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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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This Is How Masturbating Can Transform Your Sex Life

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A relationship expert explains what it means to own your pleasure.

By Wendy Strgar

For many of us, taking responsibility for our pleasure begins with healing our relationship with our body. We may think that we can experience true pleasure only when we look a certain way. When I lose ten more pounds, I’ll deserve a little pleasure. If my tan gets a little deeper, then I’ll really be able to feel good. <

Actually, the reverse is true: Opening yourself up to more sexual pleasure will make you recognize the beauty in your body as it is, and inspire you to treat it better. And here’s the thing: If you sacrifice your access to pleasure to the false belief that sexual satisfaction will find you when you are fitter or more beautiful, you will miss out on your own life. Make a decision now to stop comparing yourself to the myriad Photoshopped images of models that even models don’t look like. Instead, dedicate yourself now to finding ways to live more deeply in your body.

Sex is something you do with your body, so how you feel about and treat your body is a direct reflection of the respect you hold for your sex life. Resolve to treat your body with a little more attention and loving kindness, and it will reward you by revealing its capacity for pleasure—sexual and otherwise.

If your body needs coaxing, there is something very simple you can do to deepen your relationship with it and explore your pleasure response: masturbate. Even with all the benefits masturbation can bring to a couple’s sex life, it is still a behavior that many people are not comfortable sharing with their partners or even talking about.

In addi­tion to the religious condemnation that has long been associated with self-pleasure, the practice was not long ago considered an affliction that medical doctors used the cruelest of instruments and techniques to control. So it’s not surprising that self-reporting of this behavior still hovers at 30% to 70% depending on gender and age.

Yet there are many benefits to a healthy dose of solo sex. First and foremost, it teaches us about our own sexual response, and personal experience is an invaluable aid when communicating with our part­ner about what feels good and what doesn’t. The practice of solo sex is helpful for men who have issues with premature ejaculation, as it familiarizes them with the moment of inevitability so that they can better master their sense of control. Masturbation can also be a great balancer for couples with a disparity in their sex drive, and solo orgasm can serve as a stress reliever and sleep aid just as well as partnered plea­sure can.

A 2007 study in Sexual and Relationship Therapy reported that male masturbation might also improve immune system function­ing and the health of the prostate. For women, it builds pelvic floor muscles and sensitivity and has been associated with reduced back pain and cramping around menses, as it increases blood flow and stimulates relaxation of the area after orgasm.

The one caveat is that masturbation, like anything else, serves us well in moderation. Becoming too obsessed with solo sex play, often enhanced by visual or digital aids, has been known to backfire and lead to loss of interest in the complexity and intensity of partner sex. There are also some forms of masturbation that can make partner sex seem less appealing because the form of self-stimulation is so different from what happens in the paired experience. If you are experiencing less desire or ability to respond to your partner, ask yourself what you can do to make your solo experience more compatible with your partner’s ability to stimulate you.

Complete Article HERE!

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Should sex toys be prescribed by doctors?

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Talk about good vibrations

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They are far more likely to be found in your bedside drawer than your local surgery, but sex toys can bring more than just benefits in the bedroom; they could boost your health too.

So should GPs stop being shy and recommend pleasure products? Samantha Evans, former nurse and co-founder of ‘luxury sex toy and vibrator shop’ Jo Divine certainly believes so. Challenging stuffy attitudes could change people’s lives for the better.

“I have encountered several doctors including GPs and gynaecologists who will not recommend sex toys because of their own personal views and embarrassment about sex. However, once healthcare professionals learn about sex toys and sexual lubricants and see what products can really help, they often change their mind.”

Samantha says increasingly doctors are seeing vibrators as the way forward for helping people overcome intimate health issues.

In 2015, she was asked to put together a sexual product brochure for the NHS at the request of Kent-based gynaecologist Mr Alex Slack. The document contains suitable sex toys, lubricants and pelvic floor exercisers that can help with a range of gynaecological problems.

But sex toys can also be beneficial for many other illnesses too, Samantha reveals.

“Often people feel their body is being hijacked by their illness such as cancer and being able to enjoy sexual pleasure is something they can take back control of, beyond popping a pill. Using a sex toy is much more fun and has far fewer side effects than medication!”

Here are just some of the reasons it’s worth exploring your local sex shop (or browsing online) to benefit your health:

1. Great sex is good for you

One area sex toys can help with is simply making sex more enjoyable, helping couples discover what turns them on.

“Having great sex can promote health and wellbeing by improving your mood and physically making you feel good. Using a sex toy can spice up a flagging sex life and bring a bit of fun into your life. A sex toy will make you feel great as well as promoting your circulation and the release of the “feel good factors” during an orgasm.”

2. Sex toys can rejuvenate vaginas

Some of the most uncomfortable symptoms of the menopause are gynaecological. Declining levels of the hormone oestrogen can lead to vaginal tightness, dryness and atrophy. This can lead to painful sex and decreased sex drive.

But vibrators can alieve these symptoms (by improving the tone and elasticity of vaginal walls and improving sexual sensation) and also promote vaginal lubrication.

Sex toys can also be useful following gynaecological surgery or even after childbirth to keep the vaginal tissue flexible, preventing it from becoming too tight and also promoting to blood flow to the area to speed up healing, says Samantha.

3. Sex toys help men too

Men can benefit from toys too, says Samantha. She says men who use them are less likely to be burdened with erectile dysfunction, difficulty orgasming and low sex drive.

“They are also more likely to be aware of their sexual health, making them more likely to notice any abnormalities and seek medical advice,” she points out.

Male products can help men overcome erectile dysfunction, following prostate surgery or treatment, diabetes, heart disease, spinal cord injury and neurological conditions by promoting the blood flow into the erectile tissues and stimulating the nerves to help the man have an erection without them having to take Viagra.

4. Sex isn’t just about penetration

There’s a reason sexperts stress the importance of foreplay. Most women just cannot orgasm through penetration alone no matter how turned on they are. Stimulating the clitoris can be the key to satisfying climaxes and sex toys can make that easier. Vibrators can be really useful for vulval pain conditions such as vulvodynia where penetration can be tricky to achieve.

“By becoming aware of how her body feels through intimate massage and exploration using a vibrator and lubricant and relaxation techniques, a woman who has vulvodynia can become more relaxed and comfortable with her body and her symptoms may lessen. It also allows intimate sex play when penetration is not possible,” says Samantha.

5. Vibrators can be better than medical dilators for vaginismus

Vaginismus, a condition in which a woman’s vaginal muscles tense up involuntarily, when penetration is attempted is generally treated using medical dilators of increasing sizes to allow the patient to begin with the thinnest dilator and slowly progress to the next size. But not all women get on with these, reveals Samantha.

Women’s health physiotherapist Michelle Lyons, says she often tries to get her sexual health patients to use a vibrator instead of a standard dilator.

“They (hopefully) already associate the vibrator with pleasure, which can be a significant help with their recovery from vaginismus/dyspareunia. We know from the research that low frequency vibrations can be sedative for the pelvic floor muscles, whereas higher frequencies are more stimulating. After all, the goal of my sexual rehab clients is to return to sexual pleasure, not just to ‘tolerate’ the presence of something in their vagina!”

Samantha Evans’ sex toy starter pack

1. YES organic lubricant

“One of the best sexual lubricants around being pH balanced and free from glycerin, glycols and parabens, all of which are vaginal irritants and have no place in the vagina, often found in many commercial sexual lubricants and even some on prescription.”

2. A bullet style vibrator

“This a good first step into the world of sex toys as these are very small but powerful so offer vibratory stimulation for solo or couples play, especially if you are someone who struggles to orgasm through penetrative sex.”

3. A skin safe slim vibrator

“A slim vibrator can allow you to enjoy comfortable penetration as well as being used for clitoral stimulation too. Great for using during foreplay or when penetration is uncomfortable.”

Complete Article HERE!

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Oncologists need to discuss sexual issues with patients, says doctor

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Dr. Anne Katz was in Windsor on May 11, 2017, to address Windsor Regional Hospital staff about cancer, intimacy and sexuality.

By Chris Thompson

A Winnipeg doctor who specializes in treating sexual issues with cancer patients is hoping to spread the word about doctors being up front with their patients.

Dr. Anne Katz held an online forum for Windsor Regional Hospital workers about cancer, intimacy and sexuality.

Katz is the author of several books dealing with the issue.

“Really the message is that sexually it is really important for people, for all of us, and I really want to encourage oncology care providers to raise the topic of it with their patients, because when we don’t talk about it, the patients thinks it’s a taboo,” said Katz.

“And 80 per cent of cancer survivors experience sexual difficulty after cancer treatment.”

Katz said doctors should be more willing to bring up sex issues with their cancer patients.

“So it really is something where we have to expose people to having that conversation,” said Katz.

“All cancers, all people, men, women, gay, straight, people recognize things aren’t going right during treatment, but all more commonly sexual problems aren’t recognized until after treatment.”

Katz said many people undergoing cancer treatment don’t realize there is an issue until later.

“Usually people during treatment are really not feeling that well, so it’s kind of on the back burner but it really is a sentinel of survivorship,” Katz said.

“People come to see me and we know certainly that most men who experience prostate cancer are going to experience erectile difficulties, most women with breast cancer often experience body issues, early menopause, or exaggerated menopausal symptoms, people with colorectal cancer have problems.”

Katz said everyone who is experiencing cancer needs to address the issue.

“It really is all cancers,” Katz said. “We’re all sexual beings, literally, from cradle to grave, whether you act on it or not.

“Even if you’re not partnered. It’s so much a part of quality of life for cancer survivors. So it goes away, there are some couples that lose that connectedness, there are some couples that use sex to make up after fights. They are fighting a lot because there is no way to resolve the fights.

“Unless oncology workers can address it and talk about it, patients are very reluctant to bring up the topic.”

Complete Article HERE!

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A ‘Hand’ Book for Male Masturbation

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The new masturbation manifesto and advice manual Better Than the Hand has a bank of spank tips that are hard to beat.

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Every one knows that May is Masturbation Month, but they may not be observing this as an occasion to improve their masturbatory skill set. That’s why it’s a stroke of genius that a new book written by author Magnus Sullivan, Better Than The Hand: How Masturbation is the Key to Better Sex and Healthier Living, was just published, tossing off a toolbox of masturbation techniques and providing meaty tips to extend these practices into partner sex (if you will).

“Even after 22 years of International Masturbation Month, we still find that so many people hold a bias against masturbation,” Good Vibrations staff sexologist Dr. Carol Queen tells SF Weekly. “How can that be a good thing, to disrespect the one sexual pleasure-focused act that everyone can access whenever they want?”

Queen’s lessons on masturbation served as the inspiration for Better Than the Hand, a volume of pocket pinball tips for men or anyone with a penis. It describes a series of hand-y steps and exercises to maintain erections for longer than 15 minutes, employing various sex toys for unique penile arousal scenarios, and using masturbation tricks to regain that erection after having already blown your load once.

“Male masturbation is a very taboo thing for us to talk about, much more so than female masturbation,” Sullivan says.

Although it’s listed now, Better Than the Hand was not always available on Amazon. The online retailer’s censors shut down access to the book once they discovered it was about male masturbation, and other websites have been similarly unreceptive.

“I can’t advertise the book on Facebook,” Sullivan tells SF Weekly. “They rejected every single ad.”

He’s been able to get out of Amazon purgatory, but not without a fight.

“They sent me a note saying, ‘Your book is currently being reviewed for explicit content,’” he recalls. “There’s no explicit content in the book. We’re talking about masturbation!”

But ‘explicit content’ may be in the eye of the beholder. After all, this is a book that contains sentences like, “If you haven’t experienced the deep, muscle-penetrating hum of a Magic Wand on your perineum, anus, and cock, then you’re living in the sexual dark ages.”

Yes, this guy is advocating that men should apply the clitoral sex toy known as the Hitachi Magic Wand not only to their own junk, but to their intimate booty regions as well.

“I got one of the most powerful orgasms I’ve ever had from the Hitachi Wand,” Sullivan tells SF Weekly. “When you use it as a man, I think it’s the closest thing you can experience that’s akin to a female orgasm, because it just kind of happens to you. It isn’t this cock-centric stroking experience, it’s just like all of a sudden there’s this welling up of sensuality, sexuality, and orgasmic sensations that result in an orgasm.”

“For me, that was an eye-opener that there’s a much bigger world out there regarding my own body,” he adds.

Needless to say, there are some pretty freaky masturbation techniques described in this book. It’s called Better Than the Hand because your hand is what you’re already using for jackin’ the beanstalk, but this book sets out to expand your rubbing-out repertoire to include a number of unconventional sex toys that many heterosexual guys would be embarrassed to admit owning.

Better Than the Hand lists and evaluates a whole range of penis sleeves, Fleshlights, cock rings, penis pumps, Tenga eggs, prostate massagers, and more. There is even a section on those humanoid sex dolls, which the sex doll-owning community prefers we refer to as “full-size masturbators.”

“Masturbation isn’t seen by 99 percent of men as a way to experiment,” Sullivan says, passionately defending these sex toys for men. “Toys can be used to manage premature orgasms, to stay hard after orgasms, and to have multiple orgasms.”

Men’s sexual problems, as Sullivan sees it, can be attributed to male masturbation being a task traditionally handled quickly, quietly, and with great shame. Men have a tendency to go straight for their own primary erogenous zone and ejaculate as quickly as possible.

That’s bad technique, and why the Journal of Sexual Medicine estimates men last, on average, 5.4 minutes during vaginal intercourse. Sullivan sets out to establish male masturbation as a “process-oriented rather than a goal-oriented activity,” with specifics strategies to enhance the four separate identifiable stages of Excitement, Plateau, Orgasm, and Resolution.

In doing so, men can enhance not only their quality of sex but also their personal health. The book argues that masturbation has specific male health benefits, like reducing the risk of prostate cancer, boosting the immune system, and improving the quality of your sleep.

But most importantly, coming to grips with your masturbating habits — and being able to talk about them — can make men better lovers, and less chauvinistic as people.

“As men explore their own bodies, they’re also becoming much more skillful, knowledgeable, sensitive lovers,” Sullivan says. “When you have sexual identity and sexual behavior being constrained or restricted, it leads to a problem of toxic male sexuality.”

This toxic male sexuality has been seen in the headlines around Brock Turner, the Stanford student who assaulted an unconscious woman, or with our pussy-grabbing president. Having produced both straight and gay adult films for more than 20 years, Sullivan sees toxic male sexuality as a primarily straight male phenomenon.

“Most gay men have come to terms with what it is to be sexual,” he tells SF Weekly. “Most straight men aren’t dealing with questions like that, so they never develop the vocabulary, the empathy, or the emotional intelligence to have these subtle interactions.”

A lack of empathy or emotional intelligence can be seen in the pornography that straight men watch, and why this porn profoundly bothers their female partners.

“The biggest fantasy of most straight men is fucking some 18-year-old girl in the ass,” says Sullivan, who also manages an online porn streaming platform. “By far, the largest-watched category of porn is anal sex with young models.”

It might be fair to say this represents arrested emotional development among porn-watching straight men. But it also represents a psychological toll for their female partners, creating body-image issues and a sense of betrayal over how the porn-consuming straight guy prefers these adult-film starlets.

Men forget that feeling desired is a primary erotic trigger for many women, and that to desire someone else may feel like a violation of the couple’s intimacy. This sense of violation can also play out when masturbation or porn interferes with a guy’s ability to get erections.

“The desire thing is probably linked to the way some women freak out when their male partners can’t get erections on demand,” Queen says. “It feels like the cock is the barometer of desirability. It’s fucked up, but there it is.”

Better Than the Hand addresses many of the sticky topics that surround male masturbation, and it has some dynamite chapters on communicating masturbatory habits and the use of toys for couples, plus a detailed script for an outrageously hot mutual-masturbation scenario.

But the book’s main thrust is to give men a curiosity on how to make their dick work better, and how masturbating is key to this process. As so capably said by our long-lost muse Whitney Houston, “Learning to love yourself, it is the greatest love of all.”

Complete Article HERE!

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