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How to Have a Sex Life on Antidepressants

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

By Shannon Holcroft

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

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

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

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

Why Antidepressants May Be a Downer for Your Sex Life

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

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

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

How to Work Around the Side Effects

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

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

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

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

1. Time It Right

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

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

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

2. Switch It Up

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

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

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

3. Augment

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

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

4. Exercise

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

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

Complete Article HERE!

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Reality Check: Anal Sex

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First it was shocking, then it was having a cultural moment, now it’s practically standard in the modern bedroom repertoire—or so a quick scan of any media, from porn to HBO, will tell you. But the reality about anal is not, actually, that everyone’s doing it, says research psychoanalyst and author Paul Joannides, Psy.D., whose comprehensive book on sexuality, The Guide to Getting it On!, is used in college and medical school sex-ed courses across the US and Canada. The book is amazing not just for its straight-up factual information on practically any aspect of sex you can think of, but also for its easy, nonjudgmental, at-times humorous tone.

The CDC reports that the number of heterosexual men and women who’ve tried it vacillates between 30 and 40 percent (oddly, the CDC doesn’t report on how many homosexual men have tried it, except in a statistic that weirdly combines it with oral). If anal turns you on, you are definitely not alone, but its prevalence doesn’t change the fact that it’s the riskiest sexual behavior in terms of HIV and other STDs. Here, Joannides talks us through the realities of making anal both as safe and as pleasurable as possible.


A Q&A with Paul Joannides, Psy.D.

Q

When did heterosexual anal start to become a thing?

A

In the 80’s, I remember hearing from a friend that he had a videotape of anal porn. This seemed shocking at the time. (This was pre-Netflix: Everything was on videotape, from porn to Disney movies to highlights from the Olympics. Video rental stores were everywhere.) I’m not sure there are too many middle schoolers today who would be shocked or even surprised to watch anal sex on Pornhub or Xhamster.

Since porn became as easy to access as YouTube, porn producers have had to fight for clicks, and so porn has become more extreme. I’d say that by 2005, porn had totally blurred the distinction between a woman’s anus and vagina. This wasn’t because women were begging their lovers for anal, it’s because porn producers were afraid you’d click on someone else’s porn if they weren’t upping the ante in terms of shock value.


Q

Does the popularity of anal in porn reflect reality in both homosexual and heterosexual couples?

A

No. There are some couples who enjoy anal sex a lot, maybe 10 percent to 15 percent of all straight couples. But if you ask them how often they have anal vs. vaginal intercourse, they’ll say maybe they have anal one time for every five or ten times they have vaginal intercourse. We occasionally, as in once a year, hear from women who say they have anal as often as vaginal, but that’s unusual.

As for gay men, statistics vary widely, and studies aren’t always consistent in how they collect data—some might be looking at different levels of frequency, i.e. have you had anal once in the past year, or do you have it regularly? I’ve seen studies suggesting that 65 percent of men have anal sex, and others that suggest the figure is less than 50 percent. So, I don’t have exact figures for hetero or homosexual couples, but there is data suggesting that a good percentage of gay men would rather give and receive blowjobs than have anal sex.


Q

How should we modify the anal sex we see modeled in porn to best suit an in-real-life couple?

A

The way the rectum curves shortly after the opening tells us we need to make a lot of adjustments for anal to feel good. Also, the two sets of sphincter muscles that nature placed around the opening of the anus to help humans maintain their dignity when in crowded spaces (to keep poop from dropping out) mean there’s an automatic reflex if you push against them from the outside.

So one of the first things a woman or man needs to do if they want to be on the receiving end of anal sex is to teach their sphincter muscles to relax enough that a penis can get past their gates. This takes a lot of practice.

Also, unlike the vagina, the anus provides no lubrication. So in addition to teaching the sphincters to relax, and in addition to getting the angle right so you don’t poke the receiver in the wall of the rectum, you need to use lots of lube.

They show none of this in porn. Nor do they show communication, feedback, or trust. Couples who do not have excellent sexual communication, who don’t freely give and receive feedback about what feels good and what doesn’t, and who don’t have a high level of trust should not be having anal sex.


Q

What are the health risks of anal?

A

A woman has a 17-times-greater risk of getting HIV and AIDS from receiving anal intercourse than from having vaginal intercourse. So your partner needs to be wearing a condom and using lots of lube, unless both of you are true-blue monogamous, with no sexual diseases. Any sexually transmitted infection can be transmitted and received in the anus. Because of the amount of trauma the anus and rectum receive during anal intercourse, the likelihood of getting a sexually transmitted infection is higher than with vaginal intercourse.

Unprotected anal sex, regardless of whether it is practiced by straight or gay couples, is considered the riskiest activity for sexually transmitted diseases because of the physical design of the anus: It is narrow, it does not self-lubricate, and the skin is more fragile and likely to tear, allowing STDs such as HIV and hepatitis easy passage into the bloodstream.


Q

Are those risks all mitigated by the use of condoms and lube, or are there still issues, even beyond that?

A

The risks are substantially reduced by the use of condoms and lube as long as they are used correctly, but you won’t find too many condoms that say “safe for anal sex” because the FDA has not cleared condoms for use in anal sex. That said, research indicates that regular condoms hold up as well as thicker condoms for anal sex, so there’s nothing to be gained from getting heavy-duty condoms.

As for using the female condom for anal sex—studies report more slippage and more pain than with regular condoms.

Do not use numbing lube, and do not have anal sex while drunk or stoned. Pain is an important indicator that damage can occur if you don’t make the necessary adjustments, including stopping. If there is pain, perhaps try replacing a penis with a well lubed and gloved finger. The glove will help your finger glide more easily, and might be more pleasurable for the person on the receiving end. Also, this allows a woman to do anal play on a male partner. (When it comes to anal sex, what’s good for the goose should be good for the gander.)


Q

Are there known health consequences of anal practiced over the long-term? Can you do it too much?

A

One of the urology consultants for my book believes that unprotected anal sex can be a way for bacteria to get into the man’s prostate gland. He prefers the person with the penis that’s going into the other person’s butt use a condom.

Also, small chunks of fecal matter can lodge into the man’s urethra. So if the couple has vaginal intercourse following anal intercourse without a condom, the male partner should pee first in addition to washing his penis with soap and water.


Q

Do pre-anal enemas make a difference in terms of health safety? What about preventing accidents?

A

I know of no studies on the relationship between pre-anal enemas and health outcomes. As for its general wisdom, people seem as divided on that as on politics in Washington. So I would say, to each her own. Also, some people use a “short shot,” which is a quick enema with one of those bulb devices instead of using a bag and going the full nine yards. In any case, accidents are likely to happen at one time or another.


Q

What tests should people be getting if they practice anal?

A

There’s “should” and there’s reality. If I were on the receiving end of anal sex, I would want to be sure my partner did not have HIV before I’d even let him get close to my bum with his penis.


Q

Probably more people try anal today than in the past—are there ways to make a first experience a good one?

A

Both of you should read all you can about it first. Spend a few weeks helping the receiving partner train her/his anal sphincters to relax. Make sure you and your partner have great sexual communication, trust, and that you both want to do it, as opposed to one trying to pressure the other, or not wanting to do it but doing it because you are afraid your partner will find someone else who will. Do not do it drunk or stoned, and do not use lube that numbs your anus. If it doesn’t feel good when it’s happening, stop.


Q

Do people orgasm from anal stimulation? Is it common or uncommon?


A

Some women say they have amazing orgasms from anal, but usually they will be stimulating their clitoris at the same time.


Q

Does it usually take a few tries to enjoy anal? Are there positions that make it easiest?

A

It depends on how much you are willing to work on training the receptive partner’s anal sphincters to relax, how good your communication is, how much trust there is, and probably on the width or girth of the dude’s penis. Common sense would tell you it should go way better if a guy is normal-sized as opposed to porn-sized.


Q

What should we be telling our kids about anal?

A

We don’t tell them about the clitoris, about women’s orgasms, about masturbation, about the importance of exploring a partner’s body, and learning from each other. We don’t tell them that much of what they see in porn is unreal, and we don’t talk to them about the importance of mutual consent. So I don’t see anal being at the top of most parents’ “should talk to our kids about” lists. There are more important things we need to be talking about first.

Paul Joannides, Psy.D. is a psychoanalyst, researcher, and author of the acclaimed Guide to Getting it On!, which is now in its ninth edition and is used in college courses across the country. He’s also written for Psychology Today Magazine and authors his own sex-focused blog, Guide2Getting.com. Dr. Joannides has served on the editorial board of the Journal of Sexual Medicine and the American Journal of Sexuality Education, and was granted the Professional Standard of Excellence Award from The American Association of Sex Educators, Counselors and Therapists. Joannides also lectures widely about sex and sexuality on college campuses.

Complete Article HERE!

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Men feel sad after sex too, say researchers

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Post-coital blues is a real thing

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While orgasms are (rightly) highly sought after, feeling an unexplainable sadness after sex is something a lot of women experience sometimes. But what many people don’t realise is that the same thing can happen to men.

A group of researchers at Queensland University of Technology suggest that making love can make men occassionally depressed. So depressed in fact, that they suffer something called post-coital dysphoria (PCD).

“Everyone assumes what happens in the bedroom is normal but there are a wide range of responses in the period of time immediately following consensual sexual activity, known as the resolution phase,” explains Robert Schweitzer, study author and a professor at QUT.

“For example, some people like to cuddle, others like to be alone and there are others, as we have found in previous research that experience what is described as post-sex blues.”

He noted that most of the time, the period just after sex elicits good feelings. But it’s also pretty common for some individuals to feel melancholy or tearful after the act.

While researchers seem stumped about the true cause of PCD, some suggest post-sex blues could be the result of negative emotions coming to the surface after an orgasm (or lack of one). But Schwitzer is determined to find out for sure. He’s now recruiting participants for a new study which will survey men and women (of all sexual orientations) to explore their experience directly after sex.

“There is anecdotal evidence that postcoital dysphoria is not uncommon in both men and women. If we can better understand what is happening in the bedroom and the prevalence of post-sex blues, we can start looking at causes and possible solutions,” he added.

Complete Article HERE!

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SEXUAL HEALTH:

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A fake life is an unhappy life

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

By JOACHIM OSUR

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

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

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

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

COMMON PROBLEM

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

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It’s time to get to know your body

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Understanding your body is essential to building healthy relationships with others and yourself

Understanding your body does not require a medical degree and is integral to your overall wellness.”

By Sky Jordan

Bodies do some pretty astonishing things. Everything from love to sex to reproduction is such a personal experience, and each experience means a different thing to each person. It is extraordinary when you consider all the experiences your body has allowed you to have and will allow you to have.

However, in order to understand these magnificent experiences, we need to gain a better understanding about our bodies as a whole. This will allow us to create and facilitate healthy sexual experiences and make healthy decisions about our bodies.

Sexual education does not stop at high school or middle school, it should continue in college. ASU provides STI testing to students, but not much is provided for students who do not have extensive sexual education. Of the programs provided at ASU, most are centered around sexual assault and not exactly sexual health.

Educating yourself about your body can include anything from reading about your anatomy to sexual exploration. It’s a personal learning experience, and it’s up to you to decide how you do it and with whom you share it.

Many people believe that their bodies are too complex and intricate that they are impossible to understand without a medical degree.

For example, it’s a common expectation for women to orgasm via penetration alone, when in fact this is only possible for 25 percent of women. Similarly, many people do not know that men have a G-spot. There countless other misconceptions about anatomy and sexuality that can curb positive sexual experiences.

It’s exceptionally important to learn about our bodies. We can’t expect to have good sex lives if we do not understand how our bodies function.

Knowing and understanding one’s body can be really overwhelming and difficult for some. A lot of people are very reserved when it comes to sex, which is completely okay.

However, it’s important to note that sex is a major facet of life. Becoming more comfortable with your sexuality by understanding and learning about your body can create positive sexual experiences and positive body image. If we learn about our bodies we can get rid of common misconceptions and construct healthier expectations.

“‘Normal’ has a wide range of possibilities,” Dr. David Glassman, an OB/GYN and member of the Phoenix OB/GYN Society, said. “Having knowledge of your body plays a role in feeling comfortable with yourself and (your) sexuality as well.”

Every person’s body is different. We can more easily celebrate this by learning about our bodies and understanding that our bodies do not have to look a certain way.

This will ultimately lead to more accepting and loving attitudes toward ourselves. Having a healthy body image will positively influence every aspect of your life — including sex.

If we know our bodies, we can learn what feels good. This will enable us to communicate more effectively with our partners. As a result, we can develop healthier sexual relationships in which each partner feels fulfilled.

“As time has gone on sexuality has opened up a lot and has become more acceptable. People are much more comfortable talking about it. The more you know and understand the safer (your experiences) will be,” Glassman said.

Educating ourselves on this subject will also teach us about sexual experiences we do not feel comfortable with. This will allow us to prepare for when these situations arise, so that we can make healthy decisions and be able to accurately give and receive consent.

Learning and exploring our bodies will allow us to foster healthier body images, healthier sex lives and healthier relationships.By understanding ourselves and how our bodies work we can begin to construct more fulfilling lives and experiences as a whole.

Complete Article HERE!

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