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A stressful life is bad for the bedroom

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If you are consistently emotionally distressed due to social, economic or relationship pressures, you can be sure to lose erections. Being annoyed with your intimate partner all the time, and feeling undermined or frustrated are bad for your erections.

By JOACHIM OSUR

Lois came to the sexology clinic because she was sexually dissatisfied with her husband. It had been six months of no sex in their 11-year old marriage. Before that, her man had suffered repeated episodes of erection failure. “The few times he did get an erection, it was flaccid and short-lived,” Lois explained. “You can only imagine how that can be frustrating to a faithful wife.”

Lois suspected that her husband was getting sexual satisfaction elsewhere, and had angrily told him she didn’t want to have sex with him anymore. “I thought he was no longer interested in me because I had gained too much weight after bearing our two children, a very hurtful thought,” she explained sadly.

And so for six months the couple kept off each other. The relationship got strained and unfortunately Andrew, Lois’ husband, threw himself into his work. He stayed late at work and came home after everyone was asleep. He woke up and left the house early. He paid no attention to their two children anymore.

“So how can I help you?” I asked, lots of thoughts going through my mind due to the complexity of the case. You see, the man, who was the one having a problem, had not come to the clinic. Erection failure or erectile dysfunction (ED) is a complex symptom that requires a thorough assessment for its cause to be pinpointed. I needed Andrew to come see me himself.

VICTIM OF THE RELATIONSHIP

“What do you mean that it is a symptom of complex problems?” Lois asked, frowning. ED is simply a failure to be aroused sexually. This could be due to the derangement of some chemicals in the brain such as dopamine. It could also be due to hormonal problems such as low testosterone, high prolactin and so on.

What we are also seeing at the clinic is a rise in cases of diabetes and hypertension, usually accompanied by obesity. Most of the affected people have high cholesterol. These diseases destroy blood vessels, including those in the penis, making erections impossible. Further still, the diseases can destroy nerves, and if the nerves of the penis are affected, erections fail. People with heart, kidney, liver and other chronic illnesses may similarly get ED either from the diseases or from the medicines used to treat them.

Stressful lifestyles are also contributing to ED quite a bit these days. Many people work two jobs to get by, and have no time to relax or get adequate sleep. A physically worn out, sleep-deprived body is too weak to have an erection and you should expect ED to befall you any time if this is your lifestyle.

But emotional distress is even more dangerous for ED. If you are consistently emotionally distressed due to social, economic or relationship pressures, you can be sure to lose erections. Being annoyed with your intimate partner all the time, and feeling undermined or frustrated are bad for your erections. Further, feeling like a victim in the relationship can lead to ED. All these are further complicated by anxiety and depression, which are bound to set in as part of the relationship problem or as a result of the ED itself.

“So can’t you just give me some medicine for him to try then if it fails he can come for full assessment?” Lois asked, realising that my explanation was taking longer than she had anticipated.

Unfortunately that was not possible. We get this kind of request all the time at the clinic. In fact, people make phone calls asking for tablets to swallow to get erections immediately. Sometimes they call from the bathroom with their partner in the bed waiting for action yet the erection has failed. There is however no alternative to a thorough assessment and treatment of the cause of the ED.

Andrew came to the clinic a few days later. A full assessment found that he had a stressful career and relationship difficulties, and both had taken a toll on his sex life. He had to undergo a lifestyle change. Further, the couple went through intimacy coaching. It was another six months before they resumed having sex.

Complete Article HERE!

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Time for a Sexual Revolution In Health Care Treatment

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Why is care for sexual health issues considered a luxury when it’s a necessary part of population health?

By Zachary Hafner

When Americans seek care for most common health conditions, there is rarely much question about coverage. Every day, consumers—including those on Medicaid and Medicare—seek care for sore joints, depression, and even acne without worrying about whether or not their insurance will cover their doctor visits and medications. For the most part, coverage for sexual health issues is less straightforward—but why? Is it because sexual health issues are not considered legitimate illnesses? Because the costs are significant? Or is it because raising the topic of sexual health can offend certain personal and organizational values? Whatever the reason, it is time for a change.

It’s hard to deny the human and economic burden of sexually transmitted infections (STIs) on this country. The CDC estimates that 110 million Americans are infected with an STI, resulting in direct medical costs of $16 billion annually. The most common and fastest growing STI in this country is human papillomavirus (HPV), and it is estimated that half of sexually active men and women will get HPV at some point in their lives. In 2006, a vaccine for HPV was introduced and now there are several. CDC guidelines recommend administering a multi-dose series, costing about $250–450, to all boys and girls at age 11 or 12. (Some states require the vaccine for school admission.) It was included in mandatory coverage under the ACA. Since the HPV vaccine was first recommended in 2006 there has been a 64% reduction in vaccine-type HPV infections among teen girls in the United States.

It seems clear that this kind of care for sexual health is necessary for public health and is also part of caring for the whole individual, a central tenet of population health. But what about sexual health care that doesn’t involve infectious disease? Is it still a population health issue if there’s no communicable disease involved?

Let’s take erectile dysfunction (ED) for example. It is nearly as common in men over 40 as HPV is in the general population—more than half of men over 40 experience some level of ED, and more than 23 million American men have been prescribed Viagra. With a significant portion of the population suffering from ED, is it important for payers and providers to consider ED treatment to be essential health care and to cover it accordingly? Medications like Viagra and Cialis are an expensive burden at upwards of $50 per pill. Medicare D does not cover any drugs for ED, but some private insurers do when the medications are deemed medically necessary by a doctor. A handful of states require them to do so, but they are typically listed as Tier 3 medications—nonessential and with the highest co-pays.

Almost 7 million American women have used infertility services. Coverage for infertility diagnosis and treatment is not mandated by the ACA, though 15 states require commercial payers to provide various levels of coverage. The cost of infertility treatments is highly variable depending on the methods used but in vitro fertilization treatments, as one measure, average upward of $12,000 per attempt.

Are treatments for ED and infertility elective or necessary? In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs. Health care has advanced in both technical and philosophical ways that allow people to manage their diseases, cure their problems, and overcome limitations. It has also shone light on the significant advantages to considering a diagnosis in the context of the whole individual—their social and emotional health as well as coexisting conditions. Studies have shown, for example, that infertility, ED, and STIs all have a significant relationship with depression and anxiety.

It’s time sexual health was folded in to the broader definition of wellness instead of marginalized as a separate issue. For too many Americans, it’s too big an issue not to address.

Complete Article HERE!

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Why are some women never able to orgasm? A gynaecologist explains

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Dr Sherry Ross says there has long been a gender bias in the way women’s sexual dysfunction has been treated compared to men’s

 

By Olivia Blair

Despite modern society being able to openly discuss female sexuality, there remains a number of existing taboos.

One of the most glaring is female orgasms. Women are rarely taught about the intricate details of their anatomy and often work these things out through their own experimenting.

What is the best way to get an orgasm? How often should I have one? Should I be able to have one during penetrative intercourse? Why have I never had one? – questions not uncommon to hear among small friendship groups of women over a bottle of wine.

Dr Sherry A Ross, an LA-based gynaecologist with 25 years experience aims to educate with a complete guide to the vagina in her new book She-ology: The Definitive Guide to Women’s Intimate Health. Period.

In the foreword of her book, Dr Sherry notes that “talking about the mighty V outside of doctor’s offices and bedrooms has remained a major taboo” and devoted an entire chapter to the female orgasm. The Independent asked the gynaecologist and obstetrician all the questions about female orgasms that are rarely spoken about.

Why might some women never orgasm?

Attitudes regarding sex, sexuality and gender vary greatly between different cultures and religions. Certain sexual practices, traditions and taboos are passed down through generations, leaving little to the cause of female pleasure or imagination.

For some women, finding and/or enjoying sexual intimacy and sex is difficult, if not impossible. Research suggests that 43% of women report some degree of difficulty and 12% attribute their sexual difficulties to personal distress. Unfortunately, sexual problems worsen with age, peaking in women 45 to 64.  For many of these women the problems of sexual dysfunction are treatable, which is why it is so important for women to share their feelings and concerns with a health care provider.

Unfortunately, there has been a history of “gender injustice” in the bedroom. Women have long been ignored when it comes to finding solutions to sexual dysfunction. In short, there are twenty-six approved medications for male erectile dysfunction and zero for women. Clearly, little attention has been paid to the sexual concerns of women, other than those concerns that involve procreation.

How many women might never orgasm?

During my 25 years in private practice, I’ve met a number of women in their 30s, 40s and 50s who have never even had an orgasm. In fact, 10 to 20% of all women have never experienced one.

Issues related to sex are not talked about enough even with a health care provider. Let’s just start by saying, 65 per cent of women are embarrassed to say the word vagina and 45 per cent of women never talk about their vagina with anyone, not even with their doctor.

Some patients say they have pain with sex, have problems with lubrication, don’t have a sex drive or don’t enjoy sex.  My first question is “Are you having problems in your relationship?”, “Do you like you partner?” , “Are you able to have an orgasm?”, “ Do you masturbate?” These open-ended questions tend to bring out sexual dysfunction including the inability to have an orgasm.

There is a great deal of embarrassment and shame when a woman admits she has never experienced an orgasm.

Is the inability to not orgasm normal?

The inability not to have had an orgasm can reflect women’s inability to know they own anatomy and may not be a disorder at all. In a survey of women aged 16-25, half could not find the vagina on a medical diagram. A test group of university- aged women didn’t fare much better with one third being unable to find the clitoris on a diagram. Clearly, if you can’t find it, how are you going to seek enjoyment from it?

Women must first understand what brings them pleasure and in their pursuit of happiness they have to understand where their clitoris is and how to stimulate it. Masturbation is a skill.  It has to be learned, just as walking, running, singing and brushing your teeth.

What is an orgasm disorder and how would you categorise one? 

The inability to have an orgasm falls under the category of Female Sexual Dysfunction of which there are five main problems: low libido or hypoactive sexual desire disorder, painful sex, sexual arousal disorder, an aversion to sex and the inability to orgasm.

Hypoactive sexual disorder, the most common female sexual dysfunction, is characterised by a complete absence of sexual desire. For the 16 million women who suffer from this, the factors involved may vary since sexual desire in women is much more complicated than it is for men. Unlike men, women’s sexual desire, excitement and energy tend to begin in that great organ above the shoulders, rather than the one below the waist. The daily stresses of work, money, children, relationships and diminished energy are common issues contributing to low libido in women. Other causes may be depression, anxiety, lack of privacy, medication side effects, medical conditions such as endometriosis or arthritis, menopausal symptoms or a history of physical or sexual abuse.

You are the person in charge of your vagina and clitoris. First and foremost, get to know your female parts intimately. Understanding your sexual response is a necessary health and wellness skill. Make mastery of that skill a priority.

Complete Article HERE!

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5 Health Reasons To Make Love, Even When You’re Not In The Mood

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At the start of every relationship, everything is brand new, and we just can’t get enough of our partner. During the honeymoon phase, we engage in extra PDA, barely keeping our hands off each other, especially sexually. However, there comes a point where one of us wants sex, and the other isn’t in the mood for it, but science suggests we should consider having more sex for our health’s sake.

Sex droughts can hit couples, which can be a sign of comfortability, or married life. Infrequent sex can occur due to children, work, and stress, but having sex can actually lighten the load of these daily obstacles.

April Masini, relationship expert and author, believes “intimacy is as important as an apple keeping the doctor away.”

“Nurturing intimacy in relationships is important — and should be just as important a health concern as getting a regular mammogram or a colonoscopy! Happy, healthy, intimate relationships are crucial to good physical and mental health,” she told Medical Daily.

Scientists have found the reason why sex feels so good is due to the release of dopamine and opioid chemicals. Sexual stimulation sends the brain into an altered state of consciousness; it blocks out everything else, and allows us to solely concentrate on the sensation. In other words, it enhances brain activity.

Regular sex can do more than make us feel good; it can boost our overall health in these five ways.

Boosts Immune System

Frequent sex can help keep our immune system strong, protecting us from getting the common cold. Dr. William Kolbe, author of the book The Rejuvenating Power of Masturbation, suggests sex’s immune boosting power comes from its interaction with the pituitary.

“Sexual intimacy(solo and paired) sends signals to the pituitary to stimulate the major endocrine axis including the thymus gland, a major player in our immune system,” he told Medical Daily.

A 2009 study in Psychology Reports found having sex at least once or twice a week led to 30 percent more immunoglobulin A (IgA) in their saliva, than those who reported having no sex. IgA is an antibody that helps fight infections and the common cold. They reach their peak in couples who had sex a few times a week.

Lowers Blood Pressure

Sex does not significantly raise blood pressure in men, rather it can help lower it to normal levels. A 2000 study in Biological Psychology, researchers asked 51 healthy men and women, between the ages of 20 to 47 about how much sex they have; followed by measuring their blood pressure.

They concluded more sex was linked to decreased blood pressure.

According to Kolbe: “Intimacy is an excellent cardiovascular workout thus providing positive effects to blood pressure. The increase in sex hormone production, especially estrogen, is very beneficial for the heart.”

Aids Heart Health

Unsurprisingly, sex is good for lowering our blood pressure, and for reducing the risk of heart disease. A 2002 study in J Epidemiol Community Health found regular sexual intercourse reduces the risk of stroke and coronary heart disease (damage or disease in the heart’s major blood vessels) in men.

Similarly, a 2010 study in the American Journal of Cardiology found men with low frequency of sex had an increased risk of cardiovascular disease. Men who reported sexual activity of once a month or less had a higher risk of cardiovascular disease than men who reported having sex twice a week or more. This study is the first to look at frequency of sex and heart risk independently from erectile dysfunction, according to the researchers. They speculate men who are having sex regularly, may be in supportive intimate relationships. This may improve health via stress reduction and social support.

Stress Reducer

Feeling relaxed and mellow after sex tend to go hand in hand in the bedroom. A 2002 study in Archives of Sexual Behavior suggests semen may have antidepressant properties. Contact with semen during sex can help boost happiness levels for women, therefore, reducing stress

“Sex can reduce a woman’s stress level. This is especially so if the woman is relaxed and not constricted during the sex,” Dr. Fran Walfish, Beverly Hills family and relationship psychotherapist, told Medical Daily.

Keri Simon, a clinical social worker in St. Louis, who sees many couples, believes the stress hormone cortisol is reduced via a connection.

“More is communicated through intimate gestures which in a primitive example, communicates we have no need to be on defense, addressing our fight or flight responses. This communication is powerful — just ask anyone who has felt connection through a squeeze of the arm, pat on the back, hug, etc., and they can share that human intimacy is a powerful force of connection,” she told Medical Daily.

Improves Sleep

It’s likely some of us pass out right after sex, and this happens for a reason. The endorphins released during sex can help us enter natural states, like euphoria, leading us to feel less stressed. The oxytocin released during orgasm also promotes sleep. They’re released from the pituitary gland of the brain during periods of strenuous exercise, emotional stress, pain, and orgasm. Oxytocin is known as the “love hormone” because it’s typically released when two people make physical contact.

Interestingly, a 2014 study found women in romantic relationships who got an extra hour of sleep had higher levels of sexual desire. They also experienced a 14 percent increase in the likelihood of sex the next day. Women with longer average sleep duration also reported greater vaginal lubrication during sex than those with shorter average sleep.

The relationship between going to sleep and good sex seems to work both ways.

Complete Article HERE!

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For Veterans, Trauma Of War Can Persist In Struggles With Sexual Intimacy

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U.S. Marines march in the annual Veterans Day Parade along Fifth Avenue in 2014 in New York City.

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Much has been said about the physical and psychological injuries of war, like traumatic brain injury or post-traumatic stress disorder. But what we talk about less is how these conditions affect the sexual relationships of service members after they return from combat.

Since 2000, service members who were deployed received at least 138,000 diagnoses of PTSD. More than 350,000 have been diagnosed with traumatic brain injury since 2000. Evidence suggests the numbers are actually higher because many don’t seek treatment.

These conditions cause their own sexual side effects, such as emotional numbness, loss of libido and erectile dysfunction. And the long list of medications used to treat PTSD, TBI and other medical conditions can worsen those side effects.

‘He would sleep for days’

Chuck and Liz Rotenberry of Baltimore struggled with their own challenges when Chuck returned from Afghanistan in 2011. He’s a former Marine gunnery sergeant who trained military working dogs. He left active duty in 2012.

For Liz and Chuck, sex had never been a problem. They’ve been married for 14 years and they’re still very much in love. Liz says she fell for Chuck in high school. He was that guy who could always make her laugh, who always had a one-liner ready and never seemed sad.

But when Chuck returned from Afghanistan, their relationship would soon face its greatest challenge. Baby No. 4 was just two weeks away; for sure, it was a chaotic time. But Liz noticed pretty quickly, something was terribly wrong with her husband.

“I wouldn’t be able to find him in the house and he wouldn’t be outside, and I’d find him in a separate bedroom just crying,” Liz says. “He would sleep for days. He would have a hoodie on and be just tucked away in the bed, and he wouldn’t be able to get out of bed. He would have migraines that were so debilitating that it kept him in the bed.”

When Chuck was in Afghanistan, an IED — improvised explosive device — exploded 3 feet behind him. Shrapnel lodged into his neck and back.

It would take three years for someone at the Department of Veterans Affairs to explicitly lay out for Liz that Chuck had developed severe post-traumatic stress and suffered a traumatic brain injury — and that she would need to be his caregiver.

The Marine self-image

During that three-year period, there were times Chuck estimates he was taking 15 to 16 different medications twice a day.

Sex was usually the furthest thing from his mind.

“I didn’t think about it. I wanted to be with Liz, I wanted to be near her,” he says. “When the desire was there, it was unique. It was rare, as opposed to the way it was before. And a lot of times, with the mountains of medication I was on, you know, in my head [it was] all systems go, but that message didn’t go anywhere else.”

Liz noticed that Chuck stopped initiating physical affection.

“The thought of him reaching out to me to give me a hug wasn’t existent. It was like I had to give him the hug. I now had to step in and show him love,” she says.

Sometimes months would go by before they would have sex.

“It started off as being pretty embarrassing, pretty emasculating,” Chuck says. “It was like, ‘Really? This too doesn’t work?’ You blame it on, ‘Oh, it’s just the medication,’ or ‘You’re tired,’ or whatever initially, and you don’t realize it’s stress or my brain just doesn’t work like it used to.”

Liz and Chuck had never really talked about sex in any serious way before. So they kept avoiding the conversation — until this year. That’s when Chuck finally asked his primary care provider for help. The doctor prescribed four doses of Viagra a month. Liz and Chuck say the medication has improved things substantially — though they joke about how few doses the VA allots them every month.

But asking for just those four doses took Chuck three or four visits to the doctor before he could work up the nerve. He says it can be especially hard for a Marine to admit he’s having problems with sex because it contradicts a self-image so many Marines have.

“You know, as a Marine, you can do anything. You believe you can do anything, you’ve been trained to do nearly anything,” he says. “You’re physically fit. You’re mentally sound. Those are just the basics about being a Marine.”

If he has any advice for a Marine going through the same thing he and his wife are facing, he says you need to talk about it. Bring it up with your spouse. Bring it up with your doctors.

“Marines always jokingly hand out straws. You got to suck it up. You got to do what you need to do to get it done,” Chuck says. “It’s just a different mission. … Don’t let your pride ruin what you worked so hard for.”

 Complete Article HERE!

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