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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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7 Tips for Introducing Sex Toys to Your shy Partner

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Trust and vulnerability are required for this experimental play.

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The very first time I remember seeing a sex toy was at a “Passion Party” hosted in the apartment of one of my college friends. The entire event was incredibly awkward and I remember doing my best to just relax and have fun. We played games where we talked openly about our sex lives and previous sexcapades.

Throughout the party, different toys were described and passed around for each of the attendees to get a little hand only experience. The entire soiree was filled with nervous giggles and an almost palpable sexual electricity.

Towards the end of the party, we were given little ordering sheets of paper and were instructed to walk past a table with each toy laid out on display. I remember being so nervous to make a choice and even more nervous if I were to choose one that had to be delivered to my apartment where I lived with my high school sweetheart at the time.

I breathed a sigh of relief when the small purple vibrator I choose was the last one the party rep had in stock and available to take home. I left the event with giddiness and an excitement I hadn’t yet felt before.

Interestingly, those positives were countered by slight thoughts that yielded shame as well. I grew up in a Catholic environment and I always struggled with the idea of self-pleasure, sex used as a means for pleasure, sex outside of marriage and orgasm through means other than my spouse.

I also knew that if I wanted to bring my new purchase into the bedroom with my partner, I would have to get over more than just how to figure out which way the batteries went.

Since that time in my life, my how things have changed. Now, sex and sexuality empowerment and exploration is a fabric of my being and what I spend most of my days helping people with. I can’t help but relive a portion of the story above every time I have conversations with clients and friends who are looking to play with sex toys of any sort for the first time.

If my first experiences, with even the most basic toys, were awkward and slightly shame-filled, I can only imagine there are plenty of other people out there who are just as shy to the idea.

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Sharing from personal experience and from the experience of some of the people I have worked with, here are a few good things to know when considering adding sexy playthings into some of your sexy time.

  1. Sex toys are meant to aid in your sexual pleasure not replace your partner. If your partner makes a suggestion for the addition or exploration of sex toys, it does not mean you are not pleasing them. If anything, that is a sign that your partner trusts you enough to be vulnerable while in the midst of a very sacred, personal act.
  2. Make your decision based off of a conversation. I suggest creating a sex toy “want, will, won’t” list so you can determine your comfort level and your boundaries along with the comfort level and boundaries for your partner. Once you have a better understanding of dynamics and preferences you can make an informed sex toy purchase. Toys can be used for all sorts of play. It’s best to create your lists with open communication. Maybe take the BDSM Test at www.bdsmtest.org to help with your decision.
  3. I suggest your first sex toy purchase include a blind fold for sensory deprivation. This enhances other active senses and can make the person who is blindfolded feel less exposed when play time begins, while the person learning to give pleasure through sex toy play has the opportunity to relax and explore without eyes on them the entire time.
  4. Have a safe word and when playtime begins and continues communicating. Tell your partner when something feels good and when something does not. I find that a blindfold helps with the comfort level around keeping communication free flowing as well.
  5. All sex toys are not created equal. Choose toys that are made of high quality, non-toxic material.
    Some toys are waterproof and some are not. Make sure to check before you play, just in case your sexy session decides to change environments.
  6. Knowing about the toy does not take the fun out of it! The more information you get on sex toys that interest you, the easier it is to enjoy the experiences that include them.
  7. Get help where you need it if you are dealing with sexual shame from any area of your life.
    I needed to heal from shame surrounding my faith and regarding the lack of healthy sex related information provided to me while growing up.Step one is identifying the problem areas and then gaining assistance and support in healing from wounds that exist in those areas.

There are plenty of resources available and people like myself and other sex experts that specialize in sex education and step one is identifying the problem areas and then gaining assistance and support in healing from wounds that exist in those areas. There are plenty of resources available and people like myself and other sex experts that specialize in sex education and sexuality empowerment that can assist you on your journey. When you treat the core area of discomfort and/or pain, adding things like sex toys into your life can lead to magical, orgasmic experiences.

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Sex toys can be a fun way to spice things up in the bedroom, but they can also be a way to further connect with yourself and your partner.

Understand that sometimes things don’t go according to plan and choose to laugh when things go a little different to your expectations. Always give certain toys and instances a second chance and remember to breathe and be present.

Sex is fun and pleasure is good for you.

Complete Article HERE!

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Marijuana And Sex: How Much Weed Is Too Much?

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If you don’t know about the ‘bidirectional effect.’ you need to read this.

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It’s not a secret that medical cannabis has been proved beneficial to those seeking pain management, alleviating chronic ailments and improving appetite. And for millennia it has been reported that marijuana and sex go together, too.

A new study released this month reveals that cannabis use, indeed, can improve sexual function — but it depends on the amount you and your partner partake.

Cannabis and Sexuality,” a report authored by Richard Balon and published in Current Sexual Health Reports, suggests that low doses of marijuana enhances sexual desire, while higher doses may lead to a bad sex. Says the report:

Cannabis has bidirectional effect on sexual functioning. Low and acute doses of cannabis may enhance sexual human sexual functioning, e.g., sexual desire and enjoyment/satisfaction in some subjects. On the other hand, chronic use of higher doses of cannabis may lead to negative effect on sexual functioning such as lack of interest, erectile dysfunction, and inhibited orgasm. Studies of cannabis effect on human sexuality in cannabis users and healthy volunteers which would implement a double-blind design and use valid and reliable instruments are urgently needed in view of expanded use of cannabis/marijuana due to its legalization and medicalization.

Of course, this is not new to anyone who has smoked a joint and is not a virgin. Another study, released late last year, concluded:

“For centuries, in addition to its recreational actions, several contradictory claims regarding the effects of cannabis use in sexual functioning and behavior (e.g. aphrodisiac vs anti-aphrodisiac) of both sexes have been accumulated. … Marijuana contains therapeutic compounds known as cannabinoids, which researchers have found beneficial in treating problems related to sex.”

But dosage is important. Too much pot can be unhealthy for male sexuality. “You get that classic stoner couch lock and lose your desire to have sex at all,” according to Dr. Perry Solomon, chief medical officer at HelloMD. Perry suggests that men should consume cannabis that contains 10-14 percent THC.

Although it appears women have a different tolerance when it comes to cannabis and sexual activity, it is recommended to start with low doses before escalating the high.

According to HelloMD:

One reason why this may be so is that cannabis consumption is known to stimulate the production of oxytocin in the body. The production of oxytocin, also known as the bonding hormone, is closely related to the endocannabinoid system. Oxytocin is involved in a variety of human interactions, including sexual intercourse. Oxytocin is often released during orgasm, creating a bond between sexual partners that brings them closer together. The increased oxytocin production experienced while using cannabis during sex leaves me feeling deeply connected to my partner on a physical and spiritual level. Cannabis helps us achieve a level of closeness and unity that is truly unique.

Complete Article HERE!

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The Science of Passionate Sex

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How to have hot sex, according to science

By Scott Barry Kaufman

Our culture is obsessed with sex. Everywhere you look is another article on how to have hot sex, harder erections, mind-bending orgasms, and ejaculations that go on for days. What people seldom realize, though– and which the latest science backs up– is that this is exactly the problem.

There’s nothing wrong with desiring sex. I’m extremely sex positive. Rather, I believe it’s the obsessive focus on the pragmatics and mechanization of sex– in isolation from the rest of the person— that is making us actually less satisfied with sex. We aren’t integrating our sexual desires into the totality of our being, and our whole selves are suffering as a result.

In a series of clever studies, Frédérick PhilippeRobert Vallerand, and colleagues studied a concept they refer to as harmonious sexual passionpassion for sex that is well integrated and in harmony with other aspects of the self, creating minimal conflict with other areas of life. Harmonious integration of ones sexual desires frees one up to fully engage and enjoy sexual activity in an open, spontaneous, and nondefensive manner. Items measuring harmonious sexual passion include: “Sex is in harmony with the other things that are part of me,” “Sex is well integrated in my life,” and “Sex is in harmony with the other activities in my life.”

In contrast, those who have obsessive sexual passion have not well integrated their sexuality into the totality of their being. Their sexual desires remain detached from other areas of their self as well as other domains in life. This leads to more narrow goals, such as immediate sexual gratification (e.g., orgasm), and leads to more of an urgent feeling of sex as a goal, compelling us to perform, instead of us being in control of our sexuality. This can significantly limit the full enjoyment of sex as well as life. Items measuring obsessive sexual passion include: “I have almost an obsessive feeling for sex,” “Sex is the only thing that really turns me on,” and “I have the impression that sex controls me.”

Across a number of studies, the researchers found that these two forms of sexual passion– obsessive and harmonious– differ remarkably in the way sexual information is processed, and how sexual activities are experienced. During sexual activities, obsessive sexual passion was related to negative emotions. Outside of sexual intercourse, obsessive sexual passion was related to intrusive thoughts about sex, conflict with other goals, attention to alternative partners, and difficulty concentrating on a current goal when unconsciously viewing pictures of sexually attractive people.

Obsessive sexual passion was also related to the biased processing of information. Those scoring higher in obsessive sexual passion were more likely to perceive sexual intent in ambiguous social interactions as well as to perceive sexuality in words that don’t explicitly have a sexual connotation (e.g., “nurse”, “heels,” “uniform”). Obsessive sexual passion was also related to violent actions under threat of romantic rejection, as well as greater dissolution of romantic relationships over time.

In contrast, harmonious sexual passion showed much greater integration with more loving aspects of the self, as well as other life domains. For instance, participants were asked to list as many words as they could in 1 minute related to the word “sex”. Those scoring higher in harmonious sexual passion were still sexually passionate beings: they listed quite a number of sexually-related words. However, they had a more balanced profile of purely sexual representations (e.g., “penis”, “breasts”, “vibrator”) and sexual-relational representations (e.g., “intimate,” “caress,” “intercourse”). In fact, the magic number seemed to be a ratio of 2: once the number sexual words outweighed the number of sexual-relational words by a factor of 2, there was a substantial increase in obsessive sexual passion and a marked decrease in harmonious sexual passion.

Those scoring high in harmonious sexual passion also showed greater control over their sexual drive. Whenever a sexual stimulus was subconsciously encountered (e.g., a beautiful person), they were able remain on task (which was to identify natural vs. artificial objects). Harmonious sexual passion was also related to less sexually intrusive thoughts and was unrelated to attentiveness to alternative partners. This greater integration and absence of conflict led to higher relationship quality over time.

It’s important to note that obsessive sexual passion is not the same thing as sexual compulsivity, or even sex addiction (although it is still hotly debated whether sexual addiction really exists). Even though obsessive sexual passion was correlated with negative emotions during sexual activity, it did not lead to greater feelings of distress. Also, both harmonious and obsessive sexual passion were related to loving and enjoying sex-related activities.

In fact, both harmonious and obsessive sexual passion were equally correlated with sexual desire. This is a really important finding, because we have a tendency to stigmatize those with greater sociosexuality in our society. Those with a more unrestricted sociosexual orientation are more willing to engage in casual sex, and report greater sexual desire and frequency of fantasizing about sex. These results suggest that sociosexuality itself is not the problem; rather, it’s how your sociosexuality is integrated into your identity and other areas of your life that really matters.

Perhaps instead of our cultural obsession with sexual performance, we should shift more towards helping people accept and feel comfortable with their sexuality, embrace sexual passion, and help them harness that passion in ways that bring joy, vitality, and openness to all areas of their life.

Complete Article HERE!

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How Lube, Dildos And Dilators Are Helping Cancer Survivors Enjoy Sex After Treatment

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Tamika Felder, a cervical cancer survivor, founded the nonprofit Cervivor to help fellow survivors navigate the jagged path back to sexual health.

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“I don’t know if readers are ready for what I’ve got to say!” Tamika Felder chuckles over the phone. “I just don’t think they’re ready.”

If you’re a cancer survivor, you should be, because Felder, 42, is an intimacy advocate who dedicates her life to helping cancer survivors navigate the oftentimes brutal path back to sex and pleasure. She was diagnosed with cervical cancer at 25, and spent the next year getting chemotherapy, radiation and a radical hysterectomy. She wound up with “bad radiation burns from front to back” as well as vagina atrophy, shrinkage and dryness, all of which led to painful sex.

“I knew at 25 this just couldn’t be it for me. I knew I wanted to have sex again, and I wanted to have good sex again,” she says. “It takes time, but it’s absolutely possible.”

Felder founded Cervivor, a nonprofit that educates patients and survivors of cervical cancer. She also works with both women and men struggling to regain their sexuality and intimacy post-treatment. Many survivors aren’t aware that there are items, exercises and treatments that can help them. Felder spoke with Newsweek about what people can do to experience pleasure again, even if it’s different than it used to be.

What exactly do you do?
I am not a doctor, I’m patient-turned-advocate who is passionate about the total life beyond cancer—and that includes the sensual side. Cancer treatments are saving our lives, but they’re also damaging our lives. I knew one guy who had to have his penis removed. That’s a life-saving surgery but how do you help that patient navigate life after? I’ve counseled women who survived gynecological cancer, whose vaginal canals meshed so close together that their doctor can’t even fit a speculum inside. What does that do for the quality of life for a woman like that? You have to offer alternatives! Maybe she can’t have penetration through the vaginal canal, but I expect the medical community—her hospital or cancer center—to help her navigate to a good quality of life. Because part of a good quality of life beyond cancer is your sexual self. Doctors have to talk more freely about that.

What if they don’t?
If your clinical team doesn’t raise the concern with you, you need to speak up. Email them or call them on the phone if it’s too hard to do it face-to-face. Find your voice. If something is not functioning the same way or how you think it should be functioning, speak up.

Now that you’ve identified a problem, what are some of the ways to deal with it?
Dilators: Whether you have a partner or it’s all about self love, dilators are important because they stretch out your vagina. Start with a small size dilator and move up. If you need something more, take a field trip to a toy store and get different sized dildos and vibrators. With some cancers, if you don’t use your dilators, your vaginal canal—or whatever is left of it—can close back up, so it’s important to follow those suggestions. Other people think, If I’m not dating now it’s not an issue. No! You need to deal with it now so when you’re intimate with another person you can be ready. Practice makes perfect.

Lubrication: If you’ve had any type of gynecological cancer, lube is going to be your best friend. After chemotherapy and especially radiation, your vagina can be very dry. Women deal with it as we age, but radiation causes you to go into menopause early. For cervical cancer, not only do you have external radiation but also internal radiation. Lube is important when you become sexually active again, because your body isn’t producing moisture on its own. Otherwise you’ll have abrasive sex—it will hurt to enter the vaginal walls.

You have to find out what works for you. Coconut oil is perfect for putting in your vagina and using as lube. A little goes a long way. I also like Zestra, an arousal oil. It’s a natural lubricant. For women who may have slow libidos, you put it on your clitoris and labia and experience what some people call a tingling experience. They call it the “Zestra Rush.” It’s a slow progression of warming up and you’re like, Oh! It still works!

Pocket Rockets or Lipstick Vibrators: These bring blood flow back to the vulva. I don’t care if you’re a southern Baptist from the Bible Belt, I want you to get a pocket rocket and take it with you when you travel and use that sucker so it can help the blood flow. There are lots of fun toys out there that can help. My favorite one is the Ultimate Beaver. Order discreetly online or take a fun field trip to an adult toy store.

Mona Lisa Touch: There are new therapeutic procedures, like the Mona Lisa touch laser treatment, that helps with vaginal rejuvenation. If you’re a reality TV fan like myself, you might think, it sounds like what the Real Housewives do! It’s not just something that rich people do. In many cases, insurance won’t cover it, but we’ve seen with the right doctor and the right type of letter, they’ve gotten insurance to cover it. Or, you may find a doctor willing to donate or discount services. Take a chance and write them, saying, “This is what happened to my vagina after cancer, and this is how you can help.”

Pay Attention to Pain: Make sure you heal properly. You may have healed on the outside but it doesn’t mean you’re healed internally. If you’re properly healed but still experience pain, have a conversation with your doctor.

What pitfalls should people be aware of?
A lot of people focus on what their body was like before cancer. I hate to say, “You have to give that up,” but you do in order to move forward. Your body has changed. Your objective shouldn’t be an orgasm, because maybe your body won’t do that again. It pains me to know that women have vaginal canals that have closed and they’re just living a life where they think they can’t have pleasure stimulated vaginally anymore. It’s not fair. They weren’t given the resources to help them along the way.

How did you redefine sex and intimacy for yourself?
In my own eyes and my husband’s eyes, I’m a perfect 10, but if I’m walking down the street, I don’t look like the magazine covers. I’m a plus size woman but I do love myself. It starts with that. Part of the homework I give men and women— When you look at yourself, tell me what you see. They always start out with the negative. I’ve never had anyone, no matter the age group, in all my cancer talk about sex and intimacy, who’s started with anything good. So I flipped it: Tell me what you love about yourself? You can go get these toys and procedures, but at the end of the day, the true pleasure comes from how you feel about yourself. That’s going to make your sexual self stronger. I’m not saying, don’t go for pleasure, but it really is how you feel about yourself.

Where can people go for more help?
Sites like Memorial Sloan Kettering and Dana Farber have amazing resources. Find out if your cancer center has a program to help cancer patients reclaim their sensual side, like this one at Dana Farber. Or find someone in your local area through the American Society of Sex Educators, Counselors and Therapists.

Complete Article HERE!

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