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The Real Reason Men Lose Their Erection When Using A Condom

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by Raffaello Manacorda

Men Lose Their Erection When Using A Condom

That Awkward Moment When…

If you’re a man, you’ve probably experienced this. Everything is perfect, the foreplay is going great, and the stage is set for a throbbing, mind-blowing, heart-shattering lovemaking. Your erection is strong and powerful, and feeling it turns you on even more.

And then, that moment comes. Your lover looks at you sweetly but squarely in the eyes, and with a soft but firm voice says, “We need to use a condom.”

This makes perfect sense. The risk of STIs and/or pregnancy is real. So you’ve got to wear that condom.

But our genitals don’t understand logic. And, sometimes, it only takes a few seconds of this pause for your penis to soften. Her being sweet and comprehensive only makes things worse: something inside you tells you that you won’t be able to do it if you wear a condom.

I’ve gone through the same process. I used to consistently lose my erection whenever a woman asked me to wear a condom. It wasn’t pretty. I hate to admit it, but a couple of times I even lied to a partner, telling her that there were no condoms in the house, while I actually had plenty. I just was too scared of sexual failure. Boy, am I grateful that no one got an STI or got pregnant because of that dirty little lie of mine.

So why on Earth does this happen? Why do we men lose our erection because of condoms?

The Real Reason Condoms Turn Men Off…

You might try to fool yourself and others with explanations such as:

  • That you don’t feel enough pleasure with a condom.
  • That a condom squeezes your penis too much.
  • That the pause “takes the romance away”…

But deep in your heart, you know that those are not the real reasons.

As for sensitivity and comfort, you know well that your penis is not all that sensitive. In fact, the harder it is, the less sensitive it is. And as for the non-romanticism of the 2-minutes pause, you have fantasized or have been in way less romantic situations, where your erection stood strong and implacable.

So WHAT is the real reason why you lose your erection? And what can you do about it?

To answer this question, the first thing you need to understand is that your main sexual organ sits in between your ears or, if you prefer, inside your chest. It is your head and your heart that turn you on (or off).

So, the reason why we men lose our erection when a woman asks us to wear a condom is that some deeply uncomfortable thought and/or emotion arises in us in response to that request. And what might that thought or feeling be?

Although every man is different, that uncomfortable thought is virtually always a variation on the same theme: she asking you to wear a condom carries the message that she does not accept you inside her body. And this can be truly devastating for a man.

Some Truths About Male Sexuality

Men love to feel invited, welcomed, by a trusting lover that opens up to their force and thrust. When the body of a woman is welcoming, wet, inviting, this is a huge turn-on for a man. When the body and soul of a woman tense, close up, tighten – this is a turn-off.

Men deeply crave to feel accepted, welcomed, and trusted.

The request to wear a condom challenges that. It can seem to convey the following messages:

  • If you don’t wear it, I won’t let you inside me (you’re unwelcome)
  • I don’t trust you to be healthy, or to control your ejaculation (you’re not trusted)

This is the subterranean thought that runs into most men’s mind, and makes them lose their erection.

Understanding it is the first step towards liberating your sexuality from this blockage.

As a man, you need to realize that, even if you wear a condom, you are welcome and accepted. That she wants you just as badly. In fact, she wants you so badly that she wants to be fully trusting and surrendered. And in order for that to happen, she needs to feel safe. This conviction will take some time to build, but once it’s there, it will never leave you. Condoms won’t be an issue anymore.

In order to get there, the best thing to do is start practicing, both by yourself and with a partner.

Practicing By Yourself

Get familiar and friendly with condoms. Buy a pack of condoms and start experimenting. Wear a condom and play with yourself.

Now, I know that the condom instructions say that you should wear it only when you are fully erect. The reason they say this is that if your penis is not fully erect, then a condom can potentially slip away, which is not cool. But for now, you can forget about this. You are alone, and you can wear a condom even if your penis is completely flaccid. In fact, you should practice this skill. Wear a condom on your soft penis, and then stimulate your penis so that it becomes hard.

Familiarize yourself with the condom, and lose your aversion to it. This will be really useful once you practice with a partner.

Practicing With a Partner

This is potentially going to be scary, so you’ll need to set a firm intention: you won’t back off. You will wear a condom no matter what, whether you end up having intercourse or not.

Next time you have the opportunity, do not wait for your partner to propose using a condom. Once you have enjoyed your foreplay long enough, go ahead and say the magic phrase: “I’ll put on a condom now, just in case.”

That means that, whether you are going to penetrate your partner or not, you can wear a condom anyway and then continue with whatever you were doing. At some point you may even forget that you have a condom on.

Your partner also has a role in this. You can ask her to support you in a very simple way: by doing with your penis exactly what she would do with it if there were no condoms. Touching it, sucking it, teasing it—just as if that condom did not exist.

And now, if the moment is ripe for both of you, still wearing your condom, penetrate her. Don’t worry if your erection isn’t that strong. In that case, just make sure to hold the bottom of your condom with your fingers to make sure it doesn’t slip away. But do get yourself to the point where you can penetrate her while still wearing a condom.

This moment is a threshold, and after that, the rest will be much easier. The more you feel that things are going well, the more natural it will become to continue making love with a condom. You will notice that it isn’t all that different from not using it, and that wearing a condom will give both of you more confidence and a feeling of safety. Since you are practicing here, refrain from ejaculating inside your partner, even if you are wearing a condom. The purpose now is to gain confidence with condoms—not necessarily to have the hottest lovemaking of your life.

Every man on this planet should be able to make love with a condom, if necessary. We owe it to ourselves, and we owe it to our partners, men or women. Asking a partner not to use condoms just to protect our sexual pride is not an option. If two lovers decide to not use condoms, let that be a conscious decision, rather than a slippery workaround of a sexual blockage.

Have fun!

Complete Article HERE!

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It Must Be Something In The Air!

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A rash of pretty bizarre messages have been arriving the past few days. I’m so lucky.

While I want ya’ll to know that I’m delighted to hear from each and every one of you, particularly those of you from the far-flung corners of the globe, there’s just so much I can offer by way of advice.

Often, the best I can do is offer some generic information about one thing or another, then suggest that if the concerns persist, that person ought to seek professional help nearer to hand than me. So regardless how many people write in with further questions, the only thing I can do is repeat myself. (See below for examples.)

Others write to me with a pressing problem, but fail to include enough information for me to advise them properly. Thus I find myself asking more questions of them than they do of me.

Name: glen
Gender:
Age: 42
Location: Santa Ana CA
Is it possible to give coitus to a vagina while another man’s penis stays inside the same vagina?

Yep, you betcha! It’s called double penetration, DP for short.

Name: y
Gender:
Age: 35
Location: Indiamalia7.jpg
Will breasts become bigger due to having sex?

Not from just having sex, darling! But if you get pregnant from having sex, you can rest assured that your boobs will get larger then.

Name: aamir khan
Gender:
Age: 22
Location: pakistan
hi sir… i have a problem when i talk to girls so there will b little cum going from my penis. and i m dischargig vry soon. so whts dis??? and wht shold i do??

image-1.jpegI do believe you are referring to what is commonly called “pre-cum”. This clear alkaline fluid produced by your Cowper’s gland during sexual arousal lubricates and neutralizes the acidity of the urethra that will soon carry your jizz, with its payload of up to five hundred million sperm. Your urine, which also passes through this shared tube, leaves your urethra acidic. And if your body didn’t neutralize the acidity before you shot your wad, all your sperm would die.

Name: Jim
Gender:
Age: 50
Location: Portland
I have red balls! I have noticed many porn fellows with similar red balls, but I do not find this condition attractive. I have tried fungicides and hydrocortisone. I try to keep my crotch dry, even using cornstarch powder after a shower. Any advice?

f9905211-bf1a-48bd-b58e-26853f54503c.jpgRED BALLS? I’ve heard of blue balls, but not red balls, per se. Porn fellows often have red balls because their cockring is too tight or they have been using one for too long.

Your problem sounds, however, like a bad case of jock itch. That’s no fun! Jock itch is a pretty common fungal infection of the groin and upper thighs. If you’re using an over the counter antifungal cream and a cornstarch-based powder to keep things dry down there, and you’re still having a problem, SEE YOUR DOCTOR!

You may simply need a pharmaceutical grade fungicide. Or you could have scabies.

Name: james
Gender:
Age: 31
Location: CA
hi, i am not getting proper erection while intercourse,,,got recently married what shud i do?

I need more information! Are you not aroused enough before you start the fuck? Can you get fully hard when you jerk off? Were you a virgin when you married? This must be a bummer for a newly weds.

Name: Jim Beans
Gender:
Age: 24
Location:
What pornographic resources are available for blind folk? Do you have any suggestions?

Have you tried SexAudia.com? Besides being able to hear my weekly podcast on SexAudia.com, you can hear loads of other hot and steamy erotic stories, music and other entertainment. Check it out. Tell ‘em Dr Dick sent you.

Name: Mohan
Gender:
Age: 30
Location: Malaysia
can i have children with my hypospadias condition? Should i get an operation?

I have no way of knowing how severe your hypospadias is, or if it might interfere with you having children. SEE YOUR DOCTOR! Although, if you’ve lived with this condition for 30 years, it can’t be too severe, right? Corrective surgery is a last resort and should only be considered in the most severe cases.

Name: john
Gender:
Age: 31
Location: new zealand
Hello doc .i have hypospadias and my dick is only 3 inch if fully erect..pls advice me.

That’s small, for sure. But 3” erect is not uncommonly small. There’s not much a fellow can do about tiny meat, except learn to love it and let it give you all the joy it can. Not much you can do about the hypospadias either. But since you’ve lived you’ve lived with your dick this way for 31 years, you probably know all of this already, huh?

Name: jake
Gender:
Age: 16
Location: Grove City
im at 6 inches and I wanna get to 7 or a lil lower how can i do this? could i get pills at this age? and if so what should i get?

You could leave it the fuck alone till you finish puberty at least. You could also be happy with what you have, because some folks, like the guy above you, would be delighted to be as hung as you.

BTW, there are no pills that work for growing a dick longer. Wake up, puppy!

Name: sheema
Gender
Age: 41
Location:
hi dr, i am 41yers old lesbo mom. i love lesbian sex. i have 4kids. one dughter and 3 sons. my sons ages is 22 18 12. my dughter age is 16yers. i have one girlfriend for sex. my girlfriend come my home and we make sex. one day we having sex then my dughter see us. she ask me what you doing with aunt. i dont tell her. but in my mind a idea. i want having lesbian sex with my dughter. tell me what shold i do. plase.

SERIOUSLY! A forty-one year old woman, and a mother of four, needs to ask if it’s ok to have lesbian sex with her underage daughter? Get otta of here!

What kind of mother are you? If your daughter wants to dabble in muff-divin’, let her play with someone her own age.

Incest, particularly the adult to child type, is considered taboo in nearly every culture, both past and present. There’s plenty of good reason for this. While lesbian sex doesn’t involve the genetic concerns (inbreeding); it would involve the most devastating aspect of incest — the secrecy. No one violates this universal taboo in the open. The secrecy and the inevitable shame and guilt will, sure as shootin’, destroy you family dynamic.

People, if you find yourself in a seductive situation with family member, don’t give in to the temptation.

Good luck everyone!

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Stop, I Want To Get Off!

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Name: Stefanni
07.jpg

Gender:
Age: 28
Location: California

Dr Dick: I get off on making out or having sex in public spaces? Is this illegal? Am I Sick? Stefanni

All depends, Stefanni. Most jurisdictions, particularly there in the Golden State would

probably wink at a couple making out in public. I suppose you’d be pushing the envelope if the make-out session included heavy petting. And as to full-on sex in public…CumOn, honey, a 28 year-old female who can’t discern if fucking in public is illegal or not, needs to be in supervised care 24/7. You’re not sick, dearie, you’re retarded.

Good Luck!

Name: stefan
Gender:
Age: 24
Location: GA

Is it weird if I can suck my own dick? Sometimes I do it when I’m really horny?

dares-selfsuck.jpg

Reminds me of the old joke about two guys sittin’ around shootin’ the shit. When they notice a dog over yonder lickin his balls. One guy turns to the other and says; “I wish I could do that!” And the other guy says, “Gee, I hope the dog doesn’t bite!”

Is it weird that you can suck your own cock? Dude, it’s every man’s freakin’ dream! Anyone who is limber enough and/or has a big enough dick to blow himself — wins, IMHO.

Good Luck!

Name: Chris
Gender:
Age: 18
Location: TN

Dr Dick: I’m an uncut male, but am thinking about getting circumcised for the sake of appearance? I don’t like how my dick looks like an anteater. Is this safe? Any suggestions where or what type of doctor to consult? Should I go to a urologist? Plastic Surgeon? Thanks, Chris

Whoa, puppy, stop right there. This ain’t like getting a haircut or trimmin’ your toe nails or even gettin pierced. Circumcision is irreversible and it’s mighty risky too.

I need to say one thing from the outset. Circumcision is a particularly thorny issue for

ijk2.jpg

me. I firmly believe in the right of an adult to augment, adorn and embellish, or in any other way customize his or her body. Just as long as that person has taken enough time to think it through. None of this, “OMG, I got so drunk and then the next thing I know I have this tattoo emblazoned across my chest!”

At the same time I am a furious proponent of genital integrity. So you see my conflict.

There are, of course, medical reasons for adult circumcision. But having a foreskin that looks like an anteater is not one of them. Besides, no self-respecting physician is gonna start cutting on an 18 year old guy’s cock, just because the fella doesn’t like the way his unit looks.

Here’s what I want you to do, Chris. Take a really close look at your foreskin. I mean a really close look. What do you see? Veins, right? Now pinch your foreskin between

your thumb and forefinger as hard as you can. OUCH! Ya know why that is? Your foreskin is just chock-full of nerve endings, darlin’. Your foreskin contains about 240 feet of nerve fibers and tens of thousands of specialized nerve endings, which can feel the slightest pressure, the lightest touch, the smallest motion, the subtlest changes in temperature, and the finest gradations in texture.

In many ways, your foreskin is just like your eyelid. It covers, cleans, and protects your dickhead just like your eyelid covers, cleans, and protects your eye. Your foreskin keeps the surface of your dickhead healthy, clean, shiny, warm, soft, moist, and sensitive. And there are a whole lot of us who think a foreskin is like totally hot.

Your foreskin is a specialized, sensitive, and functional organ of touch. No other part of the body serves the same purpose. You may be too young to have noticed how pleasurable having an intact dick can be, how it enhances your sexual enjoyment. You

certainly have no frame of reference to the contrary. Therefore, I encourage you to hold on to your lace curtains till you have a little more experience. Besides, if you get cut it removes 50% of the skin of the cock. Do you really have that much to give away?

Finally, I’m of the mind that millions of years of evolution has provided us a covering for our dickhead for a purpose. And to remove it is simply unnatural.

So, Chris, keep your skin unless there’s a medical necessary to remove it!

Good Luck!

Name: Nick
Gender:
Age: 64
Location: Chicago

Are there any vitamins or minerals that will increase the amount of ejaculate? Thanks…your site is very cool and provides a great service!

Why, aren’t you a sweetheart, Nick. Thank you for your kind words.

There sure are loads and loads of companies out there who claim to have products that will increase the volume of a man’s ejaculate. When I search the web for products that promote male sexual enhancement of any sort, I do so as a skeptic. That’s how anyone should go about such a search. If you keep your eyes open and look beyond the pseudo-medical babble you’ll discover two things, as I did.

First, every site I visited advertises their product as a miracle medical breakthrough. Often there is a testimonial or two from some doctor (MD) or doctor (Ph.D.) who substantiates the claims being made. We never really discover who these professionals are, but we are encouraged to take their words as gospel…well because we all know that professional types would never knowingly try and hoodwink us. Exactly! And if you buy that we have some swampland in Louisiana for you too.

Each site also claimed that the product they hawk has undergone rigorous clinical studies proving its efficacy. But they never actually cite any of the studies in question or where these supposed studies were published. Here’s a tip, If there is a sited study and that study was sponsored by the company that produced the product, or is published by them, then you know you’re in trouble.

Second, inevitably each product makes the most outlandish claims. Take this one for instance. I’ll not disclose the product name, because that would be like shooting fish in a barrel. But this is actual copy from one site. Product X will…

  • Intensify ejaculatory contractions due to the strengthening of the vas deferens muscle (the muscle responsible for the expulsion of semen)
  • Increase volume of released ejaculate
  • Produce faster recovery for second orgasms
  • Improve semen quality
  • Produce more satisfying orgasms due to increased contractions and ejaculate
  • Improve prostate health
  • Improve Erectile Dysfunction caused by diabetes
  • Increase sexual well-being and vitality
  • Cure cancer
  • End world hunger

Ok, I made the last two up.

One only has to look closely at the claims to realize they’re hogwash. Besides, they don’t really tell us anything other than the product in question might somehow improve something that may have something to do with male virility. The same could be said about a glass of water. Please read on…

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The truth is, Nick, you can probably do just as well with a modest daily intake of zinc and lecithin supplements. For some, these nutrients have a noticeable effect on the volume of ejaculate. And they’re a whole lot cheaper and easier to get then the trumped-up stuff you see online.

Also keeping yourself hydrated also will also increase the volume of your spunk. It just

stands to reason, the more hydrated you are the easier and more efficiently all your glands responsible for secreting a watery substance, like your prostate, will have getting water from the bloodstream. If you’re dehydrated, your prostate will not have as much water available, and subsequently you’ll spooge considerably less.

Good Luck!

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Japanese macaques grinding on deer can teach us to be more open-minded about sex

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So if macaques do it, dolphins do it, birds and probably even bees do it, why do humans still have so much difficulty talking about sexual pleasure?

by Lux Alptraum

If you grew up in America, there’s a good chance that you learned that sex is, first and foremost, a reproductive act. Sure, it feels good, but that’s just a way for our bodies to trick us into breeding. Many church doctrines will inform you that any sexual experience that doesn’t stand a chance of resulting in pregnancy is sinful, perverse, and unnatural.

But someone might want to tell that to nature.

A recently released study documented multiple instances of adolescent female macaques in Japan having “sexual interactions” with sika deer – or, not to put too fine a point on it, macaques humping the backs of deer like a pre-teen girl with a pillow. Researchers are still trying to figure out why the monkeys are doing this, as NPR explains: “It might be a way for a less-mature monkey to practice for future sex with other monkeys,” or an option for a monkey that doesn’t have any other sexual partners at the moment. It’s also possible that the monkeys, which hitch rides on deer for non-sexual reasons, too, simply discovered by accident that grinding on the deers’ backs felt good.

The discovery has prompted a lot of marveling from the media. But if you’re surprised to learn that animals like to pleasure themselves, you’re not paying attention. There are numerous documented instances of animal masturbation, a habit enjoyed by primates as well as creatures including dolphins, elephants, penguins, and bats. (Although the role of the sika deer adds a layer of complexity: Can a deer consent to interspecies frottage? “Most deer were nonchalant, continuing to eat or stand passively during the thrusting,” Quartz observes.)

It’s impossible for us to know exactly what the deer think about all this. That matter aside, there are a lot of animals out there who are, if you will, spanking the monkey. So if macaques do it, dolphins do it, birds and probably even bees do it, why do humans still have so much difficulty talking about sexual pleasure?

Even those of us who’ve gotten past the idea that sex outside the bonds of heterosexual marriage is a one-way ticket to hell still have difficulty talking about pleasure. Sex education curricula rarely venture beyond discussions of condoms, birth control, and puberty (if they even cover condoms and birth control); for many of us, the idea of discussing masturbation seems particularly prurient and unseemly. It’s been twenty-three years since Jocelyn Elders was forced to resign from the post of surgeon general in the US after daring to suggest that young people be taught to think of masturbation as a form of safer sex. And in spite of all the progress we’ve made since the early 1990s, it’s still hard to imagine a government official coming out in favor of masturbation. (Not that I necessarily want to hear a member of the Trump Administration talking about double-clicking the mouse.)

Our reticence on the subject of masturbation is particularly damaging for women. Copious amounts of ink have been spilled about the gender orgasm gap, with lots of hand-wringing about how straight men are letting their female partners down in bed. But it’s not just straight male selfishness that fuels the orgasm gap. One of the main reasons why women are less likely to find pleasure in bed is that we rarely discuss the tools to access our own pleasure, or even an understanding that pleasure can, and should, be a primary goal in our sex lives.

When sexual pleasure is discussed, it’s almost always from a straight male perspective, rationalized as an added bit of biological incentive intended to encourage men to spread their seed. As Peggy Orenstein writes in her recent book Girls & Sex, American culture teaches girls that men pursue sex and pleasure, while women passively provide it. “When girls go into puberty education classes, they learn that boys have erections and ejaculations and girls have periods and unwanted pregnancies,” Orenstein told Quartz in 2016. And when women do experience orgasms, it’s frequently positioned as the result of a partner’s skill, rather than something we’re naturally wired to actively pursue, all by ourselves, for our own selfish reasons.

These macaques throw all of these assumptions into disarray. Not only are they animals getting off just for fun, they’re female animals going to unusual lengths in pursuit of their own sexual pleasure. What we should take away from this is that sexual pleasure isn’t an also-ran to reproduction; it’s an essential part of many animals’ life experiences—regardless of our species, sex, or gender.

So instead of getting Puritanical on the macaques, let’s use them as a jumping-off point for discussions about just how natural it is to pursue sexual pleasure. Whether we’re monkeys or men—or women!—we’re all wired to seek out sensations that feel good.

Complete Article HERE!

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New treatments restoring sexual pleasure for older women

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By Tara Bahrampour

When the FDA approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding decades to their vitality. Meanwhile, older women with sexual problems brought on by aging were left out in the cold with few places to turn besides hormone therapy, which isn’t suitable for many or always recommended as a long-term treatment.

Now, propelled by a growing market of women demanding solutions, new treatments are helping women who suffer from one of the most pervasive age-related sexual problems.

Genitourinary syndrome, brought on by a decrease in sex hormones and a change in vaginal pH after menopause, is characterized by vaginal dryness, shrinking of tissues, itching and burning, which can make intercourse painful. GSM affects up to half of post-menopausal women and can also contribute to bladder and urinary tract infections and incontinence. Yet only 7 percent of post-menopausal women use a prescription treatment for it, according to a recent study.

The new remedies range from pills to inserts to a five-minute laser treatment that some doctors and patients are hailing as a miracle cure.

The lag inaddressing GSM has been due in part to a longstanding reluctance among doctors to see post-menopausal women as sexual beings, said Leah Millheiser, director of the Female Sexual Medicine Program at Stanford University.

“Unfortunately, many clinicians have their own biases and they assume these women are not sexually active, and that couldn’t be farther from the truth, because research shows that women continue to be sexually active throughout their lifetime,” she said.

With today’s increased life expectancy, that can be a long stretch – another 30 or 40 years, for a typical woman who begins menopause in her early 50s. “It’s time for clinicians to understand that they have to bring up sexual function with their patients whether they’re in their 50s or they’re in their 80s or 90s,” Dr. Millheiser said.

By contrast, doctors routinely ask middle-aged men about their sexual function and are quick to offer prescriptions for Viagra, said Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.

“If every guy, on his 50th birthday, his penis shriveled up and he was told he could never have sex again, he would not be told, ‘That’s just part of aging,’” Dr. Streicher said.

Iona Harding of Princeton, New Jersey, had come to regard GSM, also known as vulvovaginal atrophy, as just that.

For much of their marriage, she and her husband had a “normal, active sex life.” But after menopause sex became so painful that they eventually stopped trying.

“I talked openly about this with my gynecologist every year,” said Mrs. Harding, 66, a human resources consultant. “There was never any discussion of any solution other than using estrogen cream, which wasn’t enough. So we had resigned ourselves to this is how it’s going to be.”

It is perhaps no coincidence that the same generation who first benefited widely from the birth control pill in the 1960s are now demanding fresh solutions to keep enjoying sex.

“The Pill was the first acknowlegement that you can have sex for pleasure and not just for reproduction, so it really is an extension of what we saw with the Pill,” Dr. Streicher said. “These are the women who have the entitlement, who are saying ‘Wait a minute, sex is supposed to be for pleasure and don’t tell me that I don’t get to have pleasure.’”

The push for a “pink Viagra” to increase desire highlighted women’s growing demand for sexual equality. But the drug flibanserin, approved by the FDA in 2015, proved minimally effective.

For years, the array of medical remedies has been limited. Over-the-counter lubricants ease friction but don’t replenish vaginal tissue. Long-acting mosturizers help plump up tissue and increase lubrication, but sometimes not enough. Women are advised to “use it or lose it” – regular intercourse can keep the tissues more elastic – but not if it is too painful.

Systemic hormone therapy that increases the estrogen, progesterone, and testosterone throughout the body can be effective, but if used over many years it carries health risks, and it is not always safe for cancer survivors.

Local estrogen creams, suppositories or rings are safer since the hormone stays in the vaginal area. But they can be messy, and despite recent studies showing such therapy is not associated with cancer, some women are uncomfortable with its long-term use.

In recent years, two prescription drugs have expanded the array of options. Ospemifene, a daily oral tablet approved by the FDA in 2013,activates specific estrogen receptors in the vagina. Side effects include mild hot flashes in a small percentage of women.

Prasterone DHEA, a naturally occurring steroid that the FDA approved last year, is a daily vaginal insert that prompts a woman’s body to produce its own estrogen and testosterone. However, it is not clear how safe it is to use longterm.

And then there is fractional carbon dioxide laser therapy, developed in Italy and approved by the FDA in 2014 for use in the U.S. Similar to treatments long performed on the face, it uses lasers to make micro-abrasions in the vaginal wall, which stimulate growth of new blood vessels and collagen.

The treatment is nearly painless and takes about five minutes; it is repeated two more times at 6-week intervals. For many patients, the vaginal tissues almost immediately become thicker, more elastic, and more lubricated.

Mrs. Harding began using it in 2016, and after three treatments with MonaLisa Touch, the fractional CO2 laser device that has been most extensively studied, she and her husband were able to have intercourse for the first time in years.

Cheryl Edwards, 61, a teacher and writer in Pennington, New Jersey, started using estrogen in her early 50s, but sex with her husband was painful and she was plagued by urinary tract infections requiring antibiotics, along with severe dryness.

After her first treatment with MonaLisa Touch a year and a half ago, the difference was stark.

“I couldn’t believe it… and with each treatment it got better,” she said. “It was like I was in my 20s or 30s.”

While studies on MonaLisa Touch have so far been small, doctors who use it range from cautiously optimistic to heartily enthusiastic.

“I’ve been kind of blown away by it,” said Dr. Streicher, who, along with Dr. Millheiser, is participating in a larger study comparing it to topical estrogen. Using MonaLisa Touch alone or in combination with other therapies, she said, “I have not had anyone who’s come in and I’ve not had them able to have sex.”

Cheryl Iglesia, director of Female Pelvic Medicine & Reconstructive Surgery at MedStar Washington Hospital Center in Washington D.C., was more guarded. While she has treated hundreds of women with MonaLisa Touch and is also participating in the larger study, she noted that studies so far have looked only at short-term effects, and less is known about using it for years or decades.

“What we don’t know is is there a point at which the tissue is so thin that the treatment could be damaging it?” she said. “Is there priming needed?”

Dr. Millheiser echoed those concerns, saying she supports trying local vaginal estrogen first.

So far the main drawback seems to be price. An initial round of treatments can cost between $1,500 and $2,700, plus another $500 a year for the recommended annual touch-up. Unlike hormone therapy or Viagra, the treatment is not covered by insurance.

Some women continue to use local estrogen or lubricants to complement the laser. But unlike hormones, which are less effective if begun many years after menopause, the laser seems to do the trick at any age. Dr. Streicher described a patient in her 80s who had been widowed since her 60s and had recently begun seeing a man.

It had been twenty years since she was intimate with a man, Dr. Streicher said. “She came in and said, ‘I want to have sex.’” After combining MonaLisa Touch with dilators to gradually re-enlarge her vagina, the woman reported successful intercourse. “Not everything is reversible after a long time,” Dr. Streicher said. “This is.”

But Dr. Iglesia said she has seen a range of responses, from patients who report vast improvement to others who see little effect.

“I’m confident that in the next few years we will have better guidelines (but) at this point I’m afraid there is more marketing than there is science for us to guide patients,” she said. “Nobody wants sandpaper sex; it hurts. But at the same time, is this going to help?”

The laser therapy can also help younger women who have undergone early menopause due to cancer treatment, including the 250,000 a year diagnosed with breast cancer. Many cannot safely use hormones, and often they feel uncomfortable bringing up sexual concerns with doctors who are trying to save their lives.

“If you’re a 40-year-old and you get cancer, your vagina might look like it’s 70 and feel like it’s 70,” said Maria Sophocles, founding medical director of Women’s Healthcare of Princeton, who treated Mrs. Edwards and Mrs. Harding.

After performing the procedure on cancer survivors, she said, “Tears are rolling down from their eyes because they haven’t had sex in eight years and you’re restoring their femininity to them.”

The procedure also alleviates menopause-related symptoms in other parts of the pelvic floor, including the bladder, urinary tract, and urethra, reducing infections and incontinence.

Ardella House, a 67-year-old homemaker outside Denver, suffered from incontinence and recurring bladder infections as well as painful sex. After getting the MonaLisa Touch treatment last year, she became a proslyter.

“It was so successful that I started telling all my friends, and sure enough, it was something that was a problem for all of them but they didn’t talk about it either,” she said.

“I always used to think, you reach a certain age and you’re not as into sex as you were in your younger years. But that’s not the case, because if it’s enjoyable, you like to do it just as much as when you were younger.”

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