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A new way to think about dementia and sex

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There’s an urgent need for a new ethic of dementia care that supports the facilitation of sexual expression.

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Persons living with dementia don’t have sex. Or they have weird sex. Or they have dangerous sex, in need of containment.

When it comes to dementia and sexuality, negative language and apocalyptic warnings abound. The aging population has been described in the media as a “rape case time-bomb.” Health practitioners often respond in punishing ways to sexual activity in residential care. And the sexual rights of persons living with dementia are largely ignored within residential care policy, professional training and clinical guidelines.

As critical social researchers, we argue that a new ethic of dementia care is urgently needed, one that supports the facilitation of sexual expression.

Practitioners and administrators often hold negative and judgmental attitudes about dementia and aged sexuality

Our research at the University of Toronto and the Toronto Rehabilitation Institute-University Health Network investigates embodiment, relationality, ethics and dementia. We are motivated by a shared concern about the reductive focus of dementia care on basic physical needs, and our desire to foster a more humane and life-enriching culture of care. We have explored how the sexualities of persons living with dementia are poorly supported in long-term residential care settings such as nursing homes.

Sex and dementia in the media

When we see persons living with dementia and sex linked in the media, it tends to be in high profile cases of

Institutional policies, structures and practices must support sexual expression.

alleged abuse. One example is the legal trial of Henry Rayhons, an Iowa lawmaker found not guilty of sexually abusing his wife who at the time was living with dementia in a nursing home. Another example is the wider investigation into sexual assaults in nursing homes in Ontario.

Vital as such investigations are to the safety of residents in long-term care, we rarely see sexual expression valued or as fundamental to human flourishing.

Our research has explored how these negative representations of the sexualities of persons living with dementia are also found within long-term residential care settings such as nursing homes.

Practitioners and administrators often hold negative and judgmental attitudes about dementia and aged sexuality. When faced with sexual activity, they can intervene in threatening and punishing ways. And long-term care policies, professional training and clinical guidelines tend to ignore the sexual rights of persons with dementia.

The problem with biomedical ethics

The sexualities of persons living with dementia are considered troubling partly because long-term care polices are shaped by biomedical ethics. This ethical approach relies on four core principles: autonomy, beneficence, non-maleficence and justice. These principles support intervening in residents’ sexual expression if it will cause harm to themselves or cause harm or offence to others.

However, this approach sets the bar for practitioners’ interference excessively high. It can restrict voluntary sexual expression by residents living with dementia in nursing homes.

Biomedical ethics also ignore the performative, embodied and relational aspects of ethical reasoning. It assumes that people are rational autonomous beings. It also assumes that self-expression, including sexuality, results only from cognitive and reflective decision making. Given that dementia involves progressive cognitive impairment, persons living with dementia may be unfairly discriminated against by this approach to sexual decision making.

A duty to support sexual expression

We use a model of relational citizenship to create an alternative ethic in which sexuality is seen as embodied self-expression. It is an ethic that recognizes human beings as embodied and embedded in a lifeworld. And one that views sexuality as an important part of being human.

Social and leisure activities supportive of the development of intimate relationships are essential within nursing homes.

This new ethic broadens the goals of dementia care. No longer do health professionals just have the duty to protect persons with dementia from harm. There is also a duty to support their right to sexual expression.

We argue that institutional policies, structures and practices must also support sexual expression. These should facilitate sexual rights. We must also introduce education for health professionals and the broader public — and policy initiatives to counteract the stigma associated with sexuality and dementia.

Social and leisure activities that are supportive of sexual expression and the development of intimate relationships are also essential within nursing homes.

Of course, protection from unwanted contact or sexual harm is still important. However, freedom of sexual expression should only be restricted when necessary to protect the health and safety of the individuals involved.

Complete Article HERE!

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8 Things That Happen to Your Body During Sex

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Your heart quickens. Your hormones flow. See what else is happening, head to toe, in the heat of the moment.

Ever wondered what happens to your body during a steamy session between the sheets? From the good (happy hormones! increased sensitivity!) to the not-so-good (increased risk of urinary tract infections, for example), here are eight things that happen when you’re having sex.

1. Happy hormones are released. Sex stimulates the secretion of hormones such as oxytocin, which makes you feel connected to others, and dopamine, which activates the brain’s reward center. The result: You feel satisfied and close to your partner.

2. Blood vessels widen. What do dilated blood vessels do for you? “Your clitoris and vulva become engorged, as do the vessels in the vaginal wall,” says urologist and sexual-health expert Jennifer Berman, MD. “This leads to more secretions and lubrication.” Your face and chest can also get flushed.

3. Sensitivity skyrockets. Your erogenous zones, including the nipples, ears, neck, and genital area, become extra sensitive because of increased blood flow and the release of sensation-enhancing neurotransmitters.

4. Bacteria may build up. During sex, bacteria from the vagina and anus can get into the urethra and multiply, leading to a urinary tract infection. Tip: Pee immediately after the act to flush out bacteria.

5. You burn (some) calories. A study in The New England Journal of Medicine found that a 154-pound person would burn 21 calories during six minutes of sexual activity. So a roll in the sack isn’t as effective as spin class, but a sexy half hour could torch around 100 calories.

6. Your heart races. Like any aerobic activity, sex raises your heart rate. It peaks when you orgasm and settles back to its baseline within 10 to 20 minutes, research shows.

7. Your muscles tense. “During orgasm, the pelvic floor muscles involuntarily contract,” says Dr. Berman. Actively tensing and releasing those muscles during sex can help boost engorgement, arousal, and pleasure. Kegels, anyone?

8. You feel relaxed. Your big O may be the ultimate chill pill: Orgasms trigger an increase in prolactin, a calming hormone that reaches its highest levels when we’re asleep.

Complete Article HERE!

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Here Are The Best Places In The World To Take A Sex Vacation

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By Bobby Box

Weather, affordability and sight-seeing and shopping opportunities are all definitive factors when planning a vacation, but have you ever considered the level of a city’s sex-positiveness? . undefined

If you’re on the hunt for a sex-fuelled sabbatical and need some direction, you’re in luck. Adult mobile app portfolio Lazeeva has put in a ton of work and consulted an assemblage of permissable research to determine which cities around the world are the most “sex-positive,” which Lazeeva describes as “having or promoting an open, tolerant, or progressive attitude towards sex.”

To quantify how sexual a city is, Lazeeva’s team began by researching 10 critical factors in over 200 cities from around the world. These components include: gender equality, LGBT friendliness, access to contraception, swinger-friendliness, adult entertainment, porn consumption, sex toy consumption, sexual satisfaction, willingness to experiment and sexual activeness.

To quantify how sexual a city is, Lazeeva’s team began by researching 10 critical factors in over 200 cities from around the world. These components include: gender equality, LGBT friendliness, access to contraception, swinger-friendliness, adult entertainment, porn consumption, sex toy consumption, sexual satisfaction, willingness to experiment and sexual activeness.

After attributing a rank for each category, Lazeeva used in-house data and combined it with research from the UN, the World Bank, as well as various listings in each city for sex and sexual health resources available for swingers, LGBTQ groups and charities, to give a comprehensive and decidedly fair score to each city studied. They then crafted a near-encyclopedic ranking of the 100 most sex positive cities worth the stamp in your passport. We’ve narrowed it down to the top 10.

The most sex-positive city in the world is–drum roll, please…–Paris, France! Which proved to be exceptionally sexually-active and gay-friendly. The city of love also boasts quite a thriving swingers scene.

In a very close second comes Rio de Janeiro, Brazil, which received top scores in sexual activeness and willingness to experiment. However, their paltry score in gender equality brought the overall average down significantly.

London, England came third, thanks, in great part, to their thriving adult entertainment scene and praiseworthy scores in LGBT friendliness.

The first American entry is none other than Los Angeles, USA, ranking fourth overall. The porn capital recieved top scored in–you guessed it–porn consumption, as well as very imposing scores in its willingness to experiment sexaully. We should add that both Playboy HQ and the Playboy Mansion are located here and, in case you couldn’t tell, we love us some sex.

If you like to swing, you might want to book a trip to Berlin, Germany, which ranks fifth. In addition to a prosperous swingers scene, they also received soaring scores in adult entertainment. But be warned: Berlin has horrible access to contraception. So bring rubbers.

New York City comes sixth. The Big Apple was impressive across the board, but boasted exceptionally high scores in porn and remarkably low scores in gender equality, which evened themselves out.

In seventh comes Sao Paulo, Brazil, who earned the highest possible score in sex toy consumption and a commendable score in their willingness to experiment. No doubt a winning combination for the sexually dauntless.

Vegas, baby! Coming in eighth overall, sin city proved prolific in–duh–adult entertainment and–double duh–its swingers score.

Ibiza, Spain, is known to be a party place, so it makes perfect sense that they’re sexually progressive. That is, if you’re a man. Gender equality in Ibiza, however, proved upsetting.

Bookending the top 10 is one I’m willing many of us predicted would be higher on the list. This is, of course, Amsterdam in the Netherlands. Surprising, considering the city is host to the world’s only (legal) Red Light District and lax laws around drug use.

Understandably, if you didn’t want to book a nine-hour flight in the interest of sexual exploits, a number of American cities broke the top 10, most of which are located across the map, making them a fun little road trip. These sex-positive American cities include: San Francisco (11th), Miami (14th), Austin (19th), Chicago (25th), Seattle (35th), Portland (36th) and Boston (49th).

To see the full list of sex-positive cities, click here.

Complete Article HERE!

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College Students Want to Talk About Sex. They Just Don’t Know How.

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Fear of sexual assault on college campuses is twofold: Many students are afraid of being victims of assault, while others are terrified of being accused of it.

If that sounds ridiculous, consider this: Apps have popped up in recent years that allow students to sign virtual consent forms before engaging in intimate encounters. The contract on SaSie, one such app, prompts consenting parties to fill in their names and e-signatures, and add pictures of their photo IDs so as to provide “a legally binding modicum of evidence for students and adjudicators.”

Clear communication in sexual encounters is paramount and the stakes are high. Nonconsensual sex is rape. But it’s ridiculous to think that consensual sex should require a legal contract.

This is not the way for students to get clarity on healthy sex. If we are going to change a culture of normalized drunken hookups and damaging acts of sexual violence, we must get to the roots of the problem: communication and education.

Most colleges and universities require that freshmen and other new students attend orientation workshops to familiarize them with guidelines for consent, a term that is often narrowly defined to avoid confusion. Sex, our administrators and peer leaders tell us, requires verbal positive affirmation at each progressing stage of physical intimacy.

This is not a bad way to define consent, but it overlooks emotional intimacy and vulnerability entirely. When gymnasiums full of relatively inexperienced undergraduates hear an administrator explain “No means no” over a microphone, no matter how intently we pay attention or how much we agree with that statement, we are not receiving guidance on language that will help us communicate with future partners. Consent workshops can be as impersonal and utilitarian as an SAT prep book: fact-based, transactional, generalized and devoid of human emotion.

As a transfer student at Middlebury College, I sat through two such orientations and several mandatory forums about sex on campus. It was uncomfortable.

But I can see the connection between these awkward seminars and the rise of swipe-for-consent apps: Both are the outcome of a culture completely out of touch with healthy communication about sex, especially when it comes to educating young adults about it.

It’s not any school administration’s fault. There are no national guidelines for sex ed, and the curriculum for it varies greatly around the country, often from state to state. Fewer than half of the states require sexual education in public schools, and only 20 of them even require that it be medically, factually or technically accurate. Think about that.

To be clear, inaccurate sex ed isn’t to blame for all cases of sexual violence, which college-age women are three to four times more at risk of experiencing than all other women, according to a 2014 Department of Justice report.

Still, as young adults, we have no real guidance for modeling intimate behavior on anything other than the glamorized, highly choreographed sexual encounters we see on TV and in movies, music and pornography. Those media generally fail to include any language of consent at all. Nowhere are Americans exposed to the idea that talking to your partner before, during and after sex — regardless of whether you met five years or 15 minutes ago — makes sex better! Why is nobody teaching us that “great sex” happens when both partners are equally engaged in respecting and communicating their expectations?

To address this intimacy gap in our language, my peers and I started the Consent Project at Middlebury. We invite speakers to address topics like pleasure, anatomy and masculinity. On weekends we host a “Morning-After Breakfast,” where students talk about sex and relationships without judgment. Every breakfast begins with an icebreaker — a game of sex and anatomy trivia to loosen up language around taboos — and then students break into smaller groups to air out personal confusions.

The idea is to identify, through group communication and brainstorming, what defines good and healthy sex. Our goal is to develop a shared idea of consent that encompasses self-advocacy, respect and mutual fulfillment — and not to treat it like a checkbox.

In Consent Project meetings, students bring up topics that don’t necessarily come up in school-sponsored consent workshops. They talk about drinking to overcome inhibitions, only to wake up the next morning feeling unfulfilled, unsure and sometimes even regretful about their choices. Both women and men admit to feeling inadequate and a pressure to “perform.” Women more often voice frustration over not having their own sexual needs met or respected, while men express anxiety about sexual rejection. There are many elements that add to students’ confusion, but the role that drinking and recreation drug use play cannot be overstated.

It may seem like a small thing, but these conversations actually do seem to make students more comfortable. There is always a healthy amount of laughter despite the seriousness of the conversations. We get a lot of feedback from students who say they feel willing — or even excited — to start talking about sex more openly.

The miscommunication that can lead to sexual violence, on campus and off, is not unavoidable. Absent reform in the K-12 system, students can help create safe environments and learn from one another. Teachers, administrators and the media tell us only part of the story. Let’s learn to talk openly and respectfully about sex, pleasure and our boundaries, in all the ways we individually define them.

Complete Article HERE!

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Why Men Wake up With Erections

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By </span

Have you ever wondered why men often wake up with an erection?

The morning penile erection, or as it is medically known, “nocturnal penile tumescence”, is not only an interesting physiological phenomenon, it can also tell us a lot about a patient’s sexual function.

Morning penile erections affect all males, even males in the womb and male children. It also has a female counterpart in the less frequently discussed nocturnal clitoral erection.

What causes erections?

Penile erections occur in response to complex effects of the nervous system and endocrine system (the glands that secrete hormones into our system) on the blood vessels of the penis.

When sexually aroused, a message starts in the brain, sending chemical messages to the nerves that supply the blood vessels of the penis, allowing blood to flow into the penis. The blood is trapped in the muscles of the penis, which makes the penis expand, resulting in an erection.

Several hormones are involved in influencing the brain’s response, such as testosterone (the main male hormone).

This same mechanism can occur without the involvement of the brain, in an uncontrolled reflex action that is in the spinal cord. This explains why people with spinal cord damage can still get erections and why you can get erections when not sexually aroused.

What about erections while we sleep?

Nocturnal penile erections occur during Rapid Eye Movement (REM) sleep (the phase during which we dream). They occur when certain areas of the brain are activated. This includes areas in the brain responsible for stimulating the parasympathetic nerves (“rest and digest” nerves), suppressing the sympathetic nerves (“flight and fight” nerves) and dampening areas producing serotonin (the mood hormone).

Sleep is made up of several cycles of REM and non-REM (deep) sleep. During REM sleep, there is a shift in the dominant system that’s activated. We move from sympathetic (fight and flight) stimulation to parasympathetic (rest and digest) stimulation. This is not found during other parts of the sleep cycle.

This shift in balance drives the parasympathetic nerve response that results in the erection. This is spontaneous and does not require being awake. Some men may experience nocturnal penile tumescence during non-REM sleep as well, particularly older men. The reason for this is unclear.

The reason men wake up with an erection may be related to the fact we often wake up coming out of REM sleep.

Testosterone, which is at its highest level in the morning, has also been shown to enhance the frequency of nocturnal erections. Interestingly, testosterone has not been found to greatly impact visual erotic stimuli or fantasy-induced erections. These are predominantly driven by the “reward system” of the brain which secretes dopamine.

Men don’t wake up with erections because they’ve been having sexy dreams.

Since there are several sleep cycles per night, men can have as many as five erections per night and these can last up to 20 or 30 minutes. But this is very dependent on sleep quality and so they may not occur daily. The number and quality of erections declines gradually with age but they are often present well beyond “retirement age” – attesting to the sexual well-being of older men.

It’s also important to highlight the counterpart phenomenon in women, which is much less researched. Pulses of blood flow in the vagina during REM sleep. The clitoris engorges and vaginal sensitivity increases along with vaginal fluidity.

What’s its purpose?

It has been suggested “pitching a tent” may be a mechanism for alerting men of their full overnight bladder, as it often disappears after emptying the bladder in the morning.

It’s more likely the reason for the morning erection is that the unconscious sensation of the full bladder stimulates nerves that go to the spine and these respond directly by generating an erection (a spinal reflex). This may explain why the erection goes away after emptying one’s bladder.

Scientific studies are undecided as to whether morning erections contribute to penile health. Increased oxygen in the penis at night may be beneficial for the health of the muscle tissues that make up the penis.

What does it mean if you don’t get one?

Loss of nocturnal erection can be a useful marker of common diseases affecting erectile function. One example is in diabetics where the lack of morning erections may be associated with erectile dysfunction due to poor nerve or blood supply to the penis. In this case, there’s a poor response to the messages sent from the brain during sleep which generate nocturnal erections.

It is thought nocturnal erections can be used as a marker of an anatomical ability to get an erection (a sign that the essential body bits are working), as it was thought to be independent of psychological factors that affect erections while awake. Studies have suggested, however, that mental health disorders such as severe depression can affect nocturnal erections. Thus its absence is not necessarily a marker of disease or low testosterone levels.

The frequency of morning erections and erection quality has also been shown to increase slightly in men taking medications for erectile dysfunction such as Viagra.

So is all this morning action good news?

While some men will put their nocturnal erections to good use, many men are not aroused when they have them and tummy sleepers might find them a nuisance.

Since good heart health is associated with an ability to have erections, the presence of nocturnal erections is generally accepted to be good news. Maintaining a healthy lifestyle is important in avoiding and even reversing erectile dysfunction, so it’s important to remember to eat healthily, maintain a healthy weight, exercise and avoid smoking and alcohol.

Complete Article HERE!

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