Tag Archives: Sex Therapist

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

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Yup, we mean the bad kind of pain.

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

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

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

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

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

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

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

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

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

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

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

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

Some of these include:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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Medically assisted sex? How ‘intimacy coaches’ offer sexual therapy for people with disabilities

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‘For me, the sex is obviously why I’m seeking this out, but I’m also seeking services like this out because … I feel the need to be touched, to be kissed,’ says Spencer Williams.

For years, Spencer Williams felt he was missing something in his love life.

The 26-year-old Vancouver university student and freelance writer has cerebral palsy. He says he meets lots of potential sex partners but had trouble finding what he was looking for.

“I always refer to my wheelchair as it comes to dating … as a gigantic cock block,” he says. “It doesn’t always get me to the places I want, especially when it comes to being intimate.”

“I thought, if something didn’t happen now, I was going to die a virgin.”

So he Googled “sexual services for people with disabilities.”

That’s how Williams found Joslyn Nerdahl, a clinical sexologist and intimacy coach.

‘Intimacy coach’ Joslyn Nerdahl says sex can be healing.

“I answer a lot of anatomy questions. I answer a lot of questions about intercourse, about different ways that we might be able to help a client access their body,” says Nerdahl, who moved from traditional sex work to working as an intimacy coach with Vancouver-based Sensual Solutions.

“I believe [sex] can be very healing for people and so this was a really easy transition for me, to make helping people with physical disabilities feel more whole.”

Sensual Solutions is geared toward people with disabilities who want or need assistance when it comes to sex or sexuality. It can involve relationship coaching, sex education or more intimate services. They call the service “medically assisted sex.” It costs $225 for a one-hour session.

Nerdahl notes that some people with disabilities are touched often by care aids or loved ones who are assisting with everyday activities such as getting dressed or eating.  But her clients tell her that despite that frequent physical contact, the lack of “erotic touch” or “intimate touch” can leave them feeling isolated, depressed or even “less human.”

‘Help a client access their body’

Nerdahl says each session with a client is different, depending on the person’s level of comfort and experience, as well as his or her particular desires and physical capabilities.

Williams says his sessions might start with breathing exercises or physio and move on to touching, kissing and other activities.

An intimacy coach may help a client put on a condom or get into a certain position.

A session might also involve “body mapping,” Nerdahl says, describing it as “a process of going through different areas of the body, in different forms of touching, to figure out what you like and what you don’t like.”

Social stigma

Sex and sexual pleasure remains a taboo topic when it comes to people with disabilities.

For Williams, accessing this service is about more than sexual pleasure. But it’s about that, too.

The sex is obviously why I’m seeking this out, but I’m also seeking services like this out because I feel the need to be close. I feel the need to connect. I feel the need to be touched, to be kissed.”

“Sometimes people … offer to sleep with me as a pity, and I often don’t appreciate that. I want things to be organic and natural,” says Williams.

He much prefers his sessions with Nerdahl, in which he is able to explore physical and emotional intimacy in a non-judgmental and supportive setting, even though it’s something he pays money for.

“I think it freaks people out when we talk about sex and disability because most of the time they haven’t thought about that person in a wheelchair getting laid,” Nerdahl says. “They just assume they don’t have a sex life because they’re in a chair, and that’s just not the case.”

Legal grey area

The stigma is further complicated because Canada’s prostitution laws have no provisions for services that blur the line between rehabilitation and sex work.

Kyle Kirkup is critical of Canada’s current prostitution laws that criminalize the sex trade regardless of context or intent.

Currently, it’s legal to sell sex and sex-related services, but illegal to purchase them. (Sex workers can be charged for advertising services or soliciting services but only if in the vicinity of school grounds or daycare centres.)

Kyle Kirkup, an assistant professor at the University of Ottawa’s Faculty of Law, calls the current laws a “one-size-fits-all approach” that criminalizes the sex trade regardless of context or intent.

The current law doesn’t include provisions for people with disabilities, or which deal specifically with services like Sensual Solutions whose intimacy coaches may come from clinical or rehabilitation backgrounds.

“A person with a disability who purchases sexual services would be treated exactly the same as any other person who purchased sex,” he says.

“So it’s a very kind of blunt instrument that doesn’t actually do a very good job of contextualizing the reasons why people might pay for sex.”

There are other countries, however, such as the Netherlands that view medically assisted sex in another way entirely; sex assistants’ services may be covered by benefits, just like physiotherapy or massage.

Complete Article HERE!

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How to Spice Up Your Relationship With Porn

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Believe it or not, porn can strengthen your relationship

 

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Let’s face it, many believe that pornography ruins relationships by setting unrealistic expectations in the bedroom. It’s a sound argument. But it would only be fair to make an opposing case that in some ways porn can improve your sex life.

“Pornography can spark curiosity and open conversation between partners. It’s so easy to get into a routine with your significant other, and it can be hard to break out of that. Watching or reading erotica allows couples to explore sexual activities that they may be curious about,” says Polly Rodriguez, CEO of Unbound.

A study published in the journal Sexual Medicine even shows that watching at least 40 minutes of porn twice a week can boost your sex drive and your overall desire to have sex. Not to mention, it’s really hot to watch people have sex, and sharing this with someone you love can enable a deeply sensual experience.

Convinced enough? Here are nine ways to incorporate porn into your sex life.

1. Have an open & honest conversation about it

Talk about your desires and interests and set boundaries of what is and isn’t OK, suggests Rodriguez. “From there, only good things can happen if you’re open and honest with each other about what you’re curious to try.”

2. Use porn as a source for inspiration

Be it BDSM or role-play, Rodriquez explains that having an example you can both watch and learn from together helps to frame what it is you’re curious to try.

3. Expand your sexual repertoire

Talk about the type of porn or fantasy you like to watch. Girl on girl, threesomes, just oral… have you always wanted to try a certain position or sex act? “This is the chance to open up and be honest about what you may have been afraid to voice to your partner,” says Antonia Hall, a psychologist and award-winning author of The Ultimate Guide to a Multi-Orgasmic Life.

4. Don’t be judgmental

Your partner might like something you don’t, notes Alicia Sinclair, Founder and CEO of b-Vibe and Le Wand. “It’s important to find the common ground and make the process sexy.”

5. Start soft

Begin with something you know turns you both on. “Try something in the amateur or couples section. It’s probably not a good idea to start with a hardcore sex scene (unless you’re both already into that of course),” says Sinclair.

6. Find a website both of you enjoy

Send each other clips you want to watch together later. “I’m a personal fan of Bellesa (run by Michelle Shnaidman) because it’s a bit more sensual than what you’d find on one of the bigger tube sites,” says Rodriguez.

7. Let it put you in the mood

Before your sweetie gets home. Put on your favorite video, rub one out and let yourself get totally aroused. As soon as they walk through the door, you’ll be in full get-it-on mode.

8. Aim for quality content

Sinclair suggests, Trenchcoatx. “This porn-for-women site is run by two women and has tons of quality content. Plus, you’re supporting women making porn, which is kind of a win-win in my book,” she adds.

9. Make you own porn

Get creative and make your own erotic video. It’s a fun way to experiment, act and enjoy watching it together later on. Just make sure to use a digital camera and not your cell phone so you don’t have to worry about it accidently getting uploaded and can delete it at any time.

Complete Article HERE!

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Dating someone with a fetish when you don’t have one

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As you may have seen from our A to Z of fetishes series, there is a huge spectrum of kinks out there.

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Where you might be into a fumble on the couch, your new partner might be fingering the ball-gag they’ve hidden under a cushion, wondering about the right time to approach the topic.

There’s a big gap between missionary with the lights off and latex at dawn, which means there’s a hell of a lot of wiggle room for both of you to try new things. But, if your sexual tastes are wildly differing, it can cause friction in your relationship.

If you’re worried you’re too vanilla while your partner is more of a rum and raisin type, however, there are plenty of ways to remedy this.

Be honest

Don’t rush in, pretending you know your way around bondage knots or puppy play if you’re not au fait. Have an honest chat about what turns you on and off. Sex is an important part of most relationships, and there’s no point in going through the motions if you’re not enjoying it.

Whether it’s something you want to try more of, or something you’re not comfortable with, forget trying to be cool and just say it. You don’t owe anyone anything, so don’t try and bend your needs and wants to fit somebody else’s. Makes things much easier for everyone involved.

Recognise unhealthy traits

People who practise things like BDSM are overwhelmingly disciplined and respectful. There are safe words involved, and a focus on communication and physical and emotional wellbeing. Don’t let someone who’s watched 50 Shades of Grey come into your life and start treating you unfairly.

If someone starts to exercise control over you that makes you uncomfortable or affects your daily life, that can qualify as abuse.

Don’t judge

It sounds obvious, but kink-shaming is a real thing and some of us don’t even realise we’re doing it. If someone likes roleplaying something, that doesn’t make it exclusively part of who we are.

Someone can be a loving, kind, and generous person and still love getting spanked and told they’re a worthless piece of sh*t. As long as they’re respecting your boundaries and being clear with you, that’s what matters.

Understand balance is key

If you’re with someone who refuses to compromise with you, and work out ways that you can both do what works for you, bail immediately. Regardless of specifically what it is they’re into, selfish lovers are uncool.

If you like Thai food and your partner likes roast dinners, you wouldn’t be okay with tucking into a Yorkshire pudding every day of the week. That kind of compromise will look different in every relationship, but it’s vital to have it.

Be open minded

You might find that you’re into something you never even knew about. Their kink might be something you never even thought about before, yet here you are getting a golden shower and it’s the horniest you’ve ever been!

Complete Article HERE!

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The Reason Most Couples Stop Enjoying Sex

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(And How To Heighten Your Capacity For Pleasure)

Everywhere I go, I hear stories about the challenges professional women are having sexually with their partners. It happens to women between 20 and 70, with kids and without. It’s described in one of a few ways:

  • “I used to like sex, but then we had kids, our careers picked up, and something changed.”
  • “When we do have sex, half the time I’m thinking about my to-do list. I feel relieved when it’s over, because then I can do what I really want to do—like finish my book.”
  • “We feel more like roommates or business partners than lovers.”
  • “I’m worried my libido is broken and there’s something wrong with me.”

The high stakes of intimacy in long-term relationships mixed with the inaccurate beliefs about female sexuality we face from all sides make for a volatile combination. But I’ve seen these issues get resolved. It’s absolutely possible. No matter where it’s coming from, sexual dissatisfaction can be remedied when both people commit to learning a new way to relate intimately. These are the keys to creating mutually fulfilling intimacy that lasts a lifetime.

I see that these patterns can change when couples commit to learning a new way of relating sexually that women enjoy. Here are the keys to successfully moving toward intimacy that’s mutually fulfilling:

1. Normalize your experience.

When intimacy is the issue, it can be very difficult to discuss openly. Often, we feel alone and don’t realize that sexual struggles in long-term relationships are not just normal, but they happen to the majority of couples at one time or another. Having discussed these issues with countless female clients who believe that they are to blame for their unhappiness, I realized that we just tend to place blame on ourselves. The truth is that there’s nothing wrong with you. Your libido is not broken. You’re not alone and this IS fixable.

2. Clearly articulate your need for change.

One of the biggest mistakes I see otherwise straightforward women make is downplaying their sexual distress to their partner. Many of us believe our male partners don’t care about our sexual fulfillment, or that enjoying sex isn’t worth the tension it would place on your relationship to bring up what isn’t working. Don’t let this stop you from getting what you need.

I have almost as many male clients as female ones, and they all want the same thing when it comes to sex: a partner who is turned on, happy, and enjoying themselves. Regardless of gender or relationship style, if sex only works for one partner in the relationship, then the sex isn’t working.

Have you clearly articulated to your partner that you aren’t sexually satisfied and that you need something to change? If not, your chances of fulfillment are slim. Blaming yourself doesn’t make anything better; taking responsibility for dealing with it as a team does. Get in the habit of talking with your partner regularly about what’s working for you and what isn’t.

3. Stop following a script.

We seem to all have been given the same misinformation about how sex should go: It starts with kissing and ends with intercourse. We’ve also been taught that happy couples have sex once per [day, week, month, insert stereotype here]. We’ve learned that sex is over when the man reaches orgasm. But I’m here to tell you that every single one of these statements is not only false but harmful.

The truth is that when couples drop expectations about sex and adopt a new approach—one that makes both parties’ genuine fulfillment a prerequisite rather than a bonus—women’s genuine fulfillment (which includes much more than having orgasms)—it supports deeper intimacy and can make a woman’s libido more active than it ever was before. Learn more about how to enter a new, infinitely satisfying paradigm here.

4. Recognize that orgasms are not sex’s raison d’être.

Orgasms are wonderful, but in truth, our fixation on them keeps our sex lives from becoming extraordinary. Let’s get real: If orgasms were all it took for radical fulfillment, far more of us would feel fulfilled. We wouldn’t even need relationships to make that happen. But we know it’s not the same. Self-pleasure is healthy, and may temporarily alleviate feelings of exhaustion or anxiety, but it doesn’t provide us with the connection or intimacy that partnered sex can.

5. Seriously, get rid of the script—before you even start the first act.

You’ll see a night-and-day difference in your sexual encounters if you let go of expectations before either of you starts getting hot and bothered. Nothing hinders women’s enjoyment of sex more than feeling pressured in bed. It’s almost impossible for us to enjoy ourselves if we’re worried about expectations about how or how much we are. Instead of feeling the pleasure, we get stuck wondering whether we’re doing it right or whether our partner is satisfied. Tossing expectation out the window is the most reliable way to start having fantastic sex immediately.

6. Touch each other for the sake of touching—with no apprehension or expectation about where it might lead.

Physical contact is essential for sexual fulfillment. But when sex isn’t working, we often avoid touching each other. I encourage couples to touch each other frequently and in a wide variety of ways—foot massages, hand-holding, and everything in between. But, by the same token, I encourage couples to stop tolerating touch they don’t like or want.

Tolerating touch leads to sexual shutdown—the person being touched isn’t enjoying themselves but won’t say it; the person doing the touching knows something is wrong but isn’t being told how to fix it. It creates distance rather than fostering intimacy. The solution is to have physical contact with zero expectations. When pressure and expectations are lifted, touch becomes an exploration of sensation and connection rather than a race to orgasm or “those same three moves.”

7. Don’t look at sex as a means to achieve any goal other than giving and receiving pleasure for pleasure’s sake.

Goals are great for business plans and exercise regimens, but they have the opposite effect on sex. Few of us have ever touched our partner without trying to achieve a goal. We use our touch to prove we’re a good lover, to make peace in the relationship, or to bring our partner to climax. How would we touch each other if we weren’t trying to achieve anything except to connect and explore each other’s bodies? Given an open-ended approach to sex that is full of touch and free of pressure, both desire for and enjoyment of sex will grow exponentially.

8. Learn what you like, and allow yourself to receive it.

Desire is vital to fulfillment. When we lose touch with that inner spark, our sex lives fall flat. Ask yourself the question, “What do I want?” 10 times a day. Seriously. And get very good at answering it. Desire is the first step. Only then can we receive it. It may sound simple, but I see women struggle sexually for years because they don’t know how to receive the help, love, and touch their partner wants to give. It takes as much work to receive as to give—sometimes more.

Practice receiving by focusing on the enjoyment of what you’re experiencing. Sink into the warm embrace of a hug. Delight in the smell of your favorite baked good. Relax as your partner touches you. Think less; feel more.

9. Practice, practice, practice.

Yes, even great sex requires practice. Create habits that can be easily incorporated into your daily routine. I encourage all couples I work with to develop a habit of sexual research—open-ended sessions where couples explore new ways to connect without pressure. Like any new habit, allowing yourself to feel more pleasure and connection takes practice.

10. If it seems helpful, get professional coaching.

If you don’t feel like you can do it alone, don’t. There’s nothing to be ashamed of except not using every tool at your disposal to create the relationship you want. Get the support of a coach whose philosophy inspires you.

11. Be patient with yourself and with your partner.

Sexual connection is deeply personal and one of the most vulnerable elements of our identities. Don’t be discouraged if you, your partner, or your sex life doesn’t change as quickly as you’d hoped. People transform in different ways, through different means, over different periods of time. In seeking long-lasting change, favor paradigm shifts over quick fixes. Stick with it and be patient with each other.

Complete Article HERE!

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