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A Very Sexy Beginner’s Guide to BDSM Words

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Me talk dirty one day.

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The vocabulary of BDSM can be intimidating to newcomers (newcummers, heh heh). What is your domme talking about when she tells you to to stop topping from the bottom and take off your Zentai suit for some CBT? What, while we’re at it, is a domme? So, let’s start with the basics: “BDSM” stands for bondage and discipline, dominance and submission, and sadism and masochism, the core pillars of kinky fun. Beyond that, there’s a whole language to describe the consensual power exchange practices that take place under the BDSM umbrella. At press time there’s still no “kink” on Duolingo, so here’s a handy glossary of some of the most common BDSM terms, from A to Z.

A is for Aftercare
Aftercare is the practice of checking in with one another after a scene (or “play session,” a.k.a., the time in which the BDSM happens) to make sure all parties feel nice and chill about what just went down. The dominant partner may bring the submissive ice for any bruises, but it’s important to know that aftercare involves emotional care as well as physical. BDSM releases endorphins, which can lead to both dominants and submissives experiencing a “drop.” Aftercare can help prevent that. There’s often cuddling and always conversation; kinksters need love too.

B is for Bondage
Bondage is the act of tying one another up. In most cases the dominant partner is restraining the submissive using ropes, handcuffs, Velcro, specialty hooks, clasps, or simply a belt if you’re on a budget.

C is for CBT (Cock and Ball Torture)
In BDSM, CBT does not refer to cognitive behavioral therapy, it refers to “cock and ball torture,” which is exactly what it sounds like: The dominant will bind, whip, or use their high-ass heels to step on their submissive’s cock and balls to consensually torture them.

D is for D/S
D/S refers to dominance and submission, the crux of a BDSM relationship. While kinky people can be on a spectrum (see: “Switch”), typically you’re either dominant or submissive. If you take away one fact from this guide, it should be that even though the dominant partner in D/S relationship may be slapping, name-calling, and spitting on the submissive, BDSM and D/S relationships are all about erotic power exchange, not one person having power over another. The submissive gets to set their boundaries, and everything is pre-negotiated. The submissive likes getting slapped (see also: “Painslut”).

E is for Edgeplay
Edgeplay refers to the risky shit—the more taboo (or baddest bitch, depending on who you’re talking to) end of the spectrum of BDSM activities. Everyone’s definition of edgeplay is a little different, but blood or knife play is a good example. If there’s actually a chance of real physical harm, it’s likely edgeplay. Only get bloody with a partner who knows what they’re doing without a doubt and has been tested for STIs. You don’t have to get maimed to enjoy BDSM.

F is for Fisting
Fisting is when someone sticks their entire fist inside a vagina (or butthole). Yes, it feels good, and no, it won’t “ruin” anything but your desire for vanilla sex. Use lube.

G is for Golden Showers
A golden shower is when you lovingly shower your partner with your piss. It’s high time for the BDSM community reclaimed this word back from Donald Trump, who, may I remind you, allegedly paid sex workers to pee on a bed that Obama slept in out of spite. This is not the same thing as a golden shower. Kink is for smart people.

H is for Hard Limits
Hard limits are sexual acts that are off-limits. Everyone has their own, and you have to discuss these boundaries before any BDSM play. Use it in a sentence: “Please do not pee on me; golden showers are one of my hard limits.”

I is for Impact Play
Impact play refers to any impact on the body, such as spanking, caning, flogging, slapping, etc.

J is for Japanese Bondage
The most well-known type of Japanese bondage is Shibari, in which one partner ties up the other in beautiful and intricate patterns using rope. It’s a method of restraint, but also an art form.

K is for Knife Play
Knife play is, well, knife sex. It’s considered a form of edgeplay (our parents told us not to play with knives for a reason.) If you do play with knives, do it with someone who truly respects you and whom you trust. Often knife play doesn’t actually involve drawing blood, but is done more for the psychological thrill, such as gliding a knife along a partner’s body to induce an adrenaline rush. Call me a prude, but I wouldn’t advise it on a first Tinder date.

L is for Leather
The BDSM community enjoys leather as much as you’d expect. Leather shorts, leather paddles, and leather corsets are popular, although increasingly kinky retailers provide vegan options for their animal-loving geeks.

M is for Masochist
A masochist is someone who gets off on receiving sexual pain.

N is for Needle Play
Also a form of edgeplay (blood!), needle play means using needles on a partner. Hopefully those needles are sterile and surgical grade. Don’t do this with an idiot, please. Most professional dommes have clients who request or are into needle play. It can involve sticking a needle (temporarily) through an erogenous zone such as the nipple or… BACK AWAY NOW IF YOU’RE QUEASY… the shaft of the penis.

O is for Orgasm Denial
You know how sexual anticipation is hot AF? Orgasm denial is next-level sexual anticipation for those who love a throbbing clit or a boner that’s been hard forever just dying to get off—which is to say, almost everyone. The dominant partner will typically bring the submissive close or to the brink of orgasm, then stop. Repeat as necessary.

P is for Painslut
A painslut is a dope-ass submissive who knows what they want, and that’s pain, dammit.

Q is for Queening
Queening is when a woman, a.k.a. the queen you must worship, sits on your face. It’s just a glam name for face-sitting, often used in D/S play. Sometimes the queen will sit on her submissive’s face for like, hours.

R is for RACK
RACK stands for Risk Aware Consensual Kink, which are the BDSM community guidelines on how to make sure everyone is aware of the dangers they consent to. Another set of guidelines are the “SSC,” which stresses keeping activities “safe, sane, and consensual.” We kinksters want everyone to feel happy and fulfilled, and only experience pain that they desire—without actual harm.

S is for Switch
A switch is someone who enjoys both the dominant and submissive role. Get thee a girl who can do both.

T is for Topping From The Bottom
Topping from the bottom refers to when a bottom (sub) gets bratty and tries to control the scene even though negotiations state they should submit. For example, a submissive male may start yelping at his domme that she’s not making him smell her feet exactly like he wants. It can be pretty annoying. It can also be part of the scene itself, such as if the submissive is roleplaying as a little girl with her daddy (this is called “age play”).

U is for Urination
Urinating means peeing (duh) and aside from pissing on a submissive’s face or in their mouth you can do other cool and consensual things with urine, like fill up an enema and inject it up someone’s butt! I am not a medical doctor.

V is for Vanilla
Vanilla refers to someone (or sex) that is not kinky. It’s okay if you’re vanilla. You’re normal and can still find meaningful love and relationships no matter how much society judges you.

W is for Wartenberg Wheel
A Wartenberg Wheel is a nifty little metal pinwheel that you can run over your partner’s nipples or other erogenous zones. It looks scary, but in a fun way, like the Addams Family. It can be used as part of medical play (doctor fetish) or just for the hell of it. Fun fact: It’s a real-life medical device created by neurologist Robert Wartenberg to test nerve reactions, but kinksters figured out it was good for the sex, too.

Y is for Yes!
BDSM is all about enthusiastic consent. The dominant partner won’t step on their submissive’s head and then shove it into a toilet without a big ole’ “yes, please!”

Z is for Zentai
Zentai is a skintight Japanese body suit typically made of spandex and nylon. It can cover the entire body, including the face. Dance teams or athletes may wear Zentai, but some people get off on the sensation of having their entire body bound in tight fabric, and wear it for kinky reasons.

Complete Article HERE!

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How to Spice Up Your Relationship With Porn

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Believe it or not, porn can strengthen your relationship

 

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Let’s face it, many believe that pornography ruins relationships by setting unrealistic expectations in the bedroom. It’s a sound argument. But it would only be fair to make an opposing case that in some ways porn can improve your sex life.

“Pornography can spark curiosity and open conversation between partners. It’s so easy to get into a routine with your significant other, and it can be hard to break out of that. Watching or reading erotica allows couples to explore sexual activities that they may be curious about,” says Polly Rodriguez, CEO of Unbound.

A study published in the journal Sexual Medicine even shows that watching at least 40 minutes of porn twice a week can boost your sex drive and your overall desire to have sex. Not to mention, it’s really hot to watch people have sex, and sharing this with someone you love can enable a deeply sensual experience.

Convinced enough? Here are nine ways to incorporate porn into your sex life.

1. Have an open & honest conversation about it

Talk about your desires and interests and set boundaries of what is and isn’t OK, suggests Rodriguez. “From there, only good things can happen if you’re open and honest with each other about what you’re curious to try.”

2. Use porn as a source for inspiration

Be it BDSM or role-play, Rodriquez explains that having an example you can both watch and learn from together helps to frame what it is you’re curious to try.

3. Expand your sexual repertoire

Talk about the type of porn or fantasy you like to watch. Girl on girl, threesomes, just oral… have you always wanted to try a certain position or sex act? “This is the chance to open up and be honest about what you may have been afraid to voice to your partner,” says Antonia Hall, a psychologist and award-winning author of The Ultimate Guide to a Multi-Orgasmic Life.

4. Don’t be judgmental

Your partner might like something you don’t, notes Alicia Sinclair, Founder and CEO of b-Vibe and Le Wand. “It’s important to find the common ground and make the process sexy.”

5. Start soft

Begin with something you know turns you both on. “Try something in the amateur or couples section. It’s probably not a good idea to start with a hardcore sex scene (unless you’re both already into that of course),” says Sinclair.

6. Find a website both of you enjoy

Send each other clips you want to watch together later. “I’m a personal fan of Bellesa (run by Michelle Shnaidman) because it’s a bit more sensual than what you’d find on one of the bigger tube sites,” says Rodriguez.

7. Let it put you in the mood

Before your sweetie gets home. Put on your favorite video, rub one out and let yourself get totally aroused. As soon as they walk through the door, you’ll be in full get-it-on mode.

8. Aim for quality content

Sinclair suggests, Trenchcoatx. “This porn-for-women site is run by two women and has tons of quality content. Plus, you’re supporting women making porn, which is kind of a win-win in my book,” she adds.

9. Make you own porn

Get creative and make your own erotic video. It’s a fun way to experiment, act and enjoy watching it together later on. Just make sure to use a digital camera and not your cell phone so you don’t have to worry about it accidently getting uploaded and can delete it at any time.

Complete Article HERE!

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The Reason Most Couples Stop Enjoying Sex

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(And How To Heighten Your Capacity For Pleasure)

Everywhere I go, I hear stories about the challenges professional women are having sexually with their partners. It happens to women between 20 and 70, with kids and without. It’s described in one of a few ways:

  • “I used to like sex, but then we had kids, our careers picked up, and something changed.”
  • “When we do have sex, half the time I’m thinking about my to-do list. I feel relieved when it’s over, because then I can do what I really want to do—like finish my book.”
  • “We feel more like roommates or business partners than lovers.”
  • “I’m worried my libido is broken and there’s something wrong with me.”

The high stakes of intimacy in long-term relationships mixed with the inaccurate beliefs about female sexuality we face from all sides make for a volatile combination. But I’ve seen these issues get resolved. It’s absolutely possible. No matter where it’s coming from, sexual dissatisfaction can be remedied when both people commit to learning a new way to relate intimately. These are the keys to creating mutually fulfilling intimacy that lasts a lifetime.

I see that these patterns can change when couples commit to learning a new way of relating sexually that women enjoy. Here are the keys to successfully moving toward intimacy that’s mutually fulfilling:

1. Normalize your experience.

When intimacy is the issue, it can be very difficult to discuss openly. Often, we feel alone and don’t realize that sexual struggles in long-term relationships are not just normal, but they happen to the majority of couples at one time or another. Having discussed these issues with countless female clients who believe that they are to blame for their unhappiness, I realized that we just tend to place blame on ourselves. The truth is that there’s nothing wrong with you. Your libido is not broken. You’re not alone and this IS fixable.

2. Clearly articulate your need for change.

One of the biggest mistakes I see otherwise straightforward women make is downplaying their sexual distress to their partner. Many of us believe our male partners don’t care about our sexual fulfillment, or that enjoying sex isn’t worth the tension it would place on your relationship to bring up what isn’t working. Don’t let this stop you from getting what you need.

I have almost as many male clients as female ones, and they all want the same thing when it comes to sex: a partner who is turned on, happy, and enjoying themselves. Regardless of gender or relationship style, if sex only works for one partner in the relationship, then the sex isn’t working.

Have you clearly articulated to your partner that you aren’t sexually satisfied and that you need something to change? If not, your chances of fulfillment are slim. Blaming yourself doesn’t make anything better; taking responsibility for dealing with it as a team does. Get in the habit of talking with your partner regularly about what’s working for you and what isn’t.

3. Stop following a script.

We seem to all have been given the same misinformation about how sex should go: It starts with kissing and ends with intercourse. We’ve also been taught that happy couples have sex once per [day, week, month, insert stereotype here]. We’ve learned that sex is over when the man reaches orgasm. But I’m here to tell you that every single one of these statements is not only false but harmful.

The truth is that when couples drop expectations about sex and adopt a new approach—one that makes both parties’ genuine fulfillment a prerequisite rather than a bonus—women’s genuine fulfillment (which includes much more than having orgasms)—it supports deeper intimacy and can make a woman’s libido more active than it ever was before. Learn more about how to enter a new, infinitely satisfying paradigm here.

4. Recognize that orgasms are not sex’s raison d’être.

Orgasms are wonderful, but in truth, our fixation on them keeps our sex lives from becoming extraordinary. Let’s get real: If orgasms were all it took for radical fulfillment, far more of us would feel fulfilled. We wouldn’t even need relationships to make that happen. But we know it’s not the same. Self-pleasure is healthy, and may temporarily alleviate feelings of exhaustion or anxiety, but it doesn’t provide us with the connection or intimacy that partnered sex can.

5. Seriously, get rid of the script—before you even start the first act.

You’ll see a night-and-day difference in your sexual encounters if you let go of expectations before either of you starts getting hot and bothered. Nothing hinders women’s enjoyment of sex more than feeling pressured in bed. It’s almost impossible for us to enjoy ourselves if we’re worried about expectations about how or how much we are. Instead of feeling the pleasure, we get stuck wondering whether we’re doing it right or whether our partner is satisfied. Tossing expectation out the window is the most reliable way to start having fantastic sex immediately.

6. Touch each other for the sake of touching—with no apprehension or expectation about where it might lead.

Physical contact is essential for sexual fulfillment. But when sex isn’t working, we often avoid touching each other. I encourage couples to touch each other frequently and in a wide variety of ways—foot massages, hand-holding, and everything in between. But, by the same token, I encourage couples to stop tolerating touch they don’t like or want.

Tolerating touch leads to sexual shutdown—the person being touched isn’t enjoying themselves but won’t say it; the person doing the touching knows something is wrong but isn’t being told how to fix it. It creates distance rather than fostering intimacy. The solution is to have physical contact with zero expectations. When pressure and expectations are lifted, touch becomes an exploration of sensation and connection rather than a race to orgasm or “those same three moves.”

7. Don’t look at sex as a means to achieve any goal other than giving and receiving pleasure for pleasure’s sake.

Goals are great for business plans and exercise regimens, but they have the opposite effect on sex. Few of us have ever touched our partner without trying to achieve a goal. We use our touch to prove we’re a good lover, to make peace in the relationship, or to bring our partner to climax. How would we touch each other if we weren’t trying to achieve anything except to connect and explore each other’s bodies? Given an open-ended approach to sex that is full of touch and free of pressure, both desire for and enjoyment of sex will grow exponentially.

8. Learn what you like, and allow yourself to receive it.

Desire is vital to fulfillment. When we lose touch with that inner spark, our sex lives fall flat. Ask yourself the question, “What do I want?” 10 times a day. Seriously. And get very good at answering it. Desire is the first step. Only then can we receive it. It may sound simple, but I see women struggle sexually for years because they don’t know how to receive the help, love, and touch their partner wants to give. It takes as much work to receive as to give—sometimes more.

Practice receiving by focusing on the enjoyment of what you’re experiencing. Sink into the warm embrace of a hug. Delight in the smell of your favorite baked good. Relax as your partner touches you. Think less; feel more.

9. Practice, practice, practice.

Yes, even great sex requires practice. Create habits that can be easily incorporated into your daily routine. I encourage all couples I work with to develop a habit of sexual research—open-ended sessions where couples explore new ways to connect without pressure. Like any new habit, allowing yourself to feel more pleasure and connection takes practice.

10. If it seems helpful, get professional coaching.

If you don’t feel like you can do it alone, don’t. There’s nothing to be ashamed of except not using every tool at your disposal to create the relationship you want. Get the support of a coach whose philosophy inspires you.

11. Be patient with yourself and with your partner.

Sexual connection is deeply personal and one of the most vulnerable elements of our identities. Don’t be discouraged if you, your partner, or your sex life doesn’t change as quickly as you’d hoped. People transform in different ways, through different means, over different periods of time. In seeking long-lasting change, favor paradigm shifts over quick fixes. Stick with it and be patient with each other.

Complete Article HERE!

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Writing Graphic Sex Scenes Can Be a Feminist Act

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‘We don’t put enough value on female pleasure in our culture’

By Stef Penney

Why is there explicit sex in my new book? Because I’m a feminist.

Under A Pole Star, my third book, is a novel about late 19th century arctic explorers that features, alongside ice, ambition and rivalry, more than one sexual relationship. And there’s a lot of detail. My central characters fall in love, and yes, they have a lot of sex. I was nervous about how the passages would be received. One Amazon reviewer has already complained about “copious quantities of copulation.” The specter of the Literary Review’s Bad Sex Award, given annually to authors of “poorly written, perfunctory or redundant passages of sexual description in modern fiction,” hovers over us all, tittering. Some judge writing explicitly about sex to be less than literary — or worse, discrediting of female characters. But why should achieving romantic and sexual satisfaction — one of the most difficult challenges we face as humans — be redacted or blurred?

There’s a problem with leaving “it” up to the reader’s imagination: Every reader will fill your tasteful ellipsis with something different — possibly with unachievable fantasy, with prejudices, with bad experience, with pornography. I wasn’t going to do that to my characters. I felt I owed it to readers to treat the characters’ intimacy with the same precision and seriousness I would any other intense human experience.

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I’ve read too much bad sex in otherwise good books: bizarre, metaphorical sex; coy, breathless sex; baffling, what-just-happened-there sex; most of all, phallocentric, male-experience-dominated sex. Too often, in sex scenes between a man and a woman, the woman’s sensations are barely mentioned, as if her experience is incomprehensible or irrelevant. It’s important to ask why this is — and the fact that a lot of those writers are male is not a satisfactory answer. We don’t put enough value on female pleasure in our culture. The way we write about sex only exacerbates that problem.

In my quest for knowledge and precedent, I sought out scientific research, erotic poetry and literature. I trawled the Internet as much as I could bear. I wanted to dissect the composition of sex scenes — and waded through many, many passages that didn’t come close to answering essential questions: Did she climax? Has this man heard of a clitoris? What were they using for contraception? Some uncovered even more questions about our culture’s perception of female sexuality: Did men in D.H. Lawrence’s time really accuse women of “withholding” their orgasms, as happens to Lady Chatterley? Because that’s absurd.

There’s so much ignorance, confusion and frustration out there. Delving into sex forums online, I was shocked by the prevalence of questions from women like, “How do I know if I’m having an orgasm?” The fact that so much confusion prevails is no surprise: studies have found that more men orgasm more frequently than women and 40% of women have sexual dysfunction, which can make it difficult to achieve climax. One study found that 80% of women fake orgasms.

The more I read, the more I realized how important it would be for me to write my scenes in steamy, awkward, mutual and real graphic detail. I wanted to write about a sexual relationship in a way that convinced me and reflected what I know to be true about female sexuality — that it’s complicated, beautiful and worth equal attention. So I included accounts of great sex, horrible sex, indifferent sex, sex that just doesn’t work despite both partners’ best intentions — and I showed how and why they were different.

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I wanted to create a story that honored the sexual biographies of both partners from both points of view, that showed how they reach the point where they come together and why their relationship is the way it is. And while we’re on the subject of coming together, simultaneous orgasm was one myth I encountered over and over again in my research that was never going to get an outing here.

When my friends began to read my book and wanted to talk about it, I learned things I’d never known about them, and I became more forthright in turn. We tumbled through a flood of questions. Why had we never talked about our sexual pleasure in explicit detail before? Why did we not achieve good, orgasmic sex until our mid-twenties, or later? Why were we too ignorant, too embarrassed to ask? Why did we expect so little in bed?

One reason, we all agreed, was that we’d had to learn about good sex through trial and error, because that behavior wasn’t modeled for us in a healthy, explicit way.

We need to be able to talk, teach, learn, write and read about sex, honestly and seriously, without — or in spite of — derision and censure. Unless we share specifics, we’ll never understand one another’s experiences. You can’t support women’s empowerment without frank and open discussion of their sexuality.

Complete Article HERE!

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How To Talk To Your Doctor About Sex When You Have Cancer

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More people are surviving cancer than ever before, but at least 60 percent of them experience long-term sexual problems post-treatment.

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So you’ve survived cancer. You’ve endured brutal treatments that caused hair loss, weight gain, nausea, or so much pain you could barely move. Perhaps your body looks different, too—maybe you had a double mastectomy with reconstruction, or an orchiectomy to remove one of your testicles. Now you’re turning your attention back to everyday life, whether that’s work, family, dating, school, or some combination of all of those. But you probably aren’t prepared for the horrifying side-effects those life-saving measures will likely have on sex and intimacy, from infertility and impotence, to penile and vaginal shrinkage, to body shame and silent suffering.

More than 15.5 million Americans are alive today with a history of cancer, and at least 60 percent of them experience long-term sexual problems post-treatment. What’s worse, only one-fifth of cancer survivors end up seeing a health care professional to get help with sex and intimacy issues stemming from their ordeal.

Part of the challenge is that the vast majority of cancer patients don’t talk to their oncologists about these problems, simply because they’re embarrassed or they think their low sex drive or severe vaginal dryness will eventually go away on their own. Others try to talk, but end up with versions of the same story: When I went back to my doctor and told him I was having problems with sex, he replied, ‘Well, I saved your life, didn’t I?’ And many oncologists aren’t prepared to answer questions about sex.

“Sex is the hot potato of patient professional communications. Everyone knows it’s important but no one wants to handle it,” says Leslie Schover, a clinical psychologist who’s one of the pioneers in helping cancer survivors navigate sexual health and fertility. “ When you ask psychologists, oncologists and nurses, ‘Do you think it’s important to talk to patients about sex?’ they say yes. And then you say, ‘Do you do it routinely?’ They say no. When you ask why, they say it’s someone else’s job.”

Schover spent 13 years as a staff psychologist at the Cleveland Clinic Foundation and nearly two decades at the University of Texas MD Anderson Cancer Center. After retiring last year, she founded Will2Love, a digital health company that offers evidence-based online help for cancer-related sex and fertility problems. Will2Love recently launched a national campaign called Bring It Up! that offers three-step plans for patients and health care providers, so they can talk more openly about how cancer treatments affect sex and intimacy. This fall, the company is collaborating with the American Cancer Society on a free clinical trial—participants will receive up to six months of free self-help programming in return for answering brief questionnaires—to track the success of the programs.

Schover spoke to Newsweek about the challenges cancer patients face when it comes to sex and intimacy, how they can better communicate with their doctors, and what resources can help them regain a satisfying sex life, even if it looks different than it did before.

NEWSWEEK: How do cancer treatments affect sex and intimacy?
LESLIE SCHOVER: A lot of cancer treatments damage some of the systems you need to have a healthy sex life. Some damage hormone levels, and surgery in the pelvic area removes parts of the reproductive system or damages nerves and blood vessels involved in sexual response. Radiation to the pelvic region reduces blood flow to the genital area for men and women, so it affects erections and women’s ability to get lubrication and have their vagina expand when they’re sexually excited.

What happens, for example, to a 35-year-old woman with breast cancer?
Even if it’s localized, they’ll probably want her to have chemotherapy, which tends to put a woman into permanent menopause. Doctors won’t want her to take any form of estrogen, so she’ll have hot flashes, severe vaginal dryness and loss of vaginal size, so sex becomes really painful. She’ll also face osteoporosis at a younger age. If she’s single and hasn’t had children, she’s facing infertility and a fast decision about freezing her eggs before chemo.

What about a 60-year-old man with prostate cancer?
A lot of men by that age are already starting to experience more difficulty getting or keeping erections, and after a prostatectomy, chances are, he won’t be able to recover full erections. Only a quarter of men recover erections anything like they had before surgery. There are a variety of treatments, like Viagra and other pills, but after prostate cancer surgery, most men don’t get a lot of benefit. They might be faced with choices like injecting a needle in the side of the penis to create a firm erection, or getting a penile prosthesis put in to give a man erections when he wants one. If he has that surgery, no semen will come out. He’ll have a dry orgasm, and although it will be quite pleasurable, a lot of men feel like it’s less intense than it was before. These men can also drip urine when they get sexually excited.

Why are so many people unprepared for these side-effects?
If you ask oncologists, ‘Do you tell patients what will happen?’ a higher percentage—like in some studies up to 80 percent—say they have talked to their patients about the sexual side-effects. When you survey patients, it’s rare that 50 percent remember a talk. But most of these talks are informed consent, like what will happen to you after surgery, radiation or chemotherapy. And during that talk, people are bombarded by so many facts and horrible side-effects that could happen, they just shut down. It’s easy for sex to get lost in the midst of this information. By the time people are really ready to hear more about sex, they’re in their recovery period.

Why is it so hard to talk about sex with your oncology team?
It takes courage to say, ‘Hey, I want to ask you about my sex life.’ When patients get their courage together and ask the question, they often get a dismissive answer like, ‘We’re controlling your cancer here, why are you worrying about your sex life?’ Or, ‘I’m your oncologist, why don’t you ask your gynecologist about that?’ Patients have to be assertive enough to bring up the question, but to deal with it if they don’t get a good answer. Sexual health is an important part of your overall quality of life and there’s nothing wrong with wanting to solve or prevent a problem.

What’s the best way for people to prepare for those conversations?
First, because clinics are so busy, ask for a longer appointment time and explain that you have a special question that needs to be addressed. At the start of the appointment, say, ‘I just want to remind you that I have one special question that I want to address today, so please give me time for that.’ Bring it up before the appointment is over.

Second, writing out a question on a piece of paper is a great idea. If you feel anxious or you’re stumbling over your words, you can take it out and read it.

Also, some people bring their spouse or partner to an appointment. They can offer moral support and help them remember all the things the doctor or nurse told them in answering the question.

So you’ve asked your question. Now what?
Don’t leave without a plan. It’s easy to ask the question, get dismissed, and say, I tried. Have a follow-up question prepared. For example, ‘If you aren’t sure how to help me, who can you send me to that might have some expertise?’ Or, ‘Does this particular hospital have a clinic that treats sexual problems?’ Or, ‘Do you know a gynecologist or urologist who’s good with these kinds of problems?’ If you want counseling, ask for that.

What happens if you still get no answers?
I created Will2Love for that problem! It came out of my long career working in cancer centers and seeing the suffering of patients who didn’t get accurate, timely information. When the internet became a place to get health info, it struck me as the perfect place for cancer, sexuality and fertility. Sex is the top search term on the Internet, so people are comfortable looking for information about sex online, including older people or those with lower incomes.

Also, experts tend to cluster in New York and California or major cancer centers. I only know of six or seven major cancer centers with a sex clinic in the U.S. and there are something like 43 comprehensive cancer centers!

We offer free content for the cancer community, including blogs and forums and resource links to finding a sex therapist of gynecologist. We also charge for specialized services with modest fees. Six months is still less than one session with a psychologist in a big city! We’re adding telehealth services that will be more expensive, but you’re talking to someone with expert training.

What can doctors do better in this area?
For health care professionals, their biggest concern is, ‘I have 40 patients to see in my clinic today and if I take 15 extra minutes with four of them, how will I take good care of everybody?’ They can ask to train someone in their clinic, like a nurse or physician’s assistant, who can take more time with each patient, so the oncologist isn’t the one providing sexual counseling, and also have a referral network set up with gynecologists, urologists and mental health professionals.

 

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