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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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How to successfully navigate friends with benefits

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The idea of having a friends with benefits relationship—two friends who have sex without a romantic relationship or commitment—can be very temping and convenient while in college. Due to the fact that students live away from their parents and in close proximity to many other people their age, friends with benefits relationships tend to be popular.

In theory, a limited relationship involves having sex with one person while also staying single and having the freedom to have sex with other people at the same time. Friends with benefits are more reliable than a hookup, but less reliable than a significant other. While this may sound like a good idea, these friendships oftentimes do not work.

Having friends with benefits comes with one small detail that everyone tends to forget about when first jumping into one of these relationships—you spend a chunk of time with someone that you find physically attractive. This aspect heightens the probability of developing feelings for this person.

While feelings are not always necessarily a bad thing, friendships involving sex can get messy if the other person does not reciprocate those feelings. Sex does not by any means always have to be serious; people generally use it to connect and as a result display feelings of love. Two people need to take this into consideration when deciding to become friends with benefits.

Just like any other relationship—whether romantic or platonic—communication is key for people participating in friends with benefits relationships. In order for these relationships to work, both parties must openly discuss their expectations for the relationship and set concrete ground rules before a bad situation occurs and feelings get hurt.

Some important things to discuss in a friends with benefits relationship include whether or not both parties will engage in sex with other people or just each other, whether they have any interest in hanging out in addition to having sex and whether they have feelings for one another at the moment.

By ensuring that each party understands the other’s desires and expectations, both people are completely aware of what they sign up for when it comes to their friends with benefits relationship. In addition, setting some ground rules helps make for a successful friends with benefits relationship.

Lastly, it is important to practice safe sex in any relationship, whether it be a one-night stand, a romantic relationship or a friend with benefits. Many times, a friends with benefits relationship is non-exclusive. Having sex with more than one person increases the likelihood of spreading sexually transmitted diseases, which makes protection and communication integral to maintaining your own personal health.

Though friends with benefits can come with many risks, STDs and unplanned pregnancies aren’t the type of risks you should take. Many friends with benefits relationships do not end well, so remaining cautious is how you can protect yourself.

It’s encouraged to ask what your partner expects out of the friends with benefits relationship. But, most importantly, don’t be afraid to tell them what you expect as well.

Complete Article HERE!

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How To Have The ‘Sex Talk’ with Your Kids

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USA, New Jersey, Jersey City, Mother with daughter (8-9) talking on bed

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Let’s talk about “the talk.” Yep! The birds and the bees.

At some point, every parent needs to give their kids a heads up on what’s going on with their bodies and their sexuality, right? In a perfect world, that would be true, but even well-meaning parents may not know how to approach the topic. In my family, for example, I never even heard my mother or father say the word “s-e-x” until I was in my 30s!

I want to equip ESSENCE moms with a cheat sheet on how to give your kids “the talk.” After all, sexuality is a natural part of life, and loving your sexual self is important to having high self-esteem overall. Since I’m not yet a mom, I called on a friend who is also a parenting specialist to weigh in on the topic.

Parenting expert Erickka Sy Savané was once an international model and host of her own video countdown show on MTV Europe. These days, the woman who has also written for almost every major publication can be seen as the host of a new digital series called POP MOM. She says that the show and accompanying blog is a way to get African American mothers to share and discuss hot topics. Erickka lives in New Jersey with her husband and two daughters, ages 6 and 4.

Sex ed is such an important topic. Consequences of poor sexual education at home may include unintentional pregnancies, sexually transmitted diseases, body hatred and low self-esteem. My parents told me absolutely nothing about love, sex, dating and relationships. Were your parents open about sex and sexuality?

I grew up with a single mom talked to me about my period after it happened, and I vaguely remember her telling me something about sex when I was in high school. She might have mentioned getting on birth control pills if I felt like I was going to have sex. But it wasn’t a talk that started when I was young, like I’m starting to do with my daughter who is 6 years old. For instance, my daughter asked me about my current POP MOM episode that talks about ‘the sex talk and dads,’ so I had a conversation with her.

I want to be honest and I want sexuality to be something that is viewed as normal, while also letting her know that it is something for when she is much older. I wish my mom would have talked to me about sex as I was growing up so by the time I was in high school it wouldn’t have been such a big deal. I think it’s important to take the taboo out of it because as humans we are here to reproduce.

When parents ask me about how to talk to their kids about their bodies and sex, I generally advise them to begin early with age appropriate topics, as you’re doing with your daughter. How young is too young to have these conversations?

I say, if they’re asking give them answers that they can handle, while maintaining certain levels of truth. I had to start the sex talk with my daughter when she was in kindergarten because she had a classmate and best friend that started telling her all these inappropriate stories that she was observing either in her home or on TV. I didn’t want my daughter learning about sex through a 5-year-old. Psychologist Dr. Kristin Carothers says that appropriate sex conversation should begin as early as 8 or 9 years old.

Whenever we have thought about sex ed at home previously, as a culture, it has been mom talking to girls and dad talking to boys. I am so grateful for you approaching the topic of daddies talking to daughters as our relationships with our fathers define, to some extent, our de facto relationships with men.

I decided to address the sex talk from a dad’s perspective when I realized that, “Oh! I have a husband.” Unlike my mom, who was a single parent and had to do it alone, I was able to see that I can share this experience with him so it made me ask my own husband about his plans with our two daughters, and from there I wanted to hear from other dads. I was able to see that dads do have plans, even if they don’t verbalize them. I was also able to see that just by posing the question to dads, they were able to more clearly define their plans. It’s a conversation that moms and dads should be having, and having with their girls together because dads do have a different perspective that girls need to hear. It’s real value.

Growing up, my mom gave me a stack of pamphlets and books to answer my questions. How does a parent who is nervous and uncomfortable about the topic themselves bring up the issue?

Good question. Books and youtube videos give good advice. Also, a parent doesn’t have to go all-in, from the first conversation. They can start by talking about related topics like dating boys and what that means to them and their friends. Start slow and build up.

What do you advise moms say to their sons?

I think they should be honest about how babies are born. Like the technical and emotional aspects of it. I think moms should talk about respecting a woman’s body, the consequences of sex (pregnancy and disease), and I think women and men should be big on discussing consent. I read that Nate Parker [who was accused of rape] had no talks about consent beyond if a woman says yes or no. How about if a woman is drunk, unconscious? It’s still a no. I think that needs to be addressed with boys for sure. Women can do it.

Great conversation, Erickka. I am thankful for your work. Why do you feel that this topic so important?

It’s important because we were put on this planet to reproduce; so sex is a natural part of our lives like eating and sleeping. If we normalize it from a young age by talking about it, with all it’s grey areas, kids will have a better time. I find myself having identity, gay and transgender talks with my daughters because there’s no way around it

Complete Article HERE!

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Dismantling the myths of rape culture

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By Matthew Wade

slutwalk

It’s a double edged sword: as a queer woman, your sex life is objectified if you’re too femme, or dismissed if you’re too masc. In light of the recent SlutWalk rally in Melbourne to protest slut-shaming and victim-blaming, Matthew Wade spoke to queer women about how their sexual identities are policed in Australia.

Men often fetishise the sex lives of queer women or erase them completely, with little elbow room in between.

When she first came out and started dating women, Natasha Smith was femme-presenting, and her sex life was a point of objectification.

“A common question at the time was around what I did in bed, but not in a way that made me feel empowered,” she told the Star Observer.

“People would ask if what I did was really sex, and who the ‘man’ was in the bedroom.

“When there’s no man involved other men have to try and figure out what this tantalising thing is… when a woman’s sexuality isn’t defined by them they turn it into a form of entertainment.”

On the flip side, Smith believes the sexualities of queer women that are more masc-presenting are often invisible, as they’re not seen by men as ‘real’ women.

“Queer women live in this weird dehumanising space where they’re stigmatised as sex objects for the straight male gaze or they’re denied,” she said.

For her Master’s thesis Smith focused on the impact homophobia and sexism had on same-sex attracted women.

She interviewed women aged 18 to 60 and many told her they had experienced street harassment and ogling, with men yelling at them for holding another woman’s hand.

“There’s this idea that you’re an object but if you fight back and resist that, it comes with the threat of escalating violence,” she said.

For many of her interviewees, revealing their sexuality to a male who may be flirting with them in a nightclub would have damaging repercussions.

“As soon as they said they were a lesbian, they’d be called a slut, a dyke, and would be subject to public humiliation,” she said.

While shame and stigma are commonly heaped on the sex lives of queer women, this becomes much more apparent when a queer woman has a more grievous encounter with sexual assault or rape.

According to the United Nations, Australia has one of the highest rates of reported sexual assault in the world, more than double the global average.

However, because men often try to delegitimise the sexualities of queer women, their voices and experiences are left off the table.

Smith believes rape culture affects society at large, but that for queer women it can be particularly damaging.

“If you’re a queer woman and you happen to be more masc-presenting there’s a weird sort of erasure of your sexuality,” she said.

“And because people misunderstand rape as something connected to sexuality, many think queer women aren’t likely to be raped.”

When it comes to survivors of sexual assault and rape, Smith wants to debunk a common misconception: that rape is about sex.

“There’s an assumption when it comes to sexual assault and rape that they’re inherently sexual acts – but they’re not,” she said.

“They’re violent acts of power that use sex as the weapon.

“The myth that rape is somehow related to the sexual attractiveness of women is what leads to the dismissal of the experiences of queer women.”

Beyond the masculine and feminine gender binary that subjects queer women who present either way to sexual fetishisation or erasure, queer women who sit somewhere along the spectrum also face stigma around their sexual identity.

Where Smith recalls being asked intrusive questions about her sex life as a femme-presenting woman, Melbourne resident Luca Vanags-Smith is at times assumed to not have one.

As someone who now identifies as gender queer, Vanags-Smith has seen a noticeable shift in the way her sexual identity has been perceived.

“I think if you’re femme you’re hyper sexualised, and if you don’t fit the stereotypical model of femininity you’re invisible,” she said.

“I’ve had the lived experience of being gender queer for about two years and I’m viewed by many men as being sexless, or as being an asexual creature.

“I think there’s also this idea that two people that have vulvas can’t really have sex because there’s no penetration involved, so men see women sleeping with each other as entertainment for them.”

The desexualisation and dismissal of masc-presenting or gender queer women can also lead to homophobic views around Vanags-Smith’s sexual identity and her relationships with other women.

“I think when I was more femme-presenting people didn’t take it as seriously, but now my relationships often get pushed into a more heterosexual lens, which isn’t the case at all – after three or four months at a job I had, I had to break it to my boss that I wasn’t in fact a man,” she said.

“It can definitely erase the queerness of my relationships.

“People just assume I must be the one that uses the strap on, when one: that’s none of their business and two: that isn’t the case at all.”

Vanags-Smith has also found that heterosexual men will treat her as ‘one of the guys’ and attempt to engage her in a sexist conversation.

“Men will come up to me, point out a particular woman and say, ‘she’s got a great ass mate,’” she said.

“I know how awful that can make someone feel, especially a same-sex attracted woman.

“I’ve also had guys calling me love and telling me I just haven’t had a good fuck, and asking me how I have sex.”

As a means to combat this, Vanags-Smith believes sex education in schools needs to become increasingly sex positive.

She also added that sexist attitudes and misogyny are the bedrock of homophobia, transphobia, and whorephobia.

“With same-sex intimate relationships between women, men don’t really fit into that equation,” she said.

“And some see that as affronting.”

Melbourne recently played host to the annual SlutWalk rally, a march developed as a means to protest the slut-shaming and victim-blaming of women around the world, irrespective of gender or sexual identity.

It was created in Canada in 2011 after a police officer said “women should avoid dressing like sluts” if they wanted to avoid being sexually assaulted.

In Melbourne the rally sees speakers with a diverse range of experiences speaking out against misogyny and rape culture, and how it affects women.

Smith believes SlutWalk does well at being as inclusive as it can be, particularly now that the conversation around trans and queer identities has become more prominent.

“When I started going to SlutWalk I wasn’t as out as I am now, and it was through being emerged in the march that I found a community of feminists that understood me,” she said.

“They enabled me to grow into someone I’m very proud of and to be comfortable in my sexuality.”

Vanags-Smith said she loves SlutWalk because it changes people’s opinions of what a sexual assault survivor might look like, to include women of different ages, cultural backgrounds, and sex ual and gender identities.

“It acknowledges that there may be people who are femme and attractive, but there may be women who don’t fit these archetypes who may also experience sexual assault,” she said.

“The idea that some women are more at risk than others is a massive myth in rape culture that SlutWalk seeks to dismantle.”

Complete Article HERE!

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American Men Are Pretty Happy With Their Penises

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penis-satisfaction

For understandable reasons, society’s conversation about body satisfaction tends to focus on women. Women, it can safely be argued, face a lot more social pressure to look good all the time, to feel ashamed of their bodies, and to harp on minor imperfections.

Men aren’t immune from all that, though. And one particularly painful area where it manifests, according to sexual health researchers, is in insecurity about their penises. This can lead to some bad outcomes. As a team led by Thomas Gaither, a urologist at the University of California, San Francisco, point out in a new study in the Archives of Sexual Behavior, “Case reports have shown men undergo risky procedures, such as silicon injections, to lengthen their penis and increase penile girth.” In addition, “Genital piercings, silicone injection, and subcutaneous implant are increasingly common and are associated with numerous complications.

Gaither and his colleagues wanted to better understand how men view their penises, so they conducted what they say is the first nationally representative survey using a newly developed scale called the Index of Male Genital Image, or IMGI. It consists of 14 statements ranked on a score of 1–7 involving penis length, girth, and so on — a score of 1–3 is coded as “dissatisfied,” while 4–7 is coded as satisfied. They got results from 3,996 men, the sample drawn from 18-to-65-year-olds who weren’t institutionalized.

Comparing those who landed in the “satisfied” (greater than 4.0) versus “unsatisfied” (4.0 or lower) buckets when the scores were averaged, the researchers didn’t find any statistically significant differences in penile satisfaction when it came to age, “race, marital status, education, location, income, or sexual partners.” Penile (dis)satisfaction appears to be pretty much constant across these categories.

Overall:

A total of 3433 (85.9%) reported an average greater than 4 per item on the IMGI and thus were classified as satisfied. Men reported highest satisfaction with the shape of their glans (64%), followed by circumcision status (62%), girth of erect penis (61%), texture of skin (60%), and size of testicles (59%). Men reported dissatisfaction with the size of their flaccid penis (27 %), length of erect penis (19%), girth of erect penis (15%), amount of pubic hair (14%), and amount of semen (12%). Men reported neutrality with the scent of their genitals (44%), genital veins (43%), location of urethra (42%), color of genitals (40%), and amount of pubic hair (36%). Of note, those who were extremely dissatisfied (score of 1 or 2) reported dissatisfaction with their flaccid penis (10.0%), length of erect penis (5.7 %), and girth of erect penis (4.5%).

There were some decent-size differences in terms of the sexual experiences of men who were satisfied versus dissatisfied with their penises. Those who were satisfied were less likely to be sexually active (73.5 percent versus 86.3 percent), and engaged in less daily and weekly sexual activity. There were also slight but statistically significant differences in the percentage of dissatisfied versus satisfied men who reported having had vaginal or receptive oral sex (85.2 percent versus 89.5 percent, and 61 percent versus 66.2 percent). The obvious question here is what’s causing what: To what extent are men who are dissatisfied with their penises less likely to seek out sex as a result of their insecurity? A correlational self-report study can’t answer that, nor can it answer whether these mens’ likes and dislikes were shared by their sexual partners.

It’s interesting that a sizable minority of men reported dissatisfaction with their testicle size or glans shape. On the one hand, in a survey like this you are explicitly asking about certain features, so these responses don’t mean that they are wandering around obsessing over this stuff. (It would be another thing entirely if you asked men to generate an open-ended list of body features they didn’t like and these kept popping up.) But on the other: It’s an interesting comparison to what women go through, because it highlights the fact that at least some of the things both men and women worry about probably aren’t, in fact, of much import to anyone else. If you’re a guy, the odds that a partner is going to care that much about the size of your testicles or the “shape of your glans” — that’s something I can honestly say I had never even thought about before reading this article, and which the researchers note “has little anatomic variability” — are probably pretty low.

More broadly, the main takeaway, as a first-pass attempt at understanding this stuff, is that men mostly feel pretty happy with their penises. Which can maybe explain the epidemic of unsolicited photos.

Complete Article HERE!

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