Everyone awaits the day when the COVID-19 pandemic will end. Yet, backlash caused by the SARS-CoV variant is far from over for COVID long-haulers who continue to be ill long after they experience their first symptoms.
Despite the worldwide burnout known as “COVID fatigue,” sexual long COVID may motivate the global community to continue its best efforts to prevent the spread of coronavirus variants.
Below are a few possible symptoms of long COVID leading to sexual long COVID:
Erectile dysfunction in males; emotional distress and low libido in females
Circulation disorders that block blood flow to the genitals
Brain fog, including confusion, forgetfulness, inability to concentrate or stay awake during sex
Endocrine disorders involving a new onset of diabetes, thyroid disease, or low testosterone levels
Anxiety and depression related to long-haul problems that suppress libido
Sensory dysfunctions or nerve pathway disorders causing tingling or pain in hands and feet
Musculoskeletal pain and joint tenderness that makes intimate activity uncomfortable
Brain events (such as strokes) and cardiac dysfunctions ranging from extra beats to heart attacks
Lung problems like shortness of breath, cough and chest discomfort that deter intercourse
Many physicians tell survivors they have no measurable COVID-19 after-effects and blame nuisance symptoms like poor sexual performance on “pandemic stress.” Unfortunately, these misdiagnoses diminish the COVID survivor’s plea for help.
Moreover, physicians don’t discuss sexual health issues unless the patient mentions the problem first — many patients are too embarrassed to report sexual performance issues while struggling to recover, so sexual long COVID often goes untreated.
Anita’s COVID Nightmare
Sixty-four-year-old Anita (a pseudonym), who lives in The Villages in Florida, caught COVID-19 in December 2021. She tested positive after developing a fever, fatigue, and cough. She soon became short of breath and struggled to perform simple tasks.
Anita went to the Emergency Department and was in intensive care for five days because of low oxygen levels caused by COVID pneumonia. She reported feeling death anxiety as soon as her hospitalization began, and her thoughts about death persisted for months.
To this day, Anita has not fully recovered from COVID-19 because of her anxiety and shortness of breath. This fear affects her love life. She also claims that experiencing COVID-19 is still her most debilitating issue.
“Before I discovered that my illness caused me to develop asthma, I would wake up in the middle of the night and feel so confused. It took weeks to realize that I was awakening because I was short of breath.”
“I admit to having significant problems with my love life because I am afraid sexual activity will trigger an asthma attack.”
Fortunately, after months of doctor’s visits, testing, and medication trials, Anita reports her asthma to be in better control. “I now depend on two inhalers, especially when I exert myself. I cannot hike or exercise like I did before I got sick without having an asthma attack.”
“However, I admit to having significant problems with my love life because I am afraid sexual activity will trigger an asthma attack. I’m hopeful I’ll one day feel as well as I did pre-COVID. I don’t have the same quality of life since long COVID impacted my world. I’m so glad my husband didn’t catch my infection, but I think he knows my illness has damaged our love life.”
Anita’s experience of having to endure months of doctor visits and testing confirms how hard it was for her to get the health care she eventually received for her breathing issues.
Her primary care physician kept telling her that she was imagining her long COVID problems and suggested she needed a therapist. She admits that no one has asked her if COVID-19 has affected her sexual health.
Long COVID and Tiny Blood Clots
Clyde Goodheart, of Fort Lauderdale, Florida, is a biomedical research scientist who studies viruses and other disease causes. Goodheart believes that long COVID complications are likely due to “micro clots” that block blood flow to multiple affected organs.
According to Goodheart, “COVID long haulers who have problems with breathing most likely have tiny clots in the smallest blood vessels (capillaries) in their lungs.”
Goodheart explains how tiny blood clots cause endothelial dysfunction, which occurs when the linings of blood vessels become damaged, causing circulation to the affected organs to become blocked. Post-COVID endothelial dysfunction contributes to erectile dysfunction (ED) when micro clots impair the circulation inside the penis, which causes problems with getting or keeping an erection.
Genital circulation is not the only organ system affected by impaired circulation; lungs, brain, heart, nerves,and muscles can all potentially be damaged by micro clots that impair circulation.
Erectile Dysfunction as a Marker for Sexual Long COVID
A study by the University of Florida Health (UFH) shows that men infected by a SARS-CoV-2 variant are three times more likely to develop erectile dysfunction than men unaffected by infection.
Here’s what UFH researchers discovered:
In men who suffered significant COVID-19 infections, those with increased risk factors for COVID-19 complications were most likely to develop long-term ED.
Complication risk factors include prior history of diabetes, lung disease, obesity, circulation or heart disease and smoking.
The virus binds to primary organ tissues, including the penis and testicles. This bond decreases the amount of testosterone produced and increases the risk of ED. The virus has been found in penis tissue biopsy long after the initial infection.
Testosterone loss increases the risk of developing all other complications associated with long COVID.
The study also confirmed that sexual long COVID causes both genders to experience brain fog, breathlessness, anxiety and fatigue.
The Impact of Sexual Long COVID
It is fair to say that the next global public health crisis may be to care for patients afflicted with life-altering disabilities caused by long COVID.
The threat of sexual long COVID may be psychologically more intimidating to the COVID-weary community than are other long-haul complications. Sexual long COVID may spur more people to vaccinate or to improve their social distancing and other transmission precautions.
Only time will tell how COVID-19 will affect those most affected by the long-term exponential complications. More research and a better understanding of all factors that make COVID-19 an enduring pandemic are needed to provide the best treatment practices for the millions infected worldwide.
A team of researchers led by Alexandra Dubinskaya, of Cedar-Sinai Medical Center has found that the medical benefits of women using vibrators are strong enough to warrant doctors prescribing their use to female patients on a regular basis. In their paper published in The Journal of Urology, the group describes their metastudy of research into the health impacts of vibrator use by women and why they believe the time may have come for them to be considered medical therapy devices.
Prior research has suggested that frequent masturbation by women can have positive health impacts, both physical and mental. In this new effort, the researchers noted that little work has been done on the use of vibrators as a masturbation aid and whether they have positive health impacts. They reviewed research databases for studies that involved use of vibrators for medical benefits and found 558 papers, which they whittled down to 21.
In their analysis, the researchers found evidence of a host of benefits of regular vibrator use, noting that it improved the health of the pelvic floor, reduced vulvar pain and led to improvements in overall sexual health. They also found instances of regular vibrator use leading to improvements in incontinence along with pelvic floor muscle strength.
The researchers note that use of a vibrator during masturbation reduces the time it takes for a woman to achieve an orgasm, and also helps with achieving multiple orgasms. Other prior research associates experiencing regular orgasms with stress reduction and an improvement in overall sexual health. They suggest that adding a vibrator to masturbatory experiences leads to better outcomes.
The researchers conclude that vibrators can and should be considered not just sex toys, but therapeutic devices. And that, they point out, suggests that it is time that female pelvic medicine and reconstructive surgery specialists, and perhaps doctors in general, begin prescribing vibrators to their female patients. The team will be presenting their findings at this year’s Annual Scientific Meeting of the American Urological Association.
Love is one of the highest-impact subjects you can teach. Fortunately, it’s also one of the easiest to broach.
If you’re tempted to open up a discussion of romantic relationships with “no dating until you’re 30!” you wouldn’t be alone or entirely misguided. Throughout history, conventional wisdom held that fathers should teach their daughters about the perils of love, stop their potential ravishers at the door, and avenge their heartbreaks.
While your role has evolved, and dad jokes about scaring dates away are far past their prime, there are some real dangers you want to address. Identifying these risks can help your daughter recognize any potentially harmful patterns in her relationships and help her avoid or address them early on:
The risks of romantic relationships:
Loss of personal identity. Girls can become so wrapped up in their romantic relationships that they get distracted from schoolwork, let their friendships slip, and devote less focus to their own passions.
Emotional distress. Fights, disappointment, and heartbreak can send girls spiraling.
Risky sexual behavior. If girls’ relationships become intimate, there is the chance for risky sexual behavior to occur. Girls need to be educated about sexual health.
Dating violence. Dating violence, including sexual misconduct, is a matter of international concern.
The building blocks of healthy relationships.
Some of these building blocks may seem obvious, but you can’t take for granted that your daughter will figure them out easily. Telling her the basics can make a positive difference, saving her time and limiting confusion and heartache. Here are some characteristics of good relationships:
Partners feel happy and content in the relationship most of the time.
There are strong feelings of psychological safety and joy and low levels of drama and jealousy.
Partners feel accepted. They don’t feel pressured to change their appearance, values, hobbies, or other personal characteristics.
Partners maintain their personal identities and activities and stay focused on their individual goals and responsibilities, enjoying their relationship as just one part of their lives.
Partners communicate openly and directly to voice boundaries, build trust, and solve conflicts quickly.
Partners speak and act kindly to each other, boosting each other’s self-esteem.
Partners are not physically violent.
Partners end relationships respectfully.
Red flags in relationships.
Discussion of potential red flags also has an important place in this conversation. Here are some concerning signs your daughter should be aware of:
Feeling like a romantic partner is excessively jealous.
When a romantic partner acts controlling or tries to dictate what their significant other is allowed to do, where they can go, and who they can spend time with outside the relationship.
A partner feels guilty, like they can’t do anything right, or that they are “in trouble” with their romantic partner often.
Any type of physical violence or threat of violence.
Any type of sexual violence.
Girls’ common questions and concerns.
Why it seems like “everyone is in a relationship.”
Explain that for a lot of reasons, it might feel to your daughter like she is the only one not in a relationship. It’s easy to focus on what others have. A lot of movies depicting life in middle and high school focus on a love story, which makes it seem like having a relationship in your teens is something that needs to happen or should always happen. And romantic relationships are glorified and depicted in the music girls listen to and the Netflix shows they binge. Since our culture places so much value on relationships, it makes total sense she may feel like the only single person at one time or another.
Make sure she knows that most people have their first relationships after high school and that relationships don’t always happen on our timelines. Relationships are about connecting with the right person at the right time. And make sure she realizes that lots of people have the moment she is having, where they feel like they are the only one without a significant other. Her time to be with someone will happen, and it will be worth the wait.
With this approach, you are making her feel heard, honoring her feelings, and reassuring her while also offering her facts to back up a different point of view. She may not be in the mood to consider her situation from a different perspective, but she may come back to it later.
How to get into a relationship.
This is another common question for girls. Mention that relationships begin in all different ways. Help her see the benefit in spending time with people who make her happy and who make her feel relaxed and confident. Sometimes, girls focus on crushes who don’t have the same feelings or who are interested in other people. Encourage your daughter to really pay attention in these moments, noticing whether certain crushes and relationships actually make her happy. Explain that you can’t always choose the way you feel or who you are attracted to, but you always have the ability to change your focus to the people you feel comfortable around and who value you.
Things to say:
I love you.
Love is an important part of life.
Healthy relationships can be a fun and meaningful part of life.
It can feel like everyone else is in a relationship, but that isn’t the case.
Relationships should add to your sense of inner peace and confidence, not cause anxiety.
You should never feel like you have to change or be uncomfortable to make someone else happy.
Trust your gut feelings about someone.
Jealousy, controlling behaviors, and violence are not markers of authentic love.
Be truthful and kind in relationships.
Things to not say:
You’re not dating until you’re 30.
Relationships don’t matter right now; focus on your homework and friendships.
You’re too young to be in love.
You don’t know what love is.
Relationships never work out.
All men are dogs.
Questions to ask:
The topic of love and relationships comes up in a song, TV show, or movie. Ask:
Do you think the way they are talking about love is realistic?
Do you think the media sets healthy expectations for real-life relationships?
Do you think the media influences the way your friends view love and relationships? How?
Who do you think are the most realistic TV or movie couples? Why?
Your daughter and her friends are talking about crushes and/or significant others in your presence. Later on, ask:
Do you think most people you know in relationships are happy? Or do people get caught up in the drama?
Do you feel like your friends are always respectful and caring when talking about other people’s relationships?
What do you think are the best things about relationships right now?
What is most exciting to you about relationships?
Your daughter is in a relationship that seems positive. Ask:
What is your favorite thing about [name]?
Are there ways you feel that being in this relationship is helping you?
What do you feel like you’ve learned so far about relationships?
What are the ways you communicate best together?
Beyond the conversation: modeling healthy relational behaviors.
When it comes to teaching your daughter to recognize healthy relationships and incorporate healthy relationship strategies, the example you set is paramount. You don’t have to be perfect, but whenever possible, model the habits you hope your daughter will form, even in trying times. Show her what it means to treat loved ones with respect and resolve conflicts in caring ways. If you have a romantic partner, be mindful of cultivating healthy relationship dynamics together. Your daughter will notice and develop expectations for her relationships based in great part on your actions and behaviors.
Kissing, making out, Frenching, locking lips…whatever you call it, it’s one of the most intimate and thrilling things that two people can do. And while the focus often lies on sex when thinking about how to be a better lover, perfecting your kissing game is just as (if not more) important. Here, we’ve collected a bunch of different tips to help you land your makeouts just right every time.
Why humans kiss.
To understand how to kiss better, it’s helpful to understand why humans kiss in the first place.
People kiss in order to express feelings of closeness and desire, as well as to amplify or intensify the arousal they might be feeling. “Kissing stimulates the brain’s pleasure regions, causing it to release a mix of hormones that leave you feeling oh-so-fantastic,” explains clinical psychologist Judy Rosenberg, Ph.D. “These molecules include oxytocin, dopamine, and serotonin, which are pleasurable and promote feelings of affection and bonding.”
Interestingly, though, while we might think of kissing as something intrinsic to being human, it’s actually culturally specific and only observed in around half of the world’s societies.
Tips & techniques to try:
1. Focus on your partner.
“The No. 1 most important trait of being a better kisser is paying attention to your partner’s response,” says sex and intimacy coach Leah Carey. “Too often we learn a ‘technique’ and become completely dedicated to that way of doing things.” The goal of kissing shouldn’t be mastering one particular “move” but to get to know your partner’s particular desires.
2. Ask, ask, ask!
“It’s so obvious, but many people are scared to ask their partner what they like because they think it will make them look foolish. In fact, it’s exactly the opposite!” says Carey. “Your partner may be sitting on a few things they want to tell you but don’t know how to bring it up.”
If it feels intimidating, you can think of it as a sexy and fun way to learn together instead of something that indicates that something has been “wrong” up until now. You can say, “I want to kiss you even better, so let’s spend 15 minutes teaching me exactly what you like and how you like it. Then we can turn the tables, and I’ll do the same for you!”
3. Prioritize kissing.
Often kissing is thought of as a precursor to sex, instead of an intimate activity in its own right. Set time aside where you focus just on kissing. You can ramp up the excitement by telling your partner you can only kiss and not take off any clothes for X number of minutes. By focusing purely on kissing, you’ll become more adept at it.
4. Make eye contact.
Before going in for the kiss itself, “lock eyes with your partner, give a sensual smile, and slowly lick your lips with a twinkle in your eye,” says sexuality coach Renee Adolphe. By establishing eye contact before making physical contact, you ramp up the anticipation and sexiness. (See also: the viral psychology love eye trick.)
5. Draw out the anticipation.
“Linger in the stages before the kiss,” adds sex educator Suzannah Weiss. “Run your hands through each other’s hair, touch each other’s faces and bodies. Graze your lips against theirs before going in for the kiss. Kiss other parts of their face before going toward their lips. Try to keep teasing each other like this until you can’t take it anymore.”
6. Build it up.
Once you get into it, start with the softest, most feathery kisses you can manage, suggests clinical psychologist and sex therapist Lori Beth Bisbey, Ph.D. Then slowly work up to kissing harder and faster. You can also use your hands at the same time to caress and passionately grab your partner for extra emphasis.
7. Use your tongue.
“Work on your tongue game,” encourages Bisbey. Try different patterns and strokes, alternating pressures and rhythms. See what your partner responds well to when it comes to this so-called French kissing.
8. Don’t be afraid to bite.
You can tug on your partner’s lips with your teeth if that’s something that they’re into. Just make sure not to bite too hard, too suddenly, says Bisbey. People’s mileage may vary with biting, so ask before diving in.
9. Suck it.
You can try sucking briefly on your partner’s tongue—bring it deep into your mouth while creating a brief but strong suction action and then gently release it, says sex therapist Lori Lawrenz, Psy.D., of the Hawaii Center for Sexual and Relationship Health.
10. Involve your whole body.
Weiss also recommends making kissing a full-body experience: “Playfully lean forward and away as you kiss your partner. Graze your hands over their arms and legs. Grind your hips against theirs if that’s something you’re both comfortable with,” she recommends. These actions help to increase the desire between the two of you and add an edge to your kisses.
11. Pay attention to your partner’s reactions.
“Look at how your kissing partner reacts when you kiss their neck, nibble their ear, do a playful lip bite, or slip your tongue in,” says sex therapist Aliyah Moore, Ph.D. By being mindful of these things, you’ll know whether or not your partner is into what you’re doing and then you can make adjustments.
12. Kiss places other than their mouth.
Kissing doesn’t have to be limited to mouth-on-mouth. Play around with other places to kiss on your partner’s body. Try their eyelids, their nose, the crook of their arm. (Here’s our full guide to erogenous zones, too.)
13. Be a tease.
Another fun way into a make-out session: “Play a game where you lick your partner’s lips, but as soon as they try to reciprocate, you pull away. Don’t let them know what you’re doing; just keep pulling away until they finally understand that if they want your kissing, nibbling, licking, and teasing, they have to lie back and receive it,” suggests Carey.
14. Focus inward.
“Kiss mindfully,” suggests body coach Sarah Bick. “Notice everywhere your lip touches theirs. Home in to the sensation.” When you force yourself to be in the moment instead of letting your mind wander, the pleasure you feel from the kiss will be intensified.
15. Get into the groove.
Certified sex therapist Janet Brito, Ph.D., LCSW, recommends that you practice relaxation techniques so that your body isn’t tense while making out. A few stretches can ground you in your body and make you a little looser so that you can really find your rhythm and have fun without feeling tight or stressed.
16. Pamper your lips.
Before you actually get to the kissing, AASECT-certified sex therapist Jessica Kicha, LMHC, recommends making sure that you always have a soothing lip balm on hand to ensure your pout is silky smooth. “No one likes kissing chapped lips!”
17. Brush up.
It’s also important to stay on top of your oral hygiene, says Kicha. Make sure you brush and floss at least twice a day. A quick swill of mouthwash before a kissing session is also considerate. You want your date to focus on how good it feels to kiss you, not on how much your mouth tastes like noodles.
18. Keep it fresh.
“If you are planning on kissing after a date scheduled around a mealtime, have mints on hand to refresh your mouth,” Oakland-based psychotherapist Julia Simone Fogelson, LCSW, adds. “This demonstrates to the person you are kissing that you care enough to do a little extra to make sure they have a positive kissing experience with you.”
19. Get consent.
“There’s nothing sexier than consent,” Fogelson says. “There will not always be the Hollywood movie moment where the two people dive in for a passionate kiss. A simple ‘Can I kiss you?’ with eye-gazing and a smile shows that you are into clear communication and respect.”
20. Follow their lead.
When you are moving your tongue into their mouth, check to see if they seem to be responding in kind. If so, keep going. If you feel like they are pulling away at all, bear that in mind and correct course, says Bat Sheva Marcus, LCSW, MPH, Ph.D.
21. Embrace awkwardness.
When you go in for the kiss, you and your partner might turn your heads in the wrong directions, you might bump heads or glasses, etc. Instead of getting flustered and pulling yourself and your partner out of the moment, try to keep it lighthearted. Laugh gently at yourself, and then try again, says therapist Renetta Weaver, LCSW.
22. Don’t forget to breathe!
“Take breathing breaks. Everyone needs to breathe,” says Marcus. It can be really easy to get swept up in the moment and not focus on your bodily needs. But if you don’t breathe regularly and deeply while making out, you risk getting dizzy and having to take a break.
23. Close your eyes.
“Closing your eyes increases the sensual nature of the kiss because it forces both parties to anticipate what will happen next. Not knowing exactly what will happen next is part of the excitement!” says marriage and family therapist Janine Piernas, M.A., LMFT. If you accidentally open your eyes to see your partner staring at you, it can be a little off-putting. Eyes closed is safest unless otherwise specified.
24. Use your hands.
Kissing is obviously mouth-centered, but that doesn’t mean you can’t get your hands in on the action too. Use your hands to gently pull your lover’s hair or grab their butt or cup their face. Ask your partner where they most like to be touched while being kissed.
25. Positive feedback is everything.
“Want a kiss booster? Tell your partner they’re a good kisser. If that’s not how you feel, you can still give them compliments with some constructive critique in the middle,” says Moore. When giving constructive criticisms, use “I” sentences so it won’t look as if your kissing partner failed at kissing you. These statements soften the blow and make it easier for the other person to overcome.
26. Use your words.
Kissing is a way of expressing desire or affection without words, but the pleasure that you can derive from a kiss can be intensified if you also tell your partner how you feel about them before the kiss.
The takeaway.
Being a more thoughtful kisser can lay the foundation for a better, more satisfying experience for everyone involved. Increase the intimacy and create moments of real connection by treating kissing like something worthy of attention rather than just a step on the way to sex.
Sex is more than about intercourse – it’s the relationship you have with yourself
By Bibi Lynch
If you’re lucky, every day will feel like National Sex Day.
But on our official calendar, that special occasion falls today, on June 9.
To celebrate the moment, we chatted with Annabelle Knight – sex and relationships guru and the body language expert for ITV’s Ready To Mindgle – about orgasms, solo pleasure, and how we can prioritise our sexual wellness.
Here’s what she had to say.
Explain the day, if you will…
National Sex Day is putting pleasure at the forefront of the conversation.
It takes all the sharp, pointy edges off sex – the things that feel awkward, such as the orgasm gap [the disparity between straight men and women in terms of, yes, orgasming] or performance anxiety – and provides a warm hug of satisfaction.
The vibe is pleasure-centric coupled with information, education and entertainment.
It’s about feeling happy, healthy and contented with your sex life – a blend of your physical and mental state, your social wellbeing and your connection with your sexuality.
So what can make you feel sexually unwell?
A lack of communication. When we talk about sex, what comes to a lot of people’s minds is sex that involves more than one person and also about gaining pleasure from that person.
But sexual wellness and wellbeing is really about the relationship you have with yourself – it’s about being honest with yourself. So I’m not necessarily saying ‘the words you say to your partner’, I’m saying ‘the messages you internalise within yourself’.
Communication is everything
What happens if the messages are negative?
You’re getting in your own way. Sex, orgasm and pleasure are really important to our emotional and physical wellbeing.
Lots of studies show that regular orgasm, or regular sexual connection, promotes better immune response. You get fewer coughs and colds.
An apple a day keeps the doctor away? Well, so does an orgasm. And that’s free.
Are we going to get ill if we don’t have sex?
No. Talking about ‘is not having sex bad for you?’ just brings in shame and feelings of ‘I don’t go to the gym, I don’t eat well and now I’m not having sex! Just another thing I’m bad at’.
But sex is great for you and it’s helpful to redefine what sex is. You could think of it as being this big beach umbrella covering a giant expanse of beach – and every grain of sand is a different type of sexual encounter you can have.
Sex is anything you want it to be. And if we redefine the word sex to mean ‘the giving and receiving of sexual, sensual pleasure’, it changes the conversation.
Masturbation is sex. A heavy make-out session is sex. Mutual masturbation is sex. Even just reading erotic fiction is sex. Anything you derive sensual pleasure from, or have a sexual response to, is a form of sex. It is way more than intercourse.
Let’s talk about solo pleasure…
Solo pleasure is a 100% safe space – you can’t catch an STI or get pregnant, no one can judge you, you can’t have a bad experience and want the person to leave immediately… it is entirely about you.
That can be masturbation manually but I’m a great believer in sex toys. If I’m making a cake, I’m not whisking it by hand, I’m using my KitchenAid. That’s what you have to take into the bedroom with you. Not literally.
There are so many sex toys – absolutely something for everyone. And one of the great things about sex toys is the shopping for them.
Shopping for lingerie, sex toys and lube helps build what is called ‘positive anticipation’ – the feeling of excitement for your sexuality and sensuality. That is brilliant for confidence boosting and making you feel sexually well.
Have a solo sesh
And what is the recipe for good partnered pleasure?
Communication, exploration and experimentation is the triangle of pleasure for partnered experiences. I advocate being a trisexual – just trying things!
Lube gets a bad rap…
Yes! Lube shouldn’t be an accessory, it should be a necessity. A lot of people still believe lube is a ‘fix’ – to help with vaginal dryness, for example.
If we think of it like that, we are telling ourselves we are broken in some way. That isn’t the case at all.
Sometimes the mind is willing and the body is not. If you know you’ve got a bit of lube in your bedroom drawer, it takes away pressure to perform and you reduce the stress-induced hormones that get in your way, sexually.
I see different stages of life as different sexual challenges to overcome. You can either be dragged down by them or realise finding solutions to any problems can be pleasurable in itself.
Lube, sex toys, sex aids… they give the best chance of achieving the greatest pleasure. There is no age limit, no expiration date, on a good sex life.
What’s your aim for National Sex Day?
Great sex for everyone, full stop. That people are happy and contented in the sex they are having with themselves, their partner, their many partners… and not just on National Sex Day, every day!
It would mean I’d be out of a job but it would also mean I’d done my job fantastically well.
Fewer people know that some men and womenhave same-sex encounters, yet nonetheless perceive themselves as exclusively straight. And these people are not necessarily “closeted” gays, lesbians, or bisexuals.
When a closeted gay or bisexual man has sex with another man, he views that sex as reflecting his secret identity. He is not open about that identity, likely because he fears discrimination. When a straight man has sex with another man, however, he views himself as straight despite his sex with men.
It involves two related but separate issues: first, why men identify as straight if they have sex with other men, and second, why straight men would have sex with other men in the first place.
Skirting around cheating
As part of my research, I spoke with 60 straight men who have sex with other men and specifically looked at men in rural areas and small towns. The majority of men I interviewed were primarily attracted to women, not men. So why would they have sex with other men?
My findings revealed several reasons as to why straight men have sex with other men. Several men explained that their marriages did not have as much sex as they wanted, and while they wanted to remain married, they also wanted to have more sex. Extramarital sex with men, to them, helped relieve their sexual needs without threatening their marriages.
Tom, a 59-year-old from Washington, explained: “I kind of think of it as I’m married to a nun.” He continued: “For me, being romantic and emotional is more cheating than just having sex.” And Ryan, a 60-year-old from Illinois, felt similarly. He said: “Even when I have an encounter now, I’m not cheating on her. I wouldn’t give up her for that.”
These men felt as though extramarital sex with women would negatively affect their marriages, whereas extramarital sex with men was not as much of an issue. Most men had not told their wives about their extramarital sex, however.
Identities reflect sexual and nonsexual aspects of life
In order to answer why men would identify as straight despite having sex with other men, it’s important to know that sexual identities indicate how people perceive the sexual and nonsexual aspects of their lives. Connor, a 43-year-old from Oregon, noted:
“I think there’s a definite disconnect between gay and homosexual. There’s the homosexual community, which isn’t a community, there’s the homosexual proclivity, and then the gay community. It’s like you can be an athlete without being a jock. And you can be homosexual without being gay, or into all of it. It just becomes so politically charged now.”
The men I talked to identified as straight because they felt that this identity best reflected their romantic relationships with women, their connections to heterosexual communities or the way they understood their masculinity. Straight identification also, of course, meant that they avoided discrimination. They felt that sex with men was irrelevant to their identities given every other part of their lives.
Living in small towns and in more rural settings also shaped how the men perceived themselves. Larry, 37, from Wyoming, explained: “I would say straight because that best suits our cultural norms around here.” Most of the men I talked to were happy with their lives and identities, and they did not want to identify as gay or bisexual — not when people asked them, and not to themselves.
It may come as a surprise, but internalized homophobia was not a major reason the men I spoke to identified as straight. Most supported equal legal rights for lesbians, gays, and bisexuals. Other research also shows that, on average, straight men who have sex with men are not any more homophobic than other straight men. Additionally, while most men knew bisexuality is a valid identity, they felt that bisexual did not describe their identity because they were only romantically interested in women.
Many factors beyond sexual attractions or behaviors shape sexual identification, including social contexts, romantic relationships, and beliefs about masculinity and femininity, among others. Straight men who have sex with other men are not necessarily closeted, because they do genuinely see themselves as heterosexual.
Sexual encounters with men simply do not affect how they perceive their identity.
‘Same-sex sex can feel daunting even if you’ve had plenty of “straight” sex before,’ sex and relationships expert Annabelle Knight tells Metro.co.uk. ‘The reason it feels so different is because… it is!
‘The idea of first time same-sex can feel scary because it’s an entirely new experience. Nerves are part and parcel of pushing yourself out of your usual space and into something new.’
There’s a lot of fear when trying anything new (including queer sex) that you’ll get stuff wrong, that you’ll be rubbish, that it’ll be embarrassing.
You’re about to do something new – what if instead of viewing that as a scary thing, you see it as exciting?
‘Try to focus on the positives. As with lots of new experiences things can seem daunting, however if you re-package nerves as excitement then you’ll be able to build what’s known as “positive anticipation”, which will help you to really get the most out of the experience as a whole,’ Annabelle suggests.
Reframe anxiety as excitement
Talk about it
You don’t need to pretend to be totally cool or act like you know what you’re doing. It’s actually pretty endearing to openly say that you’re a touch nervous.
‘We can combat nerves by opening up communication with our partner, or if you feel able to, telling them that you might be feeling a bit nervous,’ says Lelo’s sex and relationships expert Kate Moyle.
Redefine sex
You might still be holding on to a traditional definition of sex, viewing it only as penis in vagina penetration.
The reality is that sex can encompass all sorts of joyous things – stroking, licking, caressing…
And the thing is, if you’ve been in ‘straight’ sex setups before, you’ve likely played with all of these bits of sex. Remembering that makes same-sex sex feel a lot less scary.
‘Appreciate that there’s more to sex than penetration alone,’ Annabelle says. ‘This means that everything from kissing, cuddling and sensual massage can fall under the banner of sex.
‘Great sex is how you define it so don’t feel constrained by the idea that penetration = proper sex.’
Be playful
Hey, this is supposed to be fun.
‘Even if we haven’t had a sexual experience with someone of the same gender before, bodies are still sensual and sensitive – be creative and playful with your touch, which will help to build up arousal and desire,’ suggests Kate.
Keep communication open
Bring in sex toys
Sex toys are not a necessity, but they can be a bonus – and can definitely help to relieve the pressure of delivering an orgasm with your hands and genitals alone.
Don’t feel pressured to orgasm every time
Not climaxing doesn’t mean you’ve ‘failed’. It’s the journey that counts, and every bit of sex can be a glorious experience – not just the orgasm.
Annabelle adds: ‘To get the most out of your first same-sex experience make sure you’re in the right head space.
‘You don’t need to have everything figured out, nor do you need to put a label on yourself – instead embrace the fact that you’re ready to experiment and open yourself up to a different type of connection.’
Top tips for great first-time same-sex sex
Trim your nails
‘Long fingernails look great but can be a bit of a pain in the clit when it comes to same-sex experiences,’ notes Annabelle.
Lube
One thing Annabelle recommends for great same-sex sex? ‘Lube, lube, and more lube!’
‘Anal doesn’t just happen, she notes. ‘The anus isn’t self-lubricating and needs a lot of help in that department. A good quality water based lube is a fabulous all-rounder. It’s skin safe, toy safe, and condom safe too.’
Lube is great for vaginas, too, particularly if the woman you’re dating is going through menopause or has given birth (both of which can cause hormones to drop and dryness to occur).
Wetter is better, so feel free to lube liberally.
Stay safe
Pregnancy won’t be a risk during same-sex sex, but make sure you’re still protecting yourself from STIs. Condoms, dental dams – all necessary.
Oh, and ‘if you’re sharing sex toys make sure you give them a clean between uses,’ says Annabelle.
Explore different turn-on spots
‘For women and vulva owners the clitoris is the source of most sensitivity and sexual pleasure, and most women report orgasming via direct clitoral stimulation,’ Kate tells us. ‘But having said that, take your time to explore sensually and not just focusing on the areas of the body commonly associated with sex.
‘This build up gives the body a chance to sexually warm up and become aroused which is key to pleasure.’
It’s pretty much the bread and butter of every mainstream romance book and rom-com: the ~exclusive relationship~. Cue the hearts, sunsets, and kisses in the rain! And while exclusive relationships might seem like the end-all-be-all definition of lurve, there’s actually a lot more to monogamy than what you’ve seen in Hallmark movies. In fact, if you’re trying to figure out what it really means to be in an exclusive relationship, the IRL version is a little less “hold me forever” and a little more “it’s your turn to take out the trash.”
In reality, people typically enter into exclusive relationships for emotional support, physical comfort, companionship, stability, and even safety, explains dating coach Blaine Anderson, founder of Dating By Blaine. “The right partner can accentuate and improve virtually every aspect of your life, from mundane things like waking up and making coffee, to big things like starting a new job or traveling to a foreign country,” she says.
But being in an exclusive relationship is about more than just having someone to eat dinner with and argue over what to watch on Netflix. Relationship therapist and consultant, Stephanie Mintz, LMFT, adds that some individuals don’t feel comfortable being physically intimate with others unless they’re monogamous. This could be because they view physical intimacy as an expression of singular commitment, or it could be due to health concerns.
Whether you’re considering taking the leap with a special someone or you’re just trying to learn more about different types of relationships, you’ve come to the right place. Here’s everything you need to know about being in an exclusive relationship and having the coveted, perpetual plus-one.
What does “exclusive” mean?
The movies usually stop when the couple finally gets together, which can make the whole concept of what it actually means to be in an exclusive relationship a little confusing. “Typically, it means monogamy,” says licensed psychotherapist Rachel Wright, founder of Shame Free Therapy and Zumio sex educator. “It means: ‘We’re no longer available for romantic or sexual relationships with anyone else.’” The concept usually applies to both the emotional and physical aspects of a romantic relationship. So, in theory, you like/love only this person, and you also do the no-pants dance with them and only them too.
Additionally, Anderson adds, both partners in an exclusive, monogamous relationship are typically expected to be physically and emotionally faithful. “[This] can mean different things to different people though, so it’s beneficial to set clear expectations and boundaries with anyone you’re considering being exclusive with,” she says.
As with most things, this isn’t a one-size-fits-all deal. Some people aren’t a fan of the lack of variety or spontaneity generally associated with exclusivity, while others choose to adapt the concept to fit their needs. Nowadays more and more couples are taking the time to lay out what exclusivity means to their relationship, Anderson says, so the definition won’t necessarily be the same for everyone.
In fact, there can be—and oftentimes is—exclusivity in open and polyamorous relationships too, notes Mintz. “The exclusivity can be with more than one person with discussions and agreements understood by all of the people in the relationship.”
What counts as cheating in an exclusive relationship?
Just like the definition of an exclusive relationship varies on who you ask, what it means to cheat is going to depend on the couple. As a very base level across the board, though, cheating = a broken agreement, Wright says. That’s why cheating can happen in non-monogamous relationships; it all goes back to crossing some sort of boundary. When it comes to exclusive relationships, though, Wright adds that this typically means “having sex or flirting” with someone other than your monogamous partner.
But since every relationship—exclusive and non—is different, what one couple counts as cheating, another might consider a normal Tuesday night. Some partners might be cool with kissing but intercourse is off the table, while others count any type of physical or emotional intimacy (like long, heart-felt chats or mushy texts) with someone outside of their relationship to be cheating, Mintz says.
This is why agreeing on what your relationship does and doesn’t mean in regards to intimacy is essential to fostering a successful bond. You might come to find that you’re okay with your partner flirting with other people but not crossing a physical line, or vice versa, and it’s all totally normal.
How do you talk about exclusivity with your partner?
If you think you’re ready to define the relationship, the first thing you want to do is find a good time to bring up the convo so it won’t feel rushed. Waiting in line at the grocery store or catching them between Zoom meetings isn’t ideal. Anderson says you’ll also want to bring the topic up in a safe, private place where you both feel comfortable sharing and listening.
When you go to lay your heart on the line, Wright suggests explaining that you want to talk about relationship exclusivity and check to see if they’re receptive to that conversation. This isn’t an ambush. They might need more time to get in the proper headspace. From there, honesty—even if it’s hard—is key to ensuring both of your needs are heard. Try to keep the conversation respectful, open, and judgment-free, and take breaks if needed.
The caveat here, of course, is that you could be on two totally different pages. You might want to be exclusive and they might not believe in closing the relationship or aren’t ready for that step. While that might hurt, it doesn’t mean you should take that as your cue to pressure them or give an ultimatum. “Being respectful does not include trying to convince someone to change their mind so you’re on the same page,” Mintz explains. “Take what the person is saying at face value and decide whether you want to continue being with them in light of the knowledge you’re given.”
Does exclusivity work for everyone?
Nope! Despite how most mainstream media makes it seem, monogamy isn’t always the move. In fact, according to Anderson, many people rush into this type of relationship before they’re actually ready. If you’re considering embarking on an exclusive relationship, Anderson and Mintz say you should really consider whether or not you know each other well enough to make such a commitment. Are you aware of each other’s imperfections? Do you trust them to meet (at least most of) your needs and expectations? Can you meet (most of) theirs? And finally, are you both actually ready to be exclusive?
Unfortunately, people often say they *want* to be exclusive, but their actions speak otherwise. “If you’re seeing someone who talks about wanting exclusivity, but doesn’t seem to want it in practice, they don’t want it,” Anderson says. The same thing goes for you. If you find yourself thinking of straying, missing being single, or going behind your partner’s back, exclusivity probs isn’t a good fit right now. (Or ever, even.)
The good news is that relationships and exclusivity aren’t synonymous. If you love the idea of being with one person, great. If not, also great because there are a lot of different types of fulfilling relationships out there to explore. “We are brought up into a mononormative society, so most folks assume an ‘exclusive’ relationship is the only way to move towards moving in together and potentially marriage and kids,” Wright says. “But monogamy is not the only long-term committed relationship design option.” There are open relationships, ethically non-monogamous relationships, polyamorous relationships, and triads, just to name a few.
That’s what’s great about modern relationships: It’s up to you and your partner(s) to define them. As long as you communicate with each other, respect one another, and maybe even share a few kisses in the rain, you’ll have that coveted romantic comedy-worthy bond.
— A conversation with a sex educator on sexual well-being, pleasure and porn
By Alia E. Dastagir
When someone says “sexual health,” what comes to mind? Perhaps you think about the absence of disease or ways to prevent unplanned pregnancy. Maybe you think of sexual dysfunction. But sex educators say sexual health encompasses all aspects of physical and mental well-being related to sexuality, and during September’s Sexual Health Awareness Month, sexual health is emphasized as a human right.
USA TODAY spoke with sex educator and “Come As You Are” author Emily Nagoski on the importance of sexual health, and the necessity for every person to have access to sex-related information, medical support and pleasure.
Question: What is sexual health?
Answer: Governmental, non-profit and professional organizations all have extensive, detailed definitions of sexual health. As a sex educator who works primarily with adults, I define sexual health not just as the absence of disease or distress, but as every individual having access to the resources they need to attend to every domain of their sexual and reproductive well-being, including physical, mental, emotional and spiritual.
The theme of this year’s Sexual Health Awareness Month is “Let’s Talk Pleasure.” How is our experience of sexual pleasure challenged by our culture?
Educators like me talk generally about the exclusion of a variety of people from being included in our sense of who “deserves” pleasure, but I want to talk about the impact of that on our brains. Pleasure is processed in the brain by just a handful of “hedonic hotspots,” and stress—including identity stress—can disrupt those hotspots’ ability to respond to sensations that, in a different context, it would.
Students of neuroscience have all heard that “neurons that fire together, wire together.” Well, many of us have had our brains trained not to be able to notice pleasure. People of color, people with disabilities, LGBTQ people and others have been raised in a culture that told them their bodies do not belong and they do not deserve pleasure, and their brains reflect that.
But I think it’s not a coincidence that pleasure-based activism now is led by precisely the people who were taught they don’t deserve pleasure: Adrienne Maree Brown and Ericka Hart, to name just two.
What are some areas of sexual health that don’t get enough attention, and why are they important?
Two fundamental areas are race and disability. The bleak reality is that sex education in America originated in the eugenics movement. Even “comprehensive” formal sex education is still grounded in ableist white supremacy. That shows up in our cultural discourse and even in sex research which overwhelmingly problematizes Black people’s sexuality, rather than treating it as a normal, healthy part of their lives. That’s beginning to change, though I worry sometimes that racial justice in sex ed will get overlooked as reproductive rights and basic evidence-based sex education are eroded more and more.
And people with different physical, cognitive, and social abilities deserve sex education that supports their diverse needs. Sex ed needs to be accessible, of course, but the larger culture has to change, too. I have had women college students with physical disabilities tell me their doctors had never, not once, talked to them about how their disability might affect their sexuality, and certainly didn’t offer resources for expanding their access to pleasure.
Which groups face the most challenges in caring for their sexual health and why?
I dream of a world where a Black, kinky, queer, nonbinary transfemme immigrant, who is unhoused and undocumented, has access to all the resources they need to attend to every domain of their sexual and reproductive well-being. Fully. Freely. Across their whole lifespan. And any objections anyone has to that, any judgments anyone has about my imaginary person, those are the obstacles we have to overcome in order for everyone to be able to care for their sexual health.
Are there universal truisms around sexual health, or is sexual health defined by individuals?
As much as I might wish there were universal truisms—each person’s body belongs to them and they get to choose how and whether they are touched, the gender binary is a trap that stops us from truly understanding ourselves and others, stigma is worse for our health than STIs, no one gets to impose their values on anyone else, people are allowed to be who they are—it really is for the best that each person has their own definition of sexual health.
Are you concerned about the attacks on comprehensive sex education?
I am deeply worried about the continuing attacks on real sex education all over the country. We need comprehensive, evidence-based sex education because it normalizes the reality of human sexuality. I particularly advocate for values-based sex ed that offers an opportunity for young people to think about what matters to them, instead of explaining to them what’s supposed to matter to them.
The worst part to me is that the evidence of the efficacy of sex education in reducing harm has been there for decades. It is not that we do not know what works, it’s that we lack the political will to give young people the education they deserve. But we can change that. Organizations like EducateUS: SIECUS In Action are working to change sex education policies across the country.
What is sex positivity?
People have different definitions, but here’s mine: Sex positivity is the radical, all-inclusive belief that each person’s body belongs to that person, and they get to choose what they do with it and how they feel about it.
Internet porn is a much-debated topic. I’ve heard people call it inherently sexist, say it has led to the exploitation of performers, that it’s psychologically damaging to children. I’ve read defenses about the ways in which porn can be healthy, feminist and autonomous. What is your position on internet porn?
Porn can be all those things. And it can also be a fun addition to individual or partnered sex, or a way to introduce a new idea to your partner, or even a way to learn about yourself. For adults.
Apart from the potential for harm to performers you mentioned, especially women and trans performers in mainstream porn, the worst consequence of the instant availability of endless porn online has made it a replacement for actual sex education.
By the early 2010s, college students were asking me questions about their bodies and how sex worked, based on what they had learned from porn. They thought they were broken because their bodies didn’t do what bodies in porn did. Learning about sex from porn is like learning to drive by watching NASCAR. Those are professionals on a closed course with a pit crew.
My advice about Internet porn is that if you decide you’d like to watch it, you should pay for it, just like you’d pay for a magazine. And just as you might buy coffee based on its alignment with your values—the eco-friendly option, the fair trade option, etc.—buy porn that is ethically produced, gives performers true choice about what they do and don’t do,
If you could only emphasize one message about sexual health, what would it be?
The question I’m asked most often is some variation of “Am I normal?” To me, “normal” sex is any sexual contact where everyone involved is glad to be there and free to leave whenever they choose, with no unwanted consequences, and no one experiences unwanted pain. Beyond that, your body and mind are yours to explore or not, based on your curiosity and your values.
Talking about sex with someone you’re newly dating isn’t the easiest thing to do, but these experts in health and wellness share tips on how to go about it.
Having conversations about almost anything relating to sex can be awkward for the average person. However, sex is one of the most intimate things you can do, so talking about it is something we should all learn to get more comfortable with. Sex is a broad topic, which means you have more than enough ground to cover, be it one’s STD status, sexuality, sexual trauma, or sexual kinks. It is essential to mention the gamut of sex as sometimes, we assume the term “sexual health” is only comprised of your STD status.
The World Health Organization defines sexual health as a state of physical, emotional, mental, and social wellbeing as it relates to your sexuality. Since sex is such a broad topic, how can you approach talking about sexual health with a new person you’re dating? Where should you start? Perhaps choose any starting point, and see where the conversation goes from there. What’s most important is actually opening the floor to have the conversation.
“There’s a number of ways to broach the topic,” says Jen Caudle, DO, a family physician and associate professor at Rowan University. She explains that you can initiate the conversation over dinner or coffee. “Pose things as ‘I’d like to talk about something that can be difficult for some people to talk about, but it’s important to me,’ or, ‘Can I talk to you about something that’s been on my mind?’ she says. “Everybody’s going to have a different way to do this based on your personality or style and your relationship with the other person, but letting the other person know that you come from a good place and that you mean well can be helpful.”
Caudle adds that letting the person know you understand conversations around sex can be awkward is a good way to set the tone also.
Once you do get the ball rolling and begin having conversations around the topic, what types of questions should you ask the person you’re newly dating? Asking your prospect how they define sexuality and sexual health is a good starting point says Lorneka Joseph, a pharmacist, coach and speaker. She is also a certified HIV/AIDS counselor and tester.
“Listen to what this person is saying. Is sex, a taboo for them? Do they like talking about sex? Were they sexually abused? [Maybe] they don’t want to talk about sex,” she tells ESSENCE. “I think initially asking their definition [of sexual health] will also break the ice and then you can go into [other] questions, like ‘Do you believe in multiple sex partners?’ ‘Do you believe in threesomes?’ ‘Have you ever had an HIV or STD test?’”
Caudle recommends taking it a step further and going beyond just having conversations about STDs and putting some action behind it. “I recommend people get tested before they’re into it with one another as well. I think that’s very important,” she says.
There is technology you can use to exchange test results, so you’re not simply relying on each other’s word. iPlaySafe is a helpful app you can use to take an at-home STI test and securely share your results with the person you’re seeing. There is also Hula, which enables you to find a pre-verified clinic and have the results delivered from the doctor to your phone. It also tells you how much time has passed since the user was last tested for that extra blanket of safety.
If you already know your STD status and you’re living with an incurable one, disclosing that information can be tough. However, it’s an important thing to consider doing. “I have women clients I coach who have tested positive for STDs, and we are walking through building their confidence and I am teaching them how to break the ice and bring up this information, even though it’s vulnerable,” says Joseph.
The conversations around existing STDs you may have should especially come up before engaging in sexual intercourse. It’s a way to show the person you’re dating you care about their wellbeing and it gives them the chance to choose whether or not they’d like to engage in sexual activities with you.
“If I’m going to say that I care about the person that I’m dating and I am HIV positive, or I just tested for herpes and we’re about to get down, then I believe that that is showing a lack of concern and care because I did not take the time to let this person know, ‘I actually tested positive for herpes,’ or ‘I actually have chlamydia and X, Y and Z.’ That’s showing you don’t care about that person and your relationship.”
Another tip for having conversations around sex is to invite or ask permission of the person you want to speak with. Ask them if they’re comfortable having that talk before diving in, says Joseph. “Sometimes we’ll assume [they] want to talk about sex. Not necessarily, because maybe this new prospect just came out of a relationship where there was no sexual awareness or there was trauma,” she explains.
These are all tips to help you converse in a healthy way about sexual awareness, but there’s no guarantee these conversations will always run smoothly or the other person will be forthcoming. So what happens when said person doesn’t want to talk about their sexual health or disclose any information? Joseph says it could mean that they need to see a therapist about some challenges they’re having or maybe it’s just not the right time to talk about it. However, she says it could also be a red flag to look out for.
“If I’m gonna be vulnerable with you, if we’re gonna be sexually intimate together and you’re not being honest or you are afraid to talk about it, then there isn’t much conversation for us to have.”
You can increase your sex drive with diet, exercise, sleep, relaxation, herbs, and more.
Everyone’s sex drive is different, and there is no “normal” or “abnormal” desire for sex.
Low libido can be caused by health conditions, medication, mental health issues, and more.
Media and societal norms lead people to believe that they should be ready to have sex at any given moment. While this is the experience of some people, it certainly isn’t the case for everybody.
If you’re looking to increase your sex drive or libido, there are a few things you can do to boost your desire. Here is what the research says.
What is libido?
Libido is a person’s sexual desire or appetite. A person’s libido can be affected by hormones, mental state, stress, brain function, and behavior patterns.
Everyone’s libido is different, and the same person’s sex drive might fluctuate over time, depending on circumstances. This is normal.
“Low desire is only a problem if you deem it one or you find it distressful. Some people want sex several times per day, and others don’t want it at all, and all experiences can be perfectly healthy,” says O’Reilly.
However, if you do find your lack of sexual desire distressing and you want to be more interested in sex, O’Reilly recommends looking at whether your libido is low due to lifestyle or relational factors, which could range from trouble communicating with each other, lacking emotional connection, or dealing with existing conflicts such as fighting over money or kids.
Try these 12 tips to increase your libido:
1. Reduce stress levels
Stress can cause various physical symptoms, including a lower libido.
O’Reilly says your levels of cortisol — commonly referred to as the stress hormone — rise when you’re stressed out, and this can interfere with your sexual desire and arousal. A 2018 survey conducted by the BBC found that 45% of respondents said that stress negatively affected their sex drive. A low sex drive in women can be caused by stress, more so than in men, according to research.
However, learning to reduce or manage stress can be difficult. Don’t be afraid to ask for help and support, whether it’s from your partner or a therapist. A few options for relieving stress include:
For many people, the desire for sex isn’t there 24/7.
“Desire does not always occur spontaneously. Most people need to get aroused first, and then they might experience desire. If you sit around waiting for sexual desire to occur on its own, it simply may not happen,” says O’Reilly.
There are plenty of ways you can ramp up arousal and, thus desire. Try some of the following:
Get creative and experiment with what turns you on most and increases your desire. O’Reilly says that once you’re aroused, it’s much more likely that desire for sex will follow.
Expanding your definition of what sex means can also be helpful. If you are not excited by the type of sex you have been engaged in, trying something new can be exciting.
3. Let go of performance anxiety
Performance anxiety, pressure, and stress surrounding sex are likely to curb your arousal and your desire.
“Pressure is the antithesis to pleasure, so if you feel pressure to have sex in a certain way, look a certain way, have an orgasm, get hard, get wet, make specific sounds or want sex with a specific frequency, you may find that you lose interest altogether,” says O’Reilly.
Take time out to really get to know yourself sexually. O’Reilly says that spending time better understanding your body’s unique responses through masturbation can help you to be more at ease when you’re with a partner. She also highly recommends using mindfulness during masturbation, and mindfulness in general, which will result in benefits in partnered sex.
Practicing mindfulness has been studied with great results in regard to libido. A 2014 study examined 117 women who struggled with low desire. After mindfulness training, there was a significant decrease in “sex-related distress.”
4. Get enough sleep
Sleep affects many aspects of your health and behavior, including your sex drive. A 2019 study found that lack of quality sleep is correlated to low libido, as well as difficulty orgasming in women.
O’Reilly says exhaustion can lead to a lack of desire for sex. In this case, you should be prioritizing sleep over sex. Once you take care of your sleep habits, you may notice a difference in your libido, according to O’Reilly.
When you’re in a relationship, and you’re experiencing issues with your partner, it’s likely that those problems will spill over into the bedroom and leave one or both of you less likely to want sex.
“If you’re harboring resentment, dealing with a partner who doesn’t want to engage, struggling with ongoing conflict, recovering from hurt and trauma, it’s unlikely that you’ll want sex spontaneously,” says O’Reilly.
It’s best to work on these issues with your partner rather than sweep them under the rug and hope they go away. O’Reilly suggests talking about underlying sources of tension and being open about issues.
6. Reduce negative anticipation
You might not be looking forward to sex if you are worried about potential or actual negative consequences.
If you don’t want to get pregnant or are worried about sexually transmitted infections (STIs), use barrier methods such as condoms and hormonal birth control. Be sure to have conversations with any partner about your comforts and concerns.
Some people also experience unwanted pain with sex. Ask your doctor about any pain or discomfort you experience.
If you regularly have issues with getting or maintaining erections and control over orgasms, you might be worried about sex being pleasurable for you and your partner. Make an appointment with a urologist if you have any issues with erections or orgasms.
7. Talk to a therapist
Talking to a general therapist or a sex therapist can help you deal with underlying psychological reasons that you might be experiencing low sex drive. O’Reilly says this can be particularly helpful if you’re dealing with shame surrounding sex, body image, or trauma.
There is nothing to be embarrassed or ashamed about regarding sex or seeking therapy to help with your sex life. This can be a way to examine the sources of your distress.
If there is an underlying psychological cause, then simply trying to boost your libido probably won’t help. You need to address the fundamental issue at hand first.
8. Consider hormone therapy
If your low libido stems from symptoms of menopause, hormone therapy could help. Vaginal dryness and atrophy can make sex painful, but hormonal patches, gels, sprays, and medications can all help.
Learning how to increase sex drive in women can be a matter of speaking with a doctor to receive hormone therapy. These therapies include:
Eating libido-boosting foods isn’t a quick fix for low sex drive. However, there is some truth behind the concept of aphrodisiacs. According to research, certain nutrients can help boost sex drive and fertility.
For example, diets high in animal protein, trans-fatty acids, and carbohydrates can have a negative impact on fertility. Diets high in vegetable protein, omega-3 fatty acids, and antioxidants could improve fertility.
Getting an adequate amount of these nutrients could help boost sex drive in some people. Some foods with the potential to boost libido include:
Citrus fruits
Legumes
Whole grains
Fresh vegetables
Nuts
Seafood
Foods that could contribute to a low sex drive may include:
Saturated fats like those found in fried food
Polyunsaturated fats like those found in vegetable oil
White flour and sugar
High sodium items
10. Try herbs for sex drive
If you prefer to stick with natural remedies for a low sex drive, herbs can be a great option. Some studies show that select natural herbs have the potential to boost libido.
Some herbs with the potential to boost your sex drive include:
Ginseng: Especially Korean Red Ginseng, which has been shown to help improve sex drive in women with menopause.
Maca: There is anecdotal evidence that this Peruvian root is an aphrodisiac.
Ginkgo Biloba: This extract has been shown to increase blood flow to the genitals.
Many of these herbal supplements can be found online or in natural health food stores.
11. Practice body acceptance
A low sex drive in women and men could be caused by a person’s body confidence.
Societal pressures, the media, upbringing, and mental health issues can cause some people to dislike their bodies. When you’re not feeling comfortable in your skin it may lower your sex drive. Practicing acceptance of your body can help you feel grateful for the skin you’re in, and boost confidence.
Body acceptance is definitely a practice, so don’t get too frustrated with yourself if you find it’s a challenge. Ways to practice body acceptance include:
Dressing in a way that makes you feel confident and comfortable.
Limiting media that makes you feel bad about yourself or your body.
Practicing positive self-talk.
12. Limit alcohol
Sure, alcohol may temporarily lower your inhibitions, but it can lower your libido and disrupt sexual functions.
One 2016 study showed that women reported less lubrication and difficulty reaching orgasm after drinking. Males reported that they felt less sensation in their genitals — also known as “whiskey dick” — when having sex under the influence of alcohol.
If you’re going to drink and are hoping to boost your sex drive, try to stay within one to three drinks.
What causes low sex drive?
There are many reasons someone may experience a low sex drive. Some of these reasons include:
Everyone’s sex drive is different, and that’s okay. If you’re experiencing a lower sex drive than what is normal for you, there can be many reasons. Health conditions, medications, psychological issues, and relationship problems can all cause low libido.
There are plenty of ways to boost your sex drive, though. Healthy lifestyle habits like exercise, diet, mindfulness, and self-love can get your libido up and running. Whether your libido is low or high, it doesn’t really matter, as long as you’re happy and satisfied with your sex life. If you’re not, there are plenty of ways to make a change.
Grooming is the process of normalizing inappropriate behavior between minors and adults.
If an adult tells you to keep secrets or starts giving you gifts out of nowhere, it may be a red flag.
It’s also not normal for an adult to want to spend lots of alone time with you or offer you alcohol.
If you’re a minor who’s encountering unusual behavior from an adult — like love bombing or asking to spend a lot of alone, you may be a victim of grooming.
“Grooming is a set of actions that an adult takes to subtly or overtly assert inappropriate control and power over a vulnerable person, like a child,” says Kyle Zrenchik, a licensed family and marriage therapist and co-owner of All In Therapy Clinic.
Adults groom to slowly normalize an abnormal relationship, manipulating the young person to believe that they’re safe, trustworthy, and that the nature of the relationship is normal –– when in reality it’s anything but that.
“The ultimate goal of grooming is abuse,” says Rachel Wright, a licensed marriage and family therapist and psychotherapist in private practice. This means a groomer may engage in sexual, physical, or emotional abuse. Or, they might even force their victim to do violent or illegal acts, Wright says.
Here are seven signs of grooming to be on the lookout for.
1. They’re taking a quick, significant interest in you and your life
Sure, it’s nice when someone’s interested in what’s going on in your life. However, it can be alarming if it’s excessive or coming out of nowhere.
Wright says that behaviors could indicate grooming are:
Texting or trying to contact you all the time
Making promises quickly
Giving you gifts out of nowhere
Groomers work very hard to befriend their victims and earn their trust, says Wright. By taking a lot of interest in you and weaseling their way into your life, they’re ultimately manipulating you and likely going to eventually start asking for something in return.
2. They tell you to keep secrets
If someone is sharing sensitive information with you or engaging in certain behaviors with you and telling you to keep it a secret, this could be indicative of grooming, says Zrenchik.
Zrenchik says a couple of examples of this could look like a groomer saying:
“Don’t tell your mom, but I think she’s really hard on you. You’re a better kid than that and you really deserve somebody who realizes how special and amazing you are…but don’t tell her I said that.”
“Don’t tell anybody that I rubbed your back. It’s just us being friends –– other people wouldn’t understand. So don’t tell them because they wouldn’t get it.”
3. They discuss inappropriate adult topics with you
Groomers may bring up unnecessary and inappropriate topics in conversation with you. Zrenchik says they may try to discuss:
Their intimate relationships
Their marriage
Sex
Or they might bring up topics that seem a bit more harmless, like problems at work or with friends, Zrenchik. But the problem lies within how heavily they rely on you for emotional support or comfort.
For example, they may try to excessively call you, cry to you, or ask for lots of hugs. You should not be responsible for taking care of an adult’s emotional needs, and if an adult makes you feel this way, it’s a big red flag.
“An adult is supposed to comfort a child –– not vice versa,” Zrenchik says.
4. They try to fulfill your needs
When someone is going out of their way to spend time with you and listen to you, it can certainly feel flattering, but ultimately, it’s a manipulation tactic by the groomer, says Zrenchik.
Wright says if you tell an adult that you’re struggling with something or that you have nobody else to talk to, they will use this opportunity to get closer to you. They may even go overboard showing up as your confidant.
“This person will make themselves readily available to be there to hear all the details so that you can confide in them. They get information, you bond to them. It’s a win-win…until it’s not,” Wright says.
Ultimately, it’s about getting you to rely on them for comfort: “In becoming reliant and trusting of this person, you wind up feeling brainwashed, doing things you wouldn’t typically do, and feel close to this person who has manipulated you,” Wright says.
5. They try to spend time alone with you
It’s common for groomers to try to get their victims alone so they can do and say things that they wouldn’t be able to around other adults, says Zrenchik. Additionally, this gives them a chance to feel it out and read how you respond to this behavior, testing the waters, so to speak.
The groomer may suggest this alone time in a way that seems innocuous, such as asking for help around their house, or saying they have an extra ticket to an event and no one to go with, Zrenchik says.
It’s easy for the line to be blurry here. A 2014 review states that some of this behavior —for example, a well-meaning mentor taking time to help you with an extracurricular interest — is not nefarious. But the review notes that groomers can use that to their advantage, making the scenario seem “normal” when it’s not.
But if someone is always trying to get you alone and insists that your parents or other adults don’t need to be there, it may be a way of isolating you.
“Abusers don’t want anyone figuring out what they’re doing so the less other people in the person their grooming’s life knows about them, the better. The isolation is about control,” Wright says.
6. They give you drugs or alcohol
If an adult is providing you with drugs or alcohol, this is a dangerous sign, says Zrenchik. According to a 2022 study, groomers use substances as a “tool” to aid in the abuse. This is because mind-altering substances can lower a victim’s inhibitions or their ability to consent.
Furthermore, this can be another attempt for the groomer to make the victim feel special, or even more grown-up, setting the stage for further abuse.
7. They’re touchy
While sexual touch is a more obvious sign of grooming or abuse, an adult might also engage in inappropriate touch by massaging or tickling you, Zrenchik says.
It’s common for groomers to start out with “innocent” touch in an effort to desensitize you to it, so they can later progress to more intense inappropriate touch.
Furthermore, according to the same 2014 review, it’s not unlikely for groomers to claim that their inappropriate touching is accidental.
Insider’s takeaway
Grooming is dangerous –– however, it isn’t always easy to spot when you’re a victim of it due to its often subtle nature. Be on the lookout for signs like attempts at alone time, adult conversations, or inappropriate touching. Trust your gut when you think something is wrong.
If you’re a minor and you think an adult is grooming you, it is imperative to distance yourself from the groomer and to tell a trusted adult, like a parent or school counselor, to prevent further abuse and stay safe.
For the past few years, mainstream society has been steadily moving toward a culture of sexual acceptance and pleasure celebration. While it’s great that wanting and having sex is becoming increasingly normalized, the idea of not wanting sex has started to become increasingly pathologized, which is not so great. In reality, both conditions can be true: People can naturally desire sex, and people can naturally have no interest in it. And equating sex with an instinctual “drive” doesn’t accurately capture that range.
To say that sex is not a drive, again, does not mean that people don’t naturally crave having it—because many of them do (more on how that works below). It just means that sex is not a drive in the way that a drive connotes an inherent human need for something. “Physiologically, drives are reserved for survival-related activities such as the need for oxygen, food, and water,” says gynecologist and sexual-medicine specialist Christie Cobb, MD. And we all know, you won’t die without sex, however much you might want it.
“Physiologically, drives are reserved for survival-related activities such as the need for oxygen, food, and water.”
—Christie Cobb, MD, gynecologist and sexual-medicine specialist
The strong degree of sexual yearning many people feel, though, may be the reason sex was first linked with the idea of a “drive”—back when sex was far more hush-hush than it is today, particularly outside the scope of marriage or for non-procreative reasons. “’Sex’ and ‘drive’ became associated in the late 1800s due to Sigmund Freud’s theory of infant sexuality, called ‘drive theory,’” says clinical psychologist and AASECT-certified sex therapist Lori Lawrenz, PsyD. Generally, his concept of the development of libido (his term from a Latin word for desire and lust) included the idea of being driven to have sex, she says.
It is true that people are driven to have sex, in a colloquial sense, which is perhaps why the idea of a “sex drive” has become so popular in the zeitgeist. But, it’s crucial to clarify what someone means when they are talking of their sex drive, says Dr. Lawrenz. “Are they driven to have sex like they are driven to succeed at work?” she says. Because, in that case, drive might be an apt term.
Still, just as it’s normal to lack a drive to excel at work, it’s also normal to not have a “drive” for sex, which is why sexual “desire” is often a more accurate term than “drive.” “The desire for sex is a motivational system,” says Dr. Cobb, differentiating it from the physiological undertone of a “drive.” “With that motivation for sex often comes a reward, which reinforces the cycle.”
If sex is not a drive, then why are some people motivated to have it?
Sex can certainly be a natural desire, if not technically a drive. And generally, that occurs in two ways: spontaneous and responsive. The first is likely what you associate with libido or a sex “drive” that seems randomly (ahem, spontaneously) generated: It’s that feeling of horniness that makes you want to jump someone’s bones (or bring yourself to climax) for no apparent reason. Because libido has been widely depicted this way in pop culture, it’s easy to assume that this is the only “normal” way to experience sexual desire, and that there’s something wrong with you if you don’t typically or ever feel this random sexual fervor.
But in reality, the other type of desire—responsive desire—is not only just as valid, but also may be more common in folks with female sex organs. This refers to having a desire for sex in response to physical arousal or other motivations, like a yearning to be more intimate with a partner. And the simple fact that sexual desire is often only incited in this way, through external factors, is another key reason why sex is not inherently a drive.
How the concept of a “sex drive” excludes people on the asexuality spectrum
Though a “drive” isn’t quite an accurate term to describe how and why people get turned on, it also implies that humans need to have sex, in the way that they need food or water. Not only is this inaccurate, but also, it erases the existence of a category of people who do not often or ever want sex.
“People who do not experience much if any sexual attraction may identify as asexual,” says Dr. Cobb. But, this doesn’t preclude people on the asexuality spectrum from having an interest in romance or intimacy. “Plenty of asexual people are in healthy committed relationships, but their attraction is just not sex-based,” she adds.
“There is nothing wrong with existing on the asexuality spectrum.”
—Dr. Cobb
This is also not emblematic of an underlying sexual dysfunction, either, as the person who’s identifying as asexual does not experience any distress with regard to their lack of sexual desire. “An asexual person is accepting of their experience of being a person with minimal to no sexual desire,” says Dr. Lawrenz, “whereas someone with hypoactive sexual desire disorder, as characterized by the DSM-5, experiences it as a problem to not have the desire for sex.”
In the latter case, where a person is experiencing distress about the fact that they lack sexual desire, there are certainly treatment options, including sex therapy, psychotherapy, and medication, which can help rev up libido. But in the former case of simply on the asexuality spectrum, the issue is not a pathology and, in turn, does not need to be “treated,” says Dr. Cobb: “There is nothing wrong with existing on the asexuality spectrum.” And if that’s you, know that you’re not lacking some sort of natural human “drive.”
The only reason why asexuality seems to be such an “abnormal” or pathological identity is because it comprises a very small percentage of the population, says Dr. Cobb, “so most people are living with different sexual expectations [than those of asexual people].” Given that many allosexual folks (aka people who do experience sexual desire) equate sex with romance and intimacy, it’s important for asexual people to communicate their needs and boundaries with any romantic partner in order to ensure that their expectations for having—and not having—sex are known and respected.
Tantric sex is a whole new way of being in sexual connection that allows you access to deeper levels of feeling, sensation, and energy, and ultimately more of who you really are.
This path is simple but profound: It’s about wholeheartedly celebrating the sacredness of our bodies and desires while bringing a quality of mindful awareness to the shared expression of pleasure.
It can help you release shame, trauma, and blocks around sex, unleashing the transformative power of your erotic energy and leading you to some of the most soul-shattering orgasms ever.
Through this holistic approach, sensuality also becomes a doorway to beingness, to the divine, and to a more intimate experience of the present moment.
What is tantric sex?
Tantric sex is a sexual practice that’s part of the ancient spiritual path known as tantra. Tantra (pronounced tahn-tra, with an ahh sound in that first syllable) is a Sanskrit term that translates to “weave.”
It refers to weaving together or uniting the masculine and feminine forces within all of us, heaven and earth, the human body with the transcendent, collapsing the polarities.
The purpose of tantra is to discover an ecstatic union with all of life beyond the separate sense of self. Sacred or tantric sex—an aspect of tantra—is seen as one doorway to that transcendent truth, once we learn how to harness it.
The simplest explanation of tantric intimacy is that it’s about bringing the fire of your sexual energy, passion, and desires into alignment with your heart, your spirit, and a sense of goodness in your life.
When these forces come into balance and harmony, the sparks of interpersonal magic really start flying, and sex becomes something healing, empowering, transcendent, and profoundly beautiful.
I’m talking about the kind of lovemaking that feels truly connected, aligned, massively powerful, and filled with the utmost respect and devotion between you and your partner.
This kind of intimacy evokes your highest self and leaves you overflowing with love. Time slows down, your intuition expands, and you can find yourself in nearly psychedelic realms of orgasmic possibility that you might have only heard about or imagined.
Sounds pretty good, huh?
Summary
Tantric sex is a sexual practice that’s part of the ancient spiritual path known as tantra. It focuses on bringing the fire of your sexual energy, passion, and desires into alignment with your heart, your spirit, and a sense of goodness in your life.
What happens during tantric sex
Tantric sex involves a wide array of erotic activities, not all of which involve the same kind of penetration and physical stimulation of erogenous zones that most people associate with sex.
A typical tantra session involves the subtle realms of sex, including slow embraces, gentle caresses, getting present within the body, and focusing on the movement of energy between the partners’ bodies.
Sometimes during tantric sex, you’re barely moving, and the focus is on the meditative, devotional dimension.
If you relax and take things slowly, or ramp up and slow down the action, you can make love for hours, and the enjoyment can just keep building.
People with penises might also explore practices like edging (getting close to orgasm and backing off), which builds their ability to last longer and hold more pleasure before flipping over into orgasm.
That said, all sexual energy can be tantric when done with awareness.
Tantric sex can dive into the raw, intense, and animalistic spaces, where the body’s instinctual intelligence takes over and you are blind to pleasure. Dominance and submission can be tantric as well.
Breathwork is also central to tantric sex; people might use their breath and awareness to move sexual energy throughout their whole body, awakening their capacity for full-body pleasure (rather than pleasure localized specifically in the genitalia).
Neotantra vs. classical tantra
Tantra stems back to at least the seventh century if not earlier, appearing in various forms and texts in Hindu, Buddhist, and Jain traditions.
But usually when Westerners use the word “tantra,” we are really talking about the field of “neotantra.”
There are various complex and rigorous spiritual paths of “classical tantra,” which aim at full spiritual awakening or enlightenment as the goal. These include Kashmir Shaivism, a strand of religious philosophies from Kashmir and India, and the Vajrayana Buddhist path of India and Tibet.
These paths often involve serious study and personal dedication, meditative practices, and can include various elements of ritual, such as the use of mantras, visualizations, and deity worship. Working with sexual energy was only a small part of the practice and was for advanced students only.
By contrast, neotantra has developed over the last 150 years and aims specifically at more fulfilling intimacy and connection, a deeper connection to one’s own body and emotions, healing trauma and blocks, and opening to greater states of orgasmic ecstasy.
This body of teachings has been deeply inspired by some of the core tenets of classical tantra, but it is important to acknowledge that much of what is taught and shared among modern tantric sex practitioners are not “ancient practices” in the literal sense, though meaningful and relevant in their own ways.
Tantric sex positions and practices to try
1. Create a sacred space
Consciously disconnect from the mundane world and enter the world of the Divine—the world of pleasure. Turn off devices, light candles or incense, and gather any special treats like chocolates or berries.
Purify yourself by showering and dressing in something lovely; purify your space by tidying up and putting away the laundry piles. It’s also best to skip or go light on the substances in order to be fully present.
Set intentions for this session of intimacy, such as, “My intention is to show you with my body how much I love you” or “I’m curious to explore deeply receiving.”
2. Eye gazing (or “soul gazing”)
In the powerful gaze of your partner, there is nowhere to hide, and you practice fully revealing yourself to the other with all that you feel and all that you are. You see them fully while at the same time letting yourself be seen.
Sit up straight on a pillow or chair facing your partner. You can look left eye to left eye or just gaze softly at both eyes, and you can also hold hands if you like. Let the love that is in your heart shine out through your eyes.
Gazing at your beloved, see the divine spark in their eyes, marveling at the pure life force that is animating them. Feel the sacredness of this simple moment together.
Try for two minutes. Notice what emotions or sensations come up, or if you feel tempted to look away. It isn’t a staring contest, so you can always close your eyes for a few seconds and then open them again.
3. Hands on hearts circuit
This one can often flow nicely after eye gazing. While sitting facing each other with a soft gaze, bring your hands to your own heart and breathe up into your heart.
As you feel the love that is welling up in your heart for your partner, reach across and place your right hand on your partner’s heart (with consent), and they can place their right hand on your heart.
Each person’s left hand then covers the hand on their own heart. Synchronize your breathing, with slow, deep, nourishing breaths.
On the inhale, receive breath and love into your own heart, and on the exhale, send that love from your heart down your right arm and into your partner’s heart, making a circuit of love and energy flowing between you. Do this for about 10 breaths.
4. Tantric massage
Tantric massages are another powerful part of tantric sex, one that can be the key to multiple orgasms for both people with clitorises and people with penises.
In a tantric massage, one partner gets to just lie back and receive, getting the chance to tune into their pleasure and sexual energy and see how it wants to open up through their body, while the other partner moves their hands slowly and meditatively along their body to let them feel every single new sensation.
Consider trying out the yoni massage (a tantric massage for the vagina and clitoris), lingam massage (a tantric massage for penises), and tantric nipple play.
5. The yab-yum position
This classic tantric sex position represents the union of Shiva and Shakti, the two divine energies of masculine and feminine. But remember these are just energies, and it doesn’t matter the gender of the participants. Even for relationships between cis men and cis women, it’s powerful to practice switching between each role.
The base partner (representing Shiva, who is energetically or physically penetrative) sits cross-legged on a pillow in the “holding” position while the other partner (representing Shakti, who is energetically or physically receptive) can either drape their legs over their partner’s legs with their butt on the bed or a pillow or can fully sit in the lap of their partner. The base partner’s arms should go around the waist of the other partner, whose arms go around the shoulders of the base partner. Your heads can be cheek to cheek, or you can touch forehead to forehead. This position aligns the chakras of the partners and allows for sexual energy to move upward along the spine.
Once you come into alignment, start by taking a few deep, slow breaths together, synchronizing your breathing. Then begin to move together in slow undulations, arching, swirling in circles, finding a flow and a rhythm that feels delicious, activating your sexual energy together. The base partner “gives” to the partner on top who is “receiving” that energy up into their body.
Connect with your breath to expand the pleasure and sexual energy throughout the entire body, lighting up every cell with that life force. You can try staying with smaller, subtle movements or get as vigorous as you like, but either way, use your breath to draw orgasmic energy from your pelvis up the spine and up to your third eye (the spot between your eyebrows) or crown (the top of the head) and beyond.
This position can be practiced fully clothed, naked, or in whatever form of penetration you like. You can even learn to have full-body energy orgasms—with no penetration whatsoever—while remaining fully clothed, though that might take a little more practice!
The purpose of tantric sex
There can be a whole array of goals and expectations around sex that put pressure on us to be a certain way, as well as routines and habits that keep us stuck in a sexual rut.
Tantra is about throwing all of that out the window and starting fresh with a beginner’s mind, redefining sex by making it more about intimacy, connection, and playful possibility rather than a race to the orgasm or a box to be checked.
When you let go of goals like “getting someone off” or achieving anything in particular, there is literally endless room for discovery and such a wide range of what is possible.
And whatever you’re experiencing now in terms of orgasm, you can safely assume there is way more to experience through tantric sex—more powerful orgasms, longer-lasting orgasms, non-ejaculatory orgasms and multiple orgasms for men, numerous kinds of orgasms for women, deep states of surrender, visionary states, and states of oneness with your partner and life itself.
Sacred sexuality can also be an integral part of the path of awakening and personal evolution.
Various spiritual teachers have admitted that orgasm is an experience that gives us a glimpse of divinity because there’s a melting of the regular egoic self in those moments of communion.
Longer lovemaking sessions, relaxation, and a quality of spaciousness
Enhanced communication and communion
Holistic mind-body-spirit connection with yourself and with your partner
The takeaway
There are many myths about tantra that can make people feel like it’s not for them. But I feel inspired to teach tantra because I believe most people have a ton of their power and truth locked up in their sexuality, right alongside all the messed-up cultural conditioning and trauma most of us carry.
When people get aligned in their sexuality, when their sexual “life force” energy is fully activated in them and connected to their hearts and spirits, they can become the most thriving, unstoppable, and inspired versions of themselves to go actualize their purpose in the world.
Workers with the UK National Health Service take part in the London Pride Parade in 2019.
Personalizing cancer treatment doesn’t only mean matching a drug to molecular markers on a tumour — it should also take into account a person’s sexual identity, interests and wishes.
In 2007, 55-year-old Australian sociologist Gary Dowsett was diagnosed with prostate cancer. On the basis of his relatively young age and his test results, his physicians told him that radical prostatectomy — surgery to remove his prostate completely — was his best option. The procedure went well, but Dowsett had questions — he wanted to know how it would affect his sex life as a gay man, and how to negotiate the physical, sexual and emotional changes that would result from his treatment. For the most part, his questions went unanswered. “Medical professionals were sympathetic, but most knew next to nothing about gay men,” says Dowsett.
Having worked in social HIV/AIDS research for about 40 years, Dowsett, an emeritus professor at the Australian Research Centre in Sex, Health and Society at La Trobe University in Melbourne, was shocked to discover how far behind prostate-cancer physicians and researchers were in understanding men’s sexuality. “It was all about erections, as if sex starts and ends there,” he says. There were no patient-education materials available for men who have sex with men; nor was there much scientific literature. “There was quite a bit for heterosexual men in terms of intimacy with their wives,” Dowsett says. But for gay and bisexual men, who are more likely than heterosexual men to be single when diagnosed with prostate cancer1, and might engage in different sexual practices, little of that applied. “That’s really what got my dander up,” he says.
Physicians might not realize that the needs and concerns of gay and bisexual men are different from those of heterosexual men, says Channa Amarasekera, a urologist and director of the Gay and Bisexual Men’s Urology Program at Northwestern Medicine in Chicago, Illinois. Although the biology of prostate cancer is the same for all, the impact that the disease and its treatments have on a person can vary significantly depending on their sexual orientation and preferred sexual practices.
Dowsett started working in prostate-cancer research after his treatment. He and other researchers have made considerable progress in documenting the experiences of people from sexual and gender minority groups, and uncovering the impact that prostate-cancer treatments have on them. “The quality of life is really affecting some people, and we need to recognize that,” says Daniel Dickstein, a radiation oncologist at Icahn School of Medicine at Mount Sinai in New York City. However, evidence of the problems facing gay and bisexual men will not by itself enable clinicians to advise their patients properly: empowering physicians with evidence-backed guidance, and improving communication, will also be crucial.
Understanding the impact
The prostate, a gland which lies along the urethra between the bladder and penis, is the second most common site of cancer in men worldwide, trailing only slightly behind lung cancer. About one in six gay and bisexual men will develop prostate cancer; there is little research into its incidence in transgender women. But it is only in the past decade that research into prostate cancer specifically in gay and bisexual men has gained interest, says Simon Rosser, a behavioural psychologist at the University of Minnesota in Minneapolis.
Prostate cancer is typically treated by removing the gland through surgery, or by killing cancerous cells using radiation. These can be combined with androgen-deprivation therapy, in which the person’s levels of testosterone are reduced to slow the growth of the tumour.
Common side effects of these treatments include urinary incontinence, erectile dysfunction, a reduced libido and impaired ability to ejaculate. These are broadly similar for all patients, but some differences have been noted between heterosexual men and gay and bisexual men. One study, for example, showed that gay and bisexual men have worse urinary, bowel and hormonal function than heterosexual men after treatment for prostate cancer, but better erectile function2. Similarly, a study led by Jane Ussher, a clinical psychologist at Western Sydney University in Australia, found that gay and bisexual men are more likely than heterosexual men to be able to get and sustain an erection after prostate-cancer treatment3. “One of the reasons for that is that they are more likely to do something about it — like to go and get counselling, try penile injections and suction devices, or use Viagra,” she explains.
In many cases, the impact of sexual dysfunction arising from prostate-cancer treatment is magnified in gay and bisexual men. “Due to differences in sexual practices, they may have additional concerns, and some sexual side effects will be more bothersome or challenging to manage,” says Sean Ralph, a consultant therapeutic radiographer at Leeds Cancer Centre, UK, and co-founder of Out with Prostate Cancer, the United Kingdom’s first prostate-cancer support group for gay and bisexual men and transgender women.
For example, an erection must be 33% firmer for anal intercourse than for vaginal intercourse4. This makes any loss of erection hardness more of a problem for men who engage in insertive anal intercourse — not purely the preserve of gay and bisexual men, but nonetheless a part of many such relationships.
Channa Amarasekera (right) consults with a patient at Northwestern Medicine in Chicago.Credit: Northwestern Medicine
The prostate also acts as an organ of sexual pleasure and orgasm for some people through anal stimulation. “Many men think prostate stimulation is the be-all and end-all in gay sex,” says Rosser. If the prostate is removed, in many cases so, too, is the pleasure for men who have receptive anal intercourse5. Rosser also estimates that one-third of these men experience anodyspareunia, or pain during anal intercourse — double the rate before treatment. And removing the prostate puts a stop to ejaculation. “That was a real blow for me,” says Dowsett. Visible semen can be a sign of a satisfying sexual experience. In a 2013 study, Dowsett and his team found that men who have sex with men were more distressed by the loss of ejaculate than were heterosexual men6.
Communication blockage
A 2016 study led by Ussher found that gay and bisexual men with prostate cancer report significantly lower quality of life and satisfaction with treatment than do heterosexual men1. In some cases, the psychological impact might be made worse by the fact that many people are not made aware of all of the consequences of their therapy beforehand.
Dowsett notes that the loss of the ability to ejaculate after a radical prostatectomy was absent from much of the public-health literature at the time he was diagnosed — he learnt of it only after he went for a second opinion. Similarly, Ussher says that many people are not told that their penis can shorten after a radical prostatectomy, or that this is sometimes temporary. Failure of health professionals to discuss these highly relevant effects of treatments with their patients often leads to lasting anger, distress and harm, says Rosser. “It’s an ethical violation in my mind,” he says.
Physicians also commonly overlook the specific side effects for people from sexual and gender minorities — essentially taking away their ability to make an informed decision about their treatment, Amarasekera says. When physicians do consider a person’s sexuality, there are actions that might improve quality of life. For example, Dickstein suggests that inserting a hydrogel spacer between the prostate and rectum, which reduces the amount of radiation the rectal wall is exposed to, might improve a person’s ability to engage in receptive anal intercourse.
There are also risks that particularly affect gay and bisexual men that could be avoided if physicians are made aware. For example, men are usually advised to resume sexual activity soon after prostate-cancer treatments to help with erectile function, but receptive anal intercourse can cause damage. Clinicians should also consider the use of drugs called poppers in this group of people, Dickstein says. These inhaled drugs, made from chemicals called alkyl nitrites, are commonly used by gay and bisexual men to relax their anal sphincter muscle and enhance sexual pleasure. However, if they are combined with Viagra — often prescribed for erectile dysfunction — the results could be devastating, warns Dickstein. Both drugs lower blood pressure, and the mixture could cause serious cardiovascular problems.
Unfortunately, most physicians do not ask people about their sexual orientation or practices7. “This sets up a don’t-ask-don’t-tell dynamic where patients can’t be honest with you about who they are and what their problems are,” says Amarasekera. Urologists have reported concern about offending their older, more conservative patients by asking about their sexual orientation. “But the majority are not offended,” says Rosser. “All you need to do is ask.” The fact that transgender women are at risk of prostate cancer is also often forgotten (see ‘Targeting treatment for transgender women’).
Targeting treatment for transgender women
Prostate cancer in transgender women is thought to be rare — but it does occur. “Trans women will have a prostate, even if they’ve had gender-affirmation surgery,” says Alison May Berner, an oncologist and gender-identity specialist at the Tavistock and Portman NHS Foundation Trust in London. However, advice for physicians on caring for this population is lacking.
“A lot of physicians forget to check trans women’s prostate,” says Channa Amarasekera, a urologist and director of the Gay and Bisexual Men’s Urology Program at Northwestern Medicine in Chicago, Illinois. And even when they do, subsequent care cannot follow an identical path to that for cisgender men. For example, gender-affirming surgery that some transgender women undertake could be more difficult if they have already had radiotherapy for prostate cancer. “Surgeons do not like operating on parts of the body when they have been treated with radiotherapy,” explains Sean Ralph, a consultant therapeutic radiographer at Leeds Cancer Centre, UK.
There is also no level of prostate-specific antigen (PSA) — a common biomarker for prostate cancer — that is agreed to be cause for concern in transgender women. Gender-affirming hormone therapy artificially suppresses PSA levels, meaning a low PSA reading in a transgender woman might not mean a clean bill of health, as physicians might otherwise assume.
But there are potential positives. Worries that treatments are in some way feminizing might not be an issue for some transgender women or non-binary people. In addition, some scientists think that gender-affirming hormone therapy might actually protect against prostate cancer. A study by researchers in the Netherlands of 2,281 transgender women who received androgen-deprivation therapy and oestrogens found they had a lower risk of prostate cancer than did cisgender men10. “Gender-affirming hormones reduce the testosterone to the prostate which usually drives the cancer,” explains Berner. However, the hormones used in other parts of the world can differ, so the data might not be transferable to other countries.
In many cases, the problem is a lack of education and training among clinicians. Amarasekera has found that many urologists have received less than five hours of instruction on how to treat people from sexual and gender minorities7, and most felt that they needed more.
There is, for example, a lack of guidance on how to discuss the various sexual roles that a gay or bisexual person can take on in anal intercourse, and the implications for treatment. “One might identify as a top or insertive partner, a bottom or receptive partner, or might be versatile and engage in both, and that may change the treatment discussion,” explains Dickstein. In some cases, changing roles after treatment could improve quality of life. However, such a change will not be acceptable for everyone. “It’s not as simple as, I’ll just change a role — both the psychological and social consequences of that are much more complicated and long-term,” warns Dowsett.
It is therefore important that conversations between physicians and patients go deeper than covering just sexual orientation. “You have to move past orientation and understand sexual preferences or interests if you really want to take into account the whole post-treatment experience,” Dowsett says. And this goes for people who are heterosexual, as well — even though the average age of diagnosis is 66, Dowsett says that many people might be willing to try new things, including sexual aids, to improve their quality of life after treatment if physicians are able to discuss it. “It’s very hard to shift the urology and oncology fields to stop thinking about straight men with prostate cancer as being their grandfathers,” Dowsett says.
Culture of trust
Another obstacle to tailoring treatment to gay and bisexual men is that some people might not be forthcoming about their sexual orientation because of mistrust or past trauma. Many people will have had negative experiences with health-care services, says Ralph. For example, one gay man in his support group had surgery without disclosing his sexual orientation because he was worried that his operation would be performed in a careless manner if the clinicians knew he was gay. Others will choose to wait until they have met the physician to decide whether they feel safe to discuss it with them, or simply assume that the physician would be able to tell without having to discuss it openly.
To address this, last year Amarasekera launched a programme specifically to help people from sexual and gender minorities to access care. “There was a significant number of patients who identified as gay or bisexual who felt like there wasn’t a space where they could be open about what their issues were when it came to prostate-cancer treatment,” he says. In 2019, the UK National Health Service (NHS) adopted the rainbow-badge initiative, in which staff can opt to wear a badge that marks them as an ally for LGBT+ people and a safe person to talk to. Clinicians applying for the badge do not receive specific training, but are expected to read some brief information and pledge to promote inclusion. “However, the onus is still on the patient to disclose their sexual orientation or gender identity,” says Ralph.
The guidance available to prostate-cancer clinicians and patients is also improving. The American Society of Clinical Oncology and the US National Comprehensive Cancer Network note that discussions on sexual activity and sexuality are important for cancer treatment, although they still do not address specifics of how to tailor screening or treatment to gay and bisexual men.
In 2021, Ralph published recommendations on anal-sex practices before, during and after prostate cancer interventions8. The advice is based on the opinions of 15 clinical oncologists and 11 urological surgeons in the United Kingdom. It includes recommendations on how to long to wait before engaging in receptive anal sex after radical prostatectomy and radiotherapy, as well as after a biopsy and before a test for prostate-specific antigen — a blood test that is commonly used in screening, but which can be invalidated by prostate stimulation.
To provide further recommendations for clinicians, much more research on people from sexual and gender minorities is required, Dickstein says. “It’s difficult to offer patients advice,” he says. “I can’t say this is the treatment that you should choose because it’s better for having anal receptive intercourse — I seriously do not know.” Evidence for how different treatment approaches might affect problems such as anodyspareunia, for instance, is lacking.
Research into gay, bisexual and other men who have sex with men has been hampered by small sample sizes, says Rosser. The largest such research sample, collected by Rosser in 2019, included 401 people9. “Cancer registries do not routinely collect data on gender diversity and sexuality,” says Ussher. “We don’t know how many people out there with cancer identify as queer, bisexual, gay or lesbian, or who are trans or have an intersex variation.”
We still have a long way to go, says Rosser — not just in terms of research, but also in educating patients and clinicians on how to communicate with each other about sexual orientation and practices. “This might take a while,” he says. But it is essential that prostate-cancer treatment is tailored to each person’s needs. Equitable care does not mean treating everyone the same, Dowsett says, and any clinician who holds that opinion is wrong. “You can still treat people fairly and equally, but must recognize differences that require different responses.”
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