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Cancer patients and survivors can have trouble with intimacy

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

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

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

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

kelly-shanahan

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

But she does not feel like herself.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

28 Realities of Long-Distance Dating

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long-distance-dating

In short, long distance sucks. It’s the suckiest of all possible sucks, and not always for the reasons you’d expect. You might think you’re going to miss your SO when you’re hanging out with your couple gang, or when you fancy a movie date, and you will, but it will be the moments of frustration — like when you’re trying to put the quilt cover back on — that you’ll find yourself in tears because you miss them so much.

My partner and I are on our second bout of LD. In a way it’s easier than the first time — I know the lonesome drill — and in other ways it’s harder — I thought I’d paid my dues! Here are 28 things you totally know to be true when your SO lives in another city.

  1. You know your best FaceTime angle and where in your house has the best lighting. Especially important if you’re going to be talking after you’ve washed your face.
  2. You spend even more time looking at your phone. Who even knew that was possible? You’ve also downloaded 15 new ways of communicating with each other: Words with Friends, WhatsApp, Viber, Facebook Messenger, Pair . . . and if you’re planning a wedding like us: Trello, Google Docs and Evernote.
  3. You feel like you’re in a relationship with your phone. It’s like he actually lives in your phone, because it’s the only place you see him. If you lose your phone, it’s like you’ve killed him.
  4. All your money goes to flights. And you’re booking the cheapest, nastiest airlines so you’re not even accumulating points.
  5. You have a similar dating life to that of the girls on The Bachelor. When the ladies were complaining that it was all or nothing with Richie you could totally relate. When you finally see your SO it’s all fancy dinners, romantic strolls and helicopter rides (OK, maybe not that bit) but then it’s back to the #nunlife.
  6. You can get a bit *cough* lazy with the personal grooming. Are legs really hairy if no one’s there to feel them?
  7. You have about five conversations that are just “checking in” and one during which you download all information and admin. Wake-up call, mid-morning coffee call, lunch call, 3 p.m. call, and the “I’m heading home” call put together don’t run longer than 2.5 minutes. 8 p.m. call goes for an hour.
  8. You enjoy the luxury of more space. In the wardrobe, in the bed, in the kitchen — who knew those stupid protein powders were preventing you from having a teacup collection?!
  9. You devour every girly series he vetoed. You’ve cried your way through the later seasons of Downton Abbey, got into Outlander, devoured every season of Ru Paul’s Drag Race, rewatched Sex and the City — your Netflix has never looked so pink.
  10. You jam-pack your social calendar just to stop yourself feeling lonely. Exhausted and broke is better than lonely, right?
  11. You’re really happy when he’s having a good time without you, but also a teeny bit jealous. Shake it off girl.
  12. Your single mates like you so much more. You can stay out all night because no one’s waiting for you to come home and you’re basically chaste — you’re the ultimate wing-woman.
  13. You go back to having hours-long convos with your girlfriends. You know the kind you had in high school when time seemed to drag on forever? The downside of this is that time seems to drag forever.
  14. You get really good at mingling. Flying solo at a party for the first time in forever will actually make you feel awesome. You’re still fun. People still like you, see? Something you’ll recount to your partner later with the phrase, “I was the life of the party.”
  15. You say “yes” to a lot more. See above. Why would you not go to that Aztec party of a Facebook you forgot you had? You’re the life of the party.
  16. You become more sure of yourself. Jokes aside, it’s a huge confidence boost knowing you don’t need your dude with you to have a good time. You’re together because you want to be, not because you need to be. *sings “Independent Woman”*
  17. Time differences become your enemy. People will think you’re being a pathetic but even half an hour is annoying.
  18. Podcasts are your friend. Because your transit time is at an all-time high.
  19. You count down days like a kid waiting for Christmas. You literally mark them off the calendar like you’re in a ’90s Disney movie. Where did you even find a calendar?
  20. You get butterflies in your stomach when you’re about to see him. You’d kind of forgotten what it was like to be so nervous and excited at the same time.
  21. You get to discover another city. You’re going there so much that you learn where all the good cafes and bars are, and become a bit of an expert.
  22. People totally get it when you say you can’t do something because your SO is in town. The most you’re going to hear out of anyone that weekend is a love-heart emoji on your Insta pic. They’re just happy you’re together!
  23. You experience the most severe Sunday blues known to man. Your time together is over and it’s as if a group of Dementors have arrived for a sleepover.
  24. You do a lot more communicating. It’s all you’ve got, babe!
  25. You become more thoughtful. Because you know that a little note in his suitcase will brighten his whole day.
  26. You begin to appreciate him a lot. When you’re in each other’s face it’s easy to start taking each other for granted, but with a little distance you see, he’s amazing.
  27. You learn a lot more about yourself. If for no other reason than you’re spending a lot more time solo, making all the decisions. And yes, you do think a bowl of steamed broccoli followed by a block of Lindt chocolate is an adequate dinner.
  28. Your relationship will be stronger than ever. This is how I see it: when you start doing LD your relationship is like Goku, going into the Gravity Chamber to begin his training. It’s tough and at times he wants to go back to how things were, but he carries on and eventually he becomes super saiyan (blonde) and basically invincible.
     
    If Dragon Ball Z references are wasted on you, I’m basically saying, if you can make it through long-distance, you can make it through anything.

Complete Article HERE!

Should we teach teens about BDSM in sex ed?

By Leigh Cuen

Could talking to students about BDSM culture help combat rape on college campuses? Psychology researcher Kathryn Klement thinks so.

Klement is the co-author of a newly published study out of Northern Illinois University, which showed that BDSM practitioners are less likely to believe victim-blaming myths or sexist stereotypes than the general population.

That’s why she believes that teaching college students about BDSM and kink practices can be hugely beneficial.

“A sex education program [with information about BDSM] would help people understand what’s consensual and what’s not,” Klement said in a phone interview.

Woman shops for whips, paddles and other kink gear.

Woman shops for whips, paddles and other kink gear.

Klement’s study analyzed surveys filled out by 60 college students, 68 random online respondents recruited through Amazon’s MTurk site and 57 self-identified BDSM practitioners.

The groups, which included a robust mix of ages and genders, answered whether they agreed with such sexist and victim-blaming statements as “when girls go to parties wearing slutty clothes, they are asking for trouble,” and “many women have a quality of purity that few men possess.”

Across the board, Klement said, kinky participants had a healthier understanding of sex and consent than the other groups. A whopping 84% of BDSM respondents said wearing “slutty clothes” isn’t asking for trouble, compared to only 45% of the MTurk adults.

Kinky participants were also less likely than college students to support benevolent sexism, or stereotypes that misrepresent women as weak creatures in need of male protection. “It’s not assumed [in the BDSM community] that just because she’s a woman that she wants to be submissive,” Klement said.

“These results fly in the face of stereotypes about BDSM,” Klement added, citing the misconception that BDSM is all about violence, or that kink communities celebrate unhealthy” sexual desires.

Woman at an Israeli Slut Walk with the words "still not asking for it" scrawled across her exposed chest.

Woman at an Israeli Slut Walk with the words “still not asking for it” scrawled across her exposed chest.

Although there’s much to be gained from the mainstream community borrowing BDSM mainstays like safe words during sex, Klement thinks the most important thing the kink community can teach us is the concept of affirmative consent.

Many BDSM practitioners follow a “yes means yes” mentality, where partners explicitly ask about specific sex acts rather than assuming it’s kosher until somebody says no.

According to Klement, most BDSM practitioners believe consent can be withdrawn any time. That’s the bottom line.

its-not-assumed

Because BDSM often involves physical danger and role-play, many practitioners advocate constant communication throughout every stage of seduction and sex.

Klement said some people worry all that talking will kill the mood, but in reality it can often have the opposite effect. “It’s actually quite sexy to talk about what we want to do beforehand,” she said. “People might be more informed [if they learned from BDSM] and have a better idea of how to handle sexual situations.”It looks like a lesson in consensual humiliation and kinky foreplay might be the ticket to fighting rape culture.

more-informed

Complete Article HERE!

Sex education is not relevant to pupils’ lives, says report

International study finds schools’ teaching about sexuality out of touch, moralistic and unwilling to accept some students are already in relationships

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A sex education lesson at Chelmsford grammar school.

A sex education lesson at Chelmsford grammar school.

Sex education in schools worldwide is so “out of touch” with pupils’ experiences that they find it irrelevant and switch off, research of young people in 10 countries including the UK shows.

Many students find lessons about sex and relationships negative, moralistic and too scientific to help them deal with the feelings and situations they are encountering, according to an analysis of young people’s views published in the journal BMJ Open.

The study, led by Dr Pandora Pound of the school of social and community medicine at Bristol University, found a surprising consistency in young people’s views on sex education regardless of whether they were in Britain, the US, Iran, Japan, Australia or elsewhere.

“It is clear from our findings that SRE [sex and relationship education] provision in schools frequently fails to meet the needs of young people,” Pound said. “Schools seem to have difficulty accepting [that] some people are sexually active, which leads to SRE that is out of touch with many young people’s lives.”

Pound and her colleagues reached their conclusions after examining 55 previously published studies that set out young people’s views of sex education between 1990 and 2015. It also included pupils and ex-pupils in the Republic of Ireland, New Zealand, Canada, Brazil and Sweden.

SRE lessons too often left female pupils at risk of harassment if they participated and male students anxious to hide their ignorance about sex, they found. Some young men were disruptive in class in order to disguise their inexperience.

Many pupils believed that schools saw sex as a problem to be managed, that there was too much focus on heterosexual relationships and that females were often portrayed as passive and males as predatory, the researchers found.

Many pupils also found it uncomfortable and unhelpful that teachers they had for other subjects also taught them SRE. “They expressed dislike of their own teachers delivering SRE due to blurred boundaries, lack of anonymity, embarrassment and poor training,” according to the study.

A 2013 report into sex education by Ofsted, the schools inspectorate for England, found that just 19% of 18-year-olds believe that SRE should be taught by a teacher from their own schools.

For their part, teachers themselves often admit to “discomfort” at teaching SRE. Ofsted’s review also found that one in three English schools delivered poor quality SRE.

Schools could tackle these problems by instead holding some single sex SRE lessons and using sex educators from outside to deliver lessons, the authors suggest.

They also suggest that schools should be much more “sex-positive” – open, frank and positive about sex in a way that challenges negative attitudes in society to sex.

“It is disappointing that the pattern of inadequate sex and relationships education is repeated from country to country, with young people in England and elsewhere saying that SRE starts too little and too late and is often too biological with little attention to relationships, and lessons fail to reflect the reality of young people’s lives,” said Lucy Emmerson, co-ordinator of the UK’s Sex Education Forum.

“Teachers have repeatedly said that they need subject-specific training so that they can teach good quality sex and relationships education, but in England there has been a failing on the part of government to require that SRE must be taught in every school, so there are huge gaps in provision with some schools not teaching the subject at all,” she added.

The study, which was funded by the NHS’s National Institute for Health Research, also found that SRE often does not give pupils practical information such as what to do if they become pregnant and the pros and cons of different methods of contraception. In addition it found that sex education is often delivered too late for some pupils.

Without an overhaul of SRE, “young people will continue to disengage from SRE and opportunities for safeguarding and improving their sexual health will be reduced”, the paper warns.

“The international evidence is clear, comprehensive SRE taught early by trained educators results in improvements for young people’s sexual health and reductions in sexual violence,” added Emmerson. “But too many countries are failing to respond and take action and provide children and young people with the education they need and deserve.”

Complete Article HERE!

The Sex Talk You Can’t Skip

These conversations with children are far more critical than parents think

by Deirdre Reilly

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Moms and dads typically grit their teeth, square their shoulders, and take a deep breath when it’s time for “the birds and the bees” talk with their kids. For many parents, by the time they gather the courage to have “the talk” — it’s way too late.

One father of two from Charlottesville, Virginia, joked to LifeZette, “I had the sex talk with my kids, and it was not bad at all. Sure, they were asleep — but I have to say it really went pretty well!”

There is no reason to avoid or fear the talk with the kids.

“Talking to kids about sexuality does not encourage them to be sexual,” Dr. Rita Eichenstein, a pediatric neuropsychologist in Los Angeles, told LifeZette. “We give our kids all types of information to protect them — why wouldn’t we talk to them about sex? There are a lot of bad things in this world, but sex isn’t one of them. The facts of life aren’t scary — they’re beautiful.”

The best way to discuss a healthy sexual identity with children is to make the topic as normal as possible for both parent and child.

Bobbi Wegman, a Brookline, Massachusetts, clinical psychologist, advocates using the world around you to begin teaching age-appropriate sexual information.

“I’m a mother of three kids, and it is absolutely vital to talk about sex with your children in a direct and 002honest manner that is appropriate for their age,” she told LifeZette. “Personally, the first time this came up in our home, my son was four — he asked where babies came from. We had just finished the summer and he had planted and raised the vegetables in our garden, and I used that as a metaphor for where children come from. ‘Dad planted a seed in Mommy and it grew into a baby, just like the tomato plant you planted,’ I told him. It is best to model that sex and our bodies aren’t shameful, and that sex is completely natural,” she added.

One Boston-area mom recounts how her third pregnancy opened the door for discussion with her first child, a fifth grader.

“He asked me how I first knew I was pregnant, and I said I had missed my period,” this mom of three told LifeZette. “He said, quite casually, ‘Yeah, so what is that?’ We were able to move on from there to a great discussion, which I had been longing to have with him.”

Waiting until your child is a teenager is to late to begin, the experts say.

“Teens, by virtue of their developmental stage, believe they are invincible and thus may not consider the risks associated with their actions,” Laguna Beach, California, psychiatrist Gayani DeSilva told LifeZette. “However, health risks can have lasting implications. For example, teens should be aware that contracting herpes is a lifelong condition that will impact sexual activity for life — and will need to be disclosed to all future sexual partners.”

Other health risks include mental health problems. “Sex in the context of a respectful, loving relationship will not be mentally damaging,” said DeSilva. “But sex in the context of a power struggle, assault, incest, rape, or molestation can have devastating effects on a person’s self-esteem and mental well-being. It may even be the trigger for suicide.”

Adults can hold the view that sexual activity is to be enjoyed only through marriage and still talk to their kids about sex — and the risks associated with it.

“Be consistent in your beliefs — if you are conservative, act conservative,” said Eichenstein. “Be modest, attend church and give them exposure to this topic in a way that is consistent with your morals and values. No closet Puritans allowed — you have to talk the talk and walk the walk of your own family’s moral code.”

Eichenstein understands a parent’s discomfort over “the talk.”

“The media and the culture have made sex really sleazy, and that’s what parents are embarrassed about,” she said. “All the ‘Fifty Shades of Gray’ stuff mangles the reality of normal, healthy sex, and that’s why it is critical that lines of communication are open from very early on. Body parts should be correctly named with young children, and parents should work hard to stay natural about sex.”

Chunking sexual information is good, said Eichenstein, beginning with a series of little talks starting very young. “Remember, the older children get, the less likely they are to listen to the information you have to share. Use books or other helpful materials — don’t fly on your own if it’s not working. Leave a book on your child’s night table and they will read it, guaranteed.”

003“Before sexual activity is the time for the talk — after is too late,” Eichenstein emphasized, adding that 4th, 5th and 6th grade is the window in which to share more in-depth information about sex. “It is good to say, ‘I don’t endorse that you become sexually active. But I hope that if and when you are ready down the road, I hope you’ll be open to talking to me — I’m here to help you.’”

Pornography now seems normative, said Eichenstein, which makes “the talk” an uphill battle for parents.

“Pornography desensitizes kids to sexuality, and cheapens it, too,” she said. “They no longer know how to have a healthy relationship, or how to trust their instincts. My guess is that girls actually want the type of relationships people had in the 1950s — a very romantic relationship.”

It is important to help girls have a sense of self when it comes to sexuality, and to always refuse to do what they don’t want to do — and how to say no to overtures from boys that are not welcome. “That’s the most important part of sex education for girls, in my view — knowing how to get out of a bad situation.”

Eichenstein said parents talk to boys a lot less about sex than they talk to girls, and this is dangerous. “Boys can turn into aggressors and they need to be taught by responsible parents,” she noted.

“Simple empathy between the sexes is a huge part of good sexual education for children,” noted Eichenstein. “For boys, it’s the ability to put themselves in a girl’s shoes — and act accordingly.”

Complete Article HERE!