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Sex Therapy—What Is It and Who Needs It? – Part 1

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I’m often asked about my work as a sex therapist. I’m surprised at how few people have any sense of what a sexologist does. While I can’t speak for all my fellow therapists, I can tell you a bit about my own practice.

Most of the work I do is Cognitive Behavioral Therapy (CBT): short-term, goal-directed and personally liberating (I don’t believe this kind of therapy should become a lifestyle). Basically, I suggest that people with sexual issues change the behaviors that contribute to their problems as a surefire way to solve them. I try to give my clients all the tools they need to successfully work things out on their own once the therapeutic intervention is over. This approach doesn’t fit everyone; however, 99.9 percent of the people I work with respond positively.

I encourage my clients to give themselves permission to investigate their sexuality. This in turn assists them in taking charge of making themselves feel better and/or perform better. And as soon as they do, they almost immediately have a greater sense of wellbeing. Like they say, nothing breeds success like success.

Once we identify an area of concern, my client and I create a plan of action for them to implement. I believe the more an individual is part of their own healing process, the more productive that process will be.

Sadly, I find that fewer and fewer people are willing to give their sexual issues the attention they deserve. Rather than investing the time and energy to get to the bottom of their issues, many opt instead for the quick fix—the “Give me a pill for that” mentality. They’re often unwilling to make the necessary lifestyle changes to actually solve their problems. For example, I encounter people who are eating themselves to death, or abusing alcohol or drugs. Of course they have the accompanying sexual response issues—erection problems for men and arousal concerns for women. They may desperately want to resolve these issues, but without committing to any change in behavior—i.e.: “I want my erection back, but I won’t stop drinking”—such interventions almost always ends in disappointment.

Sexual dysfunction of one sort or another is the issue I see most recurrently in my practice, although the reason why a client reaches out varies. Sometimes an individual’s tolerance level peaks, and they finally decide to do something about an issue that may have been smoldering for years. Sometimes it’s a partner who brings in their proverbially “broken” partner, telling me to “fix him/her.”

Couples often seek sex therapy together, as sexual problems tend to be more obvious within relationships. However, by the time the couple comes for therapy, the issues have most likely been plaguing them for some time. The relationship often comes close to ending before the couple agrees to address the problem. For example: Say a guy brings his wife in because she’s “frigid,” whatever that may entail. They’ve been married for X-number of years, and he’s finally had it. She, on the other hand, doesn’t want to be in therapy, because she doesn’t really think there’s anything wrong with her. She just doesn’t want to have sex anymore, and she doesn’t want to discuss it. Period.

This is a difficult way to start therapy. Resentments are high and frustrations rage. If the couple does continue, we usually discover that there’s also something desperately wrong with the husband. Inevitably, we ascertain that he’s an ineffectual lover—and his inability to pleasure his wife is the root of her “problem.” It’s often painfully clear that he knows little (if anything) about his wife’s sexual needs or desires. Meanwhile, the wife has never had permission to know her body, so she’s unable to help or direct him. As you can imagine in a case like this, there’s a load of remedial sex education that must come before anything else is resolved.

Couples also seek therapy when one spouse has cheated on the other. The “cheat-ee” declares, in no uncertain terms, that this therapy is the last-ditch effort before “the end of the road.” Often in such cases, it’s too late for a successful intervention, because each partner is so angry and shamed that the chance of turning the situation around is slim. Sometimes the best we can do is end the relationship with as little acrimony as possible.

In difficult couple counseling situations like this, my first effort is to get the couple to disarm. There will be no sex therapy—and God knows there is a need for sex therapy—until there is some semblance of peace between partners. If we don’t establish at least a small bank of goodwill, our efforts are doomed.

We’ll pick this up next week at this time.

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Running on Empty

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I know things are a bit mixed up this week.  Frequent visitors to Dr Dick’s Sex Advice will know that Wednesdays are traditionally Video Days on the site. But I have to veer off course this week.  I have some questions to respond to and I can’t do my Q&A on Friday this week, as I usually do, because I have a swell Product Review scheduled for Friday.

Do you see how nutty things can get when you have more things to do than days to do them on?  Anyhow, breaking with tradition every now and again is a good thing.

Name: lost angel
Gender: Male
Age: 21
Location: cali
Is the base of the penis behind the balls??? When I get hard my cock points kinda upward is this ok????

The base of your cock is not behind your balls.  That’s what’s called your dick root.  The base of your cock is where your cock meets your pubic bone on the dorsal (top) side of your johnson.

Having your boner point upward is as good as a place for it to point as any; and maybe better than some.

Name: Stephen
Gender: Male
Age: 41
Location: Va
As I have gotten older my sex drive has decreased tremendously. What can I do to turn it around?

Everyone’s libido decreases as he/she ages.  There’s no gettin around that.  However, a healthy lifestyle — good nutrition, maintaining your proper weight, getting an adequate amount of sleep, eliminating stress, modest alcohol and caffeine consumption and regular exercise will keep your sexual response cycle at its peek throughout your life.  Simply put, the healthier you are; the more libido you will enjoy.

That being said, I am increasingly more optimistic about the use of herbal supplements to help us gh.jpgropex.jpgolder folk stay in tip-top sexual condition.  To that end, I’d like to turn you on to three products I am currently testing on myself — Ropex, GH and Onkor Energy.   A full product review of Ropex and GH will appear on this site in time.  But the Onkor Energy review is already available on the Product Reviews page. Look for REVIEW #14.

What I’ve discovered through my product testing and review is that not all herbal supplements are created equal.  But you’ve probably figured this out on your own, huh?  I’ve tried several similar products that were completely ineffectual.  Others had unpleasant side effects.onkormen.jpg

Here’s something everyone should know.  A lot of these “Male Enhancement” and herbal products are produced in China under dubious conditions.  And everyone in the supplement industry will tell you, confidentially of course, that most of these products are adulterated with knock-off pharmaceuticals.  And that’s down right dangerous for us all.

I confidently offer these three products to you, because they work for me.  Just be assured that neither one of these products will not override a pathologically unhealthy lifestyle.  Look to your personal health and wellbeing first.  Supplement that if you must.

Hej from Sweden,
I am Mark and wanting advice regarding douching correctly.  I am 100% bottom but for personal reasons I decided to give up sex for at least 1 year.  NOW I have the horn again and I’m definitely in the mood!  I am wanting to be sure that all is ‘clean’ down there before having my ass played with  …..any advice on proper cleaning.
Great website BTW!
Hugs and blowjobs….
Mark x

Warm water is all you need.  Never use soap.b712.jpg

Some men add lemon juice or vinegar (1-2 Tbs. per quart) of the warm water.  Others dissolve (2 Tbs.) of baking soda in a quart of warm water.

Stay away from commercially produced douches; most contain harmful and irritating chemicals.  And trust me, you don’t want that.  Besides, all those over the counter douches are expensive.  And all that packaging is definitely not eco-friendly.  And we all want to be green perverts, don’t we?

Finally there is always the ever-versatile shower or bath bidet option. You can find one model, the Travel Shur Shot, in My Stockroom.

There are also stainless steel options that hook up to your shower head.

Name: Tommy
Gender: Male
Age: 36
Location: Ontario,CA
HI Dick : I had a problem keeping an erection when under the influence of crystal meth. It’s not that i wasn’t aroused. Is this common when taking speed?

Ahhh HELLO!  Are you so new to the Tina scene that you’ve never heard the term — “Crystal Dick”?   Holy cow!  Time to wake up and smell the coffee, honey.

 

meth_kills9.jpg

All tweakers will inevitably experience erection problems; some will be so serious that the guy will never recover.  Tweakers will often try to compensate for this lack of wood by taking Viagra, or another erection enhancing drug.  This is extremely dangerous because this combination will raise one’s blood pressure to dangerously high levels.  Or one could experience a really long lasting hardon, that could actually permanently damage your rod.

You’ve probably heard the old adage:  Meth Kills, right?  Well, it true.  While it may not be the death of you, per se.  You can be assured that it will kill your sexual response cycle.

Name: jack
Gender: Male
Age: 26
Location: denmark
hey I’m a 26 year old male who has struggled with alcohol abuse for many years as a result my balls have shrunk I don’t know what to do but I’m nervous about having sex and have even thought of taking my life.  I feel humiliated.  Is there something I can do or can I learn to live with this?  Will guys mind?

First off, congratulations on kickin’ the booze habit.  My hat is off to you!  If you can conquer balls6.jpgalcoholism, you’re pretty much set up to handle anything life sends your way; including a case of shrunken nuts.

Don’t despair, my friend, no one’s gonna kick you out of the sack for havin’ marbles in the sack instead of eggs.  Lots of men have smaller than usual testicles and it has nothing to do with alcohol consumption.  It’s just a natural variation on size and shape.

No need to be self-conscious about something as trivial as ball size and lose sight of the fact that you’ve overcome one of the worst scourges known to human kind.  You are a hero!  Never forget that.  And if the only scars you have to show for your valiant battle against demon alcohol is smaller cajones, then you’re luckier than most.

Get out there and learn to enjoy yourself again.  You will soon find that most men will be attracted to you for your personal courage and tenacity.  They won’t give a damn about the size of your balls.

Name: sami
Gender: Male
Age: 25
Location: Pakistan
I have visit many website and read about the erectile dysfunction problems but I want to know some thing about my problem which I have with my penis and I have used too much medicine for this and this problem is with me more than 6 years. I m from Pakistan and here doctors not treat me well or they are not expert in erectile dysfunction.
I’m 25 year old now and single.  The problem is that when ever I think about the sex or see any porn movie or chat with girl on sex topic then the drops like water come outside but its not like water its some juicy type and after this no erection come in my penis. And it cum soon without erection. I have used many medicines but to no avail.  Please tell me about my disease what is this?
And when ever I try to do sex with girl then again this drops come very fast in early and after that no erection and I can cum after one minute using my hands. I have also problem of early ejaculation too. While when i sleep and get up in morning some time my penis is in full erection and full motion but whenever I think about sex these drops come and the erection finish of my penis. So please tell me in details about this disease. Diagnose it and tell me the medicine for this because I want treatment from online doctor not from the Pakistani doctors and also want to take medicine online imported one because in Pakistan also not available good quality and variety medicine. Thanks

Things sound like they are in a pretty sorry state there in Pakistan.  That’s regrettable.

First up, if I understand you correctly, and that is a big “IF”; I’m gonna guess that you don’t need a doctor or medication.  It appears to me that you are dealing with two distinct issues:  1) excessive precum and 2) premature ejaculation.  Ok, let’s handle each one of these in turn.

You’ll find all the postings and podcasts I’ve done on the topic of pre-ejaculate by going to the precum03.jpegCATEGORIES section in the sidebar and searching for the word “precum”. Basically, excessive precum is nothing more than a bothersome issue for most men who experience it.  But it’s not a medical condition.  And there aren’t any medications you can take to relieve the problem.  Think of it as the equivalent of excessive sweating. There’s not a whole lot you can do about that either.  Issues like these tend to clear up on their own as we age.

You’ll find all the postings and podcasts I’ve done on the topic of premature ejaculation by going to the CATEGORIES section in the sidebar and searching for the words “lasting longer”.  Basically, a guy can easily learn to control his ejaculation response with a little effort on his part.  These postings and podcasts contain detailed “how to” instructions on how to achieve this control.  Again, this is not a medical condition.  And there aren’t any medications you can take to relieve the problem.

Name: liza
Gender: Female
Age: 30
Location: tyne and wear
My boyfriend is a transvestite and just recently he has started taking fenugreek seed tablets and red clover blossom tablets do you have any ideas why? I am concerned that michael5.jpgmaybe he is wanting to become a woman full time could this be a possibility? Please help???

I think I’m a pretty wise and insightful guy, but I would never hazard a guess as to what might be going on in the mind of a drag queen…ever!  😉

I suppose the only way you will know for sure what he’s up to is to ask.

What I can say with some certainty is that most TV’s (transvestites) are not TS’s (transexuals), nor are they gender dysphoric.  They just like frilly knickers!

I looked up the herbal supplements you mentioned and I didn’t find anything that would suggest a sex change in the offing.  It’s more likely a case of dyspepsia.

Dear Dr. Dick,
I asked this question on the anonymous form but would prefer and
answer in my email.
I am concerned about my ED that I seem to have developed over the last
year or so. It could be the anti-depressants I am on but I have a
feeling it is Viagra. I have used Viagra for many years even when I
didn’t need it. It was just a guarantee that I could go all night. My
concern is that I have become dependent on it. When I don’t use it I
can get hard but it never last which is frustrating when with a very
hot bttm guy.
Hope to hear from you soon.

Yes, the use of antidepressants will surely impact, in a negative sort of way, one’s (both women and men) sexual response cycle, particularly the arousal stage.  In your case, your ability to get and/or cockbeans.jpgmaintain an boner.

I’ve written and spoken a lot about the use of Viagra and its fellow drugs.  You can find the postings and podcasts by going to the CATEGORY section in the sidebar of my site and search for Erection Enhancing Drugs.

Many men are becoming “hooked” on these drugs.  I would seriously recommend that you not use these meds recreationally.  I, for example, tend to rely on a cockring as opposed to a pharmaceutical.

You might also consider a high quality herbal supplement, like the ones I recommended to Steven up above.

Good luck ya’ll

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Writes Of Spring

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Can you believe it’s freakin’ spring already? Holy cow, it seems like it was only a few weeks ago that I was calling attention to the winter solstice and here we are at the vernal equinox. My, how time flies.

Despite the relentless passing of time, sexual concerns are perennial.

Name: pete
Gender: Male
Age: 33
Location: florida
I have been notice that some of the skin on my dick is starting to wear away from me masturbating…there is no blood or anything like that. Just the skin turning light in color around head of my dick. I think its my grip. Is there a way the color will come back or have i rubbed the skin cells to death. I masturbate about 3-4 times a week. Im not in a relationship and prefer that over random sex.

Your dick skin is wearing away??? Really? How are you handling your unit, darlin’,g003.jpg with sandpaper?

You say you think it’s your grip. Ya think? Hey Pete, are you using lube when you stroke? Or are you just yanking away down there with wild abandon? If you’re not using a good jack off cream like, Elbow Grease, Original 15 oz (G003) then ya better start! This stuff is not for use with condoms, but you don’t have to worry about that if all you’re doing is pullin’ your pud.

As to the rather sudden coloration change on your dick, I’d be willing to guess that it has nothing to do with jerkin’ off, even if you’re doin it like a maniac. More likely it’s a genetic condition known as vitiligo. And the coloration change is actually a loss of pigment. This is not a health concern, really! Nor is it contagious. So you don’t have to worry about it in that regard. If it is indeed vitiligo, there’s nothing you can do about it. It’s irreversible, but it can and does spread.

vitiligo_032904.jpg

Here’s a relatively easy way to self-diagnose this pesky, but benign condition. While naked as a jay-bird, squat over a mirror. If you have vitiligo, you will also see the same kind of color changes (loss of pigment) around your asshole. You may also notice it on your elbows and knees. If you are fair-skinned, the loss of pigment will be less noticeable then if you have a darker complexion.

If it’s not vitiligo, you might consider a visit with your physician. But I pretty much can guarantee you that unless you are absolutely ruthless in your masturbation technique, manhandling yourself as you do, is not the cause of the color change on your joystick.

Name: heater
Gender: Female
Age: 36
Location: USA
I have been Married for 10 years I have told my Husband 6 years ago i not physical attracted to him anymore I stopped wanting Sex from him he just turned me off no matter what he did he cleaned cooked run me a bath eat me and so on but nothing works I start to get wet and as soon as he gets started i try up like a prune what should i do i have not had good sex in a long time

Well, if you’re not attracted to him anymore, you’re not attracted to him anymore…plain and simple. But what I don’t get is, how come after six years you’re old man still hangs in there? Is he some kind of glutton for punishment?

If I was your long-suffering hubby and I was doin all this stuff, including cooking, cleaning and eatin’ out your pussy, I’d sure as hell demand an explanation for yourdominatrix_2.jpg attitude change. Of course, maybe he likes being the doormat. Some men really get off on being dominated and treated like shit. Is that why you are no longer into him?

Or is there something else he’s done that has put you off? Did he gain weight? Does he not attend to his personal hygiene? Did he become a Republican? Ya know, things like that. If it is something he’s done or failed to do and he can change his behavior to better suit you, maybe you oughta clue him in on this.

If however, it’s not something he’s done or failed to do, but it’s you. Then he needs to know that too. You did say that you dry up like a prune. Perhaps it’s your libido that’s gone south, not his relative attractiveness? Sometimes women get these two things confused.

Do you have sexual fantasies? Do you masturbate? Are horny for anyone else — either real or imagined? How’s your health? Are you on birth control? Are you depressed? Sleep deprived? Are you putting on the pounds? Could you be experiencing early-onset menopause? As you can see, there are innumerable reasons for a decrease in libido.

At any rate, Heater, you really need to get to the bottom of this, and soon, six years is a mighty long time to live like this. I’d look for a sex-positive therapist to connect with, if I were you. Clearly, you’ve been unable, in six years, to discern the cause of your attitude change on your own. It’s irresponsible to continue to drift with the status quo.

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

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

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

That being said, getting over a phobia, of whatever kind — fear of flying, snakes, spiders, public speaking, or sex — can be accomplished without dredging up the past. Try this:

  • Identify the specifics of your fear as they play themselves out in your life now. What precisely frightens you about sex and/or intimacy?
  • Create a plan to take the edge off your fear in small steps. For example, start out with holding hands, move to embracing, then kissing. What behaviors push the panic button for you?
  • Address each and every thing that hampers your progress. For example, why does kissing push your buttons and holding hands and/or cuddling doesn’t?
  • Be firm in your resolve to push past your discomfort and stretch your limits. Sinking to the lowest common denominator will not do.
  • Address the emotional response you have to each aspect of your phobia before moving on to the next one. Build on your successes.

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

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

Name: afeisha
Gender: Female
Age: 21
Location: pennsylvania
i usually have orgasms when i masturbate, but why when im having sex its so hard to arrive at an orgasm? even when the sex is great.

Women suffer from performance anxiety too, ya know.

While performance anxiety is mostly talked about in terms of men and their erection problems, the guys don’t have a monopoly on the annoying issue.

I’d be willing to guess, my dear, that you’ve got some performance anxiety goin onbeatuy_booty.jpg yourself, possibly even big time. Sad to say, this difficulty often plagues younger women the most. Young women tend to have less self-esteem. And if they are new to sex, they may not know what they are doing, which can be disturbing and distracting. On the other hand, if a young woman is not a sexual novice and she appears too knowledgeable about sex, she runs the risk of being labeled a slut. So basically, young women can’t win for losing. Regrettable, but there ya have it.

So let’s see if we can get to the bottom of this, as it were. Let me ask you a few questions. First and foremost, where is your mind when you are having sex with a partner? Is it on the pleasure you are giving and receiving? Or is it, like so many people, on something other than that?

  • If your mind is busy with how you look, or how you smell, or if you are wondering if that birthmark is too obvious. Or if you’re worried about how accomplished you are at performing a particular sex act, or if you’re concerned about your partner feelings for you. Then you may have performance anxiety.
  • If you anxious about what your partner is thinking of you, of if he/she is turned on by you, or loves you, or is just bangin’ away at you like a slab of beef. Then you may have performance anxiety.
  • If you’re afraid to let go and have a screamin’ meme of an orgasm, because it might not look lady-like, or you’re not sure you can trust the person who’s bumpin’ you enough to just relax and enjoy the ride. Then you may have performance anxiety.

However, performance anxiety is only one explanation for the problem you experience in partnered sex. Many women report that their partnered sex is not as satisfying as their solo sex, because they’re not able to stimulate themselves in the same fashion in partnered sex as you do when they’re jillin’ off on their own. If you are self-conscious about showing your partner the particulars of gettin yourself off, or too intimidated to incorporate a vibrator in your love making, you might not be getting what you need when you need it. Thus you might be aroused, but not to the point of lettin’ one loose…if ya catch my drift.

Finally, one of the easiest solutions to this problem is to simply have a frank discussion with your partner(s) about what gets you off before the fuck-fest begins. That will clear the air of unnecessary anticipation and you both will be able to relax more into the event itself, rather than being distracted by the externals.

Good luck ya’ll

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Older people still have sex, but it’s the intimacy and affection that matters more

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Sexuality is still an important part of life for older people, but it’s seldom discussed and rarely researched.

By and

Sexuality encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction and what we think, feel and believe about them. It has been a research focus for over a hundred years, and highlighted as an important part of the human experience. Since the first studies on human sexuality in the 1940s, research has consistently demonstrated that sexual interest and activity are sustained well into old age. However, only a fraction of the research has explored sexuality in the later years of life.

Most of the early research on sexuality and ageing looked at the sexual behaviours and biology of older adults, generally ignoring the wider concept of sexuality. When researchers did discuss sexuality more broadly, many referred to sexuality as the domain of the young, and emphasised this was a major barrier to the study of sexuality in older adults.

Sexuality in later life ignored

Towards the end of the 20th century, research expanded to include attitudes towards sexual expression in older adults, and the biological aspects of sexuality and ageing. Consistently, the research showed sexual expression is possible for older adults, and sustained sexual activity into old age is more likely for those who had active sex lives earlier in life.

By the late 1980s, there was a strong focus on the biological aspects of ageing. This expanded to include the reasons behind sexual decline. The research found these were highly varied and many older adults remain sexually active well into later life.

But despite evidence adults continue to desire and pursue sexual expression well into later life, both society in general and many health professionals have inadvertently helped perpetuate the myth of the asexual older person. This can happen through an unintentional lack of recognition, or an avoidance of a topic that makes some people uncomfortable.

Why does this matter?

These ageist attitudes can have an impact on older adults not only in their personal lives, but also in relation to their health needs. Examples include the failure of medical personnel to test for sexually transmissible infections in older populations, or the refusal of patients to take prescribed medications because of adverse impacts on erection rigidity. We need more health practitioners to be conscious of and incorporate later life sexuality into the regular health care of older adults. We still have a long way to go.

By ignoring the importance of sexuality for many older adults, we fail to acknowledge the role that sexuality plays in many people’s relationships, health, well-being and quality of life. Failure to address sexual issues with older patients may lead to or exacerbate marital problems and result in the withdrawal of one or both partners from other forms of intimacy. Failure to discuss sexual health needs with patients can also lead to incorrect medical diagnoses, such as the misdiagnosis of dementia in an older patient with HIV.

It’s not about ‘the deed’ itself

In a recent survey examining sexuality in older people, adults aged between 51 and 89 were asked a series of open-ended questions about sexuality, intimacy and desire, and changes to their experiences in mid-life and later life. This information was then used to create a series of statements that participants were asked to group together in ways they felt made sense, and to rank the importance of each statement.

The most important themes that emerged from the research encompassed things such as partner compatibility, intimacy and pleasure, and factors that influence the experience of desire or the way people express themselves sexually. Although people still considered sexual expression and sexual urges to be important, they were not the focus for many people over 45.

Affectionate and intimate behaviours, trust, respect and compatibility were more important aspects of sexuality than intercourse for most people. Overall, the message was one about the quality of the experience and the desire for connection with a partner, and not about the frequency of sexual activities.

People did discuss barriers to sexual expression and intimacy such as illness, mood or lack of opportunity or a suitable partner, but many felt these were not something they focused on in their own lives. This is in line with the data that shows participants place a greater importance on intimacy and affectionate behaviours such as touching, hugging and kissing, rather than intercourse.

These results help us challenge the existing stereotype of the “asexual older person” and the idea intercourse is necessary to be considered sexually active. They also make it clear researchers and health practitioners need to focus on a greater variety of ways we can improve the experience and expressions of sexuality and intimacy for adults from mid-life onwards beyond medical interventions (like Viagra) that focus on prolonging or enhancing intercourse.

Complete Article HERE!

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Viagra rising: How the little blue pill revolutionized sex

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Twenty years ago, a little blue pill called Viagra unleashed a cultural shift in America, making sex possible again for millions of older men and bringing the once-taboo topic of impotence into daily conversation.

While the sexual improvement revolution it sparked brightened up the sex lives of many couples, it largely left out women still struggling with dysfunction and loss of libido over time. They have yet to benefit from a magic bullet to bring it all back, experts say.

About 65 million prescriptions have been filled worldwide for the blockbuster Pfizer drug approved by the US Food and Drug Administration on March 27, 1998.

It was the first pill aimed at helping men get erections.

Suddenly, talk of an amazing drug that could make an older man’s penis hard again was all over television and magazines.

The Viagra boom also coincided with the rise of the internet, and the explosion of online pornography.

Ads for Viagra were designed to reframe what had been known as “male impotence” as “erectile dysfunction” or ED, a medical condition that could finally be fixed.

Republican senator, military veteran and one-time presidential candidate Bob Dole became the first television spokesman for Viagra, admitting his own fears about erectile dysfunction to the masses.

“It’s a little embarrassing to talk about ED, but it is so important for millions of men and their partners,” he said.

The strategy worked.

Before Viagra, men wanted to talk about their erectile problems, and did, but the conversations were awkward and difficult, recalled Elizabeth Kavaler, a urology specialist at Lenox Hill Hospital in New York.

“Now, sexuality in general is very out there,” she added.

“Sex has become an expected part of our lives as we age. And I am sure Viagra has been a big part of that.”

MISUNDERSTOOD DRUG

Viagra has had a “major impact” — on a par with the way antibiotics changed the way infections are treated, and how statins became ubiquitous in the fight against heart disease, said Louis Kavoussi, chairman of urology at Northwell Health, a New York-area hospital network.

Viagra’s release also came amid a “sort of a clampdown on physicians interacting with companies,” he said.

“So this was a perfect medicine to advertise to consumers. It was a lifestyle type of medicine.”

Viagra, or sildenafil citrate, was first developed as a drug meant to treat high blood pressure and angina.

But by 1990, men who took part in early clinical trials discovered its main effect was improving their erections, by boosting blood flow to the penis.

For all its popularity, Viagra is still often misunderstood.

“It isn’t an aphrodisiac,” said Kavoussi.

“A lot of men who ask about it say, ‘My wife isn’t very interested in relations,” he added.

“And I say, ‘Viagra is not going to change that.'”

SEXUAL REVOLUTION

In 2000, the comedy show “Saturday Night Live” featured a spoof on ads that showed sexually satisfied men saying, “Thanks, Viagra.”

In it, one eye-rolling actress after another was featured groaning “Thanks, Viagra,” as a horny male partner groped her from behind or gripped her in a slow-dance.

The skit was funny because it reflected a reality few people were talking about.

“We are a very puritanical society, and I think Viagra has loosened us up,” said Nachum Katlowitz, director of urology and fertility at Staten Island University Hospital.

“But for the most part, the women have been left out of the sexual improvement revolution.”

Pfizer finally did include women in its marketing for Viagra, in 2014. The commercials featured sultry women, including at least one with a foreign accent, speaking directly to the camera, telling men to get themselves a prescription.

‘FEMALE VIAGRA’

In 2015, the FDA approved a pill called Addyi (flibanserin), which was cast in the media as the “female Viagra,” and was touted as the first libido-enhancing pill for women who experienced a loss of interest in sex.

The pill was controversial from the start.

A kind of anti-depressant, women were warned not to drink alcohol with it. It also cost hundreds of dollars and came with the risk of major side effects like nausea, vomiting and thoughts of suicide.

“It didn’t go over too big,” said Katlowitz.

Valeant Pharmaceuticals bought Addyi for $1 billion in 2015, but sold it back to the developer, Sprout Pharmaceuticals, at a steep discount last year.

Older women’s main problem when it comes to sex is vaginal dryness that accompanies menopause, and can make sex painful.

Solutions tend to include hormones, or laser treatments that revitalize the vagina. They are just beginning to grow in popularity, but still cost hundreds to thousands of dollars, said Kavaler.

“We are at least 20 years behind men,” she said.

For Katlowitz, Viagra was a prime example of “the greed of the pharmaceutical industry.”

Viagra cost about $15 per pill when it first came out, and rose to more than $50. It finally went generic last year, lowering the price per pill to less than $1.

“There was absolutely no reason to charge $50 a pill,” said Katlowitz.

“It was just that they could, so they did.”

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