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Cancer patients and survivors can have trouble with intimacy

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People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.

People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.(Photo: Getty Images/Comstock Images)

In the mirror, Kelly Shanahan looks normal, even to herself.

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Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health.

But she does not feel like herself.

The breasts she had reconstructed eight years ago look real, the nipples convincing. But her breasts have no sensation. The only time she feels them at all is during the frigid winters of her South Lake Tahoe, Calif., home, when they get so cold, she has to put on an extra layer of clothing.

“For a lot of women, breast sensation is a huge part of sexual pleasure and foreplay. That is totally gone,” says Shanahan, 55, who has lived with advanced breast cancer for three years. “It can be a big blow to self-image, even though you may look normal.”
Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health. (Photo: Kelly Shanahan)

Shanahan is part of a growing group of patients, advocates and doctors raising concerns about sexual health during and after cancer treatment.

“None of us would be here if it weren’t for sex. I don’t understand why we have such a difficult time talking about it,” she says.

Though virtually all cancer diagnoses and treatments affect how patients feel and what they think about their bodies, sex remains an uncomfortable medical topic.

Shanahan, an obstetrician herself, says that until her current doctor, none of the specialists who treated her cancer discussed her sex life.

“My former oncologist would rather fall through the floor than talk about sex,” she says.

Major cancer centers now include centers addressing sexuality, but most community hospitals still do not. The topic rarely is discussed unless the patient is particularly bold or the doctor has made a special commitment.

There’s no question that cancer can dampen people’s sex lives.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Weight gain or loss can affect how sexy people feel. Fatigue is unending during treatment. Body image can be transformed by surgeries and the idea that your own cells are trying to kill you. The constant specter of death is a sexual downer, as are the decidedly unsexy aspects of cancer care, like carrying around a colostomy bag. Then, there are the healthy partners, feeling guilty and terrified of causing pain.

And once people start to associate sex with pain, that can add apprehension and muscle tightness, which makes intercourse harder to achieve, says Andrea Milbourne, a gynecologist at the University of Texas MD Anderson Cancer Center in Houston.

There’s almost never a medical reason cancer patients or survivors shouldn’t be having sex, says Karen Syrjala, a clinical psychologist and co-director of the survivorship program at the Fred Hutchinson Cancer Research Center in Seattle. Even if there is reason to avoid intercourse, physical closeness and intimacy are possible, she says, noting that the sooner people address sexual issues the less serious those issues will be.

“Bodies need to be used and touched,” she says said. “Tissues need to be kept active.” Syrjala recommends hugging, romantic dinners, simple touching, “maybe just holding each other naked at night.”

There are ways to improve sexual problems, starting with doctors talking to their patients about sex. Milbourne and others say it’s their responsibility, not the patients’, to bring up the topic.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Communication between partners also is essential. “A lot of times, it’s unclear, at least in the mind of the other partner who doesn’t have a cancer, what has happened. ‘Why does this hurt? Why don’t you want to do anything?’ ” Milbourne says.

For women who have pain during sex, Milbourne says one study found benefit to using lidocaine gel to numb vaginal tissue.

Jeanne Carter, head of the female sexual medicine and women’s health program at Memorial Sloan Kettering Cancer Center in New York City, recommends women do three minutes of Kegel exercises daily to strengthen their pelvic floor muscles and improve vaginal tone, and to help reconnect to their bodies.

For women sent abruptly into menopause, moisturizing creams can help soften tissue that has become brittle and taut. Carter says she’s conducted research showing that women with breast or endometrial cancers who use moisturizers three to five times a week in the vagina and on the vulva have fewer symptoms and less pain than those who don’t. Lubricants can help smooth the way, too.

“We’ve got to make sure we get the tissue quality and pain under control or that will just undermine the whole process,” Carter says.

Sex toys also take on a different meaning after cancer treatment. Specialized stores often can offer useful advice and the ability to examine a product before buying. Rings and other equipment, in addition to medications such as Viagra, can help men regain erections.

Doctors and well-meaning friends also need to stop telling cancer patients that they should simply be glad to be alive, Shanahan says. Of course she is, but eight years after her initial diagnosis and three years after her disease advanced, Shanahan wants to make good use of the time she has left.

And that, she says, includes having a warm, intimate relationship with her husband of 21 years.

Complete Article HERE!

Meet The Photographer Using Rope Bondage To Create Incredible Art

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Art has a long history of drawing inspiration from the otherwise underground world of BDSM. The custom goes as far back as 1928, when the surrealist artist Man Ray captured an image of a woman sensually reclining while bound in ropes and a harness.

Robert Mapplethorpe famously stunned the ’70s art establishment with his documentation of the S&M play flourishing in certain corners of the gay community. Acclaimed Japanese artist Nobuyoshi Araki made his name with graphic, intensely sexual, and often controversial images of Kinbaku-bi, the ancient Japanese art of “tight binding” or rope play. The list goes on and on…

Contemporary photographer Garth Knight both aligns with and breaks from this complicated tradition. A former engineering student, Knight pursues his lingering interest in forces and mechanisms by creating intricate sculptural rope forms in which human models hang.

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While Knight also draws from the kinbaku tradition, his photographs are less corporal and titillating than Araki’s work or your typical bondage art. The focus of Knight’s stunning and meticulous rope suspensions is more on transcendence than the human form.

Konbini spoke with Knight about his vivid rope worlds, his process, and whether he considers his work erotic. Read the full interview below!

Konbini: When did you begin drawing from bondage and shibari in your work? What attracted you to those worlds/forms?

Garth Knight: I have always had a strong affinity with line and had enjoyed playing with rope for practical purposes. In 1999, when I first saw a person being beautifully bound, it was like a revelation.

At that stage I wasn’t particularly interested in or even really aware of erotic bondage, but just seeing the rope and the body combined aesthetically spoke very deeply to me and I knew I had to do it myself.

The mechanics of tying came quite naturally and very easily to me, but the emotional and psychological aspects of rope bondage took a long time to develop. I still feel like there are whole worlds to discover and cultivate in this respect.

There was no internet back then and Japanese rope art (shibari, or kinbaku) was also completely unknown to me. I just started playing around and for many years I was just teaching myself, developing my own style and stumbling around in the dark. When I became aware of kinbaku I was very attracted to it and started incorporating elements of it into my style, though I have always been very careful to make this symbiosis influential rather than a replication.

Garth Knight

How has rope bondage influenced your art?

The more I’ve used rope and tying, the more I’ve learned that my own place in this world is tenuous and unreal and a construct of my mind. This world is connection overlayed with connection which we try and make sense of by building patterns.

When you work with rope, you lay rope onto rope and connection onto connection making an extended and cumulative embrace, forming a vibrating web of touch on the body and in the surrounding space, the connectivity and flow of energy pulsing through the space and the body and our psyches.

It’s a very powerful and sometimes transcendent place to be. It’s compelling and overwhelming and sensual and hypnotic. To release yourself to these emotions, to be able to submit to this, is all facilitated by the constraint of the rope.

Garth Knight

What does your process look like when you are making something like your Blood Consciousness or Vortex series? Who are your models? How long does it take you to finish one of your rope sculptures?

Ideas come mostly in daydreaming states, or while drawing, sketching. The end result is usually very process-driven: I make a start and the work develops organically. Working with the model is usually a very experimental process, working together to find their “place” in the work.

The rope used to tie someone takes up their energy, their sweat and skin and touch and experience. The models are a mixture of my friends and associates, as well as people contacting me who are interested in being part of this process. I choose people who intuitively feel right for that particular image, sometimes this just comes down to serendipity.

Each shoot takes place over several hours. The entire series takes many days to produce, normally stretched out over weeks or months.

contact garth@garthknight.com

Where do you draw or find inspiration? What other artists influence you? What do you draw specifically from the BDSM or bondage world?

The natural world with its constant infinite dance of order and chaos is always my greatest inspiration and ongoing fascination. I am attracted to bonsai and the constraint of form combined with simultaneously attempting to see and bring out the individual plants “true” being.

Surrealist artists like Dali and Man Ray set me on my path early. Escher, Odd Nerdrum, Andy Goldsworthy and Da Vinci are the kind of artists that also rate highly. From the kinbaku world, Kinoko and Kanna are two artists I really admire.

From BDSM specifically, I draw an interest in transcending the body and mind through the use of extreme sensation, and the use of physicality and eroticism as a pathway to awe.

contact garth@garthknight.com

contact garth@garthknight.com

Do you regard your work as erotic or sensual? What do you hope your work conveys about the human body, submission, and constraint?

I’ve brought up a couple of times the erotic and sensual aspects, both in the process and final images, and I definitely find both of these things to be essential elements and integral parts of my work.

In the past, I have avoided talking too much about this aspect, partly because it’s definitely not the only thing the work is about and since it is such a powerful element in people’s perception it can cloud the other aspects. Mostly though I’ve come to realize it’s because I find it very confusing and difficult to extricate some meaningful description of that part of the work using words.

contact garth@garthknight.com

contact garth@garthknight.com

Hopefully, ultimately, I would like to convey that the human body is just a construct for the perception and interaction of the flow of energy which we call consciousness, which moves from the infinite collective unconscious through our momentary singular consciousness to learn and grow and then onto its ultimate dispersal into the collective super-consciousness.

This flow adds to some spiritual momentum which, once it reaches some critical level, will lead to the complete enlightenment of the One which contains us all.

My mind tells me that this thought is ridiculous and just does not add up with what it sees and the physical reality that it has built and fastidiously maintains, and which we are so constrained by and invested in. And yet, when I submit myself entirely to the experience of the creation of art, I do believe this thought to be so.


More of Garth Knight’s work can be found on his website. The “Blood Consciousness” and “Vortex” series are also available in full in Knight’s new book

Complete Article HERE!

5 Ways To Build Endurance In Bed

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5 Ways To Build Endurance

So, you love having sex. You like the ins-and-outs of the whole process and of course, the grand finale. But when you’re going at it, you find yourself getting exhausted, tired, and ready to throw in the towel (long before you actually get to a point of ecstasy). Your ability to maintain energy during sex is a lot like your strength to push through a tough boot camp class: it’s all about endurance.

“Endurance is important in bed because it gives us a sense of control and feeling of empowerment. We are able to meet our partner’s sexual needs, and feel sexually and erotically fulfilled ourselves,” Dr. Holly Richmond, psychologist and sex therapist tells Bustle. “It lets us know for certain that we are a good lover. If two people’s sexual endurance is equally matched, there will be no reason to ask, ‘Was that good for you?’ Having sexual endurance gives each person a sense of sexual self-efficacy and know-how.”

If you’re struggling with getting up your stamina, don’t worry. There are easy ways — both mentally and physically — to get your head and your body into the bedroom:

1. First, Define What Endurance Is

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When experts speak about endurance, it’s not just about how long you can stay on top of your partner or hold a position. As Richmond notes, it’s actually about all aspects of love making that require a strong will. As Dr. Richmond explains, physical endurance might be what you first think of: “The physical aspect, giving and receiving pleasure, is one of the most important pieces of sexual health that I help my clients explore. In a nutshell, it’s asking, ‘What feels good to you? How do you enjoy being sexual with others? How well do you know yourself and your sexual needs? How willing are you to ask your partner about their needs, and meet them if possible?’” she explains.

But then there’s emotional strength while having sex which she explains: “The act of staying present and attuned to your partner, is also an essential element of great sex. I might ask, ‘Do you want sex to be just about your genitals, or are you open to mind/body eroticism, an embodied experience that can make good sex great sex?’”

2. Make Sure You Invest In Foreplay

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Part of what will get everything flowing in the right direction is ensuring your body turned on. A big way to do this is with foreplay — from using your hands to your mouth on one another. This helps build your endurance because you spend less time in actual intercourse trying to turn one another one and more time warming up everything. As Richmond advises — foreplay can actually start long before you get naked, too: “Explore what gets you in the mood. Is it sexting with your partner, putting an explicit sticky note on their car seat, whispering in their ear that morning about what you want to do to them or want them to do to you? Build endurance that lasts all day,” she says.

3. Get Out Of Your Head

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It’s easier said than done, but the more you can stay present during sex, the better your endurance will be. You waste mental energy that could be focused on intimacy when you start rattling off to-do lists in your head while trying to also have sex. When you let go of everyday stresses for just an hour, you won’t wear yourself out as quickly.

One way to do that is to prioritize your daily choices, Richmond says. “Stress is not sexy. If you are constantly running from one engagement to the next, always in work mode or mom mode, your sexual endurance will be nil. It sounds cliché, but taking time for yourself (not necessarily by yourself) — time where your needs come first — is essential. Exercise, quiet time alone, and social time with friends and family are all necessary qualities that enhance your overall health and sexual health, of which endurance is feel-good byproduct.”

4. Masturbate

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It’s no secret that masturbation can seriously make your sex life better. From when you do it all by yourself to using it as a sexy addition for your partner to watch, knowing your own pleasure zones and what gets you off helps you have a fun experience. It can also help build your endurance because you don’t spend time doing things that don’t work and instead, focus on the ones that do.

“If you don’t know your body and mind, and what keeps your aroused, how do you expect your partner to? Be willing to explore your fantasies when you masturbate, and then if it feels safe, share them with your partner,” Richmond tells Bustle. “Also, practice with your hand or a vibrator by bringing yourself close to orgasm, and then bringing yourself back down…and then bringing yourself back up again. Being able to control your orgasm with your technique can extend a quickie to hours of pleasure.”

5. Lastly, Breathe

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If you’ve ever ran a race or tried to make it through a grueling workout, you likely heard your instructor (or your internal coach) reminding you to inhale and exhale. Breath is so important in anything physical, sex included. It helps you structure your pace, slow down and then dive right back in.

“The pacing of your breath is as important as the pacing of your body. Things may go too quickly if your breathing is shallow and rapid. Think long, slow deep breaths, and let your body follow,” Richmond says. “You can learn to easily regulate your excitement with your breath for an extra erotic mind/body charge.”

Complete Article HERE!

Coming strong : forceful ejaculations, part 1

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We all want to shoot our semen across the room. Granted, not many can boast to shoot that far, and to be fair we don’t always feel like cleaning the whole house after an ejaculation. But if there is something we still want, it is to have a powerful cum shot. For the uninitiated, this desire seems ludicrous or maybe appear as a show of personal vanity. But for anyone who has ejaculated more than a few times, the reason is clear : forceful ejaculations mean stronger orgasms, earth-shaking orgasms, fully draining orgasms. And maybe giving us some bragging rights too ! How can it be achieved?

Forceful ejaculations result from a combination of many elements. Some of which you can influence, and some of which you cannot.

Your level of arousal greatly influence the contraction strength of the pelvic muscles. How tired you are, how hydrated you are also directly influence your ejaculation’s strength.

Some anatomical peculiarities can greatly influence your ability to shoot forcefully. One of those is the size of the urethra. The urethra is the canal inside the penis where urine and semen flow. A urethra that’s too wide (slack) will allow semen to flow too easily, causing a rapid decrease in pressure as it leaves the posterior urethra (where the semen was assembled and pressurized before ejaculation). On the contrary, a urethra that’s too narrow will create too much resistance to the semen’s passing, in the end also diminishing the shooting distance. All in all, to be a far shooter, you need to have been granted with an ideally sized shooting tube. Can you change this ? It depends. If it’s too slack, there’s no way of narrowing the opening. If its gauge is too tapered, however, then dilation with a urinary catheter could be considered. But : be very wary. This needs to be done cleanly or you may cause severe infections (of the prostate in particular). And you should have a good understanding of your anatomy before inserting anything in your penis. That penis of yours is not built of steel and it has no user replaceable parts : you break it, you lose it ! Always ask a pro’s advice.

Exposing your body to longer sexual stimulation also influences the ejaculation’s strength. Indeed, the various glands that produce the different liquids forming semen will have all the time they need to produce and dump a lot of stuff in the posterior urethra if you take the time to prime yourself. Whatever your preparation is, the posterior urethra’s size is fixed (surprise !). So the more seminal liquid you produce, the greater the pre-ejaculatory pressure will be. And higher pressure, of course, translates as a more forceful cum shot. So a long male foreplay (the period before ejaculation) will cause you to shoot further.

Now, of course, there would be no forceful ejaculation without strong pelvic muscles. And this is the area where you can have the most influence (aside from taking your time, of course). Improving the strength of your pelvic floor muscles will in fact have numerous benefits :

  • Decrease the likelihood of peeing involuntarily (it had to be said, even if you understandably don’t care as of today !) (PC, BC).
  • Help with erectile dysfunction (BC).
  • Definitely help if you have premature ejaculation by increasing your ability to withhold your ejaculation. But even if you don’t have premature ejaculation problems, this increased ejaculation control will translate into better edging abilities : being able to edge longer and closer to the cresting point (BC, but also PC and IC).
  • Increase the strength of your orgasmic contractions, in effect enhancing your orgasmic pleasure (BC, PC, IC).
  • And finally, of course, since this is the topic, increase your shooting distance.

The pelvic muscles are a group of muscles formed of the iliococcygeus (IC), pubococcygeus (PC) and bulbocavernosus (BC). These muscles form a hammock holding the content of the pelvic floor.

  • The iliococcygeus (IC) muscles stabilize the rectal area, together with the PC muscle. The IC muscles pull the rectum towards the back. They contract rhythmically during orgasm.
  • The pubococcygeus (PC) muscles control the urine flow, and they pull the rectum towards the front. They contract rhythmically during orgasm. In women, the PC muscles also contract the vagina and are thus, for them, the most important pelvic muscles to work on. While men who strengthen their PC muscles definitely experience an improvement of their orgasmic experience, they will not shoot any further.
  • The bulbocavernosus (BC) muscles serves to maintain blood inside the penis during erection (even though the erection is largely a vascular process) and also serves to expel urine and semen out of the urethra. So this muscle is the one men should work on.

So, to summarize :

  • Forceful ejaculations are desirable because they translate into more intense orgasms
  • While the shooting distance is in direct relation with the strength of an ejaculation, shooting distance will always vary greatly between ejaculations because of various other variables. Moreover, some men will always be able to shoot further than others.
  • It is possible to improve the strength of your ejaculation by working on the pelvic muscles, in particular the bulbocavernosus. How far you will shoot, after these exercises, will vary from man to man. But a sure thing is that your sexual experience will be improved.
  • Being well hydrated and rested is also important.

Complete Article HERE!

Are you getting any closer? A pocket-sized primer on female sexuality

By Clarissa Fortin

Stay curious between the sheets, friends.

Closer: Notes from the Orgasmic Frontier of Female Sexuality
by Sarah Barmak
(Coach House Books, 2016; $14.95)

If it weren’t for Sarah Barmak’s Closer: Notes from the Orgasmic Frontier of Female Sexuality I might have gone for years of my life without ever finding out what my clitoris actually looks like.

“Illustrations of it resemble a swan with an arched neck,” Barmak writes. “When I saw an closerillustration of the clitoris’s true shape for the first time I felt like a blind man finally seeing a whole elephant when all he’s ever known was the tip of it’s trunk.” I realized while reading those sentences that no one in my Catholic high school health class ever bothered to show me such an image and I’d never thought to seek one out.

I consider myself a feminist and a sexually liberated woman. Yet, there are still surprising gaps in my understanding of my own body. And that’s why a book like Barmak’s is important. Closer tackles its subject with eloquence, intelligence and humour.

The book is split into five essays that tackle the “fear of pleasure,” the history of female sexuality, the science and psychology of the orgasm, the “female sexual underground” and the politics of acknowledging female desire.

While each essay has its own strengths, I think the most effective chapter is “A History of Forgetting.” This section aligns the historical “discovery” and “loss” of the clitoris with the individual experience of a woman named Vanessa — an actual interview subject.

We first meet Vanessa on the table at the doctor’s office filming herself masturbating in order to prove to the doctor that she can indeed ejaculate. We learn that Vanessa has been having a series of problems — pain after sex, recurring yeast infections and so on — that no doctors can figure out.

From here Barmak momentarily leaves Vanessa’s story behind and turns her attention to the clitoris itself, noting that “the mapping of the human genome was completed in 2003, years before we got around to doing an ultrasound on the ordinary human clit.”

While the tendency is to see history as ever moving forward and progressing, Barmak counters that “women’s sexuality began by being celebrated, then was feared as too potent, before being downplayed and denied in the scientific era.”

The Christian church, the scientific revolution and various other factors resulted in a demonization and rejection of female bodies. It’s a generalized historical account to be sure, but Barmak does point readers in the direction of Naomi Wolf’s Vagina, a much more comprehensive book on the subject.

What makes this essay so powerful is the way it revisits and concludes with Vanessa and her struggle. Her story held up against the larger history of the clitoris itself demonstrates all too well an overall contempt for and neglect of the female genitalia.

Along with research and anecdotes, Barmak amasses a diverse collection of interviews with doctors, researchers and sex educators. I was excited to learn many factoids that I will surely whip out at dinner parties in the future — for instance, vaginal self stimulation actually blocks pain in women, and even women who are paralysed can sometimes still feel sexual pleasure because of nerves which bypass the spinal cord and communicate directly with the brain!

Barmak combines this research and traditional journalistic writing with first-person narration, bringing her own experience into the story. This means attending seminars and workshops, watching a demonstration of a female orgasm at Burning Man, and getting a vaginal massage.

Barmak is open about her own skepticism and trepidation during these investigations. “I like to consider myself open to new things,” she writes. “Yet, the idea of a strange lady’s gloved fingers all up in my jade palace falls somewhat outside my personal boundaries.” She goes through with it and the personal account makes for a richer narrative overall.

A note about the term “woman”: Barmak uses it throughout the book to generally refer to the cisgendered female experience. If I have any strong critique of the book it is that by celebrating the distinctly female anatomy, the book sometimes verges on unintentionally emphasizing a gender binary. This is something Barmak herself seems aware of. She notes on pg. 21 that “the word woman can refer equally to cisgender, intersex, genderqueer and transgender women all representing varied shades of experience.” While it’s good that the acknowledgement is there, I think a declaration like this belongs even earlier on as a note for readers to keep in mind before the book even begins.

That said, Barmak does make an effort to include the experiences of typically marginalized women such as trans women and women of colour in her narrative. “Being white affords privileges even in non-mainstream spaces of revolt such as sexuality,” she notes.

The topic is something “that requires far more depth and attention than this little book can offer,” Barmak says and while this seems like a partial cop-out for having only a few pages devoted to women of colour and trans women specifically, Barmak makes a valid point. Issues regarding sexuality faced by marginalized women warrant entire books altogether, preferably penned by a writer who has lived those experiences.

Nevertheless, I think this book would have been more complete with a sixth section devoted specifically to these issues.

At its core this book is compassionately optimistic, celebrating the innate complexity of sexual pleasure itself and arguing in favor of orgasms for all, something I can definitely get behind.

Sex educator and vlogger Lindsay Doe has a motto she repeats at the end of each of her videos: “stay curious.” Closer isn’t the definitive book about female sexuality and it doesn’t claim to be. But it made me curious about my own body, and even more curious about the wonderfully vast array of experiences we humans have between the sheets.

I recommend it to my friends of all genders, my boyfriend, my sisters, and especially the woman who started it all, my mother.

Complete Article HERE!