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What your gynecologist wishes you would do

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By Linda S. Mihalov, MD, FACOG

No matter a woman’s age or how comfortable she is with her gynecologist, she may still be unsure about a few things — like which symptoms are worth mentioning, how often to make an appointment and how to prepare for an exam.

Based on my 30 years of providing gynecologic care to women of all ages, I thought it would be helpful to provide a few tips about how to make the most of your care visits.

Keep track of your menstrual cycle

Dr. Linda Mihalov

Menstruation is a monthly recurrence in women’s lives from early adolescence until around the age of 51, when menopause occurs. Because of the routine nature of this biological process, it’s easy to become complacent about tracking your periods. Thankfully, there are numerous smartphone apps that help make tracking periods easy.

Keeping track of your period is important for numerous health-related reasons. A missed period is usually the first sign of pregnancy. Determining the due date of a pregnancy starts from the date of the last menstrual period. Most forms of birth control are not 100 percent effective, and an unplanned pregnancy is best recognized as soon as possible.

Conversely, women attempting to get pregnant can use period tracking to learn when they are most fertile, which may greatly increase the chances of conception.

In addition, a menstrual cycle change can indicate a gynecologic problem, such as polycystic ovarian syndrome, or even uterine cancer. It is also often the first obvious symptom of health issues that have no obvious connection to the reproductive organs. When a regular menstrual cycle becomes irregular, it may indicate a hormonal or thyroid issue, liver function problems, diabetes or a variety of other health conditions. Women also often miss periods — or experience menstrual changes — when adopting a new exercise routine, gaining or losing a lot of weight or experiencing stress.

One late, early or missed period is not necessarily reason for alarm. But if menstrual irregularity is accompanied by other symptoms, a woman should schedule an appointment with her gynecologic care provider.

Get the HPV vaccine

Human papillomavirus, or HPV, is a very common virus. According to the Centers for Disease Control and Prevention, nearly 80 million Americans — about one in four — are currently infected. About 14 million people, including teens, become infected with HPV each year. Most people who contract the virus will clear it from their systems without treatment, but some will go on to develop precancerous or even cancerous conditions from the infection.

The HPV vaccine is important because it protects against cancers caused by the infection. It can reduce the rate of cervical, vaginal and vulvar cancers in women; penile cancer in men; and anal cancer, cancer of the back of the throat (oropharynx), and genital warts in both women and men.

This vaccine has been thoroughly studied and is extremely safe. Also, scientific research has not shown that young people who receive the vaccine are more prone to be sexually active at an earlier age.

The HPV vaccine is recommended for preteen girls and boys at age 11 or 12 so they are protected before ever being exposed to the virus. HPV vaccine also produces a more robust immune response during the preteen years. If you or your teen have not gotten the vaccine yet, talk with your care provider about getting it as soon as possible.

The CDC now recommends that 11- to 12-year-old girls and boys receive two doses of HPV vaccine — rather than the previously recommended three doses — to protect against cancers caused by HPV. The second dose should be given six to 12 months after the first dose.

Teen girls and boys who did not start or finish the HPV vaccine series when they were younger, should get it now. People who received some doses in the past should only get doses that they missed. They do not need to start the series over again. Anyone older than 14 who is starting the HPV vaccine series needs the full three-dose regimen.

Young women can get the HPV vaccine through age 26, and young men can get vaccinated through age 21. Also, women who have been vaccinated should still have cervical cancer screenings (pap smears) according to the recommended schedule.

Do not put off having children

Fertility in women starts to decrease at age 32 and that decline becomes more rapid after age 37. Women become less fertile as they age because they begin life with a fixed number of eggs in their ovaries. This number decreases as they grow older. Eggs also are not as easily fertilized in older women as they are in younger women. In addition, problems that can affect fertility — such as endometriosis and uterine fibroids — become more common with increasing age.

Older women are more likely to have preexisting health problems that may affect their or their baby’s health during pregnancy. For example, high blood pressure and diabetes are more common in older women. If you are older than 35, you also are more likely to develop high blood pressure and related disorders for the first time during pregnancy. Miscarriages are more common in older pregnant women. Losing a pregnancy can be very distressing at any age, but perhaps even more so if it has been challenging to conceive.

So, women who are considering parenthood should not put off pursuing pregnancy for too long or it may become quite challenging.

See your gynecologist for an annual visit

For women to maintain good reproductive and sexual health, the American College of Obstetricians and Gynecologists recommends that they visit a gynecologist for an exam about once a year. Generally, women should have their first pap test at age 21, but there may be reasons to see a gynecologic care provider earlier than that if there is a need for birth control or periods are troublesome, for instance. Although pap tests are no longer recommended every year, women should still see their provider annually for a gynecologic health assessment. This may or may not involve a pelvic exam.

Other reasons to visit a gynecologist include seeking treatment for irregular periods, sexually transmitted diseases, vaginal infections and menopause. Women who are sexually active or considering it can also visit a gynecologist to learn more about contraceptives.

During each visit, the gynecologist usually asks about a woman’s sexual history and menstrual cycle. The gynecologist may also examine the woman’s breasts and genitals. Understandably, a visit like this can cause discomfort among some women. However, periodic gynecological exams are very important to sexual and reproductive health and should not be skipped. The patient’s anxiety can be significantly decreased if she knows what to expect from the visit. Prepared with the knowledge of what actually occurs during an annual exam, women often find it can be a straightforward, rewarding experience.

There are several things women should do to prepare for a gynecological exam, including:

  • Try to schedule your appointment between menstrual periods
  • Do not have intercourse for at least 24 hours before the exam
  • Prior to the appointment, prepare a list of questions and concerns for your gynecologist
  • Since the gynecologist will ask about your menstrual cycle, it will be helpful to know the date that your last period started and how long your periods usually last

The pelvic exam includes evaluation of the vulva, vagina, cervix and the internal organs including the uterus, fallopian tubes and ovaries. Appearance and function of the bowel and bladder will also be assessed.

The gynecologic provider will determine whether a pap test is indicated, and order other tests as necessary, including tests for sexually transmitted infections, mammograms and screening blood work or bone density studies. Even a woman who has previously undergone a hysterectomy and, as a result, no longer needs a pap test can still benefit from visiting her gynecologist.

Primary care providers, including family practitioners and nurse practitioners, internists and pediatricians can also provide gynecological care.

Menopause

Menopause can be a challenging time. Changes in your body can cause hot flashes, weight gain, difficulty sleeping and even memory loss. As you enter menopause, you may have many questions you want to discuss with your gynecologist. It is important that you trust your gynecologist so you can confide in them and ask them uncomfortable questions. The more open you are, the better they can guide you toward the right treatment.

Complete Article HERE!

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Lacking the desire to have sex with your partner?

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Scientists think they know how to cure your problem – and it’s all down to chocolate

Scientists found kisspeptin, which is found in chocolate, helps to make men much more interested in sex and relationships

By Victoria Allen

A ‘chocolate hormone’ could help to get couples in the mood for sex and fall more deeply in love.

Kisspeptin, which is named after a chocolate snack, is the hormone in the brain which kickstarts puberty.

And it may explain something about the behaviour of teenage boys, after scientists found it makes men much more interested in sex and relationships.

Young men injected with the hormone and then given brain scans showed a flurry of activity in the parts of the brain activated by sexual arousal and romance. It means similar injections could be used to help men to start a family.

Professor Waljit Dhillo, the lead author of the research from Imperial College London, said: ‘Our initial findings are novel and exciting as they indicate that kisspeptin plays a role in stimulating some of the emotions and responses that lead to sex and reproduction.

‘Ultimately, we are keen to look into whether kisspeptin could be an effective treatment for psychosexual disorders, and potentially help countless couples who struggle to conceive.’

One in 10 men in the UK are believed to have sexual problems, many suffering a lack of libido caused by relationship issues, stress and anxiety.

This can cause problems for couples trying for a child and advised to have regular sex throughout the month.

But kisspeptin is hoped to hold the answer, following a trial involving 29 healthy young men.

Those injected with kisspeptin, discovered in the mid-1990s in Hershey, Pennsylvania, and named after sweets from the city called Hershey’s Chocolate Kisses, reacted differently to sexual and non-sexual romantic pictures of couples.

In an MRI scanner, where their brains were monitored, there was greater activity in the parts of the brain typically activated by sexual arousal and romance than the men given a placebo.

Professor Dhillo said: ‘Most of the research and treatment methods for infertility to date have focused on the biological factors that may make it difficult for a couple to conceive naturally.

‘These of course play a huge part in reproduction, but the role that the brain and emotional processing play in this process is also very important, and only partially understood.’

The effect is likely to come from kisspeptin’s role in starting puberty, by stimulating the release of reproductive hormones.

A study from Edinburgh University previously found it fuels the production of testosterone, which is key to male libido and fertility

The researchers now want to study how the hormone affects women as well as men, while kisspeptin might also work as an antidepressant.

Volunteers shown negative and fearful emotional faces in pictures said they felt less bad in follow-up questionnaires after receiving the hormone, with less activity in brain structures important in regulating a bad mood.

Dr Alexander Comninos, first author of the study at Imperial, said: ‘Our study shows that kisspeptin boosts sexual and romantic brain activity as well as decreasing negative mood.

‘This raises the interesting possibility that kisspeptin may have uses in treating psychosexual disorders and depression which are major health problems which often occur together, but further studies would be needed to investigate this.’

Complete Article HERE!

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Women with HIV, after years of isolation, coming out of shadows

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Patti Radigan kisses daughter Angelica after a memorial in San Francisco’s Castro to remember those who died of AIDS.

By Erin Allday

Anita Schools wakes at dawn most days, though she usually lazes in bed, watching videos on her phone, until she has to get up to take the HIV meds that keep her alive. The morning solitude ends abruptly when her granddaughter bursts in and they curl up, bonding over graham crackers.

Schools, 59, lives in Emeryville near the foot of the Bay Bridge, walking distance from a Nordstrom Rack and other big chain stores she can’t afford. Off and on since April, her granddaughter has lived there too, sleeping on a blow-up mattress with Schools’ daughter and son-in-law and another grandchild.

Five is too many for the one-bedroom apartment. But they’re family. They kept her going during the worst times, and that she can help them now is a blessing.

Nearly 20 years ago, when Schools was diagnosed with HIV, it was her daughter Bonnie — then 12 and living in foster care — who gave her hope, saying, “Mama, you don’t have to worry. You’re not going to die, you’re going to be able to live a long, long time.”

“It was her that gave me the push and the courage to keep on,” Schools said.

She had contracted HIV from a man who’d been in jail, who beat her repeatedly until she fled. By then she’d already left another abusive relationship and lost all four of her daughters to child protective services. HIV was just one more burden.

At the time, the disease was a death sentence. That Schools is still here — helping her family, getting to know her grandchildren — is wonderful, she said. But for her, as with tens of thousands of others who have lived two decades or more with HIV, survival comes with its own hardships.

Gay men made up the bulk of the casualties of the early AIDS epidemic, and as the male survivors grow older, they’re dealing with profound complications, including physical and mental health problems. But the women have their own loads to bear.

Whereas gay men were at risk simply by being gay, women often were infected through intravenous drug use or sex work, or by male partners who lied about having unsafe sex with other men. The same issues that put them at risk for HIV made their very survival a challenge.

Today, many women like Schools who are long-term survivors cope with challenges caused or compounded by HIV: financial and housing insecurity, depression and anxiety, physical disability and emotional isolation.

“We’re talking about mostly women of color, living in poverty,” said Naina Khanna, executive director of Oakland’s Positive Women’s Network, a national advocacy group for women with HIV. “And there’s not really a social safety net for them. Gay men diagnosed with HIV already historically had a built-in community to lean on. Women tend to be more isolated around their diagnosis.”

There are far fewer women aging with HIV than men. In San Francisco, nearly 10,000 people age 50 or older are living with HIV; about 500 are women. Not all women survivors have histories of trauma and abuse, of course, and many have done well in spite of their diagnosis.

But studies have found that women with HIV are more than twice as likely as the average American woman to have suffered domestic violence. They have higher rates of mental illness and substance abuse.

What keeps them going now, decades after their diagnoses, varies widely. For some, connections with their families, especially their now-adult children, are critical. For others, HIV advocacy work keeps them motivated and hopeful.

Patti Radigan (righ) instructs daughter Angelica and Angelica’s boyfriend, Jayson Cabanas, on preparing green beans for Thanksgiving while Roman Tom Pierce, 8, watches.

Patti Radigan was living in a cardboard box on South Van Ness Avenue in San Francisco when she tested positive in 1992. By then, she’d lost her husband to a heart attack while a young mother, and not long after that she lost her daughter, too, when her drug use got out of control and her sister-in-law took in the child.

She turned to prostitution in the late 1980s to support a heroin addiction. She’d heard of HIV by then and knew it was deadly. She’d seen people on the streets in the Mission where she worked, wasting away and then disappearing altogether. But she still thought of it as something that affected gay men, not women, even those living on the margins.

Women then, and now, were much more likely than men to contract HIV from intravenous drug use rather than sex — though in Radigan’s case, it could have been either. IV drug use is the cause of transmission for nearly half of all women, according to San Francisco public health reports. It’s the cause for less than 20 percent for men.

Still, when Radigan finally got tested, it wasn’t because she was worried she might be positive, but because the clinic was offering subjects $20. She needed the cash for drugs.

She was scared enough after the diagnosis — and then she got pregnant. It was the early 1990s, and HIV experts at UCSF were just starting to believe they could finesse women through pregnancy and help them deliver healthy babies. Today, it’s widely understood that women with HIV can safely have children; San Francisco hasn’t seen a baby born with HIV since 2004.

But in the 1990s, getting pregnant was considered selfish — even if the baby survived, its mother most certainly wouldn’t live long enough to raise her. For women infected at the time, having children was something else they had to give up.

And so Radigan had an abortion. But she got pregnant again in 1995, and she was desperate to have this child. She was living by then with 10 gay men in a boarding house for recovering addicts. Bracing herself for an onslaught of criticism, she told her housemates. First they were quiet, then someone yelled, “Oh my God, we’re having a baby!”

“It was like having 10 big brothers,” Radigan said, smiling at the memory. Buoyed by their support, she kept the pregnancy and had a healthy girl.

Radigan is 59 now; her daughter, Angelica Tom, is 20. They both live in San Francisco after moving to the East Coast for a while. It was because of her daughter that Radigan stayed sober, that she consistently took her meds, and that she went back to school to tend to her future.

For a long time she told people she just wanted to live long enough to see her daughter graduate high school. Now her daughter is in art school and Radigan is healthy enough to hold a part-time job, to lead yoga classes on weekends, to go out with friends for a Friday night concert.

“Because of HIV, I thought I was never going to do a lot of things,” Radigan said. “The universe is aligning for me. And now I feel like I deserve it. For a long time, I didn’t feel like I deserved anything.”

Anita Schools, who says she is most troubled by finances, listens to an HIV-positive woman speak about her experiences and fears at an Oakland support group that Schools organized.

Anita Schools got tested for HIV because her ex-boyfriend kept telling her she should. That should have been a warning sign, she knows now.

She was first diagnosed in 1998 at a neighborhood clinic in Oakland, but it took two more tests at San Francisco General Hospital for her to accept she was positive. People told her that HIV wasn’t necessarily fatal, but she had trouble believing she was going to live. All she could think was, “Why me? What did I do?”

It was only after her daughter Bonnie reassured her that Schools started to think beyond the immediate anxiety and anger. She joined a support group for HIV-positive women, finding comfort in their stories and shared experiences. Ten years later, she was leading her own group.

She’s never had problems with drugs or alcohol, and she has a network of friends and family for emotional support, she said. Even the HIV hasn’t hit her too hard, physically, though the drugs to treat it have attacked her kidneys, leaving her ill and fatigued.

Like so many of the women she advises in her support group, Schools is most troubled by her finances. She gets by on Social Security and has bounced among Section 8 housing all over the Bay Area for most of her adult life.

Schools’ current apartment is supposed to be permanent, but she worries she could lose it if her daughter’s family stays with her too long. So earlier this month they moved out and are now sleeping in homeless shelters or, some nights, in their car. She hates letting them leave but doesn’t feel she has any other choice.

Reports show that women with HIV are far more likely to live in poverty than men. Khanna, with the Positive Women’s Network, said surveys of her members found that 85 percent make less than $25,000 a year, and roughly half take home less than $10,000.

Schools can’t always afford the bus or BART tickets she needs to get to doctor appointments and support group meetings, relying instead on rides from friends — or sometimes skipping events altogether. She gets her food primarily from food banks. Her wardrobe is dominated by T-shirts she gets from the HIV organizations with which she volunteers.

“With Social Security, $889 a month, that ain’t enough,” Schools said. “You got to pay your rent, and then PG&E, and then you got to pay your cell phone, buy clothes — it’s all hard.”

At a time when other women her age might be thinking about retirement or at least slowing down, advocacy work has taken over Schools’ life. She speaks out for women with HIV and their needs, demanding financial and health resources for them. In her support group and at AIDS conferences, she offers her story of survival as a sort of jagged road map for other women struggling to navigate the complex warren of services they’ll need to get by.

The work gives her confidence and purpose. She feels she can directly influence women’s lives in a way that seemed beyond her when she was young, unemployed and directionless.

“As long as I’m getting help and support,” Schools said, “I want to help other women — help them get somewhere.”

Billie Cooper is tall and striking, loud and brash. Her makeup is polished, her nails flawless. She is, she says with a booming laugh that makes heads turn, “the ultimate senior woman.”

For Cooper, 58, HIV was transformative. Like Radigan, she had to find her way out from under addiction and prostitution to get healthy, and stay healthy. Like Schools, she came to understand the importance of role-modeling and advocacy.

Cooper arrived in San Francisco in the summer of 1980 — almost a year to the day before the first reports of HIV surfaced in the United States. She was fresh out of the Navy and eager to explore her gender identity and sexuality in San Francisco’s burgeoning gay and transgender communities.

Growing up in Philadelphia, she’d known she was different from the boys around her, though it was decades before she found the language to express it and identified as a transgender woman. But seeing the “divas on Post Street, the ladies in the Tenderloin, the transsexual women prostituting on Eddy” — Cooper was awestruck.

She slipped quickly into prostitution and drug use. When she tested positive in 1985, she wasn’t surprised and barely wasted a thought worrying about what it meant for her future — or whether she’d have any future at all.

“I felt as though I still had to keep it moving,” Cooper said. “I didn’t slow down and cry or nothing.”

Transgender women have always been at heightened risk of HIV. Some studies have found that more than 1 in 5 transgender women is infected, and today about 340 HIV-positive trans women live in San Francisco.

What makes them more vulnerable is complicated. Trans women often have less access to health care and less stable housing than others, and they face higher rates of drug addiction and sexual violence, all of which are associated with risk of HIV infection.

Cooper was homeless off and on through the 1980s and ’90s, trapped in a world of drugs and sex work that felt glamorous at the time but in hindsight was crippling. “I was doing things out of loneliness,” she said, “and I was doing things to feel love. That’s why I prostituted, why I did drugs.”

She began to clean up around 2000, though it would take five or six years to fully quit using. She found a permanent place to live. She collected Social Security. She started working in support services for other transgender women battling HIV. In 2013, she founded TransLife, a support group at the San Francisco AIDS Foundation.

“I was coming out as the activist, the warrior, the determined woman I was always meant to be,” she said.

Cooper never developed any of the common, often fatal complications of HIV — including opportunistic infections like pneumonia — that killed millions in the 1980s and 1990s. But she does have neuropathy, an HIV-related nerve condition that causes a constant pins-and-needles sensation in her feet and legs and sometimes makes it hard to walk.

Far more traumatic for her was her cancer diagnosis in 2006. The cancer, which may have been related to HIV, was isolated to her left eye, but after traditional therapies failed, the eye was surgically removed on Thanksgiving Day in 2009.

The cancer and the loss of her eye was a devastating setback for a woman who had always focused on her appearance, on looking as gorgeous as the transgender women she so admired in the Tenderloin, on being loved and wanted for her beauty.

Rising from that loss has been difficult, she said. And she’s continued to suffer new health problems, including blood clots in one of her legs. Recently, she’s fallen several times, in frightening episodes that may be related to the clots, the HIV or something else entirely.

Since Thanksgiving she’s been in and out of the hospital, and though she tries to stay upbeat, it’s clearly trying her patience.

But if HIV and cancer and everything else have tested Cooper’s survival in ways she never anticipated, these trials also have strengthened her resolve. She’s becoming the person she always wanted to be.

“A week before they took my eye, I got my breasts,” she said coyly one recent afternoon, thrusting out her chest. Behind the sunglasses she wears almost constantly now, she was smiling and crying, all at once.

Aging with HIV has been strangely calming, in some ways, giving her a confidence that in her wild youth was elusive.

Now she exults in being a respected elder in the HIV and transgender communities. She loves it when people open doors for her or help her cross the street, offer to carry her bags or give up a seat on a bus.

Simply, she said, “I love being Ms. Billie Cooper.”

Complete Article HERE!

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How do women really know if they are having an orgasm?

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Dr Nicole Prause is challenging bias against sexual research to unravel apparent discrepancies between physical signs and what women said they experienced

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It’s not always clear if a woman is really having an orgasm, as Meg Ryan demonstrated in When Harry Met Sally.

It’s not always clear if a woman is really having an orgasm, as Meg Ryan demonstrated in When Harry Met Sally.

In the nascent field of orgasm research, much of the data relies on subjects self-reporting, and in men, there’s some pretty clear physiological feedback in the form of ejaculation.

But how do women know for sure if they are climaxing? What if the sensation they have associated with climax is actually one of the the early foothills of arousal? And how does a woman know when if she has had an orgasm?

Neuroscientist Dr Nicole Prause set out to answer these questions by studying orgasms in her private laboratory. Through better understanding of what happens in the body and the brain during arousal and orgasm, she hopes to develop devices that can increase sex drive without the need for drugs.

Understanding orgasm begins with a butt plug. Prause uses the pressure-sensitive anal gauge to detect the contractions typically associated with orgasm in both men and women. Combined with EEG, which measures brain activity, this allows for a more accurate picture of a woman’s arousal and orgasm.

Dr Nicole Prause has founded Liberos to study brain stimulation and desire.

Dr Nicole Prause has founded Liberos to study brain stimulation and desire.

When Prause began studying women in this way she noticed something surprising. “Many of the women who reported having an orgasm were not having any of the physical signs – the contractions – of an orgasm.”

It’s not clear why that is, but it is clear that we don’t know an awful lot about orgasms and sexuality. “We don’t think they are faking,” she said. “My sense is that some women don’t know what an orgasm is. There are lots of pleasure peaks that happen during intercourse. If you haven’t had contractions you may not know there’s something different.”

Prause, an ultramarathon runner and keen motorcyclist in her free time, started her career at the Kinsey Institute in Indiana, where she was awarded a doctorate in 2007. Studying the sexual effects of a menopause drug, she first became aware of the prejudice against the scientific study of sexuality in the US.

When her high-profile research examining porn “addiction” found the condition didn’t fit the same neurological patterns as nicotine, cocaine or gambling, it was an unpopular conclusion among people who believe they do have a porn addiction.

The evolution of design of the anal pressure gauge used in Nicole Prause’s lab to detect orgasmic contractions.

The evolution of design of the anal pressure gauge used in Nicole Prause’s lab to detect orgasmic contractions.

“People started posting stories online that I had falsified my data and I received all kinds of sexist attacks,” she said. Soon anonymous emails of complaint were turning up at the office of the president of UCLA, where she worked from 2012 to 2014, demanding that Prause be fired.

Does orgasm benefit mental health?

Prause pushed on with her research, but repeatedly came up against challenges when seeking approval for studies involving orgasms. “I tried to do a study of orgasms while at UCLA to pilot a depression intervention. UCLA rejected it after a seven-month review,” she said. The ethics board told her that to proceed, she would need to remove the orgasm component – rendering the study pointless.

Undeterred, Prause left to set up her sexual biotech company Liberos, in Hollywood, Los Angeles, in 2015. The company has been working on a number of studies, including one exploring the benefits and effectiveness of “orgasmic meditation”, working with specialist company OneTaste.

Part of the “slow sex” movement, the practice involves a woman having her clitoris stimulated by a partner – often a stranger – for 15 minutes. “This orgasm state is different,” claims OneTaste’s website. “It is goalless, intuitive, and dynamic. It flows all over the place with no set direction. It may include climax, or it may not. In Orgasm 2.0, we learn to listen to what our body wants instead of what we think we ‘should’ want.”

Prause wants to determine whether arousal has any wider benefits for mental health. “The folks that practice this claim it helps with stress and improves your ability to deal with emotional situations even though as a scientist it seems pretty explicitly sexual to me,” she said.

Prause is examining orgasmic meditators in the laboratory, measuring finger movements of the partner, as well as brainwave activity, galvanic skin response and vaginal contractions of the recipient. Before and after measuring bodily changes, researchers run through questions to determine physical and mental states. Prause wants to determine whether achieving a level of arousal requires effort or a release in control. She then wants to observe how Orgasmic Meditation affects performance in cognitive tasks, how it changes reactivity to emotional images and how it compares with regular meditation.

Brain stimulation is ‘theoretically possible’

Another research project is focused on brain stimulation, which Prause believes could provide an alternative to drugs such as Addyi, the “female Viagra”. The drug had to be taken every day, couldn’t be mixed with alcohol and its side-effects can include sudden drops in blood pressure, fainting and sleepiness. “Many women would rather have a glass of wine than take a drug that’s not very effective every day,” said Prause.

The field of brain stimulation is in its infancy, though preliminary studies have shown that transcranial direct current stimulation (tDCS), which uses direct electrical currents to stimulate specific parts of the brain, can help with depression, anxiety and chronic pain but can also cause burns on the skin. Transcranial magnetic stimulation, which uses a magnet to activate the brain, has been used to treat depression, psychosis and anxiety, but can also cause seizures, mania and hearing loss.

Prause is studying whether these technologies can treat sexual desire problems. In one study, men and women receive two types of magnetic stimulation to the reward center of their brains. After each session, participants are asked to complete tasks to see how their responsiveness to monetary and sexual rewards (porn) has changed.

With DCS, Prause wants to stimulate people’s brains using direct currents and then fire up tiny cellphone vibrators that have been glued to the participants’ genitals. This provides sexual stimulation in a way that eliminates the subjectivity of preferences people have for pornography.

“We already have a basic functioning model,” said Prause. “The barrier is getting a device that a human can reliably apply themselves without harming their own skin.”


 
There is plenty of skepticism around the science of brain stimulation, a technology which has already spawned several devices including the headset Thync, which promises users an energy boost, and Foc.us, which claims to help with endurance.

Neurologist Steven Novella from the Yale School of Medicine uses brain stimulation devices in clinical trials to treat migraines, but he says there’s not enough clinical evidence to support these emerging consumer devices. “There’s potential for physical harm if you don’t know what you’re doing,” he said. “From a theoretical point of view these things are possible, but in terms of clinical claims they are way ahead of the curve here. It’s simultaneously really exciting science but also premature pseudoscience.”

Biomedical engineer Marom Bikson, who uses tDCS to treat depression at the City College of New York, agrees. “There’s a lot of snake oil.”

Sexual problems can be emotional and societal

Prause, also a licensed psychologist, is keen to avoid overselling brain stimulation. “The risk is that it will seem like an easy, quick fix,” she said. For some, it will be, but for others it will be a way to test whether brain stimulation can work – which Prause sees as a more balanced approach than using medication. “To me, it is much better to help provide it for people likely to benefit from it than to try to create fake problems to sell it to everyone.”

Sexual problems can be triggered by societal pressures that no device can fix. “There’s discomfort and anxiety and awkwardness and shame and lack of knowledge,” said psychologist Leonore Tiefer, who specializes in sexuality. Brain stimulation is just one of many physical interventions companies are trying to develop to make money, she says. “There’s a million drugs under development. Not just oral drugs but patches and creams and nasal sprays, but it’s not a medical problem,” she said.

Thinking about low sex drive as a medical condition requires defining what’s normal and what’s unhealthy. “Sex does not lend itself to that kind of line drawing. There is just too much variability both culturally and in terms of age, personality and individual differences. What’s normal for me is not normal for you, your mother or your grandmother.”

And Prause says that no device is going to solve a “Bob problem” – when a woman in a heterosexual couple isn’t getting aroused because her partner’s technique isn’t any good. “No pills or brain stimulation are going to fix that,” she said.

Complete Article HERE!

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Monogamy or Bust: Why Are Many Gay Men Opposed to Open Relationships?

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By Zachary Zane

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As assimilation into more mainstream culture increases, many gay men are shifting their attitudes on non-traditional relationships—becoming less accepting of them.

Full disclosure: I’m polyamorous. After being in a year-long, tumultuous monogamous relationship, I fell into polyamory by accident. After giving it a shot, I realized that I am better equipped to handle the struggles that come from polyamory than monogamy. Clearly, both setups come with a myriad of issues, but what makes me happiest, most comfortable, and most satisfied, is polyamory. Polyamory, ironically, also alleviated my jealousy issues and relationship-induced anxiety, simply because I trust my current partner unconditionally.

Like most people, I knew nothing about polyamory when I stumbled into it. I believed the false misconceptions that surround poly life. I thought people use polyamory as an excuse to screw around. I thought all polyamorous relationships are doomed to fail, with one person being left out. I also thought that poly people are insecure, given that they need validation and support from various partners. While I have encountered all of these things and people in the poly community, I can safely say, these hurtful stereotypes are false and don’t accurately capture the true spirit of polyamory.

I write about consensual non-monogamous relationships often. Without pushing any agenda, I try to help others by offering another option to monogamy. It’s worked for me, and I wish I had known poly was a viable option sooner.

But I also know I’m not special. I’m like many other queer men out there. My experience, struggle, and identity are undeniably mine, but once I stopped believing I was the center of the universe, I was able to realize that my journey mirrored many queer men before and after me, and I now think that other people could benefit from being in a monogam-ish, open, or polyamorous relationship.

Still, when I even hint at the idea of not being 100 percent monogamous, guys throw more than hissy fits; they have full temper tantrums. I’m not even saying go out and date a million people; I’m saying that if both you and he are exclusive bottoms, maybe it’s worth it to consider bringing in a third. “Consider”—that’s the world I’ll use. But that’s enough for guys to become furious, taking their comments to every social media platform. In these comments, I’m ruthlessly attacked, accused of knowing nothing about relationships, giving up on men too early, being sleazy, horny, and incapable of love, amid a bunch of other totally outlandish claims.

These comments never bother me because I know they’re wrong. They have, however, led me to repeatedly ask the same questions: Why does the mere mention of a non-monogamous relationship make these guys’ blood boil? I understand it’s not for them, but why do they get so angry that open relationships work for other men? Why do they feel that it’s important that everyone be like them, in a monogamous relationship, when it doesn’t affect them? Is it a matter of arrogance? Do they assume everyone is like them? Have these men been cheated on? Have these men been taken advantage of by men who use the “open” label, and instead of realizing that that guy was just an unethical person, they think that all guys in open relationships are unethical people? This shouldn’t be such a sore subject and source of unrelenting rage.

I’ve tried engaging with the monogamy-or-bust folks, going straight to the source, but I’ve never learned anything useful. They are so consumed by anger, that they can’t speak logically about why something that has nothing to do with them provokes such outrage. Honestly, they sound like the anti-marriage equality crowd. They say the same things repeatedly about how it ruins the sanctity of marriage (or in this case, relationships), but when you ask how it affects them personally, they don’t have an answer. But for whatever reason, this remains a source of animosity.

That said, here’s what I have noticed.

1. People in satisfying monogamous relationships don’t have reason to be angry.

When I speak to gay men who are in satisfying monogamous relationships, they’re never angered. Confused? Absolutely. Do they know that an open relationship would never work for them? Yes, very aware. Are they skeptical that it will work out? Sure. But angry? Never. The only people who are actively angered are men who are single or unhappily committed in a monogamous relationship. This had led me to believe a main reason for their anger is displacement. They’re unhappy with their relationship (or lack thereof) and are taking it out on men in happy, open relationships.

2. The angry folks have reason to be insecure and jealous.

These are people for whom a polyamorous relationship would never work, because they struggle to believe in their own self-worth. They fear they aren’t worthy of love. Because of this, these insecure men think that their partner will leave them in the dust if someone comes along who seems “better,” instead of acknowledging that a person can love two individuals. These guys are usually single.

Simon*, a gay man I interviewed, supports this notion; he thinks open-relationship shaming is a matter of projection. “…I find that there has been an increase in hypocritical slut-shaming that comes from the queer community. [We’re] always eager to feel morally superior. I think this happens because it’s easier for [some queer men] to project insecurities and/or personal issues onto someone who doesn’t seem to feel guilt or remorse for exploring their sexuality with other partners, than to be honest with themselves about their own desires and ‘deviant’ curiosities, polyamory among them.”

3. The angry gay men are homonormative AF.

In my experience, the gay men vehemently opposed to open/poly life tend to be the same men who think bisexuality is a stepping stone to gay and that being transgender is a mental illness; men who don’t see the value in the word “queer” and don’t believe gays should be supporting the Black Lives Matter movement. Their perception of open/poly life isn’t an isolated issue. It’s rooted in a larger ideology that’s riddled with entitlement and privilege.

However, as one gay man I interviewed, Noah, said, “I also think that (white) gay men’s attitudes on polyamory are shaped very heavily by our successful assimilation into mainstream culture. Remember, one of the most widespread arguments against gay marriage was that it would lead us down a slippery slope towards legalization of polygamy and other ‘deviant’ (read: alternative) relationship structures. Accepting polyamory as a positive force in the gay community means pushing back against the core world views of those naysayers. But the gay community has mostly opted for assimilation, so it’s not surprising that as a poly person I’m frequently viewed with suspicion.”

Though Noah said he hasn’t faced direct discrimination, he mentioned that a growing number of gay men refuse to date him because they think, “I am inherently unable to give them the level of intimacy that they crave or the level of commitment that they desire.” When he says he’s polyamorous, “…I lose value in their eyes since there is no chance for me to be their One True Love.” He understands the need for boundaries and respects people for realizing polyamory or open relationships aren’t for them, but at the same time, this puts him in a very precarious position when it comes to dating.

Another man I interviewed, Rob, said he has hasn’t received much discrimination aside from a snarky comment here and there. “Let’s face it,” he said, “open relationships are as common among gay guys as bread and butter!”

While I think that is true, and open relationships are quite common in the queer male community, this relates back to what Noah was discussing. With assimilation into more mainstream culture and the acquirement of rights, including that to marry, many gay men are shifting their attitudes on non-traditional relationships—becoming less accepting of them.

With all of that said, I still can’t help but see the irony in a gay man critiquing how someone else loves. Love is love—isn’t that what we’ve been preaching this whole time? And if love does conquer all, which I believe all gay and queer men believe, then we, as a community, need to be supportive of other queer men. Instead of buying into this boring, oppressive, homonormative gay culture, or losing our sense of openness as we continue to assimilate into the heteronormative mainstream, I’d like to see gay men expand their notion of what gay is, what love is, and what a relationship is.

I’m also hoping that we can think outside ourselves. Just because a certain non-traditional relationship style wouldn’t be our first choice, doesn’t mean it can’t be the ideal relationship style for our gay brothers. We’re not only being arrogant and close-minded; we’re beginning to sound a lot like the Republicans who work so hard to take away our rights.

So if you’re one of those gay men who are vehemently opposed to every type of relationship but monogamy, I ask you to ask yourself: “Why?”

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