The Ethical Slut turns 80

— A talk with poly fairy grandmother Dossie Easton

‘The Ethical Slut’ co-author Dossie Easton.

She co-wrote the book on living and loving openly. Here, she speaks to us about her decades of experience.

By Caitlin Donohue

Twenty-something me would have been verklempt: I was set to interview Dossie Easton, one of the co-authors of The Ethical Slut. The venerable sex and relationship therapist, educator, and self-proclaimed “SM diva” had just celebrated her 80th birthday (she celebrated by going to see Taylor Mac at Cal Performances, I would learn) and was due for some gassing up when it came to her lasting influence on sex education. 48hills was only too happy to oblige—we adore a slutty Bay Area legend.

Easton and her longtime co-author and lover Janet W. Hardy’s iconic book, originally published in 1997 and now on its third edition, broke onto the collective consciousness as the definitional text for those interested in living a life beyond monogamy. The duo went on to pen a passel of tomes for tarts: The New Bottoming Book (and its top-friendly sister volume), When Someone You Love is Kinky, and Radical Ecstasy: S/M Journeys to Transcendence among them.

But if you’re of a certain age and queer/polyamorous proclivity, The Ethical Slut was the book that has doubtlessly spent time on your bedside table, probably purchased on the recommendation of a crush whose language you were desperate to learn. Its impacts on our lexicon are undeniable, not the least of which being the reclamation of that titular term for those who bed without shame. Do you know what a “primary partner” is or what “compersion” feels like? Did you ever attend a SlutWalk? Conversely, was the media’s obsession with Jada Pinkett Smith’s entanglement truly baffling for you? Have you been driven to distraction by an irresponsible lover who willfully misuses the language of ethical non-monogamy? You likely have TES to thank.

Certainly, the book’s success changed Easton’s own dating life forever. “For some people it creates distance, because they get embarrassed,” says the curly-headed sex sage, Zooming in from her longtime home in Marin County. “I can understand that, because I get embarrassed around famous people myself.” But far more often: “People like me in advance, which is nice.” Indeed, who wouldn’t like a published author well-versed in lesbian fisting party protocol?

Of course, seismic cultural change has impacted our take on the pair’s seminal work. Easton was open in her discussion of how time has shaped views on The Ethical Slut, and the book itself.

“We started using less gendered language by the time we got to the second edition,” the educator, who continues to teach online seminars on navigating, tells me. “It was a consciousness thing that moved further and further for us.” Cursory sections on online dating and being BIPOC and poly were also added in later editions—two areas which Easton admits hypothetical further editions could further explore. But staying on top of emancipatory language around sex and gender does entail a steep learning curve. More recent editions of the book did still seem to rule out sexual coercion among gay men and center cis folk. Easton mentions that she saw gendered terms as necessary for describing situations in the book like those involving “somebody right after a baby was born”.  

There is no denying, however, that we have here a Bay Area sex education institution. Easton tells me she dropped out of “mainstream culture” when she was 18, discovering that psychedelics brought her closer to the spirituality she found lacking when she was growing up with a Roman Catholic family in small-town Massachusetts.

“By the time the ’60s rolled around, I was doing volunteer work.” Easton recalls. “I volunteered during the Summer of Love at the Haight Ashbury Medical Clinic, things like that, doing psychedelic crisis intervention. I didn’t have a license to practice then, but I volunteered at places like the battered woman’s shelter in the ’70s, and at San Francisco Sex Information, which is a wonderful switchboard that still exists. You can call up and have a trained volunteer answer your questions about sex, isn’t that nice? It’s celebrating its 50th anniversary sometime soon.”

The Ethical Slut’ co-authors Dossie Easton and Janet W. Hardy

Shortly after having her daughter, she left the last monogamous relationship she’d ever have, famously making a vow to forever live the poly life. Easton raised her kid (now 55) largely in communal living situations, crediting bathhouse-loving gay male housemates—who were at times deprived of contact with kids, in an era when the LGBTQs could little hope to be approved as adoptive parents—for teaching her that the s-word, at least, could be applied to all genders. To this day, she is a huge believer in the power of extended chosen families, particularly for people whose sexual orientation or practices places them outside the nuclear family industrial complex.

As advanced as her San Francisco community was, even by the late ‘80s when Easton attended graduate school to become a certified therapist, academia still had no idea what to do with non-monogamists. When they found about that it was a lived interest of hers, teachers would interrogate Easton about whether it was really possible for individuals to be happy outside of one-on-one relationships. “Then I found out that the professor who questioned me was well-known for coming onto other people’s wives. I was like, you’ve got to be kidding me,” she smirks.

Happily, times have changed somewhat and, the octogenarian reports, there are certain joys of being a slut elder. Easton hasn’t had a primary partner since 2010—she says she’s been single for roughly half of her adult life—but when she fell and hurt her elbow last year, recovery was distinctly and joyfully poly, with a community of past and present lovers and friends signing up to care for their fallen friend. “There was somebody at my house 24/7 for the first three weeks,” Easton says.

Another heartwarming ethical-slut-at-80-story: Though Easton split with a younger, former primary partner years ago due to the partner wanting to have kids, the two stayed in touch, with Easton eventually participating in the person’s touching “regeneration ceremony” and subsequently gaining two darling “fairy grandsons.” “I want people to understand that even when a breakup is really dreadful, you’re not required to somehow shut off that corner of your life and throw it in the trash. You can build something else,” she reflects.

1997 first edition cover of ‘The Ethical Slut’

If there’s one thing all of us who read The Ethical Slut recall, it’s the book relentlessly optimistic tone. It made you feel like this new world, in which we all merrily explore our sexual and gender identities, work on our jealousy and enjoy a plethora of partners should we get the hankering, is here, if you want it. But sadly, I write these lines in 2024. One of the United States’ woefully few major political parties has the imperilment of trans kids and racially-biased erasure of reproductive rights high atop its list of legislative priorities. Does Easton still hold with Martin Luther King Jr. that “the arc of the moral universe is long, but it bends toward justice”?

“I do,” she declares. “I was a teenager in the ’50s, for heaven’s sakes! […] It’s really scary, it really is, but they’re not going to be able to put the rabbit back in the hat. The information is out.”

If that sounds pat, know that she’s committed to ongoing efforts; Easton says she has “three manuscripts nagging at me”, one of them a vignette-laden journal that prompts readers to analyze their own needs and desires when it comes to sex and relationships. It reminds me of a story she told of an early revelation she had as a teen; that society did not have the right words for such a fundamental, fun part of human existence. In part, her career has been a mission to change just that.

“How do you talk about sex in a way that’s delightful?” asks the promiscuous fairy grandmother. “Wouldn’t that be dear?”

Complete Article HERE!

New study reveals 10% of Americans have history of bisexual behavior

— There are three times more people reporting partners of more than one gender than in the 1990s.

By

A recent study revealed a substantial increase in the number of Americans who either identify as bisexual or have a history of bisexual behavior. 9.6% of respondents reported having both male and female partners, over three times more than what was reported in the 1990s.

The study, published by researchers Martin A. Monto and Sophia Neuweiler in The Journal of Sex Research, utilizes the General Social Survey dataset, a nationally representative sample of over 32,000 participants. The survey aims to carefully represent each demographic of the United States, and follows up with participants across each successive decade in order to assess how responses may change over time. An additional 2,300 participants were added in the 2021 wave.

The study used a variety of tools to try and measure sexual orientation and prior sexual behavior. This includes a question that asks respondents to reply with their sexual orientation – either gay/lesbian/homosexual, bisexual, or heterosexual/straight.

For sexual behavior, the study asked participants to recall whether their past sexual partners were of the same or a different sex, with additional questions asking about whether their partners were male or female. These responses were narrowed down by the researchers to those who had multiple sexual partners in the past year.

Using a method called regression analysis, the researchers determined what the relationships were between their measures of sexual orientation and behavior with gender, assessing how these relationships changed over time. They found that not only were participants more likely to identify as bisexual than in previous years, but that there were more participants identifying as bisexual than gay or lesbian.

However, they found the reverse trend for sexual partners, with more respondents being exclusively of the same sex than those who had both male and female sexual partners. The authors also note that women were more likely than men to report being bisexual or having a history of bisexual behavior, with men being more likely to report exclusive same-sex behavior.

In addition, this study also found that young people were more likely to identify as bisexual, with 10% of those below 29 and 12% of those in their 30s identifying as such.

This study reflects the changing landscape of Americans identifying as LGBTQ+. Previous studies have suggested similar trends, with more Americans identifying as LGBTQ+. In those prior studies, bisexuality was also the most frequent orientation behind heterosexuality.

The authors detail how this demographic shift showcases a “loosening of the social norms and institutional enforcement that have privileged heterosexuality over other sexual orientations,” with modern demographics being more accepting of LGBTQ+ individuals than in the past few decades.

They suggest that a reason there may be a discrepancy between identification and behavior in their results is due to how behavior may capture those simply exploring their sexuality before coming to a new identity.

In addition, they also point out how “sexual orientation can be fluid, with some people changing their sexual behavior and/or their sexual orientation identities over time.”

Finally, they detail that “even persons who have more recently had partners of both sexes may not consider themselves bisexual, and the term may not fit their understandings of themselves and their sexual behavior.”

The authors conclude by calling for more research that “can better recognize that the terms with which we identify ourselves are social and that there is some degree of choice about how to identify our sexual orientation, particularly among individuals with histories of both male and female partners”

Complete Article HERE!

What Is “Natural” for Human Sexual Relationships?

— A biological and anthropological researcher explains how humans’ diverse ways of mating might have evolved.


Members of a pro-polyamory group march in Toronto’s 2018 LGBTQ Pride Parade.

By Rui Diogo

Marrying more than one person constitutes a crime across most of the Americas and Europe. But in countries including Mali, Gambia, and Nigeria, more than a quarter of the population lives in polygamous households.

Survey the sex lives of Homo sapiens, and you’ll find couples, throuples, harems, and other arrangements of lovers. Fidelity, adultery, and ethically non-monogamous unions. How could one species have evolved myriad ways to mate? Concerning sex, what is natural for us humans?

A green book cover features two images at the top: a painting of a person and a photo of two adults and two children gathered in a forest. Beneath the images, large white text reads, “Meaning of Life, Human Nature, and Delusions.” Smaller blue text reads, “Rui Diogo” and “How Tales About Love, Sex, Races, Gods, and Progress Affect Our Lives and Earth’s Splendor.”

As an evolutionary biologist and anthropologist, I am often asked that question. The answer is complex. It also goes to the heart of the nature versus nurture debate, a topic that I have been discussing for several years, including in my latest book, Meaning of Life, Human Nature, and Delusions.

As discussed in that book, the scientific and historical evidence suggests that our earliest human ancestors, after we split from the chimpanzee lineage some 7 million years ago, were mainly polygamous. Individuals had various sexual partners at the same time. Fast forward to today, and humans exhibit diverse mating arrangements due to a greater influence of culture and tradeoffs between sexual desire, comfort, and jealousy.

how humans mate

Numerous lines of evidence contribute to my understanding of human mating habits.

As a biologist, I turn to the sex lives of nonhuman primates: Most species appear polygamous, including our closest relatives, chimpanzees. For these apes, both males and females have several hetero- and homosexual partners.

Fossils indicate the earliest hominins—the evolutionary branch leading to humans after its split from chimps—resembled upright walking apes. Considering these first human ancestors looked and acted like apes in many ways, it’s likely they mated polygamously.

But putting on my anthropologist’s hat and observing humans today, I notice a considerable variety of mating systems. Different cultures enforce or reinforce very different sexual practices. For instance, in some regions of Tibet, a woman can live with several husbands (polyandry). In countries such as Pakistan, men typically live with more than one wife (polygyny).

Across dozens of Indigenous Amazonian societies, pregnant women and those trying to conceive have sex with different men based on the idea of “shared or partible paternity.” According to people who hold this belief, semen from multiple fathers contribute to a developing fetus. A woman might have sex with the community’s fastest runner and best hunter to pass on these desirable traits to her child.

So how did mating habits evolve from our polygamous primate past to our variable human present?

Cultural differences can overtake biological foundations, as numerous historical cases evidence. For example, ancient texts indicate that men imposed monogamy upon women—but not necessarily on themselves—when agriculture emerged in several regions around the globe. As historian Stephanie Coontz has argued, farming lifestyles created notions of private property, which extended in some places to greater subjugation of women. In the early farming societies of ancient Egypt and Mesopotamia, wedding rings, worn by the wife, symbolized that she was owned by her husband. Patriarchs from the Bible’s Old Testament such as Jacob and David had multiple wives.

TRADEOFFS AND CULTURE

This brings us to the nature versus nurture debate, which is crucial for understanding love, sex, and marriage. A person’s natural biological drives may differ from behaviors they’ve absorbed through nurture, or their upbringing in a particular culture. (The nature/nurture debate itself proves to be problematic because, for social animals like humans, biology and culture intertwine.)

But, as I see it, monogamous marriage is mostly a cultural imposition, associated with three conflicting drives: sexual desire, comfort, and jealousy.

Sexual desire, grown from our polygamous primate roots, makes people want many partners or at least sexual novelty. I suggest that is why some married partners try to introduce novelty by wearing sexy underwear or otherwise changing routines. Providing a somewhat quantitative measure, studies have shown that changing sexual partners in swing clubs or while watching pornography often reduces a penis’ recovery (“refractory”) period between orgasm and the next erection.

However, two other emotions also play key roles in shaping our mating habits. One is jealousy, which derives from territoriality, a trait observed in most primates. Monogamy can diminish jealousy but may leave one sexually desiring more.

In some cases, those with power have enjoyed reduced jealousy and many sexual partners. For example, certain rulers have maintained harems with dozens of wives, but those women were expected to only sleep with their shared husband. Similarly, sexist religious narratives have been used to justify men keeping several wives but not the opposite.

The third critical emotion is comfort or familiarity. If, say, you develop cancer at age 70, you probably would want someone by your side who loves you—a monogamous mate. That desire for familiarity may not be met in cases of polygamy, in which one person has several sexual partners without love necessarily being involved.

A person wearing an ornate red headpiece and cape stands beside a balding person in a plaid suit jacket and gray pants. Other people wearing decorative beaded head and waist bands hold umbrellas and dance behind them.

Recently, it seems polyamory has gained steam in countries such as the U.S. and Canada. This arrangement recognizes that people may have a desire for many partners but concedes to some religious and philosophical narratives: for instance, Plato’s argument that sex without love is a sin or less noble. With polyamory, the idea is, “yes I do have sex with many, but I love them all.” And those partners also love others.

I see polyamory as an evolutionary rare and historically recent form of mating. Those who partake probably satisfy their desires for multiple mates and comfort/familiarity. But they may still suffer jealousy when their beloveds openly love others.

When it comes to love and mating, there are no perfect solutions. Each type of relationship balances sexual desire, comfort, and jealousy in different measures, subject to cultural influences. Some trends indicate that monogamous marriage is falling out of fashion for younger people in places such as the U.S. But there’s no reason to think that loveless polygamy, or love-flush polyamory, will overtake other arrangements.

Likely, humans in diverse societies will continue to love and mate in many different ways.

Complete Article HERE!

Female Orgasmic Disorder Could Become a Qualifying Condition for Medical Cannabis in Four States

— Science confirms what many of us discovered on our own.

By Sophie Saint Thomas

Four states—Ohio, Illinois, New Mexico, and Connecticut—are now looking into adding female orgasmic disorder (FOD) to the list of qualifying conditions for medical cannabis. There’s mounting research that suggests that cannabis can help women have more orgasms. For those with FOD, defined by the Merck Manuel as a “lack of or delay in sexual climax (orgasm) or orgasm that is infrequent or much less intense even though sexual stimulation is sufficient and the woman is sexually aroused mentally and emotionally,” medical marijuana could not only make having an orgasm easier, but more satisfying. 

Diagnosis criteria and scientific research aside, stoners have been boasting about the sexual properties of cannabis, probably since the herb was first smoked. Now, we know that cannabis, as a vasodilator, can increase blood flow to the genitals. Because it can also aid in anxiety, using some weed before sex can help people relax into the moment, which can be especially beneficial to those whose sexual dysfunction stems from trauma. After all, we know that cannabis has a well-documented ability to treat PTSD. It even enhances the senses, often making touching and even checking out your partner more fun. And as cannabis can also aid in creativity, it can help you consider and explore more variations in your sex life. 

“Women with FOD have more mental health issues, are on more pharmaceutical medication,” Suzanne Mulvehill, clinical sexologist, and founder and executive director of the nonprofit Female Orgasm Research Institute told Marijuana Moment. “They have more anxiety, depression, PTSD, more sexual abuse histories. It’s not just about pleasure, it’s about a human right,” adding that: “It’s a medical condition that deserves medical treatment.”

Ohio is currently evaluating a proposed amendment to add the condition. Earlier this month, the State Medical Board declared that both FOD and autism spectrum disorder are advancing to the stages of expert assessment and public feedback, following online petition submissions. Public comments will be accepted until Thursday.

In Illinois, regulatory officials are scheduled for a meeting next month to discuss the inclusion of FOD as an eligible condition. New Mexico plans to address the matter in May, as per the nonprofit Female Orgasm Research Institute. The organization also noted that Connecticut is exploring the possibility of adding FOD to its list of qualifying conditions, although a specific date for a meeting has not yet been determined.

Suzanne Mulvehill plays a leading role in the initiatives advancing the therapeutic advantages of cannabis for individuals with FOD. She says that this condition impacts as many as 41% of women globally. She filed a petition last year aiming to include this disorder among Ohio’s list of conditions eligible for medical marijuana.

Present studies suggest that approximately one-third of women who consume cannabis utilize it to enhance sexual experiences—a statistic Mulvehill notes has remained relatively consistent over the years.

She’s aware of the understanding surrounding cannabis’s ability to enhance sex. “It’s not new information,” Mulvehill said in her interview with Marijuana Moment. 

The novelty lies in the readiness of government bodies to address the matter. According to Mulvehill, Ohio appears to be the first state to evaluate FOD as a condition warranting medical marijuana. Moreover, she noted that Ohio’s meeting earlier in the month marked the inaugural instance, to her knowledge, of a public government entity discussing female orgasmic disorders.

A 2020 article published in Sexual Medicine discovered that frequent cannabis use among women correlates with improved sexual experiences. Additionally, various online polls have highlighted a positive correlation between cannabis consumption and sexual satisfaction. There’s even research indicating that the enactment of marijuana legislation correlates with a rise in sexual activity.

And research published last year in the Journal of Cannabis Research revealed that over 70% of adults surveyed reported an increase in sexual desire and enhanced orgasms when using cannabis before intercourse, and 62.5% noted improved pleasure during masturbation with cannabis use. Given previous data showing that women who have sex with men often experience orgasms less frequently than their male counterparts, the researchers suggested that cannabis might help bridge this orgasm equality gap.

For some people, having an orgasm is a challenge in a way that counts as a disorder that deserves treatment, and access to medical marijuana is paramount. For others, this new legal push is just a reminder that weed can make sex better and a reminder that you don’t need a diagnosis to have hot, stoned sex.

Complete Article HERE!

Here’s How Sex and Intimacy Help You Live Longer

— Says Molly Maloof, M.D.

By

For many, sex is fun and pleasurable—but it’s also pretty important to human existence. Sex plays a significant role in individual well-being, and perhaps even longevity.

Unfortunately, some public health organizations and entities continue to advertise not-so-positive outcomes after having sex, such as sexually transmitted infections, unintended pregnancy, sexual dysfunction, and more. This outdated narrative and outlook on sex (note: sex therapy hasn’t been reinvented since the 1960s, per the American Psychological Association) can be damaging as it overlooks the fact that sexual pleasure is a distinct element of well-being.

Sexual pleasure can play a key role in nurturing healthy relationships and, ultimately, extending your lifespan. In fact, having a good sex life has been shown to improve physical and mental well-being, both of which help you have a vibrant life overall.

Here are just five ways maintaining, or improving, your sex life can have profound effects on your overall health.

5 Benefits of Sex and Intimacy

Although sex and intimacy are often used interchangeably, they’re actually two different things.

Here’s the deal: Intimacy involves openness and acceptance between partners (this can be emotional, such as communicating about what you don’t like, or physical, like post-sex cuddling). On the other hand, sex is solely the physical activity—and of course, it’s possible to have sex without intimacy and vice versa.

1. It Maintains Quality of Life

Research shows that sexual health can improve your quality of life (no big surprise there!) — even if you’re older in age. As a result, it can increase your lifespan, too.

In fact, 62.2 percent of men and 42.8 percent of women reported that sexual health was highly important to quality of life in a 2016 study of 3,515 adults in the Journal of Sexual Medicine. And, people in excellent health had higher satisfaction with their sex lives than those who had fair or poor health. Based on these results, the study authors note that sexual health screenings should be a routine part of physician visits—so if your doc doesn’t bring it up, make sure you do.

Meanwhile, those ages 65 and older who said their sexual relationship was “sufficient” reported better quality of life and lower incidence of sexual dysfunction than those who described their relationship as “moderate” or “poor,” according to a 2023 study. This was also true for those who considered themselves attractive and had sex frequently with their partner or spouse.

What do these studies suggest? When your sex life is better, your overall outlook on life may improve too.

2. It Contributes to Satisfying Relationships & Mental Health

Sexual activity may also contribute to longevity by making your relationships more stable and satisfying—and by boosting your mental health.

Sexual satisfaction is a main factor in predicting relationship satisfaction in both men and women, according to a small-scale study, found in a 2023 issue of the International Journal of Environmental Research and Public Health. For women, interpersonal closeness was also important (measured by statements like “I always consider my partner when making important decisions” or “I miss my partner when we are apart”).

In addition, one 2019 study revealed that frequent, longer lasting bouts of sex was associated with higher sexual satisfaction, which in turn, lead to stronger relationships. This was true for all relationship types, including same-sex, mixed-sex, and gender-diverse relationships.

Beyond its physical implications, sexual activity and intimacy can also contribute to mental health, something that’s increasingly understood to influence longevity.

Researchers examined the impact of sexual activity (or lack thereof) in a study published in a 2021 issue of the Journal of Sexual Medicine. They found that people who didn’t have sex during the COVID-19-related lockdown had a 27 percent higher risk of developing anxiety and a 34 percent higher chance of depression compared to those who did.

3. It May Reduce the Risk of Cancer & Heart Disease

A great sex life can also keep your prostate—and other parts of your body—healthy.

Scientists monitored the frequency of orgasms in nearly 32,000 men over an 18-year period in a 2016 study published in European Urology. Their findings suggested that a higher frequency of orgasms was associated with a reduced risk of developing prostate cancer later in life.

More specifically, men (both in their 20s and 40s) who reported 21 or more orgasms per month had about 20 percent lower risk of developing prostate cancer compared to those who ejaculated four to seven times per month.

What’s more? Engaging in a vibrant sexual life also seems to benefit heart health, even in those with heart disease, per a study from a 2022 issue of the European Journal of Preventive Cardiology.

Heart attack patients who reported having sex at least once per week had a slightly lower risk of dying from heart disease (though more research is needed to determine if that lowered risk is statistically significant) and a more notable 44 percent lower risk of dying from non-heart disease causes—compared to those who had sex less. This is even after researchers adjusted for additional factors, including age, gender, partner status, and smoking.

4. It Can Boost Your Immune System

Research suggests sex can support your immune system, as it offers a shield against illnesses and bolsters your resilience to viruses.

In a study, found in a 2021 issue of Fertility and Sterility, researchers assigned 16,000 participants to one of two groups: those who reported having sex more than three times per month and those who reported having sex less than three times per month. They found that 76.6 percent of those in the first group did not get infected with COVID-19 over the course of four months—and even those who did get infected tended to have milder cases than those in the second group, where nearly half of the group got infected.

These findings suggest that as your sexual activity increases, your immune system may be better equipped to combat pathogens. But of course, sexual activity alone can’t prevent infectious disease, so be sure to take all appropriate measures to avoid infections like COVID-19—particularly if you’re at high risk for serious disease.

5. It May Independently Extend Your Lifespan

While factors like quality of life, a strong immune system, and lowered risk of cancer may all contribute to your longevity, research shows that sex alone may be able to extend your lifespan.

For instance, the findings from a study—found in a 2022 issue of the Journal of Applied Gerontology—showed that sexual well-being was positively associated with longevity in those who perceived sexuality as important to them.

Although research suggests your desire to have sex may begin to decline as you get older, plenty of men and women continue to have sex semi-regularly as they enter those later decades of life. Among those aged 80 and older, 19 percent of men and 32 percent of women reported having sex frequently (which is described as twice a month or more), according to a study from a 2015 edition of Archives of Sexual Behavior.

Complete Article HERE!

Top 10 drugs that may contribute to sexual dysfunction

By Naveed Saleh, MD, MS

Key Takeaways

  • A variety of prescription medications, along with the conditions they treat, may contribute to sexual dysfunction.
  • Some of these drugs are known to interfere with sexual health, such as antidepressants and beta blockers; lesser known culprits include thiazide diuretics or opioids.
  • Clinicians can help by being aware of medications that may affect sexual function, having open discussions with patients, and adjusting medications where needed.

Sexual dysfunction can be an adverse effect of various prescription medications, as well as the conditions that they treat. Some of these treatments, such as antidepressants and certain antihypertensives, likely come as no surprise to the clinician. Others, however, are not as well-known.

Here are 10 types of prescription medicines that contribute to sexual dysfunction.

Antiandrogens

Antiandrogens are used to treat a gamut of androgen-dependent diseases, including benign prostatic hyperplasia, prostate cancer, paraphilias, hypersexuality, and priapism, as well as precocious puberty in boys.

The androgen-blocking effect of these drugs—including cimetidine, cyproterone, digoxin, and spironolactone—decreases sexual desire in both sexes, as well as impacting arousal and orgasm.

Immunosuppressants

Prednisone and other steroids commonly used to treat chronic inflammatory conditions decrease testosterone levels, thus compromising sexual desire in males and leading to erectile dysfunction (ED). 

Sirolimus and everolimus, which are steroid-sparing agents used in the setting of kidney transplant, can mitigate gonadal function and also lead to ED.

HIV meds

The focus of dolutegravir (DTG)-based antiretroviral therapy has been on efficacy, as measured by viral load. Nevertheless, these drugs appear to affect sexual health, which can erode quality of life, according to authors writing in BMC Infectious Diseases.[1]

“Sexual dysfunction following transition to DTG-based regimens is common in both sexes of [people living with HIV], who indicated that they had no prior experience of difficulties in sexual health,” the study authors wrote. “Our findings demonstrate that sexual ADRs negatively impact self-esteem, overall quality of life and impair gender relations. DTG-related sexual health problems merit increased attention from HIV clinicians.”

Cancer treatments

Both cancer and cancer treatment can impair sexual relationships. And cancer treatment itself can further contribute to sexual dysfunction.

For example, long-acting gonadotropin-releasing agonists used to treat prostate and breast cancer can lead to hypogonadism, resulting in lower sexual desire, orgasmic dysfunction, erectile dysfunction in men; and vaginal atrophy/dyspareunia in women.[2]

Hormonal agents given during the course of endocrine therapy in cancer care lead to a sudden and substantial decrease of estrogens via their effects at different regulatory levels. Selective ER modulators (SERMs) are used to treat ER-positive breast cancers and bind ERs α and β. These receptors are crucial in the functioning of reproductive, cardiovascular, bone, muscular, and central nervous systems. Tamoxifen is the most common SERM used.

In females, reduced estrogen levels due to endocrine therapy can lead to vaginal dryness and discomfort, pain when urinating, dyspareunia, and spotting during intercourse.

Antipsychotics

Per the research, males taking antipsychotic medications report ED, less interest in sex, and lower satisfaction with orgasm, with delayed, inhibited, or retrograde ejaculation. Females taking antipsychotics report lower sexual desire, difficulty achieving orgasm, anorgasmia, and impaired orgasm quality. 

“The majority of antipsychotics cause sexual dysfunction by dopamine receptor blockade,” according to the authors of a review article published in the Australian Prescriber.[3] “This causes hyperprolactinaemia with subsequent suppression of the hypothalamic–pituitary–gonadal axis and hypogonadism in both sexes. This decreases sexual desire and impairs arousal and orgasm. It also causes secondary amenorrhoea and loss of ovarian function in women and low testosterone in men,” they continued.

Antipsychotics may also affect other neurotransmitter pathways, including histamine blockade, noradrenergic blockade, and anticholinergic effects.

Anti-epileptic drugs

Many men with epilepsy complain of sexual dysfunction, which is likely multifactorial and due to the pathogenesis of the disease and anti-epileptic drugs, per the results of observational and clinical studies.[4]

Specifically, anti-epileptic drugs such as carbamazepine, phenytoin, and sodium valproate could dysregulate the hypothalamic–pituitary–adrenal axis, thus resulting in sexual dysfunction. Carbamazepine and other liver-inducing anti-epileptic drugs could also heighten blood levels of sex hormone-binding globulin, thus plummeting testosterone bioactivity.

Both sodium valproate and carbamazepine have been linked to disruption in sex-hormone levels, sexual dysfunction, and changes in semen measures.

Antihistamines

Allergic disease is commonly treated with antihistamines and steroids, with both drugs potentially interfering with sexual function by decreasing testosterone levels. In particular, H2 histamine receptor antagonists can disrupt luteinizing hormone/the human chorionic gonadotropin signaling pathway, thus interfering with the relaxation of smooth muscles at the level of the corpus cavernosum.[5]

ß-blockers

ß-blockers contribute to ED likely because they suppress sympathetic outflow.

“Non-cardioselective ß-antagonists like propranolol have a higher incidence of ED than cardioselective ß-antagonists which avoid ß2 inhibition resulting in vasoconstriction of the corpora cavernosa,” per investigators writing in Sexual Medicine.[6] “Nebivolol has the greatest selectivity for ß1 receptors as well as endothelial nitric oxide vasodilatory effects, and has been shown to have a positive effect on erections.”

The authors cite a double-blind randomized comparison in which metoprolol decreased erectile scores after 8 weeks, whereas nebivolol improved them.

As well, he selective β-blocker nebivolol inhibits β1-adrenergic receptors, which may protect against ED vs non-selective β-blockers.[7]

Opioids

The µ opioid receptor agonist oxycodone not only inhibits ascending pain pathways, but also disrupts the hypothalamic-pituitary-gonadal axis by binding to µ receptors in the hypothalamus, thereby resulting in negative feedback and resulting in ED, as noted by the Sexual Medicine authors.

Consequently, less  gonadotropin-releasing hormone is produced, which results in lower levels of  gonadotropins and secondary hypogonadism. 

Loop diuretics

Results of a high-powered study demonstrated that men taking thiazides were twice as likely to experience ED compared with those taking propranolol or placebo. It’s unclear whether furosemide also causes ED. It’s also unclear why thiazides cause ED. Nevertheless, the Sexual Medicine authors stress that prescribers should remain cognizant of the potential for thiazide to interfere with sexual function.

What this means for you

It’s important for clinicians to realize the potential for a wide variety of drugs to contribute to problems in the bedroom. If a patient experiences trouble having sex, they may discontinue use of the drug altogether. Consequently, physicians must tailor treatment plans with patients and their partners in mind.

The key to assessing sexuality is to foster an open discussion with the patient concerning sexual function and providing effective strategies to address these concerns.

Complete Article HERE!

What does pansexual mean?

— And how is it different from bisexual and polysexual?

How do you define pansexual vs. bisexual? That’s a very good question. Let’s take a moment to celebrate the pansexuals: the wonderful guys, gals and non-binary pals who love who they love regardless of gender.

By Emma Powys Maurice

How do you define pansexual vs. bisexual? That’s a very good question. Let’s take a moment to celebrate the pansexuals: the wonderful guys, gals and non-binary pals who love who they love regardless of gender

Pansexuality is part of the Bisexual+ Umbrella, meaning that it’s one of many identities in which someone is attracted to more than one gender.

But how exactly do you define pansexuality, and how is it different from bisexuality or polysexuality?

Every pansexual’s understanding of their sexuality is personal to them, but in general it means that they aren’t limited by sex or gender when it comes to those they’re attracted to.

The word comes from the Greek word “pan,” which means “all”. But that doesn’t mean pansexuals are attracted to anybody and everybody, just as heterosexual women aren’t attracted to all men. It simply means that the people they are into might identify anywhere on the LGBTQ+ spectrum.

This includes people who are gender-fluid, and those who don’t identify with any gender at all (agender).

In fact, some pansexuals describe themselves as “gender-blind”, meaning that gender doesn’t play any part in their sexuality; they’re attracted purely to a person’s energy rather than any other attributes.

How do you define pansexual vs. bisexual?

Good question! Sometimes pansexuality is used as a synonym for bisexuality, but they are subtly different.

Let’s take a moment to break down how to define pansexual vs. bisexual. Bisexual means being attracted to multiple genders, whereas pansexual means being attracted to all genders. Both orientations are valid in their own right and it’s up to the individual to decide which one fits them best.

Some people assume that bisexual people are erasing non-binary people or enforcing a rigid gender binary, because they believe the word bisexual implies that there are only two genders. We’re happy to inform you this isn’t the case!

The vast majority of bisexual people love and support the non-binary community, and many non-binary people are bisexuals themselves.

The reality is that bi people simply have “the potential to be attracted – romantically and/or sexually – to people of more than one sex and/or gender, not necessarily at the same time, not necessarily in the same way, and not necessarily to the same degree,” as advocate Robyn Ochs describes.

What’s the difference between pansexual and polysexual?

The word polysexual comes from the Greek prefix “poly meaning “many”, and the term has been around since the 1920s or 30s, if not earlier.

There’s some overlap between pansexual and polysexual, as both appear under the Bisexual+ Umbrella. The key difference is that someone identifying as polysexual is not necessarily attracted to all genders, but many genders.

A good analogy to describe it is how you feel about your favourite colours: a pansexual person might like every colour of the rainbow, whereas a polysexual person might say they like all the colours except blue and green.

But more often than not, those who identify as polysexual tend to ignore gender binaries altogether, especially when it comes to who they are and aren’t attracted to.

It’s worth noting that polysexuality also has nothing to do with polyamory, which is style of consensual relationship, not a sexuality.

What pansexual celebrities are there?

Pansexuality has been around for as long as humans have, but the term is becoming more mainstream as more celebrities publicly identify as pansexual themselves.

Just a few of the big pansexual names out there are Lizzo, Cara Delevigne, Miley Cyrus, Janelle Monae, Angel Haze, Jazz Jennings, Brendan Urie, Yungblud, Nico Tortorella, Courtney Act, Bella Thorne, Joe Lycett, Tess Holliday and Christine and the Queens.

And as of 2020, the UK now has its first out pansexual MP: the Lib Dem Layla Moran.

“Pansexuality, to me, means it doesn’t matter about the physical attributions of the person you fall in love with, it’s about the person themselves,” she told PinkNews.

“It doesn’t matter if they’re a man or a woman or gender non-conforming, it doesn’t matter if they identify as gay or not. In the end, these are all things that don’t matter – the thing that matters is the person, and that you love the person.”

What does the pansexual Pride flag look like?

We’re glad you asked. It looks like this:

Define pansexual vs. bisexual
The pansexual pride flag

It was designed by a creator called Jasper V. The flag has been in wide use since the early 2010s when it was posted on an anonymous Tumblr account.

Here’s a breakdown of what the colours and symbols of this flag represent:

  • Magenta: Attraction to female-identifying individuals.
  • Yellow: Attraction to those who don’t identify with the binary such as non-binary, agender, and genderfluid individuals. 
  • Cyan: Attraction to male-identifying individuals. 

When is pansexual Pride day?

Pansexual & Panromantic Awareness Day falls on 24 May. It’s a day to celebrate the pan community and educate others on what it means – so you can start by telling your friends it’s got absolutely nothing to do with saucepans. So, have we helped you to define pansexual vs. bisexual? If so, we’re glad to have been of help!

Complete Article HERE!

Can Microdosing Help Heal Sexual Trauma?

— Sexual trauma poses unique challenges to clinical treatment. Psychedelic medicine can address healing from sexual trauma through a more holistic lens.

By Kiki Dy

A sexual assault at fifteen changed the contours of Australia-based artist Lydia’s* life. She blamed herself in a haze of adolescent confusion and hid the assault from her loved ones, even when they suspected something was amiss. The next ten years became a barbed loop of trying to forget and then remembering so vividly that she couldn’t sleep. Lydia tight-roped between extremes:— long periods of abstinence splintered by sprints of hypersexuality. In her early 20’s, she pursued therapy but ultimately found the experience “painful with no payoff.” She recognized she needed a spiritually profound route to recast her sense of self and shift the narrative of her assault–that’s when mushrooms entered the picture.

Psychedelics and Sexual Trauma: An Overview

On her podcast Inside Eyes–a series about using entheogens to ease the aberrations of sexual trauma–somatic psychotherapist Laura Mae Northrup describes sexual assault as a form of spiritual abuse. The impact of sexual violence on the survivor is subjective. However, many, like Northrup, would agree that experiencing sexual assault can change how we view humanity, making us question the morality of mankind and the meaning of our existence at large.

Objectively, sexual assault is unconscionable violence against humanity, resulting in feelings of dissociation and disembodiment that can last a lifetime (and even be passed down). As survivors grow up, they frequently learn to suppress the event and its aching emotions as a defense mechanism. But trauma can never truly be suppressed. Until trauma is addressed, one small trigger has the ability to open the gateway back to the grieving phase.

Given the prolonged spiritual distress sexual abuse spurs, western medicine and traditional therapy can often fall short. For some, exploring a more mystical method of healing provides better outcomes. After all, sexual assault is a complicating factor for mental wellness, with survivors displaying psychological responses such as depression, anxiety, and post-traumatic stress disorder (PTSD)—all of which psilocybin is proven to positively benefit.

As a seasoned psychedelic researcher and professor at Johns Hopkins University School of Medicine, Roland Griffiths reports that over 70% of people who took magic mushrooms to treat depression, anxiety, or PTSD cited their psychedelic experience as being among the most impactful events in their lifetime. Additional research echoes these praises, suggesting that psilocybin often induces emotional breakthroughs and profound shifts in perspective for those who choose to use it–and for Lydia, that shift in perspective was life-saving.

“I felt stuck. All my relationships were failing, even the one with myself. I was ready to give up,” she tells us at Retreat. “It felt like one person had stolen my happiness, and I couldn’t get it back, even ten years later.”

Then, a psilocybin retreat changed everything.

Lydia, who lived in Berlin at the time, made a convenient pilgrimage to attend a magic mushroom ceremony in Amsterdam. “The trip cracked me wide open,” she shares, “I was outside my body looking at myself. Which was trippy, but more important is that the filter changed, and suddenly I saw myself with softness and empathy. I sobbed.”

Like Lydia’s anecdotal evidence suggests, psychedelics hold great promise and potential to help people reprocess their trauma in a meaningful manner. In the words of psychedelic integration therapist Dee Dee Goldpaugh, psilocybin allows us to experience a “compassionate recasting of ourselves in the story [of a traumatic event].” By introducing her mind to new ways to think, psilocybin helped Lydia unglue herself from the decade of anguish the assault catalyzed. With the muck cleared off her mind’s windshield, she began to see and accept the truth: it wasn’t her fault, and it doesn’t define her.

The Therapeutic Potential of Microdosing

The heroic dose helped Lydia forgive and reopen herself to pleasure, but microdosing helped her cement her newfound perspectives.

“I didn’t want the trip to be this epiphany that didn’t stick,” she shares. “I was so relieved but also a bit anxious that I was placing a flimsy bandaid over a bullet hole.” So, after research and casual coaching by a seasoned psychonaut friend, she started a new routine three times a week: spiking her morning matcha with psilocybin powder.

Lydia enhanced her microdosing journey with daily journaling, affirmations, and a focused effort to allow the soft voice that spoke to her during the trip to reshape her internal monologue. She insists that microdosing rewired her brain in a way SSRIs failed to achieve.

But does the science behind microdosing support her experience?

While the conclusion is clear on the therapeutic benefits of large doses of psychedelics, such as increased empathy, openness, mood, and life satisfaction—the developing research on microdosing doesn’t allow us to draw any one conclusion. Research suggests that microdosing may lead to a positive mood, increased presence, and enhanced well-being.

However, the findings do not come from controlled trials where one-half of the participants take a microdose, and the other half take a placebo.  Current knowledge is mostly from vocal success stories like Lydia’s and surveys of people who have used microdosing as a tool for mental health and personal growth. (That said, that is changing, with a number of microdosing studies in the works across the industry.)

The Bottom Line

Though universally painful, healing from sexual trauma is personal. Whether you leverage traditional talk therapy, small amounts of psilocybin, or a guided heroic trip that sends you to an alternate reality for eternity and returns you a new person–one fact remains: addressing trauma is a meaningful step toward a happier future.

As for the potential of psychedelics to facilitate healing more holistically, the science is promising. Individuals that have suffered sexual trauma often close down as fear, anxiety, and anger shrink them. In one famously-cited psilocybin study, 61 percent of participants demonstrated a lasting and measurable change in openness after just one dose of mushrooms–a significant finding because lasting personality change is often out of reach with just talk therapy alone.

However you choose to heal, and whoever you choose to help you heal, Retreat wishes you the best and is here to offer a little psychedelic support and a lot of empathy.

*Name has been changed to protect privacy.

Complete Article HERE!

How to Close the ‘Orgasm Gap’ for Heterosexual Couples

— Researchers once faced death threats for asking women what gives them pleasure. Now they’re helping individuals and couples figure it out themselves.

By

[CLIP: Woman speaks on OMGYES: “This is, like, you know, my vagina, going up and down and kind of brushing up against it, kind of like a paintbrush.”]

[CLIP: Music]

Kate Klein: There’s this, like, whole world underneath people’s clothing that no one talks about.

Sari van Anders: Our science, in some ways…, is sort of, like, catching up with people’s existences.

Meghan McDonough: I’m Meghan McDonough, and you’re listening to Scientific American’s Science, Quickly. This is part three of a four-part Fascination on the science of pleasure. In this series, we’re asking what we can learn from those with marginalized experiences to explore sexuality, get to the bottom of BDSM and illuminate asexuality. In this episode we’ll unpack why heterosexual women are having fewer orgasms than their male partners—and how researchers are bridging the gap.

[CLIP: OMGYES: “So when I’m with a partner for the first time, I’ll take one of their fingers, and I’ll tell them, ‘Just tap.’”]

McDonough: This is a woman explaining how she likes to be touched on the website OMGYES, which offers guidance to individuals and couples on finding sexual pleasure, both through masturbation and with a partner. This video is one of many how-to clips on everything from what the site has labeled “layering …”

[CLIP: OMGYES: “My clit’s really sensitive, and touching it directly would be way too intense, so I use the surrounding skin to make it less overwhelming.”]

McDonough: To “orbiting …”

[CLIP: OMGYES: “You know, it’s like the infinity sign, and it’s, like, going in loops, and you can change the direction.”]

McDonough: To essentially demystify the female orgasm—which, in heterosexual couples, is happening far less than the male orgasm, according to a 2017 U.S. national sample in the Archives of Sexual Behavior. That’s true even while research has shown that women regularly orgasm when masturbating and having sex with other women. That’s a gap that needs to be addressed because not only does orgasm make sex more pleasurable, but regular orgasm, doctors say, also lowers stress and improves sleep, mood, cognition and self-esteem. In partnership with Indiana University, the people behind OMGYES have interviewed more than 20,000 women ages 18 to 95, resulting in a number of published papers.

Rob Perkins: OMGYES started with a group of friends who would talk in a lot of detail about the stuff about, about what worked for them [and] what didn’t work for them sexually.

McDonough: This is Rob Perkins, who co-founded the company behind the website with his friend Lydia Daniller in 2014.

Perkins: We found in the conversation that there were patterns…. So we interviewed more of our friends to see, you know, if the patterns were consistent. And we found that, yes…, and that those things haven’t been named and hadn’t been studied in a rigorous way. So we reached out to folks at Indiana University, and they said, Yeah, it doesn’t get funding. Pleasure isn’t deemed important enough to be studied in that way.

McDonough: Rob says that while follow-up research has shown that OMGYES improves self-knowledge and pleasure, physical patterns are just one small piece of the puzzle.

Perkins: We found eventually that no matter how good the techniques are, with partners, there are other dynamics at play.

McDonough: So what other dynamics are at play? And what role can science play? First, let’s back up. What is an orgasm, and where does it come from? In the late 1950s and early 1960s, researchers William Masters and Virginia Johnson observed about 10,000 sexual response cycles experienced by 382 female participants and 312 male ones. Here’s them speaking at the University of New Mexico in December 1973.

[CLIP: Masters and Johnson speak at the University of New Mexico in December 197300:32]

[Masters: “We never treat the impotent male or the nonorgasmic female as a single entity. We always treat the marital unit or the committed unit …”]

[Johnson: “Or the relationship, if you want to reduce it further.”]

[Masters: “Basically speaking, we treat the relationship.”]

McDonough: They concluded that orgasm was the third of a four-stage model. They called the first “excitement,” or sexual arousal—marked by increased heart rate, breathing and blood flow. For those with a vagina, this involves engorgement of the clitoris, labia majora and minora and uterus, as well as vaginal lubrication. In the second, or plateau, phase, they noted, these responses build, and the uterus becomes fully elevated, which makes penetration more comfortable. The third stage they named was orgasm, or sexual climax—a series of muscle spasms in the genital area at 0.8-second intervals that gradually slow in speed and intensity. These are accompanied by the release of tension and feelings of euphoria. Orgasm, they said, is followed by the fourth and final stage—resolution, a return to the prearousal state. Masters and Johnson revolutionized the study of sexual response. But sex researcher Shere Hite had even more to say about sexual experience. This is her on a panel in 1977:

[CLIP: Shere Hite on a panel in April 1977:3:45 “So Masters and Johnson have said how widespread women’s sexual dysfunction is. And I’m saying it’s not women who are dysfunctional; it’s our definition of sex which makes women dysfunctional. If you didn’t define sex as intercourse, women wouldn’t be dysfunctional.”]

McDonough: The year before, Hite surveyed more than 3,000 women and girls aged 14 to 78 in open-ended, anonymous questionnaires, culminating in her book, The Hite Report. The book would be translated into a dozen languages and sell more than 48 million copies. Almost all of the women she interviewed who masturbated said that they orgasmed regularly from masturbation, but only about 30 percent reported that they orgasmed regularly from penile-vaginal intercourse. Here she is again in the panel discussion.

[CLIP: Shere Hite: “And even for this 30 percent, orgasm was, in most cases, due to the women’s own assertiveness in obtaining clitoral contact with the man’s pubic area during intercourse. Whether or not this is practical for a woman depends on many things.”]

McDonough: Even though sex researcher Alfred Kinsey had previously found in 1953 that it takes women four minutes, on average, to masturbate to orgasm, Hite was seen as widely controversial at the time for challenging deeply entrenched cultural norms.

McDonough: In the years after The Hite Report was published, Hite faced heavy criticism and even death threats. She ultimately fled the United States for Europe. Hite’s research debunked the notion that women who didn’t reliably orgasm from penetrative sex were dysfunctional. It was part of a wider cultural awakening, via second-wave feminism in the 1970s, that questioned who was served and who was hurt by such a narrow definition of “sex,” which Hite and others explicitly related to equality outside of the bedroom.

[CLIP: Shere Hite:00:42 “I was very surprised that people didn’t make this connection between women demanding their rights in sex and women demanding their rights in jobs…. I don’t think it’s militant to say that women should have orgasms and that women should be able to stimulate themselves in the same way that men can.”]

McDonough: Almost 50 years later, the heterosexual orgasm gap remains vast. A 2017 study analyzed survey results and found that 95 percent of heterosexual men regularly orgasm during partnered sexual activity, compared with 65 percent of heterosexual women and 86 percent of lesbian women. The authors noted that lesbian women could be in a better position to understand how different behaviors feel for their partner and that they may be more likely to take turns receiving pleasure until each is satisfied. The researchers also reviewed sociocultural explanations such as people placing a greater importance on male sexual pleasure than female pleasure, as well as a stigma discouraging women from exploring their own sexuality. They concluded the paper by writing, “The fact that lesbian women orgasmed more often than heterosexual women indicates that many heterosexual women could experience higher rates of orgasm.”

The research team behind OMGYES has picked up that thread by focusing on what kind of stimulation is most pleasurable. They’ve named more than 35 techniques based on thousands of interviews with women and have included the percentages of women that find those techniques useful. Many of these are based on solo or partnered masturbation, while others are meant to complement penetration.

Perkins: One of them is “pairing.” So the name for simultaneous clitoral stimulation at the same time as penetration.

McDonough: The idea is to use data to break down the taboo around sexual communication, which is associated with greater sexual pleasure.

Perkins: There’s a myth in our culture that a good male lover already knows what to do and shouldn’t ask for feedback, shouldn’t need feedback—receiving feedback would be an affront to that expertise. And we have data, you know, that 52 percent of American women wanted to tell their partners how sex could be more pleasurable for them but didn’t. And the main reason cited is not wanting to hurt the partner’s feelings

You know, if you’re giving someone a back rub or scratching someone’s back, of course, the person whose back is being scratched knows best where the itch is.

McDonough (tape): How have you found that couples work through these things?

Perkins: One thing that seems to work is time…. There’s this myth that younger people have more pleasure, and then it goes downhill with age, but actually, with more knowledge about your body and more comfort asking for it…, men get a little less performative and more curious. We have this from one of our studies—that couples who are always exploring ways to make sex more pleasurable are five times more likely to be happier in their relationships and 12 times more likely to be sexually satisfied.

McDonough: But the underlying problem, researchers say, goes beyond a lack of knowledge.

Klein: Sex doesn’t exist in a vacuum.

McDonough: This is Kate Klein, a sex therapist who has referred several clients to the OMGYES site.

Klein: So if one partner, you know, feels disempowered—doesn’t feel confident to speak up or share what they like or what they need—that’s often seen outside of the bedroom. They might not speak up about a need, a desire, whether it’s, you know, having the apartment be a certain level of tidiness, if it’s, you know, needing more emotional connection, if it’s needing more physical affection outside of sex.

McDonough (tape): So what are the main challenges to finding sexual pleasure? What are the main blocks you see people come in with?

Klein: You know, living in a sex-negative, heteronormative, patriarchal society, it really puts a lot of shame and guilt around sex. And there’s such a focus on the penis and penis owners. And I think those who are socialized as women are often really just disempowered from connecting with their pleasure…. There’s just so many ways that women are expected or socialized to put others before themselves, to make everyone comfortable, to smile. I think the orgasm gap is … specifically focused and due to our limited definitions of what sex is, right? If sex is penis and vagina penetration, that does not include the clitoris at all…. Female pleasure, female orgasms, for many, it seems unnecessary or challenging, whereas male orgasms are seen as, like, a requirement.

McDonough (tape): For people who may not know what they like sexually, where do they start?

Klein: I think the single most fundamental sexual skill any of us can have is self-pleasure…. The mind and body is so interconnected. And so, like, one, getting to a place mentally where you can be relaxed, where you can be focused, and then just being curious and playful, right—like maybe it’s touching your body overall and not even focusing on the genitals; maybe it is focusing on the genitals and doing different types of touch, different types of pressure; maybe it’s using a pleasure device; or it could be, you know, reading an erotic novel; kind of, like, whatever it is that’s going to get your desire flowing. You know, sex is not necessarily something you do but a place you go.

Complete Article HERE!

6 Questions to Ask Your Doctor About Sex after 50

— Vaginal dryness, erection challenges, safe sex and more

By Ellen Uzelac

With most physicians ill prepared to talk about sexual health and many patients too embarrassed or ashamed to broach the subject, sex has become this thing we don’t discuss in the examining room.

“So many doctors talk about the benefits of nutrition, sleep, exercise — but they don’t talk about this one really essential thing we all share: our sexuality,” says Evelin Dacker, a family physician in Salem, Oregon, who is dedicated to normalizing sexual health in routine care. “We need to start having this conversation.”

Starting the conversation about sexual health

Sexual wellness experts suggest first talking about a physical problem such as a dry vagina or erectile challenges and then segueing into concerns about desire, low libido and intimacy.

As Joshua Gonzalez, a urologist and sexual medicine physician in Los Angeles, observes: “Patients sometimes need to be their own advocates. If you feel something in your sex life is not happening the way you would like it to, or if you are not able to perform sexually as you would like, never assume that this is somehow normal or inevitable.”

Often, there are physiological issues at play or medications that can alter your sexual experience. “If you’re interested in having sex,” Gonzalez says, “there are often real solutions for whatever the problem may be.”

Here are six questions to help steer the conversation in the right direction.

1. What can I do about unreliable erections?

Erectile dysfunction is common in older men — 50 percent of men in their 50s will experience erectile challenges, Gonzalez says, and 60 percent of men in their 60s, 70 percent of men in their 70s, and on up the ladder.

The good news: There are fixes. “This doesn’t mean giving up on having pleasurable sex at a certain age,” Gonzalez says. The two primary things he evaluates are hormone balance and blood flow to the penis. A treatment plan is then designed based on those results.

Some older men also find it often takes time and effort to ejaculate. Gonzalez suggests decoupling the idea of ejaculation and orgasm. What many men don’t realize: You can have an orgasm with a soft penis and without releasing any fluid at all. “Your orgasm — the pleasure component — is not going to change.”

Also good to know: Sexual health is a marker of overall health. As an example, erectile dysfunction can be a predictor of undiagnosed health issues such as heart disease and diabetes years before any other symptoms arise, says Gonzalez.

2. Sex is different now. My body is no longer young but I still have sexual urges. How do I accommodate this new normal?

Dacker often asks her older patients: How is the quality of your intimacy? Is it what you want it to be? Have you noticed a shift as you’ve gotten older and what does that mean to you?

“Naturally, as we age our bodies start working differently,” she says. “I like to reframe what it means to be sexual by expanding our intimate life, doing things that maybe you haven’t thought of doing before.”

Dacker, who teaches courses on how to be a sex-positive health care provider, suggests exploring each other in new ways: dancing, eye gazing, washing one another while bathing, giving hands-free coconut oil massages using your stomach, arms and chest. She’s also a fan of self-pleasure.

“There’s so much pleasure that doesn’t involve penetration, orgasm and erections,” she adds. “It’s not about performance, it’s about pleasure.”

3. My vagina hurts when I have penetrative sex to the point that I’m now avoiding it. What can I do?

A lack of estrogen in older women can cause the vaginal wall to get really thin, resulting in dryness, irritation and bleeding when there is friction.

“It can be uncomfortable with or without sex,” says Katharine O’Connell White, associate professor of OB/GYN at Boston University and vice chair of academics and the associate director of the Complex Family Planning Fellowship at Boston Medical Center. “What people don’t realize is that what they’re feeling is so incredibly common. A majority of postmenopausal women will experience this.”

White offers a three-part solution for vaginal dryness: If you’re sexually active — and even if you’ve never used a lubricant before — add a water-based lube during sex play. Also, consider using an estrogen-free vaginal moisturizer, sold in stores and online, to help restore the vaginal lining. Finally, think about adding back the estrogen that the body is craving through medically prescribed tablets, rings or creams that are inserted into the vagina.

White also advises patients to engage in 20 to 30 minutes of foreplay before penis-in-vagina sex. “The whole body changes and the vagina gets wet, wider and longer, which can go a long way to alleviating any discomfort,” she says.

4. Urinary incontinence is interfering with my sex life. How can I control it?

Because the bladder is seated on top of the vagina, the thinning of the vaginal wall can also impact the bladder. When you urinate, it can burn or you will want to pee more often, symptoms typical of a urinary tract infection, according to White.

Some women feel like they need to urinate during sex, which, as White says, “can pull you out of the mood.” Her advice? “Pee before sex and pee after sex.” She also suggests using vaginal estrogen to plump up the walls of the vagina and, by extension, the bladder.

5. I’m interested in dating again. What screenings for sexual wellness should I get — and require of a new partner?

Fully understanding the importance of reducing your risk for sexually transmitted infections (STIs) should be front and center as you reenter the dating scene, according to nurse practitioner Jeffrey Kwong, a professor at the School of Nursing at Rutgers University and clinical ambassador for the Centers for Disease Control and Prevention’s “Let’s Stop HIV Together” campaign. 

“Individuals should be screened if they’re engaging in any sort of sexual activity — oral, vaginal, anal — because many times, some of these conditions can be asymptomatic,” he says. “You can transmit without symptoms and vice versa.”

Screening may involve a urine or blood test or swabs of the vagina, throat or rectum. With STIs soaring in older adults, Kwong suggests testing for HIV, hepatitis C, hepatitis B, chlamydia, gonorrhea and syphilis. In early 2024, the CDC reported that syphilis cases had reached their highest level since the 1950s.

6. My doctor was dismissive when I brought up sex, basically saying, At your age, what do you expect? What should I do now?

Sex is a special part of life no matter how old you are. “If you’re with a doctor who brushes aside any of your concerns, it’s time to find a new doctor,” White says.

Finding a good doctor, she adds, is no different from looking for an accomplished hair stylist or a reliable mechanic: Ask your friends.

“I’m horrified when I hear about things like this,” she adds. “Any good doctor really wants you to bring up the things that concern you.“

Complete Article HERE!

Here’s how to tell if a throuple might be right for you

— It’s not the same as an open relationship.

By and

The beautiful thing about non-monogamy is that it can take on many, varied forms: A non-monogamous dynamic can look like one polyamorous person having multiple romantic and sexual partners, or several individuals all in a non-hierarchical relationship together. One term you might’ve heard is ‘throuple,’ or triad, which describes a certain kind of committed relationship structure between three people.

Not to be mistaken for an open relationship (where people in a relationship have sex with people who are not their partner) or a threesome (sex between three people), a throuple is a balanced, consensual, and committed relationship. And while the term might be new to you, there’s nothing new or unusual about the concept, says Ann Rosen Spector, PhD, a clinical psychologist in Philadelphia. ‘It’s totally possible to be in love with more than one person at one time,’ she says.

So, what is a throuple, exactly—and what should you know if you’re interested in being in one? Read on for the full lowdown, according to therapists and social workers who work with polyamorous folks.

What is a throuple relationship?

A throuple, or triad, is a balanced, consensual, and committed relationship between three people. ‘What it means is that each person is in a relationship with another—it’s a three-way relationship,’ says Carolanne Marcantonio, LCSW, an AASECT-certified sex therapist with Wise Therapy in New York.

Like a couple, or a relationship between two people, the members of a throuple might have a ‘closed’ relationship, or an ‘open’ one. In some cases, ‘one person could be open to dating others, but another person in the triad isn’t,’ Marcantonio adds. ‘It really just depends.’

Different people in different dynamics might have their own definition and rules for the three-way relationship, so if you meet someone in a triad (or you’re about to join one!), it’s always a good idea to clarify what being in a throuple means to them.

What’s the difference between a throuple and other forms of polyamory?

Anything that isn’t a monogamous, exclusive, two-person relationship falls under the non-monogamy umbrella, says Anna Dow, LMFT, a therapist with Vast Love. And there are infinite types of polyamorous relationships, adds Marcantonio: ‘The sky’s the limit.’

Here are a few more polyamory-related words to know:

  • Quad: Four people who are in a committed relationship with each other
  • Polycule: A network of individuals who are all in relationships with each other
  • Kitchen table polyamory: A network of individuals who are in relationships with each other; if someone new is brought into this dynamic, they must generally get along with the rest of the group (think: feel comfortable sitting together at a large kitchen table)
  • Parallel polyamory: When a polyamorous person has multiple partners who don’t really interact with each other (essentially, the opposite of kitchen table polyamory)
  • Polyfidelity: When a throuple, quad, or larger polycule are ‘closed’ and do not see people outside of their group

Why might someone want to be in a throuple?

In some cases, a couple might meet a third person, become interested in them, and decide to bring that person into their relationship, says Spector.

In other instances, someone might know they’d like to join an existing couple, and seek out this kind of relationship dynamic. ‘If someone is oriented towards knowing that they can love more than one person responsibly, and if they feel like they can enter a relationship with an existing couple—and there’s chemistry, and connection between both and everyone agrees that they’d all like to be dating together—wonderful,’ says Marcantonio.

‘Being in a healthy throuple requires consistent communication and trust’

Aside from the joy of getting to date two people you like (or love), being in a throuple can help you get all your needs met, adds Spector. Think about it like this: When you have a third person involved, chances are, you’ll expose yourself and your original partner to qualities that both of you may want but can’t offer each other.

If you feel like you’re fully ready and wanting to add a third, Spector suggests letting your current partner know by gauging their interest. You can say something like: ‘I’d like to invite someone else into our relationship. How would you feel about having X join us and becoming a throuple?’

What are some tips for being in a healthy throuple?

Just like in any kind of relationship, being in a healthy throuple requires consistent communication and trust. ‘It’s the same as a monogamous relationship—the only difference is, it’ll be happening with two other folks,’ says Marcantonio.

However, there are some specific things you’ll want to watch out for, per relationship therapists:

1. Make sure you set ground rules first.

Different triads have different preferences, needs, and boundaries. Some examples of questions you’ll want to discuss, according to Marcantonio: ‘If everyone is open to all having other partners outside the triad, what does cheating look like? Do we all tell each other and have complete transparency when we’re talking to someone on the app, when we’re planning something, when we’ve had sex?’

Aside from discussions about sex and dating outside of the throuple, you’ll want to talk about your own dynamic as a trio, too, adds Spector. Would you prefer to only have sex as a throuple, for example, or is it okay for two people to have sex without the third?

‘It really depends on the triad and how they would like to set up the rules,’ says Jennifer Schneider, LICSW, LCSW, a psychotherapist specializing in LGBTQIA+ clients and those who identify as polyamorous or ethically non-monogamous. ‘It may be that a throuple sits down with each other and actually spends a few hours hammering out what might be relationship agreements.’

2. Continue to communicate.

People’s needs can fluctuate over time. So, continued communication is important, says Marcantonio. Spector recommends setting regular check-in times with your partners—and also checking in on your own needs, too.

3. And be sure you’re communicating *directly*, too.

One of the biggest issues a throuple might face is triangulation, says Marcantonio. ‘Triangulation in a relationship is when there’s one person who avoids directly interacting, usually with the person they have a conflict with,’ she explains. ‘So instead, they use the third person to confide in, to talk to.’

This can inadvertently put one person in the middle, Marcantonio adds. It can happen in friend groups, family dynamics, and—of course—romantic relationships that involve more than two people. So, if you have an issue or frustration with one of your partners, make sure you’re talking to them directly.

4. Get comfortable with any feelings of jealousy that might crop up.

It’s a common misconception that polyamorous folks don’t deal with jealousy. But, in fact, they can and do, says Schneider. It’s a natural human emotion. ‘It does take a lot of self-awareness and reflection to be in a poly relationship, because you will have feelings that come up that you need to sit with,’ Marcantonio adds.

If you find yourself feeling twinges of envy, Marcantonio recommends ‘staying curious’ and digging into the root of the issue. Is this something you can navigate on your own? Is this something you’d like to discuss with your partners? Did something trigger this emotion? These can be tough questions to work through, so if you’re struggling, you might want to check out a resource like The Jealousy Workbook by Kathy Labriola, which is chock-full of tools and exercises for people in polyamorous ‘ships.

What are some of the myths about throuples?

1. They’re purely sexual relationships.

When some people hear ‘throuple,’ they might hear ‘threesome.’ But this dynamic signifies an emotional, intimate relationship between three people. They go on dates together, have deep conversations together, and confide in one another.

‘It’s not all about sex,’ says Marcantonio. ‘It’s people who really uniquely enjoy having deep, intimate connections that go beyond sex.’

2. You have to have a certain sexuality, or be a certain gender, to be in one.

Throuples can be made up of people of any gender identity and any sexual orientation who choose to be together, Spector says.

‘Pop culture depicts them as primarily female-female-male threesomes in an imbalanced way that often fetishises the relationship structure,’ adds Dow. ‘In reality, however, throuples are just typical relationships comprised of people of any genders. And like all relationships, each one has its own set of benefits and challenges.’

3. They’re not natural.

News flash: throuples, quads, and other forms of polyamory are nothing new. Marcantonio recommends checking out the book Sex at Dawn by Christopher Ryan for further reading on the history of non-monogamous relationships. ‘We were much more communal many, many decades ago,’ she adds.

Ultimately, being in a throuple might not be for everyone—as humans, we all have different needs and preferred relationship structures. ‘Some people are more wired for monogamy, and that’s what they like and want. Others are able to do poly; they might be more wired for that, and that works great,’ Marcantonio says. ‘There’s no one ‘natural’ way to have a relationship.’

Meet the experts: Ann Rosen Spector, PhD, is a clinical psychologist in Philadelphia. Anna Dow, LMFT, is a therapist who specializes in non-monogamy at Vast Love. Carolanne Marcantonio, LCSW, is an AASECT-certified sex therapist with Wise Therapy in New York. Jennifer Schneider, LICSW, LCSW, is a psychotherapist specializing in LGBTQIA+ clients and those who identify as polyamorous or ethically non-monogamous.

Complete Article HERE!

How to Explore Your Sexuality, according to Science

— Some researchers say that the standard definition of sexual orientation is incomplete—and offer a tool for expanding it.

By

Stacy Watnick: The first thing that I do with clients is I tell them that we’re going to go slow—because there are three things that most clients … do not talk about in therapy, and those are religion, politics and sex.

[CLIP: Intro music]

Kate Klein: There’s this, like, whole world underneath people’s clothing that no one talks about.

Sari van Anders: Our science, in some ways…, is…catching up with people’s existences.

Meghan McDonough: I’m Meghan McDonough, and you’re listening to Scientific American’s Science, Quickly. This is part one of a four-part Fascination on the science of pleasure. In this series, we’re asking what we can learn from those with marginalized experiences to get to the bottom of BDSM, find the female orgasm and illuminate asexuality. In this episode, we’ll discuss new ways to question your sexuality, according to science that draws from feminism and queer theory.

But first, let’s get real basic.

Stacy Watnick: Tell me, when I say the word sex or sexuality to you, what comes up?

McDonough: That’s Stacy Watnick, a clinical psychologist based in San Diego, California. She specializes in relationship issues and sexuality. She’s noticed certain patterns in her clients when she asks this question.

Watnick: First, surprise—that there’s such a range of experiences in their body and in their mind about it…. Frequently, I get some shame and discomfort. They’re not sure what words they’re supposed to use: “Are those bad words?”

A little lean forward…. they’re sort of excited and there’s some tension in wanting to tell me—or a little lean back because they’re not sure it’s safe.

McDonough: Stacy asks her clients if they’ve heard of gender and orientation. They talk about the words they know. And then she brings up the zine.

Zine is short for “magazine.” But zines are different from traditional magazines. They tend to be self-published and not typically what you’d find in an academic setting.

This particular zine invites readers on a “journey through the landscape of your sexuality.” The front cover features a drawing of five people on a path leading into the horizon. Each is holding a map labeled “SCT.” SCT stands for sexual configurations theory, a term coined by Sari van Anders, a gender, sex and sexuality researcher at Queen’s University in Ontario.

>Sari van Anders: I was doing some work about multipartnering and things like polyamory…, I was at a conference where there was … a session about asexuality…. And I started thinking about the way these two … identities claimed by different people might come together.

McDonough: Here’s Sari, the creator of this theory. She and her team created the zine as a more accessible offshoot of her 2015 academic paper on the topic.

Van Anders: It was the most exciting piece of work I’ve ever done. I’ve never really done work where it just felt like it had to come out, and it was sort of bubbling out of me.

I think we can maximize our pleasure when we understand what it is that we’re wanting, what the options are, who we are. We can think through some things that we might never have had prompts to do before.

McDonough: Oxford Languages defines sexual orientation as “a person’s identity in relation to the gender or genders to which they are typically attracted.” Sexual configurations theory asks: What if this sort of definition is incomplete?

Sari’s theory basically complicates the idea that sexual orientation is only based on gender. She built it on the existing academic literature and on what people shared about their sexualities.

Van Anders: And it was really important to me to include not just diverse sexualities and genders and people with diverse sexualities and genders but people with marginalized experiences, and so on …

McDonough: Such as people who are LGBTQ+, disabled, into kink or BDSM, asexual or non-monogamous.

Van Anders: Our science, in some ways, is, if anything, sort of, like, catching up with people’s existences…. I think many women know that, like, not all women who are attracted to men, maybe including themselves, that means they’re attracted to, like, penises or that’s the thing only that turns them on. And, and so there’s sort of an assumption that gender/sex sexuality, or what people typically call sexual orientation, is about, like, genital match-ups, like, “I have these genitals, and I’m attracted to people who have those genitals.” But really, like, we rarely see people’s genitals until we’ve already decided we’re attracted to them, right…. Usually there’s so much else going on.

McDonough: Sari uses the term “gender/sex” to mean features that are both socialized and biological and considers it to be just one aspect of sexual orientation.

>Van Anders: You know, it’s not always bodies; there’s also ways of being in the world or clothes, appearance, presentation, the way people talk, how someone treats you. And research on attraction is pretty clear that a lot of other things are rated pretty high up, like kindness or sense of humor or things like that.

McDonough: Sari refers to this as “sexual parameter n”—all the other things that make us attracted to a person.

The way she visualizes these aspects is through cone-shaped diagrams where people can pinpoint their preferences.

Aki Gormezano: As an example, you could think about the tornado for gender/sex sexuality…. So there’s a space on top where there’s a ring going around the outside that SCT calls the binary ring.

McDonough: This is Aki Gormezano, a sexuality researcher who did his Ph.D. with Sari at Queen’s. The ring he’s describing represents what most people know as the sexuality spectrum.

Gormezano: And then there’s a whole space beyond that, falling inside of the binary ring, completing that circle, where you’re not just thinking about women and men, you’re thinking about gender/sex-diverse folks who are occupying spaces outside of that binary ring.

McDonough: This is called the “challenge area.”

Gormezano: That circle I described is on the top, but then it moves all the way down to a point forming what kind of looks like a cone. And there’s a little meter ranging from zero to 100 on the far left of that, and that’s to indicate the strength of your attractions.

McDonough: In lay terms, if gender/sex was an important part of your attraction to people, you’d mark a place higher up on the tornado. If it wasn’t, you’d mark a place farther down. There are also tornadoes for partner number—one, multiple or none—as well as for sexual parametern, representing the other factors Sari mentioned, such as kindness and sense of humor.

Gormezano: Growing up, I was, like, pretty uncritical of my sexuality for the most part… Like I identified as straight by default. And a lot of my attractions, you know, as a cis boy at the time, or, like, now a cis man, were to cis women.

McDonough: In case you don’t know, “cis” here refers to cisgender, when a person’s gender identity matches their sex assigned at birth.

Gormezano: I had a point in high school where I realized … I did have attractions to people who were not cis girls or cis women…. I think I was just, like, confused and upset and didn’t really feel like it was something I could talk about. You know, especially as someone who played sports and was known as an athlete, where that was a big piece of my identity—like, I played soccer all the way through and still do…. I think, for me, the hardest part about realizing that I had interests and attractions that didn’t fit with being straight was that it challenged a lot of my identity around being a man or, like, wanting to be.

McDonough: Aki says that studying sexuality as an adult has helped him see that this isn’t a problem and that sexual orientation, identity and status don’t necessarily line up perfectly. Sexual configurations theory calls this “branched.”

Van Anders: Orientations have to do with, like, attractions, interests, arousals, desire [and] pleasure, and those might be different, or they might be the same. Like, you might really enjoy the thoughts or have fantasies about being with a man. And then when it comes to the actual sex you do, you find people of any gender are really enjoyable…. And status refers to, like, what you’re kind of actually doing, have done or will do…, who you’re actually with, for example.

McDonough: In a 27-country survey conducted by the market research company Ipsos in 2021, for example, 80 percent of self-identified heterosexual people reported that they were only attracted to the opposite sex, and 12 percent of them said they mostly were. Meanwhile 60 percent of self-identified lesbian and gay people said they were only attracted to the same sex, and 24 percent of them said they mostly were. These “branches” of sexuality can all be mapped on separate “tornado” diagrams. If you’re still struggling to picture them, you’re not alone. Between gender/sex, partner number, and other factors—plus identity, orientation and status—it’s a lot. But portraying sexuality as complex is also kind of the point.

McDonough (tape): To what extent do you think sexuality labels are limiting or expanding? If you could imagine your ideal world of how people conceive of sexuality, would everyone have a label?

Gormezano: I think when you just have identities and you just have labels, especially when identities and labels are really narrow…, you might not have the language to articulate the ways in which you don’t perfectly fit with that identity or label…. And I think the more people … who are able to understand the ways in which they might branch from their label or, like, perfectly coincide with it, the more open everyone will be around, you know, just like understanding that, like, around each identity is, like, a collection of people who might vary from that in different kinds of ways.

McDonough: Stacy, the therapist we heard from earlier, commonly meets clients who are working through their sexualities.

McDonough (tape): How do you help them kind of figure that out?

Watnick: We kind of try labels on like clothes…. I’m gonna try this sort of sweater on and see: Does that feel snuggly? Do I feel comfortable? Is there, like, a resonance in my body and in my mind and my heart and my genitals, all over me, that this feels true…? And much like the sweater I put on, I don’t have to wear it all the time…. There’s a very flexible return policy on this kind of content: if they decide they don’t want it; they don’t have to keep it. But we’re trying it on. Let’s see how it feels.

McDonough: Stacy first saw Sari speak at a virtual conference during the pandemic.

Watnick: And my whole brain lit up.

McDonough: The two of them have since formed a working group to bring sexual configurations theory into more clinical settings.

Van Anders: Those of us with marginalized or minoritized or oppressed genders, sexes or sexualities are often not given the tools from science or scholarship to make sense of ourselves. And so this can be helpful in that way. But also people who are majorities…, our culture tells everyone…, you’re just a cisgender man; that’s that; there’s nothing more complex; the complexity is for, you know, the other “complicated,” quote, unquote, people. But our research finds that the majorities actually have a lot of complexity and often have had even less prompt to think about it.

McDonough (tape): I’m wondering if you’ve had any pushback from the scientific community or otherwise?

Van Anders: We get a fair bit of skepticism from academics that what people might call laypeople, just you, people on the street, could actually do SCT diagrams because they are a bit more complex than “What is your attraction…?”…. So we sometimes get people who say, “This is pretty hard” or “I’m kind of confused.” And then we’re like, “Okay, can you describe yourself?” And then we look at the dot, and it matches. So people are actually able to do it anyway.

Van Anders: And we sometimes get pushback, too, from majorities who get, like, a little bit angry, who are like, “Okay, well, here, I can locate myself, but, like, I don’t believe in all these other locations….” You know, they’re usually seeing questions that have heterosexual first if there’s a checklist. And here it’s, like, you know, if you’re interested in women, that’s just one little dot in this whole diagram, and that can be a bit disorienting for people who are used to being with the center.

McDonough: Sari thinks that accounting for this complexity is not only helpful for individuals but also for future scientific research.

Van Anders: People sometimes forget that every measure we use is sort of telling a story about what the world is…. They’re kind of almost like a sieve that you sieve the world through. And depending on what that sieve looks like—whether it’s SCT, whether it’s a one-word question with a checkbox or answer or something—is going to let kind of different kinds of things through…. What is empirical in science is to try to measure the world as it is.

Complete Article HERE!

Want To Up The Sexual Desire In Your Relationship?

— Try These Expert-Approved Tips

By Sarah Regan

When you first meet a new love interest, the surge of feel-good hormones makes them the center of your world—and of course, the object of your sexual desire.

But fast-forward a few years, and you’ll likely find desire has a way of ebbing and flowing the longer you’re with someone. It’s completely normal, but you still might want to spice things up when you’re in a sexual rut.

If that sounds familiar, here’s what to do.

Why does desire fade, anyway?

And it happens for so many reasons. Not only do the hormones we associate with falling in love start to drop off in general as the honeymoon phase ends, Gunsaullus says, but other hormonal factors are at play as well, especially if you’ve been together for years.

From childbirth to perimenopause to menopause to declining testosterone, we’re all susceptible to less sexual drive as we age. And of course, life happens too.

Kids’ schedules keep you busy, one or both partners might be stressed about work or finances, and even new medication can influence libido. If resentment has been brewing in the relationship, Gunsaullus adds, you better believe that’s a buzzkill as well.

It’s also worth noting that a lot of couples defer to having intimate time right before bed, which according to Gunsaullus, doesn’t always work out. “If folks are only thinking to have sex when they’re crawling into bed, most people just want to go to sleep or read or scroll—they want something that doesn’t feel like work. And if you’re the lower-desire person, sex can feel like work,” she explains.

5 tips to cultivate more sexual desire

1. Know that you’re not broken

If you and your partner aren’t all over each other like you once were, remember that this is completely normal—and, honestly, to be expected.

“Low-desire people often feel guilty or like they’re broken, and then higher-desire people feel rejected and unwanted and undesired,” Gunsaullus tells mindbodygreen, adding, “So just being able to call out those feelings and know that you haven’t done anything wrong—this is a very normal thing that happens to many folks in long-term relationships.”

With that in mind, she says, remember that both of you might not feel great about the decrease in desire, so be mindful not to get stuck in a cycle of pointing fingers, guilt, blame, and shame.

2. Schedule “HNFT”

Once of the best ways to boost desire in your relationship is to schedule time to be intimate, or as Gunsaullus calls it: Happy Naked Fun Time (HNFT). For 45 undistracted minutes once a week, simply enjoy each other.

If “scheduling” doesn’t sound very sexy to you, keep in mind that spontaneity doesn’t always bode well for lower-desire people, according to Gunsaullus. “They’re more responsive to creating a context, you know, an environment and a connection that helps facilitate arousal and desire,” she explains.

And the best part about this time, Gunsaullus adds, is it’s not meant to have an agenda. You don’t even need to have sex—it’s just about creating an environment in which you’re having fun, playing, connecting, and happen to be undressed.

“Bring a lightness to it, because if there’s expectation or pressure, that’s where you then get the disappointment and the blame and shame. So cuddle with each other, massage each other, talk about your day, play a game—something that feels intentional and out of the ordinary but is a sacred time,” Gunsaullus says.

3. Sit down with each other weekly

Even if you don’t schedule your HNFT every week, Gunsaullus does emphasize the importance of checking in with each other for 15 minutes every week, opening up the conversation around your sex life, needs, and desires.

Remember during this time to be nonjudgmental and open, even if it’s uncomfortable. Talking about these topics and normalizing them will ultimately help you and your partner get more comfortable with that discomfort so you can understand each other more deeply—which brings us to our next point.

4. Learn each other’s needs

If you’re on the shyer side, we’re not gonna pretend like it isn’t a little awkward to talk about your fantasies or sexual desires. But as Gunsaullus tells mindbodygreen, pushing through that awkwardness will only help your partner understand how to please you and vice versa.

She recommends filling out some sort of erotic play worksheet online in order to get super specific about what does (and doesn’t) turn you on. (Here’s a list of the most common kinks and fetishes, if you’re curious.)

Once you and your partner have both done the worksheets, compare your results. You might just find you have some overlap! And if you don’t, have no fear; Gunsaullus says that’s incredibly common and you can still meet each other halfway.

5. Consider working with a professional

Finally, Gunsaullus says, if you feel like you’ve been stuck in a sexual rut for quite some time, it might be worth working with a professional, whether a couples therapist, a sex therapist, or a sex/intimacy coach.

The takeaway

As with all matters of relationship, communication is key. Talk to each other, honor your needs, and remember that pleasure is something we all deserve.

Complete Article HERE!

True romance

— How to keep the love alive when you fight

‘A big blow-out can clear the pipes’

Research has found that couples who argue (and get over it) are more likely to stay together than those who avoid conflict. But how can you argue safely?

By

It wasn’t without a little smugness that I used to tell friends that my partner and I almost never argued. It turns out this isn’t necessarily something to be proud of. “When couples don’t argue ever, and never show their differences to each other, or their strong feelings, they risk getting quite disconnected,” says Joanna Harrison, a couples therapist and the author of Five Arguments All Couples (Need to) Have. “They might describe themselves as being on parallel tracks, and they become out of touch with each other.”

When my partner and I do have occasional disagreements, neither of us deals with them well. He is the peacekeeper and often acquiesces, but then feels resentful; I sulk, can nurse a grudge and have been known to produce percentage calculations (I am a dreadful person) to show why he’s wrong about something he says I “always” do. Both of us flinch from real conflict, preferring passive aggression. But Harrison says: “The thing about arguments is that they keep us in touch with our partners.” If, she adds, “we use them productively”.

Psychologists used to think, says Ian Leslie, the author of Conflicted, that clashes in relationships were generally harmful. Instead, when couples are studied over months and years, those who argue (and then get over it) “are the couples who are more likely to stay together, to be happy in the relationship, and to feel that they’ve made progress on whatever problems they have”. Conflict, says Leslie, “is information. In an argument, the veil of civility that we use even with our intimate partners gets ripped away and we say what we really feel. That means we get information on what our partner really cares about, what upsets them, and often that information is new. So now we have a more accurate, updated mental model of our partner and that means we can relate to them better.”

Of course some arguments, says Harrison, “are destructive and dangerous”, particularly those that are hostile and unsafe. And constant bickering over small things can, says Susanna Abse, a couples psychotherapist and the author of Tell Me the Truth About Love, be a sign that something in your relationship “needs attending to, there are feelings around something that have not been repaired, long-term grudges have emerged. Sometimes it’s because you’re competitive – what are you competing about? – rather than a notion of you being on the same side. I think if you find yourself in a relationship that is marked by constant sniping, you need to think: what really is going on here? Because it’s very eroding. The beginnings of contempt, which is very deadening to a relationship, start to creep in.”

But if we’re talking about arguments, however big, between otherwise loving couples, a disagreement can be creative, says Harrison. “It’s two minds trying to find a way of putting differences together and coming up with something new.” A big blow-out can “kind of clear the pipes and enable things that need attention to get some airing”.

Actively avoiding conflict, says Abse, “often stops life progressing, because if you avoid the difficult things, you often don’t make decisions that move you on, such as deciding to move home or have a second child. These things sometimes require conversations that involve differences between a couple. One of the biggest challenges of relationships is how to manage conflict in a healthy and creative way.”

How, then, do we prepare for battle, or rather approach a disagreement in a grownup and productive way? Leslie says we “communicate on two channels at once. There’s the ‘content’ channel – money, who’s taking the bins out – and there’s the ‘relationship’ channel, which is more about whether each party feels they are getting the respect they deserve, or the affection they want.” If you can stay attuned to that channel, “you can have a vigorous argument about the content without walking away feeling hurt or furious. Often when the other person is being difficult or irrational about the content of the argument it’s because of something at that unspoken [relationship] level – perhaps they fear that you’re trying to shame or humiliate them.” Leslie suggests putting some work in to “ameliorate that, by making sure to acknowledge your partner’s hard work or good intentions or whatever – and then get into the contentious issue you need to discuss”.

People find it difficult to be told what to think or feel – when you say “you should …” – so avoid that, says Leslie, who adds that “in tense situations, people are very alert for threats”. Describe the emotional impact of the issue on you. “It means you relax a bit and your partner realises what the emotional stakes are.”

Try not to get into a situation where you are blaming each other, says Abse. Instead, “place things in the middle, between you, as a shared problem, holding on to the idea that you’re a couple and the issues need to be grappled with by you both”.

Saying “you always” or “you never” is unhelpful, says Abse. It can lead to an escalation, which is what you’re trying to avoid. “The more the heat gets in, the less thinking there is,” she says. “You then try and rid yourself of all the bad feelings by pushing them back at your partner.” If the argument escalates, take some time out. “Say: ‘I can’t talk about this right now, because it’s upsetting me too much. I need a bit of space to think about it. Let’s talk about it again later.’ Sometimes it’s best to let things lie for a little bit and return to them,” says Abse.

“Don’t have arguments to win them,” says Harrison. “This is not a court of law.” Don’t bring in every (real or perceived) crime they have committed over the course of your relationship. “That makes the other person panic, and feel defensive.” Try to actually listen, rather than just waiting for them to finish speaking so you can have your say. If their volume is rising, it’s probably because they’re not feeling heard. It’s difficult to remember all this in the heat of the row, Harrison adds. “We’re all only human. Sometimes you’ve got to just have the argument.” Arguments can blow up out of nowhere, but if it’s an issue you know is going to be touchy, Harrison recommends scheduling a discussion. “Don’t put the other one on the spot. Say: ‘Should we go for a walk tomorrow and talk about this?’ So everyone knows that it’s coming.”

Be curious, she says. The row happened because you left a coffee cup somewhere you shouldn’t, but what is that actually about? Go into information-gathering mode. “That is a lot of what we do in therapy – being curious about disagreements and trying to find the deeper layers, because an argument about a coffee cup could be about some fundamental principle going on in the relationship that needs attention.”

The hot topics that often cause arguments – money, jealousies, big life decisions – usually have a resonance beyond the relationship, says Abse, often going back to childhood. “If you’re finding certain topics very difficult, having a bit of space where you think about why it’s so hard for you, together or on your own, is important.”

It is the repair of the relationship after an argument that is vital. “Ruptures followed by repair are strengthening and produce greater resilience in a couple than avoidance,” says Abse. Try whatever works for you both – an apology, a cup of tea, a biscuit. “And when the gesture has been made, really try to reciprocate. You can say: ‘I’m still cross with you’, but accept the hug or the cup of tea.” Refusing a peace offering “is likely to lead to gestures not being made and making it harder to come back from arguments. Sometimes it takes time – if the rupture has been about a big betrayal then you’ve got to make the gesture for longer.”

A lot of people, says Abse, are fearful of having rows – maybe you witnessed your parents arguing and found it frightening. “But sometimes you do have to have big arguments, and sometimes you have to accept that they go on for a while.” An argument may be resolved, but it may be a case of learning to live with your differences, she says. “Or realising: ‘We’re too different and we can’t live with that.’”

Since Leslie wrote his book, he has found himself more likely to engage in arguments with his wife. “Not angry ones,” he adds. He suggests having lots of “good-natured, low-stakes arguments. Then, when the bigger ones come along, you’ll be more prepared to deal with them.” As for me, I’m off to start a row.

Complete Article HERE!

Is It Safe to Have Sex If You Have Heart Disease?

by Maggie O’Neill

Key Takeaways

  • Most people with heart disease can safely engage in sexual activity.
  • But sex can exacerbate some specific heart conditions, and anyone with heart disease should be mindful of warning signs like shortness of breath or chest pain during sex.
  • It’s important to speak with a healthcare provider about the benefits and risks of sex after a heart disease diagnosis.

You should be mindful of how you feel during sex—or any other form of physical activity—if you have heart disease. However, having heart disease doesn’t necessarily mean you have to abstain from sex.

“Generally speaking, sexual activity is safe for patients with cardiovascular disease,” Lindsey Rosman, PhD, assistant professor of medicine in the division of cardiology at the University of North Carolina School of Medicine, told Verywell.1

>It may be helpful to think about the risks and benefits of sex the same way you would a workout, Jim Liu, MD, clinical assistant professor of internal medicine at The Ohio State University Wexner Medical Center, told Verywell. “I would think of sexual activity as any other physical activity—your blood pressure goes up, your heart rate goes up, and that’s how [sex] really impacts the heart,” he explained.

While sex is usually safe if you’re living with a heart condition, you should talk with your healthcare provider about any concerning symptoms to look out for during sex.

“Patients and their spouses are very reluctant to ever ask about sexual activity, and doctors are not very good at spontaneously bringing up the topic,” Glenn Levine, MD, professor of medicine in the cardiology department at Baylor College of Medicine, told Verywell. “Both patients and providers should be aware of this and not be afraid to bring this topic up on the part of the patient and their spouse.”

It’s important to know that living with a heart condition doesn’t mean that sex is “dangerous” for you. In fact, it can be good for your overall health and well-being. “Sexual activity is a form of exercise which can help strengthen your heart, reduce stress, and improve sleep,” Rosman said.

It may have benefits beyond the physical, Liu added. “Having sex has an impact on people’s quality of life, and this may have an indirect [positive] impact on heart health,” he said.

“There is a slightly elevated risk of experiencing a cardiac event whenever you’re physically active, whether it’s sexual activity or going for a walk,” Rosman said.

Is It Possible to Have a Heart Attack During Sex?

However, heart attacks during sex do not happen often. “Sex is a relatively rare trigger of heart attack or sudden death,” Rosman said. She added that less than one percent of all heart attacks occur during sexual activity.

Anyone with a heart condition should watch for the following warning signs during or after sexual activity, Rosman said:

  • Chest pain
  • Shortness of breath
  • Rapid heart rate
  • Irregular heart rate
  • Dizziness
  • Insomnia after sexual activity
  • Fatigue the day after sexual activity

If you have heart disease and start to experience these symptoms, contact a healthcare provider.

Does Heart Disease Impact Sexual Function?

A heart disease diagnosis can impact your sex life in many different ways, experts said. The disease itself and the treatments prescribed can affect sexual function.2

“Heart disease and its treatment can change the way blood circulates throughout the body and may reduce the amount of blood supplied by the heart to distant areas of your body, including the genital region,” Rosman said. “Reduced blood flow can lead to erectile dysfunction in men and sexual arousal difficulties in women, [meaning] both men and women may experience difficulty reaching orgasm.”

The toll heart disease takes on your mental health can indirectly affect your sexual health.3 “Emotional stress, depression, and anxiety are common in patients with cardiovascular disease and are associated with increased risk for sexual problems,” Rosman said.

Following a heart disease diagnosis, you may become less physically active than you were before, which could affect your sexual desire and performance, she added.

Partners of people with heart disease may also be affected: “Heart disease can be stressful for patients’ spouses and partners, which can impact intimate relationships,” Rosman explained.

Lastly, the symptoms that come with heart disease—such as palpitations, chest pain, shortness of breath, and fatigue—may make people who experience them less likely to want to engage in sexual activity.

Can People With Heart Disease Take Medications That Affect Sexual Performance?

If you’ve been diagnosed with heart disease, it’s important to speak with a healthcare provider before taking any new medications, including those for sexual performance. In general, most drugs that enhance libido (sex drive) or otherwise impact sexual performance are safe. However, some people who take erectile dysfunction medications should be aware of possible side effects or complications.

“Medications to treat erectile dysfunction such as Viagra [sildenafil], Cialis [tadalafil], Stendra [avanafil], and Levitra [vardenafil] are generally safe for patients with heart disease,” Rosman said. “[But] men with cardiovascular disease should use these medications with caution because they can cause a temporary drop in blood pressure.”

Erectile dysfunction medications can be dangerous for people with heart problems who take nitrate therapy for chest pain, experts said.3 “You can never take nitrates with those kinds of medications,” Liu said. It’s important for people who do take nitrates for chest pain to know there are other treatments for erectile dysfunction, Rosman added.

If you have heart disease, you should talk to a healthcare provider before trying any new medication, including over-the-counter [OTC] therapies. “Patients should not use dietary supplements and other [OTC] pills for erectile dysfunction without discussing these medications with their doctor,” Rosman said.

Who Should Avoid Sex With Heart Disease?

Though sex is typically safe for people with heart disease, sex may exacerbate some specific conditions, Rosman said. For this reason, “patients with advanced [heart] disease, unstable angina, or uncontrolled hypertension should talk to their doctor before engaging in sexual activity,” she explained. Those with advanced disease include people with unstable coronary disease or severe heart failure, Liu said.

Talking to a Healthcare Provider About Sex and Heart Disease

It’s normal to want to resume sexual activity after a heart disease diagnosis. “Returning to sexual activity is a common concern for patients with heart disease,” Rosman said.3

When possible, you should discuss the risks and benefits of sexual activity with your healthcare provider and your partner, Rosman said.

Your cardiologist may suggest therapies outside of heart disease treatments that may help. “If emotional distress, depression, and anxiety are contributing to sexual difficulties, patients may benefit from individual counseling with a licensed psychologist or mental health provider,” Rosman said. “Couples therapy may also be beneficial.”

Complete Article HERE!