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Oncologists need to discuss sexual issues with patients, says doctor

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Dr. Anne Katz was in Windsor on May 11, 2017, to address Windsor Regional Hospital staff about cancer, intimacy and sexuality.

By Chris Thompson

A Winnipeg doctor who specializes in treating sexual issues with cancer patients is hoping to spread the word about doctors being up front with their patients.

Dr. Anne Katz held an online forum for Windsor Regional Hospital workers about cancer, intimacy and sexuality.

Katz is the author of several books dealing with the issue.

“Really the message is that sexually it is really important for people, for all of us, and I really want to encourage oncology care providers to raise the topic of it with their patients, because when we don’t talk about it, the patients thinks it’s a taboo,” said Katz.

“And 80 per cent of cancer survivors experience sexual difficulty after cancer treatment.”

Katz said doctors should be more willing to bring up sex issues with their cancer patients.

“So it really is something where we have to expose people to having that conversation,” said Katz.

“All cancers, all people, men, women, gay, straight, people recognize things aren’t going right during treatment, but all more commonly sexual problems aren’t recognized until after treatment.”

Katz said many people undergoing cancer treatment don’t realize there is an issue until later.

“Usually people during treatment are really not feeling that well, so it’s kind of on the back burner but it really is a sentinel of survivorship,” Katz said.

“People come to see me and we know certainly that most men who experience prostate cancer are going to experience erectile difficulties, most women with breast cancer often experience body issues, early menopause, or exaggerated menopausal symptoms, people with colorectal cancer have problems.”

Katz said everyone who is experiencing cancer needs to address the issue.

“It really is all cancers,” Katz said. “We’re all sexual beings, literally, from cradle to grave, whether you act on it or not.

“Even if you’re not partnered. It’s so much a part of quality of life for cancer survivors. So it goes away, there are some couples that lose that connectedness, there are some couples that use sex to make up after fights. They are fighting a lot because there is no way to resolve the fights.

“Unless oncology workers can address it and talk about it, patients are very reluctant to bring up the topic.”

Complete Article HERE!

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We need to show real photos of genitals as part of sex education

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Labiaplasty is on the rise. Boys and men continue to worry that their penis is too small. Every other week there seems to be a new treatment promising to make your penis longer and harder or your vagina tighter, smoother, and more sparkly.

These treatments prey on our insecurities – our deep, dark worry that there’s something wrong with our genitals. That they’re not ‘normal’.

It’s no wonder we think that, though, when we don’t get to see a range of all the different ways vaginas and penises can look.

If you’re interested in same-sex relationships or, well, sex, you’ll likely get to see a few more genitals that look a bit like yours.

But this only happens once you start getting to the point of stripping down – a point you’re unlikely to reach if you’re so filled with doubt and self-hatred for the appearance of your genitals that you can’t even imagine letting someone else see them.

And for those who exclusively get busy with people of the opposite sex, it’s easy to never see a real-life alternative of your own sex-specific genitals out in the world.

Instead, you see smoothed, Barbie-perfect versions of vaginas and whopping great penises that stay erect for hours in porn.

You see blurred out images online or dainty flowers, or bananas and crude doodles to illustrate their place.

When you never see genitals that look even a tiny bit like yours, you’re going to worry that you’re abnormal, that something’s wrong, that you need to change yourself.

That’s why we need to get in there early, and show students actual photos of actual vaginas and penises.

Not doodles.

Not just vague diagrams of the reproductive system.

Actual photos or – if that greatly offends you for reasons I don’t understand – a wide range of illustrations that shows all the parts of the genitals and all the different ways they can look.

Students should see where the clitoris is, because if they don’t they’ll struggle to give women pleasure or experience it themselves.

Students should understand what a circumcised penis looks like versus an uncircumcised one.

Students should see longer labia, different skin tones, penises that are short and fat, penises that are long and lean. A range of healthy genitals to expand the definition of ‘normal’ in young people’s minds.

‘Relationships and Sex Education is an opportunity to challenge the idea that any one type of body is ‘normal’,’ Lisa Hallgarten, coordinator of the Sex Education Forum, told metro.co.uk.

‘Learning about and celebrating body diversity may start with simply thinking about the different heights; body shapes; hair, eye and skin colour of people we can see around us; and learning about the difference between female and male body parts.

‘When it comes to genitals young people may think their own are unusual or unhealthy because they haven’t seen any images of different bodies, or because many sexual images they have accessed online depict a particular type of body (e.g. men with very large penises and women with hairless, surgically-altered vulvas).

‘Whether we use photographs, anatomical drawings or art works (such as Jamie McCartney’s Great Wall of Vagina) it is essential that any images we show properly represent the great diversity that exists in the shapes and sizes of people’s genitals.’

Hear hear.

Seeing these images before we start having sex or having the power to make changes to our bodies through surgery or other means is incredibly important.

How we view our bodies informs how we view ourselves. It affects our sexual relationships, our decisions, our mental state.

Knowing that our genitals are okay, that there’s nothing wrong, gross, or weird about them just because they don’t match the images we see in porn, will inform healthier sexual decisions, make us more confident, and prevent people from considering drastic measures to ‘fix’ themselves.

As someone who was so self-concious about my vagina that I blamed it for breakups and went to the doctor to beg them to change the appearance of my vulva, I know how powerful learning that your genitals are normal can be.

It’s not just about seeing genitals similar to your own, mind you.

Seeing real, intimate pictures of bits of all genders will make sex significantly less intimidating.

If you’re shown accurate images of all different genitals, you won’t be confused and horrified when you start having sex and are greeted by a penis or vagina that looks entirely unlike the ones you’ve seen in porn.

Adding real images to sex ed will make people more understanding of the range of normal for the opposite sex, too. So boys won’t take the piss out of women’s labia or the size of their vagina*, and girls won’t say cruel things about the size of someone’s penis.**

*No, you can not tell how much sex someone’s had by how tight or loose a vagina feels. No, you should not make up songs about women’s ‘flaps hanging low’.

**No, it’s not cool to tell people your ex has a small dick just because he p*ssed you off.

It’ll make our sex lives better, too. There’ll be a greater understanding of how penises and vaginas work, and lots more pleasure happening when everyone understands where the clitoris is, which bits of the penis are more sensitive, and what to expect when they start going down.

Oh, and knowing the range of normal will make it easier to know when something’s gone a bit wrong.

If we know all the different ways a healthy vagina or penis can look, we’ll be more able to quickly notice a change in appearance or a dodgy symptom – and because we’re not holding on to the heavy worry of ‘what if my entire downstairs area is completely abnormal and the doctor will recoil in horror’, we’ll feel more able to ask for help.

And, of course, openly presenting students with pictures of genitals is all part of chipping away at our general silence and squeamishness around our bits.

Penises and vaginas are not inherently gross, or dirty, or wrong. We should be able to talk about them, ask questions about them, and not feel disgusted or scared when it comes to being presented with their natural states (*cough* periods are not gross, neither is body hair, and ‘vagina’ is not a dirty word *cough*).

Complete Article HERE!

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Is There A Vulva Version Of Morning Wood?

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By Cory Stieg

When your alarm clock rings, there’s a good chance that the only thing on your mind (besides your snooze button) is sex. People can feel very horny in the morning; John Legend even wrote a whole song about it. For people with penises, morning erections are an inevitable part of their sleep cycle, and even though a lot of people wake up with boners, it’s not always a sign that someone is aroused. But if someone with a vagina gets horny as hell in the morning, can they just blame it on biology? Maybe.

Turns out, people with vaginas also respond to their sleep cycle, and they can have increased clitoral and vaginal engorgement during the REM stage of sleep, says Aleece Fosnight, MSPAS, PA-C, a urology physician assistant and a sexual health counselor. “The clitoris has erectile tissue just like the penis, but instead of being out in the open for everyone to see, the clitoral engorgement happens internally and most women aren’t aware of the process,” Fosnight says.

Here’s how it works: During REM sleep, your body pumps oxygen-rich blood to your genital tissues to keep your genitals healthy, Fosnight says. This is also what happens when a person with a vagina gets aroused by something sexual: The erectile tissue in the clitoris becomes engorged and red because of the changes in circulation and heart rate, says Shannon Chavez, PsyD, a certified clinical sexologist. “The labia also has erectile tissue, and can become larger and more red in color as the arousal triggers a release of blood flow through the entire genital area,” she says. A person’s vagina could also get wetter or more lubricated during these bouts of arousal.

But, like penises, the changes your genitals experience at night don’t always occur because you’re exposed to something that arouses you — they just sort of happen. (Though if you woke up during one of these periods when your body thinks it’s aroused, you could subsequently feel more aroused and want to have sex, Fosnight says.)

That being said, some people do feel extra aroused in the morning, regardless of what their genitals are doing, because that’s when people’s testosterone levels peak, Dr. Chavez says. “This hormone is responsible for triggering feelings of sexual desire,” she says. You also might feel hornier in the morning because you’re more refreshed, relaxed, and comfortable than you are at night, according to Dr. Chavez. “This is the perfect formula for sexual arousal to take place,” she says, since sex at night can feel like work for some people, because you’re stressed and have used all your energy during the daytime. “There is lower tension in the morning when you are about to start the day ahead,” Dr. Chavez says.

So there you go: Women can have it all, even “morning wood.” There are tons of reasons why a person feels aroused when they do, but the time of day might have something to do with it after all. The next time you wake up with an urge to have sex, do it — morning sex is awesome, and your body knows it

Complete Article HERE!

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What’s Up With My Nips?

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Name: Dave
Gender: male
Age:
Location:
Does male nipple play excite all guys? Is there something wrong if it doesn’t?
THANKS,
Dave

Nipples of either the male or female variety are potential erogenous zones. The operative word in that sentence is “potential”. Not everyone has awakened his/her nipples to the delicious positive sex charge they can (and do) have. Some folks don’t know about the connection between their nipples and their cock (or pussy for that matter). Some folks are clueless because they’ve not taken the time to put 2 and 2 together, don’t cha know.

What a person to do? Simple! Spend some time wakin’ up them babies. This is where full-body masturbation comes in handy. While you’re pullin your pud; move the building sexual energy from your groin to other parts of your body — nipples, feet, ass hole, you name it.

If your nipples are particularly sensitive to start with, you may need a bit more stimulation than merely lightly stroking ‘em. Some guys find that the more erect their nip become, the more sensitive they are. No great mystery there, is suppose. To this end, some men employ some means of nipple enlargement. This might be done through clamps or suction. See Bully Nipple Clamps (C739), or a simple Snake Bite Kit (A300).

Once you got a nice nipple erections goin’ try stroin’, squeezin’ lickin’, suckin’ or even nibblin’ and bitin’ ‘em. Be sure to pay attention to the whole chest area, not just the nips.

If you’re workin’ on yourself, you will be getting immediate feedback on how it’s goin’. If you’re workin’ on someone else, or someone else is workin’ your nips — start out nice and gentle. Either you or your partner can ramp things up depending on the feedback you’re givin’ or gettin’. I always think adding different sensations like heat (candle wax) or cold (ice cubes) is a way to make things interesting. In other words, use your imagination. That’s why you have that block perched up on your shoulders.

Good luck

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Time for a Sexual Revolution In Health Care Treatment

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Why is care for sexual health issues considered a luxury when it’s a necessary part of population health?

By Zachary Hafner

When Americans seek care for most common health conditions, there is rarely much question about coverage. Every day, consumers—including those on Medicaid and Medicare—seek care for sore joints, depression, and even acne without worrying about whether or not their insurance will cover their doctor visits and medications. For the most part, coverage for sexual health issues is less straightforward—but why? Is it because sexual health issues are not considered legitimate illnesses? Because the costs are significant? Or is it because raising the topic of sexual health can offend certain personal and organizational values? Whatever the reason, it is time for a change.

It’s hard to deny the human and economic burden of sexually transmitted infections (STIs) on this country. The CDC estimates that 110 million Americans are infected with an STI, resulting in direct medical costs of $16 billion annually. The most common and fastest growing STI in this country is human papillomavirus (HPV), and it is estimated that half of sexually active men and women will get HPV at some point in their lives. In 2006, a vaccine for HPV was introduced and now there are several. CDC guidelines recommend administering a multi-dose series, costing about $250–450, to all boys and girls at age 11 or 12. (Some states require the vaccine for school admission.) It was included in mandatory coverage under the ACA. Since the HPV vaccine was first recommended in 2006 there has been a 64% reduction in vaccine-type HPV infections among teen girls in the United States.

It seems clear that this kind of care for sexual health is necessary for public health and is also part of caring for the whole individual, a central tenet of population health. But what about sexual health care that doesn’t involve infectious disease? Is it still a population health issue if there’s no communicable disease involved?

Let’s take erectile dysfunction (ED) for example. It is nearly as common in men over 40 as HPV is in the general population—more than half of men over 40 experience some level of ED, and more than 23 million American men have been prescribed Viagra. With a significant portion of the population suffering from ED, is it important for payers and providers to consider ED treatment to be essential health care and to cover it accordingly? Medications like Viagra and Cialis are an expensive burden at upwards of $50 per pill. Medicare D does not cover any drugs for ED, but some private insurers do when the medications are deemed medically necessary by a doctor. A handful of states require them to do so, but they are typically listed as Tier 3 medications—nonessential and with the highest co-pays.

Almost 7 million American women have used infertility services. Coverage for infertility diagnosis and treatment is not mandated by the ACA, though 15 states require commercial payers to provide various levels of coverage. The cost of infertility treatments is highly variable depending on the methods used but in vitro fertilization treatments, as one measure, average upward of $12,000 per attempt.

Are treatments for ED and infertility elective or necessary? In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs. Health care has advanced in both technical and philosophical ways that allow people to manage their diseases, cure their problems, and overcome limitations. It has also shone light on the significant advantages to considering a diagnosis in the context of the whole individual—their social and emotional health as well as coexisting conditions. Studies have shown, for example, that infertility, ED, and STIs all have a significant relationship with depression and anxiety.

It’s time sexual health was folded in to the broader definition of wellness instead of marginalized as a separate issue. For too many Americans, it’s too big an issue not to address.

Complete Article HERE!

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