Category: SEXUAL HEALTH

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1 in 4 Americans Are Disabled and They Deserve Intimate Relationships

— We should not only include but celebrate people with disabilities in conversations about sex.

By Kelly Kling

The Americans with Disabilities Act (ADA) defines a person with a disability as someone “who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.”

As many as 1 in 4 people in the United States have a disability, the Centers for Disease Control and Prevention (CDC) estimates. The most common type of disability in the U.S. is mobility, affecting as many as 1 in 7 adults. However, disabilities can have a physical or mental component, and given these statistics, it’s likely you or someone you know lives with a disability.

It’s no secret our society has a habit of branding health and wellness issues as matters of personal choice, and some people make healthier choices than others. However, in most cases, there are no “personal choices” a disabled person can make to not be disabled.

Optimal health looks different for everybody. For instance, we could all do the same exercises and eat the same foods, but we’d still have different bodies. Like health, sex and intimacy look different for everybody.

It’s a common misconception that people with disabilities are unable to have fulfilling and satisfying sex lives. But they desire and deserve the same intimate experiences of life that able-bodied individuals enjoy.

“Because of the lack of representation in the media, there is a lot of ableism that still pervades our culture,” explained Megwyn White, a clinical sexologist in New York City and the director of education at Satisfyer, a sexual wellness brand. “Many people assume that all disabled people have limited mobility or lack sexual desire, which is not true. These assumptions can lead to a lack of understanding and empathy toward challenges that disabled people face when it comes to sex.”

There is no singular way to engage in intimacy, despite the limited views we frequently see in the media and pop culture. Let’s look at some of the ways people with disabilities can enjoy intimate activities and how we can encourage cultural shifts to include them in our picture of intimacy.

It all comes down to communication

It’s true for all intimate relationships: Communication and ongoing, enthusiastic consent is the name of the game. People with disabilities may experience sex and intimacy differently than what is considered “normal,” so they may face a more difficult time opening up about their sexual experiences and desires.

“Often, couples who are outside what the ‘standard’ healthy couple looks like have a difficult time opening up about their experiences because they can feel uncomfortable, or perhaps even embarrassed, being outside of ‘the norm,'” White said. “In reality, there isn’t a ‘norm’ when it comes to a healthy and sexually active couple, as this completely varies from all aspects, such as gender, abilities, sexuality, etcetera. The best way to mitigate this internal conflict among couples is to encourage open and honest communication.”

Clarisse Quirit Rella, a product testing and affiliate manager, writer and contributor at Women’s Health Interactive, a nontraditional occupational therapist and a recreational therapist in Queens, New York, agreed that open communication is paramount when exploring intimacy while living with a disability.

“Let your partner know what you can and cannot do, what you like and do not like, what you are curious to try and not try, what is comfortable for you and uncomfortable,” she advised.

Additionally, everyone should take note that sex isn’t solely penis-in-vagina (PIV) penetration. Whatever sexual acts you’re capable of and enjoy “count” as sex, and it’s important society adopts this belief so disabled people, who may not be capable of PIV, can be included in the conversation.

“People can have sex in different ways, many of which may be unfamiliar to us and some ways that people might not even consider when it comes to mainstream ideas of what sexuality is,” Quirit Rella said.

It’s time to get creative

We’ve established that sex can include all kinds of activities outside of what we’ve learned from social conditioning. Since everyone’s not capable of penetrative sex, it’s important to consider other sources of pleasure. Thankfully, various inventions of modern pleasure science have been created with all levels of ability in mind.

“One of the methods that have a track record of working for the disabled community is using sexual wellness products,” White said. “Sexual wellness products radically expand the possibilities of sexual play and can be used to assist in facets of arousal such as blood flow and targeted stimulation. There are so many benefits of trying sexual wellness devices as it creates more opportunity for pleasure, given the various shapes and designs of each product.”

Sex toys are a great option to explore at any level of physical ability and can help people with (and without) disabilities achieve sexual satisfaction. Additionally, the use of other assistive devices, such as pillows, can make some sexual acts more comfortable for people with certain physical limitations.

“I always like to recommend adaptive equipment that can be used to enhance their sex life and sexual pleasure, such as using pillows and wedges, to name a few,” Quirit Rella said. “Pillows can be placed under the legs and stomach area as well as behind the back. These offer stability and comfort to different areas of the body. Wedges also offer support, but with a firmer feel depending on the body positioning.”

She also recommended roleplaying to help couples focus on their personal needs, abilities and strengths, and to create a fun atmosphere for experimentation.

“Roleplaying is also key and can help set the mood for an interabled couple,” Quirit Rella explained. “Use your strengths, abilities and interests to enhance the sexual experience. Create the ambience and always communicate with each other. Redefine what sex means to you and build up that self-esteem, self-worth and confidence.”

Celebrating our differences

Ableism is very prevalent in many aspects of life, which means able-bodied individuals are still often viewed as the “default” body type. We witness this every time we enter a building that has only stairs or a parking lot with one handicapped spot, or we start a new job and find they don’t allow for mental health days.

A lack of understanding and empathy toward disabilities can take an emotional toll, too. Since it’s very likely we all love someone, or are someone, with a disability, it’s important we make a conscious effort to shift our thinking about disability in general.

“It’s very important to consider the emotional challenges that can come along with disability, including issues related with self-esteem, body image or societal stigmas,” White noted. “Creating a space of nonjudgment where it’s OK to express concerns or challenges is vital for sexual health and well-being.”

When thinking about intimacy and disability, it’s crucial that we don’t focus solely on what a disabled person can physically bring to the table. A disabled person’s strength to be vulnerable about their own limitations is worth celebrating in itself. If we shift our thinking to view sex as a pleasurable bonding experience between humans no matter what it looks like, we can better appreciate what humans of all ability levels have to offer.

“People with disabilities have real sexual identities, needs and desires,” Quirit Rella said. “The beautiful part is not focusing solely on the physical aspect of sex, but instead, the intimacy felt during a whole mind-body experience with a partner or with yourself.”

Complete Article ↪HERE↩!

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A silent crisis in men’s health gets worse

— Across the life span — from infancy to the teen years, midlife and old age — boys and men are more likely to die than girls and women

By and

A silent crisis in men’s health is shortening the life spans of fathers, husbands, brothers and sons.

For years, the conventional wisdom has been that a lack of sex-specific health research mainly hurts women and gender minorities. While those concerns are real, a closer look at longevity data tells a more complicated story.

Across the life span — from infancy to the teen years, midlife and old age — the risk of death at every age is higher for boys and men than for girls and women.

The result is a growing longevity gap between men and women. In the United States, life expectancy in 2021 was 79.1 years for women and 73.2 years for men. That 5.9-year difference is the largest gap in a quarter-century. (The data aren’t parsed to include differences among nonbinary and trans people.)

“Men are advantaged in every aspect of our society, yet we have worse health outcomes for most of the things that will kill you,” said Derek Griffith, director of Georgetown University’s Center for Men’s Health Equity in the Racial Justice Institute.“We tend not to prioritize men’s health, but it needs unique attention, and it has implications for the rest of the family. It means other members of the family, including women and children, also suffer.”

The longevity gap between men and women is a global phenomenon, although sex differences and data on the ages of greatest risk vary around the world and are influenced by cultural norms, record keeping and geopolitical factors such as war, climate change and poverty.

But data looking at health risks for boys and men in the United States paint a stark picture.

  • Men are at a greater risk of dying from covid-19 than women, a gap that cannot be explained by rates of infection or preexisting conditions. The age-adjusted death rate for covid was 140 deaths per 100,000 for males and 87.7 per 100,000 for females.
  • More men die of diabetes than women. The death rates for men are 31.2 per 100,000 people vs. 19.5 per 100,000 for women.
  • The cancer mortality rate is higher among men — 189.5 per 100,000 — compared with 135.7 per 100,000 for women. Black men have the highest cancer death rate at 227.3 per 100,000. Among Black women, the cancer mortality rate is 149 per 100,000.
  • Death rates for boys and teens ages 10 to 19 (44.5 per 100,000) far outpace that for girls (21.3 per 100,000). Even among infants, the mortality rate is higher for boys (5.87 per 1,000 live births) vs. girls (4.95 per 1,000).
  • Men die by suicide nearly four times more often than women, based on 2020 data from the Centers for Disease Control and Prevention. The rate of suicide is highest in middle-aged White men, but teen boys also face a high risk.
  • In 2020, 72 percent of all motor vehicle crash death victims were male. Men also accounted for 71 percent of pedestrian deaths, 87 percent of bicyclist deaths and 92 percent of motorcyclist deaths.

Advocates for more research into men’s health say the goal isn’t to steal resources from women, girls and gender minorities.

“Some people think health care is a zero sum gain and one dollar to men’s health is taking something away from women,” said Ronald Henry, president and co-founder of the Men’s Health Network, an advocacy group. “That’s wrong. We are fully supportive of women’s health efforts and improving quality of life for women.”

But by viewing men as the privileged default, health experts are ignoring important sex differences that could illuminate health issues across gender and minority groups.

For instance, for years the widely held belief in medical circles was that women used too many health-care resources compared to men. As a result, men were viewed as the standard for seeking health care, while women were often dismissed as hysterical or “anxious” when they sought care.

“We used to think women were overutilizing health care, and men were doing it correctly,” Griffith said. “What we realized was that women were doing it better, mostly for preventive care, and men were actually underutilizing health care.”

Explaining the longevity gap

The reasons behind the longevity gap aren’t fully understood, but the global nature of the disparity suggests that biology probably plays a strong role.

For instance, high levels of testosterone, which can weaken the immune response, may be a factor in why men, and male mammals in general, are more vulnerable to parasitic infections. Estrogen may explain why women have lower rates of heart disease throughout life — and why the gap narrows after women reach menopause. (Even though estrogen appears to be protective in women, studies in the 1970s showed that when estrogen was given to men, instead of being protective, it caused double the rate of heart attacks as those in a placebo group.)

Cultural biases around masculinity that teach boys and men to hide their feelings and not complain also can influence men’s health.

“Depression in men is quite deceptive,” said Marianne J. Legato, a physician and founder of the Foundation for Gender-Specific Medicine in New York. “Men are socially programmed to not complain. Suicide is often unexpected as an early end to a man’s life compared to that of a woman.”

Cultural expectations to remain stoic can also delay men’s care. For instance, although diseases such as diabetes, heart disease and hypertension are common in men and women, men often wait longer to seek care and the illnesses are diagnosed at later stages, leading to more damage and poorer outcomes.

“It’s an interesting conundrum and in many ways it’s not well understood,” said cardiologist Steven Nissen, chief academic officer for the Cleveland Clinic. “Men need to pay close attention to cardiovascular risk factors. Treating risk factors early can mitigate a lot of the risk.”

Men also are known to engage in more risky behaviors, such as drug and alcohol use, smoking and reckless driving. While the reasons behind these trends aren’t fully understood, behavioral risks are also a reason men’s health doesn’t get studied, Griffith said.

“It’s hard to convince people that men’s health is an issue if we think it’s just because men don’t do what they’re supposed to do,” he said.

Fewer doctor visits

An oft-cited concern is that men are also less likely to visit the doctor. Although boys and girls visit the pediatrician at the same rate, the trend changes in adulthood and medical visits by men decline. CDC data show that the physician visit rate in 2018 among females was almost 40 percent higher — 3.08 visits per woman vs. 2.24 per man.

One reason is that women regularly visit the gynecologist in their reproductive years. “There is no similar pathway for men,” Nissen said.

But even when visits for pregnancy are excluded, research suggests that women still are twice as likely as men to schedule regular annual exams and use preventive services.

Doctors say that men are most likely to visit the doctor because of a sports injury or for the “Viagra” visit — when they seek treatment for erectile dysfunction. As a result, sports medicine physicians and urologists are encouraged to use those visits to check blood pressure, cholesterol and other indicators of overall health.

“Stamina and sexual health are two of the top things that men think about,” said Howard LeWine, an internal medicine physician at Brigham and Women’s Hospital in Boston and chief medical editor at Harvard Health Publishing. “When you’re 20, 30 and a man, you really don’t think about health. The idea of going to a doctor to prevent cancer or heart disease — I don’t think it’s in the mind of many men until something has happened to them.”

The irony is that men for years have been overrepresented in medical research, often at the expense of women, according to a seminal 1985 report that prompted more government investment in women’s health research.

“Men who were overrepresented in medical studies before are still underrepresented in terms of clinical care,” said Harvey Simon, an internal medicine physician and founder of Harvard Men’s Health Watch, a newsletter devoted to men’s health.

Lack of support

Men’s health advocates say one of the biggest factors is a lack of infrastructure to support research specifically focused on men’s health.

For years, the Men’s Health Network has lobbied for the creation of an Office of Men’s Health, similar to the Office of Women’s Health in Health and Human Services Department. Proposed legislation, however, has consistently failed to win support.

While some health systems claim to have departments focused on men’s health, the care is often focused on urologic and prostate health rather than cardiac care, mental health or other issues that afflict men at high rates.

The topic of men’s health simply hasn’t caught on as something that advocates, corporate sponsors and politicians want to get behind. While the pink-ribbon has been elevated to iconic status to signal breast cancer awareness, nothing in men’s health has achieved the same level of attention.

“There is an empathy gap,” Henry said. “There are people who shrug and say, ‘Yes, men die younger. That’s the way the world is.’ It doesn’t need to be that way. If we devote attention and resources, we can change the outcomes for men.”

Complete Article ↪HERE↩!

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Sex after menopause doesn’t need to hurt

— Comprehensive review offers roadmap for doctors to evaluate, treat overlooked condition

  • Between 13% and 84% of postmenopausal women experience vaginal pain during sex
  • Causes of pain other than vaginal dryness are often undiagnosed and untreated
  • Pain during sex can harm relationships, self-esteem and contribute to depression, anxiety
  • Safe, effective therapies exist but condition is rarely evaluated or treated

Between 13% and 84% of postmenopausal women experience dyspareunia—vaginal pain during sex—but the condition is rarely evaluated or treated despite the availability of safe and effective therapies. With life expectancy increasing and the functional health of older adults improving, the identification and treatment of painful penetrative sex represents a great unmet need.

A new Northwestern University Feinberg School of Medicine comprehensive review of medical studies involving painful sex in post-menopausal women provides a roadmap for doctors to evaluate and treat the typically overlooked condition.

It is the only comprehensive review of its kind because it examines multiple reasons for the condition beyond just vaginal dryness due to lack of estrogen, such as post-hysterectomy problems, arthritis, cancer treatments and more.

“Post-menopausal women shouldn’t accept painful sex as their new norm,” said Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Feinberg. “Many women try over-the-counter lubricants but continue to have pain. They, and sometimes their health care professionals, are unaware that there are other, more effective treatments.

“In addition, women are increasingly treated by telemedicine and not examined. The cause of pain with penetration is assumed to be due to vaginal dryness when they may have another condition that has been undetected.”

The review was published last week in Menopause: The Journal of The North American Menopause Society.

Aside from the obvious negative aspects of enduring pain and the inability to have penetrative sex, the consequences of dyspareunia include negatively impacting relationships and self-esteem and can contribute to depression and anxiety. In addition, other sexual dysfunctions such as hypoactive desire disorder and orgasmic dysfunction are often consequences of pain with penetrative sex.

Causes of vaginal pain during sex

Post-menopausal vaginal pain is often specifically due to lack of estrogen, but there are other, usually undetected and untreated causes for inability to have penetrative sex, Streicher said. These include post-hysterectomy problems; cancer treatments (chemotherapy, radiation, surgery); lichen sclerosus (patchy, discolored, thin skin) and other vulvar conditions; pelvic-floor tension; arthritis and other musculoskeletal problems; pelvic organ prolapse; and sexually transmitted infections.

More than 30% of women over the age of 50 are single and potentially will have a new sexual partner, Streicher added.

“Sexuality in women after the age of 50 years is marginalized, and gynecologic care is not prioritized, valued or even recommended,” Streicher said.

Why aren’t women being evaluated, treated for the condition?

Despite available treatments, dyspareunia often goes undetected for a variety of reasons. First, most American women no longer see a gynecologist after going through menopause, Streicher said. Secondly, women often don’t discuss painful sex with their primary health care clinicians, and, when they do, most clinicians are not equipped to treat these problems because they haven’t been trained to properly evaluate or treat dyspareunia in this population. Third, sexual function is often a low priority in women with other serious medical problems.

In a 2004 survey of more than 1,000 midlife women, 98% had at least one sexual concern, but only 18% of physicians broached the topic. This is particularly true in postmenopausal women who are unaware that solutions are available and rarely seek care for this complaint.

It’s also difficult to pinpoint the exact prevalence of dyspareunia in post-menopausal women because studies on dyspareunia require women to have at least one sexual encounter the month before enrollment, and women with dyspareunia avoid sexual activity because of pain.

What can be done?

Doctors should broach the topic of dyspareunia with their patients using oral or written questionnaires, Streicher said. In addition to a thorough medical history and physical examination, various tools can be used as further assessments, including vaginal pH, vaginal dilators, imaging, vulvar biopsy, vulvoscopy and photography, the cotton swab test, sexually transmitted infection screening and vaginitis testing.

Some of the treatments discussed in the review include silicone lubricants, moisturizers, vaginal estrogen, ospemifene, dehydroepiandrosterone, local testosterone therapy, cannabidiol and fractional CO2 laser treatments. In some cases, dyspareunia may need to be specifically addressed by pelvic floor physical or sex therapists.

Complete Article ↪HERE↩!

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Why Are STI Cases Soaring?

— We Asked the Experts

Newly-released data shows infections for certain sexually transmitted infections have jumped tremendously.

By Korin Miller

  • Several sexually transmitted infections have increased in the U.S., according to new data from the CDC.
  • The 7% increase continues an upward trajectory in certain STIs.
  • Doctors say there are a lot of reasons why this is happening in the U.S.

Sexually transmitted infections continue to climb in the U.S., with syphilis cases in particular skyrocketing in 2021—the most recent year data is available.

The data was shared as part of a report from the Centers for Disease Control and Prevention (CDC) released this week. The report breaks down cases of a range of STIs, including chlamydia, gonorrhea, and syphilis.

The data show that there were 1,644,416 new chlamydia cases diagnosed in 2021—a 4% increase over 2020. There were also 710,151 new cases of gonorrhea diagnosed, an illness that’s been steadily increasing 28% since at least 2017, when 555,608 cases were diagnosed.

But while syphilis cases made up a fraction of overall STI cases, they’re on a sharp upward trajectory: 176,713 new cases were diagnosed in 2021, a significant increase from the 133,954 cases diagnosed in 2020 and 129,818 cases diagnosed in 2019.

Cases of congenital syphilis (which is what happens when the disease is passed from a mom to her baby during pregnancy) also jumped up—from 2,157 in 2020 to 2,855 in 2021.

The CDC notes that case numbers were undercounted in 2020 due to the pandemic and “likely continued in 2021,” but that the impact was the most severe in 2020. “The annual report shows infections continued to forge ahead, compromising the nation’s health,” Leandro Mena, M.D., M.P.H., director of the CDC’s Division of STD Prevention, said in a statement.

Those are a lot of numbers to wade through, but the overall takeaway is this: STIs, which have already been recorded at high numbers across the country, continue to jump up. Here’s what’s going on.

Why are STIs increasing across the country?

The report didn’t specify why these STIs in particular are jumping up—it simply crunched the numbers. However, the CDC noted that certain racial, ethnic, and sexual minority groups are disproportionately impacted by STIs.

Black or African-American people made up a third of chlamydia, gonorrhea, and syphilis cases, but only make up 12% of the U.S. population, the report points out. Nearly 1/3 of all gonorrhea cases were in gay and bisexual men. Congenital syphilis rates increased for most racial and ethnic groups, but the highest rate was in babies born to American Indian and Alaska Native people, the report noted.

“While tried-and-true prevention strategies are key, social inequities often leads to health inequities and, ultimately, manifest as health disparities,” the report says. “We must work collaboratively to address social, cultural, and economic conditions to make it easier for people to stay healthy.”

But…what’s behind all this? “A lot,” says Thomas Russo, M.D., an infectious disease expert at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences. “Here’s the thing: 2021 was our breakout year where the COVID-19 vaccine became available and people started playing a lot of social catch-up,” he says. “As a result, there was a whole bunch of interactions, some of which involved sexual activity.”

STI rates “reflect how well our public health infrastructure is,” Dr. Russo says, noting that there was a big shift in resources during the height of the pandemic. “It was all about COVID,” he says. “STI public health clinics and even interactions with physicians probably took a backseat.”

Infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security, agrees. “COVID disrupted STI work dramatically,” he says. “Health departments do the bulk of STI work and they were under-resourced to do STIs and COVID.”

The opioid crisis may also play a role, Dr. Russo says. “There’s a lot of activity that occurs to get drugs for sex,” he says. “That usually involves multiple partners and unprotected sexual activity.”

There was also a lack of widespread testing for STIs during the height of the pandemic in 2020, and that may have led to less people getting screened and diagnosed—increasing the odds they spread STIs to others, says women’s health expert Jennifer Wider, M.D. “A drop in screening and testing for all sorts of diseases and conditions [in 2020] has resulted in a jump in diagnoses for many people, particularly in groups with poor access to healthcare to begin with,” Dr. Wider says.

here is also inconsistent and “inadequate sex education” in the U.S., which lowers the odds that someone will know prevention strategies for STIs and recognize symptoms, if they happen to develop them, Dr. Wider says.

Why are syphilis cases jumping up so quickly?

Syphilis cases hit “historic lows” in the early 2000s, the report says, but they’ve since surged, increasing a jaw-dropping 781% since 2001. Some states—California, Texas, Arizona, Florida, and Louisiana—have been disproportionately impacted, making up 58% of reported cases of congenital syphilis. The larger syphilis epidemic was also mostly concentrated to within 100 counties—they made up 60% of all reported cases in 2021.

A lot of the reasons why chlamydia and gonorrhea are spreading in the U.S. applies to syphilis as well, Dr. Russo says. But he also points out that syphilis “spreads reasonably well” through oral sex. “People often think that oral sex is relatively safe when it comes to STIs but, with syphilis, that’s not the case,” he says. “That’s one of the factors that can drive it.”

The CDC stressed in the report that syphilis is “completely preventable and treatable,” adding that “timely screening, diagnosis, and treatment can save lives, but if left untreated, the infection can cause serious health problems and increase the risk of getting an HIV infection.”

How to lower your risk of getting an STI

You’ve likely heard all of this before, but it never hurts to do a refresher. The CDC offers the following advice to lower your risk of getting an STI:

  • Practice abstinence. The CDC points out that the most reliable way to avoid STIs is to avoid having anal, vaginal, or oral sex.
  • Get vaccinated against HPV and hepatitis B. The vaccines won’t protect against everything, but the HPV vaccine in particular can help lower the risk of contracting certain strains of HPV that are linked to the development of cancer.
  • Reduce your number of sex partners. Less sex partners means a lowered risk, the CDC says. However, the agency still recommends that both you and your partner get tested and share your results with each other.
  • Be mutually monogamous. That means both you and your partner only have sex with each other.
  • Use condoms. The CDC recommends that you use a male latex condom every time you have anal, vaginal, or oral sex. Non-latex condoms can be use, the agency says, but they have higher breakage rates than latex condoms.

The CDC also stresses the importance of using STI testing and treatment, noting that there some pharmacy and retail health clinics allow people to get tested on-site.

Unfortunately, Dr. Russo expects things to get worse before they get better, given the state of reproductive care in the U.S. and lack of access to sexual health clinics for people in some states. “We need to do better and make a commitment to this important area,” he says.

Complete Article ↪HERE↩!

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Sexologist Chantelle Otten on the complexities of sex in both her work and her personal life

— Let’s talk about sex.

Chantelle Otten

By Alley Pascoe

As a renowned sexologist, Chantelle Otten is privy to people’s deepest desires, fears and insecurities. Here, she’s honest about her own.

I’m in bed with Chantelle Otten and she’s taking photos of her feet. It’s not as kinky as it sounds. We’re speaking over Zoom ahead of Otten’s Body+Soul cover shoot the next morning, and she’s sending the manicurist pictures of her nails so they know what to expect.

“This is very embarrassing, my nails are really, really bleak,” she says, with endearing honesty and an easy laugh.

There’s something about Otten’s voice. It’s soothing. And welcoming. Like the cosy blanket wrapped around her dachshund Sauce, who’s snuggled beside her in bed.

Chatting from her sunlit bedroom in Melbourne, Otten speaks with a warmness. She has a way of putting you at ease, making you feel comfortable and giving you the space to speak your truth. When Otten opens her mouth, you can’t help but bare your soul in return. It’s a gift – and sometimes a burden – and it’s something she was born with.

“For my entire life, I’ve always had people confide in me. I’m the person at the party sitting in the corner listening to someone’s life story,” explains Otten, who grew up in a “quirky” family in the Melbourne suburb of Murrumbeena with two younger brothers and an older sister with an intellectual disability.

“As a kid, I was always listening in on what was happening in my parents’, siblings’, grandparents’ and friends’ lives. That gave me an awareness and understanding of different personalities, and the complex nature of individuals.”

From then, Otten, now 32, has turned her skill into a successful career as a psycho-sexologist. What exactly does that involve, you may wonder? A sexologist is someone who studies the science of sex, human behaviour and sexual health and wellbeing. Their job is to help clients with their sexual concerns, and to empower them with the knowledge and the confidence they need to lead a healthy sex life.

At Otten’s sex therapy clinic in Melbourne, nothing is off limits. It’s a safe space to talk about intimate things: sexual identity, self-esteem, performance anxiety, trauma, pleasure and pain.

“I feel grateful that people trust me enough to be vulnerable with me.”

“My clinic is a place where people can be themselves; you can swear, cry, laugh and talk about things that upset you. Or not. Whatever you want,” she says. “My clients tell me that I make them feel at ease. Apparently, I’ve got a therapeutic voice.”

Soon, you’ll be able to listen to Otten’s voice in the Audible podcast Sex Therapy: Sessions with Chantelle Otten. The series promises to “take you under the covers and into the world of sex therapy”, and that’s quite literally what it does. Each episode features an anonymous recorded therapy session with real people dealing with real issues.

There’s the married couple looking for advice on opening up their relationship; the new mum trying to regain her sexual identity; the man experiencing erectile dysfunction; and the woman who has never reached orgasm. Their stories are fascinating – heartbreaking at times, oh-so relatable at others – and truly enlightening.

“We wanted for it to feel like being a fly on the wall,” says Otten. “We’re all going to have difficulties with sex at some point in our lives – all of us – so I hope this podcast can help to normalise talking about sex. I hope the episodes resonate with people, and that they take shame out of the conversation and help to alleviate any apprehension they might have around sex therapy.”

The podcast is the latest move in Otten’s mission to increase pleasure and remove shame from the bedroom. After studying psychology and undertaking a masters in sexual health, Otten worked under Dr Ingrid Pinas in a women’s sexual health clinic in the Netherlands.

Upon returning to Melbourne from Amsterdam, she founded the Australian Institute of Sexology and Sexual Medicine in 2016, followed by her namesake clinic in 2018. In the five years since her clinic has opened, Otten has grown from being a one-woman show (and disguising her voice on the phone to pretend she had a receptionist) to having a dedicated team of 20.

“I tend to only take on patients with very specialised cases, so I am dealing with a lot of complex trauma,” she says. “That’s very rewarding for me. I don’t charge my patients; I make money from my sponsorship work. So, my client work is pro bono, which is my way of giving back.”

With Otten – and many other sex educators – leading the way, times are a-changin’. As her business has grown, Otten has seen vibrators go from being ‘dirty little secrets’ to being stocked in major department stores and promoted by influencers all over Instagram. She’s watched the sexual wellness industry grow by $16.8 billion from 2017 to now. And she’s been a part of important discussions about consent and reproductive health, with her 2021 book The Sex Ed You Never Had. But as far as we’ve come, there’s still a way to go.

In the last five years, we’ve witnessed Roe v Wade overturned in America, threatening the future of reproductive rights in the country. We’ve heard shameful stories of sexual harassment and assault within Australian politics. And we’ve learned that Instagram has been censoring sex education accounts – Otten’s included.

“Oh, I think I’ve been shadowbanned on Instagram for five years. It’s problematic that so many people are being silenced, because sex education should be accessible to everyone,” she says. “The main thing I want people to know is that sex should be fun, pleasurable and free of pain and shame. I think we need to make sex sexy again!”

That’s where Sex Therapy: Sessions with Chantelle Otten comes in. Apart from the all-important destigmatising and empowering stories, perhaps the best part of the podcast is getting to listen to Otten’s silky voice in situ.

Today Otten’s voice is raspier than usual. She’s been battling a sinus infection, she tells me, and is trying to recover from the physical fatigue of taking on people’s trauma.

“The challenges that come with this line of work are heavy. When you hear someone’s trauma, it does affect you,” she says. “I am constantly doing work on myself to make sure that I’m there for my patients.”

As well as the emotional toll there are other – more, er, unique – challenges that come with being a sexologist. Namely, people confusing sexology with sex work. Remember when Otten was starting out in her business and put on a fake voice to make out she had a receptionist? Yeah, that didn’t end well.

“I had a guy call wanting to book in a session with his wife for relationship therapy. He was talking and asking questions, and I was answering as the ‘receptionist’. Then he asked me if he could watch. ‘What?’ I asked. ‘Can I watch you and my wife having sex together,’ he said. ‘Oh, no, no, this isn’t the place for that,’ I explained. ‘Just keep talking,’ he said, and I realised that he was masturbating over the phone listening to my receptionist voice,” recalls Otten, with amusement rather than horror. “That’s when I realised I really needed to get an actual receptionist.”

Otten is quick to find the humour in her work. What’s the saying? If you don’t laugh, you’ll cry. That’s the approach Otten takes with life and work. Once again, this is a trait she’s had since childhood.

After Otten’s older sister left their primary school to attend a school that provided support for her disability, she had to find her own voice. “When my sister went to a different school, I felt left behind. I had no friends, so I had to learn how to make friends. I learned how to make people laugh, and became an extroverted introvert,” she says.

Learning how to make friends has paid off. Today, it’s Otten’s friends who keep her grounded. They’re the ones she turns to when she’s struggling with the pressures of her profession and running a 20-person business.

“My best friends are all amazing, deep thinkers. When I’m with them, I’m not the therapist, I’m their friend. I feel very lucky for the community I have around me,” she admits. That community includes Otten’s partner of four years, Dylan Alcott.

As the meet-cute story goes, Otten first laid eyes on Alcott, the champion tennis player and 2022 Australian of the Year, at the launch of his book at the North Fitzroy Library in 2019. It was love at first sight. “I still remember that moment so clearly. I remember looking at him and thinking, ‘That’s my person.’ I didn’t know anything about Dylan – or that he was famous – I just knew that he’d written a book because I was at his book signing. I realised this guy wants a big life, and I was excited to live a big, wonderful life together,” she says.

The feeling was mutual. When Otten had to slip away from the book launch without speaking to Alcott, he found her on Instagram after she posted about the event, and slid into her DMs: “Where the hell did you go?” They’ve been together ever since.

“Dylan has taught me so much about life, about having a purpose and being in a long-term relationship. When you love someone so much, you need to look at yourself and your flaws and consider what you’re bringing to the table. Dylan’s a lot of fun, and sometimes I can be a bit serious, so we’ve taught each other about balance,” says Otten. “There’s no one else out there who makes me feel so excited and passionate about life.”

Alcott, also 32, shares his partner’s passion for breaking down taboos, especially when it comes to changing the misconceptions around disabled people having – and desiring – sex. “A lot of people think that people with a disability don’t have sex, but I’m having the best sex of my life and it’s important for me to say that,” Otten told Stellar magazine in 2020.

Clearly, sex is a big part of her life. But does she ever get tired of talking about it? “Of course I get sick of talking about sex,” admits Otten. “There are times when I’ve been inundated with work and under a lot of pressure, and I’ve hated my job. I’ve had to put a lot of boundaries up.”

When people recognise Otten and come up to her on the street to tell her that they love her work, she feels grateful: “That’s beautiful.” But when people approach her and ask intimate questions or unload their personal issues, Otten takes a step back. She thanks them for wanting to open up to her and suggests they book a session through her clinic.

“There’s a time and place; I can’t give good advice when I don’t know all the details of their situation or medical and sexual history. It’s very complex,” she says. “I was once recognised by a girl on the dance floor at a club in Amsterdam at 3am, and I ran off into the darkness.”

Otten can be blunt. “I’m Dutch,” she explains. “I can be direct, but that’s how I speak, and sometimes I have to be that way. I don’t mind if people don’t like me because I hold boundaries with them. That’s more on them than it is on me.” When Otten speaks about boundaries, her voice is steady and unwavering.

There’s a knowing beneath her words. It’s the voice of someone who’s heard, seen and done some sh*t – and lived to tell the tale. The thing that keeps Otten going through it all is her innate curiosity.

“The best piece of advice I was ever given was to remain curious. My mum gave it to me and I’ve held onto it. People are so complex and I’m forever curious about them,” she says. “They have such amazing private lives – you have no idea about – and they come to share it with me. How lucky am I that I get to hear people’s secrets, and hold those secrets? It’s unbelievable.”

How to have better sex

Four surprisingly simple Chantelle Otten-approved ways to improve your intimacy.

Keep learning

“I want people to remain open to learning more about their sex lives and their partner. We often make the mistake of assuming we know everything about our partner, but there’s so much that goes on behind our outer shells. That mystery is a beautiful thing.”

Get playful

“Toys can add spice to your sexual experience, making it more pleasurable and adding variety for both you and your partner. I like to think of toys like salt and pepper – they might not be needed, but they make everything better.”

Book it in

“OK, this one might seem a little bit naff, but scheduling sex once a week has been shown to increase sexual satisfaction. Even if it’s the same sexual menu every time, it still improves satisfaction. Our sex lives are something we need to work at.”

Talk it out

“When you’re stuck in a sexual rut – and we all get stuck sometimes – don’t be shy to talk about it with someone who can help. That’s what sexologists are here for, to provide a different perspective and give advice on getting more pleasure.”

Complete Article ↪HERE↩!

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Epilepsy and Sex

— How Epilepsy Can Affect Sexual Health

By Serenity Mirabito RN, OCN

Attention to sexual health in people with epilepsy is often lacking. Sexual dysfunction, however, is a side effect of epilepsy and the medications that treat it.

Although not fully understood, epilepsy can also cause endocrine disorders that negatively impact the reproductive system, leading to infertility. People with epilepsy need to talk to their healthcare providers about ways to prevent sexual problems when diagnosed with the condition.

This article addresses the cause of sexual problems in people with epilepsy and how to treat them.

What Is the Connection Between Sexual Problems and Epilepsy?

Sexual problems like decreased libido or inability to orgasm are more likely to occur in people with epilepsy compared to those who don’t have the disease. Because the brain is responsible for both epilepsy and sexual behavior, there is a connection between the two, which includes:

  • Brain excitability: Sexual dysfunction in people with epilepsy sometimes depends on the part of the brain from which the seizure originates. People with right-sided temporal lobe epilepsy have the highest rates of sexual dysfunction. People with partial epilepsy suffer from sexual dysfunction more than those with idiopathic generalized epilepsy.
  • Sex hormones: Abnormal secretion of sex hormones is common in people with epilepsy. Low testosterone and estradiol levels are associated with epilepsy and sexual dysfunction.
  • Endocrine disorders: People with epilepsy have fluctuating hormone levels that are either complicated by endocrine disorders or cause them. The hormonal instability and endocrine diseases further worsen sexual problems in men and women, including the ability to conceive.
  • Psychological effects: People with epilepsy often complain of poor self-esteem and stigma around their illness. A limited ability to work, drive, or attend school can lead to depression and anxiety. The added fear of having a seizure during sex can also inhibit the desire for intimacy.

Do Drugs That Treat Epilepsy Cause Sexual Problems?

Not only do seizures, hormones, and psychological issues diminish sexual function, but the medications that treat epilepsy also impact sexual health. Some anti-epileptic drugs (AEDs) cause elevated liver enzymes that lead to suppressed sex hormones. Other AEDs have a depressive effect on the brain that can leave people feeling sedated and uninterested in sex.

AEDs known for increasing liver enzymes and decreasing sex hormones include:

Speak to your healthcare provider about how anti-epileptic drugs could affect your sexual health.

How Are Sexual Problems Due to Antiepileptic Drugs Treated?

Some AEDs effectively treat seizures and have minimal sexual side effects. Changing medications may be an option depending on the type and severity of the seizure disorder. AEDs that have a decreased implication for sexual dysfunction are:

If switching AEDs doesn’t work, you may be able to take medications that help treat sexual dysfunctions. These include:

Reducing the dose of the AED, building up a tolerance to the medication, and taking the drug after sex may improve sexual ability. It may take various approaches to find the best solution for improved sexual health, but keeping an open dialogue with your healthcare provider is essential.

Symptoms and Gender Differences

Sexual problems in people with epilepsy can affect up to 60% of men and 50% of women. Although men and women with epilepsy may experience decreased libido, other sexual problems manifest differently in each gender.

Men

In addition to decreased testosterone levels and the side effects of AEDs, performance anxiety can cause the following sexual problems in men with epilepsy:

Women

Endocrine disorders, low levels of female hormones, menstrual irregularities, and psychiatric conditions have been linked to sexual and reproductive dysfunctions in women with epilepsy.

Epileptic women often experience the following sexual problems:

In addition, endocrine disorders that affect fertility in women with epilepsy are:

How Are Sexual Problems With Epilepsy Treated?

Treating sexual problems associated with epilepsy begins by telling your healthcare provider. Various methods can help improve sexual dysfunction in people with epilepsy. Some options that may help include:

  • Hormone replacement therapy: Replacing testosterone and estradiol may improve sexual health.
  • Medications: Drugs are available to help increase sexual desire and treat conditions like premature ejaculation.
  • Improving mental health: Treating underlying depression and anxiety can help with intimacy.
  • Lubrication: Vaginal pain and dryness during sex can be relieved with water-based lubrication.
  • Erection management: Prevent or reduce penile flaccidity by placing an elastic band at the base of the penis, using vacuum devices, or using an intracavernosal injection of vasodilators.
  • Brain surgery: Research found anterior temporal lobectomy resulted in being seizure-free in 60% of patients. Those patients also reported significant improvement in sexual function.

Summary

People with epilepsy often experience sexual problems. Hormonal abnormalities, endocrine disorders, fear, and side effects of treatment may lead to sexual dysfunctions. Depression, loneliness, and anxiety can occur if sexual health is not seriously addressed. There are various methods available for improving sexual impairments in people with epilepsy. Talk to your healthcare provider about ways to prevent sexual problems if you have been diagnosed with epilepsy.

A Word From Verywell

Sexual health plays a valuable role in the quality of life; many people feel unsatisfied and disconnected when it’s poor. If you’ve been diagnosed with epilepsy and are struggling with libido, the ability to orgasm, infertility, or depression, you are not alone. Speaking to your healthcare provider about these symptoms so they can help you feel better is essential.

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.

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Five important things you should have learned in sex ed

– But probably didn’t

It’s important to talk about sex with your partner.

By

If you grew up in the 90s and 00s, you may feel that sex education didn’t teach you much of practical value. Most sex education during this time followed a “prevention” approach, focusing on avoiding pregnancy and STIs, with most information largely targeted at heterosexual people.

While some schools are now making their sex education more “sex positive” and inclusive, that doesn’t change the fact that many in their 20s and 30s feel they’ve missed out on vital education that could have helped them better navigate the complex world of relationships and sexuality as adults.

But it’s never too late to learn. Here are five important lessons that sex ed should have taught you.

1. ‘Normal’ sex drive is a myth

Sex education never taught us that sex drive is highly variable and has no universal normal. While some may want sex several times a week, others may find once a month or less sufficient.

Regardless of how often you want or have sex, more important is understanding sex drive is affected by many factors, and may change throughout your lifetime. Many factors, such as hormone fluctuations, stress, certain medications (including antidepressants and hormonal contraceptives), as well lifestyle factors (such as smoking, drinking, exercise and diet) can all affect libido.

The most important thing is aspiring to understand your own sexual needs and desires and communicating these to your partner. This is important for personal wellbeing and healthy relationships.

Sex drive should only be considered problematic if you’re unhappy with it. If you’re concerned with it in any way, it’s worth checking with your GP.

2. Talking about sex is important

Many of us remember how sex ed tended to focus on discussing the harms that can come from sex. As such, some of us may now see the subject as taboo, and may shy away from talking about sex with our partner.

But research shows that sexual communication is associated with higher relationship and sexual satisfaction. When we openly communicate about sex, we’re revealing otherwise private aspects of ourselves (such as our desires or fantasies) to our partner. Doing so may, in turn, boost sexual satisfaction and feelings of intimacy, which may improve relationship satisfaction overall.

Thankfully, there’s ample advice online to help you learn how to start this conversation and know what sort of questions to ask your partner. Some relationship psychologists suggest starting these conversations as early as possible in relationships, to clarify needs and help ensure sexual compatibility.

They also suggest you continue sharing sexual fantasies as trust in the relationship grows, regularly asking your partner what they enjoy and sharing what you prefer as well.

3. Sexuality can be fluid

Most sex education in the 90s and 00s was largely skewed towards people who were heterosexual and cisgendered. This left those who identified as lesbian, gay, bisexual, non-binary or any other sexual or gender identity with little or no relevant information on how to negotiate sex and relationships.

This also means many people weren’t taught that sexuality can be multifaceted and fluid. Your sexuality is influenced by a combination of many biological, psychological and social factors, and may shift throughout your lifetime. So it’s perfectly normal for your sexual desire and who you’re attracted to change.

Two women hold hands while walking through a city.
It’s normal for sexuality to shift throughout your lifetime.

Research indicates that sexual fluidity may be more common among cisgender women and sexual minorities. It’s difficult to discern a clear reason for this, but one possibility is that men who identify as heterosexual may be less likely to act on same-sex attractions, perhaps for fear of negative reactions from those in their social circle.

There’s also evidence that same-sex attraction and sexual fluidity are influenced, in part, by genetics, showing us just how natural diversity in human sexuality is.

Understanding that sexuality can be fluid may help people to let go of potentially harmful misconceptions about themselves and others, and feel more open to express themselves and explore their sexual identity.

4. Sexually transmitted infections are very common

STIs are common, with one person being diagnosed every four minutes in the UK.

But most of us remember our sex ed classes focusing on prevention, resulting in stigmatised perceptions of STIs. This stigma can be harmful, and can impact a person’s mental and physical health, as well as their willingness to disclose their STI status to partners.

This prevention approach also meant we learned very little about how to recognise symptoms and treat STIs and fuelled the rise of myths surrounding STIs.

For example, one myth is that people with genital herpes can never have sex again without infecting their partner. Not only is this not true but also, as with all STIs, the earlier you’re diagnosed and treated, the easier it will be to avoid future complications such as infertility.

5. Navigating pregnancy and your fertility

Planning for pregnancy and parenthood is important for both women and men. But with sex ed’s focus so strongly placed on avoiding pregnancy, this means we missed out on important education relating to pregnancy and fertility. This means many women may not be properly educated about the many bodily changes that occur during pregnancy and afterwards.

Sex ed also failed to teach us that around 10%-15% of all pregnancies end in miscarriage. This can be a traumatic event, even in cases of early pregnancy loss. But knowing how common it is and having appropriate support could reassure many women that it isn’t their fault.

Many of us also won’t have learned about other aspects of fertility, such as how waiting to have children may affect your chances of getting pregnant. Nor will you have been taught about how lifestyle factors such as weight, diet, and exercise can also affect your chances of becoming pregnant. We also weren’t taught about how common problems with men’s fertility are, and how it can also decline with age.

Even if you did miss out on key sex ed in your earlier years, it’s never too late to begin exploring what healthy relationships and sexuality mean to you.

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Is Seasonal Affective Disorder impacting your sex life?

— Here’s how to cope.

Sex and SAD needn’t be enemies.

By Eleanor Noyce

Winter can be a bleak period. The crisp brown leaves have fallen from the trees; the flowers have wilted; everything is freezing – especially amidst a cost-of-living crisis – and there’s little to no sunshine. Joy can be sparse, and amidst all the gloom, your sex life can take a hit.

Often termed “winter depression,” Seasonal Affective Disorder (SAD) is a form of depression that comes and goes in a seasonal pattern. Symptoms can include persistent low mood, irritability, sleeping for longer than usual, feeling lethargic, and, importantly, a decreased libido.

In the UK, SAD impacts around 2 million people. It’s little surprise: during the winter, we’re plunged into darkness for months on end, and sadly, sunshine can be a rarity. Each year, around 5 percent of the U.S. population experiences SAD, and four out of five of these people are women.

Mental health and sex are completely intertwined, and like regular depression, SAD can impact intimacy and facilitate sexual dysfunction. The National Institute of Mental Health finds that SAD is diagnosed four times more often in women than in men. Elsewhere, one 2018 study concluded that women experienced seasonal variations in symptoms of depression alongside tiredness and anhedonia, or the loss of ability to feel pleasure. And that pleasure extends to the bedroom.

How does SAD affect your sex life?

So, how does SAD impact sex? Per the NHS, depression can result in women finding it more difficult to orgasm, and a loss of sex drive. Men with depression often experience these symptoms too, alongside erectile dysfunction or problems getting and maintaining an erection. Depression can impact self-esteem and body image, which in turn, can affect our desire to be intimate with partners.

Sex releases three feel-good hormones that can temporarily aid the symptoms of SAD: dopamine, endorphins and oxytocin, all of which facilitate pleasure, emotional regulation, and one-to-one bonding with a partner. Pre-bedtime sex – whether solo or partnered – can release prolactin, aiding feelings of rest and relaxation and inducing REM sleep. With all these sex-related benefits in mind, SAD’s infringement on sexual pleasure can be frustrating.

Ness, 33, has recognised her symptoms of SAD since she was a teenager. She’s always struggled with the darker periods of the year, suffering from low mood and tiredness. She’s tried everything from St. John’s Wort (a herbal medicine some people take for mental health conditions) to SAD lamps and has even had her rheumatologist recommend that she just “needs to go somewhere sunny” during winter. “I don’t want to be close to anyone – it’s like the darkness engulfs me. I find orgasms less pleasurable, too,” Ness recalls. “My sex life becomes more active during the spring and summer. I feel more connected with myself – I’m happier, and that makes it easier for me to connect sexually.”

“My sex life becomes more active during the spring and summer. I feel more connected with myself – I’m happier, and that makes it easier for me to connect sexually.”

In relationships, Ness’s SAD has been noticeable. She hasn’t always felt supported. “Past partners have often let me dwell in the sadness,” she explains. “My current partner supports me through and understands that I find everyday activity harder during the winter months, not just relationship-related matters.”

What to do when mental health is impacting your sex life

Dr. Caroline West — who has a PhD in Sexuality Studies and currently works as a consent educator — explains that our sex lives and our mental health are intrinsically linked. “If we feel depressed, that can lead to poorer physical health which can in turn lead to decreased desire and positivity towards sex and our bodies,” West says.

“When our mental health is overwhelmed, it can be a drain on energy levels which makes people not want to engage in sex as they see it as too much work. When we feel down about ourselves, sex can be the last thing on our minds, and our thoughts towards our bodies may not be very sex-positive,” West explains. “A lack of intimacy can in turn make us feel even more frustrated and depressed.”

So, how can SAD sufferers alleviate its impact on sex? Taking time out for self-care, reconnecting with the body through masturbation and allocating time for physical connection with a partner can help to alleviate the symptoms, facilitating happier, more pleasurable sex during the winter months.

“When our mental health is overwhelmed, it can be a drain on energy levels which makes people not want to engage in sex as they see it as too much work.”

Dr. Hana Patel is a GP specialist in mental health and a GP Expert Witness, issuing specialist information, guidance and opinion on the medical care provided by GPs. “Mental health problems can affect our sexual health. People suffering from depression describe symptoms of feeling tired, having low self-esteem, having less energy, feeling a reduction in sexual desire and finding it difficult to find pleasure in things they used to enjoy,” Patel tells Mashable. As she explains, low levels of vitamin D can also impact the likelihood of developing SAD, as can a family history of depression.

“To increase your vitamin D, go out as much as possible during the day, sit near the window at work, increase your exercise levels, eat a varied, balanced diet, and avoid stress as much as possible. Consider mindfulness and stress management techniques,” Patel advises. “Some people prefer to take vitamin D supplements over the winter months, and may want to try an SAD lamp.”

Likewise, mindful sex can help. According to meditation app Headspace(Opens in a new tab), incorporating mindfulness into sexual experiences — whether partnered or solo — can alleviate the experience. One study conducted amongst women at the University of British Columbia involved taking part in three mindfulness meditation sessions spaced two weeks apart alongside mindfulness meditation at home. This period of meditation increased desire, arousal, lubrication, and overall sexual satisfaction.Jasmine Eskenzi is the Founder and CEO of The Zensory, a mindful productivity app. “Being mindful during sex can increase your self-esteem, self-acceptance and self-compassion,” Jasmine notes. “Try some mindful breathing before you head to the bedroom – breathe in for four seconds, hold your breath for seven seconds and breathe out for eight. Repeat this until you feel calmer.”Try not to think of sex – whether partnered or solo – as a one-time event. Spend some time laying the foundations, whether that involves reading an erotic book, masturbating, or watching a sexy movie. If you are in a relationship – whatever that may look like – investing in that can be equally impactful. Prioritise regular date nights, whether that involves turning off the TV and cooking a nice meal together or ordering a takeaway. Creating these intimate memories can help to strengthen your bond both emotionally and sexually.

Communicate with your partner

Taking time to communicate is fundamental, so check in with your partner regularly, too. You can also practise this in your relationship with yourself – and better your solo pleasure – by examining what turns you on. “Ask your partner what they find sexy about you,” Pippa Murphy – sex and relationship expert at condoms.uk — advises. “Not only will this give you both a confidence boost, but it could also lead to better sex as you can accentuate or focus on these things in bed. The more confident you feel, the better sex you’re likely to have.”

Keeping the boudoir a no-phone zone can also have a poignant impact, as Murphy believes. “If you scroll on your phone before bed, you’re not only impacting your ability to build a deep connection with your partner, but chances are you’re decreasing your ability to get horny by being greeted with a social feed of negative news,” Pippa says. “Keep your phone outside the bedroom and spend the last 10 minutes before bed getting intimate with your partner, whether that’s through sex or a conversation.”

Remember: sex can be whatever you want it to be. As West reminds us, “sex doesn’t have to be a big production or involve penetration. Intimacy can be defined however you want.” Explore what works for you: consider keeping a SAD sex diary, noting down how you’re feeling each day mood-wise and libido-wise. That way, you’ll be able to spot patterns and develop self-tailored coping mechanisms for making your boudoir as spicy and depression-friendly as possible. Sex and SAD needn’t be enemies.

If you’re feeling suicidal or experiencing a mental health crisis, please talk to somebody. If you’re in the U.S., text “START” to Crisis Text Line at 741-741. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text “START” to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don’t like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources. If you’re in the UK, call the Samaritans on 116 123 or contact Shout, a 24/7 free mental health service in the UK (Text SHOUT to 85258).

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Bedroom Athletics

— A Guide to Sexercise Fitness

Sexercise is a workout that combines sex with intense exercise. It’s a great way to burn energy, tone muscles, and get your heart pumping. Not only does it feel good – it can reduce stress and boost your mood, too!

By Zia Sherrell, MPH

Amazing sex and a top-notch workout? We’re talking about sexercise of course! This amazing fusion of erotic fun and fitness is a great way to burn calories, tone muscles, and have lots and lots of orgasms.

Keep reading for expert tips on how to make the most of your next sexercise sesh solo or with a partner!

What is sexercise?

Now, if you’re thinking that sexercise is just a fancy way of saying “having sex” you’re not entirely wrong. But it’s more than that. Sexercise is all about using your sexy time to get fit and toned. Think of it as a workout that’s way more fun than hitting the gym.

Sexercise means going above and beyond the physical effort you’d put into standard sex. Folding yourself into a pretzel, getting down Downward-Facing Dog style, or doing some standing poses provide a much more intense workout than missionary.

When you’re sexercising, you’re not just getting your heart rate up and burning calories (although you’re definitely doing that). You’re also using muscles you might not normally use during a traditional workout. And let’s be real — you’re probably having a lot more fun than you would be on the elliptical or in a Zumba class!

Benefits of sexercise for health

Sexercise is awesome for physical, mental, and emotional health. For starters, it’s a great workout, and regular physical activity has been linked to a plethora of health benefits. Yep, engaging in partnered sexual activity is associated with increased immunity and improved heart health, including lower blood pressure and a reduced risk of heart disease.

In terms of mental and emotional health, sexual exercise can release endorphins, which are natural feel-good chemicals that boost your mood and reduce anxiety. Sexual activity — especially the big O — also triggers oxytocin release, which promotes bonding and eases stress. A 2021 study found that anxiety and depression scores were significantly lower in peeps who were sexually active during the coronavirus lockdown. Plus, the benefits may persist for some time after your sexy workout.

Sex can also boost your self-esteem and self-image, which has a positive ripple effect on your overall well-being. So if you need an excuse to get busy between the sheets, now you have one backed by science!

Benefits of fitness for sexual performance

Being fit isn’t just good for your physical health — it can also help you last longer in the bedroom (or wherever else you get frisky). Regular exercise increases cardiovascular endurance and muscle strength, so you can go the distance without getting tired too quickly and maintain certain positions without turning into a sweaty mess. Flexibility also comes in handy here!

Overall fitness also has other benefits for sexual performance:

  • Reduces ED: Anyone with a penis understands the frustration of a sad trombone from time to time. But regular exercise — especially when it gets the heart pumping — may reduce erectile dysfunction. A 2017 study found that moderate to high-intensity aerobic exercise worked best.
  • Eases side effects of antidepressants: Some antidepressants can play havoc with your sexual desire. However, a 2013 study found that exercising directly before sex boosted arousal and overall sexual function in females taking antidepressants.
  • Reduces the risk of chronic health issues: Regular exercise reduces the risk of developing chronic illnesses like diabetes, cancer, and heart disease. These conditions can lead to reduced sexual function, like ED and other issues.

Best exercise for sexual performance

The best exercise for sex performance depends on your aim. For instance, if you want to improve your endurance to go longer in bed, you should focus on doing cardio and HIIT workouts. On the other hand, if flexibility is more important, yoga and stretching are great options. Here are some exercises to try.

Cardio

Running, brisk walking, biking, swimming, and of course, High-Intensity Interval Training (HIIT) are all great cardio exercises that improve blood flow and circulation to every part of your bod. When your below-the-belt bits have better blood flow, you’ll feel it in the strength of your orgasms.

Remember that when it’s super hot and sweaty, you’ll benefit from a little calorie-burning boost. Just remember to hydrate.

Cardio also improves overall fitness, endurance, and stamina, all important factors for sexual performance and pleasure. Plus, cardio boosts mood and reduces stress and anxiety, which can crush your sexual desire.

Yoga

Yoga is an ancient practice that combines physical poses, breathing exercises, and relaxation. The stretching you do in yoga helps you become more flexible and agile — essential for sexual activity — and improves blood flow to your entire body. It also promotes relaxation, mindfulness, and self-love — all great for sex. Not to mention fully-clothed positions like Frog Pose, Crow Pose, and other challenging asanas can translate easily into naked fun.

Strength training

Weight lifting, squats, and lunges can help you build muscle strength to lift, thrust, and rock your way to maximum pleasure. Plus, strength training can boost testosterone levels, the hormone driving sexual desire and performance in peeps of all genders.

Strength training also helps tone your body and boosts your confidence in your appearance, making it easier to let go and get lost in the moment without worrying about what you look like.

Pelvic floor exercises

Pelvic floor muscles support the bladder, uterus, rectum, and other organs in the pelvic region. They also play an important role in sexual function. So performing pelvic floor exercises (aka Kegels) can enhance sexual pleasure and lead to better sex.

Strong pelvic floor muscles can lead to more intense and longer-lasting orgasms. Contracting these muscles during sex increases blood flow to the genital area, leading to heightened sexual pleasure. The muscles are also involved in sexual stamina. If you have a penis, strengthening these muscles can help you maintain an erection or control ejaculation, leading to longer-lasting sexual experiences.

Try performing Kegels to work those pelvic floor muscles: You’ll need to locate the muscles when you pee by stopping and starting your flow for a few seconds. Once you understand where they are, you can tense and release them several times daily, tensing them for longer as you get stronger and more used to this intimate workout.

Best sexercise sex positions

Your sexy workout needs sexplosive positions to burn calories! So get any ideas about slow missionary or casual spooning out of your head. Nope! You need spicy positions that get your heart rate pumping and your muscles quivering, like these:

    • Lifting positions. The penetrating partner standing with the other’s legs wrapped around them or a standing 69 are physically demanding positions that require strength, endurance, and, of course, balance!
    • Intense positions. When you’re going at it hammer and tongs, the speed and intensity of the sexercise elevates your heart rate.When you put your back into it, any sexual positions count as sexercise, but some particularly good ones are cowgirl and reverse cowgirl, doggy, and the wheelbarrow.
    • Flex and stretch positions. Popping your legs over a partner’s shoulders, popping into the bridge position as someone rides you, or otherwise folding yourself into a pretzel increases the challenge! Just remember, though, it isn’t a competition, and no one wins by putting their back out!

    Sexercise is a fun way to spice up your bedroom routine with the added perks of health benefits. Not only does it boost heart health, improve fitness, and tone muscles, but it also eases stress and improves mood.

    So next time you wanna get your sweat on, forget speed walking, jogging, Pilates, or HIIT workouts. Instead, grab a consenting partner (or two!) and get down to a good ol’ fashioned romp between the sheets!

    Complete Article ↪HERE↩!

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Exercise Can Help Men Last Longer During Sex

— A new research review concludes that running, yoga, and pelvic floor workouts can all help solve the problem of premature ejaculation.

One study found that running 30 minutes five times a week was as effective as medication for men who experience premature ejaculation.

By Becky Upham

Exercise could be as effective as pharmaceutical treatments in treating premature ejaculation, according to a new study published in the journal Trends in Urology and Men’s Health.

The review looked at 54 studies and nearly 3,500 participants to examine the effectiveness of nondrug interventions for premature ejaculation.

“We know premature ejaculation is a common complaint among men worldwide. The lack of a clear definition of what is or isn’t premature ejaculation has repercussions in terms of treatment, and there are relatively few effective drugs available,” said senior author Lee Smith, PhD, professor of public health at Anglia Ruskin University in Cambridge, England, in a press release.

The findings of this review suggest that physical exercise, including running and pelvic floor workouts, can help treat premature ejaculation, said Dr. Smith.

How Common Is Premature Ejaculation?

Because there hasn’t been a single definition of premature ejaculation, estimates on how many men experience it vary widely, according to the U.K. researchers. Depending on the study, prevalence ranges from 30 percent to 83 percent of men, they wrote. 

Mayo Clinic defines premature ejaculation as a man ejaculating sooner than he wants to while having sex. If it happens only rarely, it isn’t cause for concern.

A man might be diagnosed with premature ejaculation in the following scenarios:

  • Always or nearly always ejaculates within 1 to 3 minutes of penetration
  • Is never or rarely able to delay ejaculation during sex
  • Feels distressed and frustrated about timing of ejaculation and tends to avoid sexual intimacy as a result

Regular Exercise Can Help Men Delay Ejaculation

The authors found that regular physical activity as an intervention had promising results in many of the studies they analyzed in their research review.

For example, a study with 105 participants found that running for 30 minutes five times a week helped extend latency time (time until ejaculation occurs) as much as taking dapoxetine, a selective serotonin reuptake inhibitor (SSRI) drug approved for use in premature ejaculation outside the United States.

Two other studies linked yoga with statistically significant improvements in delaying ejaculation.

Pelvic Floor Exercises May Also Help

Exercising pelvic floor muscles was also shown to have some benefits. Men who practiced pelvic floor exercises increased latency time from a median of 1 minute to 3 minutes.

Pelvic floor muscles play a role in ejaculation, and men who can strengthen and improve pelvic muscle control may be able to delay ejaculation by relaxing their perineal muscles, according to the Sexual Medicine Society of North America (SMSNA).

Also called Kegel exercises, pelvic floor workouts can help strengthen these muscles, according to Mayo Clinic.

Medication for Premature Ejaculation Is Limited

The U.S. Food and Drug Administration (FDA) has not approved any drugs specifically for premature ejaculation, though physicians may prescribe some medications off-label.

Topical numbing agents can reduce sensation and help delay ejaculation. There are also oral medications that may help delay orgasm, including antidepressants, pain relievers, and drugs used for erectile dysfunction, according to the American Urological Association.

“Given that drugs often have side effects, it appears that after all, the best medicine for avoiding premature ejaculation may well lie in exercise, and this possibility requires larger studies and further investigation,” said Smith.

Treating Erectile Dysfunction May Help Treat Premature Ejaculation

Some of the studies included in the review found benefits when the men with premature ejaculation were also treated for concurrent erectile dysfunction (ED), notes Raevti Bole, MD, a urologist at Cleveland Clinic, who was not involved in the research.

“I would agree that treating ED (if present) is a very important initial treatment,” she says.

It’s Important to Consider Multiple Treatment Options

Systematic reviews can be useful in that they are able to consolidate the results of many studies, says Dr. Bole.

But even a well-executed systematic review is only as good as the studies that are included, she points out. Because many of the studies the review included didn’t use the same definition of premature ejaculation, there may be different types of patients with varying degrees of premature ejaculation, says Bole.

“The studies included also had small numbers of patients, which makes it difficult to tell whether the result was due to the treatment or chance,” she adds.

Nevertheless, the review shows that it’s important to consider multiple options when treating premature ejaculation. “A lot of factors affect premature ejaculation, including hormones, stress, anxiety, prior sexual episodes, and [overall] erectile function,” she says.

Because every patient is a little different, there is no one-size-fits-all treatment. “Medication, exercise, counseling, sex therapy, yoga, pelvic floor rehabilitation, treating underlying medical conditions — all of these things play a role,” she says.

Concerned About Premature Ejaculation? Talk With Your Physician

It’s also important for patients to understand that many men may be concerned about premature ejaculation, and there’s no shame in talking about it with their doctor, says Bole.

“Many times, patients will talk to us and realize that they’re very much within normal range for ejaculatory latency. They just didn’t know what ‘normal’ was,” says Bole. “But if we do diagnose an issue, we can work together to come up with a solution.”

Complete Article ↪HERE↩!

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When Cancer Upends Your Sex Life

— Despite a wave of new research around cancer treatment and sexual health, women say their issues are still being dismissed. Here’s how and where to get help.

By Catherine Pearson

Débora Lindley López was 28 when she was diagnosed with Stage 3 breast cancer. Within three weeks, she began chemotherapy and was thrust into medically induced menopause. Ms. Lindley López developed vaginal dryness so severe that her skin began to deteriorate and was covered in small, paper cut-like tears. Urinating was uncomfortable; sex, agonizing.

But when Ms. Lindley López, now 31, told her oncologist about her vaginal pain and about how her libido had evaporated almost overnight, she said he responded dismissively, telling her that if he had a penny for every time he heard these complaints he’d be a rich man sitting on a beach. He suggested that she confide in the nurse about those symptoms, Ms. Lindley López said.

“It was awful,” she said, tearing up. “It made me feel like, how could I even be thinking about anything else other than cancer? The fact that I would even ask felt shameful.”

Cancer can devastate a woman’s sexual function in countless ways, both during treatment and for years down the road. Chemo can cause vaginal dryness and atrophy, similar to what Ms. Lindley López experienced, but it can also prompt issues like mouth sores, nausea and fatigue. Surgery, like a hysterectomy or mastectomy, can rob women of sensations integral to sexual arousal and orgasm. Pelvic radiation therapy can lead to vaginal stenosis, the shortening and narrowing of the vagina, making intercourse excruciating, if not impossible. Sadness, stress and body image issues can snuff out any sense of sexual desire.

“The damage that is done is not only physical, though women certainly experience damage to their bodies from the cancer and from the treatments,” said Dr. Elena Ratner, a gynecologic oncologist with the Yale Medicine Sexuality, Intimacy and Menopause Program. “From the diagnosis to the fear of recurrence to how they see their bodies, they feel like their whole sense of self is different.”

Over the past decade, and particularly in the last few years, there has been a marked increase in studies on how cancer upends women’s sex lives, during treatment and after. Dr. Ratner and other experts who work at the intersection of cancer care and sexual health feel encouraged that the research world has finally begun to grapple with those complex side effects — ones that had been all but ignored in previous generations of women, she said.

Just last year, for instance, a study found that 66 percent of women with cancer experienced sexual dysfunction, like orgasm problems and pain, while nearly 45 percent of young female cancer survivors remained uninterested in sex more than a year post diagnosis. Researchers also found a high prevalence of issues like vaginal dryness, fatigue and concerns around body image among women with lung cancer — findings that highlight the toll all types of cancer (not just breast or gynecologic) can take.

And yet, some of that very same research — combined with stories from patients, advocates and doctors — suggests that the increase in scientific interest has not made much of a practical difference for women. While Ms. Lindley López’s story offers an extreme example of provider indifference on the topic, experts say the challenges she faced when trying to seek help for her issues are not unique.

“The number of women affected by sexual health concerns after a cancer diagnosis is huge, and the need for these women to have access to medical care for sexual dysfunction after cancer is enormous,” said Dr. Laila Agrawal, a medical oncologist specializing in breast cancer at Norton Cancer Institute in Louisville, Ky.

“There’s a gap between the need and the availability for women to get this care.”

Why better research hasn’t really led to better treatment

Sharon Bober, a psychologist and director of the Dana-Farber Cancer Institute’s Sexual Health Program, said several factors have helped move the needle on research. For one, survivorship is growing (in 2022, there were 18.1 million male and female cancer survivors in the United States; by 2032, there are projected to be 22.5 million). There is also a greater understanding within medicine and society at large that sex and sexuality are an important component of overall health, Dr. Bober said. Since 2018, she added, the American Society of Clinical Oncology has urged providers to initiate a discussion with every adult cancer patient — female and male — about the potential effects of cancer and cancer treatment on sex.

But some women say they’re still greeted with silence.

Cynthia Johnson, a 44-year-old from Texas, who was diagnosed with Stage 2 breast cancer at age 39, said she was “grateful for life and lifesaving treatments.” But that does not negate her frustration that not one of her doctors ever brought up her sexual health.

“They don’t tell you going into it that you are going to experience dryness. They don’t tell you that you are going to experience lack of desire,” Ms. Johnson said. “They don’t tell you that if you do, on the off chance, get in the mood to do something, it’s going to feel like razor blades.”

Surveys support her experience and also suggest there are significant gender discrepancies in who gets queried about sex. A 2020 survey of 391 cancer survivors found, for instance, that 53 percent of male patients were asked about their sexual health by a health care provider, while only 22 percent of female patients said the same. And findings presented last year at the annual meeting of the American Society for Radiation Oncology, focusing on 201 patients undergoing radiation for cervical or prostate cancer, concluded that 89 percent of men were asked about their sexual health at their initial consult, compared to 13 percent of women.

Dr. Jamie Takayesu, a radiation oncology resident physician at the University of Michigan Rogel Cancer Center and a lead author on the study, said the research was inspired by her own nagging sense that she wasn’t asking female patients about sex often enough, and she suspected her colleagues weren’t either. She has a few hypotheses about why: Prostate cancer has a high survival rate, she said, so doctors may be more inclined to focus on quality of life issues with treatment. But she also noted there were “better” and “more formalized tools” to assess sexual function in men, and that many cancer doctors — herself included — got little to no training in how to talk about sex.

Doctors say that until that changes, these types of conversations are unlikely to become standard in practice.

“This must be rolled into routine inquiry, so that it’s not something special or different, and it’s not based on a health care provider’s perspective about whether someone is sexually active,” Dr. Bober said. “I’ve had so many women say to me over time, ‘Nobody asked.’”

How and where to get help

Despite those significant headwinds, effective treatment options and interventions do exist.

Both Dr. Ratner and Dr. Bober work in multidisciplinary sexual health programs that, in many ways, represent the gold standard of care. A patient might see a gynecologist, a pelvic floor therapist who can help with treatment options like dilator therapy and a psychologist who can address emotional struggles. (Dr. Bober said that, until very recently, she could probably count the number of these centers on one hand; now she estimates there are “more than 10 and under 100” nationwide.)

A year and a half after her cancer diagnosis, Ms. Lindley López drove to one such center at Northwestern University in Chicago. At her visit, she saw a clinical sexologist who teared up during the pelvic exam. “She said, ‘You’re 29 and your vaginal area looks like you’re about 80,’” Ms. Lindley López recalled. The sexologist gave her information about laser therapy vaginal rejuvenation and recommended several estrogen creams to help with vaginal atrophy.

It was comforting “just sitting down in that office, and having someone put her hand on my shoulder and say: ‘Hey, this is important. And anybody who tells you that this is not important, is wrong,’” Ms. Lindley López said.

While they are becoming more plentiful, these types of programs still tend to exist in large hospitals or major urban cancer centers and many women in the United States may not live close enough, or have the resources or health insurance coverage, to regularly access such care. But even if going to a sexual health center is not possible, most women just need a “home base,” said Lisa Egan, a physician assistant with a focus on gynecologic oncology who leads the Sexual Health in Women Impacted by Cancer Program at Oregon Health & Science University.

Who that “home base” is can vary; it just needs to be a provider that offers help and support. Ms. Egan said it could be the patient’s primary care doctor or a cancer doctor or nurse; Dr. Bober said it might be a gynecologist or a sex therapist. Dr. Agrawal also noted that the International Society for the Study of Women’s Sexual Health had a database of providers who focused at least partially on female sexual health issues, so it could be a useful jumping-off point. To ascertain if providers are in a good position to help, it may be useful to ask outright about what their experience has been helping women with sexual dysfunction during and after cancer, and if they would feel comfortable helping you put together a plan for addressing your concerns — even if that means referring you out to other clinicians, Dr. Bober said.

All of the doctors interviewed for this story also noted that online communities and advocacy groups could be helpful resources. Ms. Johnson, for instance, is an ambassador at For the Breast of Us, which provides community and support for women of color impacted by breast cancer; Ms. Lindley López works for the Young Survival Coalition, a nonprofit focusing specifically on the needs of young adults with breast cancer. These kinds of groups offer a platform for women to swap information, connect with providers and find solidarity — particularly as the medical world struggles to fully address their needs.

“I really want women with cancer to know that sexual health problems are treatable medical problems, and they can get better,” Dr. Agrawal said. “I just want to offer that out as hope.”

Complete Article ↪HERE↩!

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5 Facts All Men Should Know About Sexual Problems and Dysfunction

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

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

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

Sexual problems may signal a cardiovascular or other medical issues

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

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

There is a strong link between sexual function and mental health

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

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

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

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

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

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

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

With age, some changes in sexual function are normal

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

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

Improving overall health can improve sexual performance

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

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

Complete Article ↪HERE↩!

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What It Really Means To Be Sex Positive

— And Why It Matters

It’s all about compassion for yourself AND others.

By Lexi Inks

Even though you’ve probably heard people talking about sex positivity online or in your own social circles, the concept is more complex than just enjoying sex, or trying to ditch shame. While there’s an entire history and movement behind it, actually embracing a sex-positive lifestyle and mindset can be very personal and nuanced.

That said, experts like board-certified sexologist and sex therapist Gloria Brame, PhD, are quick to note that the idea is all about a sense of understanding and levity regarding, well, sex. “Sex positivity recognizes that sex is a place of pleasure and emotional relief for consenting adults, not just duty to one’s country or faith. Sex positivity is more of an evidence-based, non-ideological, and non-patriarchal approach to sex,” Brame says.

The history behind the sex positivity movement is long, and the concept leaves a lot of room for personal interpretation and ways to make it feel significant to you. Ahead, experts explain what exactly it means to be sex positive and how you can adopt this new mindset in your own life and relationships.

Meet the Experts:
Gloria Brame, PhD is a sex therapist and certified sexologist based in Athens, GA.

Tara Suwinyattichaiporn, PhD is a professor of sexual communication at California State University, Fullerton and host of the Luvbites by Dr. Tara podcast.

What is the history of the sex positivity movement?

The core values behind sex positivity can be traced back quite a few decades. The ideals of the sexual liberation movement in the 1960s and 70s set up what is now known as the sex positivity movement, according to Brame. She shares that the sex positivity movement was largely inspired by the work of the late Allena Gabosch, a sex educator and advocate for the movement who founded The Center for Sex Positive Culture in 1999.

An important flagship for the movement, the Seattle-based Center for Sex Positive Culture, along with the Center for Sex and Culture in San Francisco, began using the term “sex positive” in the 1990s and promoted the mission of educating and empowering all people about sexuality and how embracing it can change their lives. These community-based spaces still exist today, both physically and digitally, and continue to spread the work started decades ago.

What does it mean to be sex positive?

You’ve probably heard the term thrown around in various capacities, but what does sex positivity mean, exactly? Brame explains that a large part of the term is derived from open-mindedness and acceptance, even when you don’t quite understand it.

“Sex positivity is rejecting the traditional narrative that sex is dirty and shameful and learning to accept it—in all its configurations—as a normal part of a healthy life,” she says. “It means respecting that everyone has a human right to engage in consensual sex, regardless of what type of sex they enjoy… It goes against the Puritanical doctrine that sex is for reproductive purposes only.”

As opposed to kink-shaming, or “yucking” someone’s “yum,” as the saying goes, being sex positive not only involves empowering your own sense of sexual identity, but also withholding judgment or shame regarding that of others.

“[Being] sex positive means being sexually empowered to communicate and make your own informed decisions regarding your sexuality and sexual activity, while keeping a compassionate, non-judgmental attitude about yourself and other people’s sexual attitudes and behaviors,” says Tara Suwinyattichaiporn, PhD, professor of sexual communication at California State University Fullerton and host of the Luvbites by Dr. Tara podcast.

Why should I be sex positive?

Empowering yourself and others to embrace your personal sexuality, whatever that looks like, and enjoy pleasure and sexual freedom without shame or negativity is always a good thing. The benefits of being sex positive are countless, so an alternative question might be: Why should you not be sex positive? As long as your sexual choices are safe and consensual, being sex positive can really only help you learn more about yourself and your desires.

Having a sex-positive mindset can not only improve your sex life, but other aspects of your wellbeing, too. Suwinyattichaiporn shares that some of the major benefits to practicing sex positivity are a higher level of sexual self-confidence, communication skills (as far as your boundaries and desires are concerned), reduced anxiety around sex, and even a higher level of sexual satisfaction. All of these “pros” can even be translated to a partner when you’re in a sexual relationship, boosting your intimacy and creating a mutually-fulfilling sex life together.

Releasing shame or stigma around sexuality is anoter massive benefit to becoming sex positive, Brame adds. She notes that whether you’re insecure about your body or your sexual interests, sex positivity can be the best antidote.

“It’s a vital aspect of human self-esteem to feel at home in your body and at peace with your sexuality. With sex-positive attitudes, you become stronger about boundaries and more focused on what actually works for you as an individual—and as a partner,” Brame says. “Being pleasure-based rather than reproductive-based relieves a lot of the pressure of sex and gives you the freedom to be more sexually authentic.”

How can I be more sex positive?

Understanding the overall concept of sex positivity may be relatively simple, but figuring out what being sex positive looks like for you is often easier said than done.

If you’re unsure where to start, Brame suggests leaning into curiosity. “Think about what has worked for you sexually: Have you been too shy to ask for it? To pursue it actively? Why?” she says. “Sexually healthy people ask for what they need to feel great.” Exploring what you really want, what makes you comfortable, and what helps you feel best sexually are the first steps to take.

When you’re ready to embark on your sex-positive journey, Suwinyattichaiporn recommends you begin with talking about sex. Even if you just share your sexual boundaries or preferences, chatting about sex more often with your partner(s) or close friends can lead you to foster a more sex-positive mindset. She also suggests trying out sexual meditations or affirmations; saying things like “I am a great lover” or “I am a sexual being” to yourself can start to shift your perspective and help you gain sexual confidence, which is a huge foundation of sex positivity.

If you’re someone who deals with shame or guilt surrounding sex, whether from a cultural/religious background or otherwise, practicing sex positivity can seem intimidating or even impossible at first. While these are valid feelings, Brame reminds that you’re not alone—shame and guilt around sex are the primary reason many of her sex therapy clients seek her help.

“Shame and discomfort can be hard nuts to crack alone. I recommend reading, going to sex-positive workshops, and working with sex therapists or coaches,” she says. “But you don’t need to have money to win the war against shame inside. Sometimes, what I recommend to clients is that they make choices with their heads and not their hearts.” This can be something as small as using safe sex protocols to ensure you feel fully comfortable and safe making your own sexual choices, which can empower you to continue exploring your desires.

Even if it seems like a big task at first, taking small and steady steps toward becoming more sex positive can only benefit you in the long-term. Whether you choose to enroll in sex therapy, try out kink-friendly spaces and events, or even just talk more about your sexual preferences and desires, the journey you take in promoting sex positivity in your own life just might inspire those around you to do the same—and the more sex-positive people there are, the better.

Complete Article ↪HERE↩!

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The Life-Changing Magic of a Urologist

— Here are three issues you may want to address with a professional.

By Jancee Dunn< Urologists often deal with health problems that arise from two very intimate functions: peeing and sex. Because of this, “most urologists tend to have a lot of brevity and a bit of humor, because we know these are hard topics for our patients,” said Maria Uloko, a urologist at UC San Diego Health and assistant professor of urology at the University of California, San Diego School of Medicine.

In my experience (as both a patient and a health journalist), urologists will happily discuss the subjects that some of us laypeople tend to avoid: erectile problems, peeing too much, peeing too little, painful sex, dwindling or nonexistent orgasms, urinary tract infections and the list goes on.

Rachel Rubin, a urologist and sexual health specialist based outside Washington, D.C., said many people don’t share these issues with their doctor even if they are ongoing; they simply learn to live with discomfort. “They’ll tell themselves, ‘Well, that’s just aging. Suck it up,’” Dr. Rubin said. But, “if it bothers you and it matters to you, then it’s a medical problem with medical solutions.”

There are two parts of a urologist’s job. “There’s the serious illness stuff, like cancers,” said Nelson Bennett, a professor of urology at Northwestern University Feinberg School of Medicine, who specializes in male sexual function. “But there’s a big chunk of our practice that is basically quality of life. I tell my patients that no one dies of not having an erection, but they’re still suffering.” All of this may be why people who have seen a urologist (present company included) sometimes say the results are life altering.

Here are three issues you may want to address with a professional.

Erection problems

If you have erectile dysfunction, Dr. Rubin said: “Don’t be embarrassed. So do your friends.” Erectile dysfunction affects as many as 30 million men in the United States, according to the American Urological Association.

There are treatment options for almost every erectile problem, including oral medications, injectable medications, surgery and cognitive behavioral therapy, Dr. Bennett said.

Although it can be tempting to furtively order medications such as Viagra on direct-to-consumer websites, a practice that Dr. Bennett found, in a 2021 study, is dramatically increasing, he said there are several reasons to see a specialist instead. “We can actually begin to figure out why you’re having the problem, as opposed to just taking medication to cover it up,” he said. Some medications can also affect erections, such as antidepressants, which can cause orgasms to be delayed, or vanish altogether. And a urologist can screen for those, he said.

What’s more, erection problems can be a sign of heart problems down the road. Penis arteries, which are one millimeter in diameter, are very small, compared with heart arteries, which are 3 millimeters. “So if you’re clogging your small pipes first, you may have erectile dysfunction before you have your first heart attack,” Dr. Rubin said.

“Those are the guys you need to start looking at,” said Dr. Bennett, “because we know that erectile issues will predate cardiovascular issues by about 10 years.”

Painful sex

For older women, painful sex is a leading sign of genitourinary syndrome of menopause, or G.S.M., a term that in 2014 replaced the dispiriting phrase “vulvovaginal atrophy.” During perimenopause and beyond, as estrogen leaves a woman’s body, the tissues in the vulva, vagina and urinary tract become dryer, less supple and more sensitive. This process can cause recurrent urinary tract infections and incontinence, and sex can become excruciating, which takes many women by surprise, Dr. Rubin said. G.S.M. may affect up to half of postmenopausal women, according to a 2019 review, and is “unlikely to improve without treatment.”

What has been shown to work for conditions like G.S.M., Dr. Rubin said, are treatments like inserts with DHEA, a steroid that mimics hormones, lubricants and moisturizers; ospemifene, an oral medication that is approved by the Federal Drug Administration to treat G.S.M.; vaginal dilators; and low-dose topical vaginal estrogen.

“There’s not a cocktail party or children’s birthday party where I don’t recommend vaginal hormones,” Dr. Rubin said. (It is important, however, that you discuss any of these treatments with your own doctor first.)

Pelvic floor therapy is another option, Dr. Rubin added. “Pelvic floor therapists rehab your muscles, just like you would do rehab after a knee replacement.” And you don’t have to do it forever, she added. “Physical therapists are there to optimize your pelvis and send you out the door.”

Then there’s the D.I.Y. approach: a 2023 review found that vibrators were considered “an accepted modality” to treat vulvar pain. “I think doctors should be prescribing vibrators, which are health aids, just like eyeglasses or hearing aids,” Dr. Rubin added. “The more we normalize them and educate patients in exam rooms about them, the better.”

Bladder issues

You may know that bladder control loss afflicts women at various hormonal stages in their lives — pregnancy, after giving birth and during menopause — but “men are plagued by urinary incontinence, too,” Dr. Bennett said. A quarter to a third of Americans have incontinence, according to the American Urological Association.

There are two main types: “stress incontinence,” which means sudden leaking brought on by activities like coughing, sneezing or exercise, and “urgency incontinence,” a strong and immediate urge to pee, which sends you on a mad dash to the bathroom.

Some male patients will visit the bathroom 10 times a night because of a prostate issue, which leads to sleep deprivation, Dr. Bennett said.

Some treatments for urinary incontinence include medication, and for women, vaginal estrogen, but urologists also teach patients Kegel exercises, use electrical stimulation and employ pelvic floor physical therapy. (Men have a pelvic floor, too.)

Urologists, Dr. Uloko said, “are really glorified plumbers. We know how to fix the leaks.”

Complete Article ↪HERE↩!

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Condom Size Chart

— Does Size Matter?

Most condoms will fit most people, but other factors matter, too

You may already know that condoms are your best way to reduce the spread of sexually transmitted infections (STIs, also called sexually transmitted diseases or STDs).

And if you didn’t already know it, let’s say it again: Condoms — the ones made from latex, polyurethane and other synthetic materials — will reduce your chances of getting chlamydia, gonorrhea, herpes, syphilis, HIV/AIDS and other infections that can be passed through bodily fluids. (Lambskin condoms, also called natural membrane or lambskin condoms, can allow viruses to pass through.)

Condoms can also prevent pregnancy by blocking semen during vaginal intercourse. That’s true of both synthetic and natural condoms.

There are two general categories of condoms:

  • Internal condoms are a pouch inserted into the vagina or anus. They come in one standard size.
  • External condoms are the ones that cover a penis, and they come in a variety of sizes.

Which external condom is right for you? Well … that may be a little complicated. Those oh-so-useful infection-stoppers are a huge market, and there’s a lot to consider: size, material, thickness and enhancements (“for your pleasure”) among them. There are also U.S. Food and Drug Administration (FDA)-approved external condoms on the market specifically for use during anal sex.

When it comes to choosing condoms, is there a right answer? Does condom size matter? And the rest of it?

We talked with urologist Petar Bajic, MD, about whether condom size matters and other factors to consider.

Finding the right size condom

Here’s the bottom line: The best condom for you is one that you’ll use and will keep you and your partner protected for the duration of sexual activity.

Research shows that when people aren’t satisfied with their condom fit, they’re more likely to have less sexual satisfaction and to remove the condom and complete their sexual engagement without it. Kind of defeats the purpose.

In truth, most people will find that most condoms will fit just fine, Dr. Bajic says.

A worldwide review of research studies found that the average erect penis length is about 5.2 inches. Average girth is 4.6 inches when erect. Guidelines from the U.S. Food and Drug Administration (FDA), which regulates condoms as a medical device, stipulate that the minimum length for external condoms is 160 millimeters (that’s about 6.3 inches).

That leaves some room for the condom to remain rolled at the base for the average-sized penis. Trojan®, for example, lists their standard condom as the proper-fitting choice for a penis between 5 and 7 inches long with a girth of 4 to 5 inches.

“For the vast majority of people, standard sizes are appropriate, but everyone’s anatomy is different,” Dr. Bajic notes. “It’s best to read the information from that specific condom manufacturer for their guidance on how to determine the best fit for you, and that information should be readily available on the packaging.”

The measurements listed on condom packaging are based on measuring a fully erect penis. To get your size, use a flexible tape measure. Length is the measurement from the base of your penis (where it meets your stomach) to the tip. Girth is the measurement around the widest part of your penis shaft.

Comfort matters

Now, whether the condom is the right size according to the manufacturer’s standards and whether it feels good to your liking may be two different things.

It’s kind of like picking out a pair of jeans. Sure, there’s no shortage of pairs that’ll cover you from hip to ankle, but you may find certain brands or certain cuts to be more comfortable. Maybe you’re the straight-leg type or perhaps bootcut is more your jam. Nothing wrong with being a little choosy.

The same is true of condoms. Any number of them may fit, but it might take trying out a few kinds to determine what you prefer. There are a lot of options out there. So, if you don’t like one, there are plenty of kinds to try and find what works best.

You can try different types of material (remembering that some people may be allergic to latex, so steer clear if that’s a concern for you or your partner). You can also try different material densities. Some condoms are marketed as being “ultra-thin” and the like, which could increase sensation. The minim thickness, per the FDA, is 0.3 mm.

Know if it fits

While most condoms will do the trick for most people, severely ill-fitting condoms could be problematic. A condom that’s too big could fall off during sexual activity. Too small, and you could be at risk of it breaking, Dr. Bajic warns.

“The important thing is to be realistic,” he continues. In other words, choosing a condom isn’t a time to … ahem … stroke your ego, if that’s not what your anatomy calls for.

A properly fitted condom will cover your penis snuggly (but not too tightly) from tip to base, with a half-inch reservoir at the tip. For some people, that may leave an extra bit of rolled condom at the base. That’s OK, and some people prefer that feeling. But if it doesn’t reach to the base of your penis near your stomach, that’s a clear sign to try a bigger size.

Chart: Troubleshooting condom fit and comfort

What you may notice What to try
The condom doesn’t reach to the base of your penis. It doesn’t leave room for a reservoir at the tip. It slips off. It breaks.  It’s uncomfortably tight. Consider going up a size.
There’s excessive rolled condom at the base of your penis. You have decreased sensation. It slips off. Try a smaller size.
It’s uncomfortably tight. Try a larger girth.
You have decreased sensation. It slips off. Try a smaller girth.
You have decreased sensation. Consider a thinner material.
The condom breaks. Try a thicker material.

There is a condom for you

An oft-repeated reason for not wanting to wear a condom is that your penis is “too big.” In reality, condoms are made to stretch. A lot. So, there’s bound to be a condom out there that fits you. (There are videos online of people fitting their whole leg into a condom. Trust us, it’ll fit.)

On the other side of the coin, the condom market is flooded with options, so chances are you’re not “too small” for a condom, either.

Again, “fitting” to the point that it’s safely in place and won’t slip off or break and “fitting” to your liking may have some slight differences. But the point is there’s a condom out there that’ll protect you and your partner from STIs and unwanted pregnancy in the case of vaginal sex. And there’s very likely a choice that you’ll feel good using, too.

“The only better way of preventing sexually transmitted infections than using a condom is abstinence,” Dr. Bajic states. “So, if you plan on engaging in sexual activity, it’s really important to protect yourself, and use barrier contraception.”

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