Category: Antidepressants

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Top 10 drugs that may contribute to sexual dysfunction

By Naveed Saleh, MD, MS

Key Takeaways

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

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

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

Antiandrogens

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

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

Immunosuppressants

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

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

HIV meds

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

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

Cancer treatments

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

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

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

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

Antipsychotics

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

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

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

Anti-epileptic drugs

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

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

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

Antihistamines

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

ß-blockers

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

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

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

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

Opioids

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

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

Loop diuretics

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

What this means for you

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

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

Complete Article ↪HERE↩!

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What to Know About the Sexual Side Effects of Antidepressants

— S.S.R.I.s, the most widely prescribed antidepressants, frequently cause sexual problems. Here’s what patients can do about it.

By Azeen Ghorayshi

Antidepressants have long been among the most widely prescribed drugs in the U.S. Their popularity only grew at the start of the coronavirus pandemic, when many people struggled with depression and anxiety. Some surveys have found a striking rise among adolescents, particularly teenage girls.

For many people, the drugs can be lifesaving or can drastically improve their quality of life.

But many of the most popular antidepressants, known as selective serotonin reuptake inhibitors, or S.S.R.I.s, come with sexual side effects. In many cases, the problems caused by the medications can be managed. Here’s what patients should know.

A wide variety of symptoms has been reported.

More than half of patients who take S.S.R.I.s report some problems having sex. They include low levels of sexual desire or arousal, erectile dysfunction, pleasureless or painful orgasms and loss of genital sensitivity.

Many people also report emotional blunting after taking S.S.R.I.s. This may make negative feelings less painful but also make positive feelings less pleasurable.

Don’t be shy about talking to a doctor.

When S.S.R.I.s went on the market in the late 1980s, patients began telling their psychiatrists that they were having sexual problems. Initially, doctors were perplexed: As far as they knew, older antidepressants had never come with these issues. But they had been wrong.

“Only in going back and looking more carefully and gathering more data did we realize that actually those serotonergic drugs, the older ones, also caused sexual dysfunction,” said Dr. Jonathan Alpert, head of the American Psychiatric Association’s research council. Doctors and patients just hadn’t been talking about it, he said.

As S.S.R.I.s boomed in popularity, and social stigmas about discussions of sex eased, researchers began documenting the problem in the scientific literature. But some patients found it easier to talk about than others did. Men were much more likely to report sexual side effects to their doctors than women were, even though women are almost twice as likely to be prescribed antidepressants.

“The charitable interpretation is that we simply have more treatments available for male patients, and so doctors are more likely to ask after things that they feel they can actually help with,” said Tierney Lorenz, a psychologist at the University of Nebraska-Lincoln who has studied antidepressant-induced sexual dysfunction in women. “The significantly less charitable interpretation is that we still live in a very sexist society that doesn’t believe that women should have sexual interest.”

Doctors may first recommend waiting it out.

For some people, the sexual side effects of S.S.R.I.s will show up almost immediately after starting the medications and then resolve on their own. So doctors may suggest waiting four to six months to see whether the patient adjusts to the drugs and the most distressing sexual effects subside.

But the odds of spontaneous resolution of sexual side effects are low, happening in an estimated 10 to 20 percent of patients who report the symptoms.

Other medications, including other antidepressants, can help.

One common way to manage sexual side effects is to try another S.S.R.I. Research suggests that certain drugs, such as Zoloft and Celexa, come with a higher likelihood of causing sexual problems. Switching drugs, however, means enduring a trial-and-error period to try to find what works.

If a patient is otherwise doing well on an S.S.R.I., a doctor may be hesitant to drastically change the drug regimen. Instead, the doctor might recommend adding an additional drug to the mix that could help counteract the sexual side effects.

For example, adding the non-S.S.R.I. antidepressant Wellbutrin, which acts on norepinephrine and dopamine in the brain, has been shown to diminish sexual symptoms in many patients, Dr. Alpert said.

For erectile dysfunction, doctors may also suggest adding phosphodiesterase type 5 inhibitors like Viagra, which acts on the vascular system, he said.

‘Drug holidays’ can help. But be careful.

Another approach that should be used cautiously and under the close supervision of a physician is temporarily stopping the S.S.R.I. or lowering the dose for 24 to 48 hours before having sex.

But for many patients, this isn’t an ideal solution. Planning ahead can be annoying. And withdrawal from S.S.R.I.s can immediately cause other unpleasant symptoms, including dizziness, nausea, insomnia and anxiety. Some doctors are concerned that frequent use of drug holidays may make patients more likely to discontinue the medications altogether, which could lead to worsening mental health problems.

In rare cases, sex problems can persist after stopping the drugs.

A small but vocal group of patients is speaking out about sexual problems that have endured even after they stopped taking S.S.R.I.s. Some have reported low libido and numb genitals persisting for many years.

Though studies are scarce, the risk appears to be low. A recent study estimated that about one in 216 men who discontinued S.S.R.I.s were subsequently prescribed medications for erectile dysfunction, a rate at least three times as high as that among the general population.

But diagnosing this condition is tricky, in part because depression itself can dull sexual responses. Among unmedicated men with depression, 40 percent report a loss of sexual arousal and desire, and 20 percent struggle to reach orgasm.

Complete Article ↪HERE↩!

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The Health Issues Men Don’t Talk About

— (But They Really Should)

It’s taken a long time. But there is finally a growing awareness of the importance of discussing health issues openly and honestly.

By Northern Life

A lot of men shy away from discussing their health concerns because of social stigmas and embarrassment. Sometimes it’s because they simply don’t know where to turn for help. Addressing these issues openly and providing the necessary information and support is crucial.

Testicular Cancer

Testicular cancer is another health issue that often goes unaddressed due to embarrassment or fear. However, early detection is crucial for successful treatment and improved outcomes. It happens when abnormal cells develop in the testicles.

Common symptoms include a painless lump or swelling in one or both testicles. You might notice a feeling of heaviness in the scrotum or that your testicles have changed shape or weight. These symptoms can also be caused by other conditions, it’s true, but you need to talk to a doctor if you notice any of them.

Regular self-examinations are recommended. By familiarizing themselves with the normal size, shape, and weight of their testicles, men can quickly identify any changes or abnormalities. If a lump or other concerning symptoms are noticed, it is crucial to consult a doctor promptly.

While the topic of testicular cancer may be uncomfortable to discuss, early detection and treatment can significantly improve the chances of a full recovery. Men should prioritize their health by raising awareness and openly discussing this issue.

Erectile Dysfunction

Erectile Dysfunction (ED) affects a significant number of men, but it remains shrouded in silence. ED refers to the inability to achieve or maintain an erection sufficient for sexual intercourse. It can stem from various factors, including physical, psychological, or lifestyle-related causes. It’s normal to have trouble getting or maintaining an erection sometimes. But persistent problems can have a significant impact.

One common physical cause of ED is the restricted blood flow to the penis. Diabetes, high blood pressure, or cardiovascular disease can be potential causes. You might also suffer from ED if you are dealing with stress, anxiety, or depression. It’s probably not too surprising to learn that smoking, drinking too much booze, and not having an active lifestyle can increase the risk of developing it.

The first step in addressing ED is to have an open conversation with a healthcare professional. Doctors can help identify the underlying causes and recommend appropriate treatment options.

It is essential to recognize that ED is a treatable condition. By breaking the silence and seeking medical assistance, men can regain control over their sexual health and improve their overall well-being. If you want to learn more about treatments for ED, then you can check out what’s available at The Independent Pharmacy. They are a regulated online pharmacy that can help you find the right prescription and over-the-counter treatment.

Mental Health

Societal expectations that encourage men to be stoic and tough can create barriers to seeking help. However, mental health issues can affect anyone. It doesn’t matter what your gender is.

Depression, anxiety, and stress are widespread right now. Men need to understand that seeking help for these kinds of issues is a sign of strength. Mental health professionals are trained to provide support and guidance in managing these conditions. There’s therapy, medication, or a combination of both. Lifestyle changes such as regular exercise, healthy eating, and practicing stress-reducing techniques like meditation or mindfulness can also help to

By breaking the silence surrounding mental health and seeking appropriate support, men can effectively manage their mental health conditions and lead fulfilling lives.

Prostate Health

Prostate health is a critical aspect of men’s overall well-being. But it can be so tough for people to talk about it openly. Prostate cancer is the most common cancer among men, and it is essential to address it openly. Early detection is crucial for successful treatment and improved outcomes. However, the fear, stigma, or lack of awareness surrounding prostate cancer can discourage men from discussing it or seeking regular screenings.

Regular prostate screenings are recommended for men over the age of 50. You should get one earlier if you have a family history of prostate cancer. These screenings can help detect any abnormalities in the prostate gland and identify potential cancerous cells.

By breaking the silence and openly discussing prostate health, men can become proactive in monitoring their prostate health, addressing any concerns, and seeking timely medical intervention when necessary. Open conversations and awareness about prostate health can help save lives and ensure a better quality of life for men as they age.

Sexual Health And STDs

Sexual health is integral to overall well-being, and men should prioritize discussions about it. Safe sexual practices and regular check-ups can help prevent and detect sexually transmitted diseases. They also mean that you can enjoy an active sexual life.

Engaging in unprotected sexual activity or having multiple sexual partners can increase your risk of catching something. Open and honest communication with sexual partners about sexual health is essential. Discussing sexual history, STD testing, and using barrier methods such as condoms can help reduce the risk of contracting or spreading STDs. Regular STD testing is recommended, especially after engaging in unprotected sexual activity or changing sexual partners.

If diagnosed with an STD, it is crucial to seek prompt medical treatment and inform any sexual partners to prevent further transmission. A lot of STDs can be treated with antibiotics or antiviral medications. Additionally, healthcare providers can offer guidance on preventive measures, safe sexual practices, and regular screenings.

Men can reduce the stigma surrounding STDs, increase awareness, and take necessary precautions to protect themselves and their partners by promoting open conversations about sexual health,

Substance Abuse And Addiction

Substance abuse and addiction are significant health concerns that affect men disproportionately. Societal expectations and pressures can sometimes lead men to turn to substances such as alcohol, tobacco, or drugs as coping mechanisms, as we saw a lot during the pandemic. There can be serious mental and physical consequences when any of those substances are abused.

Breaking the silence surrounding substance abuse and addiction is essential. Men should be encouraged to seek support. There are treatment options out there, from counseling to detox and rehab programmes.

Men can smash the stigma associated with seeking help and create a supportive environment for those struggling with these issues when they talk about them. Addiction is a treatable condition, and men can embark on a journey towards recovery and regain control over their lives with the right support,

Wrapping It Up

Addressing the health issues men often avoid discussing is crucial for their well-being. By breaking the silence and encouraging discussions about these topics, men can take control of their health, seek appropriate medical assistance, and lead healthier, fulfilling lives. Remember, it’s time to break the barriers and prioritize men’s health through open dialogue and support. There is no such thing as an embarrassing health concern. And you might just be amazed by how much better you feel once you start talking.

It’s taken a long time. But there is finally a growing awareness of the importance of discussing health issues openly and honestly. The idea of “embarrassing” health problems is being challenged more and more frequently. But some topics still get swept under the carpet, especially when it comes to men’s health.

A lot of men shy away from discussing their health concerns because of social stigmas and embarrassment. Sometimes it’s because they simply don’t know where to turn for help. Addressing these issues openly and providing the necessary information and support is crucial.

Complete Article ↪HERE↩!

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How to boost your libido if you’re taking antidepressants

— Trust us, it’s not gone forever

BY Holly Berckelman

If you take antidepressants and have found your libido’s dropped off a cliff, fear not, there are GP-approved steps you can take to bring it back.

There’s a lot of stigma around antidepressants

Due to the formerly hush-hush nature of mental illness and misconceptions spread in pop culture (hi, Stepford Wives), there’s a huge amount of misinformation that’s still present in the social conscience.

In reality, for people struggling with mental illness, particularly anxiety and depression, antidepressants medication can be life-changing. They can assist with levelling out severe peaks and troughs and bring an overwhelming sense of relief to the person taking the meds, in turn giving them the chance to work on their mental health in other ways.

Selective serotonin reuptake inhibitors (SSRIs) are one of the most common forms of antidepressants and work by slowing the rate at which the central nervous symptom reuptakes the natural serotonin produced by the body. Serotonin is a neurotransmitter attributed to happiness.

However, as with all medications, there can be side effects, one being a loss of libido.

According to Cindy Meston, a clinical psychologist and sexual psychophysiology researcher in the United States, it’s the unwanted effect women report most often.

“They don’t feel like having sex, or when they have sex, they’re just not into it,” Meston tells Goop. “And many also report an inability to attain orgasm.”

A study published in The Mental Health Clinician (MHC), a peer-reviewed, bimonthly, clinical practice journal, hypothesised that the side effects of SSRIs are attributed to the increase of serotonin in other areas of the body, and may affect “other hormones and neurotransmitters, such as testosterone and dopamine.”

“This may lead to side effects of sexual dysfunction, as testosterone may affect sexual arousal and dopamine plays a role in achieving orgasm.”

Other research shows that SSRIs “impact many key neurotransmitters (like serotonin, dopamine, histamine, and acetylcholine) and decrease the activation of the sympathetic nervous system, which alters a woman’s libido.”

Aside from the scientific specifics, an unexpected loss of libido can be difficult for couples and individuals to manage.

General Practitioner (GP) Dr Sam Saling says “For those partnered up, it can cause relationship difficulties, which has a whole heap of consequences especially if there is a mismatch between each person’s sexual drive.”

Meanwhile for people who are single, “Lowered libido can still have a great effect on self-esteem, one’s interpersonal relationship endeavours, and one’s social life.”

“For both men and women, lowered libido can have absolutely no physical and mental effects, or alternatively, a huge effect, depending on the person.”

Fortunately, there are a number of ways you can work to boost your libido if it’s dropped off a cliff since you started taking antidepressants. We asked Dr Saling for her tips on getting to the bottom of a low libido, and the best ways to boost it back up.

First, look for other causes

Dr Saling says before you look to blame the antidepressants, it’s important to look for the true cause of the feeling.

“Low libido in itself is often a symptom of an untreated mood disorder,” she tells Body+Soul. “So, often the low libido that follows the commencement of an antidepressant is actually a sign of a pre-existing illness, not a side effect of the medication.”

If you’re experiencing low libido in the first half-year after commencing medication, this is particularly true, as “It can take six months or more to start seeing the full effect of an antidepressant.”

Another common side effect of antidepressants is increased sleepiness in the short term, which Dr Saling says “can definitely lower libido just due to someone’s increased desire to sleep over other activities in bed.”

Once short-term symptoms have alleviated, and the antidepressant is working in terms of abating mood symptoms, libido may also increase.

However, if after several months libido has lessened significantly, then it could be related to the antidepressants itself (rather than mood or the desire to sleep), as “low libido is a known side effect of many of these medications,” says Dr Saling.

Then, speak to your GP

If you’re suffering from a low libido, the first port of call is your GP.

“Your GP will take a detailed history and this will indicate to us what is the likely cause,” says Dr Saling. “New mood disorder medications, or an increased dose, is a clear cause.”

If it is related to the antidepressants, “Often all it requires is a dose tweaking or a different medication type,” says Dr Saling, “Sometimes, we recommend psychological counselling and lifestyle interventions.”

There are many causes of low libido including, Dr Saling tells Body+Soul, including “vascular issues, hormonal changes, and many more contributing medical conditions. Social circumstances, financial pressures, relationship difficulties and work stress” can also contribute.

If you’re suffering with low libido, your GP is the very best person you can speak to to figure it out, regardless of the cause.

How to boost libido if your antidepressants is the cause

#1. Exercise right before sex

According to Meston’s research, having sex within 30 minutes of a moderate workout significantly increased sexual desire in women taking antidepressants. ]

“We know that exercise has a lot of chronic benefits for health and sexuality—you have more energy, better sleep, enhanced body image, decreased stress,” Meston told Goop. “But in this case, we found that, in addition, acute exercise or a single act of exercise is hugely beneficial for sexual desire.”

This may be due to activating the sympathetic nervous system, which is needed to get turned on enough to reach orgasm.

Dr Saling is also an advocate for regular exercise: “I would recommend starting with a regular exercise routine incorporating both aerobic and resistance training,” she says. “This is recommended to boost mood as well as energy levels overall.

#2. Sync sex to your medication schedule

According to Meston’s research, syncing sex with when you take your medication could also help – as if you have sex right before you take your next dose, the levels from the previous dose will be at their lowest.

There is no evidence to support this practice, but Meston tells Goop that “when levels of antidepressants are very low, their sexual side effects are likely to be low, too.”

#3. Try scheduling sex

While scheduling sex may seem daggy, it can be a great way to increase intimacy in couples, which can often be a crucial step in increasing arousal.

Setting aside time where sex does not come into the picture, along with time where sex is pre-planned can help couples bond without either party misconstruing an attempt for sex, and build anticipation for the times when sex is on the agenda.

#4. Eat a healthy diet

Taking care of your body through a nutritious diet gives you the best opportunity to let it get on with its natural processes – libido included.

“A healthy diet is essential to ensure adequate nutrition to feel one’s best,” instructs Dr Saling.

#5. Introduce sex toys

Of course, if libido has dropped to the point where you or your partner is not interested in sex at all, then that must be respected. However, if you are still keen to include sex in your relationship until low libido is resolved, you may need more stimulation to become aroused and reach orgasm.

Vibrators are a surefire way to turn things up a notch if you are experiencing decreased sensitivity, and will assist with driving blood flow into the genitals.

Dr Saling also suggests implementing regular reviews with your doctor to effectively manage the change. “Not only can we review your response to medication and make adjustments if needed, but we can also recommend non-medical interventions,” she says.

“Once we work out the cause of low libido, we can tailor the treatment plan.”

Complete Article ↪HERE↩!

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Expert Shares Why You May Be Struggling To Orgasm With Your Partner

BY Tessa Somberg

At various points in our lives, orgasms can be the ultimate bliss and the ultimate frustration. Remember that our relationships with our bodies can be fluid and changeable, and sometimes, this can change the sex we have with our partners. For many women, achieving orgasm with a partner can be a challenge — even when achieving orgasm alone, or with the assistance of something akin to a handy-dandy vibrator, comes easily. We may start to blame ourselves, our partners may start to blame themselves, and the bedroom can start to feel anxiety-provoking, rather than a relaxing space to unwind and enjoy all the pleasures our bodies can feel.

Should you be looking for solutions to easier orgasms, but you’re having trouble honing in on what could be addressed, we have some ideas for you. Women spoke exclusively with Aliyah Moore, Ph.D., a certified sex therapist, to better understand what barriers might need to be broken to achieve orgasm with your partner. She said, “Sex is not a performance, and there’s no one-size-fits-all approach. Take the pressure off of yourself and focus on enjoying the moment. Don’t be discouraged if things don’t go as planned; it happens to the best of us.”

Put your body first

Whether you have recently been struggling to orgasm in the bedroom, or have been struggling for some time, the stress of wondering, “Am I going to orgasm this time?” could be enough to stop you from being in the moment. Speaking exclusively with Women, Dr. Aliyah Moore said, “Sometimes, our brains can get in the way of our bodies. If you’re too worried about whether or not you’re going to orgasm, you might end up putting too much pressure on yourself and making it harder to actually get there.” In order to combat this, remind yourself that when it comes to sex, there is no race to the finish; there is no “right” amount of time it “should” take to get to orgasm. Instead, feeling and embracing pleasure throughout the sex act is part of the experience.

Should you feel your mind racing during sex, and the anxiety over your orgasm has set in, try to redirect your thoughts to the physical sensations in your body. Remind yourself that it is okay to let go of the expectation of orgasm. Perhaps you will be surprised how far that can take you.

Prioritize quality stimulation

Remember also that, when engaging in sex with a new partner, it could simply take time to learn about each other’s bodies. And, of course, knowing your own body is key. “Masturbation can be a helpful way to learn what types of touch and stimulation feel good for you,” Dr. Aliyah Moore said, speaking exclusively with Women. “When you know what feels good for you, it can be easier to communicate that to your partner and guide them to provide the stimulation you need to reach orgasm.”

While you might feel self-conscious speaking up to your partner when you want them to do something different, keep in mind that your partner wants to please you. You can communicate before sex, or gently guide your partner through movements that feel good to you during sex as well. “Approach the issue with empathy and an open mind, and work together to find solutions that work for both of you,” Dr. Moore said. “Try to avoid blame or criticism and instead focus on finding ways to support each other and address the issue together.” Do not be afraid to tell your partner when a certain action does not feel good, either. Incorporating longer foreplay into your sexual encounters has also been shown to increase the rate of orgasm, according to a 2014 article published in Human Reproductive Biology.

Review your medications

Being on certain kinds of medications, namely antidepressants such as selective serotonin reuptake inhibitors, aka SSRIs, can also significantly impact one’s ease in having an orgasm. For those whose depression symptoms are significantly improving on medication, but are still having trouble in bed, there are some ways you can work around side effects that might include lack of sex drive, or difficulty reaching orgasm.

First, know that over time, the side effects of SSRIs on your libido can sometimes fade as your body adjusts to the medication. Should you have just started your treatment and feel frustrated with the changes in your sex life, do what you can to be gentle with yourself, and give the circumstances some patience. Should the issue persist, “Talk to your doctor,” Dr. Aliyah Moore suggested, speaking exclusively with Women. “If you’re experiencing difficulty reaching orgasm, it’s a good idea to talk to your doctor to rule out any underlying medical conditions or medication side effects that could be contributing to the problem. Your doctor may be able to suggest treatments or adjustments to your medication that could help,” she said. This could include anything from lowering the dose when appropriate, to switching medications to see if the issue continues.

Assess your physical health issues

A number of physical issues could also hinder your ability to orgasm in bed. One is anorgasmia. According to Mayo Clinic, “Anorgamsia is delayed, infrequent or absent orgasms — or significantly less-intense orgasms — after sexual arousal and adequate sexual stimulation. Women who have problems with orgasms and who feel significant distress about those problems may be diagnosed with anorgasmia.”

There are other issues, too. Speaking exclusively with Women, Dr. Aliyah Moore said, “Unfortunately, certain health conditions can impact our sexual function. Diabetes, multiple sclerosis, and spinal cord injuries are just a few examples. But even things like hormonal imbalances or thyroid issues can play a role.”

There are also several kinds of sexual dysfunction disorders that could contribute to issues with orgasming, where symptoms could include having pain during sex, perhaps caused by ovarian cysts or fibroids, and having a lack of sexual desire or arousal. Age does tend to be a factor in many sexual dysfunction disorders, however. For any number of these concerns, see a doctor or specialist for treatment plans and ideas.

Consider the role of past trauma

ƒsubPast trauma can also be a sensitive barrier to achieving orgasm. When you have had a traumatic experience surrounding sex, reclaiming your body can be a process that necessitates care, love, attention, and trust. Survivors of sexual assault, for example, might experience self-blame, disgust, or otherwise feel disconnected from their bodies, which can make sexual experiences hard to enjoy. Some may even have flashbacks of the traumatic incident. Know that it is possible to repair your relationship with your body and with sex, even when it feels challenging. Understanding your triggers and boundaries, as well as engaging in robust communication, are just a few ideas that can help shape what you want out of your sexual experiences.

Perhaps you might simply be having issues in your relationship that make having an orgasm difficult. “If past trauma or relationship issues are impacting your ability to orgasm, working with a therapist can be helpful in addressing these issues,” said Dr. Aliyah Moore, speaking exclusively with Women. She continued, “A therapist who specializes in sexual issues can help you work through any underlying psychological factors that may be impacting your ability to reach orgasm.” And where therapy is financially unfeasible, explore sexual education resources online. The sex exploration app Ferly, for example, offers expert guides, insight, and community for a small fee each month.

In the end, Dr. Moore advised, “Be gentle with yourself and your partner: It’s important to remember that sexual function can be impacted by various factors, and it’s not necessarily anyone’s fault.”

Complete Article ↪HERE↩!

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5 Facts All Men Should Know About Sexual Problems and Dysfunction

Male sexual dysfunction can include a wide variety of problems, ranging from low libido, erectile dysfunction (ED), premature ejaculation, and other issues. While many men know that these issues are common, they can be difficult to talk about. In fact, many men wait several months, or even years, before raising the issue with their primary care physician.

Thankfully, both normal and abnormal male sexual function are now better understood medically than ever before. Dr. Sharon Parish, Professor of Medicine in Clinical Psychiatry at Weill Cornell Medicine, maintains an active faculty practice specializing in sexual medicine. “I use an integrated, holistic approach, looking at the whole man,” explained Dr. Parish. “Often, men will first see a urologist and then are referred to me for a more detailed evaluation and discussion of their overall health.”

Here, Dr. Parish shares her insight as to the connection between male sexual, physical, and mental health.

Sexual problems may signal a cardiovascular or other medical issues

“Any man that experiences a change in libido, erection, or ejaculation should bring this up to their primary care physician,” said Dr. Parish. Any issue that lasts for several months may indicate a more serious medical issue that should be addressed:

  • Early ejaculation can develop because of medication, nerve damage, or other direct urinary conditions
  • A change in libido or erection may be the first sign of diabetes
  • Problems with libido or erection may be related to a hormonal imbalance
  • Problems with erection may be a sign of a cardiovascular issue or prostate cancer

There is a strong link between sexual function and mental health

Mental health issues — including depression, anxiety, and other psychiatric illnesses — can lead to many different types of sexual disorders. “It’s clear that there is a strong connection between ED and depression,” asserted Dr. Parish. “Women, on the other hand, who experience depression are more likely to see a decrease in libido. It’s very important to diagnose the psychiatric illness first to improve sexual function.”

Sexual function is often improved by addressing, managing, and alleviating anxiety and depression. “There are many helpful therapies,” Dr. Parish explained, “including mindfulness, cognitive behavioral therapy, and relaxation techniques to help one be more present in the experience and enjoy it more fully.”

Medications for mental illness may cause sexual function changes, to varying degrees

“There is a wide misconception that the medications for mental illness cause sexual problems, but the data is clear that sexual function is more likely to improve when the mental illness is treated,” said Dr. Parish. “It’s not a good idea to avoid the medication because of the potential side effects.”

Fifty to 70 percent of men do not experience any sexual side effects from medications, and men taking medications for serious psychiatric disorders are more likely to experience a sexual side effect.

“If you do experience sexual problems as a result of a medication,” Dr. Parish explained, “work with your doctor to manage the side effects. Several drugs are known to produce lesser side effects.”

Again, Dr. Parish emphasized the importance of mental health for sexual health. “The key,” she stated, “is to treat the mental disorder and then the sexual disorder. It’s best to get the condition treated and work with the doctor to manage the side effects.”

With age, some changes in sexual function are normal

Some changes in sexual drive, performance, and function are normal parts of aging. “As men get older,” said Dr. Parish, “they may need more time for foreplay or direct stimulation. If this isn’t enough to improve normal age-related changes in sexual function, sex therapy can be very beneficial.”

However, if the changes are dramatic or difficult to work through, Dr. Parish suggested talking to a primary care physician. “Your doctor can help you differentiate normal changes from more problematic issues, including medical issues,” she said. “Don’t assume it’s a normal change that comes from getting older.”

Improving overall health can improve sexual performance

Dr. Parish ascribes to the “biopsychosocial model” for overall and sexual health. “There is so much interconnectivity when it comes to our health,” she explained. “It’s important to take a holistic view.”

Indeed, cardiovascular, neurological, hormonal, and psychological systems all interact together for sexual performance. A healthy lifestyle can significantly help improve sexual function — improving diet, achieving and maintaining a healthy weight, and exercising regularly all help promote greater overall health and, therefore, greater sexual health.

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Medicines and Sex

— Not Always a Good Mix

By Chris Woolston

For both men and women, it takes a complicated chain of events to move from arousal to a satisfying orgasm. The mind has to stay focused, nerves have to stay sensitive, and blood has to flow to all the right places. Unfortunately, many things can break the chain — including, perhaps, the pills in your medicine cabinet.

Medicines often work by altering blood flow and brain chemistry, so its no surprise that they can affect sexual function, and not always for the better. Medications can shut down a person’s sex drive, delay orgasms, or prevent orgasms entirely. Medications are also a leading cause of erectile dysfunction in men.

If you’ve noticed a drop in your ability to have or enjoy sex, talk to your doctor about possible causes. Be sure to bring a list of every medication you’re taking. A simple change of drugs or doses could be all it takes. But never stop taking a prescription drug or change dosages on your own. Your doctor can help you determine if a drug you’re taking is the problem — and help you switch to another medication safely.

What drugs can affect sexual function?

SSRIs (antidepressants) You may have noticed that television ads for common antidepressants such as Paxil (paroxetine) or Zoloft (sertraline) mention “certain sexual side effects.” The full story is that for some people, SSRI antidepressants can put desire on hold and make it difficult to achieve orgasm. A study of nearly 600 men and women treated with an SSRI, published in the Journal of Sex and Marital Therapy, found that roughly one in six patients reported new sexual problems. The number-one complaint? Delayed or absent orgasms. Many patients also reported declines in desire. Overall, men were more likely than women to report sexual problems while on SSRIs.

As reported in The American Family Physician, other studies have found that up to one-half of patients taking SSRIs have reported sexual problems. Study results vary depending on the patients studied and the questions asked, but the final message is the same: Sexual side effects caused by SSRIs are common.

If SSRIs are affecting your sex life, talk to your doctor. As reported in Current Psychiatry Reports, there are several options to get you back on track. Your doctor may suggest switching to Wellbutrin (bupropion), or another non-SSRI antidepressant that is less likely to cause sexual side effects. If your current medication is working well and you don’t want to make a switch, your doctor may want to lower the dose or give you a break from taking drugs. A few studies have suggested that men who develop erectile dysfunction while taking SSRIs may respond to Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil) added to their overall treatment plan.

Blood pressure medications

Many drugs that control high blood pressure — including commonly prescribed diuretics and beta blockers — can also put the brakes on a person’s sex life. The drugs can cause erectile dysfunction in men and, when taken by women, they can diminish sexual desire.

In many cases, the best way to overcome sexual problems caused by blood pressure medication is simply to switch prescriptions. ACE inhibitors and calcium antagonists seem less likely than diuretics or beta blockers to cause sexual side effects.

Keep in mind that not every blood pressure medication is right for every person. Your doctor will help you determine whether a different prescription would be the best option for you, and can recommend the right one for your particular circumstances.

Opioid (narcotic) painkillers Opioids such as morphine or OxyContin (oxycodone) do more than just ease pain. As an unfortunate side effect, the drugs can also reduce the production of testosterone and other hormones that help drive sexual desire in both men and women.

The sexual side effects of opioids haven’t been thoroughly investigated, but preliminary studies paint a disappointing picture. As reported in the Journal of Clinical Endocrinology and Metabolism, a study of 73 men and women receiving spinal infusions of opioids uncovered widespread sexual problems. Ninety-five percent of the men and 68 percent of the women reported a drop in sex drive, and all of the premenopausal women either developed irregular periods or stopped menstruating completely.

If you think opioids might be undermining your sex life, ask your doctor if it’s possible to get similar pain relief from non-opioid medications. Even if you don’t quit opioids completely, merely cutting back could help you regain your spark. Your doctor may be able to suggest other methods of pain relief such as massage or biofeedback that will make it easier for you to scale back on your opioids. If blood tests show that you’re low in testosterone, your doctor may want to prescribe testosterone shots or patches to help rekindle your sex drive.

Antihistamines Even some over-the-counter drugs can affect your sex life. Antihistamines are a prime example. As reported by the Cleveland Clinic, these drugs can cause erectile dysfunction or ejaculation problems in men. For women, antihistamines can cause vaginal dryness.

This is only a partial list. Other drugs that can affect a person’s sex life include oral contraceptives, tricyclic antidepressants, antipsychotics, and cholesterol medications. You and your doctor should take sexual side effects seriously, but you should be able to find a way to restore sexual abilities and desires without compromising your treatment.

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Drugs that interfere with sexual function

By Naveed Saleh MD, MS

Sexual function is multiphasic and involves sexual desire, arousal, and orgasm. Men and women can experience issues at any phase, with presentations including decreased desire, premature/retrograde/absent ejaculation, erectile dysfunction, anorgasmia, painful sex, and absence of swelling/lubrication in women.

Some commonly prescribed drugs cause disaster in the bedroom.

Sexual dysfunction can be a side effect of various prescription medications, as well as the conditions that they treat. Some of these treatments, such as antidepressants and antihypertensives, likely come as no surprise to the clinician, and are commonly implicated etiologies. Although sexual dysfunction due to drugs happens in both sexes, the preponderance of extant research has focused on men.

Here are seven types of drugs that also contribute to sexual dysfunction.

Antiandrogens

Antiandrogens are used to treat a gamut of androgen-dependent diseases, including benign prostatic hyperplasia, prostate cancer, paraphilias, hypersexuality, and priapism, as well as precocious puberty in boys. The androgen-blocking effect of these drugs—including cimetidine, cyproterone, digoxin, and spironolactone—decreases sexual desire in both sexes, as well as impacting arousal and orgasm.

Immunosuppressants

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

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

HIV meds

Results from a cross-sectional observational study (n=90) published in AIDS indicated that HIV-infected men with stable disease experienced sexual dysfunction while on antiretroviral therapy.

“Older age, depression and lipodystrophy, combined with the duration of exposure to protease inhibitor, determined a lower score on various sexual dysfunction domains,” the researchers wrote.

“There is a high prevalence of erectile dysfunction in HIV-infected men, with age and the duration of exposure to protease inhibitor being the only identifiable risk factors,” they concluded.

Cancer treatments

Both cancer and cancer treatment can impair sexual relationships. Moreover, cancer treatment itself can further contribute to sexual dysfunction. For instance, long-acting gonadotropin-releasing agonists used to treat prostate and breast cancer can lead to hypogonadism that results in lower sexual desire, orgasmic dysfunction, erectile dysfunction in men, and vaginal atrophy/dyspareunia in women.

Antipsychotics

Per the research, men taking antipsychotic medications report erectile dysfunction, less interest in sex, and lower satisfaction with orgasm with delayed, inhibited, or retrograde ejaculation. Women on antipsychotics report lower sexual desire, difficulty achieving orgasm, anorgasmia, and impaired orgasm quality.

“The majority of antipsychotics cause sexual dysfunction by dopamine receptor blockade,” according to the authors of a review article published in the Australian Prescriber. “This causes hyperprolactinaemia with subsequent suppression of the hypothalamic–pituitary–gonadal axis and hypogonadism in both sexes. This decreases sexual desire and impairs arousal and orgasm. It also causes secondary amenorrhoea and loss of ovarian function in women and low testosterone in men.” Antipsychotics may also affect other neurotransmitter pathways, including histamine blockade, noradrenergic blockade, and anticholinergic effects, the authors added.

Antiepileptic drugs

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

Specifically, antiepileptic drugs such as carbamazepine, phenytoin, and sodium valproate could dysregulate the hypothalamic–pituitary–adrenal axis, thus resulting in sexual dysfunction. Carbamazepine and other liver-inducing antiepileptic drugs could also heighten blood levels of sex hormone-binding globulin, thus plummeting testosterone bioactivity. Both sodium valproate and carbamazepine have been linked to disruption in sex-hormone levels, sexual dysfunction, and changes in semen measures.

Antihistamines

Histamine likely plays an important role in penile erection by activity of the H2—and possibly the H3—receptor, per the research. In fact, histamine has been suggested as a diagnostic tool to study erectile dysfunction. Consequently, it should come as no surprise that antihistamines—such as diphenhydramine, dimenhydrinate, and promethazine—may lead to erectile dysfunction.

Bottom line

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

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

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17 reasons you might not be enjoying sex

By Arielle Tschinkel

  • When you’re not enjoying sex, you might be wondering why, but the truth is that our sex drives are impacted by so many things.
  • Both your physical and mental health can be the cause of a low libido.
  • Stress, certain medications, and a feeling of shame could all be reasons you may not be enjoying sex.

Your sex drive is determined by so many factors and it can constantly change depending on what’s going on in your life, as well as your physical and mental health. Whether you’re dealing with short-term or long-term sexual dissatisfaction, it’s normal to wonder why you’re not enjoying sex.

According to experts, here are some reasons you may not be enjoying sex.

Editor’s note: This post contains some information that may be triggering to those who have experienced sexual assault or trauma.

You’re engaging in sexual activities before you’re adequately aroused.

Taking extra time for foreplay can help.

Preparing your mind and body for sex can be crucial to actually enjoying it and taking time to get aroused may help prepare your body for sex.

“Foreplay gets the ‘blood flowing’ to the genitals and helps with lubrication and the ability to climax during sexual activity,” Michael Ingber, MD, Board-certified in Urology and Female Pelvic Medicine & Reconstructive Surgery at the Center for Specialized Women’s Health, division of Garden State Urology/Atlantic Medical Group told INSIDER.

“Many people get caught up in the idea that sex is equivalent to intercourse,” added Melissa Coats, psychotherapist and owner at Coats Counseling, LLC. “Foreplay is sex and by taking the pressure off of the thought that there must be one outcome in a sexual experience, you can free yourself up to enjoy foreplay and focus on your own pleasure rather than the worry.”

You’re not mentally or emotionally ready to have sex.

Your body and mind should both feel ready.

As important as it is for your body to be ready for sex, your mind also needs to be ready, too. “Context is everything,” said Coats. “For example, If you come home from a long day of work feeling anxious, upset, and overwhelmed and your partner tries to make sexual contact, you will most likely not be able to access your [feelings of] desire and pleasure easily.”

She said context includes a variety of things including your environment, level of stressors, or even the state of your relationship with a sexual partner.

You’re dealing with anxiety about your body or appearance.

Focusing on negative thoughts about your body and self could make sex less pleasurable.

Sex can be an extremely vulnerable situation, so if you’re not feeling comfortable in your own skin, you may find it more difficult to enjoy sex.

“Anxiety is the enemy of desire and pleasure,” Coats told INSIDER. “In order to experience sexual pleasure, we need to be present in the moment and with our bodies. If you are experiencing negative self-talk about your body, your mind is not on how much you are enjoying your body and what it is experiencing.”

You’re uncomfortable about past sexual experiences.

If you don’t feel safe, it can be tough for your body to relax.

Whether you’re dealing with a past sexual trauma or worrying that your experience level is different from your partner’s, these feelings can understandably creep up before, during, or after sex, making it tough for you to find enjoyment in a sexual experience.

Coats said that communicating with your partner can help you to feel more comfortable during sex.

You’re not comfortable around your partner.

Sex could make you feel vulnerable.

Since sex oftentimes involves so many layers of intimacy, if you’re not fully comfortable with your partner, you’ll likely have a difficult time fully enjoying your experience.

“By expressing these aspects of your sexuality with someone, you are trusting them with that vulnerability,” said Coats. ” If you are not comfortable with your partner, feeling vulnerable will not seem appealing and may even feel physically or emotionally unsafe.”

You feel shame or stigma about your sexual needs or wants.

Having a conversation with your partner about what you want and what you’d like to try might help.

Sexuality exists on such a wide spectrum and everyone has different wants, needs, and desires. Opening up about what you like and don’t like can feel intimidating, even if you’re with a long-term partner. And, feeling like you cannot express your wants or needs can be making sex less pleasurable for you.

“Shame and stigma are attacks on identity,” Coats told INSIDER. “Whether the shame is related to a sexual identity, fantasy, kink, (or something similar,) feeling attacked either by your own thoughts or someone else’s thoughts or actions, you may automatically feel unsafe and want to retreat.”

You’ve been given false or sex-negative messages about sex or sexuality.

Not everything you were taught in sex education is necessarily accurate.

Similarly, it can be easy to believe things you’ve heard about sex, from how much you should be having to stereotypes about the kinds of sex people have, and these can seep through to your own sexual experiences, likely without you even realizing it.

“There is an abundance of misguided, harmful, and plainly false messages about sex that people take at face value as fact. If something doesn’t feel right, allow yourself to question that message, whether it is from yourself or someone else,” said Coats. In these cases, she suggested exploring sex-positive resources to help you to feel more comfortable with sex.

You’re on a medication that impacts your libido or physical sensations during sex.

Antidepressants commonly cause a decrease in sexual desire.

You might not link your medications to your sex drive, but plenty of over-the-counter and prescription medications can impact your sex drive, including birth control, antidepressants, anti-anxiety medications, blood pressure medications, and even allergy meds and antihistamines.

“Several medications can affect not only libido, but also the sexual experience in men and women,” said Dr. Ingber. “Antidepressants are notorious for this, causing a decrease in sexual desire and often interfering with the ability to orgasm.”

If you think a new or existing medication is causing a dip in your libido or ability to orgasm, check with your doctor.

You’re dealing with a medical condition that makes sex painful.

Endometriosis can cause intense cramps and make sex painful.

Even though it’s incredibly common, experiencing pain during sex can be the quickest way to put the brakes on your enjoyment in the moment. There are several medical conditions that can contribute to pain, dryness, or irritation during or after sex, as Jessa Zimmerman, a certified sex therapist and author of “Sex Without Stress,” previously explained to INSIDER.

“There are some medical causes of sexual pain, including skin conditions, autoimmune disorders, pain conditions due to overgrowth of nerves, endometriosis, and vaginismus, an involuntary clenching of the vagina that develops in anticipation of pain and is painful in itself,” said Zimmerman.

Other medical conditions that might cause painful sex include prostatitis, dyspareunia, and even skin allergies.

If you suspect a medical condition is causing you to feel pain during sex, check with your doctor, who can help you to find treatment options and ways to help ease your pain or discomfort.

You may be trying positions that make you feel uncomfortable or pained.

If certain positions cause you pain, your body could be trying to tell you something.

Pain or discomfort during sex isn’t always due to a chronic medical issue — some positions may not be enjoyable to you.

“If you have sought medical attention with no clear answers, try using different positions, lubricant, or talking to a pelvic floor physical therapist to help figure out what your body is trying to tell you,” said Coats

Dr. Ingber agreed, adding that everyone is different and what’s comfortable and enjoyable for one person isn’t necessarily pleasant for another.

You’re not prioritizing sleep, eating well, or exercising regularly.

If you’re feeling constantly hungry or moody, your body might be trying to tell you that you need more sleep.

As Coats told INSIDER, “Physical, mental, emotional, and sexual health are all connected. When one is being neglected, it is like trying to drive a car with the emergency brakes on. It will go, but it will slow you down a lot and it’s not great for your engine. Engaging with your sexuality when you feel physically un-aligned can be stressful and difficult.”

Taking care of your entire body by getting enough sleep, eating a balanced diet, and getting regular exercise will help give you the energy your body needs to not just have sex, but thoroughly enjoy it, too.

You’re not sure what feels good for you and your body.

Figuring out what you like and don’t like can make sex more enjoyable.

Sexual desire and preferences are different for every person. And, according to Coats, popular misconceptions about sex being a “task to be mastered instead of an activity to enjoy” could make it tough for someone to figure out what they like.

Taking time to explore your own body by way of masturbation or trying new things that you’re comfortable with, whether with new toys, positions, or other sexual stimuli, can help you learn what feels enjoyable for you.

You’re skimping on water intake.

Being dehydrated can also cause you to feel dizzy or pass out.

Believe it or not, being dehydrated can lower your libido and even make sex painful. If you’re not drinking enough water, you might experience headaches, fatigue, and irritability, which can definitely hinder your ability to get in the mood.

But the same way that your cells need water to remain adequately hydrated, dehydration can cause dry, irritated skin, potentially leading to pain and irritation down below.

Similarly, Healthline notes that there’s a link between dehydration and erectile dysfunction, and your body needs sufficient oxygen to help maintain an erection. When you’re not getting enough water, you might not get adequate blood flow throughout your body, which includes your sex organs.

You’ve recently given birth.

Postpartum is a different experience for everyone.

For those who have recently given birth, Dr. Yvonne Bohn, OB/GYN at Los Angeles Obstetricians & Gynecologists told INSIDER that postpartum tearing and healing can cause intercourse to be painful.

She said doctors typically recommend abstaining from sex for six weeks or longer post-delivery, but it depends on the patient’s body and their healing process. She also added that breastfeeding can decrease one’s estrogen levels, causing one’s vagina to be less lubricated and less elastic, thus making sex more painful.

You’re afraid of pregnancy or sexually transmitted infections.

You’re afraid of pregnancy or sexually transmitted infections.

Even if you’re taking precautions for safe sex, it’s natural to worry about pregnancy or STIs. “Any fear that exists while engaging in a sexual encounter is going to impact how you feel about your experience,” Coats told INSIDER. “If you are afraid of getting pregnant, remember, sex does not [have to] equal intercourse. There are plenty of ways to express and experience pleasure and eroticism other than intercourse.”

You’re stressed about other things.

If you’re stressed about work, you may find it hard to focus on enjoying sex.

Few things can kill the desire for sex quite like stress. From an emotional standpoint, Coats said mental energy plays an important role in enjoying sex.

“If that mental energy is being used to assess what is going on anywhere but within your own body, it is competing with your pleasure for your brain space. Creating a context where you can put other things aside and allow yourself to focus on you, also known as self-care, is crucial in sexual satisfaction.”

Your mental stress could even cause sex to be more painful. “All of these issues will impact your natural ability to relax, get aroused, lubricate and prepare the [body] for sex,” Dr. Bohn told INSIDER.

You’re just not interested in sex, either at the moment or in the long-run.

If you find yourself never really feeling sexual attraction or desire, you may identify as asexual.

The truth is that not everyone is interested in having sex and there’s absolutely nothing wrong with that.

“If sex is not that interesting to you, you are not abnormal. If you would like to become more interested in sex and your sexuality, there are plenty of ways to spark curiosity,” Coats told INSIDER. “But it must come from your own desire and not someone else’s expectation in order to be pleasurable.”

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How to Reduce Sexual Side Effects From Antidepressants

Coping When Your Libido Takes a Hit

By Nancy Schimelpfening

An unfortunate irony of depression treatment is that while depression can rob you of your desire for sex, some drugs commonly used to treat it can be just as bad, if not worse. Sexual side effects of antidepressants include low libido, erectile dysfunction, and difficulties with orgasm. If you’re taking an antidepressant and finding it’s sapping the pleasure from your sex life, it’s worth making an effort to turn that around—if not for your relationship then just for you: Sexuality is an important part of healthy living.

Reducing Sexual Side Effects of Antidepressants

Not all of these approaches will work for everyone, so it will likely take some trial-and-error to get your romantic life back to normal. Do talk to your doctor, though, because some of these tactics require fiddling with your prescription or adding an additional medication, neither of which you can do on your own.

1. Take a Lower Dose

With your doctor’s guidance, it may be possible to lower the dose of your antidepressant enough to reduce the sexual side effects while still easing your depression symptoms. For example, it’s been shown that some people get just as much relief from 5 or 10 milligrams (mg) of Prozac (fluoxetine) as from 20 mg, but with fewer sexual side effects.

2. Pop Your Pill After Sex

Scheduling the timing of when you take certain drugs, such as Zoloft (sertraline) and Anafranil (clomipramine) for right after the time you typically have sex may be one strategy to help lower side effects. That way you’re engaging in intimacy at a time when the levels of the drug are lowest in your body. In other words, if you and your partner tend to make love in the evenings, get into the habit of taking your antidepressant at night.

3. Augment With a Drug That May Reduce Sexual Dysfunction

The antidepressant Wellbutrin (buproprion) is a norepinephrine-dopamine reuptake inhibitor (NDRI). It works somewhat differently than selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, and Paxil (paroxetine), and tends to not affect sexual dysfunction as much. Some people are able to switch to Wellbutrin alone and still get enough relief from their depression symptoms. Others can take Wellbutrin in addition to their regular medication. Ask your doctor if either approach might be an option for you.

4. Take a Drug That Treats Sexual Dysfunction

Drugs targeted at erectile dysfunction, such as Viagra (sildenafil) or Cialis (tadalafill), may help some patients.

5. Take a “Drug Holiday”

If you take Zoloft (sertraline) or Paxil you may be able to schedule a two-day drug holiday each week in order to restore sexual function without losing the benefits of the antidepressant. This strategy isn’t likely to work with medications that have a long half life, such as Prozac.

6. Experiment With Alternatives

Both exercising before sex and vibratory stimulation are suggested as possible options. In addition, psychotherapy, acupuncture, or even nutritional supplement approaches have been tried. Don’t give up if you don’t find the answers right away.

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How to Have a Sex Life on Antidepressants

When quitting isn’t an option, is it possible to overcome the sexual side effects that come with an SSRI?

By Shannon Holcroft

So, you’ve finally filled the antidepressant prescription that’s been acting as a bookmark for the most recent novel you’re feigning interest in. Somewhere between missing your own birthday party and watching everyone else have fun without you, you gave in. After a few medicated weeks, things are starting to look up. Except for your sex life, that is.

Just last week, you were tied to a kitchen chair enjoying an amazing (albeit rather mournful) few minutes of escape through sex. Today, getting naked seems less appealing than all the other pressing tasks you have new-found energy to complete.

“Is it the meds, or is it just me?” you wonder as you deep-clean the fridge with new vigour. After some soul-searching, it becomes clear that you’re still the same person—just with fewer festering foodstuffs and a lot less crying.

“It must be a side effect,” you decide. But months after filling your prescription, your genitals are still giving you the physiological equivalent of 8d2cc2c1a43108301b149f7f33e1664d.png

Why Antidepressants May Be a Downer for Your Sex Life

“[Sexual dysfunction] is a difficult, frustrating, and very common issue with this class of medications,” says Jean Kim, M.D., clinical assistant professor of psychiatry at George Washington University.

Twelve percent of American adults reported filling an antidepressant prescription in the most recent Medical Expenditure Panel Survey. Not just for clinical depression, but for all kinds of off-label conditions like chronic pain and insomnia.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant class. And between 30 percent and 50 percent of individuals taking SSRIs experience sexual dysfunction. Desire, arousal and orgasm may be affected by changes in function of neurotransmitters like serotonin and dopamine; the very mechanisms through which SSRIs treat depression.

How to Work Around the Side Effects

When fighting to survive a potentially fatal mental illness, there are often more important concerns than getting it on. It’s frequently not an option to stop taking life-saving medication to avoid side effects. So what’s a sexual being to do?

Despite SSRIs being pretty pedestrian, there’s no concrete answer to addressing sexual side effects. “Unfortunately, not much is reliably effective to deal with this [sexual dysfunction],” Dr. Kim notes.

This may sound pretty gloomy, but there are plenty of things you can try to bring sexy times back around. “Don’t hesitate to bring up the issue with your prescribing clinician, as there might be some helpful interventions available,” says Dr. Kim.

Here are other ways to work around the sexual side effects of antidepressants:

1. Time It Right

“Some literature advises trying to have sexual activity when the serum level of a daily antidepressant might be lowest in the bloodstream,” says Dr. Kim. In other words, the ideal time to get it on is right before you take your next daily dose.

If your dosing schedule makes it tough to pencil in sexual activities, chat with your clinician about changing the time of day you take your meds. In many cases, there’s room for flexibility.

“This would not work much with some SSRIs that have a longer half-life like fluoxetine (Prozac),” Dr. Kim adds. Those taking antidepressants that exit the body quickly, like Paxil and Zoloft, could be in luck.

2. Switch It Up

Switching to a different medication, with the support of your prescribing clinician, may make all the difference. Certain antidepressants have a greater incidence of sexual side effects than others. Commonly prescribed SSRIs associated with a high frequency of sexual dysfunction include paroxetine (Paxil), sertraline (Zoloft) and fluoxetine (Prozac).

Besides exploring the SSRI class, venturing into atypical antidepressant territory is another option. Buproprion (Wellbutrin) is an atypical antidepressant observed to present the lowest sexual side-effect profile of all antidepressants.

It may take some trial and error, mixing and matching to identify what works best for you, but it will all be worth it when you can [insert favorite sex act here] to your heart’s content again.

3. Augment

Some treatment add-ons may act as antidotes to SSRI-induced sexual dysfunction. “Supplementing with other medications that have serotonin blocking effects (like cyproheptadine [Peritol] or buspirone [Buspar]) or enhance other neurotransmitters like dopamine (like Wellbutrin) might help,” says Dr. Kim. She is quick to note that these findings are yet be confirmed by “larger-scale randomized controlled clinical trials.”

“Another common strategy is to prescribe erectile dysfunction drugs like sildenafil (Viagra) and the like for as-needed use before activity,” says Dr. Kim. Viagra has been found to reduce sexual side effects, even if you’re not in possession of a penis. In Dr. Kim’s clinical experience, “[Viagra] seems to help in more than a few cases.” Discuss with your doctor before adding any more medications to the mix.

4. Exercise

Now’s the time to take up aquacycling, indoor surfing sans water or whatever fitness fad tickles your fancy. Keeping active could be the key to preventing sexual dysfunction caused by SSRIs.

“Sometimes sexual dysfunction is not just a primary SSRI drug side effect but part of underlying depression/anxiety as well,” Dr. Kim explains. “Anything that helps enhance overall blood circulation, mood and libido might be helpful, such as exercise.”

Complete Article HERE!

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Early Spring 2014 Q&A Show — Podcast #413 — 03/31/14

[Look for the podcast play button below.]

Hey sex fans,rifleman

After a spate of marvelous interview shows, it’s time to turn our attention to the sexually worrisome in our audience. I have a swell Q&A show in store for you today, which just so happens to be our last podcast before our annual spring break. Each of my correspondents is eager to share his or her sex and relationship concerns with us. And I will do my level best to make my responses informative, enriching and maybe even a little entertaining. And I think there will be enough time for us to do some sex science too. So please stay tuned, you won’t want to miss this.

  • Kennedy, Jim, and Ronald’s lives are being fucked up by meth.
  • Sam wants to know about and share some information about penis pumps.
  • Rebecca has a heartbreaking story to tell of the last days before her husband of 46 years died.
  • Tracy asks about babies and gender. So you know it’s time for some Sex Science.

Today’s podcast is bought to you by: Dr Dick’s Sex Advice and Dr Dick’s Sex Toy Reviews.

BE THERE OR BE SQUARE!

Look for my podcasts on iTunes. You’ll find me in the podcast section, obviously, or just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

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You’ve lost that lovin’ feelin’

Name: Heather
Gender: Female
Age: 36
Location: USA
I have been married for 10 years. I told my husband 6 years ago that I was not physically attracted to him anymore. I stopped wanting sex from him, because he just turned me off. No matter what he does — cleaning, cooking, running me a bath, eat me and so on but nothing works. I start to get wet and as soon as he gets started but I dry up like a prune what should I do? I have not had good sex in a long time.

Well, if you’re not attracted to him anymore, you’re not attracted to him anymore…plain and simple. But what I don’t get is, how come you’re old man is still hangs in there after six years of disinterest on your part? Is he some kind of glutton for punishment?he & she hips

If I was your long-suffering hubby and I was doin all this stuff, including cooking, cleaning and eatin’ out your pussy, I’d sure as hell demand an explanation for your attitude change. Of course, maybe he likes being the doormat. Some men really get off on being dominated and treated like shit. Is that why you are no longer into him, because he’s behaving like an emasculated pussy?

Or is there something else he’s done that has put you off? Did he gain weight? Does he not attend to his personal hygiene? Did he become a Republican? Ya know, things like that. If it is something he’s done or failed to do and he can change his behavior to better suit you, maybe you oughta clue him in on this.

haven't had sex in a whileHowever, if it’s not something he’s done or failed to do, but it’s you. Then he needs to know that too. You did say that you dry up like a prune. Are you using lube with your penetrative sex? Perhaps it’s your libido that’s gone south, not his relative attractiveness? Sometimes women get these two things confused. And there are any number of things that can mess up the arousal phase of your sexual response cycle.

Do you have sexual fantasies? Do you masturbate? Are horny for anyone else — either real or imagined? How’s your health? Are you on birth control? Are you depressed? Sleep deprived? Are you putting on the pounds? Could you be experiencing early-onset menopause? As you can see, there are innumerable reasons for a decrease in libido.

At any rate, Heather, you really need to get to the bottom of this, and soon, six years is a mighty long time to live like this. I’d look for a sex-positive therapist to connect with, if I were you. Clearly, you’ve been unable, in six years, to discern the cause of your attitude change on your own. It’s irresponsible to continue to drift with the status quo.

Good luck

Name: Pete
Gender: Male
Age: 33
Location: Florida
I’ve noticed that some of the skin on my dick is starting to wear away from me masturbating…there is no blood or anything like that. Just the skin turning light in color around head of my dick. I think it’s my grip. Is there a way the color will come back or have I rubbed the skin cells to death. I masturbate about 3-4 times a week. I’m not in a relationship and prefer masturbation over random sex.

Your dick skin is wearing away??? Really? What are you handling your unit with, darlin’, sandpaper?

You say you think it’s your grip. Ya think? Hey Pete, are you using lube when you stroke? Or are you just yanking away down there with wild abandon using a dry hand? If you’re not using a good jack off lube like, Spunk Lube then ya better start right away! This stuff is also great for use with condoms.jeans 1

As to the rather sudden coloration change on your dick, I’d be willing to guess that it has nothing to do with jerkin’ off, even like a maniac. More likely it’s a genetic condition known as vitiligo. And the coloration change is actually a loss in pigment. This is not a health concern. Really! Nor is it contagious. So you don’t have to worry about it in that regard. If it is indeed vitiligo, there’s nothing you can do about it. It’s irreversible, but it can and does spread.

Here’s a relatively easy way to self-diagnose this pesky, but benign condition. While naked as a jaybird, squat over a mirror. If what you have is vitiligo, you will also see the same kind of color changes (or more properly — loss of pigment) around your asshole. You may also notice it on your elbows and knees. If you are fair-skinned, the loss of pigment will be less noticeable then if you have a darker complexion.

If it’s not vitiligo, you might consider a check up with your physician. But I pretty much can guarantee you that unless you are absolutely ruthless in your masturbation technique, manhandling yourself is not the cause of the color change on your joystick.

Good luck

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Starting Over

Name: LD
Gender: Male
Age: 38
Location: Atlanta
How do you jump back into the game when your partner passed away suddenly? Getting really horny but its still awkward to actually do it.

Good question, LD. You say you’re feeling awkward. Why exactly? Is it because you’re out of practice with the whole dating thing? Are you concerned that people might think you’re jumping the gun, trying to get back into the game before your partner is cold in the grave? People can be pretty heartless about this. Or, is your awkwardness associated with your grief?

Grief has a profound effect on every aspect of our lives. Yet there is hardly any literature on the effects grief has on our sexuality. To my mind, grief is the leading causes of sexual dysfunction for those who have experienced the death of a partner.

Allow me a bit of time here for one of my pet spiels. Healing and helping professionals often misdiagnose grief. I want to make one thing clear, grief is not depression. Treating grief with an antidepressant is counterproductive. It can actually take away the impetus to resolve the grief and get on the rest of one’s life.

Making sure that you have processed your grief may eliminate some of your awkwardness you are currently experiencing. This is something I’m pretty familiar with. A good portion of my private practice is with sick, elder and dying people and their friends and family who survive them. I know the impact a terminal illness and dying process can have on the surviving spouse or partner. We often go into survival mode, shutting down so much of ourselves in an effort to have the strength to cope with this life-altering experience. Of course, trying to kick-start our life afterwards is often a monumental effort. Without the support and guidance of a professional or a group of similarly challenged people, some of us just sink to the lowest common denominator.

I believe in the resilience of the human spirit. I believe that we can honor our dead and continue to live and love. It sounds to me like you have a desire to get on with your life, LD, to fill the void, to make new connections, but you simply don’t know how. Acknowledging that fact is a real good place to begin.

Perhaps you could start by reawakening your sexuality through self-pleasuring. Reconnect with your body and the joy it can bring you. Reestablishing a social life will no doubt follow, slowly at first. But the inevitable tug of the need for human-to-human contact will draw you, if you let it. Remember the best testament to those who have died is to continue to celebrate life itself.

Allow me to draw your attention to my latest book, The Amateur’s Guide To Death And Dying; Enhancing The End Of Life. Actually it’s more of a workbook then a text and while its primarily target are those currently facing their mortality it’s not exclusively for them. Concerned family and friends, healing and helping professionals, lawyers, clergy, teachers, students, and those grieving a death will all benefit from participating in the interactive environment the book provides.

Of special interest to you will be Chapter 6, Don’t Stop. My good friend and colleague, Dr Cheryl Cohen Greene, joins me in presenting this chapter on sex and intimacy concerns. Like I said above, there is a dearth of information about this timely topic for sick, elder and dying people as well as those who are grieving. So I am delighted that my book helps break this deafening silence.

I hope you take the time to write back, LD. I’d very much like to keep tabs on how you are doing.

Good luck

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A Labor of Love Q&A Show — Podcast #228 — 09/06/10

[Look for the podcast play button below.]

Hey sex fans,

It’s another holiday weekend here in the good old USofA. And despite the fact that so many of you are enjoying a well-deserved break from your labors; I am at my post here in front of this blasted microphone. I took a break from podcasting the past couple weeks so that I could work on the redesign of my sites. And of course, I gotta catch up on all the questions that have been piling up since our last Q&A session back in early July. There is no rest for the wicked!

Before we get to today’s questions, I want to call your attention to the new redesign of my two primary websites — drdicksexadvice.com and drdicksextoyreviews.com.

As you’ve probably noticed, both sites now mirror one another, at least in terms of presentation and functionality. The old blog format is out; and a brand-spankin-new magazine format is in. Everything is bright, cheery, clean and sleek. All the functions of the old sites — search-ability, the Links, the Categories, the Sponsors and the Tags are still in place. But the new magazine format allows visitors to quickly scan a thumbnail image and a blurb for each posting without having to scroll through the whole blasted posting to get to the next one. There is also a Headline posting and a handful of Featured postings. Now you can see several weeks of postings by just scrolling down a page.

There are other new features too. I decided to use a bunch of icons — a blue heart for Donate to Dr. Dick; a blue envelope for Ask an Anonymous Sex Question; and a blue telephone icon for the Toll Free — Voicemail — HOTLINE. There is a blue movie projector icon that designates the presence of a video in the posting. And Special Announcements are designated by a red and white “special announcement” icon.

The top navigation has been simplified too. You can toggle between the two sites effortlessly. If you are on the ADVICE site, click on Toy Reviews in the header. If you are on the REVIEW site, click on Sex Advice With An Edge. It’s that simple.

Dr Dick’s Stockroom and Dr Dick’s How To Video Library now have their own banner in the sidebar.

I hope you like all the new changes. And as always, your thoughts and comments are welcome.

Today we hear from:

  • Scott Daddy tells us about his new videos posted HERE.
  • Brennen is off his antidepressant and he’s having trouble with his wood.
  • Marcus wants to know about nipple enlargement.
  • Kimberly thinks her man might like some ass play.
  • Ali wants two more inches…guess where.
  • Jade is all hot and bothered.
  • Luke is using penis extenders and he and his wife love it.
  • Abigail wants to make her own sex toys.
  • Kevin wants to know if it’s safe to spooge on a pussy not in it.
  • Jennifer has been gettin plowed deep and heavy; now there’s a problem.
  • Craig is worried about being a dirty fuck.
  • Patrick thinks his “lace curtains” are too long.

BE THERE OR BE SQUARE!

Check out The Lick-A-Dee-Split Connection. That’s Dr Dick’s toll free podcast voicemail HOTLINE. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.

Got a question or a comment? Wanna rant or rave? Or maybe you’d just like to talk dirty for a minute or two. Why not get it off your chest! Give Dr Dick a call at (866) 422-5680.

DON’T BE SHY, LET IT FLY!

Look for my podcasts on iTunes. You’ll fine me in the podcast section, obviously, or just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

Today’s Podcast is bought to you by: DR DICK’S — HOW TO VIDEO LIBRARY.

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