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Sit and Stay…Longer

Podcasting will resume next week Monday with a swell Q&A Show. Today, however, I want to pay tribute to my long-time companion, Ginger The Dog, who died last Friday, one month shy of her 14th birthday. She was so much a part of my life that she often appeared in my posting and provided sound effects in numerous podcasts. Here’s one such posting, re-posted from January 2005. This particular column remains one of my most popular postings ever.

 

 

Anyone the least bit familiar with Dr Dick’s wacky household will know all about Ginger. For the uninitiated, Ginger is a 5 year old German Shorthair Pointer, who believes she’s the center of the universe and who daily runs the good doctor into the ground.24604.jpg Ginger is special. She’s no one’s pet — least of all mine.

She doesn’t even think of herself as a dog — except when she forgets herself and takes off after a squirrel or a rabbit. And she makes a point of reminding me, several times a day, that she doesn’t “belong” to me. Rather, it is I who have the great privilege to share a domicile with her. I tell you all of this by way of introducing today’s topic. No, it’s not bestiality, ferchrisake! It’s behavior modification and sexual response. Ya know — learning how to last longer.

Here we’ll discuss the remedy for that pesky premature ejaculation problem everyone is talking about. Ginger was a year and a half old when she moved in and took over the joint. She had been abandoned and was, for all intents and purposes, completely feral when she arrived. Once here, Dr Dick tried to imprint a more civilized behavior pattern on his new housemate using several tried and true dog-training methods. Which, for all intents and purposes, are simply behavior modification techniques for doggies.

Successful behavior modification is dependent on the consistency of the stimulus. Consistent stimuli — a command and a treat — are supposed to create the desired response —sitting and staying. Sadly, this approach wasn’t overly successful for Ginger and me. In fact, about the only one who got trained/modified was Dr Dick. Ginger remains blissfully resistant to all efforts to civilize her.

The following correspondents, we hope, will succeed in modifying their sexual response with greater ease than my attempts to train Ginger The Dog. What differentiates them from the dog is that each of my correspondents has the motivation to change. Ginger, on the other hand, has no such motivation. She thinks she’s perfect just the way she is.

Hey Doc,I have a major problem that I hope I could get some advice from you. It’s about my sexual issue. Whenever I’m having sex, I can’t control my nerves. It means I can’t relax. And I come too fast and rapidly. I can’t have foreplay or enjoy sex. Do you know any medications or anything that would help me to prevent this? I guess my problem is what people called “premature ejaculation”. I can ejaculate rapidly, at first I thought it was really good. But later I figured out that wasn’t good. And that it’s a sickness. Please help me. Hope to hear from you soon.Thanks Dylan

Hey Dylan,Your premature ejaculation concern is not a sickness. In fact, it’s a very common complaint. Learning to last longer is a relatively easy thing to accomplish if that’s really what you want. Motivation is key.Let’s start with how you jack-off. If I had to guess these little sessions are speedy affairs, right? Quick jack-off sessions, just to relieve sexual tension can be a good thing, but they are also modifying your sexual response and interfering with your partnered pleasure.

Premature_Ejaculation_ManIf your body is being sensitized to cuming quickly, like while jerkin’-off, then that’s how it will respond later, when you are at play with a partner.I suggest that you take a different approach to your self-pleasuring activity. Some, if not all, of your masturbation should be dedicated to full body masturbation. That is, while you’re diddlin’ yourself with the one hand, your other hand is busy exploring the rest of your body. The object is to play with the sex tension and move it around. Some people call this edge play or edging.

The object here is to avoid an ejaculation. Move the sexual energy all over your body, touch and pleasure your whole body while stroking you cock. A nice massage lotion will add to the enjoyment. Make this time last as long as you can. As you approach the point of ejaculation, stop stroking your dick and continue to play with another part of your body, your tits, ass hole, prostate, feet, etc. When the urge to cum subsides, you can start to stroke your dick again. Practice this method over and over until you can last 30 minutes.

Successful behavior modification is dependent on the consistency of the stimulus.5431362.jpg Consistent stimuli — full body masturbation — will create the desired response — lasting longer.You are teaching your body a new way to respond to sexual stimulation. This will no doubt also increase your stamina when you’re with a partner. When you’re having sex with a partner do the same thing as when you are masturbating. Encourage your partner to spread the sexual energy around. Discourage her/him from concentrating on your dick. Work at stalling your orgasm. If you’re getting close to cuming, have him/her turn his/her attention to another pleasurable activity.

Don’t get frustrated if you can’tt regain control over your sexual response right away. This is gonna take some practice, but I think it’s worth the effort. Once you mastered this technique, there are other more advanced methods that I can tell you about later.Good luck.

Hi Richard,

My question is in two parts. 1. How can I orgasm more quickly? 2. How can I orgasm easily when someone else is doing the stimulation?I know this question might sounds strange because many guys are trying to not cum too quickly.Here’s some background; over the years, I have gotten very in-touch with my physical sexual side. I have learned control the build up to orgasm and my orgasm. Having this control is amazing for the most part — it allows long periods of edge play, which I really enjoy.

However, the disadvantage is that I can’t easily orgasm quickly and usually can’t orgasm at all when someone else is doing the stimulation. These two limitations haven’t been a big concern until recently. My orgasm isn’t necessarily the most important part of sex for me. Unfortunately, many times my limitations are disappointing to a sex partner. He wants to see me cum and/or wants to make me cum. Both of these desires are totally understandable — I really enjoy doing the same for him.Is it possible for me to “learn” to cum more quickly and is it possible to “learn” how to cum from the stimulation of someone other than myself? Any suggestions or advice would be greatly appreciated!!

Jim

Hey Jim,

What an interesting predicament you present. As you suggest, I’m forever hearing from guys who have the opposite problem as you. They what to prolong their sex play before 180402.jpgcoming. Your message to me proves my point to them; our sexual response is altered, for good or for worse, by how we stimulate ourselves.Curious enough, the answer to your query resides in the detail you present about your particular sexual practices. Clearly, you have conditioned your body, and thus your sexual response cycle, to last a very long time, perhaps too long. I guess that’s the downside of long periods of edge play.

How does one remedy this? Gosh, you’ve conditioned yourself so successfully; there may be little you can do to reverse this.

Orgasms, as you know, are not things we can will to happen or not to happen. However, you could try to find a stroke or a type of stimulation that you could use to successfully bring yourself to climax. Concentrate on that stroke with the intention of getting yourself off ASAP. You would then have to show your partner(s) this technique if you wanted them to get you off. Just a thought, does ass play and prostate massage speed up your orgasm? It does for lots of other men. So if you’re not already doing so, perhaps you could incorporate some…or more of this.

What you’re gonna want to do here is reverse some of the conditioning you’ve done and relearn a new sexual practice or response. It can be done. Will it take determination? You betcha!

Good luck

How to Have a Sex Life on Antidepressants

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!

Married LGBT older adults are healthier, happier than singles, study finds

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Same-sex marriage has been the law of the land for nearly two years — and in some states for even longer — but researchers can already detect positive health outcomes among couples who have tied the knot, a University of Washington study finds.

For years, studies have linked marriage with happiness among heterosexual couples. But a study from the UW School of Social Work is among the first to explore the potential benefits of marriage among LGBT couples. It is part of a national, groundbreaking longitudinal study with a representative sample of LGBT older adults, known as “Aging with Pride: National Health, Aging, Sexuality/Gender Study,” which focuses on how historical, environmental, psychological, behavioral, social and biological factors are associated with health, aging and quality of life.

UW researchers found that LGBT study participants who were married reported better physical and mental health, more social support and greater financial resources than those who were single. The findings were published in a February special supplement of The Gerontologist.

“In the nearly 50 years since Stonewall, same-sex marriage went from being a pipe dream to a legal quagmire to reality — and it may be one of the most profound changes to social policy in recent history,” said lead author Jayn Goldsen, research study supervisor in the UW School of Social Work.

Some 2.7 million adults ages 50 and older identify as lesbian, gay, bisexual or transgender — a number that is expected to nearly double by 2060.

Among LGBT people, marriage increased noticeably after a 2015 U.S. Supreme Court ruling legalized same-sex marriage nationwide. A 2016 Gallup Poll found that 49 percent of cohabiting gay couples were married, up from 38 percent before the ruling.

For the UW study, more than 1,800 LGBT people, ages 50 and older, were surveyed in 2014 in locations where gay marriage was already legal (32 states and Washington, D.C.). About one-fourth were married, another fourth were in a committed relationship, and half were single. Married respondents had spent an average of 23 years together, while those in a committed, unmarried relationship had spent an average of 16 years. Among the study participants, more women were married than men, and of the respondents who were married, most identified as non-Hispanic white.

Researchers found that, in general, participants in a relationship, whether married or in a long-term partnership, showed better health outcomes than those who were single. But those who were married fared even better, both socially and financially, than couples in unmarried, long-term partnerships. Single LGBT adults were more likely to have a disability; to report lower physical, psychological, social and environmental quality of life; and to have experienced the death of a partner, especially among men. The legalization of gay marriage at the federal level opens up access to many benefits, such as tax exemptions and Social Security survivor benefits that married, straight couples have long enjoyed. But that does not mean every LGBT couple was immediately ready to take that step.

According to Goldsen, marriage, for many older LGBT people, can be something of a conundrum — even a non-starter. LGBT seniors came of age at a time when laws and social exclusion kept many in the closet. Today’s unmarried couples may have made their own legal arrangements and feel that they don’t need the extra step of marriage — or they don’t want to participate in a traditionally heterosexual institution.

Goldsen also pointed to trends in heterosexual marriage: Fewer people are getting married, and those who do, do so later.

“More older people are living together and thinking outside the box. This was already happening within the LGBT community — couples were living together, but civil marriage wasn’t part of the story,” she said.

The different attitudes among older LGBT people toward marriage is something service providers, whether doctors, attorneys or tax professionals, should be aware of, Goldsen said. Telling a couple they should get married now simply because they can misses the individual nature of the choice.

“Service providers need to understand the historical context of this population,” she said. “Marriage isn’t for everyone. It is up to each person, and there are legal, financial and potentially societal ramifications.” For example, among the women in the study, those who were married were more likely to report experiencing bias in the larger community.

At the same time, Goldsen said, single LGBT older adults do not benefit from the marriage ruling, and other safeguards, such as anti-discrimination laws in employment, housing and public accommodations, are still lacking at the federal level.

Over time, Goldsen and colleagues will continue to examine the influence of same-sex marriage policy on partnership status and health.

The study was funded by the National Institutes of Health and the National Institute on Aging. Other researchers were Karen Fredriksen-Goldsen, Amanda Bryan, Hyun-Jun Kim and Sarah Jen in the UW School of Social Work; and Anna Muraco of Loyola Marymount University.

Complete Article HERE!

A stressful life is bad for the bedroom

If you are consistently emotionally distressed due to social, economic or relationship pressures, you can be sure to lose erections. Being annoyed with your intimate partner all the time, and feeling undermined or frustrated are bad for your erections.

By JOACHIM OSUR

Lois came to the sexology clinic because she was sexually dissatisfied with her husband. It had been six months of no sex in their 11-year old marriage. Before that, her man had suffered repeated episodes of erection failure. “The few times he did get an erection, it was flaccid and short-lived,” Lois explained. “You can only imagine how that can be frustrating to a faithful wife.”

Lois suspected that her husband was getting sexual satisfaction elsewhere, and had angrily told him she didn’t want to have sex with him anymore. “I thought he was no longer interested in me because I had gained too much weight after bearing our two children, a very hurtful thought,” she explained sadly.

And so for six months the couple kept off each other. The relationship got strained and unfortunately Andrew, Lois’ husband, threw himself into his work. He stayed late at work and came home after everyone was asleep. He woke up and left the house early. He paid no attention to their two children anymore.

“So how can I help you?” I asked, lots of thoughts going through my mind due to the complexity of the case. You see, the man, who was the one having a problem, had not come to the clinic. Erection failure or erectile dysfunction (ED) is a complex symptom that requires a thorough assessment for its cause to be pinpointed. I needed Andrew to come see me himself.

VICTIM OF THE RELATIONSHIP

“What do you mean that it is a symptom of complex problems?” Lois asked, frowning. ED is simply a failure to be aroused sexually. This could be due to the derangement of some chemicals in the brain such as dopamine. It could also be due to hormonal problems such as low testosterone, high prolactin and so on.

What we are also seeing at the clinic is a rise in cases of diabetes and hypertension, usually accompanied by obesity. Most of the affected people have high cholesterol. These diseases destroy blood vessels, including those in the penis, making erections impossible. Further still, the diseases can destroy nerves, and if the nerves of the penis are affected, erections fail. People with heart, kidney, liver and other chronic illnesses may similarly get ED either from the diseases or from the medicines used to treat them.

Stressful lifestyles are also contributing to ED quite a bit these days. Many people work two jobs to get by, and have no time to relax or get adequate sleep. A physically worn out, sleep-deprived body is too weak to have an erection and you should expect ED to befall you any time if this is your lifestyle.

But emotional distress is even more dangerous for ED. If you are consistently emotionally distressed due to social, economic or relationship pressures, you can be sure to lose erections. Being annoyed with your intimate partner all the time, and feeling undermined or frustrated are bad for your erections. Further, feeling like a victim in the relationship can lead to ED. All these are further complicated by anxiety and depression, which are bound to set in as part of the relationship problem or as a result of the ED itself.

“So can’t you just give me some medicine for him to try then if it fails he can come for full assessment?” Lois asked, realising that my explanation was taking longer than she had anticipated.

Unfortunately that was not possible. We get this kind of request all the time at the clinic. In fact, people make phone calls asking for tablets to swallow to get erections immediately. Sometimes they call from the bathroom with their partner in the bed waiting for action yet the erection has failed. There is however no alternative to a thorough assessment and treatment of the cause of the ED.

Andrew came to the clinic a few days later. A full assessment found that he had a stressful career and relationship difficulties, and both had taken a toll on his sex life. He had to undergo a lifestyle change. Further, the couple went through intimacy coaching. It was another six months before they resumed having sex.

Complete Article HERE!

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!