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‘Discovering my true sexual self’: why I embraced polyamory


My husband and I were together for 12 years and had two children – but while he was happy with one person, I needed more

By Anita Cassidy

It was the hardest thing I’d ever had to say to my husband, Marc. Three years ago, I sat down and told him: “The idea of having sex just with you for the next 40 years – I can’t do it any more.” But I had come to realise that my life was built around something I didn’t believe in: monogamy.

We had been together for 12 years and had two children, now nine and seven. I love being a mother and I set the bar high from the start – cloth nappies and cooking from scratch. But I needed something more in my emotional and sexual life.

Marc’s reaction was remarkable; he agreed to support me and open our marriage to other partners, although it wasn’t really what he wanted. We started counselling to try to identify the best of what we had, to save it and protect it. Sex is a big part of a relationship, but it is only a part. We didn’t want it to scupper us.

If that sounds difficult, it was. I don’t think we could have done it if we hadn’t spent most of our marriage reading, talking and exploring together.

I quickly embraced the dating scene and discovered another side of my sexual self. I enrolled on lots of sites, where you are asked specific questions about yourself and your preferences. It was illuminating: do I like this? Yes. Do I like that? Well, let’s see. They were the kind of questions I’d never been asked before – and had never asked myself.

I became convinced that traditional relationships are like an air lock. You meet someone. It’s amazing and it’s rare, and then you lock it; you shut the windows and doors, and you try desperately to keep it all to yourselves. Then the air turns sour because there’s no oxygen. You might make a sexual mistake on the spur of the moment because you are craving some – any – contact. Why not live in a world where you can have room for that connection, that spark?

I think most people’s reaction was that Marc should have kicked me out. My immediate family have been supportive, although my mother is still ambivalent. We discuss everything openly, and she understands where I’m coming from, but worries that I’m going to end up on my own. If I do, though, it will be because I have chosen that.

People who choose to be polyamorous often do so after delving deep into themselves and their desires, so it runs close to the kink scene, which was also something I wanted to explore. There’s a temptation to think that, had Marc and I explored these things together, our marriage might have worked without opening it up. I’m not sure that it would have, though, given that he wasn’t into it. It can seem quite intimidating, but I was so ready for it. The first time I went to a fetish club, I felt like I was at home – that I’d found my people.

I now have a partner of two years, Andrea. We work as a couple, but we also have sex with friends. He’s the only partner I have introduced to my children. I love Andrea and I’m very lucky to have him, but I don’t want to live with him – we both value our solitude too much. He and I can flirt with other people and ask for their number, but I still feel jealous sometimes. He went away with another woman and, yes, it was difficult.

Anita, Marc and Andrea, too: ‘I’m not sure our marriage would have worked without opening it up.’

Meanwhile, Marc and I realised we were no longer compatible. I had changed too much. We still share the family home and parent our children together. We still get on. We have counselling together, we spend Christmas together – we are still reading and learning as we used to. We wanted to keep all the bits that worked.

We have had to learn so much about communicating better, and I think the children have benefited from that. We have explained that Dad needs one person to be with and Mum needs more people to make her happy. The talk is ongoing; we won’t wait to sit them down when they are teenagers, expecting them suddenly to get it. Understanding polyamory is complicated, but monogamy is fraught with ambiguity, too.

You can craft your own polyamory, but I’m not sure I would want more than two or three other partners. I’m hoping two people I met recently will become lovers, but there’s no rush. People assume that I’m constantly having sex, but it’s not as simple as that. I want an emotional and mental connection with someone, so it takes time to build up to that.

Monogamy, meanwhile, feels more like a competition where you need to bag someone before anyone else does. None of that applies in a poly setup, which is incredibly liberating. Think how strange it would be to have only one friend. You can’t get everything from one platonic relationship. Why would you try with one lover?

But it’s a challenge: you’re swimming against the cultural norm and it’s difficult emotionally, with or without the support of an existing partner. On top of that, the amount of work involved in maintaining multiple relationships, sexual and platonic, is huge.

Andrea and I look to the future, but there are no expectations. We are part of a broader community and we think developing that is more important. Put it this way: I don’t see myself sitting on a park bench at 80 with one other person. I’d like to be part of a group of people, a community. We seem to want a silver bullet for everything. One God. One partner. But life is plural.

Marc’s view

I’d realised for a few years that Anita wasn’t completely happy, so it wasn’t a total shock when she told me she wanted to explore non-monogamy. It was upsetting to hear that what we had wasn’t meeting her needs, but it was very important to me that she was happy. If that meant her exploring a different relationship style, then I would be there to support her.

I did a lot of reading around the subject of ethical non-monogamy. It makes a lot of sense intellectually, but it doesn’t resonate with me emotionally. It didn’t feel right. I was prepared for our marriage to continue, with me being monogamous and Anita having other partners, but that proved more difficult than we envisaged.

I completely support Anita. I’m glad she has been able to share with me what she’s discovering about the honesty and communication needed to make polyamory work. It’s also true of monogamous relationships, and I hope to take what I have learned from this experience into my future relationships.

What I have always wanted – and still do – is to be with one partner, long-term, with whom I can share all of life’s rich experiences, to enjoy the journey and the inevitable changes together.

Complete Article HERE!


Recharge your sexual energy


If lack of energy has drained your sex life, there are ways to reignite the passion.

close-up of a mature couple relaxing in bed at home

Your sexual drive can stay high late in life, but often your energy for sex can diminish. Low energy not only affects your sex life, but can carry over to other parts of your life, too. You can become apathetic, no longer find pleasure in favorite activities, and become more sedentary.

However, many of these issues related to lost sexual energy can be addressed. “Never think lack of energy means an end to your sex life, and there is nothing you can do about it,” says Dr. Sharon Bober, director of the Harvard-affiliated Dana-Farber Sexual Health Program. “There are many strategies you can adopt to get back in the game.”

Find your energy drainers

Your lost sexual vim and vigor is often related to some kind of physical, emotional, or relationship issue. Here’s a look at the most common causes.

Low hormones. Lack of sexual energy could be due to male hypogonadism, which occurs when the testicles do not produce enough testosterone, the male sex hormone. In fact, fatigue is one of the most common side effects.

Testosterone levels drop about 1% each year beginning in a man’s late 30s, and could fall by as much as 50% by age 70. (A blood test from your doctor can determine if you have low testosterone.) Testosterone replacement therapy, which is given via absorbable pellet implants, topical gels, patches, and injections, can often help spark sexual energy in men with low levels.

Findings from a study published online Aug. 1, 2016, by The Journal of Clinical Endocrinology & Metabolism showed that a year of testosterone therapy improved libido in 275 men (average age 72) with confirmed low testosterone. Compared with men in a placebo group, frequency of sexual arousal increased by about 50%, and they were able to have almost twice as many erections.

Speak with your doctor about whether testosterone therapy is an option for you. Long- term risks are not well known, but there is concern for an increased risk of heart disease and prostate problems.

Erectile dysfunction. Men with erectile dysfunction can experience low energy because the condition can be a blow to their self-esteem. “Men may feel embarrassed about it or worry they will be judged in some way if they cannot perform as well as they once did, so motivation and energy for sex gets depleted,” says Dr. Bober.

In this case, speak with your doctor about taking an ED drug or exploring other options for getting or keeping an erection, like using a penile pump.

Even though talking about ED may be difficult, it’s important to open up lines of communication with your partner. “For many men, it can help relieve stress to know they are not alone and someone is there for support.”

Poor sleep. Lack of sleep can be one of the main energy zappers. Poor sleep can increase stress levels and interfere with how your body and brain store and use energy, which is why you feel so sluggish after not sleeping well. And if you are tired, you have less energy for sex. Talk with your doctor if you have trouble sleeping. Steps like changing medication or dose, cognitive behavioral therapy, and adjusting your diet and sleeping environment can often improve sleep quality.

Lack of movement. When you have no sexual energy, you need to get moving. Regular exercise is one of the best natural energy boosters. Numerous studies have linked exercise with improving fatigue, especially among sedentary people. You don’t need much to get a jolt — 2.5 hours per week of moderate-intensity exercise can do the trick. Focus on a combination of cardio and weight-bearing exercises like brisk walking and strength training.

Get checked out

Many medical conditions can affect sexual drive, such as obesity, diabetes, heart disease, high blood pressure, and high cholesterol. So be diligent about regular medical check-ups. Also, many drugs, including blood pressure drugs, antidepressants, and tranquilizers can produce erectile difficulties. Consult with your doctor if you take any of these.

Back in sync

Lack of energy also could be relationship-oriented, if you and your partner are not in sexual sync. For instance, you may have energy for sex, but your partner doesn’t, or at least not at the same level.

“Sex may not always be comfortable for women because of menopausal symptoms like vaginal dryness. If sexual activity is physically uncomfortable, not surprisingly, a woman’s sex drive also diminishes,” says Dr. Bober. “This can affect both partners, and if a man is worried that he might hurt his partner, that will certainly affect his interest in sex, too.”

In this situation, you need to communicate with your partner about how important sex is to you. It’s not about making demands, but about finding ways to explore mutual goals, such as pleasure and closeness.

“Perhaps it means negotiating a compromise just like you do in other aspects of a relationship,” says Dr. Bober. “Partners find ways to share everything from household chores to bill planning, and sex shouldn’t be any different.”

There’s a lot of room to find common ground, she adds. “There are many ways to be sexually active with your partner besides traditional intercourse. For example, you can ask your partner to be with you when you pleasure yourself, which feels intimate and can allow both partners to feel connected.”

Talk about it

Sometimes the sexual barrier is not about sex at all. An open dialogue also can reveal issues beneath the surface that may interfere with your partner’s sexual energy.

“Your partner may desire sex as much as you, but there may be underlying problems in the relationship that could affect sexual desire and need to be addressed,” says Dr. Bober.

Finally, another way to ignite lost sexual energy is to do new things together. “Couples can get into routines that can make for boring sex lives,” says Dr. Bober. “It can be fun to speak with your partner about ways to keep the relationship interesting and erotic.”

Many times, this can be done outside the bedroom, like having more date nights, going for long weekend romantic getaways, or even doing simple activities together like joining a club or taking a class.

“Investing in change can energize both you and your partner, and most important, pave the way for a renewed sense of closeness and novelty that is great for all couples,” says Dr. Bober.

Complete Article HERE!


When “No” Isn’t Enough And Sexual Boundaries Are Ignored


Violence is so normalized that we often don’t even recognize sexual abuses in the moment.

By Sherronda J. Brown

I recently realized that sex is unhealthy for me. Not sex in theory. No, of course not. Sex is healthy for our bodies and even our hearts and minds.When I say that sex is unhealthy for me, I mean the kind of sex that I have experienced — an experience that I share with many women, femmes, and bottoms. The sex where my needs are neglected and my boundaries are ignored in favor of whatever desires my partner may have.

Not everyone experiences sex and the things surrounding it in the same way, for various reasons. Some of those reasons might include gender cultivation, (a)sexuality, choice of sexual expression, knowledge of self/knowledge one’s own (a)sexuality, or relationship with one’s own body. Some of those reasons might include how certain body types are deemed “normal” and acceptable while others are only ever fetishized or demonized.

Some of those reasons might include the fact certain folks are told that they should be grateful that anyone would even be willing to look at them, let alone touch or love them, while others are expected to always be available for sexual contact. Some of those reasons might include the fact that some people are afforded certain permissions to make decisions about their sex and love life without being eternally scrutinized, while others are nearly always assumed to be sexually irresponsible.

Some of those reasons might include past or current trauma and abuse. And a host of other reasons not mentioned here, or reasons that you or I have never even considered because they’re not a factor in our personal story.

I’m not straight. I’m just an asexual with a libido—infrequent as it may be—and a preference for masculine aesthetic and certain genitalia. Most of the sex that I have had is what we would consider to be “straight” sex, and I am fairly certain that I would enjoy the act more and have a healthier relationship with it if more sexual partners were willing to make the experience comfortable and safe for me. Instead, men seem to want to make sex as uncomfortable and painful as possible for their partners, whether consciously or unconsciously, regardless of whether or not that is what we want.

Many men seem to judge their sexual partners abilities the same way that they gauge how much we love them and how deep our loyalty goes — by how much pain we can endure. I say this based on my personal experience, as well as the experiences of many of the people around me who have been gracious and trusting enough to share with me their testimony. Many of us have been conditioned to measure ourselves in the same way, using our ability to endure pain as a barometer for our worth.

Not only do we need to address the fact that far too many women have sex when they don’t want to because it’s “polite”, but we also need to talk about how many of us, of various genders, are having sex that is painful and/or uncomfortable in ways that we don’t want it to be, but we endure it for the sake of being polite, amiable, or agreeable. Many times, we also endure it for our safety.

This goes beyond simply not speaking up about what we want during sex. It’s also about us not being able to speak up about our boundaries and limits without fear of the situation turning violent. The truth is that many of us have quietly decided in our heads, “I would rather suffer through an uncomfortable/painful sexual situation than a violent one, or one that I might not survive.” This is about too many men not being able to tell the difference between a scripted pornographic situation or a story of sexual violence.

There have been too many times when I have been engaged in sexual situations and told my partner that I did not want a particular sexual act done to me, and they proceeded to do it anyway, with no regard for my boundaries, comfort, or safety. I gave them a valid reason for why I did not want the particular sexual act done to me, but I didn’t have to. My “No” should have been enough.

I once had to blatantly ask a guy if he understood what the word “No” meant. He had been attempting to persuade me into performing a sexual act that I was not interested in and had already declined several times. Therefore, it seemed a valid question.

“Yea, I do,” He responded. “It means keep going.” His answer did not stop there, but I will spare you the totality of the violent picture that he painted for me with his subsequent vulgarities. His voice was steady with a seriousness I dared not question. There was anger behind it, but also excitement and pride. The very thought of ignoring my “No” seemed to arouse him, even as he was filled frustration at my audacity to ask him such a question. I abruptly ended the phone call, grateful that this conversation had not been in-person. A chill came over me and I felt the urge to cry. My head and neck ran hot and the rise and fall of my chest quickened. Anxiety gripped me as I remembered that he knew where I lived and my panic drew out for weeks.

This is only one of my stories. I have others that include blatant disregard of boundaries, harassment, and other forms of sexual misconduct. I spent much of the last year contemplating the many ways that I have been coerced, manipulated, or even forced into sexual situations or sexual acts in the past, and how this violence is so normalized that we often don’t even recognize these abuses in the moment. Instead, they come back to fuck with us days, weeks, months, years, decades, centuries after the fact.

It took me more than seven years to realize that the first guy I ever had sex with coerced me into it. Literally trapped me in his apartment and refused to take me home until I gave in. After this, he went on to violate my trust and disregard my sexual boundaries in other ways until I ended our “friendship.” It took me months to name the time a former partner admitted to having once removed the condom during our encounter without my knowledge or consent as a sexual violation.

Unfortunately, I don’t know a single woman who doesn’t have stories like mine. And these stories belong to many people of other genders, or without gender, as well. This is our “normal,” and that is not okay. We need a broader understanding of what sexual violence and misconduct look like, and we need to deal with the fact that they are more a part of our everyday lives and common experiences than some of us are willing to admit.

We have to stop thinking of sexual violence and misconduct as something that only happens when someone is physically assaulted, drugged, or passed out. It’s far more than being groped by your boss, or terminated or otherwise punished for rejecting their advances. In a world where people do not feel safe saying “No,” not only to sex itself but also to certain sexual acts and types of sex, we cannot go on talking about sexual violence as if rape and harassment are the only true crimes. In doing this, we are leaving people behind.

The ways in which our bodies and boundaries can be violated are abundant. Too abundant. Fuck everyone who ever made another person feel like they couldn’t safely say “No.”

Complete Article HERE!


New treatments restoring sexual pleasure for older women


By Tara Bahrampour

When the FDA approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding decades to their vitality. Meanwhile, older women with sexual problems brought on by aging were left out in the cold with few places to turn besides hormone therapy, which isn’t suitable for many or always recommended as a long-term treatment.

Now, propelled by a growing market of women demanding solutions, new treatments are helping women who suffer from one of the most pervasive age-related sexual problems.

Genitourinary syndrome, brought on by a decrease in sex hormones and a change in vaginal pH after menopause, is characterized by vaginal dryness, shrinking of tissues, itching and burning, which can make intercourse painful. GSM affects up to half of post-menopausal women and can also contribute to bladder and urinary tract infections and incontinence. Yet only 7 percent of post-menopausal women use a prescription treatment for it, according to a recent study.

The new remedies range from pills to inserts to a five-minute laser treatment that some doctors and patients are hailing as a miracle cure.

The lag inaddressing GSM has been due in part to a longstanding reluctance among doctors to see post-menopausal women as sexual beings, said Leah Millheiser, director of the Female Sexual Medicine Program at Stanford University.

“Unfortunately, many clinicians have their own biases and they assume these women are not sexually active, and that couldn’t be farther from the truth, because research shows that women continue to be sexually active throughout their lifetime,” she said.

With today’s increased life expectancy, that can be a long stretch – another 30 or 40 years, for a typical woman who begins menopause in her early 50s. “It’s time for clinicians to understand that they have to bring up sexual function with their patients whether they’re in their 50s or they’re in their 80s or 90s,” Dr. Millheiser said.

By contrast, doctors routinely ask middle-aged men about their sexual function and are quick to offer prescriptions for Viagra, said Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.

“If every guy, on his 50th birthday, his penis shriveled up and he was told he could never have sex again, he would not be told, ‘That’s just part of aging,’” Dr. Streicher said.

Iona Harding of Princeton, New Jersey, had come to regard GSM, also known as vulvovaginal atrophy, as just that.

For much of their marriage, she and her husband had a “normal, active sex life.” But after menopause sex became so painful that they eventually stopped trying.

“I talked openly about this with my gynecologist every year,” said Mrs. Harding, 66, a human resources consultant. “There was never any discussion of any solution other than using estrogen cream, which wasn’t enough. So we had resigned ourselves to this is how it’s going to be.”

It is perhaps no coincidence that the same generation who first benefited widely from the birth control pill in the 1960s are now demanding fresh solutions to keep enjoying sex.

“The Pill was the first acknowlegement that you can have sex for pleasure and not just for reproduction, so it really is an extension of what we saw with the Pill,” Dr. Streicher said. “These are the women who have the entitlement, who are saying ‘Wait a minute, sex is supposed to be for pleasure and don’t tell me that I don’t get to have pleasure.’”

The push for a “pink Viagra” to increase desire highlighted women’s growing demand for sexual equality. But the drug flibanserin, approved by the FDA in 2015, proved minimally effective.

For years, the array of medical remedies has been limited. Over-the-counter lubricants ease friction but don’t replenish vaginal tissue. Long-acting mosturizers help plump up tissue and increase lubrication, but sometimes not enough. Women are advised to “use it or lose it” – regular intercourse can keep the tissues more elastic – but not if it is too painful.

Systemic hormone therapy that increases the estrogen, progesterone, and testosterone throughout the body can be effective, but if used over many years it carries health risks, and it is not always safe for cancer survivors.

Local estrogen creams, suppositories or rings are safer since the hormone stays in the vaginal area. But they can be messy, and despite recent studies showing such therapy is not associated with cancer, some women are uncomfortable with its long-term use.

In recent years, two prescription drugs have expanded the array of options. Ospemifene, a daily oral tablet approved by the FDA in 2013,activates specific estrogen receptors in the vagina. Side effects include mild hot flashes in a small percentage of women.

Prasterone DHEA, a naturally occurring steroid that the FDA approved last year, is a daily vaginal insert that prompts a woman’s body to produce its own estrogen and testosterone. However, it is not clear how safe it is to use longterm.

And then there is fractional carbon dioxide laser therapy, developed in Italy and approved by the FDA in 2014 for use in the U.S. Similar to treatments long performed on the face, it uses lasers to make micro-abrasions in the vaginal wall, which stimulate growth of new blood vessels and collagen.

The treatment is nearly painless and takes about five minutes; it is repeated two more times at 6-week intervals. For many patients, the vaginal tissues almost immediately become thicker, more elastic, and more lubricated.

Mrs. Harding began using it in 2016, and after three treatments with MonaLisa Touch, the fractional CO2 laser device that has been most extensively studied, she and her husband were able to have intercourse for the first time in years.

Cheryl Edwards, 61, a teacher and writer in Pennington, New Jersey, started using estrogen in her early 50s, but sex with her husband was painful and she was plagued by urinary tract infections requiring antibiotics, along with severe dryness.

After her first treatment with MonaLisa Touch a year and a half ago, the difference was stark.

“I couldn’t believe it… and with each treatment it got better,” she said. “It was like I was in my 20s or 30s.”

While studies on MonaLisa Touch have so far been small, doctors who use it range from cautiously optimistic to heartily enthusiastic.

“I’ve been kind of blown away by it,” said Dr. Streicher, who, along with Dr. Millheiser, is participating in a larger study comparing it to topical estrogen. Using MonaLisa Touch alone or in combination with other therapies, she said, “I have not had anyone who’s come in and I’ve not had them able to have sex.”

Cheryl Iglesia, director of Female Pelvic Medicine & Reconstructive Surgery at MedStar Washington Hospital Center in Washington D.C., was more guarded. While she has treated hundreds of women with MonaLisa Touch and is also participating in the larger study, she noted that studies so far have looked only at short-term effects, and less is known about using it for years or decades.

“What we don’t know is is there a point at which the tissue is so thin that the treatment could be damaging it?” she said. “Is there priming needed?”

Dr. Millheiser echoed those concerns, saying she supports trying local vaginal estrogen first.

So far the main drawback seems to be price. An initial round of treatments can cost between $1,500 and $2,700, plus another $500 a year for the recommended annual touch-up. Unlike hormone therapy or Viagra, the treatment is not covered by insurance.

Some women continue to use local estrogen or lubricants to complement the laser. But unlike hormones, which are less effective if begun many years after menopause, the laser seems to do the trick at any age. Dr. Streicher described a patient in her 80s who had been widowed since her 60s and had recently begun seeing a man.

It had been twenty years since she was intimate with a man, Dr. Streicher said. “She came in and said, ‘I want to have sex.’” After combining MonaLisa Touch with dilators to gradually re-enlarge her vagina, the woman reported successful intercourse. “Not everything is reversible after a long time,” Dr. Streicher said. “This is.”

But Dr. Iglesia said she has seen a range of responses, from patients who report vast improvement to others who see little effect.

“I’m confident that in the next few years we will have better guidelines (but) at this point I’m afraid there is more marketing than there is science for us to guide patients,” she said. “Nobody wants sandpaper sex; it hurts. But at the same time, is this going to help?”

The laser therapy can also help younger women who have undergone early menopause due to cancer treatment, including the 250,000 a year diagnosed with breast cancer. Many cannot safely use hormones, and often they feel uncomfortable bringing up sexual concerns with doctors who are trying to save their lives.

“If you’re a 40-year-old and you get cancer, your vagina might look like it’s 70 and feel like it’s 70,” said Maria Sophocles, founding medical director of Women’s Healthcare of Princeton, who treated Mrs. Edwards and Mrs. Harding.

After performing the procedure on cancer survivors, she said, “Tears are rolling down from their eyes because they haven’t had sex in eight years and you’re restoring their femininity to them.”

The procedure also alleviates menopause-related symptoms in other parts of the pelvic floor, including the bladder, urinary tract, and urethra, reducing infections and incontinence.

Ardella House, a 67-year-old homemaker outside Denver, suffered from incontinence and recurring bladder infections as well as painful sex. After getting the MonaLisa Touch treatment last year, she became a proslyter.

“It was so successful that I started telling all my friends, and sure enough, it was something that was a problem for all of them but they didn’t talk about it either,” she said.

“I always used to think, you reach a certain age and you’re not as into sex as you were in your younger years. But that’s not the case, because if it’s enjoyable, you like to do it just as much as when you were younger.”

Complete Article HERE!


Some drugs can cause unwanted sexual side effects in men



You might assume that erectile dysfunction, or ED, is a normal problem that men face as they age. But because men (and women) take more medications as they age, the experts at Consumer Reports’ Best Buy Drugs report that side effects from those drugs are a little-known yet common cause of ED.

“Many medications can affect things like erectile dysfunction, desire and ejaculation in different ways and through different mechanisms of action,” says J. Dennis Fortenberry, former chair of the board of the American Sexual Health Association and the Donald Orr Professor of Adolescent Medicine at Indiana University School of Medicine.

Medications that can have these effects include high blood pressure drugs such as beta blockers, including atenolol (Tenormin), clonidine (Catapres), metoprolol (Lopressor) and methyldopa (Aldomet), and diuretics such as hydrochlorothiazide (Hydrodiuril).

Popular antidepressants and anti-anxiety drugs such as alprazolam (Xanax), diazepam (Valium), duloxetine (Cymbalta), fluoxetine (Prozac) and paroxetine (Paxil) can cause sexual problems such as delayed ejaculation, reduced sexual desire in men and erectile dysfunction. Lesser-known drug types that can also cause such sexual problems include antihistamines such as diphenhydramine (Benadryl) and antifungal drugs such as ketoconazole (Nizoral).

Surprisingly, heartburn drugs, including famotidine (Pepcid) and ranitidine (Zantac) are known to reduce sexual desire in men. In addition, reduced desire and erectile dysfunction have been reported in men taking the powerful painkillers oxycodone (OxyContin) and hydrocodone (Vicodin), muscle relaxers such as baclofen (Lioresal), and even over-the-counter ibuprofen (Advil, Motrin).

And perhaps not surprisingly, the more drugs a man takes, the greater his odds are of experiencing an issue. For example, in a 2012 study of men ages 45 to 69, those who took three to five drugs were 15 percent more likely to have erectile dysfunction than men taking two or fewer. Men who took six to nine drugs were 51 percent more likely to have erection problems.

What you can do

Before making any change to your medications, talk with your doctor, says David Shih, a board-certified emergency medicine physician and executive vice president of strategy on health and innovation at CityMD, a network of urgent care centers in the New York metro area and Seattle.

If appropriate, your physician can make changes such as “lowering the medication dose, switching to a new medication or a combination therapy of lower doses each,” notes Shih.

Your doctor may also suggest temporarily stopping a medication — often referred to as taking a “drug holiday” — before having sex, if that is possible.

If you’ve just started taking a new drug, sexual side effects may disappear as your body adjusts. But if after a few months they don’t, discuss it with your physician. He or she will want to rule out other conditions that could cause your sex drive to take a nose-dive.

“The prescribing physician will need to explore if these symptoms are from cardiovascular disease, depressive disorder, diabetes, neurological disease and other illnesses,” says Shih.

Even suffering from sleep apnea is known to affect sexual interest or response.

That’s why, if you experience ED, it’s important to get to your doctor’s office for a detailed discussion about what could be causing it.