Category: SEX THERAPY

Fear of Sex, Lasting Longer, Performance Anxiety, Preorgasmic Women, Sensate Focus

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How to have a good fight with your partner

— Trust us, it’s possible

By Shona Hendley

Before you panic, fighting in a relationship isn’t necessarily a bad thing – but there’s a right way to go about it, plus four things that actually do spell the end.

While arguing and fighting with someone, particularly a partner, is often viewed as a sign that things may not be going well, many experts argue the opposite.

In fact, according to US clinical psychologist Deborah Grody married couples who don’t have any conflict are often the ones who end in divorce.

“Relationships that can’t be saved are relationships where the flame has completely gone out, or it wasn’t there in the first place,” she told Time magazine –because the indifference behind this lack of motivation can be a sign they don’t care enough about their partner, or their relationship to fight.

The sometimes beneficial nature of arguing was also backed up by a 2012 paper published by the Society for Personality and Social Psychology. 

This research showed that constructively having conflicts with your partner may bring you closer together because while they cause short-term discomfort, they also incite honest conversations that can benefit the relationship in the long run.

In saying this, clinical psychologist and author of Difficult People, Dr Rebecca Ray says that not all arguing is beneficial and the determining factor behind what is and isn’t, can have a lot to do with how you fight, or your fighting style and whether, as the researchers specified, it is constructive.

“A good fight is one where both partners face the problem from the same side, not necessarily the same perspective. That is, you are both committed to a resolution of the problem itself, rather than making each other the problem (which is a bad fight),” she tells Body+Soul.“A good fight is also one where both partners make room for each other’s perspectives and how difficult it can be to express vulnerability,” she adds.

Your fighting style is so important, believe psychologists and relationship experts, John and Julie Gottman, that it can be one of the best predictors of divorce.

After years of extensive research, the pair identified four primary predictors of divorce, coining them, the “Four Horsemen of the Apocalypse.” 

These predictors are criticism, contempt, defensiveness, and stonewalling, and when they are used when arguing with a partner, they can be a telltale sign of a bad fight says Dr Ray.

“A bad fight is full of accusations and contempt, ineffective listening, and the pressure on each other to be perfect or be met with punishment.” 

So, how do you work out your fighting style and if it is ‘bad’ or ‘good’?

“In my book, Difficult People, I discuss psychoanalyst Karen Horney’s three styles of interpersonal coping which, when used often enough, can become automatic and habitual in times of conflict,” says Dr Ray.

These include moving towards people (compliance); moving against people (aggression); and moving away from people (detachment).

“There are both healthy and unhealthy versions of each of these coping strategies,” she explains. “Unhealthy moving towards looks like habitual people-pleasing, which means one partner will have difficulty speaking up for their own needs and often end up resentful.

Unhealthy moving against looks like blaming, accusing, and generally aggressive communication, which can stop the other partner from feeling psychologically safe.

And unhealthy moving away looks like avoidance of addressing the problem altogether, or being indifferent to a workable outcome. While each of us will lean towards one of these tendencies, with awareness and willingness, conflict doesn’t have to be coloured by unhealthy versions of these coping strategies.”

How to have a ‘good’ fight

One simple change that can help move your argument from negative territory to somewhere more positive, is altering the language you use.

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“A good fight sounds like ‘I’ statements rather than ‘you’ statements,” says Dr Ray. “It also sounds like respectful language and tone,” she says, which means no yelling or swearing because this can be disrespectful in this context.

And while giving each other space and taking a break from the situation if things become tense can be helpful, there should be a willingness to return to solve the issue.

“A problem won’t be solved unless it’s brought into the light. Don’t sweep things under the carpet. Address them before they become too big to carry,” she says.

Complete Article ↪HERE↩!

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How the anti-gender movement is bringing us closer to authoritarianism

An all-gender restroom in San Francisco.

By Judith Butler

In the United States, gender has been considered a relatively ordinary term. We are asked to check a box on a form, and most of us do so without giving it too much thought. But some of us don’t like checking the box and think there should be either many more boxes or perhaps none at all. The myriad, continuing debates about gender show that no one approach to defining or understanding it reigns. It’s no longer a mundane box to be checked on official forms.

The anti-gender ideology movement, however, treats the range of sometimes conflicting ideas about gender as a monolith, frightening in its power and reach.

The fear of “gender” allows existing powers — states, churches, political movements — to frighten people to come back into their ranks, to accept censorship and to externalize their fear and hatred onto vulnerable communities. Those powers not only appeal to existing fears that many working people have about the future of their work or the sanctity of their family life but also incite those fears, insisting, as it were, that people conveniently identify gender as the true cause of their feelings of anxiety and trepidation about the world.

The project of restoring the world to a phantasmatic time before gender promises a return to a patriarchal dream order that only a strong state can restore. The shoring up of state powers, including the courts, implicates the anti-gender movement in a broader authoritarian, even fascist project. We see the rolling back of progressive legislation and the targeting of sexual and gender minorities as dangers to society, as exemplifying the most destructive force in the world, in order to strip them of their fundamental rights, protections and freedoms.

Consider the allegation that “gender” — whatever it is — puts children at risk through programs such as reading books with queer characters cast as examples of indoctrination or seduction. The fear of children being harmed, the fear that the family, or one’s own family, will be destroyed, that “man” will be dismantled, including the men and man that some of us are, that a new totalitarianism is descending upon us, are all fears that are felt quite deeply by those who have committed themselves to the eradication of “gender” — the word, the concept, the academic field and the various social movements it has come to signify.

The resulting authoritarian restrictions on freedom abound, whether through establishing LGBTQ+-free zones in Poland or strangling progressive educational curricula in Florida that address gender freedom and sexuality in sex education. But no matter how intently authoritarian forces attempt to restrict freedoms, the fact that the categories of women and men shift historically and contextually is undeniable. New gender formations are part of history and reality. Gender is, in reality, minimally the rubric under which we consider changes in the way that men, women and other such categories have been understood.

As an educator, I am inclined to say to these people, “Let’s read some key texts in gender studies together and see what gender does and does not mean and whether the caricature holds up.” Reading is a precondition of democratic life, keeping debate and disagreement grounded and productive.

Sadly, such a strategy rarely works.

A woman in Switzerland once came up to me after a talk I gave and said, “I pray for you.” I asked why. She explained that the Scripture says that God created man and woman and that I, through my books, had denied the Scripture. She added that male and female are natural and that nature was God’s creation. I pointed out that nature admits of complexity and that the Bible itself is open to some differing interpretations, and she scoffed. I then asked if she had read my work, and she replied, “No! I would never read such a book!” I realized that reading a book on gender would be, for her, trafficking with the devil. Her view resonates with the demand to take books on gender out of the classroom and the fear that those who read such books are contaminated by them or subject to an ideological inculcation, even though those who seek to restrict these books have typically never read them.

To refuse gender is, sadly, to refuse to encounter the complexity that one finds in contemporary life across the world. The anti-gender movement opposes thought itself as a danger to society — fertile soil for the horrid collaboration of fascist passions with authoritarian regimes.

We need to take a stand against the anti-gender movement in the name of breathing and living free from the fear of violence.

Transnational coalitions should gather and mobilize everyone the anti-gender ideology movement has targeted. The internecine fights within the field must become dynamic and productive conversations and confrontations, however difficult, within an expansive movement dedicated to equality and justice. Coalitions are never easy, but where conflicts cannot be resolved, movements can still move ahead together with an eye focused on the common sources of oppression.

Whether or not people are assigned a gender at birth or assume one in time, they can really love being the gender that they are and reject any effort to disturb that pleasure. They seek to strut and celebrate, express themselves and communicate the reality of who they are. No one should take away that joy, as long as those people do not insist that their joy is the only possible one. Importantly, however, many endure suffering, ambivalence and disorientation within existing categories, especially the one to which they were assigned at birth. They can be genderqueer or trans, or something else, and they are seeking to live life as the body that makes sense to them and lets life be livable, if not joyous. Whatever else gender means, it surely names for some a felt sense of the body, in its surfaces and depths, a lived sense of being a body in the world in this way.

As much as someone might want to clutch a single idea of what it is to be a woman or a man, the historical reality defeats that project and makes matters worse by insisting on genders that have all along exceeded the binary alternatives. How we live that complexity, and how we let others live, thus becomes of paramount importance.

There is still much to be understood about gender as a structural problem in society, as an identity, as a field of study, as an enigmatic and highly invested term that circulates in ways that inspire some and terrify others. We have to keep thinking about what we mean by it and what others mean when they find themselves up in arms about the term.

Complete Article ↪HERE↩!

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LGBTQ+ in Africa

— How the US far-right whips up homophobia

Sexual minorities say they have faced a wave of abuse since Uganda’s harsh anti-LGBTQ+ law was enacted last year

Tough laws targeting homosexual acts or abortion in African nations are often preceded by lobbying from American hard-liners. Often well-financed, these networks campaign against equality and diversity.

By Martina Schwikowski

Fundamentalist Christian churches from the United States are increasingly gaining power and influence in societies and political spheres across Africa. Many of them have been whipping up negative sentiments against LGBTQ+ people and abortion rights.

Haley McEwen, a sociologist at the University of Gothenburg in Sweden, has examined some of their influential networks.

“US Christian right-wing groups have been very active in the US foreign policy since the early 2000s,” McEwen told DW.

“There are several organizations that have been around since the 1970s — and in the early 2000s they started to increase their influence internationally.”

A protester joins supporters of the LGBTQ+ community as they stage a protest against a planned lecture by Kenyan academic Patrik Lumumba at the University of Cape Town
Conservative activists often portray LGBTQ+ people as alien imports who threaten African societies

The groups have expanded into African countries like Uganda, Nigeria, Kenya, Ghana and South Africa.

According to McEwen, the networks also focused on UN organizations “in response to the advances being made by the international feminist movement to gain recognition of sexual and reproductive health and rights within the UN frameworks.”

‘Hatred from outside our history’

These conservative activists — who describe themselves as “pro family” — seem only interested in safeguarding one special type of family: heterosexual, monogamous nuclear families ordained by marriage.

“We continue to advocate that this is hatred that is deliberately being stirred, that it is not organic and not within our history and it is actually producing the conditions for violence and assault of LGBTQ+ persons in Kenya,”Irungu Houghton, Kenya director at Amnesty International, told DW.

Homosexuality has always been being practiced discreetly in what is now Kenya, according to Houghton. British colonialists enacted the first laws that criminalized gay sex in the 1930s.

Influence comes with money

These days, it’s African leaders who introduce the new laws — which is why they’ve been targeted by far-right networks from the US.

According to McEwen, these groups want to win over African leaders in order to implement what is being described as “family friendly agendas” — both in their home countries and internationally at the United Nations.

McEwen said this influence was also being exerted by funding African organizations which domestically propagate “nuclear family” policies and oppose LGBTQ+ rights and comprehensive sexuality education.

There is a homegrown network of such groups in Africa, but according to McEwen, they heavily rely on funding from outside Africa.

Who’s funding the anti-LGBTQ+ sentiment?

UK-based media platform openDemocracy published a 2020 report that examined more than 20 American Christian groups.

The paper revealed that the groups — which are known for their campaigns against LGBTQ+ rights, access to safe abortion, contraceptives and comprehensive sex education — have spent at least $54 million (€49.5 million) in Africa since 2007.

One of these groups is Christian conservative organization Family Watch International (FWI) which, according to openDemocracy “has has been coaching high-ranking African politicians … to oppose comprehensive sexuality education (CSE) across the continent.”

Uganda signs anti-LGBTQ bill into law

In May 2023, Ugandan President Yoweri Museveni signed one of the world’s toughest anti-LGBTQ+ laws — including the death penalty for “aggravated homosexuality” — drawing Western condemnation and risking sanctions from aid donors.

According to activist Frank Mugisha, director of Sexual Minorities Uganda, FWI was highly influential in the genesis of Uganda’s legislation.

However, FWI said in a statement on its website that it is “opposed to the Uganda Anti-Homosexuality Act 2023” and it “opposes legislation that penalizes a person for having same-sex sexual attractions or for their gender identity.”

“Family Watch opposes the death penalty or harsh penalties in the context of Uganda’s pending law and other similar bills,” according to the statement.

Africa’s tough anti-LGBTQ+ laws ‘stirring up hatred and acrimony’

Shortly afterward, Uganda passed the law, and a Kenyan lawmaker proposed a bill that has often been described as “copy paste” of the Ugandan law. The Kenyan bill is still undergoing parliamentary procedures.

In Ghana, a similar bill was recently passed by parliament. But it’s still unclear when and whether president Nana Akufo-Addo will sign it into law.

“There is a direct link between the emergence of hate bills in Uganda and Ghana and now Kenya with these interests,” said Amnesty’s Houghton.

“We have been very concerned that this is not only focusing on stirring up hatred and acrimony between societies but is also focusing on reversing many gains with regards to comprehensive sex education and sexual productive health rights.”

Complete Article ↪HERE↩!

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

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

By Sophie Saint Thomas

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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How to be a sex positive parent?

— It is important to instill sex positivity in your kids. If you have been wondering how to be a sex-positive parent, here are some expert-approved ways that can help.

By Arushi Bidhuri

Sex is a natural part of our lives and it only makes sense to talk about sexuality in all its fairness. Yes, conversations about sex are still hushed and laden with stigma, but embracing a sex-positive approach as a parent becomes an important tool to shape the future of your child. With so many sexuality terms being thrown around, it is more important than ever to be a sex-positive parent and to teach kids how to be sex-positive.

For the unversed, sex positivity is a way of being that gives importance to pleasure and freedom, instead of shame and judgment. If you are confused about sex positivity and how you can instill it in your kid’s life, read on.

What is sex positivity for children?

In the most simple terms, sex positivity is believing that sex is a positive thing in a person’s life. Psychiatrist Dr Sanjay Kumavat explains, “Sex positivity is the way children are brought up with age-appropriate and adequate knowledge about their orientation, and the concept of sex. This comprises knowledge sharing with respect to sex organs, the importance of healthy relationships, all aimed at letting them know about sexuality positively.”

What makes a parent sex-positive?

There is never a right time to have the “talk” with your kid. However, it is still important to know that you must not avoid talking about sexuality with your children. It is important for their overall development. For a parent to be sex-positive, they need to be comfortable and have a clear understanding of what sexuality means.

“Sex-positive parents are not embarrassed to talk about sexuality openly and adequately. Adequate is the word I emphasise, because it should not be too much or less, and they should not be embarrassed about communicating about these issues. They should start talking as soon as the child starts developing secondary sexual characters, and when they see that the child is showing some interest in sexuality, like showing interest in cross-gender relationships and friendships,” says Dr Kumavat.

How to be a sex-positive parent?

If you have been wondering how to be a sex-positive parent without going overboard, here’s what you can do.

1. Have open communication

The first thing is to be open to your children by communicating your ideas and thoughts clearly. Be very open and always watch for the signs that your child is showing some interest in sexuality.

2. Do not judge

Parents should not suppress children. If they ask you queries, be open to clear their doubts. Even if parents find the queries stupid or which will require too much information sharing, the doubts shouldn’t be suppressed. Keep communicating with children and give them adequate information by resolving their queries and avoiding snapping at them, advises the expert.

3. Teach them about consent and safe sex

Make them aware of being guarded about sexuality, and the precautions to be taken. Talk to them particularly about sexuality under the influence of drugs and alcohol, or sexuality crossing the limits, which is not age-appropriate. Talk about appropriate touch, and how it should be an act of respect and compassion.

Also Read: 5 things to know about condoms to avoid unwanted pregnancy

4. Be vigilant

With so much information available, it can be confusing for kids to know what information they should consume or avoid. One of the biggest influences on kids these days is social media. Make sure that you know the kind of information your child is consuming through these platforms. Give them some guidance about what the problems are with believing things on this website, and the misinformation that is shared, recommends Dr Kumavat.

5. Limit internet access, but do not judge

It is important to help your child understand the ways to separate right from wrong. You have to make sure your kids are not hooked or addicted to certain kinds of inappropriate sites. Such kind of openness and guardedness also should be there as necessary. Don’t give too much access to the Internet – it has to be monitored and a judicious approach must be taken when giving internet access, says the psychiatrist.

Takeaway

Being sex-positive means that you think of sex as a positive thing and do not associate it with shame and guilt. It is vital to instill these values in your child to make sure they do not judge the world too harshly or feel judged for the choices they make. Your child should feel comfortable talking about sexual matters, feelings they get, ideas or thoughts that cross their mind, or how someone’s touch makes them feel. They should be able to define sexuality in a positive sense – one that allows them to be free and not caged. And there is not a better feeling for a parent to help their child understand who they are and be true to themselves.

Complete Article ↪HERE↩!

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Stress of Being Outed to Parents and Caregivers

— What Are the Mental Health Consequences?

‘Policymakers should be aware of the harms that bills targeting LGBTQ+ youth have on the well-being of students and strongly argue for their right to disclose their identities on their own terms’

By Danielle Faipler

In 2023, lawmakers across the U.S. introduced a record number of anti-LGBTQ+ bills. Although the 2024 legislative session has just begun, the American Civil Liberties Union (ACLU) is already tracking 429 bills, a figure on pace to surpass 2023 numbers.

The rise in anti-LGBTQ+ policy rhetoric has coincided with an increase in anti-LBTGQ+ violence. According to data from the Federal Bureau of Investigation’s (FBI) 2022 annual crime report, anti-LGBTQ+ hate crimes increased 13.8% from 2021. As more policy proposals are directed at LGBTQ+ youth, advocates are concerned about how children’s mental and physical well-being will be affected.

Ryan Watson, co-director of the UCOnn
Ryan Watson, co-director of the UConn SHINE Lab

“In recent years, we’ve seen an increase in anti-LGBTQ+ legislation targeting kids, and even though not all of these bills will become law, even the introduction of the bills may have an immediate and real impact on kids’ lives and their mental health,” says Ryan Watson, associate professor in the Department of Human Development and Family Sciences (HDFS).

Thirty-two such proposals have advanced in in the legislatures of Arizona, Hawaii, Missouri, New Hampshire, South Carolina, Oklahoma, Tennessee, Washington, West Virginia, and other states. At least six states have laws on the books to forcibly out students.

Lisa Eaton, co-director of the UConn SHINE Lab
Lisa Eaton, co-director of the UConn SHINE Lab

“It’s critical that as researchers we stay engaged in understanding and speaking out against legislative policies that have the potential to do real harm to LGBTQ+ youth, equally important is supporting policies that protect youth. These policies have the potential to greatly and quickly impact the lives of LGBTQ+ youth,” says Lisa Eaton, professor of Human Development and Family Sciences.

Despite social progress, SGDY experience higher levels of discrimination, bullying, and stress, depression, and anxiety compared to their cisgender and heterosexual peers, and these health disparities continue to grow. SGDY report experiencing bullying, violence, discrimination, and rejection based on their sexual orientation and gender identity. When youth choose to disclose their identity, they often consider the support they may receive.

To investigate the mental health consequences of sexual and gender-diverse youth (SGDY) whose sexual or gender identity is forcibly disclosed to their parents without their permission, a team of researchers at UConn’s Sexuality, Health, and Intersectional Experiences (SHINE) Lab conducted a study that was recently published in the Journal of Research on Adolescence.

Watson and Eaton, both are principal investigators at UConn’s Institute for Collaboration on Health, Intervention, and Policy (InCHIP), co-direct the SHINE Lab. The SHINE Lab conducts research to improve understanding of how sexual orientation and gender identity, family experiences, school contexts, and ethnoracial identity affect health outcomes among sexually and gender-diverse youth and adults.

Peter McCauley, second-year Ph.D. student in the Department of Human Development and Family Sciences
Peter McCauley, second-year Ph.D. student in the Department of Human Development and Family Sciences

“Unique stressors, like bullying based on sexual and gender identities, are experienced at a time when youth are meeting important developmental milestones; at this same time, SGDY are typically financially and legally dependent upon their caregivers. There is a critical gap of knowledge on how the manner of disclosure may be related to the well-being of sexual and gender diverse youth. Our study aimed to understand how experiences of being outed to parents were related to mental health,” says the study’s lead author Peter McCauley, a second-year HDFS Ph.D. student and research assistant at the SHINE Lab.

McCauley and his collaborators used data from the LGBTQ National Teen Survey collected in partnership with the Human Rights Campaign (HRC) between April and December 2017. Respondents were between the ages of 13 and 17, identified as LGBTQ+, spoke English, and were U.S. residents.

The team found that respondents who were outed (about 30%) to their parents were more likely to experience elevated depressive symptoms and lower LGBTQ family support compared to those who were not. Parents who affirmed and supported their child’s identity could potentially mitigate depressive symptoms from the stress of being outed.

The study demonstrates that a lack of agency in disclosing a sexual and/or gender identity to parents can greatly undermine the well-being of SGDY and indicate lower levels of family support. It also underscores the importance of enabling SGDY youth to have greater control over when they disclose their identities.

“A staggering number of anti-LGBTQ+ bills have been proposed that mandate school officials to out students’ identities to parents and caregivers. Policymakers should be aware of the harms these bills have on the well-being of students and strongly argue for their right to disclose their identities on their own terms,” says McCauley.

Complete Article ↪HERE↩!

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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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33 ways to have better, stronger orgasms

— Everything to know about the 11(!) types of orgasm.

By , and

Look, everyone wants to have a mind-blowing orgasm every time they have sex. But unfortunately, it’s not always that easy.

Only about half of women consistently climax during partnered play, and nine percent have never orgasmed during intercourse, per one study published in Socioaffective Neuroscience & Psychology. (Worth mentioning: The percentage of pleasure-seekers who do consistently O during sex is higher for women in same-sex relationships.)

So, why is the orgasm gap so big? For one thing, your entire body has to be ~in the mood~ when you’re attempting to orgasm, says Donna Oriowo, LICSW, CST, a certified sex therapist and owner of Annodright based in Washington, D.C. ‘Orgasms require both the physical and the mental, emotional component,’ she adds. This, along with a few other reasons (that Women’s Health will get into below!), can make them hard to come by.

If this gap sounds all too familiar, you don’t have to feel like all hope is lost. Here, sex experts explain everything you need to know to have an orgasm, whether you’re trying to ring the bell for the first time or take your O to another level of pleasure.

What’s an orgasm, exactly?

Let’s start with a basic definition. ‘Clinically, an orgasm is the rhythmic contractions of the genitals,’ Jenni Skyler, PhD, an AASECT-certified sex therapist and director of the Intimacy Institute, previously told Women’s Health US. It’s marked by vaginal contractions, an increased heart rate, and a higher blood pressure.

But how an orgasm feels, exactly, will vary from person to person. Skyler typically describes it as a ‘pinnacle of pleasure, or the capacity for the whole body and genitals to feel alive and electric.’

What are the different kinds of orgasms?

Each type of orgasm is named for the body part that’s stimulated in order for them to occur, including:

Clitoral Orgasm

The clitoris is the small, nerve-dense bud at the apex of the labia that serves no function other than to provide sexual pleasure (!). When orgasm happens as a result of clitoral stimulation—be it from your partner’s hands or tongue, or a clitoral vibrator—it’s called a clitoral orgasm. FYI: This is the most common type of orgasm for those with vulvas, says Ian Kerner, PhD, LMFT, a certified couples and sex therapist based in New York, New York, and the author of She Comes First.

How to have a clitoral orgasm:

  • Use lube. Remember: the clitoris is sensitive. If there’s not proper lubrication, ‘you can cause [yourself or your partner] pain unnecessarily,’ Oriowo says, especially if you start off using lots of pressure. Which brings me to…
  • Start slow and gentle. Add gradual pressure and stimulation as time passes. Feel it out, literally. That way, you can let your orgasm build and avoid experiencing any pain or discomfort.

Vaginal Orgasm

Less than one in five of those with vulvas can orgasm from vaginal intercourse alone, according to the Mayo Clinic. If you have an orgasm from vaginal penetration, without any direct clitoral stimulation, that’s a vaginal O!

How to have a vaginal orgasm:

  • Lube, lube, and more lube. Again, use lube to minimise any discomfort or irritation, Oriowo says. There’s nothing worse than *that* burning feeling that can result otherwise.
  • Find the right rhythm. Whether you’re solo or partnered, you’ll want to figure out what you like, and then (if you are with someone else), communicate your preferences. Then, the name of the game is ‘maintaining the rhythm when the person is having an orgasm—don’t change it up,’ Oriowo says.

Cervical Orgasm

Your cervix is the vaginal canal’s anatomical stopping sign. Located at the wayyy back of the vaginal canal, the cervix is what separates the vagina from your reproductive organs. But beyond just what keeps tampons from traveling into your bod (#bless), the cervix can also bring on some serious pleasure when stimulated.

How to have a cervical orgasm:

  • Be gentle. Since a lot of people can experience pain in this area, again, it’s best to start gently. If you experience any new sensations while dabbling in cervix play, make sure that they’re not painful, Oriowo adds.
  • Use a toy. Sometimes, a penetrative vibrator can hit those deep spots that a human being can’t. ‘A toy can shake things up with the cervical orgasm,’ she says.

G-Spot Orgasm

Often described as feeling more full-bodied than clitoral orgasms, G-spot orgasms occur from stimulating the G-spot, a nerve-packed patch of sponge located two (ish) inches inside the vaginal canal.

How to have a G-spot orgasm:

  • Warm yourself up. Use your fingers and warm up by touching (or having a partner touch) the G-spot area to prepare for deeper penetration, Oriowo says.
  • Move with purpose. If your goal is a G-spot orgasm, the same-old, same-old moves might not work. Instead, practice ‘picking your positions in a way that will help you to really get to the G-spot,’ she adds.

  • Nipple Orgasm

    A nipple orgasm is ‘a pleasurable release of sexual arousal, centred on nipple stimulation and not caused by stimulating the clitoris [or penis] directly,’ Janet Brito, PhD, a nationally-certified sex therapist and the founder of the Sexual Health School in Honolulu, Hawaii, previously told Women’s Health US.

    How to have a nipple orgasm:

    • Use a toy. ‘There are so many nipple toys that I think get left in the dust because we tend to buy toys for our genitals, but not necessarily our nipples,’ Oriowo says. So, invest in some nipple clamps or even a clit-sucking toy that you can use in *both* places.
    • Dabble in sensation play. It doesn’t have to be with a traditional toy, either. Ever tried a feather? An ice cube? You’ll def want to try different things to ‘enhance the pressure that we receive in that area,’ Oriowo adds.

    Anal Orgasm

    An anal orgasm is exactly what it sounds like: any kind of orgasm that ensues from anal stimulation. For some, this means stimulation of just the external anus (for instance, during a rim job). And for others, it means stimulation of the internal anal canal (for instance, with anal beads, a penis, or finger).

    How to have an anal orgasm:

    • Rimming = your best friend. Rimming, or analingus, is the act of someone performing oral sex on the ‘rim’ of the anus. It’s an important part of anal play because many of your nerve bundles are around the opening of the anus, not deep inside it, Oriowo says.
    • Ease into it. If you’re new to anal play and you’re interested in using toys, you’ll generally want to use something the size of a finger, Oriowo says. (And not the size of a penis!) And, of course, use lube. ‘However much lube you thought you needed… put a little bit more,’ she says.

    Blended Orgasm

    This is any orgasm that comes from stimulating two or more body parts. Nipples + anus = blended orgasm! Clit + vagina? Also a blended orgasm. ‘Bringing in sensations to the other areas of the body can also help to increase the strength of any orgasms,’ Oriowo adds. So, blended orgasms might feel extra intense.

    How to have a blended orgasm:

    • Be intentional upfront. Ask yourself which areas you want to stimulate, Oriowo says. If the clit is too sensitive for dual stimulation, for instance, target the G-spot or cervix instead, and add in some nipple play, too.

    Oral Orgasm

    An oral orgasm can be induced by someone going down on you, and it requires a couple of things, Oriowo says. For instance: Awareness of the giver’s lips and teeth, which can ‘enhance the sensation that a person is experiencing,’ she explains. So, you may want to graze your teeth along someone’s clit, but you defs won’t want to bite them—accidentally or not. (Ouch!)

  • Also, ‘paying attention to what your partner is responding to’ is super important, she adds. ‘If they’re saying they’re about to have an orgasm, continue doing what you are doing at the same pace and pressure.’ Noted.

    How to give an oral orgasm:

    • Incorporate teasing. Yup, sometimes just the anticipation of physical sensation can be enough to increase someone’s arousal. Try just ‘whispering near the vagina, but not quite touching it,’ Oriowo recommends, then move from there.
    • Use your tongue. ‘You can do oral in so many different ways,’ Oriowo says. Maybe you try light, tickling touches with the tip of your tongue, interchanged with a broad, deep stroke with your entire tongue.

    A-Spot Orgasm

    The A-spot is between the vaginal opening and the bladder, ‘about two inches higher than your G-Spot, along the front vaginal wall,’ Oriowo says. You know how you have some spongy tissue in your G-spot area? Well, the A-spot is a bit deeper. If you can’t feel it, that doesn’t mean it’s not there, she says—it just means that your A-spot might not be as sensitive.

    How to have an A-spot orgasm:

    • Incorporate a toy. Because this area is deeper than the G-spot, you might want to use a toy to reach it rather than a finger. Still, you can try to move your fingers from side to side (rather than a penetrative in-and-out motion), and you might be able to find the A-spot better.

    U-Spot Orgasm

    The U-spot orgasm is a urethra-based orgasm, Oriowo explains. Therefore, her biggest tip is to be gentle when stimulating the area, then listen to what your partner is requesting (or what your body is telling you, if you’re going solo). After all, ‘this is the area where urine exits the body,’ she says. (Oh, and you’ll definitely want to lube up, too.)

    How to have a U-spot orgasm:

    • Start with fingers. This tip especially applies to those who are just starting to explore the area. ‘The fingers give you a little bit more control,’ she says. Oriowo also recommends exploring down there by yourself first before doing so with a partner. ‘Then, you know what kind of pleasures you’re already capable of,’ she adds.
    • Then, show and tell. After you’ve gotten the swing of things, guide your partner through the process so they don’t end up accidentally hurting you. That way, they can learn ‘how to do it on their own without your guidance eventually,’ she continues.

    Exercise-Induced Orgasm, or Coregasm

    Amazing news for anyone who loves working out: Some people are able to engage the core and pelvic floor in a way that will result in an orgasm. ‘Orgasms are created through the increase in tension and then its release,’ Oriowo says. ‘Engaging your abdominal muscles, often [is] going to be pulling on, or stimulating, the pelvic floor muscles, as well.’ And the rapid release can create a beautiful O.

    Can I have multiple orgasms in a short time period?

    Yes! This happens when you’re in a semi-aroused state and your genitals are resting a bit, Kerner says. ‘Assuming you potentially transition into the right kind of foreplay activities, you would be primed to experience genital stimulation again that would result in a second orgasm,’ he explains.

    Anyone can have multiple orgasms, but it does depend on the person—some people are more likely to have multiple Os than others, Brito says. And again, depending on the person, their second (or third) orgasm after the first may or may not feel as powerful.

    Jennifer Wider, MD, a women’s health expert, author, and radio host, encourages practicing Kegel or pelvic floor-strengthening exercises to strengthen your pelvic muscles in pursuit of an orgasm. By doing these contractions during the initial orgasm, a second or third may be possible, when combined with stimulation to another area.

    ‘Remember, the clitoris is usually a bit sensitive after the first orgasm, so moving to another erogenous zone and going back to the clitoris after a short break can help,’ she says.

    How to have an orgasm:

    Achieving consistent, mind-blowing orgasms is kind of like winning the lottery. Sounds amazing, but basically a pipe dream, right? With these little tricks, it doesn’t have to be.

    1. Prioritise cuddling.

    In the name of boosted oxytocin, rather than saving spooning for after sex, spend some time snuggling up pre-play.

    Known as the ‘love hormone,’ oxytocin might be the key to better orgasms, according to a study in Hormones and Behavior. The study found that couples who received oxytocin in a nasal spray had more intense orgasms than couples who took a placebo.

    Since you probably don’t have oxytocin nasal spray on your nightstand, try giving yourself the same jolt of the hormone naturally by hugging, cuddling, or making other gestures to show your love to your partner. Your post-cuddle O might just surprise you.

    2. Don’t skip right to penetration!

    According to Kerner, having an orgasm requires a few key ingredients:

    1. Vasocongestion (i.e. blood flow to your pelvis);
    2. Myotonia (muscular tension throughout your body);
    3. The brain’s natural opiate system being turned on (because it triggers oxytocin)

    The best way to get these ingredients? ‘Gradual[ly] building up arousal, rather than a race to orgasm,’ he says. In other words, slow down and build both physiological and psychological arousal. Trust, the end result will be worth the wait.

    3. Focus on positions that favour the clit.

    Wider suggests focusing on sex positions that directly stimulate the clitoris during penetrative sex. ‘That can provide a consistent orgasm in the majority of [people with vulvas],’ she says. Try rider-on-top, which allows you to grind your clit against your partner, or rear entry, with you or your partner stimulating your clitoris. Kerner agrees that being on top generally makes it easier for people with vulvas to cum.

    4. Use a vibrator.

    Vibrators are literally made to help you orgasm, after all. ‘Vibrators increase the frequency and intensity of orgasms—whether you’re alone or with a partner,’ says Jess O’Reilly, PhD, a Toronto-based sexologist and host of the Sex with Dr. Jess podcast. She suggests starting with a vibrator that will target your clitoris, G-spot, or both. A few to get you started:

    5. Think about your cycle.

    If you feel like your orgasms have been meh or not even there lately, consider trying to time sex around your cycle. Generally, your libido peaks during ovulation—that’s about two weeks before your period shows up—so the chances of having an orgasm will go up during this time period, Wider says. ‘There may be an evolutionary basis for this, because those with vulvas are most fertile at this time during their cycle,’ she adds.

    FYI: This is especially important if you’re exploring cervical orgasms. That’s because, as O’Reilly previously told Women’s Health US, some people are more likely to have cervical orgasms during ovulation. If having your cervix touched feels painful but you’re still curious, try it during a different time of the month to see if it feels better.

    6. Make sure you have lube on hand.

    Lube reduces uncomfortable friction and allows you to ‘safely engage in a wider range of acts, techniques, and positions,’ O’Reilly says. Not only that, it also ‘leads to higher levels of arousal, pleasure, and satisfaction,’ she says.

    7. Whip out a fantasy.

    Adding a little psychological stimulation to the equation can help enhance physical stimulation, which is why Kerner recommends fantasising on your own or with your partner. ‘Fantasy is also a powerful way to take your mind off other stressors or any other anxieties you may be experiencing,’ he says. And, for the record, ‘it’s okay to fantasize about someone other than the person you’re having sex with,’ Kerner says. (Maybe just keep that info to yourself, though.)

    8. Try sensation play.

    ‘The simple act of turning off the lights, closing your eyes, using a blindfold, or wearing sound-canceling headphones can help you to be more mindful and present during sex—and lead to bigger, stronger orgasms,’ O’Reilly says. ‘This is because the deprivation of one sense can heighten another, so when you remove your sense of sight or sound, you may naturally tune into the physical sensations of the sexual encounter.’ But before you tie an old tube sock around your boo’s eyes, just be sure to ask for consent first.

    9. Feel yourself up in the shower.

    Sure, you shower to get clean, but you can also have some fun when you’re in there. ‘It’s very simple: As you shower, rather than touching to wash yourself, take one minute to touch for sensuality and pleasure,’ O’Reilly says. ‘Feel your skin, take a deep breath, and bask in the heat and warmth that surrounds your body.’ This can help you de-stress and get in touch with what feels good to you—and that can do you a solid when you’re in bed later, she says.

    10. Take an orgasm ‘break.’

    On a similar note, ‘sometimes taking a masturbation and orgasm break for a day or two can be a good “refresh,”‘ Kerner says, noting that people sometimes ‘report stronger orgasms during masturbation after taking a short break.’ If you can, try taking sex or solo love off the table for a day or so and see where that gets you. A simple reset may be just what you need to ramp things up.

    11. Make the most of *that* time of month.

    Raise your hand if Os are, like, significantly better on your period. (My hand is all the way up.) While that may not be the case for everyone because orgasms feel different for every person, it’s good to take note of when your Os feel the best. ‘Some people do say that they’re more likely to feel aroused before their period or during their period, and that might have to do with hormones, but then other people say that’s not true for them,’ Brito says.

    As an added bonus, period sex has the power to literally make you feel better physically. ‘Orgasm has analgesic effects,’ Kerner adds. ‘If you experience sometimes pain or heavy cramping or even headaches during PMS, orgasm could actually help to relieve some of those symptoms.’

    12. Make your fave positions feel that much more intense.

    Stick to your fave sex positions, but get your clit in on the action with the help of a clitoral vibe. Or, take matters into your own hands by bringing your digits downstairs.

    ‘A nice combination is pressure and friction against the glands of the clitoris,’ says Kerner. ‘That is sometimes why a combination of external and internal stimulation can really enhance and get the most out of the potential for orgasm.’ Make sure your focus is within the first few inches of the vaginal entrance, he says.

    13. Be present.

    It can be super easy to get distracted before or during sex. But the best Os come from when you (either alone or with your partner) are in the mood for it.

    ‘The main thing that can affect a woman’s orgasm is not being fully absorbed or present—fully absorbed in the flow of the sexual experience or having that flow interrupted,’ Kerner says. So, try your best to get rid of distractions or other environmental factors.

    You can also practice some mindfulness before you head to the bedroom…

    And on that note, make sure you and your partner’s arousal is synced up. To do that, communicate before, during, and after sex to make sure the experience is going well for all involved.

    14. Don’t let intercourse be the main event.

    Outercourse, which is exactly what it sounds like—everything but penetration—deserves just as much attention, if not more. Make sure there’s a healthy balance of outercourse versus intercourse during sexy time. ‘There’s lots of outercourse positions that provide better or more higher quality clit stimulation,’ Kerner says. ‘That’s gonna generate an orgasm.’

    15. Practice positive handwriting.

    Communication is everything in relationships, and when it comes to sex, it’s even more so. Positive handwriting is when you help guide your partner’s hand around your body, showing them how you like to be touched rather than have them try to guess how you like it.

    ‘That teaches them the rhythm that you want or the circular motion or the speed,’ Brito says. ‘By you knowing yourself, you’re able to teach your partner how to do it for you.’

    16. Take the pressure off of being goal-oriented.

    Obviously, everyone wants to experience ~the big O~, but TBH, just being along for the ride is fun enough. When you have a goal, you’ll automatically feel more under pressure, and sex is supposed to be fun, not stressful.

    ‘The main thing is not having that as a goal in mind,’ Brito says. ‘When it becomes more goal-orientated, it gets a little bit bit harder to do that because now you’re in a performance mode.’ Try to focus on the sensations you’re feeling instead.

    17. Try yogic breathing.

    ‘Some people have luck elongating their orgasm through breath work,’ Wider says. For a longer and stronger orgasm, she suggests yogic breathing, which is a breathing technique used in yoga where you control your breath according to postures.

    Wanna DIY? Take a longer breath right before you climax and then breath through the orgasm instead of holding your breath during it, Wider recommends. That ‘may actually extend the length of it,’ she adds.

    18. Figure out what kind of foreplay you like best.

    This extends your level of arousal, Kerner says. Touching, talking dirty to one another, feeling up your erogenous zones, role playing, and sharing fantasies can all help draw out the period of foreplay and in turn, help make your orgasm *that* much better. You can also try getting in ~the mood~ by listening to a sexy audiobook, reading something, or watching porn, if that’s not usually your vibe.

    ‘For some people, it might help them to engage in some type of erotica,’ Brito says. ‘That can help someone have a better orgasm because their mindset is there.’

    19. Make it a full-body experience.

    Don’t just focus on the downstairs neighbor. ‘You wanna be able to activate the nerve fibers throughout your body that are sensual and respond to stimulation—so you don’t wanna just start with your genitals, you wanna start with a more full-body experience of yourself,’ Kerner says.

    Whether it’s really engaging all of your senses or experiencing with touching different parts of yourself, like your nipples, don’t count any body parts out.

    20. Don’t shift your stimulation right before you’re about to orgasm.

    Kerner says it’s a common instinct to do something different right before a woman reaches orgasm, like shifting their position or way of stimulation. ‘That can really interrupt the orgasm itself in ways that might make it harder to get back on track,’ he says. ‘It’s important that whatever is happening that is generating orgasm, that that continues in a consistent, persistent way.

    So, figure out what your partner likes, and if it’s going well, follow through!

    21. Lean into pregnancy sex.

    Like ovulation orgasms, pregnancy orgasms have the potential to feel *real* good. ‘There’s so much blood that’s sort of just pulling in the pelvis and in the genitals, and so much of arousal is about blood flowing into the genitals,’ Kerner says. So pay attention to those pregnancy Os, because they might be higher quality than during other times, he says.

    22. Remove judgment.

    It’s easy for people to feel shame or guilt around masturbation, sex, or general sexual pleasure depending on one’s upbringing, Brito says.

    ‘Ideally, you’re approaching your body in a loving, caring, compassionate way and being very curious and open to exploring your body parts, including your erogenous zones,’ she adds. ‘It’s like, ‘This is another body part, and I’m open to exploring this area in a loving way.’ It’s a form of self-care.’

    And she’s right—it’s your ‘you’ time! Make sure you have a healthy mindset so you can fully enjoy it.

    23. Be aware and vocal of how the sensations feel.

    It’s easy to get out of sync with your partner during sex, so make sure you’re on the same page by communicating. ‘Sometimes sex is painful and a woman isn’t aroused enough, or the sex causes some kind of pain,’ Kerner says. ‘Generally, men don’t experience sexual pain during sex in the way that women can.’

    If anything isn’t feeling right, make sure to be assertive about it with your partner.

    24. Don’t be afraid to step outside your comfort zone.

    In addition to removing judgment from your mindset, you’ll also want to stay curious and open-minded when it comes to exploring your body, whether it’s with a partner or not. If you’ve always been a little intrigued by anal toys or BDSM, consider tapping into something new. After all, sometimes the most unexpected things give you the greatest Os. (And you can quote me on that.)

    25. Combine types of touch.

    Didn’t you hear? Only stimulating the vagina is, like, so yesterday. Combining different types of touch can look different for everyone—it could be using your hands to stimulate your nipples while you’re getting fingered, or fully using a sex toy while getting massaged all over your body. ‘The more types of touch you engage in, the more intensive it could be,’ Brito says.

    26. Embrace the mini Os.

    Sometimes, people with vulvas experience ‘wavelike feelings of orgasms, or mini orgasms sometimes leading up to an actual physiological orgasm,’ according to Kerner. Often, they think they’re having multiple orgasms, but they’re actually just little peaks and highs before the climax. And they still feel great, so be on the lookout (feel-out?) for any feelings representative of that description.

    27. If you’re not feeling it, consider why.

    Sex is never fun if you aren’t feeling good about yourself, and self-esteem issues are a particular roadblock on the way to an orgasm, Kerner says. If you suddenly aren’t in the mood or you’re feeling bad about yourself mid-act, think about why, and try to get to the root of the issue.

    28. Invest in a new toy.

    Sometimes you gotta mix it up—I get it! If you’ve had a bullet vibrator for while and you’re ready to jump into more intense toys head-on, go for it.

    The type of vibrator you try will depend on the type of stimulation you enjoy—and the type of orgasm you’re interested in exploring. A vibrating butt plug or string of vibrating anal beads will bring a whole lot of ‘oh baby!’ to your backside, while vibrating nipple clamps will make you tingle and giggle without any between-the-leg lovin’.

    29. Use lube on more than just your downstairs area.

    If you’re willing to get a little creative, lube can seriously elevate your sex game in surprising ways. Try to lube up your favorite toy before some solo sex, or even use some on your nipples. Just remember not to use oil-based lube with condoms (it’ll disintegrate the latex) or silicone-based lube with silicone toys (it’ll damage your toys and cause an environment rife for bacteria), Jordan Soper, PsyD, CST, an AASECT-certified sex therapist and licensed psychologist previously told Women’s Health US.

    30. Maintain stimulation throughout the entire O.

    It might sound obvious, but make sure to keep the stimulation going until you know it’s over. ‘Maintaining stimulation through an orgasm, the entirety of an orgasm can get the most out of the duration of an orgasm,’ Kerner says. Longer orgasms? Yes, please.

    31. Tighten your pelvic muscles.

    This tip is especially helpful for G-spot orgasms. ‘The G-spot is located inside the vagina up toward your navel,’ Wider says. Not only will firm, deep penetration help to hit the spot, but also, some [people with vulvas] find it’s helpful to tighten their pelvic muscles during rhythmic sex,’ she adds. Again, you can try Kegel or pelvic floor-strengthening exercises to help this area.

    32. Try edging.

    Edging is when you’re masturbating or engaging in sexual activity, creating a buildup, and stopping before you orgasm, then continuing the cycle over again. Literally, what’s hotter than bring yourself and/or your partner to almost climax, but then not allowing yourself or them to? Sheesh. ‘That can definitely make you have a more intense orgasm,’ Brito says.

    33. Know your body.

    At the end of the day, you know your own body best. Sex toys aren’t for everyone, just like manual stimulation isn’t for everyone, either. Take time to be with yourself and figure out what you like best to maximize your experience, either alone or with partner(s). ‘Do what works for you, arousal levels should build gradually—some [of those with vulvas] enjoy manual stimulation, others prefer toys,’ Wider says.

    Once you know what you like, you can help others in assisting to give you your best orgasm yet.

    Frequently Asked Questions

    Is there a difference between a ‘male’ and ‘female’ orgasm?

    First off, people with vulvas *can* ejaculate through the form of squirting. However, they ‘can both squirt and have an orgasm at completely separate times,’ Oriowo explains.

    On the other hand, people with penises typically experience orgasms that include ejaculation a majority of the time. It is possible for them to have an orgasm without ejaculating, she says—it’s just rarer. Also, some might say that it’s ‘easier’ for those with penises to orgasm than those with vulvas, which leads me into the next question…

    What is the ‘orgasm gap’?

    This is the difference ‘between how often men have orgasms versus how often women who have sex with men have orgasms,’ Oriowo says. ‘Women who have sex with women are more likely to have orgasms than women who have sex with men.’

    I don’t think I’ve had an orgasm before—what can I do?

    There are a few things to get you started.

    Get psychological.

    Aside from exploring your body—likes, dislikes, the whole shebang—’sometimes, we are having mental emotional hangups that are preventing us from being able to connect with our bodies,’ Oriowo adds. For instance, sometimes shame plays a role when you first start to masturbate, she says.

    If it’s affecting you, she recommends looking into therapy or using a workbook or guide that goes over those feelings. Overall, you’ll want to think about the narrative you have around pleasure, masturbations, and orgasms that are preventing you from being able to have one.

    Consider your lifestyle choices.

    Both smoking and drinking a lot of alcohol can negatively impact your ability to experience orgasms. Smoking can affect your circulation, and increases the risk of erectile dysfunction for men. Because people with vulvas have similar tissue sets, especially in the clitoris, ‘that is going to impact the sensations that you’re having and the blood flow to your own clitoris,’ which is what causes an orgasm to feel so good.

    Alcohol, on the other hand, impacts the ability to feel sexual stimulation. So, maybe skip that third pre-sex glass of wine, and instead fully feel the sensations that might lead to an orgasm.

    Hydrate, hydrate, hydrate.

    Yup, you can add better chances of orgasming to the long list of positive effects that hydration has on the body. ‘Hydration really helps with best orgasm results,’ Oriowo says. ‘We are literally walking around here dry, wanting our bodies to perform at peak levels for our orgasms—but lack of hydration can also lead to lack of vaginal lubrication, natural lubrication.’ So, drink that water!

    Drinking enough water will also help blood flow and your muscles will be hydrated enough to move, both of which will help your orgasm. Wins, all around!

    Complete Article ↪HERE↩!

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Can Microdosing Help Heal Sexual Trauma?

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

By Kiki Dy

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

Psychedelics and Sexual Trauma: An Overview

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

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

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

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

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

Then, a psilocybin retreat changed everything.

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

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

The Therapeutic Potential of Microdosing

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

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

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

But does the science behind microdosing support her experience?

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

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

The Bottom Line

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

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

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

*Name has been changed to protect privacy.

Complete Article ↪HERE↩!

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How to Close the ‘Orgasm Gap’ for Heterosexual Couples

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

By Meghan McDonough

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

[CLIP: Music]

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

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

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

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

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

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

McDonough: To “orbiting …”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Klein: Sex doesn’t exist in a vacuum.

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

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

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

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

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

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

Complete Article ↪HERE↩!

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6 Questions to Ask Your Doctor About Sex after 50

— Vaginal dryness, erection challenges, safe sex and more

By Ellen Uzelac

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

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

Starting the conversation about sexual health

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

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

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

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

1. What can I do about unreliable erections?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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

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

By and

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

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

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

What is a throuple relationship?

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

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

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

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

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

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

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

Why might someone want to be in a throuple?

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

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

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

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

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

What are some tips for being in a healthy throuple?

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

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

1. Make sure you set ground rules first.

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

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

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

2. Continue to communicate.

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

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

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

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

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

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

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

What are some of the myths about throuples?

1. They’re purely sexual relationships.

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

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

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

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

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

3. They’re not natural.

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

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

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

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How to Explore Your Sexuality, according to Science

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

By Meghan McDonough

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

[CLIP: Intro music]

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

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

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

But first, let’s get real basic.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

McDonough: This is called the “challenge area.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Watnick: And my whole brain lit up.

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

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

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

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

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

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

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

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True romance

— How to keep the love alive when you fight

‘A big blow-out can clear the pipes’

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

By

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The science of sex

— What happens to our bodies when we’re aroused?

Sex helps with sleep and allows the brain to switch off

It’s good for our mental and physical health, lowering blood pressure and boosting the immune system

By

Sex is the most talked-about, joked about, thought-about topic in our culture. Every grown adult is expected to know how to do it, but beyond the basic mechanics we’re not taught about it and fiction is coy. We are not short of information on sexual practices – thank you, Fifty Shades of Grey – but there is a general absence of accurate detail of what happens to our bodies during, and as a result of, the act.

Yet sex is good for our mental and physical health. It lowers the heart rate and blood pressure. It may boost the immune system to protect us against infections and it certainly lowers stress. The NHS even recommends it, in a section tucked away on its website, where few are likely to find it, that advises: “Weekly sex might help fend off illness.”

The consultant obstetrician and gynaecologist Dr Leila Frodsham thinks we should be better educated about it. She’s even supporting a project to open a Vagina Museum in Camden, London – after all, there is a Penis Museum in Iceland. More information could make us healthier, happier and save the NHS lot of money, she believes.

“People who have difficulties with sex are much more likely to present with other problems,” says Frodsham. She would like to see more investment in sexual health as preventive medicine.
When hooking up is working out

Sex can be good exercise, although that rather depends on how energetically you go at it. A study in the open-access journal Plos One in 2013 found that healthy young heterosexual couples (wearing the equivalent of a Fitbit) burned about 85 calories during a moderately vigorous session, or 3.6 calories a minute. It’s unlikely to be enough. The NHS says: “Unless you’re having 150 minutes of orgasms a week, try cycling, brisk walking or dancing.”

Tales of men having heart attacks and expiring on the job are much exaggerated. Sex raises the heart rate, which is generally a good thing. A study in the British Medical Journal of 918 men in Wales in 1997 found that sex helped protect men’s health. Men who (admittedly from their own report) had more frequent orgasms had half the risk of dying over the 10 years of the study compared with those who had the least orgasms. As a general rule, if you are able to walk up two flights of stairs without chest pain, you are probably safe to have sex, experts say.

The key to many of the health benefits of sex is the love hormone – oxytocin. Also sometimes called the cuddle hormone, it can even be released when petting your dog. The same hormone causes contractions in childbirth and is in the pessaries given to induce labour. It’s even in sperm. It’s not a myth that sex can help an overdue baby get going. When she was working as an obstetrician, Frodsham says, male partners used to “leave grinning from ear to ear because I’d suggest having sex on all fours to make labour come on”. There’s plenty of oxytocin around when people have sex or even just get friendly. “Any touch releases oxytocin,” says Frodsham. Keeping up physical activity affects libido, she says. “If you don’t use it, you lose it.”

She doesn’t often see people with intrinsically low libido, she says. “But we do see people who kind of get into a sexual rut and it sort of disappears. I often encourage people to schedule sex. A lot of couples feel that it is not natural and it is forcing things, but sometimes you need to get them to become habitual so they can become spontaneous.”

Sex helps with sleep, and allows the brain to switch off. “If you are having sex, you should be getting into a zone where your brain is not in overdrive,” she says. It’s like mindfulness. “I don’t think there are many people who actually give themselves time to relax any more,” she says.

Prof Kaye Wellings, at the London School of Hygiene and Tropical Medicine, blames our busy lives for a decline in sexual activity in Britain. Her large recent study of 34,000 men and women, in the British Medical Journal, suggests we are having less sex than we were a decade or more ago. Half of the women and two-thirds of the men told researchers they would prefer to have sex more often. Wellings says the digital age is partly to blame. “We are bombarded with stimuli. I can see that the boundary between the public world and private life is getting weaker. You get home and continue working or continue shopping – everything except for good old-fashioned talking. You don’t feel close when you are on the phone.”

The sexual response, step by step

The best explanation of what actually happens during sex is still credited to two scientists who started work in 1957 – William Masters and Virginia Johnson – although later researchers have criticised parts of their work.

Masters and Johnson worked at Washington University in St Louis, Missouri. Masters convinced Johnson to have sex with him in the interests of research while he was married to someone else. He eventually divorced and they married in 1971, splitting up 20 years later. Together they founded the Masters and Johnson Institute where they carried out their research and trained therapists.

In a book called Human Sexual Response, published in 1966, they described a four-stage cycle in heterosexual sex. First is the excitement or arousal phase in response to kissing, petting or watching erotic movies. A small study by Roy Levin in 2006 found that almost 82% of women said that they were aroused by their nipples being fondled – and so did 52% of men.

Half to three-quarters of women get a sex flush, which can show as pink patches developing on the breasts and spreading around the body. About a quarter of men get it too, starting on the abdomen and spreading to the neck, face and back. Men quickly get an erection but may lose it and regain it during this phase.

Women’s sex organs swell. The clitoris, labia minora and the vagina all enlarge. The muscles around the opening of the vagina grow tighter, the uterus expands and lubricating fluid is produced. The breasts also swell and the nipples get hard.

Masters and Johnson say there is then a plateau phase, which in women is mostly more of the same. In men, muscles that control urine contract to prevent any mixing with semen and those at the base of the penis begin contracting. They may start to secrete some pre-seminal fluid.

The third stage is orgasm, in which the pelvic muscles contract and there is ejaculation. Women also have uterine and vaginal contractions. The sensation is the same whether brought about by clitoral stimulation or penetration.

Frodsham says about a third of women easily have orgasms from penetrative sex, a third sometimes do and a third never do. “I have never seen anything that could be a G-spot,” she says. But the clitoris is much larger than some people assume. “The clitoris actually surrounds the vagina. The protuberance is only 5% of the clitoris.”

Women can quickly orgasm again if stimulated, but men cannot. Last is the resolution phase, when everything returns to normal. Muscles relax and blood pressure drops. But, says Cynthia Graham, a professor in sexual and reproductive health at the University of Southampton, “we still don’t understand everything about what happens even though research has been going on since Masters and Johnson’s early lab studies”.

Take the female orgasm, for instance. “Women report so many different sensations. Some women describe orgasm in a much more focal way. Some describe it in a diffuse way with, for instance, a tingling down their legs. Some women describe losing consciousness.”

And then there is the male erection. A healthy man may have three to five erections in a night, each lasting around half an hour. The one many wake up with is the last of the series. The cause is unknown, but there are suggestions of a link with REM (rapid eye movement) sleep, when people are most likely to dream. Even in the daylight hours, erections are not necessarily under conscious control. Usually they are associated with sexual arousal, but not always.

There is an assumption that sexual desire and libido are strongest in the young and fade out as we age. But there is plenty of evidence of people wanting sex and having sex at older ages. For women, the menopause can be a real obstacle. The loss of oestrogen leads to vaginal and vulval dryness. Frodsham points out that hormonal treatments, from oestrogen tablets in pessaries delivered locally into the vagina to creams and gels, are safe and effective. But so is having regular sex, she says. It’s like exercising a muscle.

“There is very good evidence, particularly in menopausal women, that the more they have sex, the better their physiology is,” she says.

But she cautions against the current enthusiasm for promoting the health benefits of sex for all ages. “There can be a kind of pressure on older adults who don’t want to. A lot of older adults do, but not everybody. There’s no norm about sexual desire.”

However biologically similar we may have been at birth, the one thing that is certain is that sexual desire and preference – as well as means of achieving satisfaction – differ from one individual to the next. Frodsham, for one, thinks enhanced understanding could boost our mental and physical health. And, she believes, it needs to start early.

“Many schools present sex as something that is going to cause STIs and pregnancy,” she says. They’re missing something important, she adds: “They don’t talk about the very natural reason to want to have sex, which is pleasure.”

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