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Parents struggle to discuss sex with LGBTQ teens

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It’s hard enough for parents to have “the talk” about sexual health with their kids, but parents of LGBTQ children feel especially uncomfortable and unequipped when they try to educate them about sex and dating, reports a new Northwestern Medicine study.

The study examined parents’ attitudes toward talking about with their lesbian, gay, bisexual, transgender and queer teens (LGBTQ).

“Parents play an important role in helping their children learn how to have healthy sexual relationships, but they really struggle when discussing this with their LGBTQ teens,” said lead author , an assistant professor of medical social sciences at Northwestern University Feinberg School of Medicine.

In contrast to heterosexual youth, very little research has previously been conducted on the relationships between LGBTQ youth and their parents, and how parenting can affect children’s sexual behaviors.

Parents in the study reported that they face many challenges when trying to educate their LGBTQ children about sex. These challenges include general discomfort with talking about sex with their children, as well as feeling unequipped to provide accurate advice about what constitutes safe LGBTQ sexual practices.

“My challenge around talking about sex is that I have no idea what sex is really like for men, especially for gay men,” commented one mother in an online focus group.

Another parent sent her bisexual daughter to a lesbian friend to talk to her about “gay sex.”

“I felt challenged that I’m straight, my daughter is dating a gal, and I didn’t know anything about that,” the mom said. “All my sex talks were about how not to get pregnant and how babies aare conceived.”

One parent reported feeling isolated in handling sex talks with her gay child. “I don’t have an opportunity to talk to other parents whose kids are LGBTQ,” she said.

“We need resources to help all parents—regardless of their child’s sexual orientation or gender identity—overcome the awkwardness and discomfort that can result from conversations about sexual ,” said Newcomb, associate director for scientific development at the Institute for Sexual and Gender Minority Health at Feinberg.

The Institute for Sexual and Gender Minority Health conducted the survey examining attitudes toward talking about sexual health from the perspective of parents of LGBTQ teens.

The study was published March 26 in the journal Sexuality Research and Social Policy. There were 44 participants in the study who were parents of LGBTQ adolescents ages 13-17.

“Having a healthy and supportive relationship with parents is one of the strongest predictors of positive health outcomes in teens, and this is true of both heterosexual and LGBTQ teens,” Newcomb said. “Many parents and their LGBTQ teens want to have supportive relationships with one another, so if we can design programs to strengthen these relationships, it could have a tremendous impact on LGBTQ teens’ health and well being.”

The Institute also recently published a separate study in the Archives of Sexual Behavior focused on talking about sex from the perspective of LGBTQ adolescents.

“We found that many of the gay and bisexual male youth in our study wanted to be closer to their parents and to be able to talk about sex and dating,” said lead author Brian Feinstein, a research assistant professor at the institute. “However, most of them said that they rarely, if ever, talked to their parents about sex and dating, especially after coming out. And, even if they did talk about sex and dating with their parents, the conversations were brief and focused exclusively on HIV and condom use.”

Participants in the youth study were ages 14-17 and identified as gay or bisexual males.

Brian Mustanski, director of Institute for Sexual and Gender Minority Health and professor of medical social sciences at Feinberg, noted, “Research on family relationships is a high priority for us because it is an extremely understudied area, and parents are asking us for advice. We need new research to give these the right answers.”

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8 Things Doctors Wish You Knew About Dyspareunia, AKA Painful Sex

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Yup, we mean the bad kind of pain.

Pop culture’s depictions of sex typically focus on the romantic, the salacious, and (in some refreshing cases) the embarrassing.

But one thing that’s still rarely mentioned—both on screen and IRL—is pain during sex (also known as dyspareunia), or the shame, confusion, and stigma that often accompany it. (And we’re not talking about the good, consensual kind of pain during sex, FYI, we’re talking about sex that hurts when you don’t intend it to.)

While dyspareunia may be absent from many sexual-health discussions, it’s not rare, and it’s certainly nothing to be ashamed of. Here, doctors walk us through what they wish more people knew about painful sex:

1. Unfortunately, pain during intercourse isn’t that rare. In fact, it’s really common.

Nearly 75 percent of women will experience pain during sex at some point in their lives, according to the American College of Obstetrics and Gynecologists (ACOG). Sometimes, this pain will be a one-time thing. Other times, it will be more persistent.

2. The thing is, sex isn’t supposed to hurt unless you want it to.

Some people accept painful sex as the norm, but it shouldn’t be. “The most crucial thing for women to know is that pain during or after intercourse is never really OK,” Antonio Pizarro, M.D., a Louisiana-based gynecologist specializing in pelvic medicine and reconstructive surgery, tells SELF. There are, of course, some circumstances in which someone might seek out some level of pain during sex. But there’s a difference between a sexual kink and undesired, severe, or persistent pain in the vulva, vagina, or pelvis.

3. Minor soreness during or after sex and intense, chronic pain are not the same thing.

There are tons of reasons you might be sore after sex, Natasha Chinn, M.D., a New Jersey-based gynecologist, tells SELF. They include inadequate lubrication, penetration with a particularly large object or body part, and sex that was especially rough or fast.

If these are minor issues you only encounter every now and then, Dr. Chinn says you can usually pinpoint the cause of the problem and address it on your own (use more lube, seek out smaller sex toys, or have slower, more gentle sex). (Of course, you can go straight to seeing a doctor if you prefer.)

But what if your problem isn’t an every-now-and-then thing? If these issues are happening every time you have sex, happening more frequently than they used to, or if they’re not going away after you try to address them on your own, your painful-sex cause might be more complicated.

4. Unfortunately, there are a ton of health conditions—like endometriosis, cervicitis, and vaginismus—that can lead to painful sex.

Some of these include:

  • Contact dermatitis: a fancy medical name for an allergic reaction on the skin—and yes, that includes the skin on your vulva. This can happen if, say, the delicate skin around your vagina doesn’t react well to a soap, body wash, or detergent you’re using. Contact dermatitis can leave your skin cracked and uncomfortable, and chances are that any kind of sex you’re having while you’re experiencing this reaction is going to be pretty painful.
  • Cervicitis: a condition where the cervix, or lower end of the uterus connecting to the vagina, becomes inflamed, typically due to a sexually transmitted infection. While it often presents without symptoms, Dr. Pizarro cautions that it sometimes causes pain during urination or intercourse.
  • Endometriosis: a condition associated with pelvic pain, painful periods, and pain during or after sex. While the exact cause of endometriosis is not well understood, it seems to be the result of endometrial tissue (or similar tissue that’s able to create its own estrogen) growing outside of the uterus, which can cause pain, scarring, and inflammation. This can lead to pain that’s sometimes worse around your period, when going to the bathroom, and even during sex.
  • Ovarian cysts: fluid-filled sacs found in or on the ovaries. Sometimes they don’t cause any symptoms, but other times they rupture, causing pain and bleeding, including during sex.
  • Pelvic inflammatory disease (PID): this condition is typically caused when bacteria from a sexually transmitted infection spreads to the reproductive organs. PID can cause pain in the abdomen or pelvis, pain during urination, pain during intercourse, and even infertility if left untreated.
  • Uterine fibroids: noncancerous growths in or on the uterus. Fibroids often don’t cause symptoms, but they can make themselves known via heavy menstrual bleeding and pelvic pressure or pain, during sex or otherwise.
  • Vaginismus: a condition that causes the muscles of the vagina to spasm and contract. This can lead to pain during sex—or even make any form of vaginal penetration impossible, whether it’s sexual or just inserting a tampon.
  • Vaginitis: an umbrella term for disorders that inflame the vaginal area. Examples include bacterial vaginosis and yeast infections, both of which occur when the balance of microorganisms in the vagina gets thrown off, causing some kind of bacterial or fungal overgrowth. Other forms of vaginitis are sexually transmitted infections such as trichomoniasis (an STI caused by a parasite), chlamydia, and gonorrhea. All three of these infections are characterized by changes in vaginal discharge, vaginal irritation, and, in some cases, pain during intercourse.
  • Vulvodynia: a condition charactized by chronic pain at the opening of the vagina. Common symptoms include burning, soreness, stinging, rawness, itching, and pain during sex, Dr. Chinn says, and it can be devastating. According to the Mayo Clinic, vulvodynia consists of pain that lasts for at least three months that has no other identifiable cause.

Dr. Chinn says that women going through menopause might also experience pain during sex as a result of vaginal dryness that happens due to low estrogen levels.

People who recently gave birth may also grapple with discomfort during sex, Dr. Chinn says. It takes time for the vagina to heal after pushing out a baby, and scar tissue could develop and make sex painful.

5. There are so many other things that can mess with your sexual response, making sex uncomfortable or legitimately painful.

Any negative emotions—like shame, stress, guilt, fear, whatever—can make it harder to relax during sex, turning arousal and vaginal lubrication into obstacles, according to ACOG.

Of course, the source of these negative emotions varies from individual to individual, Dr. Pizarro says. For some, it’s a matter of mental health. Feeling uncomfortable in your body or having relationship issues might also contribute.

In an unfair twist, taking care of yourself in some ways, like by using antidepressant medication, blood pressure drugs, allergy medications, or some birth control pills, can also cause trouble with lubrication that translates into painful sex.

6. You shouldn’t use painkillers or a numbing agent to try to get through painful sex.

This might seem like the best way to handle your pain, but Dr. Pizarro cautions against it. Your body has pain receptors for a reason, and by numbing them, you could end up subjecting your body to trauma (think: tiny tears or irritation) without realizing it—which can just leave you in more pain.

7. If you’re not ready to see a doctor yet, there are a few things you can try at home, first.

According to ACOG, a few DIY methods might mitigate your symptoms:

  • Use lube, especially if you feel like your problem is caused by vaginal dryness.
  • Apply an ice pack wrapped in a towel to your vulva to dull a burning sensation when needed.
  • Have an honest conversation with your partner about what’s hurting and how you’re feeling. Let them know what hurts, what feels good, and what you need from them right now—whether that’s a break from certain sex acts, more time to warm up before you have sex, or something else.
  • Try sex acts that don’t involve penetration, like mutual masturbation and oral sex, which may help you avoid some of the pain you typically experience.

It’s totally OK to experiment with these things, Dr. Pizarro says, especially if they help you associate sex with something positive. But these tactics cannot and should not replace professional care.

8. If you’re regularly experiencing painful sex, you should talk to a doctor.

It’s really up to you to decide when to see a doctor about painful sex. “It’s like a cold,” Dr. Pizarro says. “If you’ve got a little cough, you might be all right. But if you have a cough and fever that haven’t gone away after a few days, you might want to see a doctor.” When in doubt, mention your concerns to your care provider, especially if any of these sound familiar:

  • Sex has always been painful for you
  • Sex has always been painful but seems to be getting worse
  • Sex is usually pain-free but has recently started to hurt
  • You’re not sure whether or not what you’re experiencing is normal, but you’re curious to learn more about painful sex

When you see your doctor, they’ll likely ask questions about your medical history and conduct a pelvic exam and/or ultrasound. “It’s important for doctors to ask the right questions and for patients to voice concerns about things,” Dr. Pizarro says.

From there, your doctor should take a holistic approach to treatment to address the possible physical, emotional, and situational concerns. “You really have to look at the total person,” Dr. Chinn says. Treatment options for painful sex vary wildly since there are so many potential causes, but the point is that you have options. “Many people think that it’s acceptable to experience pain during intercourse,” Dr. Pizarro says. “Use your judgment, of course, but it probably isn’t acceptable. And it can probably be made better.”

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Masturbation hacks and consent advice: how YouTubers took over sex education

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With UK schools increasingly falling short, vloggers such as Hannah Witton and Laci Green have stepped up to offer guidance on everything from body confidence to sexual pleasure

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When Lily was at school, she remembers the boys and girls being separated for a sex education class. The boys were given one booklet; the girls another. “In the boys’ booklet, there was a section on masturbation and there wasn’t in the girls’ booklet,” she says. “A girl put her hand up and said: ‘Why don’t we have that?’ and one of the teachers said: ‘Girls don’t do that, that’s disgusting.’ It shouldn’t be a shameful thing to talk about. It can be a bit awkward and embarrassing, but we should be talking about it.”

Afterwards, Lily, who is now 19 and identifies as bisexual, went online and discovered sex education videos on YouTube, particularly those made by a young woman, Hannah Witton. “Within my friendship group it has really opened up a conversation about things you don’t normally discuss,” she says. “In schools, LGBT sex ed is just not talked about. Sex was never discussed as a pleasurable thing, especially for women.” Magazines such as Cosmopolitan filled some of her knowledge gaps, she says, but most of her sex education has come from Witton.

YouTube sex educators are increasingly popular, and for the young people I speak to, such videos are where almost all their information about sex now comes from. Witton, who is 26 and British, is incredibly popular, with 430,000 subscribers to her YouTube channel and videos racking up millions of views. Why Having Big Boobs Sucks! has received 3.5m views; 10 Masturbation Hacks has had 1.2m. In the US, Laci Green has 1.5 million subscribers and her videos on, among many topics, nudity, vaginas, foreskins and pubic hair reach millions. There are several other hugely successful sex-ed vloggers, such as Shan Boody and Dr Lindsey Doe. In Poland, where sex education was recently removed from schools, young people are turning to vloggers such as Natalia Trybus, while the model Anja Rubik and a women’s rights organisation, Dziewuchy Dziewuchom, have also launched a series of sex education videos on YouTube.

Hannah Witton talks about masturbation on YouTube.

Amy, 16, says these videos are where almost all of her sex education has come from. “I only really started being given proper sex education in year 10 or 11, when I was about to leave school.” It would have been helpful to have had it earlier, she says. She started watching Witton’s videos when she was about 12. “Everyone around me seemed to understand sex stuff and I was completely clueless,” she says. What did she find most helpful? “Quite a lot of it was her masturbation videos. She presents it in a very positive way – female masturbation is a controversial subject when it shouldn’t be. It helped me understand that side of things. If I had questions, I could probably go on her channel and scroll back and see if she’d posted on it. I’m not that sexually active but I feel like I’m more understanding of what [happens]. I feel a bit more confident because I’ve learned about it in a way that isn’t porn. It’s helped me become more sex positive. It helps me feel like I can talk about it with my friends, whereas before it was like: ‘I can’t talk about that even though everyone’s going through it.’” Has it made it easier to talk to her parents, too? “A little bit,” she says.

It is not surprising that young people are turning to the internet for information, says Lisa Hallgarten, policy manager at Brook, the sexual health and education charity. “Partly because they get everything from the internet. But there is also the fact that in schools they’re just not getting what they need. Even in schools where they’re trying to do a good job, young people aren’t getting the information they need, when they need it. Young people are saying: don’t talk to us about contraception when we’re 17, because some of our friends are already pregnant.”

At the moment, personal, social, health and economic education (PSHE) – in which sex education is often included – is not a statutory part of the curriculum in the UK, although schools are expected to provide it. Last year, the Department for Education announced that relationships and sex education (RSE) would be compulsory in all secondary schools, and an eight-week consultation on what should be included recently ended; the guidance has not been updated since 2000, during which time children have had to face then-unheard of things such as sexting, cyberbullying and access to online pornography. “What we would like is for RSE to be a mandatory part of PSHE and for PSHE to be a statutory subject and taught as a timetabled lesson,” says Hallgarten.

Some aspects of sex education are compulsory and taught in science classes. However, parents have the right to remove their children from RSE. “Most parents want RSE for their children but we are worried that those who get withdrawn are possibly the most vulnerable and the least likely to be in households where they get that information from their parents,” says Hallgarten. “They may well resort to looking on the internet of their own accord, and in that case more power to the vloggers. I think there are good vloggers and mediocre vloggers. Some of what people see will be misinformation. I think vlogs should be a supplement, not a replacement to classroom teaching.”

As it is, many teachers are not supported well enough to deliver great sex education lessons, she says. “I think there are a lot of teachers who feel awkward about talking about any aspect of RSE and that’s why we are lobbying hard to make it a real subject and provide real training. There are teachers who really love doing it and are really excellent, but lots of teachers don’t want to do it. If they feel awkward talking about it then it’s not really helpful for young people.” As Amy puts it: “Sex education isn’t seen as a positive thing. It’s seen as cringey. [Watching YouTubers] where it’s people who are only a little bit older than us and not like 40-year-old teachers, it might help people understand it better.”

Hallgarten identified particular areas in which conventional RSE is lacking. “Things like talking about sexual pleasure is something that lots of teachers would really shy away from. They are told about unhealthy relationships but they often don’t have a good model for what a healthy sexual relationship would look like. The vast majority of people will have sex at some point in their life and we hope that it will be a nice experience, but we don’t talk about that. That’s one of the things young people go online to try to understand.”

Some teachers have started even using YouTube sex-ed clips in a classroom setting. “We use a lot of the vloggers in our work,” says Eleanor Draeger, senior RSE trainer at the Sex Education Forum. “We go out and train teachers and show them a wide range of different resources they can use in their classrooms, and one of the resources is vlogs. The idea is that the teacher chooses the things they think will work with the students in their class.” Many of the topics might not be appropriate for secondary school age children; some of the most popular sex education videos are on topics such as encouraging stripping, and the use of sex toys and porn.

“One of the ways we might recommend using a vlogger is we show the video on whichever subject you’re teaching and then the teacher can explain anything the students didn’t understand or expand on the topic. If you were only getting your sex education from [videos] you might not get a rounded sex education. Having said that, I think they’re fantastic as an adjunct and I wish that kind of thing had been around when I was younger.”

Witton launched her first sex education video in January 2012 (she had been posting videos on YouTube for some time before that). It was a video on contraception, presented with a friend. “Sex education is pretty crap, at least in the UK,” she said in it, “so I wanted to make a mini series of sex education videos that hopefully you guys will enjoy and learn some stuff.” That “mini series”, as she endearingly described it, presented and filmed without her more recent polish, has turned into dozens of videos, millions of viewers, a book, and a full-time job as a YouTube star. Witton is smiley and chatty and presents her videos from her flat. She has covered sex toys, hormones, masturbation, porn, consent and open relationships (she doesn’t only talk about sex and relationships – in recent weeks she has been talking about undergoing surgery for ulcerative colitis and what it is like to live with a stoma).

“I was very much inspired by Laci Green in the US,” she says, “and I decided I wanted to start making content about that because I noticed that most of my audience were young women. I felt like I wanted to do something. In terms of my personal experience, [sex education] was very much lacking in school. I had more of an open household so I could talk to my parents, in theory. I remember meeting people once I got to sixth form, who had maybe been to a different school from me or had a different upbringing, who didn’t know some stuff I thought was really basic. I met someone who thought it was totally fine to not use a condom and just pull out. I was like, ‘nooo’.”

She is direct and funny. “I genuinely feel no awkwardness at all. It was one of the reasons I felt like it would be a good idea to start making videos like this, because I know some people don’t feel comfortable talking about these things. If I have a platform and I’m OK talking about them, I can use that platform for good.”

The videos that have done particularly well, she says, include those on masturbation, “especially female masturbation, which for some reason is still taboo. A lot of people either don’t want to admit it’s happening or feel too ashamed to talk about it. There is a general shame and stigma around that topic, in terms of actually doing it but also talking about it.”

Her main audience is women aged between 18 and 24, with 25- to 34-year-olds the next biggest group. People have to be 13 to have a YouTube account (or say they’re 13, and there will be many people who watch without an account) but the 13-17 age bracket makes up just 6% of her audience. Witton, who is an ambassador for Brook, is careful about accuracy. Are there sex education vloggers who are spreading misinformation? “I couldn’t [think of any] off the top of my head, but it’s the internet, so yeah.”

Does she feel that for many young people, she’s their main provider of sex education? “That feels like a lot of pressure, but I’m always really clear that I’m not a doctor. I like to think of my videos as a conversation-starter and from there people’s curiosity can lead them to other bits of information if they want to look into it further. I don’t want to ever take a didactic approach of ‘I’m the teacher’. It’s more of a peer-to-peer education thing.”

In the US, Green started making videos at university. Growing up as a Mormon, her only sex education at school was around abstinence. “A lot of the teenagers in my community just didn’t have the information and resources they needed, so I was a bit miffed about that. I didn’t really ever get sex ed in school. It was only in college, which for me was much later – I’d started having relationships, dating, having sexual experiences. I felt it was too late.” Her videos, she says, felt like “a good platform to have a conversation with other people who thought the same way I did and to share information. As I was trying to figure this stuff out, I was getting the information I needed and sharing it online.”

Around 60% of Green’s subscribers are young women. “I think a lot of the problems we struggle with in society fall around misogynistic ideas around women’s bodies and about relationships, and this is what women are supposed to be and this is what men are supposed to be, which feeds into homophobia and transphobia as well.”

She says around two-thirds of the people who contact her have had no sex education at school, or abstinence-based lessons. “Then the other third did have sex ed but didn’t have all their questions answered. I think a lot of people are awkward about sex. A lot of teachers in the US don’t know how to answer these questions, they’re very restricted in what they can say or do and that makes it really hard for them to have an honest relationship with their students.”

Thea, 19, started watching sex education videos by Green and then found Witton’s. “I definitely got most of my sex ed from YouTube videos,” she says. “Which is sad, because some of this stuff should be taught in school to educate young teenagers properly about sex, but also about the gender and sexuality spectrums. My parents weren’t a lot of help either. It’s really awkward to talk to them about that stuff and they’re another generation so they don’t even know most of it.” She says YouTube videos have changed the way she thinks about sex, sexuality (she identifies as “queer”) and herself. “I feel a lot more confident about my body and I feel a lot more comfortable talking about sex. I probably wouldn’t have been able to actually come to terms with my sexuality if it wasn’t for YouTubers talking about theirs so openly. Online, people aren’t as reluctant to talk about sex, their sexuality and their gender any more, and that’s beginning to be the case in the real world as well, which is awesome.”

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When the Cause of a Sexless Relationship Is — Surprise! — the Man

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There are varying definitions of a sexless marriage or sexless relationship: no sex in the past year, no sex in the past six months or sex 10 or fewer times a year. According to one study, approximately 15 percent of married couples are sexless: Spouses haven’t had sex with each other in the past six months to one year.

I was once in a sexless relationship.

I have debated admitting this publicly, but my story feels different than the narrative advanced by our patriarchal society. Why? Because I was the one begging for sex from an uninterested male partner. Sex 10 times a year would have been 10 times more than what I was having.

This topic comes up a lot in my work. As a gynecologist, I’m frequently asked about the “right number” of times to have sex a month. The answer is that there isn’t one. If both people are truly happy, then it’s a healthy sex life.

I understand the confusion about frequency. Messaging around sex is everywhere: It’s used to sell almost everything, and news articles remind us that various hormones and neurotransmitters may spike in response to having sex.

Yet a single hormone surge does not a rewarding relationship make, and virtually no one has studied the hormonal impact, on a relationship, of grocery shopping, making dinner or doing the dishes. If a couple doesn’t have sex but they both feel satisfied, then there is no problem. The issue is when there’s a mismatch in desire.

Of course, libido ebbs and flows, and there will be times when one partner is temporarily uninterested. Back in 2003, I was home with two premature infants, both on oxygen and attached to monitors that constantly chirped with alarms. Had even Ryan Reynolds — circa “The Proposal,” not “Deadpool” — shown up, he would have needed to display expertise in changing diapers and managing the regulator on an oxygen tank to interest me.

Looking back on my relationship, the frequency of sex dropped off quickly. I told myself it would get better because there were other positives. I falsely assumed that men have higher libidos, so clearly this was temporary.

Pro tip: Nothing in a relationship ever gets better on its own. You might as well ask the ingredients in your pantry to bake themselves into a cake.

I was embarrassed when my attempts at rekindling the magic — things like sleeping naked or trying to schedule date night sex — fell flat.

I started to circuitously ask friends if they ever felt similarly rejected. The answer was “Not really.” One who was going through an especially acrimonious divorce told me that she and her future ex still occasionally had wild sex. People have needs, after all.

The fact that people who hated each other were having more sex than me did not make me feel better. Not at all.

Eventually I decided that sympathy sex once or twice a year was far worse than no sex. I worried that no intervention would be sustainable, and the time not addressing the issue had simply taken its toll. We were terribly mismatched sexually, and it wasn’t something that he was interested in addressing.

My experience led me to listen differently to women speaking about their sex lives with men, whether in my office or in my personal life. There are spaces between words that tell entire stories. When I ask someone about her sex life and there is a pause or a generic “O.K.,” I say, “You know, the libido issue is often with the man.”

I say this to friends, acquaintances and even people I barely know on airplanes (after they learn what my job is). The responses from women are so similar that I could script it. A pause, then relief that it’s not just them, followed quickly by the desire to hear more. Many tell me intimate details, so glad to have someone in whom they can confide.

Libido can be affected by a number of things, including depression, medication, stress, health, affairs, previous sexual trauma, pornography, pain with sex and relationship dissatisfaction (having sex while going through an ugly divorce is probably an outlier).

Erectile dysfunction is a factor for some men, especially over the age of 40. Other men may have low testosterone (although there is a lot of dispute in this area). There is also the possibility that one partner in a heterosexual relationship is gay.

New love is intoxicating, and I’m not being metaphorical. A functional MRI study suggests that new love activates the reward centers of the brain and, like opioids, increases pain tolerance. I wonder how much the drug that is new love affects libido? If some men and women are simply on a lower libido spectrum in everyday life, might they revert to that once this “love drug” subsides, leaving those with a higher libido frustrated?

I want women to know that if they are on the wanting end for sex, they are not alone. If you love the person you’re with, then the sooner you speak up, the better. You can try what I did — sleeping naked and scheduling sex — because the more you have sex, the more you may want to have it, if you’re doing it right and it feels good. However, if things are not changing in the way you want, you may need help from a couples counselor, a sex therapist, a clinical psychologist or a medical doctor, depending on the situation.

Waiting until months or even years have passed can weaponize the bedroom. It will add so much more complexity because resentment compounds like a high-interest credit card.

Sexuality and relationships are complex, and there are no easy answers. It’s not good or bad to have a high, a medium or a low libido. You like what you like, but if you don’t speak up about what you want, you can’t expect the other person to know.

Our society seems almost built on the erroneous idea that all men want sex all the time, so I imagine it would be hard for men to admit to a lower libido, even anonymously. I have lied about my weight on many forms. That doesn’t make me a broken person; it just proves that a cloak of invisibility doesn’t hide you from yourself. The most damaging lies are the ones we tell ourselves.

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How to build sexual confidence

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Having sex for the first time is nerve wracking but it isn’t the only time when the thought of sex can feel daunting. Many of us will go through periods of abstinence later in our lives and the thought of engaging in sexual activity again can spark feelings of insecurity.

There are a variety of reasons why someone might have experienced an extended amount of time without having sex (divorce, a breakup, the loss of a loved one, or difficulty meeting the right person) and often by the time we get round to having sex again it feels as if we are back to square one with our sexual confidence.

Here, we speak to Valeria Chuba, PhD, MS, ACS, a board certified clinical sexologist and a certified intimacy coach. She helps her clients overcome sexual shame and anxiety, achieve sexual confidence, and create pleasure-filled intimate relationships. She is the creator and host of the Get Sex-Smart podcast, which offers expert information and guidance to listeners around the world.

“Finding that special spark with a new partner can often take a long time,” she explains. “Regardless of the reasons why we may find ourselves without a lover, when the time comes to get back into the groove, most of us experience feelings of fear, anxiety and low self-confidence.”

So to help anyone who is feeling less than empowered about the idea of a new sexual encounter, we asked Valeria to give us some practical advice on how to feel less nervous and more confident when starting a new sexual relationship…

1. Learn from the past

Each new relationship offers a promising beginning, which means an opportunity to do things differently and better than before. “Now is the perfect time to look back at your past sexual experiences,” Valeria advises.

“What were some of the things that worked well (or didn’t work) in your intimate relationships? What partners were the most memorable, and why? What would you like to do differently this time around? For example, would you speak up more about your need for sensual foreplay, or share more of your sexual imagination with your partner? Getting clarity around your needs and boundaries will help you start a new sexual relationship in a more proactive way, which in turn will help you feel more safe and grounded.”

2. Know what gives you pleasure

“As a sexologist, I often tell my clients that masturbation is the foundation for partner sex,” says Valeria.

“The more you know about what turns you on and helps you experience pleasure and orgasm, the better you’ll be able to share these things with your partner, leading to a more positive intimate experience.”

Reacquainting yourself with your body in this way will help you to first accept and then to gain confidence when it comes to being with someone else. It’s easy to forget the positive things about our body when we are feeling insecure and focusing on the parts we don’t like as much.

“If you are new to self pleasure or just want to broaden your sexual repertoire, sex-positive books like Come As You Are or fun and instructional sex ed DVDs will both inform you and spark your sensuality. It’s important to note that you should always consider seeking professional help for specific sexual concerns, like trouble experiencing orgasm with a partner, early ejaculation, erectile difficulties, or performance anxiety. Working with a sex-positive, compassionate professional can be a huge boost to your sexual confidence.”

3. Communication is key

“I often tell my clients that they should begin a new relationship as they mean to go on; and good communication is a big part of any successful sexual relationship,” says Valeria.

“There are few things more attractive in a lover than the confidence to speak up about his or her needs and desires, and the ability to listen to his or her partner. Speaking up improves your chances of getting what you want from your sexual relationship; and being accepting of your partner will make him or her feel special and appreciated. Either way, you will come across as a generous and thoughtful lover, which is sure to boost your self-confidence.”

4. Focus on pleasure and not performance

Whenever we begin a new relationship, especially after a long time without partner sex, we tend to feel anxious about things like our attractiveness; our size, shape and weight; and how well we will ‘perform’ during sex.

“This mindset keeps us caught up in our heads and disconnected both from our bodies and pleasure, and from our lovers and the process of lovemaking. Whenever you feel yourself getting caught up in performance pressure, focus instead on your body sensations. Breathe deeply and if need be, slow down. Pay attention to how things feel as opposed to how perfect you appear to be. As a bonus, a lover who is focused on pleasure and sensuality comes off as a lot more empowered and confident than someone who is insecure about their ‘performance’.”

5. Have a sense of humour

Sex can be complicated and intimidating at the best of times, let alone when we’ve been celibate for an extended period. Because of this, we tend to forget that at its core, sex is about connection, pleasure and fun. And since partner sex happens between bodies, it can also be a messy, embarrassing and unintentionally hilarious experience. Using this as a point of connection with your lover, rather than something to be ashamed of, can help you lighten things up. Chances are your partner is also feeling nervous, so bonding lightheartedly over your shared anxiety and the absurdity of it all can be both relaxing and very, very sexy.

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