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How to Have a Sex Life on Antidepressants

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When quitting isn’t an option, is it possible to overcome the sexual side effects that come with an SSRI?

By Shannon Holcroft

So, you’ve finally filled the antidepressant prescription that’s been acting as a bookmark for the most recent novel you’re feigning interest in. Somewhere between missing your own birthday party and watching everyone else have fun without you, you gave in. After a few medicated weeks, things are starting to look up. Except for your sex life, that is.

Just last week, you were tied to a kitchen chair enjoying an amazing (albeit rather mournful) few minutes of escape through sex. Today, getting naked seems less appealing than all the other pressing tasks you have new-found energy to complete.

“Is it the meds, or is it just me?” you wonder as you deep-clean the fridge with new vigour. After some soul-searching, it becomes clear that you’re still the same person—just with fewer festering foodstuffs and a lot less crying.

“It must be a side effect,” you decide. But months after filling your prescription, your genitals are still giving you the physiological equivalent of 8d2cc2c1a43108301b149f7f33e1664d.png

Why Antidepressants May Be a Downer for Your Sex Life

“[Sexual dysfunction] is a difficult, frustrating, and very common issue with this class of medications,” says Jean Kim, M.D., clinical assistant professor of psychiatry at George Washington University.

Twelve percent of American adults reported filling an antidepressant prescription in the most recent Medical Expenditure Panel Survey. Not just for clinical depression, but for all kinds of off-label conditions like chronic pain and insomnia.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant class. And between 30 percent and 50 percent of individuals taking SSRIs experience sexual dysfunction. Desire, arousal and orgasm may be affected by changes in function of neurotransmitters like serotonin and dopamine; the very mechanisms through which SSRIs treat depression.

How to Work Around the Side Effects

When fighting to survive a potentially fatal mental illness, there are often more important concerns than getting it on. It’s frequently not an option to stop taking life-saving medication to avoid side effects. So what’s a sexual being to do?

Despite SSRIs being pretty pedestrian, there’s no concrete answer to addressing sexual side effects. “Unfortunately, not much is reliably effective to deal with this [sexual dysfunction],” Dr. Kim notes.

This may sound pretty gloomy, but there are plenty of things you can try to bring sexy times back around. “Don’t hesitate to bring up the issue with your prescribing clinician, as there might be some helpful interventions available,” says Dr. Kim.

Here are other ways to work around the sexual side effects of antidepressants:

1. Time It Right

“Some literature advises trying to have sexual activity when the serum level of a daily antidepressant might be lowest in the bloodstream,” says Dr. Kim. In other words, the ideal time to get it on is right before you take your next daily dose.

If your dosing schedule makes it tough to pencil in sexual activities, chat with your clinician about changing the time of day you take your meds. In many cases, there’s room for flexibility.

“This would not work much with some SSRIs that have a longer half-life like fluoxetine (Prozac),” Dr. Kim adds. Those taking antidepressants that exit the body quickly, like Paxil and Zoloft, could be in luck.

2. Switch It Up

Switching to a different medication, with the support of your prescribing clinician, may make all the difference. Certain antidepressants have a greater incidence of sexual side effects than others. Commonly prescribed SSRIs associated with a high frequency of sexual dysfunction include paroxetine (Paxil), sertraline (Zoloft) and fluoxetine (Prozac).

Besides exploring the SSRI class, venturing into atypical antidepressant territory is another option. Buproprion (Wellbutrin) is an atypical antidepressant observed to present the lowest sexual side-effect profile of all antidepressants.

It may take some trial and error, mixing and matching to identify what works best for you, but it will all be worth it when you can [insert favorite sex act here] to your heart’s content again.

3. Augment

Some treatment add-ons may act as antidotes to SSRI-induced sexual dysfunction. “Supplementing with other medications that have serotonin blocking effects (like cyproheptadine [Peritol] or buspirone [Buspar]) or enhance other neurotransmitters like dopamine (like Wellbutrin) might help,” says Dr. Kim. She is quick to note that these findings are yet be confirmed by “larger-scale randomized controlled clinical trials.”

“Another common strategy is to prescribe erectile dysfunction drugs like sildenafil (Viagra) and the like for as-needed use before activity,” says Dr. Kim. Viagra has been found to reduce sexual side effects, even if you’re not in possession of a penis. In Dr. Kim’s clinical experience, “[Viagra] seems to help in more than a few cases.” Discuss with your doctor before adding any more medications to the mix.

4. Exercise

Now’s the time to take up aquacycling, indoor surfing sans water or whatever fitness fad tickles your fancy. Keeping active could be the key to preventing sexual dysfunction caused by SSRIs.

“Sometimes sexual dysfunction is not just a primary SSRI drug side effect but part of underlying depression/anxiety as well,” Dr. Kim explains. “Anything that helps enhance overall blood circulation, mood and libido might be helpful, such as exercise.”

Complete Article HERE!

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Why men and women lie about sex, and how this complicates STD control

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When it comes to reporting the number of sex partners or how often they have sexual intercourse, men and women both lie. While men tend to overreport it, women have a tendency to underreport it. Although the story is not that simple and clear-cut, I have discovered some interesting reasons why this is the case – and why it matters to doing research on sexual health.

Lying is an inherent aspect of reporting sexual behaviors. For instance, more females report being a virgin (i.e., had not had sexual intercourse) despite having had genital contact with a partner, compared to males.

I have studied sexual avoidance and also frequency of sex in patient populations. In this regard I have always been interested in gender differences in what they do and what they report. This is in line with my other research on gender and sex differences.

The low validity and usefulness of self-reported sexual behavior data is very bad news for public health officials. Sexual behavior data should be both accurate and reliable, as they are paramount for effective reproductive health interventions to prevent HIV and STD. When men and women misreport their sexual behaviors, it undermines program designers’ and health care providers’ ability to plan appropriately.

Pregnant virgins, and STDs among the abstinent

A very clear example is the proportion of self-reported virginal status among pregnant women. In a study of multi-ethnic National Longitudinal Study of Adolescent Health, also known as Add Health, a nationally representative study of American youth, 45 women of 7,870 women reported at least one virgin pregnancy.

Another example is the incidence of sexually transmitted diseases (STDs) which are not expected among young adults reporting sexual abstinence. Yet more than 10 percent of young adults who had a confirmed positive STD reported abstaining from any sexual intercourse in the last year before STD testing.

If we ask youth who have had sexual experience, only 22 percent of them report the same date of first sex the second time we ask about it. On average, people revise their (reported) age at first sex to older ages the second time. Boys have higher inconsistency reporting their first sex compared to females. Males are more likely than females to give inconsistent sexual information globally.

Why don’t people tell the truth about sex?

Why do people lie about their sexual behavior? There are many reasons. One is that people underreport stigmatized activities, such as having multiple sexual partners among women. They overreport the normative ones, such as higher frequency of sex for men. In both cases, people think their actual behavior would be considered socially unacceptable. This is also called social desirability or social approval bias.

Social desirability bias causes problems in health research. It reduces reliability and validity of self-reported sexual behavior data. Simply said, social desirability helps us look good.

As gender norms create different expectations about socially acceptable behavior of men and women, males and females face pressures in reporting certain (socially accepted) behaviors.

In particular, self-reports on premarital sexual experience is of poor quality. Also self-reports of infidelity are less valid.

Although most studies suggest these differences are due to the systematic tendency of men and women to exaggerate and hide their number of partners, there are studies that suggest much of this difference is driven by a handful of men and women who grossly inflate and underreport their sexual encounters.

Even married couples lie

Men and women also lie when we ask them who is making sexual decisions regarding who has more power when it comes to sexual decision-making.

We do not expect disagreement when we ask the same question from husbands and wives in the same couples. But, interestingly, there is a systematic disagreement. More interestingly, in most cases when spouses disagree, husbands are more likely to say “yes” and wives “no.” The findings are interpreted in terms of gendered strategies in the interview process.

Not all of the gender differences in reported sexual behaviors are due to men’s and women’s selective under- and over- reporting of sexual acts. And, some of the sexual behaviors do vary by gender. For instance, men have more sex than women, and men less commonly use condoms. Men have more casual partners, regardless of the validity of their report.

Secretive females, swaggering males

Studies have found that on average, women report fewer nonmarital sexual partners than men, as well as more stable longer relationships. This is in line with the idea that in general men “swagger” (i.e., exaggerate their sexual activity), while women are “secretive” (i.e., underreport sex).

Structural factors such as social norms shape men’s and women’s perceptions of appropriate sexual behaviors. Society expects men to have more sexual partners, and women to have fewer sexual partners.

According to the sexual double standard, the same sexual behavior is judged differently depending on the gender of the (sexual) actor (Milhausen and Herold 2001). Interestingly, men are more likely to endorse a double standard than women.

In the presence of sexual double standards, males are praised for their sexual contacts, whereas females are derogated and stigmatized for the same behaviors, “He’s a Stud, She’s a Slut.”

Research suggests that lifetime sexual partnerships affect peer status of genders differently. A greater number of sexual partners is positively correlated with boys’ peer acceptance, but negatively correlated with girls’ peer acceptance.

Self-serving bias is common

As humans, self-serving bias is a part of how we think and how we act. A common type of cognitive bias, self-serving bias can be defined as an individual’s tendency to attribute positive events and attributes to their own actions but negative events and attributes to others and external factors. We report on sexual behaviors which are normative and accepted to protect ourselves, and avoid stress and conflict. That will reduce our distinction from our surroundings, and will help us feel safe.

As a result, in our society, men are rewarded for having a high number of sexual partners, whereas women are penalized for the same behavior.

The only long-term solution is the ongoing decline in “double standard” about sexual morality. Until then, researchers should continue questioning the accuracy of their data. Computerized interviews may be only a partial solution. Increasing privacy and confidentiality is another partial solution.

Complete Article HERE!

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SEXUAL HEALTH:

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A fake life is an unhappy life

If you want to be healthy in body, mind and soul, then do not lie about how little pleasure you receive in bed.

By JOACHIM OSUR

Up to 60 per cent of women have faked orgasm at one point or another. In fact, a quarter of married women fake orgasms all the time. That was my overarching message to Jane when she walked into the sexology clinic distressed. She had just been thrown out of her marital home for faking orgasm.

Trouble started when Jane revealed to her husband that she had faked it for two years of their marriage. “I meant well all these two years. I did not want to hurt him by revealing that I was not satisfied,” Jane explained, wiping her tears.

It was 8am and she was the first patient of the day. She had come in in her nightdress – her husband had pushed her out of the house and locked the door after they disagreed the night before. She spent the night on her verandah.

“He throws me out of the house because I tried to find a solution, but he never wants to talk about sex,” she lamented.

COMMON PROBLEM

Faking orgasm is not unique to Jane. Studies have shown that it is the best and most friendly way to end a boring sexual act, performed by women who want to reassure their man that he has not laboured in vain.

We now know that it is not just lack of sexual skills that leads to faking orgasm. The faker could also be having her own problems, either with the sexual function or with the relationship and intimacy. Take it this way: you are responsible for your own pleasure and your lack of it cannot be fully blamed on the man.

Some women dread sex, because of fear of disease or pregnancy, and values that teach them to look at sex negatively. The impact is that the person switches off sex, and orgasm is impossible under such circumstances. “Well, I am not such a big fan of sex anyway. I find it dirty,” Jane interrupted.

Whatever the reason is, it is important to note that faking is totally against the natural purpose of sex. Sex does not just give physical pleasure; there is something divine and supernatural about it. Good sex leads to enhanced self-esteem. The person’s feeling of well-being goes up and there is emotional healing. This improves a person’s happiness and gives them a positive outlook on life.

People who have healthy sex feel loved and radiate love and compassion to others. They have a sense of acceptance, beauty, reverence, grace and a feeling of rejuvenation. They feel powered to face life; in fact, they get a better sense of spiritual connection with their God. Healthy sex is therefore not just good for the body but also for the spirit and the soul.

Faking orgasm denies the faker all this. In itself, it is a symptom that the sex or the relationship is no longer healthy and needs attention. Unhealthy sex destroys emotions and the wellbeing of the people involved, and influences the way the affected people view life and other people. Unhealthy sex is not good for life.

I enrolled Jane and her husband in counselling and coaching on intimacy and sex. John, the husband, grudgingly came to the clinic after my pleas. He believed that it was Jane, not him, with a problem. It however turned out that they both lacked sex skills. Further, they had never freely discussed their sexual feelings and so were sexually illiterate about each other.

It took months of skills training and sexual values clarification before the couple could have healthy sex. Fortunately, they were both dedicated to having the relationship work out.

“This is what we needed to have gone through before our wedding,” Jane said on their last day of counselling. “I feel we have wasted two years of our marriage.”

“Yes, but better late than never. We are finally up to the task!” John replied. The couple burst out in laughter as they waved goodbye and walked out of the consultation room holding hands.

Complete Article HERE!

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“Coming out” as a parent of a gay child

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By Alison Walsh

My elder son David was fifteen when he told us he was gay – not that he had actually intended to tell us quite then.

He said he was meeting someone but was evasive as to who this might be? I forced the issue never expecting to hear that this was some guy he had met on line through a gay website.

Alarm bells rung at the possible danger!

David must have guessed we might find the news of him being gay difficult as he kept repeating, “It’s OK Mum, there’s nothing wrong”.

My husband’s first thought was “I love my son. I don’t want to lose my relationship with him”.

As for me, I have an unfortunate knack of sometimes putting my big feet in things.

Whilst reeling from the shock, thankfully I avoided saying anything that my son would feel hurt or rejected by.

We both understood that what mattered most was for David to stay believing in himself and to know that our love and support was unconditional.

David appreciated the way we had accepted his sexuality and to stop us feeling anxious, he agreed to cancel the internet date.

David and Alison

Having “come out” to his friends and immediate family, David visibly looked happier by the day.

Now the ball was in our court. Was it our turn to “come out” as parents of a gay son? Would that be fair to David? Was it for him to decide who and when to tell others or not? At the young age of fifteen, we felt it was. That made it much harder because I wanted to feel accepted too.

Up to the point when David told us he was gay, I had no knowledge or experience of what being LGBT+ meant.

My head was full of fears which were further fuelled when I went on-line and came across far right materials discounting LGBT+ as wrong and blaming being gay on abuse or an unhealthy mother-son relationship.

Was I a bad Mum? I feared being judged. I was worried now how David would be treated. Would his school teachers who had praised him as a role model now think less of him?

Would he find himself rejected as unsuitable to be an RSY Summer Camp Leader?

Having brought my boys up to feel strongly Jewish, I now felt anxious that this might not sit comfortably with fully accepting and supporting David’s sexuality.

My Jewishness is all bound up in family and home, celebrating Friday night and all the family traditions. So for validation and support, I turned to my Jewish roots. As I said, I wasn’t ready to “come out” publicly and so like my son before he “came out”, I turned to the privacy of the internet for help. I tapped into Google “Jewish Mum of gay son” and up came “Parents of Jewish Gays and Lesbians” with a number you could phone in confidence.

Going for the first time to the group “Parents of Jewish Gays and Lesbians”, I was scared as to quite who I would find there.

The wonderful thing was how unbelievably just like the two of us the other parents all were. They could have come straight out of any Shul – parents anxious to do right by their children. We were no longer on our own.

Hearing from other parents and sharing our own story in a Jewish group in which we felt understood and accepted, helped us feel better. The first pernicious lie it immediately destroyed for me was the idea that being gay had anything to do with upbringing or by extension anything I had done or not done. It was a fact of life, period.

A Dad said that the last thing he would ever wish on his son would be to be imprisoned in an unhappy marriage hiding his sexuality. That hit home and made me rethink the dream I had been nurturing of one day seeing my son under the Chuppah with grandchildren to follow. My son had his own life to lead. I just wanted him to be happy and true to himself. And so in the group we parents chatted on into the night. We discussed why it was that so many of our LGBT+ children were going to Shul less? Did our LGBT+ children no longer feel they could count themselves as proper members of the club?

Perhaps like me before I became aware of LGBT+, our kids assumed by default that within Shul life their sexuality was taboo and that they would not be understood or accepted unless they hid their sexuality.

To be fair, if I joined any club, I would want to feel that there was someone there a bit like me and that I wasn’t just going to be tolerated, but actually wanted by the club.

My journey has been much easier than for some as being of my own making – struggling with my own prejudices. Thankfully the positive attitude of both our Shul and my son’s school explains why David has never felt ashamed of his sexuality and why both his friends and our Shul friends when told have had no issues.

In the twilight zone before feeling ready to come out to the world as a Jewish parent of a gay child, it helps to share feelings in the trust of absolute confidentiality with likeminded parent souls who understand. I am now Co-Ordinator for the parents’ group, “Parents of Jewish Gays and Lesbians” which helped me so much and which I would like to see there for other parents.

It is a really important group not just for the parents but also for LGBT+ children as “happy parents make happy kids”. Unfortunately the group is hardly known about so if you get a chance to tell others about the group, I would ask you to please do so.

Complete Article HERE!

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Researchers Reveal an Evolutionary Basis for the Female Orgasm

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Though a common occurrence (hopefully), the female orgasm has been a biological mystery.

by Philip Perry

Few things are as magical as the female orgasm, whether you are experiencing it, inducing it, or just a casual observer. It is essentially pure art in motion. Yet, there are many things we don’t know about the phenomenon, scientifically speaking, such as, why it exists. Scientists have been pondering this for centuries.

Apart from vestigial organs, there are few structures in the body we don’t know the function of. It seems that the clitoris is there merely for pleasure. But would evolution invest so much in such a fanciful aim? Over the years, dozens of theories have been posited and hotly debated.

One prevailing theory is the “byproduct hypothesis.” The penis gives pleasure in order to drive males toward intercourse and ensure the perpetuation of the species. The sex organs are one of the last things developed in utero. Due to this, and the fact that women develop their pleasure organ from the same physical structure the penis is formed from, the clitoris is therefore a “byproduct” of the penis. You could imagine how some women feel about this theory.

Another is the mate-choice hypothesis. Here, it is thought that since a woman take longer to “get there,” it would pay for her to find a mate invested in her pleasure. A considerate lover would make a good father, the theory posits. Yet, the female orgasm happens rarely during penetrative intercourse, undercutting this theory.

It’s been thought that the act plays a role in conception. Several studies have shown that the woman having an orgasm during intercourse increases the likelihood of impregnation. But how and why is not well understood. Now, a team of scientists suggest that the female climax once played a role in reproduction, by triggering ovulation.  

Mary Magdalen in Ecstasy. By: Michelangelo Merisi da Caravaggio. 1606.

Researchers at Yale University posed this theory, in a study published in the Journal of Experimental Zoology Part B Molecular and Developmental Evolution. Gunter Wagner was its co-author. He is a professor of ecology and evolutionary biology at the university. According to him, previous research has been looking in the wrong place. It focused on how human biology itself changed over time.

Instead, these Yale researchers began by analyzing a large swath of species and the mechanisms present in females associated with reproduction. Wagner and colleagues also looked at the genitalia of placental mammals. They focused on two hormones released during penetrative intercourse across species, prolactin and oxytocin.

Prolactin is responsible for the processes surrounding breast-milk and breast feeding, while oxytocin is the “calm and cuddle” hormone. It helps us to bond and feel closer to others. Placental mammals in the wild need these two hormones to trigger ovulation. Without them, the process cannot occur.

One major insight researchers found is that in other species, mammalian ovulation is induced by contact with males, whereas in humans and other primates, it is an automatic process operating outside of sexual activity, called spontaneous ovulation. From here, they looked at those female mammals who induce ovulation through sexual contact with males. In those species, the clitoris is located inside the vagina.

Evolutionary biologists believe that spontaneous ovulation first occurred, in the common ancestor of primates and rodents, around 75 million years ago.  From here, Wagner and colleagues deduced that the female orgasm must have been an important part of reproduction in early humans. Before spontaneous ovulation, the human clitoris may have been placed inside the vagina. Stimulation of the clitoris during intercourse would trigger the release of prolactin and oxytocin, which would in turn, induce ovulation. This process became obsolete once spontaneous ovulation made it onto the scene.

“It is important to stress that it didn’t look like the human female orgasm looks like now,” said Mihaela Pavličev, Wagner’s co-author of this study. “Homologous traits in different species are often difficult to identify, as they can change substantially in the course of evolution.” She added, “We think the hormonal surge characterizes a trait that we know as female orgasm in humans. This insight enabled us to trace the evolution of the trait across species.”

While the hypothesis is compelling, it has drawbacks. The biggest is that it’s difficult, if not impossible, at least currently, to investigate what, if any, sexual pleasure other female animals derive during copulation. Other experts say, more data is needed from other organisms to shore up this theory. Still, it seems the most persuasive argument to date.

To learn more about the biological basis of the female orgasm, click here:

 

Complete Article HERE!

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