would have had the same look of alarm, which she interpreted as guilt. I also confronted the woman about the issue of privacy. Listen parents, even young children need and deserve their privacy. You don’t want to see embarrassing things? Avoid the temptation to walk in on your kids without knocking first.

The reason I tell you all of this, Nora, is I want you to realize that the way you address your son’s behavior is probably more important than what you actually tell him. If you approach the discussion all worried, or distressed, or alarmed, or agitated; you can be assured that your body language will tell him all he needs to know, even before you speak your first word.

If your son’s behavior doesn’t course correct all by itself, which it probably will, my advice is schedule a little family meeting. The key here is that you’ll want to talk about several things besides the bothersome behavior. You might bring up school, putting away his toys, playing doctor with the neighbors, and helping with some of the household chores. You’ll notice that the more difficult subject is couched between more mundane concerns. This will help keep the sexual issue properly situated…as part of everyday life.

When you ask him about his “doctor” play, and if you do it in a casual sort of way, he will probably tell you all about it as if he were telling you about his other play. My guess is he is not yet made the distinction between types of play. You might ask him why he’s playing this particular game. Maybe even ask him what he discovered, if anything. Once this part is over and you have some information about his motivation, you could add your perspective…the adult perspective. Here’s where you get to explain that some parts of our bodies are private. And now that he’s getting bigger he needs to understand the difference between public and private. You could make the distinction between bad and inappropriate — his play is not bad, just out of place. I’d be willing to guess that he already has a grasp on this concept.

You may not even have to tell him not to do it again. You could tell him that if he thinks he wants to play “doctor” again, he should ask for your permission. In the same way he would have to ask your permission to cross a busy street or stay at a friends house for lunch.

If after the family meeting you think you and your husband didn’t get it precisely right, just let it go. If the behavior continues you’ll have another opportunity to get it right. Here’s a tip, if you guys casually talk about body things, like personal hygiene…particularly if your son is uncut…on a regular basis you’ll have a foundation on which to build more complicated sex related discussions in the future.

Finally, keep all sex related talks firmly grounded in every day life. One good way of doing that is use examples from nature and apply it to human behavior.

Good luck

Hey dr dick! What’s that toll-free podcast voicemail telephone number? Why, it’s: (866) 422-5680. DON’T BE SHY, LET IT FLY!

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The Doctor is IN!

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Name: Paul
Gender: male
Age: 32
Location: Seattle
I hope this isn’t the first time you’ve gotten this kind of question but I’ve recently discovered that I have a urine fetish. And I guess what I want to know is if among gay men I am in a minority or what? Do you know of other guys out there who share my fetish? Also I’m in a relationship and I don’t think my boyfriend shares my interests so I was wondering if you might have some ideas on how to break the news to him. Thanks a lot.

A urine fetish, huh? Ok! Are you talking about what those in the know call watersports or golden showers, right? I think you’re telling me you like to play with your pee, or the pee of other folks, right?

40.jpgOh my god, this is like a totally popular fetish, and not just common among the gays, don’t cha know. I’m surprised that you haven’t encountered loads of other pee queens before now. Folks of every sexual stripe and persuasion are known to enjoy piss play. There’s even a scientific name for it: urophilia. Doesn’t that sound fun? Honey, guess what? I’m a urophiliac and you can be one too!

Hell, this is such a popular fetish that it has a full subset of associated fetishes. There are clothes wetting, bed-wetting and diaper fetishes, and urinal fetishes. For the BDSM crowd there are humiliation scenes and bladder control scenes just to name a few.

Historically speaking, people have been drinking their own urine as an alternative medicine for as long as…well, as long as there’s been pee to drink. Bathing in urine is also very common in some cultures.

Curiously enough, watersports is not necessarily always a sexual fetish, although it can be sexual in nature. Activities where piss is taken internally (swallowed or received anally or vaginally) can be risky. The pee-ee will no doubt ingest any and all un-metabolized drugs — pharmaceutical as well as recreational — which were consumed by the pee-er. In some societies and in some situations, this is the actual intent — for example intensifying and prolonging the effects of a hallucinogenic drug.

Prospective pee drinkers should be aware that there are a few drugs that pass through the body either partly unchanged or entirely unchanged, like those nasty amphetamines and their derivatives. So it’s all together possible to get really high from drinking a druggie’s piss.

Finally, how do you come out as a pee-queen to your boyfriend? I’m of the mind that the direct approach works best. There’s less room for misunderstandings. You could come right out and ask him for what you want. Darling, meet me in the bathroom. I want to show you something really festive and entertaining. I mean, what homo’s isn’t gonna fall for that?

A less assertive way would be to visit several golden shower oriented websites, they abound on them internets, ya know. Leave the page open for the BF to find. That will stir things up. And unless he’s as dense as a post, he’ll begin to get the message. You could also “accidentally” rent a watersports video. That would, no doubt, open the desired discussion. “Holy cow honey, look what I picked up by mistake. You wanna watch it? Isn’t this hot? Oh my god, I think I just wet my pants. Wanna see?”

Name: Maria
Gender: Female
Age: 24
Location: California
Hi Dr, My question is a little strange. My boyfriend has this weird fetish about cumming on me…not just on me but all over me. On my boobs, on my face, he likes to get it in my hair, on my feet. I’m practically swimming in the stuff. Most of the time I don’t mind it and sometimes it gets me off. But I’m just wondering what’s this all about. Why does he have this desire to cum all over me? Most of the time he wants me on my knees waiting for his gift, tongue sticking out like a dog. Any thoughts why?

Maria, darling, this is absolutely precious! I love it!

Did you ever see the brilliantly funny Mel Brooks movie, High Anxiety?

In the movie Mel Brooks plays Dr. Richard H. Thorndyke, the new administrator of the Psychoneurotic Institute for the Very, VERY Nervous. He goes to San Francisco for a conference where he is framed for a murder. Mid-way through the movie there’s a scene where Thorndyke is on the lam. He phones his new friend, Victoria Brisbane, (played by the amazing Madeline Kahn) from a phone booth to ask for her help. Victoria is in her hotel room when she answers the phone. Just at that moment, the real killer attacks Dr Thorndyke and has him by the throat. Because of all the heavy breathing and choking sounds on the Thorndyke end, Victoria thinks she getting a prank sex call. She protests but then is drawn into the call. It’s comic genius. Dr Thorndyke’s struggle comes to an end when his attacker is impaled on a shard of glass. His death gasp makes Victoria think her caller just shot his wad. She responds with disgust, “You animal!

That’s where my mind went, Maria when I got your call. The description of your boyfriend’s spooge fetish made me think of Victoria Brisbane and her exclamation, “You Animal.”

p10.jpgYa see, Maria, us boys think all the world is as enamored with our spunk as we are. And so we think we’re doing everyone a big favor by spreading our junk around. We’re particularly fond of getting as much of our joy-juice as possible on our partners and the messier the better. We’ll tell you that we do this because we love you and we just whipped up this tasty little batch of seed just for you. That’s bullshit of course.

What we’re really doing is marking our territory. Did you ever notice how pleased with himself a male dog is when he’s blissfully lifting his leg to pee on everything in site? I’d be willing to bet you’d see a similar shit-eatin’ grin on the BF as you’d see on that dog. Your BF is marking his territory, but he’s marking you with his jizz.

The upside of this is that our little nut concoction is heavily protein laden, so you’ll not find a better skin emolument. Just make sure he doesn’t get any in your eyes. That shit burns! Enjoy!

Name: Jim
Gender: male
Age: 23
Location: Sydney
I’m addicted to porn. I look at porn for hours and hours at a time at work at home on my cell phone whatever. I am noticing that the more porn I look at the more I want and now I’m searching out some real weird shit the weirder the better. I’m afraid this is taking over my life, but I can’t stop. What should I do?

Listen Jim, there’s no such thing as an addiction to porn! PERIOD!

Nowadays people bandy about the term addiction as if it could be applied to any and all obsessive behaviors. I have an addiction to chocolate, I’m addicted to shopping, or I’m a sex addict. NONSENSE!

Let’s be clear about this. An addiction is a very specific condition. It denotes a dual dependency, physical as well as a psychological. A physical dependency occurs when a substance is habitually used to a point where the body becomes reliant on its effects. The substance must be used constantly, because if it is withheld it will trigger symptoms of withdrawal. Psychological dependency occurs when the substance habitually used creates an emotional reliance on its effects. There is no functioning without it. Its absence produces intense cravings, which if not fed will trigger symptoms of withdrawal.

What you report about yourself, Jim, is not an addiction. Your behaviors, however, are a classic example of a severe fixation or obsession. Just because out of control behavior isn’t an addiction, doesn’t mean it’s not serious.

You may say to yourself, “What the fuck, doc, fixation, addiction it all sounds the same to me.” Well, sounding alike and being the same are two very different things. Besides, if one doesn’t properly identify the problem; how will one find the proper intervention? And you, my friend, need an intervention ASAP.

n.jpgYour relentless pursuit of pornography, your obsession with more and more graphic and extreme depictions of sex is clearly interfering with you living a normal life. And at such a tender age, what’s up with that? This has got to stop, pup. You can’t continue to take refuge in fantasy material in lieu of having healthy interpersonal relationships.

I’d also challenge your suggestion that you are enjoying the porn you consume. When consumption of anything — porn, food, whatever — is this unrelenting, there is no enjoyment factor anymore.

If you have the psychological capacity to limit your porn consumption on your own, great — Do it! Be strict with yourself. Deny yourself access to the materials that fuel your fixation. Channel that energy into connecting with other LIVE humans.

If you are unable to monitor your behavior on your own — seek professional help right away. Look to a sex-positive therapist who will assist you in creating boundaries for yourself. Your therapist will help you learn how to reward your successes and not reward your failures. You will, in time, be able to put this obsession behind you. But you must act now. Your humanity hangs in the balance.

Good luck, ya’ll!

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How Your Penis Exercises While You Sleep

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If you want to maintain your penis size and keep it ready to perform, it is important to know how to exercise your penis. While the “love muscle” is not actually a muscle itself, your member contains spongy tissue and chambers that fill with blood to make it harder and larger; so it’s important to exercise it like any other part of the body.

You can exercise your penis by engaging in activities that increase blood flow into it. And the best way to encourage blood flow and preserve penis length is to have regular sex and/or to masturbate more. Simply put, it’s a case of use it or lose it. The more you have sex or masturbate the better shape your penis will be in. Another thing you may not know is that your penis actually exercises itself while you sleep.

Exercising Your Penis in Your Sleep

Your penis actually gets a workout while you sleep. Those middle-of-the-night and early-morning erections have an important function. They are a way for your penis to pump itself up and get some exercise. These erections are called “nocturnal erections,” and they serve several purposes such as promoting oxygenation and blood flow to the penis and helping prevent erectile dysfunction (ED). Plus, from a biological perspective, waking up with your “little friend” ready to go with your partner nearby helps encourage reproduction. Isn’t that convenient?

This “nature’s little helper” is also a natural penis extension therapy, helping to maintain penis size by continuously stretching the penile tissue. When you have an erection, oxygenating blood fills the penis, making it hard. Having good blood flow is an essential component to achieving and maintaining that erection. All healthy men with normal erectile function have multiple erections during their sleep cycle.

As you get older, you may notice that these nocturnal and morning erections are not as strong or as frequent as you had in your younger years. One of the reasons nocturnal erections reduce as you age is because of decreased testosterone, but their absence and other erectile problems could indicate a larger health problem. If you can’t remember the last time you woke up with a hard-on, or if you have experienced erectile dysfunction while awake, talk to your doctor because erectile dysfunction (ED) can be a sign of heart disease.

The downside to having fewer nocturnal erections as you age is that you stop receiving the extension and exercise benefits they provide. That makes it so you have to start working harder in the non-sleeping hours. If you don’t exercise your penis regularly, your penis can actually shrink 1-2 centimeters. Some of the other risks for loss of penis length include weight gain, aging (due to lack of use and declining hormones), genetics, and prostate surgery.

About 70 percent of the men who have their prostate removed can expect to lose some of their penis length. Prostate cancer patients are often unable to achieve an erection for 6-24 months, so doctors sometimes prescribe penis pumps. A penis pump is a tool that keeps the blood flowing in and out, and it helps prevent permanent shrinkage by stretching the penile tissue.

How to Test for Nocturnal Erections

If you are not waking up with erections and are not sure if you still even have nocturnal erections, here’s a simple nocturnal erection test you can do over three nights in the privacy of your own home. Before you laugh, this is actually a real test used by urologists, and it has a name—the nocturnal penile tumescence (NPT) stamp test.

Get a strip of four to six postage stamps (you’ll need a strip for each night). Wrap the strip around the shaft of the penis and moisten to seal the ring. Once the stamp is dry, carefully place your penis into your shorts or underwear to protect the stamps from falling off. In the morning, check to see if the stamps have been broken along their perforation. During at least one of the three nights you should see the ring of stamps broken. If the ring is not broken there may be a physical problem, and you should talk to your doctor.

ED and Heart Disease

If you no longer are getting nocturnal erections or if you have had trouble with your erectile function during the waking hours, talk to your doctor to get your heart checked. A lack of nocturnal erections is one of the signs of ED, and ED is connected with another, scarier ED: early death. So even though exercising your penis is important, you also need to exercise your heart and eat a heart-healthy diet to protect both your heart and your love life.

When Size Matter

If you are concerned about losing your penis length, the best and most enjoyable plan is to use it as much as possible. There are penis-lengthening procedures, but they all have some cautions or drawbacks. One of the interesting penis facts, is that about 50 percent of your penis is actually inside your body courtesy of a suspensory ligament that attaches the penis to your pelvic bone. During surgery, a doctor releases the ligament so that more of the penis can move outside the body. It’s a serious procedure that takes awhile to heal, so you should look into whether gaining that extra inch or so is worth it.

If girth is more your concern than length there are some penile widening procedures as well. You can have a doctor implant silicone, fat, or tissue grafts into your penis. Another procedure that improves girth is to inject hyaluronic acid (a substance found in your body) into the penis. It is said to be painful but effective.

Maintaining a healthy sex life remains the best natural “sex-ercise plan” you can follow (along with exercise, diet, and lifestyle modifications). There are also other great sex exercises for men that can help strengthen muscles and increase stamina and flexibility for better performance. Most men will agree that having sex regularly to maintain penis size sounds much more inviting than cutting or injecting their favorite—and most sensitive—body part unless there is a serious medical reason for it.

Complete Article HERE!

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Raising Sex-Positive Kids

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My daughter is 12 years old, and she has already been groped. It happened at a local water park last summer in the wave pool, the kind of swimming pool where mechanically generated waves simulate the swell of the ocean. As one wave lifted her up, she felt the hand of a teenage boy grabbing her bikinied butt. How strange, she thought. It must have been a mistake; maybe the wave had carried him into her. Yet the same thing happened to her 11-year-old friend who was swimming nearby. Then they heard two more girls remarking loudly that the boy had touched them, too. Apparently, this young man was groping every female buttock in the pool like he was testing for ripe fruit at the farmers’ market. Soon, the two lifeguards on duty were frantically blowing their whistles. The waves stopped and the red-handed boy, standing by the lifeguard station with his father, was told to leave the water park immediately.

While the news that my young daughter had been groped horrified me, I couldn’t have imagined a better outcome. She was with a friend and her friend’s mother, able to share and process the experience and even laughed about it a little. More important, the teenage offender was caught, confronted, and suffered the consequences. He was publically shamed for his stupid and intrusive acts, as he deserved to be. And yet, my girl had been groped. She had been initiated into the world of women everywhere who are plagued by men behaving badly. Or in the words of a recent “Saturday Night Live” skit, “Welcome to Hell.”

The recent spate of news stories about women (and some men) being sexually harassed in the entertainment industry and in politics may be painful to witness, but it’s also liberating. The #metoo movement has broken the code of silence and unleashed a formidable backlash against many men who have unfairly wielded their power. Women and men are talking; mothers and fathers are talking. And many of us are wondering: How did we get here, and how can we stem the tide of sexual misconduct for the generations to come? How can we do things a little more mindfully so that we can raise girls who are empowered and expressive, and boys who are enlightened and empathetic?

A True Yes and a True No

Alicia Muñoz, a psychotherapist and couples’ counselor based in Falls Church, Virginia, sees one solution in the growing trend toward raising sex-positive kids. “Sex positive” is a relatively new buzz-phrase that’s gaining traction in the therapy world and beyond. “It’s about helping your children grow up with a sense of sexuality as a natural, normal, healthy, pleasurable part of being alive, of being a human being,” says Muñoz. “That’s easier said than done, especially in a culture that is so weighted toward sex negativity and gender biases and power differentials that are unfair. It’s a tall order, but an important thing.”

One essential message of sex positivity is that any sexual activity, and any touching of body parts, should be consensual. “Taking the shame out of sexuality is part of what provides a foundation for the awareness of consent,” says Muñoz. “It’s being able to grow up in an environment where you’re not ashamed of your own sexuality, or of sexuality in general. That’s part of what empowers you to have a voice, and having a voice means you’re connected to your right to give a true yes or a true no in different situations, including sexual ones. And on the other side of it, you’re primed to respect another’s true yes or true no when you view sex as a positive, integral, normal part of being human.”

Raising kids to be sex positive is a lifestyle that begins at the onset of parenthood. Many parents worry about when to have “the talk” with their children, but, in a sense, we’re already talking about sex to our kids before they have language. “From the moment they’re born, babies and kids are receiving data related to sex and sexuality and gender—through their senses, touch, longings, hunger, their relationship to their body, and their parents’ or caregiver’s relationships to their bodies,” says Muñoz. Yet the time will come when children want to put sex into words they can understand. And the sex-positive way for parents is to start talking about sex as soon as a child starts asking about it. “When a child asks a question, even if that child is just two and a half or three, you answer it in simple, true language,” says Muñoz. “You call a vulva a vulva, a penis a penis. You don’t call it a wee-wee or a pee-pee or another nickname. You show that, even in the naming of body parts, there’s no need to hide it.”

While the goal is to remove any negativity and evasiveness from sexuality, it’s important not to take the message too far and give your child more than he or she is ready to handle. Talk about sex should be age-appropriate, keeping in mind what young brains need. “Little kids need short-sentence explanations rather than long lectures,” says Muñoz. “For a four-year-old who asks where babies come from, a short answer might be that babies are created by a man and a woman giving each other a special kind of hug.” Yet with sex positivity, the aim is to always expand the lens of sexuality and give a sense of inclusiveness beyond limited cultural norms or biases. So, parents might want to add that some babies are created by a man’s seed that’s put with the help of a doctor into a woman, and then that baby might be raised by two men, or it might be raised by two women. Then no matter which path the child takes later in terms of sexual preference or gender identity, the stage is set for a sense of normalcy and acceptance from the outset.

Following Your Child’s Lead

With so much buzz about sexual harassment and assault in the news and popular culture, parents may wonder how to talk about such heavy issues with their children—and how to protect them from the bullying and power imbalances that start as early as elementary school. “Most kids don’t pay attention to what happens in the news, so in terms of discussing something disturbing with your child, it’s best to wait until the child raises up the issue themselves,” says Stanley Goldstein, PhD, a child clinical psychologist based in Middletown and the author of several books including Troubled Children/Troubled Parents: The Way Out 2nd edition (Wyston Books, 2011). The idea is to follow the child’s lead; equally important is to speak with them rather than to them, even when you’re laying down guidelines designed to keep them safe—such as explaining to your teenage daughter why you don’t want her to walk alone at night.

“It’s crucially important not to say to a child or teenager, ‘Do this because I say so.’ If you do that, then you repress the capacity for abstract thinking. Instead, say, ‘Do it because…’ and express your concerns. Explain that the world is generally a safe place, but you have to be cautious. If you feel that they’re not ready to do certain things, tell them no and tell them why.” While many parents believe that the major influence for teenagers is their peer group, Goldstein posits that the major influence for healthy teenagers remains the parents. “They might say, ‘Joey does this, so why can’t I do it?’ They might give you a hard time, but they’ll appreciate it. There’s nothing worse for a child than feeling like their parent doesn’t care.”

In the same spirit, parents are modeling behaviors to their children all the time, without speaking. Empathy is not something that you can inculcate into a child, but they’ll develop the capacity for it through osmosis, says Goldstein. “If the child sees a healthy interaction between the parents, sees them supporting each other and talking about their feelings, they’ll grow up with these kinds of capacities. Empathy is something that really derives from the family experience.” Yet some things do need to be put into words, and in a world where sexual misconduct is rampant, therapists tend to agree about one thing to tell your kids unequivocally: “The hard and fast rule is that you don’t have the right to put your hands on someone else, period. And no one should put their hands on you. Period.”

The Power of Speaking Out

Parents are not the only influencers; cultural messaging is very powerful as well. Terrence Real, a psychotherapist who wrote I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression (Scribner, 1998) and other books, says that boys lose their hearts when they’re five or six, and girls lose their voices when they’re 11 or 12. “Five or six is when the socialization process starts to really impact boys as they get shamed for doing things they were allowed to do when they were younger,” says Muñoz. “They might be called weak or girly. So, when you have a boy, how do you keep him connected to his heart yet still have him belong in his circle of peers? How do you keep your girls raising their hands in class rather than becoming wallflowers? How do you keep them speaking up when the society says that if you speak up you’re a bitch, or you’re not as attractive?”

Expressiveness in girls is crucial to encourage for two main purposes: their ability to share difficult experiences, and their empowerment in speaking out and defending themselves. “Letting your child lead the conversation, or lead the play when they are younger, creates a space where your child trusts you to share things such as, ‘Oh, one of the boys grabs my behind at school’ or ‘I saw a video with naked people on the internet.'” Parents can practice not reacting in fear or letting their anxiety show, but opening a space to calmly help and guide them. In turn, some self-defense teachers have girls practice yelling on the top of their lungs and using their voice, so if they are assaulted or groped in the subway or on the street, they can call attention to the perpetrator and get help if help is needed.

To raise sex-positive kids requires some work from the parents, and not all of it is easy. If a parent has any sexual trauma or abuse in their own past, it’s essential for them to be willing to face and work through it, not only for their own sake but for their children’s sake. Otherwise, says Muñoz, “In your well-intentioned desire to protect your children, you’re going to be communicating a lot of sex-negative messages to them.” Another challenge for parents is resisting the impulse to impose their power as adults over their children in everyday interactions. “What they learn there is, ‘Oh, I have to obey somebody more powerful than me even if it doesn’t feel good,'” says Muñoz. “Not telling your child they have to obey isn’t the same thing as having the inmates run the asylum. Instead it’s telling them, ‘I’m with you. We work as a team.'”

Complete Article HERE!

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New treatments restoring sexual pleasure for older women

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By Tara Bahrampour

When the FDA approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding decades to their vitality. Meanwhile, older women with sexual problems brought on by aging were left out in the cold with few places to turn besides hormone therapy, which isn’t suitable for many or always recommended as a long-term treatment.

Now, propelled by a growing market of women demanding solutions, new treatments are helping women who suffer from one of the most pervasive age-related sexual problems.

Genitourinary syndrome, brought on by a decrease in sex hormones and a change in vaginal pH after menopause, is characterized by vaginal dryness, shrinking of tissues, itching and burning, which can make intercourse painful. GSM affects up to half of post-menopausal women and can also contribute to bladder and urinary tract infections and incontinence. Yet only 7 percent of post-menopausal women use a prescription treatment for it, according to a recent study.

The new remedies range from pills to inserts to a five-minute laser treatment that some doctors and patients are hailing as a miracle cure.

The lag inaddressing GSM has been due in part to a longstanding reluctance among doctors to see post-menopausal women as sexual beings, said Leah Millheiser, director of the Female Sexual Medicine Program at Stanford University.

“Unfortunately, many clinicians have their own biases and they assume these women are not sexually active, and that couldn’t be farther from the truth, because research shows that women continue to be sexually active throughout their lifetime,” she said.

With today’s increased life expectancy, that can be a long stretch – another 30 or 40 years, for a typical woman who begins menopause in her early 50s. “It’s time for clinicians to understand that they have to bring up sexual function with their patients whether they’re in their 50s or they’re in their 80s or 90s,” Dr. Millheiser said.

By contrast, doctors routinely ask middle-aged men about their sexual function and are quick to offer prescriptions for Viagra, said Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.

“If every guy, on his 50th birthday, his penis shriveled up and he was told he could never have sex again, he would not be told, ‘That’s just part of aging,’” Dr. Streicher said.

Iona Harding of Princeton, New Jersey, had come to regard GSM, also known as vulvovaginal atrophy, as just that.

For much of their marriage, she and her husband had a “normal, active sex life.” But after menopause sex became so painful that they eventually stopped trying.

“I talked openly about this with my gynecologist every year,” said Mrs. Harding, 66, a human resources consultant. “There was never any discussion of any solution other than using estrogen cream, which wasn’t enough. So we had resigned ourselves to this is how it’s going to be.”

It is perhaps no coincidence that the same generation who first benefited widely from the birth control pill in the 1960s are now demanding fresh solutions to keep enjoying sex.

“The Pill was the first acknowlegement that you can have sex for pleasure and not just for reproduction, so it really is an extension of what we saw with the Pill,” Dr. Streicher said. “These are the women who have the entitlement, who are saying ‘Wait a minute, sex is supposed to be for pleasure and don’t tell me that I don’t get to have pleasure.’”

The push for a “pink Viagra” to increase desire highlighted women’s growing demand for sexual equality. But the drug flibanserin, approved by the FDA in 2015, proved minimally effective.

For years, the array of medical remedies has been limited. Over-the-counter lubricants ease friction but don’t replenish vaginal tissue. Long-acting mosturizers help plump up tissue and increase lubrication, but sometimes not enough. Women are advised to “use it or lose it” – regular intercourse can keep the tissues more elastic – but not if it is too painful.

Systemic hormone therapy that increases the estrogen, progesterone, and testosterone throughout the body can be effective, but if used over many years it carries health risks, and it is not always safe for cancer survivors.

Local estrogen creams, suppositories or rings are safer since the hormone stays in the vaginal area. But they can be messy, and despite recent studies showing such therapy is not associated with cancer, some women are uncomfortable with its long-term use.

In recent years, two prescription drugs have expanded the array of options. Ospemifene, a daily oral tablet approved by the FDA in 2013,activates specific estrogen receptors in the vagina. Side effects include mild hot flashes in a small percentage of women.

Prasterone DHEA, a naturally occurring steroid that the FDA approved last year, is a daily vaginal insert that prompts a woman’s body to produce its own estrogen and testosterone. However, it is not clear how safe it is to use longterm.

And then there is fractional carbon dioxide laser therapy, developed in Italy and approved by the FDA in 2014 for use in the U.S. Similar to treatments long performed on the face, it uses lasers to make micro-abrasions in the vaginal wall, which stimulate growth of new blood vessels and collagen.

The treatment is nearly painless and takes about five minutes; it is repeated two more times at 6-week intervals. For many patients, the vaginal tissues almost immediately become thicker, more elastic, and more lubricated.

Mrs. Harding began using it in 2016, and after three treatments with MonaLisa Touch, the fractional CO2 laser device that has been most extensively studied, she and her husband were able to have intercourse for the first time in years.

Cheryl Edwards, 61, a teacher and writer in Pennington, New Jersey, started using estrogen in her early 50s, but sex with her husband was painful and she was plagued by urinary tract infections requiring antibiotics, along with severe dryness.

After her first treatment with MonaLisa Touch a year and a half ago, the difference was stark.

“I couldn’t believe it… and with each treatment it got better,” she said. “It was like I was in my 20s or 30s.”

While studies on MonaLisa Touch have so far been small, doctors who use it range from cautiously optimistic to heartily enthusiastic.

“I’ve been kind of blown away by it,” said Dr. Streicher, who, along with Dr. Millheiser, is participating in a larger study comparing it to topical estrogen. Using MonaLisa Touch alone or in combination with other therapies, she said, “I have not had anyone who’s come in and I’ve not had them able to have sex.”

Cheryl Iglesia, director of Female Pelvic Medicine & Reconstructive Surgery at MedStar Washington Hospital Center in Washington D.C., was more guarded. While she has treated hundreds of women with MonaLisa Touch and is also participating in the larger study, she noted that studies so far have looked only at short-term effects, and less is known about using it for years or decades.

“What we don’t know is is there a point at which the tissue is so thin that the treatment could be damaging it?” she said. “Is there priming needed?”

Dr. Millheiser echoed those concerns, saying she supports trying local vaginal estrogen first.

So far the main drawback seems to be price. An initial round of treatments can cost between $1,500 and $2,700, plus another $500 a year for the recommended annual touch-up. Unlike hormone therapy or Viagra, the treatment is not covered by insurance.

Some women continue to use local estrogen or lubricants to complement the laser. But unlike hormones, which are less effective if begun many years after menopause, the laser seems to do the trick at any age. Dr. Streicher described a patient in her 80s who had been widowed since her 60s and had recently begun seeing a man.

It had been twenty years since she was intimate with a man, Dr. Streicher said. “She came in and said, ‘I want to have sex.’” After combining MonaLisa Touch with dilators to gradually re-enlarge her vagina, the woman reported successful intercourse. “Not everything is reversible after a long time,” Dr. Streicher said. “This is.”

But Dr. Iglesia said she has seen a range of responses, from patients who report vast improvement to others who see little effect.

“I’m confident that in the next few years we will have better guidelines (but) at this point I’m afraid there is more marketing than there is science for us to guide patients,” she said. “Nobody wants sandpaper sex; it hurts. But at the same time, is this going to help?”

The laser therapy can also help younger women who have undergone early menopause due to cancer treatment, including the 250,000 a year diagnosed with breast cancer. Many cannot safely use hormones, and often they feel uncomfortable bringing up sexual concerns with doctors who are trying to save their lives.

“If you’re a 40-year-old and you get cancer, your vagina might look like it’s 70 and feel like it’s 70,” said Maria Sophocles, founding medical director of Women’s Healthcare of Princeton, who treated Mrs. Edwards and Mrs. Harding.

After performing the procedure on cancer survivors, she said, “Tears are rolling down from their eyes because they haven’t had sex in eight years and you’re restoring their femininity to them.”

The procedure also alleviates menopause-related symptoms in other parts of the pelvic floor, including the bladder, urinary tract, and urethra, reducing infections and incontinence.

Ardella House, a 67-year-old homemaker outside Denver, suffered from incontinence and recurring bladder infections as well as painful sex. After getting the MonaLisa Touch treatment last year, she became a proslyter.

“It was so successful that I started telling all my friends, and sure enough, it was something that was a problem for all of them but they didn’t talk about it either,” she said.

“I always used to think, you reach a certain age and you’re not as into sex as you were in your younger years. But that’s not the case, because if it’s enjoyable, you like to do it just as much as when you were younger.”

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