Category: SEXUAL HEALTH

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A Guide to Using Prostate Massagers

By Nina Smith

When it comes to sex toys, most people automatically think about the toys that are used for female pleasure. Men, however, don’t have to be sidelined when it comes to using toys in the bedroom.

Prostate massagers are a largely unexplored part of sexuality for most men, but we believe that the stigma around male sex toys needs to be broken. If you or your partner are looking to experiment with a prostate massager, here is everything you need to know before diving in.

What is a Prostate Massager?

If you weren’t already aware, men can experience orgasm through prostate stimulation. In fact, it is said that a prostate-induced orgasm is the male equivalent of a woman’s orgasm through her G-spot. Some experts even refer to the male prostate as the P-spot.

It is a different kind of orgasm than the one you would experience through stimulation of the penis due to the difference in muscle contractions that occur during the climax. A penile orgasm typically involves four to eight muscles, but a prostate orgasm involves around a dozen muscles. This makes for a far more intense orgasm.

If you are looking to experience this more intense climax, then it’s time to bring in the help of a prostate massager. If you are having sex with someone with female genitalia, or if you are engaging in solo sex, a prostate massager is going to be the best way to experiment with prostate stimulation. Although these orgasms may be more satisfying, they also require more skill to achieve. But with a little bit of time and practice, you are sure to be achieving unbelievable orgasms in no time.

A prostate massager will look similar to a standard dildo. While some dildos are designed to mimic the shape and appearance of a penis, others have a sloped design to hit the female G-spot. Prostate massagers look more similar to the latter. The “come hither” design on G-spot dildos and prostate massagers help the device to hit in just the right spot.

Many of these designs come with a second head or “rabbit” design which allows for the vibration to hit not just the P-spot internally, but also externally. The external head will rest right between your anus and scrotum while the internal one will be inserted. Most devices will come with a variety of vibration settings for you to test out so you can find what works for you.

Where to Get a Prostate Massager

Although we find no shame in walking into a sex shop and asking to purchase a prostate massager, we are also aware that everyone’s comfort level surrounding this topic is different.

If you are looking for a discrete way to acquire a prostate massager, you will be glad to learn that many shops that sell prostate massagers online will ship their products in discreet packaging and some will even disguise the charge on your credit card. This is great for people who live with roommates, family, or anyone else that you want to keep out of your private sexual activities.

How to Use it

So now that you know all about prostate massagers and the orgasms that you can achieve, let’s talk about how to actually use one. If this is your first time inserting anything into your anus, you are going to want to take your time. Try not to force the device in. Instead, wait for your muscles to relax before insertion. And don’t be afraid to use lubrication to help everything go more smoothly.

Once you are able to insert the prostate massager, you are going to want to experiment with what feels good. This typically involves finding the right places to stimulate yourself. Move the device around and experiment with different vibration modes to find what you like, and before you know it you’ll be having orgasms that you never even thought were possible.

Clean Up

This should go without saying, but make sure that you clean your prostate massager after each use. Some devices are designed to be used in the shower or bath so cleanup will be easy if you purchase one of these waterproof designs.

If your design isn’t fully waterproof, make sure you read the instructions before cleaning so you know how to properly wash and care for your toy without damaging the electronic parts.

Start Experimenting!

If you are ready to break the stigma around male sex toys and start having intense and incredible orgasms, it’s time to try out your first prostate massager. Use it on yourself, or have a partner help you out to spice things up in the bedroom. Everyone deserves a little fun every now and then, so what are you waiting for?

Complete Article ↪HERE↩!

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LGBTQ+ mental health

— From anxiety to abuse, how to better protect yourself and seek support

by Jamie Windust

Open dialogue around mental health is becoming more consistent every single day. Whether it be in the workplace or at home, as a society we are learning to talk more about what’s going on in our minds.

But what if you’re LGBTQ+? Often we face specific challenges that our non-queer counterparts don’t face. Anxieties around coming out or transitioning can make life hard in ways that we can’t always openly share.

To help out, GAY TIMES sat down with LGBTQ+ psychiatrist Dr David McLaughlan to ask some of the most common questions LGBTQ+ people have surrounding their mental health. See this as a resource to save and keep handy whenever you feel like there isn’t a space to have your questions answered.

Is there anything LGBTQ+ people should avoid doing if they’re struggling with their mental health?

Be wary of ‘quick fixes’ or self medicating with drugs and alcohol. It almost always makes things worse. I’d also avoid bottling things up. If something doesn’t seem right, don’t just leave it and hope it gets better by itself. Sometimes it can feel frightening asking for help, but almost no one regrets it once they’ve done it. It’s a bit like coming out – liberating and a relief.

Who should LGBTQ+ people try and speak to if they’re worried about their mental health?

You should speak to anyone you feel comfortable with. The most important thing is just speaking to someone. It could be your best friend, your sibling, a neighbour or even a stranger. Sometimes just hearing yourself acknowledge your own mental health out loud can be the first step. I’ve had patients who told me that they began by journaling first. This helped them reflect upon their thoughts and feelings by themselves before they felt confident enough to talk about it out loud with another person.

What do you see most in LGBTQ+ people who come and speak to you about their mental health?

Lots of my LGBTQ+ patients have experienced trauma or adverse life events. Sometimes there is a significant event which triggered an initial deterioration in their mental health, such as an assault. However, there often is an insidious accumulation of trauma or adverse life effects which accumulate over time.

These are things like bullying, discrimination or micro-aggressions. It can happen anywhere; at home with family, in the workplace or out in public when using public transport for example. On a cellular level, trauma or an adverse life event exposes our neurons (the cells in the brain responsible for receiving sensory input from the external world) to the stress hormone cortisol, which is cytotoxic. This means that stress literally kills brain cells… In studies, scans have shown that people exposed to trauma or repeated adverse life events have structural differences in their brains.

In terms of diagnosis, I see a lot of anxiety disorders within the LGBTQ+ community. Anxiety disorders are a diverse range of conditions which include Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), Panic Attacks as well as Generalised Anxiety Disorders and specific phobias. For example, Agoraphobia.

I also see lots of substance misuse. There are specific trends and patterns of substance misuse within LGBTQ+ subcultures. For example, the use of Crystal Meth within cis-gay men engaging in chemsex compared to an older cis-gay woman may be more vulnerable to alcohol abuse, often characterised by drinking alone at home.

One of the things I always try to communicate and recognise is that we are a really diverse community, with diverse biological, social and psychological experiences and accordingly, our needs are really diverse which makes it tricky sometimes to understand and support everyone. However, the key is to continuously listen and actively seek opportunities to learn.

What are your top tips for handling anxiety around coming out?

It’s okay to feel anxious about coming out. It can be a really big deal for some people and it’s not always easy. Each of us has a different set of circumstances that we have to navigate when we come out. Our families, friends, homelife, cultural background, careers and environment all play a big part in the experience of coming out.

However, sometimes when we are really anxious we imagine that things will be much worse than they really will. These negative predictions about the future can be affected by a cognitive distortion called ‘catastrophisation’. In this situation, our mind goes into ‘what if’ mode, automatically imagining the worst possible thing that could happen.

It might be worth gently challenging some of these predictions. Ask yourself, ‘Is it possible that I could be catastrophising?’, ‘Are there other possible outcomes which aren’t as bad?’.

The most important thing is doing it when you feel safe and ready.

What should LGBTQ+ people do if they’re struggling with alcohol or drug dependency?

LGBTQ+ people are disproportionately affected by drug and alcohol misuse as well as mental health difficulties. Despite this, they’re less likely to ask for help, with 14% reporting a fear of discrimination as the barrier to seeking mainstream support. 

According to Stonewall’s LGBT Health In Britain Report (2018) and the UK Household Longitudinal Study (Becares. L 2020)

  • 1 in 6 LGBTQ+ people said they drank alcohol almost every day over the last year
  • 1 in 5 Gay, Bisexual or Trans men drank alcohol almost everyday over the last year compared to 13% of LGBT women and 11% of non-binary people
  • 52% of LGBT people experienced depression in the last year
  • LGBT older women are almost twice as likely as heterosexual women to have harmful drinking habits. 

This was, in part, why I co-founded Jitai – an app which helps people reduce or cut down drinking. I felt passionately that everyone who wants to reduce or quit drinking, should be able to access support, regardless of their sexuality, gender or financial status.

The app will offer a range of personalised tools and techniques such as mindfulness, breathing exercises and its own unique motivation board to help beat temptation. In our first pilot study, 90% of our users told us that we had helped them achieve their goal of cutting down or quitting drinking. 

We’ve had some really incredible feedback from users which was amazing and made me realise that we are really helping people. 

What’s the best way to deal with social anxiety as an LGBTQ+ person?

A lot of LGBTQ+ people experience social anxiety. We grew up in a world where being ourselves was potentially something dangerous or put us at risk of bullying or social exclusion. 

One of the exercises that I do with my patients at The Prior Hospital in Roehampton is an attention training exercise. I ask my patients to practise shifting the focus of attention away from themselves and onto the world around them. 

Stage 1 is to recognise when you are experiencing self-conscious thoughts, feelings or bodily sensations. For example, thoughts such as ‘everyone is staring at me, I sound so stupid’.

Stage 2 is about shifting the focus of your attending away from our internal world and fixing it onto the world around us. Start by taking a few deep breaths, then looking around you. What can you see? Do you notice anything interesting about the shapes, colours or textures? How would you describe an object you’re looking at to someone who had never seen it before? Can you take a curious, non-judgemental approach and work through each of your five senses to draw the focus of your attention away from yourself and onto the world around you?

Your mind is like a muscle. This exercise can be tricky at first, but gets easier with practice.

Complete Article ↪HERE↩!

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Walk Your Way to Better Erections

— Taking a stroll for as little as 30 minutes a day can improve sexual health.

By Lauren Dodd

Seeking to improve your sex life as the new year kicks into gear? This one isn’t all that difficult. Resolve to walk your way to better erections.

Men who experience erectile dysfunction (ED), the consistent inability to get or maintain an erection satisfactory for sexual intercourse, may benefit from incorporating more heart-pumping physical activity—as little as a 30-minute walk—into their 2023 routine.

More than 30 million men in the United States experience ED, which can lead to higher rates of depression and anxiety. ED is generally seen as a growing public health concern. But a portion of ED sufferers may be able to improve their condition by simply adding extra steps to their daily life.

Medical conditions such as cardiovascular disease, the leading cause of death in men, produce changes to the penis’s blood flow and are common causes of ED, as blood flow is necessary to achieve and sustain an erection. Without the need of a doctor or a prescription, better sexual health may literally be around the corner for men who resolve to lace up their sneakers and head outdoors.

Better erections could be just a few steps away

Walking, one of the most popular forms of exercise in the world, is also one of the cheapest. No gym membership required.

Increasing your daily steps can be as easy as parking farther away from entrances or opting to take the stairs rather than the elevator. As little as 40 minutes of moderate to vigorous exercise four days a week—a grand total of 160 minutes—sustained over the course of six months can improve ED caused by physical inactivity, obesity, hypertension, metabolic syndrome and/or cardiovascular disease, according to a 2018 systematic review that looked at a decade of erectile dysfunction research.

Moderate exercise can be achieved by walking briskly at a pace of 4 mph or bicycling at a pace of 10 to 12 mph, according to Harvard research. Another Harvard study found walking 30 minutes a day was linked with a 41 percent decline in risk for ED.

Considering the leading causes of ED are atherosclerosis (hardening of the arteries) and diabetes, additional physical activity may improve more than just erectile function.

People who took 12,000 steps a day had a 65 percent lower risk of dying over the course of 10 years compared with those who took 4,000 steps a day, one 2020 study found.

“Higher step counts were also associated with lower rates of death from heart disease and cancer,” the study stated.

Quitting smoking or vaping and reducing alcohol consumption in the new year may also lead to better performance in the bedroom. Heavy smokers, even younger ones, are twice as likely to develop ED than their nonsmoking peers.

Heavy drinking doesn’t help, either. One study found men’s “episodic erectile failure” occurred at “significantly higher” rates in those consuming more than three standard units of alcohol a day. (One standard unit is any drink that contains 14 grams of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism.)

Maintaining a healthy weight is essential

The risk of developing ED and losing sexual function increases along with a man’s waistline, according to Harvard research. A man with a 42-inch waist is 50 percent more likely to have ED than one with a 32-inch waist.

Regular physical activity such as walking can aid vascular health. It helps arteries by boosting nitric oxide production, thereby increasing blood flow to the penis and making it easier to get an erection.

One of the first suggestions Susan MacDonald M.D., a urology specialist at Penn State Health in Hershey, Pennsylvania, offers her male patients is to lose a little weight.

“There is an obesity epidemic in America, so odds are most of your readers have five to 10 pounds to lose,” MacDonald said. “If they were to start walking, that would help.”

Quitting smoking is another one of her top recommendations for men experiencing ED.

“If we’re making New Year’s resolutions here, stopping smoking is a huge one,” MacDonald explained. “I think if you’re smoking, you’re paying double, because you’re paying for the cigarettes and you’re paying for [medication] to fix the erectile dysfunction it’s causing.”

Symptoms of erectile dysfunction should be taken seriously because a man’s penile dysfunction may be the first red flag of other illnesses and disorders, she said.

“In most cases, it’s the disease process leading to the ED,” MacDonald said. “In cardiovascular disease, we see the ED before we see the heart attack.”

Walking can curb more than erectile dysfunction

Walking has been proved to lower blood pressure, ease joint pain, curb sweet-tooth cravings and improve sleep. It can also help ward off breast cancer, heart disease, stroke, and early onset Alzheimer’s disease and dementia.

During peak flu and cold seasons, walking is another way to boost your immune system to fend off germs. It can increase bone health and bone density in osteoporosis patients and improve a person’s balance.

In addition to physical benefits, walking can offer mental health perks, such as improving feelings of sadness, anxiety, anger and depression.

But as with anything, the trick to picking up a new exercise habit is to do so safely.

Anyone taking to the streets should map out a path in advance, use sidewalks when possible, choose a well-lit area, be aware of major changes in the weather, stay hydrated and wear bright, reflective clothing. If sidewalks are unavailable, public school tracks and indoor shopping malls can be additional areas to squeeze in a little extra physical activity.

Be sure to consult a primary doctor before making changes to your diet and exercise routine.

If lifestyle and diet changes improve your overall health but erectile dysfunction persists, even intermittently, a wearable device free of the negative side effects of medication may help restore sexual function. Eddie® is an FDA-registered Class II medical device designed to treat erectile dysfunction and improve male sexual performance. Its specific shape optimizes blood flow as it puts pressure on the veins of the penis but not the arteries.

Complete Article ↪HERE↩!

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Blue Balls

— A Cause of Testicular Pain

Anyone who has ever experienced “blue balls” can tell you that it is a painful and frustrating consequence of sexual arousal. Of the many causes of pain in the testicles and scrotum, blue balls are the most benign. It is not a serious medical condition, but that does not make it any less tolerable. Here is what you need to know about blue balls and what you can do to relieve the pain.

By Kristopher Bunting, MD

  • Blue balls (epididymal hypertension) is a real condition that causes pain and tenderness in the testicles and scrotum after prolonged sexual arousal without ejaculation or orgasm.
  • Blue balls is temporary, usually lasting no more than a few hours, but can be relieved through sexual release, a cold shower or cold compress, or the Valsalva maneuver.
  • Severe, persistent, or worsening scrotal or testicular pain may indicate a medical emergency, not blue balls.

What are blue balls?

Blue balls also called “lover’s nuts” or epididymal hypertension is a condition that causes scrotal and testicular pain. Epididymal hypertension can occur after prolonged sexual stimulation without sexual release. In other words, being sexually excited by foreplay or other sexually arousing activities that do not end in ejaculation or orgasm can lead to tender and painful testicles.

Medically speaking, the condition known as blue balls is poorly understood. There is little to no research into the causes and treatments of epididymal hypertension and there is only one known case report present in the current medical literature. This lack of published research is because epididymal hypertension is not a medical emergency and has no long-term negative effects on health. It is a real condition, but it is nothing to be alarmed about.

What are the symptoms of blue balls?

The primary symptoms of blue balls are pain and tenderness in the scrotum and testicles. The skin of the scrotum can also develop a slightly bluish tint. The experience varies between individuals but can be described as aching, heaviness, or fullness of the testicles. The discomfort may also be felt in the groin and lower abdomen. Blue balls do not cause swelling, bleeding, discharge, or fever. The pain subsides within a few hours (or less) without requiring treatment.

What causes blue balls?

While epididymal hypertension is not well understood, it is believed that a buildup of excess blood in the testicles after sexual arousal causes blue balls. Blood flows into the penis and testicles during sexual arousal and normally leaves the genitals after achieving orgasm. However, when the blood does not leave the testicles it can lead to pain.

Treating blue balls

There are several ways to relieve the pain of blue balls:

Give it time: blue balls typically only lasts for a few hours at most before resolving on its own.

Sexual release: ejaculating or having an orgasm through intercourse or masturbation can relieve blue balls quickly.

Cool it down: taking a cold shower or applying a cool compress (such as a towel soaked in cold water) may help relieve the pain of blue balls.

Try the Valsalva maneuver: the Valsalva maneuver can help relax blood vessels, allowing blood to leave the testicles.

Other recommendations for relieving the pain include distracting yourself to take your mind off of sexual arousal or exercising to increase blood flow out of the groin.

Other causes of testicular pain

Having blue balls can be a very unpleasant experience, but it is not a serious medical issue. However, many other conditions can cause pain in the testicles and scrotum, including some serious medical emergencies. Pain in the testicles and/or scrotum that is severe or is associated with bleeding, discharge, nausea, vomiting, fever, or swelling can indicate a serious medical condition. If you have symptoms other than mild to moderate pain or discomfort that lasts for up to a few hours, you should seek medical help immediately.

Testicular torsion is a medical emergency that can cause intense scrotal and testicular pain that usually comes on suddenly. Epididymitis or orchitis causes painful inflammation of the testes due to an infection that requires medical treatment. Testicular varicoceles can also cause testicular or scrotal pain. Varicoceles are caused by enlarged veins in the scrotum, similar to varicose veins, that can feel like a ”bag of worms”. While this is not an emergency, it may affect fertility.

Sexual arousal without sexual release can lead to blue balls, a real medical condition that causes pain in the scrotum and testicles. It is a temporary condition that resolves on its own and does not require treatment, but there are steps you can take to relieve the pain. Sexual release is the fastest way to relieve pain from blue balls, but this should never be used as an excuse to pressure anyone into sex.

While blue balls are not a serious condition, pain in the scrotum or testicles should always be a cause for concern. Seek immediate medical attention for severe or persistent pain in the testicles lasting more than a few hours.

Complete Article ↪HERE↩!

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Staying Healthy While Staying Open

— The Polyamory Dilemma

By Jenna Fletcher

Angie Ebba, 42, of Portland, OR, has two local girlfriends, one long-distance partner, and a platonic life partner.

Ebba is polyamorous, having multiple intimate romantic relationships at the same time. Her partners know about each other and have consented to the arrangement, she says.

Polyamory is becoming more common in the United States. In 2021, one in nine Americans said they’d been in polyamorous relationships, and one in six said they wanted to try it, according to a study by researchers at the Kinsey Institute.

While a high level of transparency is required to make polyamory work, those who practice it don’t always feel comfortable sharing their relationship status with health care professionals. The fear of disclosure is not unfounded. Of the those in the Kinsey study who said they weren’t and had never been interested in polyamory, fewer than 15% said they respect people who engage in the practice.

“I hear all the time from patients who have sexual questions and issues but are uncomfortable talking to their doctors or even other therapists,” says Ian Kerner, PhD, a psychotherapist and sex therapist in New York City. “As polyamorous systems are still on the outskirts of the mainstream, some doctors may have implicit biases or explicit judgments, especially if they are lacking in experience.”

Roadblocks to Care

People who practice polyamory face unique health issues. These include a potentially higher risk of sexually transmitted infections (STIs) from having multiple sexual partners, and anxiety or depression stemming from managing multiple relationships.

“It is of particular importance in OB/GYN given the risk of STI transmission, and its consequences such as infertility, vaginal discharge, and systemic illness,” says Cheruba Prabakar, MD, the CEO of Lamorinda Gynecology and Surgery in Lafayette, CA. “Disclosing information will allow the provider to think about the patient more holistically.”

Ebba does not tell her doctors about her personal life. She knows other people in these relationships who have felt judged in clinical encounters, and she avoids disclosure unless absolutely necessary.

“Primarily, I don’t let my providers know because I’ve already in the past faced discrimination and awkwardness for being queer; I don’t want that for being poly as well,” she says. “If I can avoid it, I will.

A study from 2019 of 20 people in consensual non-monogamous relationships – which can include polyamory – found most of them reported challenges in addressing their health care needs related to lack of provider knowledge, not enough preventive screenings, and stigmas that impacted their health and trust in the medical system.

“Polyamorous people often have trouble seeking out health care because they fear being judged by their doctor or other clinicians who don’t understand or respect their lifestyle choices,” says Akos Antwi, a psychiatric mental health nurse practitioner and co-owner of Revive Therapeutic Services in Rhode Island and Massachusetts. “They may also be reluctant to share information about their relationships with providers who aren’t familiar with the complexities of polyamory.” Sharon Flicker, PhD, a clinical psychologist and assistant professor of psychology at California State University-Sacramento, says she understands why people are worried about discussing the topic of multiple relationships with their health provider.

“Health care providers’ interactions with patients are often shaped by their mono-normative assumptions, that monogamy is ideal and deviations from that ideal is pathological,” she says. “Non-disclosure presents a barrier to sensitive care that meets the individualized needs of the patient.”

Flicker says health care professionals can seek training to reduce their biases, and to better understand and address the unique needs of people involved in consensually non-monogamous relationships. In addition, offering to answer any questions that a doctor might have after disclosure can open the door to dialogue, according to Prabakar.

“They may be simply embarrassed to ask, as many may not be familiar with” polyamory, Prabakar says.People in polyamorous relationships also can look for affirming language on the websites of health providers, which may mention welcoming patients of all sexual orientations or gender identities. A first appointment can serve as an interview to find out what kind of terms a provider uses when referring to non-monogamy.

Safely Navigating Sexy Time With Multiple Partners

Prabakar says sexual health and safety is at the forefront for her patients in polyamorous relationships because they are engaging with multiple partners.

She recommends anyone who has multiple partners use condoms and dental dams for the prevention of STIs, like herpes and gonorrhea, in addition to receiving regular screening tests for the diseases.

Tikva Wolf, from Asheville, NC, says she’s been in polyamorous relationships for 20 years. She says she has strict boundaries for engaging in new romantic relationships to protect her sexual health: She has sex only with people who know their current STI status, are clear communicators, and use protection.

“If the conversation feels awkward, or they don’t seem to know what they’ve been tested for, I don’t engage in sex with them,” she says. “I don’t start romantic partnerships with people unless they’re on the same page about relationships, and I don’t have casual sex.” Wolf says her actions toward transparency mirror the greater community of people who engage in polyamorous relationships.

Monogamy is the default setting, so there’s a tendency to be more transparent about specific preferences upfront in any relationship that doesn’t quite fit into that standard box,” she says.

Some research backs up Wolf’s hypothesis. A 2015 study in The Journal of Sexual Medicine found that polyamorous people reported more lifetime sexual partners than people in monogamous relationships, but were more likely to report using condoms and be tested for STIs. About one-quarter of monogamous partners reported having sex outside of their primary relationship but not informing their primary partner.

Kerner explains that each partner in a polyamorous relationship may have different ideas about sexual activity; some partners may be interested in casual sex, while others are interested in maintaining steady primary and secondary relationships.

“These systems are always different, and without clear boundaries, honesty, and communication – for example around the use of protection – the potential to contract an STI within the system increases,” and the potential for the polyamorous relationship to not work increases, he says.

Taking Care of Mental Health

Not only does a polyamorous lifestyle require talking about sexual health and romantic boundaries, it demands an openness with feelings as they come up.

“Couples in a polyamorous relationship don’t fully anticipate the emotional response they might have to their partner being with another person,” says David Helfand, PsyD, a therapist in St. Johnsbury, VT, who has worked with many polyamorous couples.

People may have feelings of insecurity or jealousy, which can lead to anxiety in navigating the complexity of multiple relationships.

“The first time your spouse goes on a date with another person, or you hear them in the bedroom with someone else, it can create an intense emotion that you might not know how to process or have been prepared for,” Helfand says.

Seeing a therapist can help with processing emotions raised by dating multiple people. Ebba says she sees a therapist regularly, in part for help setting boundaries on how much time to spend with different partners. “Poly relationships can be great because you have more support people in your life,” she says. “But you’re also giving more of your time and energy away too.”

Complete Article ↪HERE↩!

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Maintaining Your Sex Life After Prostate Cancer

Sex may be different after prostate cancer treatment, but it can still be enjoyable

If you have prostate cancer and your healthcare provider recommends treatment, you might be wondering how your sex life may or may not be affected. You’re not alone if you have questions about this, as this is a common concern.

“Treating prostate cancer is about treating the whole person,” says urologist Raevti Bole, MD. “We have many effective therapies to help you resume intercourse if that’s your goal. But we want you to feel like you can talk to your provider and partner about your issues or concerns.”

Dr. Bole explains how your sex life may evolve after treatment and answers some commonly asked questions.

Can you have sex after prostate cancer?

Sexual and urinary side effects are common after prostate cancer treatment. “But yes, we can help most people get back to a satisfying sexual experience, though this may look different after treatment,” says Dr. Bole.

There are two gold-standard treatments for prostate cancer:

  • Radical prostatectomy removes your prostate gland and the two small glands at the base of your prostate called seminal vesicles. Pelvic lymph nodes may also be removed as part of this operation.
  • Radiation therapy delivers radiation to your entire prostate to destroy cancer-specific cells, and often the pelvic lymph nodes as well. If you opt for radiation therapy, you may receive androgen deprivation therapy to reduce testosterone in your body. This combined approach provides improved overall treatment.

New treatment options, such as high-intensity focused ultrasound therapy and cryotherapy, are being investigated for the potential to treat focused areas of the prostate gland and potentially lessen sexual side effects. But these treatments are typically only an option for certain types of prostate cancer, and you may eventually need a prostatectomy or radiation therapy down the line. Consultation with a urologist who specializes in prostate cancer is the best way to determine if you’re a candidate for any type of focal therapy.

Sex after prostate biopsy

To confirm a diagnosis of prostate cancer, you need to have a biopsy. During this test, your healthcare provider collects a sample of prostate tissue to look for cancer. They can do this in one of two ways:

  • Transrectal biopsy: This biopsy occurs by inserting an ultrasound probe into your rectum and then using a needle to pass through that probe to get the sample cells from your prostate.
  • Transperineal biopsy: This biopsy is taken by inserting a needle into the skin of your perineum (the area of skin between your genitals and your anus) to remove sample tissue cells from your prostate.

Though you may be sore for a couple of days, there aren’t any restrictions on sexual activity after having a biopsy. It’s common to notice old blood in your ejaculate for up to a month or two. This typically goes away on its own as you heal and isn’t associated with pain. Infection is a risk after a biopsy, though the risk is much lower when it’s taken through your perineum.

“For the vast majority of men undergoing an uncomplicated biopsy (either transrectal or transperineal), long-term sexual function should not be affected,” reassures Dr. Bole.

In most cases, if you’re feeling well, you should be able to ejaculate or have sex again when you feel ready. If you participate in receptive anal sex, you should wait for two weeks or until you’re fully healed, especially if you had a transrectal biopsy. But if you experience any blood, pain or swelling, you should refrain from sexual activity until you meet with your healthcare provider.

Sex after prostatectomy and radiation therapy

Once your provider confirms a diagnosis, they’ll discuss your treatment plan with you. Both prostatectomy and radiation therapy can affect your sexual performance in the following ways:

Anal sex safety

Your anus doesn’t create its own lubricant, so the tissue inside of your anus is delicate and susceptible to tearing. Luckily, that tissue heals relatively quickly. If you have anal sex, it’s important to let your surgeon know before you have your prostate removed. Your surgeon will help you determine when it’s safe to insert anything anally. In most cases, it’s OK to participate in anal sex after six weeks.

“Know your body and take your time,” advises Dr. Bole. “If you’ve waited to heal after prostate removal, but you have anal intercourse and notice pain or blood, talk to your surgeon who may advise you to wait longer.”

In some cases, having your prostate removed may affect your ability to enjoy receptive anal sex.

Erectile dysfunction after prostate cancer treatment

For some people, undergoing prostate cancer treatment can result in some difficulty getting or maintaining an erection. This erectile dysfunction (ED) occurs because the nerve bundles that help control erections sit behind your prostate.

Surgeons make every effort to leave these nerve bundles intact, but the nerves may become damaged. If the tumor has grown into your nerve bundles, your surgeon may remove the nerves entirely.

“Erectile dysfunction is not uncommon after prostate cancer surgery, but the level of effect is variable in the short and long term,” explains Dr. Bole. “Your prognosis depends on your erectile function before treatment, your age and whether your nerves were spared. Erectile function can improve for up to two years after surgery, but it’s possible that it does not return to normal. This is also affected by natural aging and any other health conditions you have.”

Radiation therapy can also affect the nerves around your prostate depending on the type of radiation, your age and health conditions. According to Dr. Bole, in general, five years after radiation therapy, about half of people have some level of erectile dysfunction.

Orgasm after prostate cancer treatment

You can orgasm after prostate cancer treatment, but it usually results in a dry orgasm. With a dry orgasm, no fluid comes out of your urethra when you climax. But you can still feel the pleasurable sensation of climax.

Why do you have a dry orgasm? If you had a prostatectomy, the procedure removes the seminal vesicles (which produce and hold your semen) and cuts the vas deferens, so there isn’t any semen to come out. And radiation therapy causes the tissues in and around your prostate, including your ejaculatory ducts, to become fibrous, or stiff and dense. Although there isn’t a reliable treatment to improve a dry orgasm, it’s a common condition where up to 90% of people who receive radiation therapy can develop dry orgasms over time.

Climacturia after prostatectomy

Climacturia is when you leak any drops of urine during an orgasm. Though this number can vary, on average, climacturia can occur in about 25% of people after prostate removal. Studies have found that of these people, only half of them have enough climacturia to be bothersome.

Lack of interest in sex after prostate cancer treatment

Androgen deprivation therapy often accompanies radiation therapy and reduces testosterone production in your body. When you have low testosterone, you could experience a decrease in your sex drive (libido). “The general stress and anxiety of treatment may also affect your desire to have intercourse,” notes Dr. Bole.

Infertility after prostate cancer treatment

If you’ve had your prostate removed, you can’t get someone pregnant through intercourse. After surgery, you no longer produce semen, which carries sperm when you ejaculate. Radiation therapy also reduces semen production and affects your ability to make sperm.

If you’re considering having children, talk to your healthcare provider before prostate cancer treatment. There are several options for preserving fertility before cancer treatment or retrieving sperm (if you have them) after treatment.

Treatment options for ED after prostate cancer treatment

Sex is often different after prostate cancer treatment, but it can still be enjoyable. “Treatments for ED are often focused on penetrative intercourse,” says Dr. Bole. “But the sexual experience is often not just about penetration. We work with you to discuss your goals for sexual health or intimacy with a partner.”

Treatments for ED include:

Erectile dysfunction medications

There are many medications to treat ED, including Viagra® and Cialis®. “These medications are often the first treatment we recommend,” says Dr. Bole. “They are inexpensive, and if you don’t like them, or they don’t work well for you, you can stop taking them at any point.”

Penile rehabilitation

The goal of penile rehabilitation is to reduce the risk of permanent ED before you have treatment. It focuses on increasing oxygenation and preserving the structures of the erectile tissues to prevent long-term damage. The theory is that helping people regain erections earlier than later after treatment could prevent long-term damage. Think of it as a “use it or lose it” approach.

This is an active area of research and there’s no standard protocol that’s been proven best for every person, says Dr. Bole. Your oncology team may recommend their preferred protocol, such as oral medication, to promote the early return of erectile function and, hopefully, longer-term recovery.

Penile injections

Medication you inject into the base of your penis, called intracavernous injections, can improve your ability to stay erect. Your healthcare provider can teach you how to inject the medication for times when you want an erection.

“The medication takes about 10 or 15 minutes to take effect and may not be the best option if you have a fear of needles,” notes Dr. Bole. “But if you’re looking for a better erection after prostate treatment, and the oral medications are not working, injections can be very effective.”  

Vacuum constriction device

A vacuum erectile device (also known as a penis pump) draws blood into your penis to help you get an erection. Usually, it comes with a rubber ring you slip down over the base of your penis to hold the blood in. It can be a good option if medications aren’t working well or you don’t want surgery.

Surgery

There are several types of penile implants to improve erections, including:

  • Malleable prosthesis, a noninflatable implant that’s always semirigid and you bend it up or down.
  • Inflatable implant, a device placed in your penis that inflates using a pump in your scrotum.

Climacturia treatment

If you have climacturia, pelvic floor muscle therapy can help you improve urinary control. This noninvasive treatment involves simple exercises to strengthen the muscles that help regulate urination.

Surgery is another option. Your healthcare provider can insert a sling made from synthetic mesh-like surgical tape around the area of your urethra to reposition it. The pressure caused by the sling often helps prevent leakage.

People with climacturia may also experience erectile dysfunction. “In the instance you experience both, we can do a combined surgery to put in a penile prosthesis and a sling to address both problems,” says Dr. Bole.

Therapy for you and your partner

Sex therapy, couples therapy and support groups are important resources for people who’ve undergone prostate cancer treatment and their partners. Sex can often be an uncomfortable topic, especially if you or your partner are experiencing changes in sexual behavior and are unsure of how to communicate your feelings. If you’re experiencing shame or embarrassment, or feel like you’re inadequate, please know that these side effects of prostate cancer treatment are common and (in most cases) treatable with the right tools and therapies.

Some therapeutic options that can be beneficial after your treatment include:

  • Couples therapy centers around your relationship with your partner. It can help resolve conflicts and find ways to communicate better about things that are upsetting to you and your partner. A couples therapist can help you discuss these issues, so they don’t interfere with your relationship.
  • Sex therapy focuses on sexual intimacy and helping couples show affection with and without penetration. That may include the use of sex toys or other activities you may not have considered before. Some sex therapists even specialize in working with people who have or who’ve had cancer.
  • Support groups connect you with others going through the same experience as you. They can help you understand what to expect and how others have handled specific challenges. Many people find support groups as a source of hope and comfort, and your healthcare provider can help connect you to these resources should you need them.

“Our goal is to make sure you live the longest, healthiest and most fulfilling life possible,” says Dr. Bole. “We treat cancer to protect your life, then we help get back your quality of life. If intimacy and intercourse are important to you, we can help you get back to experiencing those again safely.”

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How Does Disability Affect Sex?

— People living with disabilities are often assumed to be asexual, which can have disastrous effects on their well-being. Humans are inherently sexual and, as such, deserve to have safe and pleasurable sexual experiences and be free to explore their sexuality and gender.

By Rhiannon John, MSexol

  • Many people within society view people living with disabilities as asexual, leaving them with little access to sexual and reproductive healthcare and education.
  • People living with disabilities are sexual beings and are entitled to safe and pleasurable sexual experiences and to explore their sexual and gender identities.
  • Mobility, fatigue, and pain can affect the sex of someone living with a disability. However, there are multiple toys and positions that can be used to help alleviate some of these issues.

Although limited mobility, pain, and fatigue may affect a person’s sex life, certain toys and positions can aid in pleasure.

How does disability affect sex?

Having a disability can affect sex in several ways, particularly for people with limited mobility, chronic pain, and fatigue. However, this doesn’t mean that those living with a disability cannot enjoy a healthy and pleasurable sex life, as having a physical or cognitive disability doesn’t limit a person’s sexuality.

Humans are inherently sexual and have sexual thoughts, feelings, desires, and fantasies. However, many people within society view people living with disabilities as ‘asexual,’ not wanting to have sex, or not experiencing sexual feelings. This stereotype can affect people living with disabilities in numerous ways, including diminishing self-confidence, desire, ability to find a partner, and ability to view themselves as sexual being. People living with disabilities exist along the same spectrum as nondisabled people, with varied sexual orientations and gender identities.

Those living with mobility issues and chronic pain may have to approach sex a little differently than they’d like to. However, there a sex toys designed specifically to help with this issue for those who’d like to engage in solo sex. For those wanting to engage in sex with a partner, several positions and tools can help alleviate pain and maximize pleasure.

How to maximize pleasure while living with a disability?

Give yourself permission to be sexual

Sadly, research has found that people living with disabilities often internalize the asexuality stereotype, which diminishes their sexual desire and arousal. However, all humans are sexual beings that deserve sexual pleasure. Permitting yourself to be sexual, both solo and with a partner, allows you to reclaim your sexuality and cultivate a pleasurable life.

Allowing yourself to be a sexual being has added benefits, particularly concerning sexual health, as those who are sexually autonomous have been found to make informed decisions about their sexual health, leading to healthier outcomes.

Use toys, tools, and positions that work for you

There are a number of tools, positions, and toys that assist people with limited mobility and chronic pain.

The Bump’n sex toy can be used in several different ways depending on your needs. It’s designed to be a huggable pillow that you can insert a number of sex toys into to hump or grind on, which is great for solo play.

Sex wedges and pillows can also assist with placing your body in a position that is comfortable for you. Depending on your mobility and your partner’s mobility, there are many different positions that you can use to increase pleasure. When exploring new positions with a partner, both partners need to be communicative and express what feels good and what doesn’t. And remember that lube goes a long way in making things feel good.

How does disability affect sexual health?

As many people living with a disability are labeled ‘asexual’ by society, they often do not receive adequate sexual health care from health providers. Those living with a disability need regular pap tests, breast exams, prostate exams, and testicular checks, just like the rest of society.

People living with a disability who engage in sex need to have regular STI checks and have access to education on the importance of contraception.

People living with disabilities should expect to be treated as the whole person by healthcare professionals and expect to receive necessary sexual health care. If your health care needs are not taken seriously, we encourage you to advocate for yourself or access services available in your area to get the care you deserve.

People living with disabilities are not given comprehensive sexual health education

Again, as many people in society see people with disabilities as asexual, sexual education is often overlooked. However, sex and relationship education is just as important for people with disabilities as for those without disabilities. Sex education for disabled people should be given as children, with age-appropriate information. Additional information should also be covered, including:

  • People living with disabilities can have romantic, meaningful, and pleasurable relationships.
  • Sexual information that is specific to their individual needs.

Receiving this education allows people to live sexually healthy and pleasurable lives in healthy relationships.

Humans are inherently sexual beings deserving of safe and pleasurable sexual experiences, relationships, and sexual healthcare access, including those with disabilities. If you are living with a disability, you are entitled to be treated and respected as a sexual being. Although limited mobility, pain, and fatigue, may not allow you to have the sex you would like, there are toys, tools, and positions that can aid in pleasurable sexual experiences for solo and partnered play.

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The Most Effective Erectile Dysfunction Treatments for Older Adults

By James Roland

Erectile dysfunction (ED) is very common. Although it can affect men of all ages, it occurs more often in older adults and those with certain medical conditions, like diabetes.

Older research estimates that about 70 percent of men ages 70 and older report being “sometimes able” or “never able” to achieve an erection adequate for satisfactory intercourse, compared with just 30 percent of older men who report being “usually able” or “always or almost always able.”

Though it isn’t inevitable for everyone, ED is considered a normal part of aging as its risk factors include conditions common among older adults, such as:

  • cardiovascular disease
  • diabetes
  • reduced levels of testosterone
  • use of medications that treat conditions including:
    • high blood pressure
    • chronic pain
    • prostate disorders
    • depression
  • long-term, heavy substance use, including alcohol and tobacco
  • psychological conditions, including stress, anxiety, and depression
  • overweight or obesity

Sometimes treating an underlying condition can cure or reverse ED. However, most ED treatments are designed for temporary symptom relief, so an erection can be achieved that’s satisfactory for both the person with ED and their partner.

Best ED treatment for 70s and over

A variety of ED treatments are currently available. Researchers continue to develop new medications and other therapies.
For older adults, treating ED may require a two-prong approach:

  1. treat underlying conditions that contribute to ED, such as cardiovascular disease and diabetes
  2. address ED symptoms with oral medications or other alternatives

Medications

The most commonly used ED medications among older adults are from a class of drugs called phosphodiesterase-5 (PDE5) inhibitors.

PDE5 inhibitors block the activity of an enzyme in the walls of blood vessels. As a result, blood vessels are able to relax. In the penis this means more blood can fill the blood vessels, producing an erection.

The main PDE5 inhibitors available with a prescription are:

  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • vardenafil (Levitra)
  • avanafil (Stendra)

Except for avanafil, all of those medications are available in both brand-name and generic versions. (As of 2020, avanafil is still only sold as the brand-name drug Stendra.)

More ED medications are in the testing and approval process. In the United States, PDE5 inhibitors require a prescription. None are available over the counter.

Side effects from these medications are usually temporary and minor. More serious reactions such as priapism (a painful, prolonged erection) may occur in some cases.

Typical side effects include:

  • headache
  • flushing
  • congestion
  • stomach and back pain

ResearchTrusted Source indicates that PDE5 inhibitors are appropriate for most older adults.

Each medication works a little differently. For example, vardenafil usually works faster than the other medications, while tadalafil’s effects last longer.

Tadalafil is often a good choice for older adults who also have an enlarged prostate because it can be prescribed for daily dosing.

Sildenafil should be taken on an empty stomach and may require dose adjustments to get it right.

Talk with your doctor to find the right ED medication for you and your lifestyle.

Who shouldn’t take these meds

People who have certain health conditions, including heart disease, shouldn’t take these medications.

People who take certain medications to manage another health condition shouldn’t take PDE5 inhibitors either. This includes nitrates and alpha-blockers.

Older men are more likely to have heart disease or take nitrates for blood pressure.

Your doctor will take into consideration your overall health and lifestyle when prescribing an ED medication.

Injections

For older adults who find that PDE5 inhibitors don’t produce the results they want or who don’t like their side effects, self-administered penile injections may be a preferred option.

The three most widely used medications for penile injection therapy include:

  • papaverine
  • phentolamine
  • prostaglandin E1 (PGE1) or alprostadil (Caverject, Edex, MUSE)

To use these, you inject the medication into the penis with a syringe before intercourse. While this approach often results in some minor, temporary pain, research shows that about 90 percentTrusted Source of men who used alprostadil were satisfied with the results.

These medications are often used in combination with other treatments and require dosing adjustments. Your first injection should be done in your doctor’s office so they can make sure you do it correctly and safely.

Who shouldn’t use these

Older adults who feel they or their partner can’t carefully administer an injection should consider other options, whether due to lack of dexterity or other reasons.

Taking blood thinner medications is another reason to avoid injectables.

Inflatable prosthesis

If oral or injected medications can’t be used or don’t provide desired results, another ED treatment is an inflatable prosthesis surgically implanted in the penis.

In a 2012 studyTrusted Source of men ages 71 to 86, researchers found that an inflatable penile prosthesis was well tolerated and largely effective in treating ED.

Because it’s a surgical procedure, it carries the slight risks of infection or other complications. It’s important to go over all the risks and benefits of this treatment approach with your doctor. Together you can decide whether your overall health makes you a good candidate for the procedure.

It’s also important to note that an implant is permanent. It would only be removed under certain circumstances, such as infection or malfunction.

Once you have a penile implant, it permanently alters the penile anatomy. This means other treatments can’t be used after it’s placed.

Lifestyle changes

While not a specific treatment, making some changes in your day to day can make a noticeable difference in erectile function. Some helpful strategies include:

  • quitting smoking
  • limiting or avoiding alcohol or substance use
  • maintaining a moderate weight
  • exercising more often than not
  • following a healthy diet that supports cardiovascular health, such as the Mediterranean diet

Why these treatments?

PDE5 inhibitors are widely used among older adults because they’re generally safe, effective, and convenient.
Because ED medications are taken on an “as needed” basis, there isn’t the same concern about missing a dose that there may be with potentially lifesaving drugs, such as high blood pressure medications or blood thinners.

Older adults who find the side effects of PDE5 inhibitors too uncomfortable may prefer injections. Those who are used to self-administering medications, such as people who give themselves insulin shots to treat diabetes, may be more comfortable with penile injections.

Penile implants avoid the concerns about side effects altogether. And since the body’s response to medications can change over time, an implanted prosthesis also means not having to worry about changing medications or dosages.

How effective is it?

ED treatments vary in how long each one is effective, as well as side effects. Regardless of which kind of treatment you choose, there are some important facts to keep in mind:

  • ED medications typically take 30 to 60 minutes to become effective. Medications such as sildenafil usually wear off in about 4 hours or so, while tadalafil’s effects can linger for nearly 36 hours. Your general health and other factors will affect these time estimates.
  • If you don’t get the results you want from one PDE5 inhibitor, a different one may be a better match.
  • ED medications don’t cause erections. Sexual stimulation is still required to become aroused.
  • As you get older, you may require more stimulation to become aroused than you did when you were younger.
  • An erection triggered by a penile injection may occur within 15 minutes, though sexual stimulation may still be required for the medication to work.
  • Recovery from inflatable penile prosthesis surgery can take 4 to 6 weeks. This means no sexual activity or great physical exertion should take place during that time. Once you’re free to engage in intercourse, the prosthesis takes only minutes to be inflated.
  • Lifestyle changes, such as strategies that boost cardiovascular health and weight management, have also been proven to be effectiveTrusted Source.

Is it safe?

ED medications can be taken safely with most other medications, though they shouldn’t be used if you take nitrates or alpha-blockers.

The combination of PDE5 inhibitors and these medications could causeTrusted Source a dangerous drop in blood pressure.

People with heart disease or kidney disease should discuss the use of PDE5 inhibitors with their doctor. They may prescribe a lower dose, which may or may not help you achieve the results you want.

Injections pose different risks than oral medications as it may be possible to hit a blood vessel or nerve with the syringe. Also, scarring is possible. It’s best to make the injections in different places each time to reduce scarring.

Implant surgery is generally safe, and the technology is constantly improving. It’s important to find a surgeon who has ample experience with this procedure.

When to see a doctor

You can often chalk up occasional episodes of ED to stress, fatigue, relationship conflicts, or other temporary conditions. They don’t necessarily indicate a problem that needs medical attention.

But frequent problems with ED can point to the need for medical attention, especially if the ED is affecting relationships, self-esteem, and quality of life. Talk with your doctor or a urologist if this is the case for you.

Having that conversation is also important because ED can sometimes be an early symptom of diabetes or cardiovascular disease. Your doctor may want to order blood tests and other screenings to check for these underlying conditions.

The bottom line

ED at any age can be a troubling condition. Among older adults, it may be more expected, but it’s nevertheless still a concern.

ED medications and other treatments have a track record of effectively and safely treating ED symptoms in older adults.

Proper treatment starts with a frank conversation with your doctor. Don’t be embarrassed to have this conversation. Rest assured your doctor has the same talk with many other people, year in and year out.

It’s also important to talk openly and honestly with your partner. ED is simply a health condition. It should be approached thoughtfully in a straightforward manner, in the same way you would address any other condition, like arthritis or high blood pressure.

Counseling may also be helpful for both you and your partner while you seek the right medical care for this common concern.

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France to Make Condoms Free for Young People

— The new policy, which will take effect in January, is part of an effort to counter an increase in sexually transmitted diseases in recent years.

French health authorities say that sexually transmitted infections have been on the rise as a result of a decline in the use of prevention methods.

By Constant Méheut

France will begin offering free condoms in pharmacies for people up to age 25 starting Jan. 1, in a bid to reduce the spread of sexually transmitted diseases, President Emmanuel Macron said on Friday.

“It’s a small revolution for prevention,” Mr. Macron said as he announced the news in a video message posted on Twitter.

The move comes as health authorities have observed an increase in sexually transmitted infections, such as chlamydia and gonorrhea, in recent years. But it is also part of a broader public health campaign that has led France to expand free access to contraception and screening for sexually transmitted diseases.

Mr. Macron said that “regarding sexual health” of young people, “we have a real issue,” according to reports from French news outlets present at the debate. And he acknowledged that, when it comes to sex education, “We’re not good on this topic.”

The French president had initially announced on Thursday, during a health debate with young people, that the measure would only apply to people ages 18 to 25. But on Friday — after several people and activists called him out on the fact that minors, too, were at risk of contracting sexually transmitted diseases — Mr. Macron announced that he was extending the policy to underage people.

“Let’s do it!” Mr. Macron, who by the evening had traveled to Alicante, Spain, for a European summit, said in the video message.

Since 2018, people have been able to get the cost of condoms reimbursed by the national health system if they were purchased in a pharmacy with a prescription. But the measure is not well known to young French people. And more than a quarter of them say they “never” or “not always” use condoms during sexual intercourse with a new partner, according to a study released last year by HEYME, a student health insurance company.

“Condom use is very low, especially among young people,” said Catherine Fohet, a gynecologist and top member of the National Federation of Institutes of Medical Gynecology. She said the price of condoms can be prohibitive but also pointed to their “bad image” as devices that reduce tactile sensation.

French health authorities say that sexually transmitted infections, or S.T.I.s, have been on the rise in recent years, especially among young people, as a result of a decline in the use of prevention methods.

Recently released figures show that the number of people infected with chlamydia rose last year by 15 percent compared with 2020, and more than doubled compared with 2014, based on data from screenings at private health centers.

Meanwhile, gonorrhea infections have been growing since 2016, and H.I.V. infections, which condom use had helped curb in the 1980s and 1990s, have stagnated around 5,000 from 2020 to 2021.

“There’s an explosion of S.T.I.s,” said Jérôme André, the director of HF Prévention, an association that organizes screenings among university students. He added that in some universities of the Paris region, the rate of S.T.I.s reached 40 to 60 percent of those tested.

“We end up testing tons of people who should not be infected,” Mr. André said.

Mr. Macron said in a message posted on Twitter following his announcement that other health measures would be implemented as part of a recently passed health care law. They include free emergency contraception for all women in pharmacies and free testing for sexually transmitted infections without a prescription, except H.I.V., for people under 26.

Ms. Fohet welcomed Thursday’s announcement, but she said free condoms “won’t solve everything.” She added that “education and information” were key to convincing people to use protection during sexual intercourse.

Mr. Macron acknowledged on Thursday that France needed “to train our teachers much better on this topic, we need to raise awareness.”

Earlier this year, the French government made contraception free for all women up to age 25. The move was welcomed by the country’s National Council of the Order of Midwives, which said in a statement that it should be accompanied by better sexual education for all teenagers ages 15 to 18.

“Handing out condoms is good,” Mr. André said. “But when people are already infected, it’s too late.”

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Common Questions About Condoms

— Yes, there is a condom that will fit

Condoms are often part of safe sex and contraception discussions because, when used correctly, they’re effective for birth control and sexually transmitted infection (STI) prevention.

But there’s quite a bit of confusion out there about condoms. Do they truly protect against herpes? Are two condoms better than one? Are some penises really “too big” for every condom out there? Physician assistant and sexual health expert Evan Cottrill, PA-C, AAHIVS, HIVPCP, helps clear up common myths about condoms.

What are the types of condoms?

First, some basics. What are the different types of condoms? There are two main types:

  • External condoms are worn over the penis to collect ejaculation fluids.
  • Internal condoms are worn inside the body to act as a barrier and keep ejaculation fluids from entering someone’s body.

There are also dental dams, which act as a barrier during oral sex of any kind.

All types of condoms reduce the risk of transmitting STIs through bodily fluids. Condoms also prevent pregnancy by keeping semen from entering the vagina. There are many other methods of birth control to prevent pregnancy, but a condom can also protect you from STIs. This is also true if you’re having anal sex.

Below, Cottrill walks us through nine facts about condoms and debunks some popular myths along the way.

Are lambskin condoms different from latex condoms?

Condoms made from latex, polyurethane and other synthetic materials can protect you from STIs. But lamb cecum condoms, also called natural membrane or lambskin condoms, can allow viruses to pass through.

If you’re only concerned about preventing pregnancy, lambskin condoms are fine. But if you want protection from STIs, use a latex or polyurethane condom.

Are some people too big for condoms?

If someone has ever told you, Condoms don’t fit me, don’t buy it — this is a myth.

“Anatomic size varies, of course,” says Cottrill. “But there is a condom that can fit every person.”

Most penises don’t require a special condom size. But if needed, there are larger — and smaller — condom sizes available. If you can’t find the right fit at your local grocery store, try searching for them online.

Do condoms protect against herpes?

“Yes, when you use condoms consistently and correctly, they do protect against herpes,” says Cottrill.

The myth that condoms don’t protect against herpes probably came from people who weren’t using them correctly or weren’t using them enough. Herpes is a lifelong condition that spreads through close contact with someone who’s had the infection — even when they’re not having an outbreak and show no signs or symptoms of infection. Herpes can also spread through oral sex and by sharing sex toys, which means it’s important to use a dental dam or condom when participating in these activities.

“You need to use condoms for all types of sex, including oral sex, to prevent the spread of herpes,” states Cottrill.

Do condoms protect against HIV?

“Condoms most definitely reduce the risk of transmitting HIV,” says Cottrill.

However, when it comes to protecting against the spread of viral STIs, such as HIV, hepatitis C and herpes simplex virus (HSV), the condom material matters. For the best protection, avoid lambskin condoms and use latex or polyurethane instead.

Do condoms protect against HPV?

Yes, condoms protect against human papillomavirus (HPV) infection.

“Condoms are effective against any STI, whether bacterial or viral,” notes Cottrill. He again emphasizes that latex and polyurethane condoms — not lambskin — are your best protection.

Is it bad to keep a condom in your wallet?

“This is a very popular question,” says Cottrill. “I do not recommend keeping condoms in your wallet because heat lowers the quality of the material over time. Plus, the packaging can get torn or opened.”

It’s also not a good idea to keep condoms in your car, which can get very hot in the sun. It’s best to store condoms in a cool place where the package won’t get crushed, folded or punctured.

Should you use two condoms?

It might seem logical that two condoms would be better than one — twice the protection or something like that, right? But it’s actually the opposite.

“Do not use two condoms at the same time,” says Cottrill.

Friction during sex can weaken the condoms as they slide against each other, leading to breakage. You also don’t want to wear external condoms while your partner wears an internal condom for the same reasons. Using one condom at a time is most effective.

Can you use any lube with condoms?

Choosing the right lubricant depends partly on the type of condom you’re using. If you’re using latex, stick with silicone or water-based lubricants. Don’t use oil-based substances such as petroleum jelly (Vaseline®), lotion, massage oil or coconut oil, as these can weaken the latex and lead to tears.

But you can use oil-based lubricants with condoms made of polyurethane or other synthetic materials, as these won’t break down so easily.

Do condom expiration dates matter?

Yes, condoms expire, and it’s important to look at those dates.

“It’s best not to use a condom that’s past the date printed on the package or over five years old,” cautions Cottrill.

The condom material breaks down over time, so an older condom is more likely to tear during sex.

Tips for choosing and using condoms

When choosing a condom, consider:

  • Size: Regular-sized external condoms work just fine for most people. But you can find other sizes available, if necessary, typically right on the shelf at your local drugstore or online.
  • Material: Lambskin condoms work for avoiding pregnancy but aren’t great for STI protection. Latex and polyurethane condoms are best if you want to prevent the spread of STIs.
  • Allergies: Some people are allergic to latex. If that’s you or your partner, use condoms made of polyurethane or another synthetic material.

No matter what type of condom you’re choosing, use a new condom every time and follow the directions on the package to minimize the risk of slippage, leakage or breakage. If your condom does tear or break while you’re having sex, stop immediately and replace it with a new condom. If you’re concerned about possible pregnancy or STIs, make an appointment with a healthcare provider.

If you’ve tossed the box and need a refresher on how to properly use external condoms, the Centers for Disease Control and Prevention (CDC) has a handy guide for using external condoms.

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Sex After Cancer

— The Midlife Woman’s Edition

Help for sexual side effects from cancer treatment is out there — but you may need to ask for it.

The impact of cancer treatment on women’s sexual health, and how to mitigate it, was highlighted at the 2022 North American Menopause Society annual meeting.

By Becky Upham

When it comes to sexual dysfunction caused by cancer treatment, most women suffer in silence.

With significant advances in oncology care, the majority of women and girls diagnosed with cancer will go on to become long-term cancer survivors. An estimated 89 percent of female cancer survivors are age 50 and older, according to the American Cancer Society.

That is no small number of women, and the North American Menopause Society (NAMS), a leading medical association dedicated to promoting the health and quality of life of all women during midlife and beyond, focused on women facing the issue at this year’s annual meeting in Atlanta in October. Sharon L. Bober, PhD, an associate professor at Harvard Medical School and the director of the sexual health program at Dana-Farber Cancer Institute in Boston, presented on the topic of sex and cancer.

Cancer Treatment Can Impair Sexual Function

Every major type of cancer treatment — surgery, radiation, chemotherapy, and hormonal therapies — has the potential to disrupt or impair sexuality and sexual function, according to Dr. Bober.

More than two in three women with cancer, or 66 percent, will experience sexual dysfunction, according to a meta-analysis published in January 2022 in the International Journal of Reproductive Biomedicine. This can encompass various aspects of sexual function, such as desire, arousal, and orgasm as well as other aspects of sexual health such as sexual satisfaction and perceived body image.

Yet, despite how common these issues are, most women cancer survivors do not receive adequate information, support, or treatment, says Bober. Studies suggest that most oncology providers lack training in this aspect of patient care, are not familiar with validated tools to efficiently identify patients with sexual problems, and do not feel knowledgeable about available resources.

Ask About Potential Sexual Side Effects

Both patients and oncology providers report they do not want to make each other uncomfortable, which means that the problems go unaddressed. Women undergoing cancer treatment should ask their providers about sexual side effects. “I think women need to ask their oncology providers if treatment will result either in menopause or an increase in menopausal symptoms so they can be proactive about seeking help if necessary,” says Bober. Chemotherapy or radiation therapy to the pelvis are examples of cancer treatments that may trigger menopause, she says. This can lead to genitourinary symptoms of menopause (GSM), which can include vaginal dryness or burning, issues with urination, recurrent UTIs, tightening of the vagina canal, and discomfort with intercourse.

Commonly Reported Problems During and After Cancer Treatment

In addition to GMS, other commonly reported symptoms can include psychological distress (including distraction and avoidance), decreased desire and sexual satisfaction, body image distress, loss of sensation and body integrity, relationship stress, and dating challenges.

Because support for sexual health and sexual recovery is not yet a standard part of oncology care, it’s especially important to be able to identify changes that are bothersome and then specifically seek out resources as needed, says Bober.

Sexual Aids Can Help Address Symptoms That Contribute to Sexual Dysfunction

Sexual health resources can include vaginal lubricants and moisturizers, dilator therapy (a tube-shaped device that can help stretch the vagina), and pelvic floor exercises, all of which may help women with genitourinary symptoms, says Bober.

In a survey of 218 female cancer survivors published in the August 2017 Breast Cancer Research and Treatment, most women reported knowing about these options, but nearly 1 in 5 women, or 19 percent, had never tried any.

Online Resources for Finding Help With Sexual Dysfunction

Depending on your issue, Bober recommends finding an expert who can help; for example, a provider certified in menopause care or a therapist who has experience with sexual health after cancer.

“This is often where resources online can be helpful, including the NAMS practitioner finder, the Scientific Network on Female Sexual Health and Cancer and the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) to find a certified sex therapist,” says Bober.

Sexual side effects of treatment do not typically resolve on their own; that’s why being proactive is so important, she emphasizes. For some women, a physical therapist who has specialized training and expertise around the pelvic floor may be useful, says Bober. Not every PT has this type of training, she cautions. The American Academy of Pelvic Health Physical Therapy offers a guide to nearby therapists who are certified in pelvic health. Sexual dysfunction is also associated with anxiety, depression, relationship stress, and loss of self-efficacy (belief in one’s ability to complete a task or achieve a goal).

Sexual issues that arise as a result of cancer treatment don’t just impact quality of life; they can also impact adherence to cancer treatment, says Stephanie S. Faubion, MD, the Penny and Bill George Director of the Mayo Clinic’s Center for Women’s Health and the medical director of the North American Menopause Society. In fact, sexual symptoms are the primary reason for premature discontinuation of treatment or failure to initiate therapy. “If women are actually stopping their therapies because of sexual dysfunction, that doesn’t help anybody,” she says.

More Cancer Centers Offer Treatment, Support for Sexual Dysfunction

Bober recommends an approach that takes into account the physical, mental, social, and cultural issues that contribute to sexual dysfunction related to cancer, which she calls a biopsychosocial model.

On a positive note, there is evidence that this may be changing for the better, says Bober, with increased interest in the treatment of cancer-related sexual dysfunction, including medications, physical therapy, and counseling options. Some of these options are being offered at cancer centers.

At the Dana-Farber Cancer Institute where Bober is the director of the sexual health program for cancer patients and survivors, the healthcare team includes a psychologist specializing in sexual rehabilitation counseling for men, women, and couples, a gynecologist specializing in female sexual health, a urologist with expertise in male sexual health, an endocrinologist who focuses on hormonal changes after cancer treatment, a reproductive endocrinologist who specializes in fertility issues after cancer, and a fertility expert specializing in fertility and reproductive health during and after cancer treatment.

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Breast Cancer and Sex

— How Can Breast Cancer Affect Sexual Health

By Serenity Mirabito RN, OCN

Physical changes in your body due to breast cancer treatment paired with feelings of loss and fear can reduce libido (sex drive) and ultimately lead to depression.

It’s important to have open communication with your healthcare provider if you’re experiencing sexual problems after a breast cancer diagnosis.

This article will discuss how breast cancer affects sexual health and ways to prevent or treat sexual problems associated with breast cancer

Connection Between Sexual Problems and Breast Cancer

Although chemotherapy, hormone therapy, surgery, and radiation are needed to treat, cure, or prevent breast cancer, they can also cause sexual dysfunction. Due to hormone fluctuations, medication side effects, and poor body image, sexual health is greatly affected by breast cancer. Intercourse is not usually dangerous; however, sex can be painful for women, and men may experience erectile dysfunction.

Does Breast Cancer Treatment Cause Sexual Problems

The following are ways breast cancer treatment can cause sexual dysfunction in men and women:12

  • Chemotherapy: Certain chemotherapy agents (anthracyclines and taxanes) have toxicities that reduce sexual arousal and desire. These medications cause fatigue, nausea, and diarrhea, all of which can lead to decreased interest in sex and intimacy.
  • Hormone therapy: Hormone receptor-positive breast cancers are often treated with aromatase inhibitors and selective estrogen receptor modulators, which cause hot flashes, vaginal dryness, insomnia, and painful intercourse in women. Men on hormone therapy for breast cancer can experience low libido and erectile dysfunction.
  • Surgery: Breast surgeries (mastectomy, which is removal of the breast, and lumpectomy, which is removal of the cancerous tumor) and sentinel lymph node dissection (lymph node removal) result in emotional and physical distress. Pain, numbness, and swelling of the surgical site can cause discomfort, while the scars from surgery can lead to poor body image.
  • Radiation: Radiation therapy can result in persistent pain, lymphedema (swelling), reduced flexibility, and pain in the affected breast, arm, and axilla (armpit). Studies show these side effects correspond with poor quality of life, including sexuality.

How Are Sexual Problems With Breast Cancer Treatment Alleviated?

Following your treatment regimen is essential to surviving and thriving with breast cancer. These tips may help prevent or alleviate sexual problems from breast cancer treatment in men and women:3

  • Be open and honestly communicate your feelings with your partner.
  • Try sex in different positions until you find one that’s comfortable.
  • Intimacy isn’t just about sex. Kissing, snuggling, and touching can also provide intimacy.
  • Use lubrication to help make sex more comfortable.
  • Some antidepressants are used to improve sexual desire.
  • Sexual rehabilitation/therapy can help assess and treat sexual dysfunction in people with breast cancer.

Studies show that healthcare providers don’t always provide sex education to patients with newly diagnosed cancer. Be sure to discuss this topic with your oncology team before treatment starts so you know what to expect.4<

Symptoms and Gender Differences

While breast cancer is the most common cancer in women (after skin cancers), male breast cancer is rare. However, both genders experience symptoms of sexual dysfunction with breast cancer.

Men

Because male breast cancer makes up less than 1% of the total breast cancer cases yearly, information about breast cancer in men is significantly lacking. One study found education about sexuality was the most frequent unmet information need reported by male breast cancer survivors.5

Common sexual problems men with breast cancer may experience include:

  • Loss of libido
  • Erectile dysfunction
  • Poor body image
  • Feeling emasculated
  • Infertility

You will likely need to ask your healthcare provider how your treatment will affect your sexuality, as little information is shared with men on this topic.

Women

Symptoms of sexual problems in women with breast cancer include:

Although there is a great deal of information about how breast cancer affects the sexual health of women, you will likely need to ask for education on this topic as well.

How Are Sexual Problems With Breast Cancer Treated?

The first step in treating sexual problems with breast cancer is to speak to your healthcare provider. Whether male or female, sharing your new or worsening sexual side effects with your oncology team is vital. Additionally, being referred to a sex therapist or for sexual rehabilitation can help assess and diagnose the dysfunction and formulate a treatment plan that fits your individual needs.

It may also help to do the following:

  • Premenopausal women with breast cancer may improve libido by using Addyi (flibanserin), a prescription medication that increases sexual desire.
  • All women with breast cancer should use lubrication to prevent painful intercourse. Ask your healthcare provider about topical lidocaine if lubrication doesn’t improve comfort during sex.6
  • Men with breast cancer experiencing sexual problems may find relief from oral medications that help get and keep an erection. Other medical options include penile injections, urethral pellets, vacuum erection devices, and penile implants.6

For both men and women, the following may help improve sexual problems associated with breast cancer:

Check with your healthcare provider before implementing any new treatments for sexual dysfunction.

Summary

Whether you’re male or female, you will likely experience sexual problems if you have breast cancer. The consequences of cancer treatments such as chemotherapy, hormone therapy, surgery, and radiation can cause sexual dysfunction leading to depression. Speaking to your healthcare provider about how breast cancer will affect sexuality is important as there are ways to prevent or alleviate these side effects.

A Word From Verywell

Changes in appearance from breast cancer surgery can greatly influence body image and self-esteem in both men and women. Weight gain or loss, hair loss, breast removal, and scars can make you feel self-conscious. It’s important that you don’t feel rushed into sex until you’re ready. Enjoying other ways to feel close to your partner is equally as satisfying. Be sure to seek help from your healthcare provider if new or worsening sexual problems occur.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. American Cancer Society. Treating breast cancer in men.
  2. Boswell EN, Dizon DS. Breast cancer and sexual function. Transl Androl Urol. 2015;4(2):160-168. doi:10.3978/j.issn.2223-4683.2014.12.04
  3. Breast Cancer Now. Sex and breast cancer treatment.
  4. American Cancer Society. Cancer, sex, and the female body.
  5. Bootsma TI, Duijveman P, Pijpe A, Scheelings PC, Witkamp AJ, Bleiker EMA. Unmet information needs of men with breast cancer and health professionals. Psychooncology. 2020;29(5):851-860. doi:10.1002/pon.5356
  6. Carter J, Lacchetti C, Andersen BL, et al. Interventions to address sexual problems in people with cancer: american society of clinical oncology clinical practice guideline adaptation of cancer care ontario guideline. JCO. 2018;36(5):492-511. doi:10.1200/JCO.2017.75.8995

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Low Sex Drive (Loss of Libido)

By Heather Jones

Libido (also called sex drive) means the overall interest a person has in sexual activity. It is separate from sexual arousal, which is the body’s response to sexual stimuli. A low libido does not always indicate a problem, but it may be related to a medical condition or can cause a person distress, particularly if there has been a drop in libido.

Statistics vary, but up to 20% of men experience low libido sometime in their life. Up to 43% of women experience sexual dysfunction—a problem that occurs during any part of sexual activity, from arousal to orgasm—at some point, including low libido. About 1 in 3 women report having a low sex drive.123

Low libido itself is not considered a condition. If certain criteria are met, however, a woman with low libido may be identified as having female sexual interest/arousal disorder (FSIAD).4

Some references, particularly those published before 2013, refer to low libido as hypoactive sexual desire disorder (HSDD). Since then the definitions for low libido and HSDD conditions have changed. In 2013, the official handbook that classifies mental health disorders, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), combined the two diagnoses and now refers to it as sexual interest/arousal disorder.45

Read on to learn about low libido, when it’s considered a problem, and what can be done about it.

Symptoms of Low Libido

A person with low libido may experience:6

  • Little or no interest in any type of sex, including masturbation
  • Rare, if any, thoughts about sex or sexual fantasies

FSIAD is marked by a lack (or serious reduction) of sexual interest or arousal in women. To meet the criteria for FSIAD, a person must show an absence or reduction in at least three of the following, for at least six months:5

  • Interest in sexual activity
  • Initiation of sexual activity and being unreceptive to a partner’s attempts to initiate
  • Sexual or erotic thoughts and fantasies
  • Sexual interest/arousal in response to sexual or erotic cues
  • Sexual excitement or pleasure during sexual activity
  • Genital or nongenital sensations during sexual activity

The symptoms the person experiences also must cause them clinically significant distress and not be better explained by factors such as a nonsexual mental health disorder, severe relationship distress, or another significant stressor.
<h3″>What Is the Sexual Response Cycle?

A person’s sexual response cycle has four phases:7

  • Sexual desire: A person’s interest in sexual activity
  • Sexual arousal: Excitement/physical response
  • Orgasm (climax): Peak of sexual excitement (when pleasure is highest), and ejaculation occurs
  • Resolution: The body recovers and returns to its usual state

Causes of Low Libido

A number of factors can cause low libido, including that it may be a person’s natural preference. Libido commonly lowers with age for all genders.3

>Most research on low libido focuses on cisgender men or cisgender women. More research is needed to examine low libido in people who do not fall within this narrow gender binary.

Causes of low libido may include:8916235

  • Hormonal changes: Such as reduced sex hormones with aging, with hormonal contraception use, or with antihormone therapy
  • Medical conditions: Such as diabetes, cardiovascular disease, fibroids, underactive thyroid, endometriosis, premenstrual syndrome (PMS)
  • Medications: Including many antidepressants and antipsychotics
  • Psychological distress: Stress, anxiety, exhaustion, problems with body image, etc.
  • Depression: Can cause a loss of interest in things once enjoyed, including sex
  • Relationship problems: Overfamiliarity with partner in long-term relationships, conflict, partner’s lack of interest/functioning in sex, etc.
  • Dissatisfaction or discomfort during sexual activity: Such as erectile dysfunction, problems with ejaculation, vaginismus (involuntary tightening of the muscles around the vagina before penetration), difficulty with orgasm, vaginal dryness, or pain
  • Substance misuse: Excess amounts of alcohol can affect libido, as can drug misuse and/or smoking
  • Life stage or event: Such as menopause, pregnancy, postpartum, breastfeeding, loss of a loved one, retirement, job loss, divorce, illness, etc.
  • Trauma: Such as a history of unwanted sexual contact or post-traumatic stress disorder (PTSD)

A 2017 study also identified high levels of chronic, intense, and greater durations of endurance training on a regular basis, as a possible contributor to decreased libido in men.10

What Medications Can Cause Low Libido?

Medications that may cause low libido include:31112

  • Serotonin-enhancing medications, such as selective serotonin reuptake inhibitors (SSRIs)
  • Antipsychotics, such as Haldol Decanoate (haloperidol)
  • Blood pressure medications, including diuretics and beta-blockers
  • Medications used to treat seizures
  • Medications that block the effects or reduce the production of testosterone, such as Tagamet HB (cimetidine), Propecia (finasteride), and Androcur (cyproterone)

Is Low Libido Always a Problem?

Having a low (or no) libido in and of itself can be perfectly normal for a person. Comparing your libido to someone else’s, including your partner’s, is not an accurate way to determine if your libido is “too low.”12

There is no set amount of sex that’s considered “normal.” A person may be content thinking about or having sex once a year, while another person may be unhappy with sexual activity once a week.136

Unless your low libido is a symptom of a health condition that needs to be addressed (such as diabetes, depression, etc.), the level of your libido is only a problem if it is bothering you.2

How to Treat Low Libido

If a person wants to treat their low sex drive, there are a number of approaches that can be tried.

Hormones

Supplementation of testosterone in those with low testosterone levels may help with low libido, but should only be attempted under the guidance of a healthcare provider who is knowledgeable about this treatment.11

Those who have been through menopause (either naturally or surgically) with low libido may benefit from transdermal testosterone therapy (with or without accompanying estrogen therapy). However, data on the benefit of testosterone therapy are limited and inconsistent, and there is a lack of long-term data on safety and effectiveness.

Hormone treatment comes with risks as well as benefits. Talk to your healthcare provider about whether taking hormones is appropriate for you.1

Medication

If low libido is a side effect of medication, talk to your healthcare provider about changing the dose or type of medication you are on. In some cases, another medication, such as the atypical antidepressant Wellbutrin (bupropion), may be added to help address the sexual dysfunction.12

Flibanserin

In 2015, the Food and Drug Administration (FDA) approved the medication Addyi (flibanserin) for use in the treatment of FSIAD of any severity in people who are premenopausal.5

Reported side effects include:

  • Headache
  • Dizziness
  • Fatigue
  • Drowsiness
  • Nausea

Flibanserin carries a boxed warning (the strongest FDA warning) for hypotension (low blood pressure) and syncope (fainting) in certain settings, particularly with the use of alcohol and/or moderate or strong CYP3A4 (an important drug-metabolizing enzyme) inhibitors, and for people with liver impairment.

Alcohol should be avoided during the entire course of treatment with flibanserin.

Flibanserin is taken daily as an oral pill.2</span

Long-term studies on flibanserin are needed. The benefits of flibanserin in improving sex drive are minimal compared to placebo, and in many cases are outweighed by the risks of using it.

Before taking flibanserin, it’s important to discuss these benefits vs. risks with a healthcare provider who is knowledgeable about this medication.

Bremelanotide

Vyleesi (bremelanotide) was approved in 2019 for treatment of HSDD in people who are premenopausal.14

Bremelanotide is taken as needed, about 45 minutes before sexual activity, as an injection in the thigh or abdomen.2

Evidence on efficacy is limited, and shows minimal effect on the number of satisfying sexual events compared to placebo.

The most common side effects of bremelanotide are:14

  • Nausea (about 40% of people who took bremelanotide in clinical trials experienced nausea and 13% needed medication to treat the nausea)
  • Vomiting
  • Flushing
  • Injection site reactions
  • Headache

People with uncontrolled high blood pressure, with known cardiovascular disease, and those at high risk for cardiovascular disease should not take bremelanotide.

Address Underlying Medical Conditions

If your low libido is caused by a health condition, managing that condition may improve your libido.111

Therapy

Therapy such as cognitive behavior therapy (CBT) with a therapist or counselor who specializes in sexual and relationship issues may help with sexual dysfunction.121

Therapy can help you address psychological issues that may be affecting your sex drive, including:13

Lifestyle Changes

General healthy lifestyle practices, such as eating nutritious foods, being physically active, and getting enough quality sleep, may help improve your libido.6

Mindfulness exercises, relaxation techniques, and other ways to reduce and manage stress may also be beneficial.1

For some people, engaging in sexual stimulation and triggering the arousal response can help the person “get into it,” even if they weren’t desiring sex before. While this may be helpful for some people, no one should feel pressured to engage in sexual activity if they don’t want to.12

Relationship Strategies

Open and honest communication with your partner about your sexual desires can help both of you feel sexually fulfilled.11

You may also benefit from psychosexual counseling, which can help you and your partner work through sexual, emotional, and relationship issues that may be affecting your libido.3

Remember that sex is more than intercourse. There are activities you can do together that can “spice things up” or let you engage in intimacy without having sex. Some things to try include:136

  • Exploring each other’s bodies through caressing, kissing, etc.
  • Giving and receiving massages
  • Bathing or showering together
  • Experimenting with different sexual techniques
  • Using aids such as toys or massage oils
  • Planning romantic activities or taking a weekend away

You may also find that self-exploration helps you find what works for you.

Are There Tests to Diagnose the Cause of Low Libido?

To look for a cause of low libido, your healthcare provider may:11

  • Ask about history of low libido (when it started, severity, situational and/or medical factors around the time it started, previous treatments, and if there other sexual problems present, etc.)
  • Get a general medical history, including medications and mental health
  • Perform a physical examination
  • Discuss your partner(s)
  • Run laboratory tests, such as a blood test to check hormone levels
  • Refer you to a specialist if needed (such as a mental health professional if FSIAD is suspected)

When to See a Healthcare Provider

loss of libido, especially if prolonged or recurring, may be an indication of an underlying problem. It may be a good idea to see if there are potential medical or psychological reasons that should be explored.3

Even without a medical reason, if your low libido bothers you, talk to your healthcare provider.

Summary

A low libido means little or no desire to engage in sexual activities. It may be linked to a medical condition, medication, relationship issues, hormones, and other factors. It may also be normal for that person.

Unless there is an underlying medical condition, low libido is only a problem if it causes the person distress.

Treating unwanted low libido depends on the cause, but may include medication, therapy, lifestyle changes, hormone therapy, and/or relationship building.

A Word From Verywell

If you have a low sex drive that is not caused by a medical condition and isn’t bothering you, then it is not a problem. If you are bothered by your low libido or are concerned about what may be causing it, talk to your healthcare provider. A medical professional can help you figure out what is going on and how best to approach it.

Frequently Asked Questions

  • Is low libido the same as low arousal?While related, libido and arousal are different. Libido refers to a person’s overall interest in sexual activities. Sexual arousal is how the body responds to sexual stimuli (“turned on”).
  • Is low libido normal?For some people, having a low libido is normal. A low libido is only a cause for concern if it is caused by a medical condition or if the person does not want to have a low libido.
  • Does low libido vary by gender?
    Women are more likely than men to experience low libido. The causes of low libido can also depend on gender.

Most studies on low libido include cisgender people only. More research is needed to understand how libido affects people across the gender spectrum.

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Our culture isn’t sex positive just because kink is trending

Even “vanilla” people feel sex shamed.

By Tracey Anne Duncan

As a person who writes about sex and pleasure, I meet a lot of pleasure activists — people working to reclaim pleasure and sexuality as radical domains. Many are kinksters, queers, or both; all on a mission to return some dignity back to folks who have been marginalized. Recently, though, I came across a pleasure activist who’s advocating for the validity of “vanilla” sex. Frankly, I was a bit taken aback. Do people who like simple sex really need activism? Isn’t “normal” sex just, well, normal?

Sure, in the past decade, kinky sex has become much more socially acceptable. I’m not saying you should try to bond with granny about your favorite shibari harnesses, but you can probably post about them on social media without much to-do. But while the #trending of kink seems like some form of progress in our generally prudish society, if folks who love “vanilla” sex feel shamed by their preferences, our culture is still far from being a sex-positive Eden of earthly delights.

“As soon as you say something like, ‘Umm, you know, I love vanilla sex,’ you might as well grow a Victorian-style bonnet on your head,” Alice Queen, a sex writer in Detroit who runs a sex toy blog dubbed “Vanilla is the New Kink,” tells me. “I’m under the impression that society as a whole will never stop trying to whip us (back) into shape, one way or another, by framing any and [all] of our sexual behaviors into social mores.” Basically, Queen believes vanilla sex oftentimes gets the same negative treatment from others as sex that’s widely considered “deviant.”

“As soon as you say something like ‘Umm, you know, I love vanilla sex,’ you might as well grow a Victorian-style bonnet on your head.” – Alice Queen

But does Alice think there needs to be an actual, formal movement to advocate for those who like to keep sex simpler? “On the one hand, I’d love for people to be able to freely admit their vanilla preferences without being scoffed at,” she says. “On the other hand, I’m more than aware of potential pitfalls: Before long, someone would try to hijack my genuine vanilla [sex] pride and use it as a wrapper for exclusion because it’s just so easy to do from a traditional point of view.”

In other words, no, even vanilla sex “activists” view something like an earnest “vanilla sex pride” movement as something that would harm already marginalized communities who actually need or benefit from Pride movements.

The experts I spoke with agree that there’s a big difference between taking pride in your sexuality and trying to make a social justice movement out of it. “Benefiting from, or even being an activist in, a social justice movement or a project to make the word ‘sex’ non-judgmentally inclusive of more sexual options (especially your own) doesn’t necessarily open you up to true comfort with and belief in sexual diversity,” Carol Queen (no relation to Alice), co-founder of the Center for Sex and Culture in San Francisco, tells me.

“My starting point is that the only thing that should be excluded is exclusion itself — as well as, of course, any practice that lacks consent or can never have it by definition.” – Alice Queen

The truth is that while Alice may be a self-described vanilla sex “activist,” she’s not vying for the primacy of any one kind of sex. Yes, the name of her blog could be read as creating a divide between vanilla and kink, but it’s really just catchy phrasing meant to wink at sex negativity. “I wouldn’t want to end up unwittingly promoting exclusion,” Alice says. “On the contrary, my starting point is that the only thing that should be excluded is exclusion itself — as well as, of course, any practice that lacks consent or can never have it by definition.”

The point Alice is trying to make is that, while the preponderance of BDSM-themed merch may make it seem like America has gotten really freaky, our culture is actually still so sex negative that even people who prefer “normal” sex feel like they can’t state their desires without being judged. The fashionability of the aesthetics of kink in many ways masks the reality that the U.S. is still a sex-negative culture, as evidenced by, among other things, our egregious sex education policies.

In fact, the whole idea of kink versus vanilla is essentially just a tool used to create divisions between anyone who might attempt to reclaim pleasure. After all, there’s not even an agreed-upon definition of vanilla sex. We invent these categories in order to express our desires, which should be fun, but our overly prudish culture has turned even the most normative desires against us.

“We should not be put in a position of feeling shame about our sexuality unless we are hurting someone else via our actions.” – Carol Queen

Alice describes vanilla sex as simple and mindful, which honestly, is a great way to approach any kind of sex, kinky or otherwise. “We do not have to have sex a certain way — except, y’know, consensually — no matter what right-wing politicians and preachers [or] hipper-than-thou ‘sex-positive’ folks might say,” Carol says. Basically, in a genuinely sex-positive culture, all sex — vanilla, kink, clown, whatever — would be welcome.

In working toward such a culture, it’s crucial that we don’t get the idea of sex positivity twisted. “Since humans tend to one-up each other, that ‘Yippee, sex!’ POV has morphed into ‘Sex-positive means I like all the sex — [and] if you don’t, you are not sex-positive,” she says. “This is not what sex-positive means.”

The truth is, as Carol notes, that what’s considered sexually “normal” or “fashionable” is always in flux, and it doesn’t always correspond to how we actually think about — or do — sex. As Carol says, “We should not be put in a position of feeling shame about our sexuality unless we are hurting someone else via our actions.”

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Sexual health week

— 5 common myths about STIs that need to be dispelled

By

Cast your mind back to your secondary school sex education lessons: does the very thought of it make you cringe?

Because shockingly, putting condoms on bananas and labelling diagrams of vulvas is quite limited. In fact, a 2016 study found that almost three-quarters of pupils are not taught about important issues like consent and at least 95% don’t receive education about lesbian, gay, bisexual and transgender relationships in school.

Therefore it’s no surprise that when it comes to STIs, even though there were 317,901 diagnoses of STIs made in England in 2020, there’s still plenty we don’t know or get wrong.

Over 70% of men and over 85% of women are classified as having had unsafe sex in the past year, but 64% of men and 73% of women said they perceived themselves as not at all at risk for STIs.

So to mark sexual health week, Valentina Milanova, founder of Daye, a gynaecological health company that is committed to raising the standards in gynae health, is helping Stylist to dispel some of the most common myths.

Myth: all STIs have symptoms

One of the most common myths associated with sexual health is that all STIs have symptoms. However, Milanova explains that some 70% of female STIs are asymptomatic, so you won’t know you have an STI unless you get tested. “This is why it’s extremely important to get tested regularly, even if you are in a monogamous relationship,” she says.

Myth: STIs will eventually disappear without treatment

Unfortunately, STIs will not go away by themselves. However, most STIs can be treated with a simple course of antibiotics. “Early detection is important,” Milanova suggests. “Like other infections, the longer an STI is left untreated, the more serious the potential health implications become.”

Myth: condoms can protect against all STIs

While condoms are generally great at protecting against STIs such as chlamydia and gonorrhoea, you can still catch herpes, genital warts and syphilis even if you always practise protected sex. “This is why it’s important to ensure that both you and your partner get tested regularly, even if you do use a condom when having sex,” repeats Milanova.

Myth: STIs only affect young people who have sex frequently with multiple people

Actually, anyone who is sexually active can contract an STI, no matter their gender, age, or sexuality. STIs do not discriminate and are perfectly normal. 

Myth: the contraceptive pill protects against STIs

The pill can prevent pregnancy, but it cannot stop you from catching an STI. The most effective way to protect against STIs is by using a condom.

Complete Article ↪HERE↩!