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Running on Empty

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

Writes Of Spring

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

Why Can’t I Orgasm During Sex? Chronic Pain And 5 Other Factors That Affect Ability To Climax

By

Imagine this: You and your partner are getting hot and heavy in between the sheets. You’re feeling sexually aroused — but you’re unable to climax. In frustration you ask yourself: “Why can’t I orgasm during sex?”

The Kinsey Institute indicates 20 to 30 percent of women don’t have orgasms during intercourse, compared to only 5 percent of men who don’t climax every time they have sex. Men and women who are unable to sustain an erection or reach orgasm, respectively, are usually labeled as having some type of sexual dysfunction. However, the inability to orgasm could be triggered by several issues that range from physiological to psychological.

Below are six causes of why you have trouble orgasming during sex.

Tight Condoms

Condoms are often seen as an “evil” necessity that reduces sensitivity and sensations for men. The truth is condoms can inhibit male orgasm if they do not fit properly. A condom that is too tight can feel like the penis is in a chokehold, which can be distraction, and make it difficult to keep an erection. A 2015 study in journal Sexual Health found about 52 percent of men report losing an erection before, or while putting a condom on or after inserting into the vagina while wearing a condom.

Stress

High levels of stress impact your psychological and physiological health, which can interfere with the ability to orgasm. This makes it harder to concentrate on the sensation and relax during sex. Women with high salivary cortisol and stress levels have significantly less desire to masturbate or have sex with their partner.

Stress causes us to produce fewer sex hormones, like estrogen and testosterone, and more cortisol and stress hormones. When the body releases cortisol, a fight-or-flight response kicks in, and redirects the blood flow away from the sex organs, causing you to breathe shallowly.

couple-holding-hands

Depression

Depression affects your mood, and even the desire to have sex. A 2000 study in the American Family Physician found 70 percent of adults facing depression without treatment had problems with their sex drive. This is because sexual desire starts in the brain as sex organs rely on chemicals in the brain to jumpstart your libido, and change blood flow. Depression disrupts these brain chemicals, making sexual activity more difficult to initiate and enjoy.

Chronic Pain

More than 75 million people live  with persistent or debilitating pain, according to the national pain foundation, which can often lead to a low sex drive. Chronic pain sufferers find it difficult to feel pleasure during sex since the body hurts all the time. This is unfortunate since having an orgasm can alleviate some pains and aches.

Prescription Meds

Drugs tend to be among the most common causes of sexual problems. Prescription meds are responsible for as many as one of every four cases of sexual dysfunction. A 2002 study published in Family Practice found statins and fibrates (used in lowering LDL “bad” cholesterol) may cause erectile dysfunction, while later research has found both men and women taking statins showed increased difficulty achieving orgasm. The levels of sexual pleasure declined along with LDL cholesterol.

Negative Body Image

When you feel good about your body, you tend to feel better psychologically as well. The mind-body connection is imperative in sexual pleasure. For example, if you feel bad about your body, it;ll become more difficult to enjoy sex and have orgasms. A 2009 study in The Journal of Sexual Medicine found women between the ages 18 to 49 who scored high on a body image scale were the most sexually satisfied. Positive feelings associated with weight, physical condition, sexual attractiveness, and thoughts about our body during sex help promote healthy sexual functioning.

Complete Article HERE!

Cancer patients and survivors can have trouble with intimacy

cancer-patients-and-survivors-can-have-trouble-with-intimacy

People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.

People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.(Photo: Getty Images/Comstock Images)

In the mirror, Kelly Shanahan looks normal, even to herself.

kelly-shanahan

Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health.

But she does not feel like herself.

The breasts she had reconstructed eight years ago look real, the nipples convincing. But her breasts have no sensation. The only time she feels them at all is during the frigid winters of her South Lake Tahoe, Calif., home, when they get so cold, she has to put on an extra layer of clothing.

“For a lot of women, breast sensation is a huge part of sexual pleasure and foreplay. That is totally gone,” says Shanahan, 55, who has lived with advanced breast cancer for three years. “It can be a big blow to self-image, even though you may look normal.”
Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health. (Photo: Kelly Shanahan)

Shanahan is part of a growing group of patients, advocates and doctors raising concerns about sexual health during and after cancer treatment.

“None of us would be here if it weren’t for sex. I don’t understand why we have such a difficult time talking about it,” she says.

Though virtually all cancer diagnoses and treatments affect how patients feel and what they think about their bodies, sex remains an uncomfortable medical topic.

Shanahan, an obstetrician herself, says that until her current doctor, none of the specialists who treated her cancer discussed her sex life.

“My former oncologist would rather fall through the floor than talk about sex,” she says.

Major cancer centers now include centers addressing sexuality, but most community hospitals still do not. The topic rarely is discussed unless the patient is particularly bold or the doctor has made a special commitment.

There’s no question that cancer can dampen people’s sex lives.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Weight gain or loss can affect how sexy people feel. Fatigue is unending during treatment. Body image can be transformed by surgeries and the idea that your own cells are trying to kill you. The constant specter of death is a sexual downer, as are the decidedly unsexy aspects of cancer care, like carrying around a colostomy bag. Then, there are the healthy partners, feeling guilty and terrified of causing pain.

And once people start to associate sex with pain, that can add apprehension and muscle tightness, which makes intercourse harder to achieve, says Andrea Milbourne, a gynecologist at the University of Texas MD Anderson Cancer Center in Houston.

There’s almost never a medical reason cancer patients or survivors shouldn’t be having sex, says Karen Syrjala, a clinical psychologist and co-director of the survivorship program at the Fred Hutchinson Cancer Research Center in Seattle. Even if there is reason to avoid intercourse, physical closeness and intimacy are possible, she says, noting that the sooner people address sexual issues the less serious those issues will be.

“Bodies need to be used and touched,” she says said. “Tissues need to be kept active.” Syrjala recommends hugging, romantic dinners, simple touching, “maybe just holding each other naked at night.”

There are ways to improve sexual problems, starting with doctors talking to their patients about sex. Milbourne and others say it’s their responsibility, not the patients’, to bring up the topic.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Communication between partners also is essential. “A lot of times, it’s unclear, at least in the mind of the other partner who doesn’t have a cancer, what has happened. ‘Why does this hurt? Why don’t you want to do anything?’ ” Milbourne says.

For women who have pain during sex, Milbourne says one study found benefit to using lidocaine gel to numb vaginal tissue.

Jeanne Carter, head of the female sexual medicine and women’s health program at Memorial Sloan Kettering Cancer Center in New York City, recommends women do three minutes of Kegel exercises daily to strengthen their pelvic floor muscles and improve vaginal tone, and to help reconnect to their bodies.

For women sent abruptly into menopause, moisturizing creams can help soften tissue that has become brittle and taut. Carter says she’s conducted research showing that women with breast or endometrial cancers who use moisturizers three to five times a week in the vagina and on the vulva have fewer symptoms and less pain than those who don’t. Lubricants can help smooth the way, too.

“We’ve got to make sure we get the tissue quality and pain under control or that will just undermine the whole process,” Carter says.

Sex toys also take on a different meaning after cancer treatment. Specialized stores often can offer useful advice and the ability to examine a product before buying. Rings and other equipment, in addition to medications such as Viagra, can help men regain erections.

Doctors and well-meaning friends also need to stop telling cancer patients that they should simply be glad to be alive, Shanahan says. Of course she is, but eight years after her initial diagnosis and three years after her disease advanced, Shanahan wants to make good use of the time she has left.

And that, she says, includes having a warm, intimate relationship with her husband of 21 years.

Complete Article HERE!

Expert Shares Tips for Talking Sexual Health With Cancer Survivors

by KATIE KOSKO

prostatecancer_600x450

Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer and survivors it can feel even more awkward. Nevertheless, sex ranks among the top 5 unmet needs of survivors, and the good news is, proactive oncology practitioners can help fill that void.

Sixty percent of cancer survivors—9.3 million individuals in the United States alone—end up with long-term sexual problems, but fewer than 20% get professional help, according to Leslie R. Schover, PhD, founder of the digital health startup, Will2Love. Among the barriers she cited are overburdened oncology clinics, poor insurance coverage for services related to sexual health, and an overall lack of expertise on the part of providers, many of whom don’t know how to talk to patients about these issues.

And, oncologists and oncology nurses are well-positioned to open up that line of communication.

“At least take one sentence to bring up the topic of sexuality with a new patient to find out if it is a concern for that person,” Schover explained in a recent interview with Oncology Nursing News. “Then have someone ready to do the follow-up that is needed,” and have other patient resources, such as handouts and useful websites, on hand.

Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for practitioners on the topic, has been a pioneer in developing treatment for cancer-related problems with sexuality or fertility. After decades of research and clinical practice, she has witnessed firsthand how little training is available in the area of sexual health for healthcare professionals.

“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” said Schover. “I submitted a grant four times before I retired, to provide an online interprofessional training program to encourage oncology teams to do a far better job of assessing and managing sexual problems. I could not get it funded.”

In her webinar, she offered tips for healthcare practitioners who want to learn more about how to address sexual health concerns with their patients, like using simple words that patients will understand and asking open-ended questions in order to engage patients and give them room to expand on their sex life.

Schover suggests posing a question such as: “This treatment will affect your sex life. Tell me a little about your sex life now.”

Sexual side effects after cancer treatment vary from person to person, and also from treatment to treatment. Common side effects for men and women include difficulty reaching climax, pain during sexual intercourse, lower sexual desire and feelings of being less attractive. Men specifically can experience erectile dysfunction and dry orgasm, while women may have vaginal dryness and/or tightness, as well as loss of erotic sensation such as on their breasts following breast cancer treatment.

Sexual dysfunction after cancer can often lead to depression and poor quality of life for both patients and their partners.

According to Schover, oncologists and oncology nurses should provide realistic expectations to patients when they are in the treatment decision-making process.

“Men with prostate cancer are told they are likely to have an 80% chance of having erections good enough for sex after cancer treatment,” Schover says. “But the truth is it’s more like 20 to 25% of men who will have erections like they had at baseline.”

To get more comfortable talking about sex with patients, Schover advises role-playing exercises with colleagues, friends, and family—acting as the healthcare professional and then the patient. When the process is finished, ask for feedback.

Brochures, books, websites and handouts are also good to have on hand for immediate guidance when patient questions do arise. But Schover is hoping for a bigger change rooted in multidisciplinary care and better patient–provider communication to find personalized treatments tailored to each individual’s concerns and needs.

Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, she explained. In addition, side effects like prolonged nausea, fatigue, and chronic pain also can disrupt a patient’s sex life.

“Simply to give medical solutions rarely resolves the problems because a person or couple needs to make changes in the sexual relationship to accommodate changes in physical function,” Schover stressed. “That kind of treatment is usually best coming from a trained mental health professional, especially if the couple has issues with communication or conflict.”

Schover wants to make sure that those resources are easily accessible to patients and survivors. Thus, she has created the startup, Will2Love, which offers information on the latest research and treatment, hosts webinars, and provides access to personalized services.

“Sexual health is a right,” concluded Schover, and both oncology professionals and patients need to be assertive in getting the conversation started.

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