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What getting intimate at 60 really means

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Most people assume getting saucy under the sheets it just for the young, but what about the young at heart?

By Ashley Macleod and Marita McCabe

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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Redefining Sexuality after Stroke

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You can have a healthy sex life after having a stroke.

By StrokeSmart Staff

You can have a healthy sex life after having a stroke. In fact, it’s a key part of getting back into a normal routine. The need to love and be loved is significant. Also, the physical and mental release that sex provides is important.

The quality of a couple’s sexual relationship following a stroke differs from couple to couple. Most couples find that their sexual relationship has changed, but not all find this to be a problem. The closeness that a couple shares before a stroke is the best indicator of how their relationship will evolve after the stroke.

However, having sex after a stroke can present problems and concerns for both you and your partner.

Stroke survivors often report a decrease in sexual desire. Women report a strong decrease in the ability to have an orgasm and men often have some degree of impotency. A stroke can change your body, how you feel and impact your sex life.

Having good communication with your partner, managing depression, controlling pain or incontinence and working with impotence can all help you resume a healthy sex life.

Communication is Key

Talking about sex is hard for many people. It gets even more complicated after having a stroke, when you may be unable to understand or say words or have uncontrollable laughing or crying spells. But it is critical to talk openly and honestly with your partner about your sexual needs, desires and concerns. Encourage your partner to do the same. If you are having a difficult time communicating with your partner about sex, an experienced counselor can help.

Depression, Pain and Medication — How They Effect Your Sex Drive

It is common for stroke survivors and their partners to suffer from depression. When you are depressed, you tend to have less interest in sexual intimacy. Depression can be treated with medications. You may also be taking medicine for anxiety, high blood pressure, spasticity, sleeping problems or allergies. Addressing these medical concerns can increase your sex drive. But know that some medication can also have side effects that interfere with your sex life. If your ability to enjoy sex has decreased since your stroke, talk with your doctor about medicines that have fewer sexual side effects.

Many stroke survivors also have problems with pain, contributing to a loss of sexual desire, impotence and the ability to have an orgasm. This is a normal reaction. Work with your doctor to develop a program to manage your pain and increase your sexual desire.

Controlling incontinence

If you are having trouble with controlling your bladder or bowel, being afraid that you will have an accident while making love is understandable. There are a few steps you can take to help make incontinence during sex less of a concern.

  • Go to the bathroom before having sex
  • Avoid positions that put pressure on the bladder
  • Don’t drink liquids before sexual activity
  • Talk to your partner about your concerns
  • Place plastic covering on the bed, or use an incontinence pad to help protect the bedding
  • Store cleaning supplies close in case of accidents

If you have a catheter, you can ask your doctor’s permission to remove it and put it back in afterwards. A woman with a catheter can tape it to one side. A man with a catheter can cover it with a lubricated condom. Using a lubricant or gel will make sex more comfortable.

Working With Impotence

Impotence refers to problems that interfere with sexual intercourse, such as a lack of sexual desire, being unable to keep an erection or trouble with ejaculation. Today, there are many options available to men with this problem. For most, the initial treatment is an oral medicine. If this doesn’t work, options include penile injections, penile implants or the use of vacuum devices. Men who are having problems with impotence should check with their doctors about corrective medicines. This is especially true if you have high blood pressure or are at risk for a heart attack. Once you have talked to your partner and you are both ready to begin a post-stroke sexual relationship, set yourself up to be comfortable. Start by reintroducing familiar activities such as kissing, touching and hugging. Create a calm, non-pressure environment and remember that sexual satisfaction, both giving and receiving, can be accomplished in many ways.

Ask the Doctor

Things to discuss with your doctor:

  1. Medications for depression and pain that have fewer sexual side effects.
  2. Changes you should expect when having sex and advice on how to deal with them. Be sure to discuss when it is safe to have sex again.
  3. Impotence and corrective medications.
  4. Incontinence — a urologist who specializes in urinary functions may be able to provide help in this area.

Tips for Enjoying Sex After a Stroke

  • Communicate your feelings honestly and openly.
  • if you have trouble talking, use touch to communicate. It is a very intimate way to express thoughts, needs and desires.
  • after stroke, your body and appearance may have changed. Take time for you and your partner to get used to these changes.
  • Maintain grooming and personal hygiene to feel attractive for yourself and for your partner.
  • explore your body for sexual sensations and areas of heightened sensitivity.
  • have intercourse when you are rested and relaxed and have enough time to enjoy each other.
  • try planning for sex in advance, so you can fully enjoy it.
  • Be creative, flexible and open to change.
  • the side of the body that lacks feeling or that causes you pain needs to be considered. Don’t be afraid to use gentle touch or massage in these areas.
  • if intercourse is too difficult, remember there are many ways to give and receive sexual satisfaction.

Complete Article HERE!

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

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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!

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Cancer patients and survivors can have trouble with intimacy

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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!

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Expert Shares Tips for Talking Sexual Health With Cancer Survivors

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by KATIE KOSKO

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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.

Complete Article HERE!

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