Category: Sexual Performance Issues

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What to Do When You Have Mismatched Libido in a Relationship

— A mismatched libido, also known as sexual desire discrepancy, is a common issue in relationships that occurs when one partner has higher or lower sex drive than the other. While a difference in sexual desire in couples is normal, it may cause a lot of stress for some couples. Luckily, there are ways to help mitigate this difference, including scheduling sex, exploring intimacy without sex, self-pleasure, and therapy.

By Rhiannon John, MSexol

  • A mismatched libido, also known as sexual desire discrepancy, is a common issue in relationships where one partner desires sex more than the other.
  • Several factors influence sexual desire, including stress, fatigue, hormones, pregnancy, medications, and illness. As partners experience these factors at different stages throughout their life, a mismatched libido is normal and may come and go.
  • If you and your partner are experiencing a mismatched libido and it is troubling you, you can have a pleasurable and satisfying sex life by being understanding, using good communication, and compromising.

What is a mismatched libido?

A mismatched libido, which is also known as sexual desire discrepancy, is when each person within a relationship has a different level of sexual desire than the other. There are a number of factors that can influence a person’s sexual desire, including:

  • Stress
  • Depression
  • Anxiety
  • Relationship problems
  • Trauma
  • Pregnancy
  • Menopause
  • Pain during sex
  • Self-esteem
  • Illness
  • Certain medications

As these factors influence a person’s sexual desire, a mismatched libido is not necessarily permanent, and some couples could experience a change in their sexual desire for a brief period in their relationships. For example, a couple may experience mismatched libido during pregnancy and postpartum, but their desire may return to previous levels once the child is sleeping through the night.

It’s important to note that the stereotype surrounding men having higher rates of desire, and women having lower rates, is not true and is also heteronormative. Many women experience higher rates of sexual desire than their partners. And sexual desire discrepancy is common in many relationship types, including gay, lesbian, and queer relationships.

How common is mismatched libido?

Having a different amount of sexual desire than your partner is normal and extremely common, with one study finding it affects around 80% of couples.

It’s important to remember that having a higher or lower sex drive than your partner is normal and that, as many factors impact sexual desire, it is bound to change at different stages of life. Having a mismatched libido isn’t necessarily an issue that needs to be worked on. For some couples, a mismatched libido isn’t a big deal, but for others, it can cause enormous strain on the relationship.

Can a relationship work with mismatched libidos?

Yes, a relationship with mismatched libidos can work. Couples who use empathy, understanding, good communication, and compromise find that they can have a pleasurable and satisfying sex life.

Mismatched libidos – what to do:

If you and your partner are experiencing mismatched libidos, there are a few things that you can try.

Communicate your concerns

If you are experiencing a discrepancy in sexual desire within your relationship, the first thing you need to do is communicate with your partner. Pick a time when both partners are free from distraction and have an open and honest discussion about your concerns, needs, desires, and boundaries. Make sure that you listen to your partner’s concerns and treat them with respect, avoiding any blame or shame.

Compromise

Once you and your partner have communicated your concerns, needs, desires, and boundaries, work out a way in which each person can have some of their needs met. To do this, both partners will need to compromise and incorporate different strategies, including scheduling sex, exploring intimacy without having sex, self-pleasure, addressing the underlying issues, and potentially seeing a therapist.

Respect each other’s boundaries

First and foremost, remember that it is always ok to say “no.” Neither partner should be pressuring the other into doing something they’re not comfortable with. However, if the relationship is safe and healthy for each partner, and the couple is committed to working through their differences in libido, the partner with the lower libido should provide their partner reassurance when saying no, to avoid them feeling personally rejected.

Tips for couples experiencing sexual desire discrepancy

If you and your partner have a different amount of sexual desire, there are a few tips that you can try.

Schedule sex

Scheduling sex has many benefits. First, it helps us to prioritize our pleasure in a world where so many other things are competing for our attention. It’s also great for those who have responsive desire, who are turned on only once they are sexually stimulated. Scheduling sex also helps to take the pressure off initiating sex, as the partner with the higher desire doesn’t feel guilt or rejection from initiating. Scheduling intimacy also creates anticipation and excitement leading up to the event.

Explore intimacy without sex

Exploring intimacy without having sex allows couples to build on their emotional connection, which increases trust and closeness, all essential ingredients to having good sex. Couples can also maintain intimacy through physical touch, such as kissing and cuddling, and spending time together doing their favorite activities.

Additionally, couples may like to reframe their understanding of sex and focus on sexual or intimate acts outside of penetration. For example, one partner may be feeling tired but open to receiving oral sex but unable to put in much effort. This may please the other partner, who is willing to give pleasure and finds this sexually stimulating.

Try self-pleasure

If you find yourself wanting more sex than your partner, self-pleasure can help to reduce the pressure on both partners, as the higher-desire partner can experience sexual pleasure without having to pressure their partner.

Self-pleasure is also beneficial for the lower-desire partner, as it can help to increase their desire and sexual self-confidence, and they may find new ways to pleasure themselves, which can be communicated back to their partner.

Try therapy

Many people find that seeing a sex therapist or mental health professional who specializes in sex and relationships is beneficial. Therapists can offer support and guidance and help address any underlying factors that may be contributing to the discrepancy in desire.

Complete Article ↪HERE↩!

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Here she comes

— Closing the orgasm gap

By Cat Tang

When Sophia Wright finished the deed with her high school boyfriend, she looked over at him and thought: “This can’t be it, right?”

It was only until years later, when she got to university, that she first heard of the term “orgasm gap.” Since then, Wright has learned more about her sex life and orgasm equality.

“I didn’t even really know what an orgasm was for a woman at that time,” says Wright, now a fourth-year psychology and gender, sexuality and women’s studies student.

The orgasm gap is the difference in orgasm rates between men and women during partnered sexual experiences. In general, men are much more likely to experience orgasm than women.

“I was also still focused on, ‘Well, I’m not supposed to come, so why does it matter?’” says Wright, describing her mindset back in high school. “You get fed this narrative for such a long time — you do have to retrain yourself and unlearn these harmful things.”

A 2017 study analyzing a sample of over 50,000 United States adults found a significant gap in frequency of orgasm during sex between heterosexual men and women. Heterosexual and gay men reported orgasming 95 and 89 per cent of the time respectively, whereas bisexual and heterosexual women were the lowest, orgasming 66 and 65 per cent of the time. Bisexual men and lesbian women were reported to orgasm 88 and 86 per cent of the time.

Jaclyn Siegel, a social psychologist who completed her PhD at Western University in 2021, now teaches at San Diego State University. Siegel has a whole lecture dedicated to the orgasm gap in her psychology of human sexual behaviour course.

“We talk about sexual empowerment, sexual equality and the playing field being even now for women and men in heterosexual hookups — but it’s not true,” says Siegel.

Siegel says there are a variety of factors that affect the orgasm gap, one being poor understanding of female sexual anatomy and the type of stimulation needed for someone with female sexual anatomy to orgasm. This often includes clitoral stimulation.

“There’s an ongoing cultural joke that no one knows where the clitoris is, which is not funny. It’s sort of pathetic,” says Siegel. 

But lack of information about female sexual anatomy is almost universal. Oftentimes, young women don’t know much about their sexual anatomy either, creating a huge barrier in communicating with their partners about how they can reach an orgasm.

Wright didn’t know she had a clitoris until she was 15 years old — she didn’t even know what it looked like.

“I took a mirror and I was like, ‘Where the fuck is it?’” says Wright.

Looking back, Wright is astounded at just how little she knew about her own body. She recalls not even knowing urine came out of the urethra until she watched an episode of Orange is the New Black.

Her Ontario public school sex education was unhelpful. She never learned about masturbation, pleasure or orgasms in school.

The lack of information she received about female sexual anatomy — along with feeling like she wasn’t as thin as attractive women were typically depicted in the media — led her to feel shame about her body.

“I still feel shame around my vagina,” says Wright. “That was something when I got to university that I really had to get through: ‘Why am I feeling so much shame towards my own body? Why do I hate this part of my body so much?’ I felt so bad for people having sex with me.”

This self-consciousness led Wright to decline oral sex — a common way for people with female sexual anatomy to reach clitorial stimulation and achieve an orgasm — even when her partners offered.

Siegel says predominating sexual scripts — cultural attitudes and norms towards how sex is supposed to go — priotitizes those with male sexual anatomy over those with female sexual anatomy.

“If you genuinely believe a sexual experience is over as soon as a person with male sexual anatomy has an orgasm, you might not feel entitled to an orgasm because you think the sexual experience is over,” says Siegel.

While Siegel does cite men’s sexual entitlement as a contributing factor to the orgasm gap, she adds it’s important to not paint all men with broad strokes.

“In conversations, people are very quick to blame men for the orgasm gap. But women contribute to this by not telling their partners what type of stimulation they need,” says Siegel. “It’s not necessarily that men don’t want to help, they might not know how.”

A 2021 study found that when women are socialized to be more sexually assertive, it can lead to more frequent orgasms and higher sexual satisfaction.

Siegel attributes the patriarchy as the reasoning behind a woman’s hesitation in communicating what they sexually like. Women may feel like their pleasure doesn’t matter to their partner, or that speaking up may hurt their partner’s feelings and make them feel inadequate.

This leads to another factor Siegel strongly believes contributes to the orgasm gap: women faking their orgasms.

A 2015 study surveying 4,685 university students at the University of Maine found that 70 per cent of sexually-active women reported having faked an orgasm.

“When you lie to your partner by pretending you’ve had an orgasm, they don’t learn how to actually give you an orgasm. You reinforce behaviours that didn’t produce the outcome you wanted,” says Siegel.

While Wright has never faked an orgasm personally, she understands why many others do.

“I think a lot of women do it because sex sometimes is super fucking boring,” says Wright. “Sex just sucks sometimes. It’s like: ‘How do I get this over with? Let me make the loudest porn moaning noise that I can for me to get the fuck out of this.’”

Wright’s journey to sexual empowerment has been long and ongoing. She says it’s taken a lot of unlearning predominating sexual narratives and ideas of what women’s bodies are supposed to look like to get to where she is today.

Her current partner noticed she was struggling to orgasm during their first few months of dating, when they bought her a vibrator to throw into the mix. An attentive partner and a shift towards a more positive mindset about her own body has resulted in a vast improvement in Wright’s sex life.

Another thing Wright’s learned? She’s allowed to finish first.

“We should all be pursuing positive sexual experience,” says Siegel. “There are a variety of ways we can move toward orgasm equality, some of which are on women, some of which are on men.”

According to Siegel, there’s still work to be done — talking more about female sexual pleasure and learning more about the bodies of people with female sexual anatomy are just the start.

“You must understand your own body before you hope someone else will understand it,” says Siegel. “Get comfortable with yourself, figure out ways to make yourself feel good.”

Exploring your body comes in many different forms, from masturbation to experimenting with sex toys. Once you understand how you receive pleasure, it’s crucial to communicate that to your partner and emphasize your sexual pleasure is important too.

If your partner is unresponsive? Leave. 

“The only people who are worth having sex with, are the people who are willing to do what they need to do to give you a positive sexual experience,” says Siegel. 

An orgasm isn’t essential to having a satisfying sexual experience, but for many, it’s an enjoyable part. Bringing more attention to the orgasm gap is essential to achieving orgasm equality. 

“People deserve to have pleasure,” says Wright. “It’s jarring when we see men receiving that pleasure more than women.”

As for Wright’s high school boyfriend? She got rid of him a long time ago. Her current partner is attentive and lets her feel her pleasure is important too.

Complete Article ↪HERE↩!

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Why can’t I have an orgasm?

— Sexperts share advice on achieving bedroom bliss

If you’ve been worrying, “Why can’t I have an orgasm?” no need to panic—the pros are here to help

By Danielle Valente

“Why can’t I have an orgasm?”

There’s no need to chuck your sex toys in the trash or skip out on a sofa sex adventure. Whether you’re experiencing something psychological or emotional that could be standing in the way of your sexual satisfaction, the pros are here to help you get back on track and revel in a satisfying O.

And, above all, it’s important to remember that the phenomenon isn’t a “make it or break it” deal.

“An orgasm isn’t the be-all and end-all of sex, nor does it define a sexual encounter,” Annabelle Knight, a sex and relationship at Lovehoney (opens in new tab) previously told My Imperfect Life.

That being said, it is still in pretty high demand, so allow the professionals to help walk you through any potential hiccups you might be experiencing.

There isn’t necessarily a clear-cut answer. While medical factors might inhibit some women from achieving orgasm, emotional hurdles might prevent others from having a satisfying experience. Regardless, the first step towards taking back the pleasure is identifying the problem.

“Many people may have anxiety that can interfere with the ability to relax and enjoy the present moment. This can lead to difficulty becoming aroused, achieving orgasm, and performance anxiety,” says sex and relationship expert Melissa Stone.

Though it may seem like everyday stressors wouldn’t be an issue in bed, that anxiety can carry over into your sex life, so it’s crucial to take an extra few steps towards calming your nerves.

“It is important to practice self-care and find healthy ways to manage stress and anxiety such as deep breathing and mindfulness meditation,” Stone says. “Additionally, talking to a therapist can help to explore deeper issues and find ways to cope with and manage them.”

When it comes to physical causes, everybody is different—quite literally. Hormone imbalances, medications and conditions like endometriosis could be contributors to your orgasm’s elusiveness. Another factor we oftentimes overlook is vaginal dryness, so perhaps it’s time to play around with different types of lube. Whatever the case might be, should you believe that the issue is pressing, make an appointment with your doctor. (And have a look at what gynecologists want you to know about your reproductive health.)

Melissa Stone is a sex and relationship expert at Joy Love Dolls, the “world’s leading authority on sexual exploration, adult toys and realistic dolls.

How to get back on track with your big O:

Before going into panic mode, there are methods to consider if you’re looking for that memorable final moment. Pippa Murphy, the sex and relationship expert at condoms.uk, and Stone, break down different remedies to consider.

1. Talk about sex

If you cannot orgasm with a partner, you have to be frank. Talking about sex is the key to making it better and analyzing what works and what might need some fine-tuning.

“Couples that communicate openly and honestly are more likely to maintain a stronger emotional connection, which naturally leads to better sex,” Murphy says.

Should you feel a little bit stressed about sex, you’ll be more relieved once you have an open dialogue.

2. Try using lube

There’s a lot of misconception about lube—don’t think that it can’t help you.

“Whilst many people believe that lube is strictly for those who suffer from dryness during sex, that certainly isn’t the case and can bring a lot of benefits to the bedroom,” Murphy says. “For example, it can enhance pleasure by creating different sensations like a warming or cooling effect wherever it’s applied. Plus, previous studies have shown that lube makes it 50% easier for everyone to orgasm. Need I say more?”

Have more Qs about lube? Don’t worry—we asked them so you don’t have to!

3. Experiment during solo sex

One-on-one time gives you the freedom to do as you please without the fear of judgment from a partner. Solo sex is necessary for you to find out what you like and what you could do without. Plus, the experts say masturbation is the key to women’s most intense orgasms.

4. Switch up positions

Should your go-to move not really feel satisfying, try switching things up. And don’t forget about erogenous zones—Murphy says a little extra attention in these spots will go a long way. (Plenty of sexperts make the case for nipple orgasms.)

5. Try foreplay

“Your brain is wired to experience more pleasure when the anticipation of a reward goes on for a long period, making foreplay even more key to an orgasm,” Murphy says. “So, if you feel that your partner rushes it, take control of the situation and ask them to slow down.”

We’ve rounded up fun foreplay ideas to get the ball rolling.

6. Don’t underestimate kissing

A simple smooch goes a long way. And science says kissing during sex increases the chance for orgasm.

“A study found that couples who kiss for at least six seconds had the most successful relationships. This is because the kiss gives you enough time to get out of your brain and, instead, be in the moment,” Murphy says. “Chances are you may get more sexually stimulated as time goes on, increasing your chances of orgasming.”

7. Stay present

Though at times it’s easier said than done, remember the importance of staying in the moment. Don’t let your thoughts drift.

“Relax and try to enjoy sex. If what goes through your mind during sex isn’t exactly sexy (e.g., “What am I doing wrong?”), it’s easy to lose sight of what matters most — enjoying yourself in the moment,” Murphy says. “So instead of focusing on how things should be or what’s going wrong, try thinking about what feels good and what makes you happy.”

While you’re at it, be sure to have a gander at the best sex tips ever and the 2023 sex trends dominating the bedroom. And again, should the orgasm issue persist, don’t be afraid to seek professional advice from a doctor.

Complete Article ↪HERE↩!

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Closing the curtain

— The importance of aftercare post-sex

By Lily Thomas

Like a play, sex has a beginning, a middle and an end. The end of sex is called aftercare, and it involves sexual partners checking in and supporting each other’s needs.

Though aftercare originated in the BDSM and kink community, it can be a part of all sexual experiences.

Rachel Zar, licensed marriage and family therapist and certified sex therapist, said sex is not a complete experience unless there is aftercare involved.

“Because the physical intimacy of sex is just as important as the emotional intimacy of sex, aftercare helps us to deal with any emotions that come up, to counter any sexual shame that there may be, to ground ourselves if we’re feeling any post-coital dysphoria (PCD), and to increase our feeling of connection with our partner.”

During sex, several hormones, such as dopamine, are heightened. When the sexual experience ends, however, Zar said oftentimes people experience a crash, which can manifest into PCD.

PCD causes negative emotions like sadness and anxiety after a consensual sexual experience. According to a study by the National Center for Biotechnology, 46% of respondents experienced PCD symptoms at least once.

“If you just had sex with this person and immediately after sex ends, they just roll over and start to do something else, it’s almost like they’re abandoning the moment, like they’re not really present with you,” Zar said. “They’re not helping you transition and you’re not helping them transition from this playful space back into reality, and that’s what’s really important.”

Zar said aftercare can be a variety of things, including: cuddling, kissing, having a snack, rehydrating, watching a movie together, showering, taking care of any injuries, or even having a simple conversation.

First-year Jamie Davis, whose major is undecided, believes there is a lot of shame surrounding the topic, which leads to miscommunications between sexual partners.

“I think we need to change the way we socially talk about sex,” Davis said. “Even though we’ve tried to come very far, I feel there’s [still] discomfort about it. I think that everyone would benefit from just being more honest and more open about things.”

To practice aftercare, Zar recommends self-advocating for the type of aftercare you want. If you do not feel comfortable asking someone for aftercare, Zar recommends considering if that is a safe person for you to be vulnerable with.

For Davis, sex has been like a “double-edged sword” because of a combination of negative and positive experiences. Though they have only experienced true aftercare once, they enjoy talking about the experience after. Going forward, they will try to discuss their wants and needs before sexual experiences.

“I’m trying to be more honest about these experiences,” Davis said. “I hope that maybe I’ll meet somebody and they’re like ‘yeah that happened to me too.’ I think there’s some kind of comfort in talking about it with people, and anyone who actually matters will be understanding.”

Freshman creative writing major Cassius Green believes that anyone who engages in sex should also be engaging in aftercare, whether you are in a relationship or not.

“A lot of people think that aftercare is only something for people that are in love or in relationships, and I think that’s also not true,” Green said. “It doesn’t always have to be holding each other and talking about how much you love each other. Aftercare can be more casual and it can also be sexy.”

His favorite form of aftercare involves cleaning up and getting dressed before making tea and toast to replenish themselves.

“It’s not also just about one person taking care of the other,” Green said. “It’s for both people to just experience connection and express appreciation for one another after you engage in sex, which is a very intimate thing.”

Complete Article ↪HERE↩!

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Ever Feel Sad After Sex?

— You Might Have Post-Coital Dysphoria

What Are the Post-Sex Blues? Here’s How To Deal With This Common Issue

BY Rebecca Strong

After sex, some people feel a sense of euphoria, relaxation, and closeness to their partner. But that’s not the case for everyone.

According to a 2019 study, almost half of men report feeling sad, distant, or irritable after sex. This is often called “post-coital dysphoria” (PCD), or the post-sex blues. But why does it happen? And are there ways to treat it?

First things first: PCD is nothing to be ashamed of. As previously noted, it’s super common. More importantly, experts say it’s nothing to worry about, and often just goes away on its own with time.

That said, if this condition is negatively impacting your sex life, relationship, or overall mental well-being, know that there are things you can do to cope — starting with pinpointing what’s driving your PCD.

Here’s what to know about the common signs and causes of PCD, and how to treat it.

What Are the Signs of Post-Coital Dysphoria?

Experts say PCD can manifest in different ways. You may be experiencing this condition if you feel any of the following after sex:

  • Aggravated
  • Sad
  • Apathetic
  • Restless
  • Uneasy

These feelings may set in immediately after sex, or up to an hour or two after you finish.

Depending on personality and history, a person experiencing PCD may start crying or seem easily annoyed, says Dr. Carla Marie Manly, a clinical psychologist and relationship expert.

“Some people with PCD may feel the need to leave the room or the situation altogether,” she explains.

What Causes Post-Coital Dysphoria?

A 2019 study found that PCD is linked to:

  • Psychological distress
  • Childhood sexual abuse
  • Sexual dysfunctions

If you’ve had traumatic sexual experiences or are currently dealing with sexual dysfunction, then intimate situations can trigger all kinds of negative emotions — like fear or shame.

There are many other possible causes, too.

Since you have higher levels of the feel-good chemical dopamine during sex, your body releases the hormone prolactin afterward to bring you back to your baseline.

In other words, you go from a major high to a sudden crash. According to Tufts University, that post-coital drop in dopamine may contribute to a low mood or other symptoms of PCD.

According to Dr. Lori Beth Bisbey, a therapist and sex and intimacy coach, performance anxiety can also be a factor.

“A history of depression, anxiety, or trauma can certainly aggravate PCD or increase the likelihood of it,” adds Manly.

“For example,” she explains, “if a person is already sad or depressed, the feelings can be magnified if the sexual intimacy was not connective or fulfilling. As well, if other stressors such as arguments, financial unrest, body issue images, etc. are at play these issues can be exacerbated given the vulnerability involved in sexual intimacy.”

How PCD Can Impact Your Sex Life & Relationship

“Post-coital dysphoria is unlikely to have a major impact on your sexual and romantic life if it’s experienced rarely,” says Dr. Justin Lehmiller, a social psychologist, research fellow at The Kinsey Institute and founder of Sex & Psychology. “However, if it’s a common occurrence, it can potentially be distressing — especially if you have a partner who does not understand it or takes it personally, in which case it may become a source of conflict.”

According to Manly, PCD can create ongoing feelings of disconnection, particularly if your partner notices that you seem cold or distant after sex.

Bisbey notes that PCD can also lead you to avoid sex and the negative feelings associated with it. Over time, this avoidance can begin to take a toll on your overall intimacy and relationship satisfaction.

“You may choose to use pornography instead of intimacy with a partner as solo sex often feels emotionally safer due to the lack of vulnerability,” adds Manly. “Over time, unaddressed PCD can actually tear a relationship apart due to the lack of emotional and sexual intimacy.”

How to Treat Post-Coital Dysphoria

If PCD is something you only experience once in a while, Lehmiller says it’s nothing to worry about.

“Psychologists think this may be a normal variation that sometimes happens following sex and that we shouldn’t pathologize it,” he explains.

On the other hand, if PCD is a persistent issue for you, and is triggering feelings of anxiety or depression, or negatively impacting your sex life or relationship, Lehmiller suggests consulting with a sex therapist. A licensed provider may be able to help you get to the root cause of the issue, whether it’s related to a mood disorder, an underlying sexual dysfunction, or a history of trauma.

Bisbey notes that it can also be helpful to tell your doctor about your symptoms of PCD, as they can help rule out any physical health issues that may be causing it.

While psychotherapy can be tremendously helpful, Manly notes that there are many other ways to address PCD — such as through support groups, self-help books, or journaling.

Manly also highly recommends being open and honest with your partner about the symptoms you’re experiencing. By openly discussing your feelings before, during, or after sex, you’re giving your partner an opportunity to be more supportive and accommodating.

“When partners work together to face PCD and address the issues with compassion, the relationship can actually become stronger and more loving,” adds Manly.

Complete Article ↪HERE↩!

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Maintaining Your Sex Life After Prostate Cancer

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

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

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

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

Can you have sex after prostate cancer?

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

There are two gold-standard treatments for prostate cancer:

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

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

Sex after prostate biopsy

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

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

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

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

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

Sex after prostatectomy and radiation therapy

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

Anal sex safety

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

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

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

Erectile dysfunction after prostate cancer treatment

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

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

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

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

Orgasm after prostate cancer treatment

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

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

Climacturia after prostatectomy

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

Lack of interest in sex after prostate cancer treatment

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

Infertility after prostate cancer treatment

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

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

Treatment options for ED after prostate cancer treatment

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

Treatments for ED include:

Erectile dysfunction medications

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

Penile rehabilitation

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

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

Penile injections

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

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

Vacuum constriction device

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

Surgery

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

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

Climacturia treatment

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

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

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

Therapy for you and your partner

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

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

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

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

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Anxiety and Erectile Dysfunction

— Is there a connection?

 

By Jana Abelovska

It may surprise you that your genitals are not your primary sex organ; your brain is! The brain plays a significant role in your ability to feel aroused. If you find it difficult to relax, it will be challenging to get aroused or reach orgasm.

Having trouble maintaining an erection isn’t always linked with age. Men often experience ED at some point. The good news is that you can now identify the cause of ED, which will usually go away with treatment.

Anxiety refers to feelings of nervousness, worry, or unease about something with an uncertain outcome. Anxiety means continuous stress or fear after the source of this stress or concern has passed. Anxiety is the most prevalent mental health condition in the Uk, and 20% of men will likely experience anxiety at some stage. You may get Viagra pills online from a trusted pharmacy if you have ED.

The causes of ED may be both psychological and physical. The success of treatment for physical reasons depends on your condition. Studies reveal that psychological factors are the most significant cause of ED. Psychological factors, like emotional and environmental factors, are usually curable. It includes stress and anxiety.

Anxiety plays a significant role in erectile dysfunction (ED) development. Psychological and behavioral responses to erectile dysfunction may lead to a heinous cycle of increased uneasiness, distance and conflicts. It, in turn, leads to fewer sexual encounters, less time spent together and a lack of communication between partners.

You might wonder how something you experience in your mind may cause erectile dysfunction. A number of key factors play a role when it comes to achieving an erection. Your nervous system, muscles, blood vessels, hormones, and emotions play a role in erection.

  • Stress and anxiety may trigger an increase in the production of stress hormones and a decrease in testosterone levels, which plays a role in the sex drive.
  • Stress and anxiety may trigger how the brain sends signals to your penis to allow for better blood flow.
  • Stress and anxiety may affect your self-esteem and feelings of desire.

Increased stress and anxiety may also increase your risk for other health conditions that may cause ED, like:

  • High blood pressure
  • High cholesterol levels
  • Heart disease
  • Obesity
  • Excessive alcohol consumption

How does anxiety cause erectile dysfunction?

Men experience three types of erections:

  • Reflexive erection due to physical stimulation
  • Psychogenic erection due to visual or mental associations
  • Nocturnal erection during sleep

These types of erections involve vital bodily systems and processes. A disruption in any of these processes may cause ED. These include:

  • Nervous system
  • Blood vessels
  • Muscles
  • Hormones
  • Emotions

Mental health conditions like stress and anxiety may also affect how the brain signals the body’s physical response. Stress and anxiety may affect how the brain sends messages to your penis to allow extra blood flow.

Stress and anxiety about erectile dysfunction may also contribute to a cycle of ongoing ED. Experiencing ED may lead to behavioral changes that contribute to anxiety and incidences of ED.

Reasons for erectile dysfunction

Men of all ages may experience ED in some shape or form caused by stress.

  • Psychological erectile dysfunction (mainly nervousness and anxiety) affects about 90% of teenagers and young men. This form of psychological erectile dysfunction is normally short-lived.
  • Men over 30 are more likely to deal with personal and professional stress, leading to erectile dysfunction. Personal and professional stress, such as relationship trouble, is the primary reason for ED in middle-aged men.
  • Impotence is the most prevalent cause for older men. Life circumstances, such as losing a partner or adjusting to retirement, may cause stress and anxiety, which can, in turn, cause erectile dysfunction.

How do you know if erectile dysfunction is psychological?

Whether you have discussed it with your healthcare professional, a few signs may suggest that erectile dysfunction is psychological. Ask yourself these questions:

  • Are you interested in sex and love your partner but have difficulty performing?
  • Do you experience morning erections?
  • Are you under much stress or have immense anxiety?
  • Do you get anxious about satisfying your partner?

An affirmative answer to any of the above questions doesn’t necessarily indicate that ED is psychological. Still, it may tell that one or several psychological factors affect your symptoms. It’s imperative to talk to your healthcare provider if you think ED may have something to do with your mental health issues, such as anxiety or major depression.

How to beat psychological erectile dysfunction?

Erectile dysfunction may occur for various reasons, from physical issues like high blood pressure and heart diseases to psychological ones like anxiety and depression. To treat psychological erectile dysfunction in the best way is to focus on the root of the problem, whether it is some mental illness or simply feelings of guilt about sex.

Cognitive-behavioural therapy (CBT) is a standard treatment for psychological issues, including depression and anxiety. The therapy helps to identify and change unhealthy thought patterns and behaviour that may contribute to erectile dysfunction and sexual health issues.

This kind of treatment relies on the idea that the situation (your inability to get or maintain an erection) isn’t the core problem; instead, your reaction to it is. If you learn to understand your thought patterns better, you may positively change them to resolve the issues.

The next option is psychosexual therapy or sex therapy. It is a specialized form of counseling that helps you (and your partner) to overcome sexual issues like erectile dysfunction. However, it is essential to realize that discussing erectile dysfunction with your healthcare provider and partner is integral to the healing process.

What should you do if you are having issues?

Whether in a relationship or single, changes in the sex drive and your ability to get an erection may be confronting issues. If you are in a relationship, speak with your partner about how you feel. A problem shared is a problem halved. Understanding between you and your partner will help you work through the sexual issues you are having.

If you are single, consider talking to someone you trust, like your friend or a doctor, about changes in your sex drive. Talking through this may help you better understand the next best steps.

Remember that it is normal to feel stressed during this time. It is normal not to feel like having sex. If your sex drive remains low and you have issues with ED for a couple of weeks or more, you should visit your doctor. The doctor may do a physical examination to help understand the causes of your ED and set up a treatment plan.

Conclusion

Stress is an underlying factor in erectile dysfunction. But over time, stress may cause anxiety, which triggers more stress, creating a heinous cycle that’s bad for your mental health and sex life.

Accepting the issue and being honest with your partner takes some weight off your shoulders. If you’re experiencing ED and think it may be psychological, it’s always best to talk to your healthcare provider. He will try to identify the cause of the erectile dysfunction and recommend an appropriate treatment, like medication or therapy.

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How Does Disability Affect Sex?

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

By Rhiannon John, MSexol

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

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

How does disability affect sex?

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

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

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

How to maximize pleasure while living with a disability?

Give yourself permission to be sexual

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

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

Use toys, tools, and positions that work for you

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

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

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

How does disability affect sexual health?

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

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

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

People living with disabilities are not given comprehensive sexual health education

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

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

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

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

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The Most Effective Erectile Dysfunction Treatments for Older Adults

By James Roland

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

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

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

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

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

Best ED treatment for 70s and over

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

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

Medications

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

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

The main PDE5 inhibitors available with a prescription are:

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

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

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

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

Typical side effects include:

  • headache
  • flushing
  • congestion
  • stomach and back pain

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

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

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

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

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

Who shouldn’t take these meds

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

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

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

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

Injections

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

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

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

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

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

Who shouldn’t use these

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

Taking blood thinner medications is another reason to avoid injectables.

Inflatable prosthesis

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

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

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

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

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

Lifestyle changes

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

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

Why these treatments?

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

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

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

How effective is it?

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

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

Is it safe?

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

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

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

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

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

When to see a doctor

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

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

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

The bottom line

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

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

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

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

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

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The No. 1 Reason Couples Stop Having Sex

It doesn’t have anything to do with physical attraction.

By Juliana LaBianca

There are so many reasons couples stop having sex, from loss of passion to busy schedules to medications that hinder intimacy. Once your sex life slows, it can be hard to get back on track. Days turn into weeks turn into months—and at a certain point, the situation might seem beyond repair. However, that doesn’t have to be the case. Ahead, therapists tell us the number one reason couples stop having sex, as well as what causes it and how you can strengthen your bond. By getting ahead of this sneaky relationship ruiner, you can keep your sex life strong for years to come.

This is why couples really stop having sex.

In many cases, a disconnect in the bedroom is caused by a disconnect in your overall relationship.

“It’s not for lack of physical desire, or that you find the person unattractive, or even that you want to sleep with someone else,” says David Tzall, PsyD, a licensed psychologist based in Brooklyn. “All those can certainly happen, but the [impetus] is that you no longer feel safe, comfortable, or connected with your partner.”

If you or your partner don’t feel that emotional security, it’s unlikely you’ll want to or be able to have a fulfilling sex life. But here’s what you should know so you can improve this part of your relationship.

Emotional distance builds over time.

Fortunately, an emotional disconnect doesn’t just pop up. If you pay close attention, you can usually stop it before it escalates. According to Tzall, emotional distance often occurs in couples that don’t communicate well.

“Slights and hurts build and grow into resentment,” he explains. “The couple speaks less and less and does not share their needs or desires, emotionally, mentally, and physically.”

Sometimes, not even the individuals in the relationship can identify the root issue. “The couple is usually unaware of the reasons and will blame themselves or their partner,” says Tzall. “If the blame is put on the partner, that might result in an affair or thinking about breaking up, which only serves to create more distance between the two.”

If the couple is still having sex at this point, it may not be as satisfying as it once was.

Other responsibilities can exacerbate emotional distance.

While a lack of communication can cause fissures that lead to emotional distance, other factors also contribute.

“Most of the couples I’ve encountered who complain about not having sex as often or at all seem to be couples that have gotten distracted by other consuming demands, like parenting, career, and illness, both mental and physical,” says Natalie Jimenez, EdS, a licensed marriage and family therapist. “The distraction, which may start gradually, grows more pervasive if not addressed in time and leads to emotional and physical disconnect, making it more difficult to become sexual.”

This is especially true for women, who tend to need an emotional connection to be sexual, Jimenez explains.

Clear communication can help you recover.

Just because you’re feeling disconnected in the bedroom now doesn’t mean you will forever.

“The best advice would be for the couple to speak about it openly,” says Tzall. “Some may see that as making the matter worse, but only through bringing it into the light, can it be examined and properly addressed.”

If discussing the issue makes you nervous, enlist the help of a couples counselor. “The couple will learn how to listen and speak to one another in an intentional manner without reacting or taking comments or behavior personally,” says Tzall. “When communication is poor between the couple, it is usually not for lack of quantity as much as quality. This means that both partners are not hearing the emotional subtext and desires and changes in their needs.”

By learning how to get on the same page, you’ll improve your communication now and throughout your relationship. That way, you can respond to issues—such as a lull in the bedroom—effectively and respectfully.

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Don’t believe the myth it’s more difficult to satisfy women

The Kinsey Institute reports that the average time it takes females to climax when flying solo is the same as it takes fellas: about four minutes.

By Kathy Lette

So, girls, what would you like for Christmas? I’m sure I speak for most women when I say that top of my wish list is … for all my Christmases to come at once. As if unequal pay isn’t enough to make females fume, apparently we are also suffering a pleasure gap. According to American Professor Elisabeth Lloyd’s analysis of 33 studies on sexuality, three-quarters of females don’t achieve regular vaginal orgasm. Women are also only having one orgasm for every three racked up by blokes.

And don’t believe the myth that it’s more difficult to satisfy women. The Kinsey Institute reports that the average time it takes females to climax when flying solo is the same as it takes fellas: about four minutes. The only women achieving the same Big O rate as men are lesbians. Obviously this is because women do not think that the clitoris is a beach in Crete and appreciate its function as the only part of human anatomy that exists purely for pleasure.

Women also understand that it’s impossible to have Academy Award-winning orgasms without an erotic warm-up. There’s so much emphasis on women faking orgasms, but what about men faking foreplay? Let’s face it, some blokes can fake a whole damn relationship!

And yet, while research reveals that the average woman requires at least 10 minutes of foreplay, most heterosexual encounters last between three and seven minutes. You don’t have to be Einstein to work out that this amatory calculation can’t add up.

I do all my own research in a detailed, scientific fashion – over cocktails with girlfriends – and what I’ve gleaned is that if a partner does attempt a little half-hearted foreplay, he invariably prods away at the clitoris as though it’s an elevator button and he’s running late for a meeting. It is then a woman is tempted to roll her eyes and grumble, “Just take the stairs.”

Without doubt, what hubbies call a “quickie”, most women would dismiss as premature ejaculation. Do you know the difference between a husband and a toy boy? About three hours.

Of course, mums go off sex because they’re exhausted. If men did more housework, women would have energy for other things. Oh, the orgasmic joy of being made love to by a man who has just vacuumed your entire house!

Orgasms are a lot like oxygen – no big deal unless you’re not getting any. And yet the female orgasm remains more of a mystery than the continued career success of Donald Trump. But new in-depth research (literally) has just discovered that there are three orgasmic varieties on erotic offer for us gals: a “wave”, a “volcano” or an “avalanche”.

James Pfaus, professor of neuroscience at Prague’s Charles University, explains that the names refer to pelvic floor movements during the build-up to orgasm and the release. Apparently, when the female volunteers climaxed, special sensors on their Bluetooth-connected vibrators predominantly showed one of three muscle patterns: wave-like undulations along the lower pelvic floor; an avalanche of contractions from the higher area; or a volcano eruption of exploding tension.

Orgasms are a lot like oxygen – no big deal unless you’re not getting any. And yet the female orgasm remains more of a mystery than the continued career success of Donald Trump.

For the study, 54 women were instructed to self-stimulate and then turn the vibrator off for two minutes after reaching orgasm. This exercise was then repeated over several days in their own homes, which must rate as the best homework assignment ever. (I doubt there’s been digital action like this since Proust wrote all seven volumes, longhand. Perhaps an unexpected upside was the wearing off of fingerprints, meaning they can now also commit the perfect crime?)

Anyway, to conclude this “Kama Sutra For One” experience, the volunteers were also asked to perform a control test in which they inserted the vibrator but did not stimulate themselves. Data was then analysed to reveal that nearly 50 per cent (26 women) enjoyed wave orgasms, while 17 relished avalanches and 11 delighted in volcanoes.

So boys, it’s basically now up to you to do your horizontal homework. Put in enough dedicated practice and your female partner will soon be so pleasured that when she cries out, you won’t be sure whether it’s an orgasm or a demonic possession. Should you share a post-coital cigarette or call an exorcist?

In short, if a woman is happy in bed, she’s going to want to spend a hell of a lot more time in it, with you. And it will be Oh, OH! OHHHH! What a feeling! So here’s to an intensely satisfying holiday season with a very, very happy ending.

Complete Article ↪HERE↩!

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15 Things You Need to Do to Be a Good Top

It’s time for all the tops out there to step their game up!

By

Here are 15 things you need to know if you want to be a good top!

1. Have some serious foreplay

We’ve all been there. We’re turned on, we’re excited, we just want to get to the game, but sometimes the tailgate is the best part. You want the experience to last. You want him to feel comfortable. Take your time before getting to the actual penetration.

2. Have the condoms

While it’s not the job of all tops to carry condoms, it’s often expected that they are the ones who will. Don’t rely on the bottom to carry the condoms. As the top, the responsibility is more on you. Also, yes, I know PrEP is a thing, and you should be on it. While a miracle drug, it doesn’t protect against other STIs besides HIV, and even if your partner is on PrEP, he may still want to use a condom.

3. Gently enter and ask how it feels

For the love of god, don’t start off by jack hammering. Go slow. Let him get used to having you inside of him. Ask how they feel. Ask if he needs more lube or if you need to pull out for a second.

4. Switch up positions and speeds

Don’t do the same thing the whole time. Speed up. Slow down. Switch positions. While (most) bottoms like to be pounded extra hard in doggystyle, that’s not the only thing we like. Oh, and it can be super sexy to make out while you’re inside of him. If you can jerk him off while you’re inside him too, even better.

5. Give him a break if he’s on top

It takes a lot of work to do cowboy, or any other riding position. Unless he’s a porn star, he’s going to get tired. Sometimes he won’t feel comfortable asking you to switch positions, which is why you should preemptively ask him if he wants to switch it up.

6. Do not false advertise

You know your junk better than anyone else. One of my biggest pet peeves is when I meet a guy, we go back, and he is freakin’ huge. Like donkey d*ck, monster huge. I’m like, where do you expect me to put that? Why did you not give me fair warning? I could have loosened up for you. This is no longer sexy that you’re well-endowed. It’s just annoying. Then there’s the other side of the coin. Don’t lie about being bigger than you are. You can’t hide it. Like, we’re going to find out and be annoyed if you gave yourself an extra three inches.

7. Pull out if you’re going to orgasm too quickly

Slow it down if you’re about to orgasm. If that’s not enough, pull out and do some other “stuff” while your body takes a break. You don’t want to ejaculate within seconds of being inside of him.

8. If you do ejaculate prematurely, let him know your refractory time, and go again

It’s not the end of the world if you orgasm quickly. Just let him know you can have some other fun for a little bit, and then go at it again. Just because you finish once, doesn’t mean that’s the end. Go again! And the second time, you’ll be able to last longer.

9. Don’t be annoying with putting on the condom

Don’t try to sneak it in there without asking. For the love of God, don’t take it off in the middle of having sex without telling him. Sex with condoms can be really annoying. Trust me, I know. But you need to respect your bottom and his wishes.

10. Say his name during sex

This is just hot. It makes him feel special and wanted. I haven’t met a single guy who doesn’t like hearing his name out loud during sex. It’s a simple yet effective turn-on technique.

11. Don’t make a big deal if you get a little “mud” on you

Butts are not chocolate soft serves. Yes, some poop can come out, but not that often or that much if you’re aware of your body. That said, it will happen at some point. It’s inevitable. Don’t make a big deal. Simply ask to change condoms. Or, if you don’t mind, afterwards, take off the condom, wrap it in a paper towel and throw it out without him seeing. Then go wash yourself off. You don’t need to tell him it happened if he didn’t realize. There’s no reason to embarrass him.

12. Read your partner and when in doubt, ask

Sometimes your partner will be vocal. It’ll be clear what he wants you to do. Other times, you’ll have to read him more. Would he like you to go slower or faster? Harder or softer? If you’re not sure, just ask!

13. Let him know when you’re about to finish and ask him where he wants you to orgasm

Some guys like it when you finish inside of them. Other guys, not so much. Some guys like you to finish on unlikely places. Be a gentleman and do what he asks. If he says he doesn’t care, still give him a heads up by telling him where you’re going to ejaculate.

14. Help him finish afterward

Just because you finished doesn’t mean the fun is over. Some bottoms don’t like to ejaculate, but many do. Don’t assume because you were the top that sex is over once you finish. Don’t be greedy. Help him finish if he wants to.

15. Don’t rush out afterward

If you want him to feel used, then yes, rush out afterwards. If not, lay in bed with him for a while. Cuddle. Have some pillow talk. Let him know that he’s more than just a piece of meat and a tight hole. Unless, of course, this was the agreement and both you knew it was a quickie. If that’s the case, then don’t overstay your welcome. Get the hell out.

Complete Article ↪HERE↩!

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6 reasons why you could have performance anxiety during sex

— And how to overcome it

Performance anxiety during sex can be related to physical fears, emotional fears, or a combination.

By Willa Hart

  • Feeling anxious during sex is incredibly common and valid.
  • This can be a result of poor body image, a hyperfocus on your partner, or prior bad experiences.
  • Fortunately, this anxiety can often be overcome through mindfulness, movement, or therapy.

When you think of performance anxiety, you might think of tests or talent shows, but this fear is also common during sex. In fact, up to 25% of men and 16% of women experience sexual performance anxiety.

Performance anxiety manifests during sexual encounters as a worry about what your partner will think of your performance. For example, people may be afraid of not getting an erection or experiencing lubrication, says Jennifer Litner, a sexologist and the founder of sex therapy practice Embrace Sexual Wellness.

But other anxieties, like worrying how your body appears to your partner, can be part of performance anxiety, too.

If you’re experiencing performance anxiety during sex, here’s some things that could be causing it, as well as some information on how it can be treated.

1. Poor body image

Not feeling great about your body can make it hard to have a great time during sex, says Lena Elkhatib, a licensed marriage and family therapist, certified sex therapist, and founder of Essential Therapy.

After all, being naked and vulnerable with someone is hard even when you feel great about how you look.

Moreover, if you’re preoccupied with what you look like, you’re probably not focused on the sensations of sex. “It really takes us out of the experience of, what are the feelings in my body, which is what we want to be focused on,” says Rachel Zar, a licensed marriage and family therapist and certified sex therapist who practices at Spark Chicago Therapy.

As a result, it might take you a longer time to orgasm – which might make you even more self-conscious, fueling performance anxiety.

How to overcome it: Working towards body acceptance is a difficult, but empowering way to reconnect with your body. In practice, this can look like:

  • Re-evaluating your relationship with food and movement: Societal bias and weight stigma has taught us to demonize food and overly celebrate exercise. Neutralizing or accepting your relationship with food and movement can help you to be kinder to yourself and celebrate all that your body does for you each day. 
  • Incorporating joyful movement: We often associate the word “movement” with exercise, but fun movements like dancing, walking, or even cleaning can encourage more positive feelings about your body.
  • Visit a boudoir photographer: Taking photos of your body that you feel good about can encourage you to channel that version of your body image in the bedroom. 

2. Feeling disconnected from your partner

Sometimes, you might feel distant from a sexual partner because you don’t know them very well. But even if you’re having sex with a long-term significant other, you could feel disconnected if you’ve recently had an argument or spent some time apart.

This disconnection could make your mind wander during sex, giving anxiety a space to creep in, Zar says. Moreover, if you’re feeling distant from your partner(s), your brain is more likely to kick into “performance mode,” triggering performance anxiety.

“Sometimes, you need some time to reconnect to a partner before you’re able to reconnect sexually,” Zar says. “After all, sex is a really vulnerable thing to do with someone.”

How to overcome it: The best thing to do is talk to your partner about what’s bothering you, Zar says. 

She also recommends focusing on foreplay – not just in bed, but also in the hours or days leading up to sex. That might include touching or kissing each other throughout the day, or cuddling on the couch.

Foreplay gives you an opportunity to reconnect with your partner without rushing straight into sex, and it promotes intimacy.

3. Negative beliefs or shame about sex

One of the most common causes of performance anxiety is negative beliefs about sex, Elkhatib says. For instance, if you were taught as a kid that sex is bad or dirty, you might feel ashamed about engaging in sexual behaviors.

This shame, in turn, might make you worry about how your partner(s) perceive you or feel about your sexual encounters.

“Shame is not a sexy feeling,” Zar says. “If you think that something you’re doing is shameful, you may be easily embarrassed by it or monitor your actions or responses.”

How to overcome it: Attending therapy with a sex-affirming mental health professional is one key way to dismantle sexual shame.

In particular, a therapist can work to help you understand what messages have led you to feel ashamed about your sexuality, Elkhatib says. You can then start to replace those narratives with more sex-positive thoughts.

Sex positive literature can help correct negative sexual beliefs. If your negative thoughts stem from a religious background, you can usually find books that can be helpful. “Come As You Are” by Emily Nagiski could be helpful to everyone.

4. Focusing too much on you partner during sex

We tend to think that being tuned in to our partners’ desires during sex is a good thing, but if you focus on your partner(s) to the detriment of your own pleasure, it can cause performance anxiety.

For instance, if you’re super dialed in to your partner(s), you may notice if they sigh or glance away from you – potentially meaningless signs that may make you worry they’re not enjoying themselves.

Focusing too much on your partner can also be tied into messaging we’ve been taught about sex, Elkhatib says.

For example, if you were raised in an environment where you were told sex is a duty you must perform to please your partner(s), that could lead you to solely focus on your partner’s pleasure during sex – and it could incite performance anxiety as you worry what might happen if you don’t satisfy them.

How to overcome it: Treating this kind of performance anxiety is all about learning to focus on yourself. That might include exercises like masturbating to relearn what feels good in your body or practicing having sex with your partner where you’re the center of attention. 

For instance, Elkhatib says you might have sex with your partner(s) where you’re not allowed to give pleasure to them: they’re only allowed to pleasure you.

If past lessons about sex have contributed to your desire to focus on a partner, then examining the source of those beliefs can be helpful too, Elkhatib says.

Focusing on other forms of bodily pleasure that aren’t sex can also shift your focus: Such as how you eat your food, shower, listen to music, or move during walks.

Mindfulness training is a great way to defeat performance anxiety, Zar says. In mindfulness training, you focus on how your body feels instead of focusing on your anxiety. This can help bring you back into your body so you can enjoy sex more.

Mindfulness can be hard at first, but you can practice it in non-sexual situations, such as at the gym or nail salon, before applying the technique in the bedroom, says Zar.

5. Physical hurdles

If something has changed in your life so that you’re not functioning sexually in the way that you used to, that can cause performance anxiety, Zar says. 

For example, if you’re no longer able to consistently achieve an erection – something that happens to many men as they age – you may develop anxiety, wondering if you’ll be able to perform as you’d like to the next time you have sex.

This may also happen if you experience

  • A lack of ability to orgasm because of taking medications like antidepressants
  • An injury or condition that impacts your sex organs
  • Other physical health conditions, such as heart disease or diabetes, that can impact erectile and orgasmic functioning

How to overcome it: Depending on the cause of the changes, you may be able to work with a primary care physician or a psychiatrist to manage your symptoms, says Litner. For instance, antidepressants can often affect your libido or ability to achieve orgasm. Your psychiatrist may be able to reduce your dosage or change your meds to alleviate these symptoms.

Even if the physical changes don’t abate, you can still manage your performance anxiety by changing how you approach sexual encounters. Litner suggests shifting from a performance-based mindset, which relies on a specific outcome being achieved, to a pleasure-based mindset, in which it’s the enjoyment of yourself and your partner that matters. Studies have shown that mindfulness training can help with this.

Working with a sex therapist that’s specifically focused on people with disabilities can also be helpful. Sex therapists can validate the different, yet equally important challenges that folks with disabilities face when it comes to sex.

6. Past negative experience with a partner

If someone has negatively commented on your sexual performance in the past, that can make you anxious about future sexual encounters.

“A lot of times we see this show up if somebody says something that is more of a rigid comment,” Litner says. “‘How come you’re not hard?’ or, ‘How come you’re not having an orgasm?'”

Even small comments made by well-meaning partners can cause performance anxiety, Litner says.

How to overcome it: Treatment will depend on the severity of the past negative experience, Litner says. If the experience was traumatic or took place during a formative period in someone’s life, trauma-based therapies can be effective. In other cases, psychotherapies like cognitive behavioral therapy and narrative-based therapy can be used.

Insider’s takeaway

Performance anxiety during sex is very common, and can be caused by poor body image, feeling disconnected from your partner(s), or changes in your sexual functioning. Treatment for performance anxiety depends on what is causing it, but a combination of therapy and mindfulness exercises are often effective.

Remember, even if you’re never able to totally eliminate your anxiety around sex, that doesn’t mean your sex life is over. “Intimacy does not mean sex, and sex doesn’t mean intercourse,” Elkhatib says. “The more that people can broaden their library of intimacy… the less pressure there will be to look and feel a certain way.”

Complete Article ↪HERE↩!

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If Your Sex is Goal Oriented, Then Expect Emotional Distance

— Here Is Why

Goal oriented sex creates emotional distance.

By Rene’ Schooler

“Men seek sex and hope for love. Women seek love and give sex.”

Patricia sits in my office crying, hands on her face, legs crossed, tears cascading down her cheeks as she sobs about Arthurs requests for sex and how she just is not interested.

“I love my husband, I really do, and that’s why I keep giving him sex as much as I can handle and pretend to enjoy it. I know that he needs it. I know that he wants it and that he is only happy if the goal is achieved.”

“And what goal is that?” I inquire.

“For us both to climax, to orgasm.” she responds.

Going on to tell me that he feels that this is a requirement of sex and that it is her duty to make sure that he achieves orgasm and that she does as well. As we speak over the course of multiple sessions, Patricia shares with me that her husband Arthur wants sex multiple times a day, most days, or at very least once a day. That the only times that he is okay with not having sex is when one of them is horribly ill and even then, it depends on what he deems as horribly ill, a migraine or sore throat is not on the list. She goes on to tell me that he wants each time to “sizzle” and be fresh and hot, saying that he wants adventure in their sex.

Over the years, like many couples Patricia and Arthur have gone through their fair share of life challenges with raising children, being a two-income household and working long hours to make ends meet and take care of responsibilities. They have fought about all the usual things and still proclaim to be committed and in love with each other, however as time goes on in my conversations with Patricia, I see that she is committed to loving Arthur but is not in love with him. She has bitterness and resentment toward him. She feels used and unseen, but like most women who have been in Patricias shoes she consistently chooses her wisest move of staying the course and allowing Artur his needs and wants without disagreement from her. She has invested over two decades into her marriage and does not want to do anything to cause issues, especially speaking up about her anger and pain or her needs with intimacy. And so, Patricia keeps giving Arthur what he wants and pretending it is all good to keep the peace.

THE TURN OFF OF ASKING FOR SEX

Rebecca and David came to me only three years into their marriage. David was frustrated that he was always the one to initiate sex as it seemed that Rebecca was either always too tired or just uninterested.

David asked for sex frequently only to be denied just as frequently by Rebecca. As I sat with the young couple and listened to their tale, I noticed that one of the main issues was that Rebecca had lost respect for her husband, she was not desiring him because he was acting out of neediness, and she knew that she could easily control him with sex.

“I work long hard days to support our growing family and future. I think she is stunning and sexy, and I just want to get close to her. I want to feel like she wants me too. Is it too much to ask that my wife want intimacy with me a few times a week?” inquires David.

“I work a part time job and take care of our one-year-old. I am exhausted at the end of the day and David comes homes, we have dinner, put Olivia down to bed, watch a show and then he says as we get into bed, ‘Can we have sex tonight?’ — it is such a turn off. Can’t he see that I am exhausted and not into it? Why does he ask like that? It’s like a kid in a store asking his mommy for candy…’Can I have this candy? PLEEAASSEE…” Rebecca says in disgust.

David goes on to share that he would not have to ask like that if she would just initiate when she was in the mood, but from his perspective she is never in the mood anymore and Rebecca’s rebuttal comes with the pain of feeling like she is just there to be his blow up doll as she says, he takes no interest in helping her with other things in the home or time to connect and speak to her about what’s happening in her work life or struggles of being a new mom. They don’t have time or money to get away from any connection and even though they eat out a lot, they no longer date.

WOMEN NEED TIME TO GET AROUSED — MEN NEED VISUAL STIMULATION

Monica and Henry started dating six months ago. They enjoyed being together, had lots of great conversations and laughter, spoke about longer-term goals together and were both feeling like this thing may really work out. They had waited to have sex until about a month in on dating seriously and like all first-time sexual encounters they had their mishaps and Henry’s stamina was not what either of them wanted it to be. Understanding, that this is often the case on the beginning side of intimate relationships, they both had patience and enthusiasm about learning each other and getting more familiar so that their sexual energy could be hot but also longer and steady. They shared about their sexual histories with each other, what they liked and did not like, what had worked well in the past and Monica was very vocal about her needs to take sex slowly, to build up with kissing and touching.

“I have told him repeatedly that I am not a light switch! You cannot give me a little peck of a kiss, rub some lube between my legs and stick it in and expect a miracle to happen.” she says in anger, going on to share, “it actually hurts me physically when he does that. Then he thinks that by slamming into me harder and faster that that is the trick. He pushes away from me, so he can watch my body, watch himself penetrating me, like it’s some live porn just for him, he grabs my breasts roughly and if I try and do anything he tells me to stop. He just really wants me to lay there and take it and somehow, he thinks that I am going to orgasm from this?”

Henry with eyes wide, “I had no clue. I thought she was liking it. The issue is that she takes so damn long to have an orgasm. I try everything and she won’t cum. I have never been with a woman like her before with these challenges.”

“How long do you two focus on foreplay typically and how long does your sexing last in total?” I inquire.

Monica rolls her eyes while Henry answers,” Foreplay maybe five to ten minutes and the same for the actual sex.”

“Are you aware that it takes a woman 20–40 minutes of foreplay, that’s kissing, touching, snuggling, oral sex, feeling loved and cared for physically to be ready for actual physical penetration? Without this her body takes physical damage. The lining of her vaginal walls can easily tear, she does not have adequate blood flow to her vagina, her clit, and her cervix is not soft and flexible. This is just the physical aspects. If we look at hormone response no healthy chemicals have dropped down to trigger arousal yet, and her emotional response is most likely armored as she is still thinking about everything else and also fearful that she won’t get the time to drop down into her body and connect to herself or you.”

THREE SEPARATE COUPLES TALES- ONE ISSUE

These three couples have all been together for different time frames. They have different levels of bonding with each other, and they all have their own unique wants in sexual relationship, however the common agendas you may see are:

  • Men focusing on a goal of orgasm through speed, action and frequency
  • Women focusing on intimate connection, slowing down, touch, laughter, courting and then letting that lead to orgasm potential

Men wonder why women have issues getting aroused after the honeymoon phase of the relationship ends, and that can be anywhere from six to eighteen months into a serious relationship where the new relationship energy (NRE) starts to wear off. The culprit is pretty simple:

    Men stop courting, stop romancing, stop applying themselves. They stop hunting the woman and connecting to her emotionally and mentally. They may stop doing all the things that they were doing even for themselves to make themselves more desirable or to feel confident and strong. In other words, men capture what they are going after and then turn their attention to the next hunt, which is not their woman any longer. This happens because men feel settled in the relationship and since men are linearly focused and compartmentalize everything, they believe that they can now change focus and the relationship will just maintain itself.
  • Women lose interest a lot quicker than men do it is shown in studies, but women once committed will stay the course of the relationship and put attention to building a family, a home or their career and forfeit the depth of intimacy or sexual arousal for the sake of security and to be cared for with a man. Women seek out love and security and they give sex to gain these things. As much as a woman desires orgasms and sexual pleasure, just like men do, women will disregard them and accept not having them to assure stability and overall relationship peace. When a woman is not being hunted by her mate any longer, when her mate stops trying to impress her with his strength, intelligence, manliness you could say, her desire and arousal dwindle. When she is not being courted and romanced, her sexual desire is limited and often will be buried for years without notice.
  • Women lie to their men about orgasm. Why? In studies it has been revealed that over 80% of coupled women do not have orgasms in their sex with their partner. The vast majority of women in the world understand that men believe that a few moans, some nails on the back, some laughter and deep breathing or hip rotating are signs of a woman having a “real O” and so they make use of this to make their man feel accomplished and then they take care of themselves when alone. It is again all about keeping the peace in the mind of the woman. Women know that they need time and attention to achieve the result their mate wants for them but is not willing to slow down and give, and so they train their man to believe that they only need five to fifteen minutes, no foreplay, no courting or romance.
  • Men have a tough time accepting, believing or even understanding that their sex is polar opposite from their female partner’s sex. Nature made us opposites in how we function, think, view the world, open to pleasure, emotionalize things and most certainly to our needs and wants sexually. For men sex happens outside of the body and is stimulated through visual stimuli, touch, sound, smell. It is an act that he can witness and feel control around. For women sex happens inside her body, she must allow and open up her body to her partner and trust that she will not be harmed. For her to feel him at all she must exit her mind and enter her heart allowing him in there as well with trust. A woman is stimulated through her mind and heart which causes an emotional response which leads her to her body.

Over and over again, I meet couples like these three I share here today with you and what I see is that disconnect and the expectation on both sides. I see the lack of integrity from the women out of fear of abandonment and hurting their partners ego’s. I see the men fearful of sinking in and letting themselves feel their hearts and become emotional with their woman out of fear that they will not have the stamina of even five minutes, so in turn they want their woman to sex like a man. I tell you though, this will never be. There are women out there that will argue these words and say that they are good with the quickie, that they don’t like or want foreplay or even courting. They will proclaim that they always have an orgasm. And some are being truthful, but the majority are hiding their pain because they are trying to live up to the new standard where women are to be men in all aspects of their lives: Including their sex.

And to this I say, how sad our world has become.

How doomed our intimate relationships are.

We claim to want connection.

To be loved and to love.

We say that we want integrity, intimacy and happiness.

And we have been brainwashed into believing that we can achieve these things with limited time, focus, dedication or commitment. That they will not and should not require us to go deeper within ourselves. Nor should we have to work at earning the trust of others’ vulnerability and we most certainly should not have to keep up the hunt, do the maintenance and ongoing work of having what we say we want and keeping it.

Complete Article ↪HERE↩!

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New theory suggests female orgasms are an evolutionary leftover

Having bad sex? Don’t blame yourself or your partner—blame evolution

Not switching off

By Elizabeth Pennisi

Billy Crystal may have been shocked when Meg Ryan so effectively—and amusingly—faked an orgasm in a restaurant during the 1989 movie When Harry Met Sally, but surveys suggest only one-third of women are regularly fully aroused during intercourse. And although poor partner performance, psychological issues, or physiological shortfalls are often cited as the reason, two evolutionary biologists now offer a provocative new explanation. In a paper published today, they argue that female orgasm is an evolutionary holdover from an ancient system, seen in some other mammals, in which intercourse stimulated important hormonal surges that drive ovulation.

Humans and other primates don’t need intercourse to trigger ovulation—they evolved to a point where it happens on its own—but the hormonal changes accompanying intercourse persist and fuel the orgasms that make sex more enjoyable, the biologists hypothesize. And because those hormonal surges no longer confer a biological advantage, orgasms during intercourse may be lost in some women. This explanation “takes away a lot of stigma” of underwhelming sexual relations, says one of the authors, Mihaela Pavlićev, of Cincinnati Children’s Hospital in Ohio.

The new work addresses what David Puts, a biological anthropologist at Pennsylvania State University, University Park, calls “one of the most contentious questions in the study of the evolution of human sexuality: whether women’s orgasm has an evolutionary function.” There are more than a dozen theories about the evolution of orgasms, most proposed decades or more ago. They include arguments that women have orgasms because their reproductive machinery has the same origins as those of men, who need to have orgasms to ejaculate sperm. Others think orgasms are an evolutionary novelty that persists because it helps foster loyal partners. Some have proposed that female orgasms induce physiological changes that increase the chances of conception, but there’s no strong evidence that women who have more have increased fecundity.

Orgasm itself may have no evolutionary function, but it is derived from a key part of the reproductive cycle, Pavlićev and her colleague propose today in the Journal of Experimental Zoology Part B: Molecular and Developmental Evolution. Pavlićev didn’t start out studying orgasms. To better understand the evolution of reproduction, she was compiling data on the ovarian cycle in different mammal species. During this cycle, cells destined to become eggs mature, escape from the ovary, and travel down the reproductive tract. She discovered that in some species, environmental factors control egg maturation and subsequent ovulation; in others, such as rabbits, sexual intercourse with a male or even just his presence causes the release of the egg. In either case, a series of changes involving the hormones oxytocin and prolactin are triggered that cause the egg to mature and migrate. In humans and other primates, the ovulatory cycle has become spontaneous, generally on a set schedule that requires neither an environmental trigger nor a male. Pavlićev then realized that women still undergo the same hormonal changes as species with induced ovulation, but during orgasm.

To see whether induced ovulation was the evolutionary predecessor of orgasms—in a similar way that fins were ancestral to limbs—she and Günter Wagner, an evolutionary biologist from Yale University, first needed to see whether induced ovulation predated spontaneous ovulation in evolutionary history. Their literature search showed that environmental- and male-induced ovulation are found in earlier evolving mammals and spontaneous ovulation appears in later species, including our own. They also noticed another change. In earlier mammals, the clitoris, which is so often key to a woman’s orgasm, tends to be part of the vagina—guaranteeing that intercourse stimulated this organ and kick-started ovulation. But in later arising species, particularly primates, the clitoris has moved ever farther away from the vagina, even out of reach of an inserted penis. “A shift in the position of the clitoris is correlated with the loss of intercourse-induced ovulation,” says Martin Cohn, an evolutionary developmental biologist at the University of Florida in Gainesville. “Their hypothesis shifts the focus of the research question from the evolutionary origin of orgasm as an evolutionary novelty, which has long been presumed but not demonstrated, to the evolutionary modification of an ancestral character.”

Pavlićev and Wagner’s theory helps explain why female orgasms during intercourse are relatively rare. “It is new to use [this] innovative, Darwinian approach to understand one of the mysteries of human sexuality—why the male orgasm is warranted, easy-to-reach, and strictly related to reproduction and the female counterpart [is] absolutely not,” says Emmanuele Jannini, an endocrinologist at University of Rome Tor Vergata. The nonnecessity of orgasms for reproduction may also explain why women’s reproductive tracts vary a lot more than men’s—there are fewer constraints, he adds.

Jannini and others point out, however, that this theory needs more confirmation. So far, it deals only with the parallels between the hormonal surges in females during male-induced ovulation and orgasm, but has not looked to see whether there are also parallels in the neurological components of these activities, says Elisabeth Lloyd, a philosopher of science at Indiana University, Bloomington, who was not involved with this work. And because it’s so difficult to assess whether other mammals feel the pleasure associated with orgasms, the work can only ever address the evolution of some of the components of female orgasm, Puts notes.

Others more strongly criticized the new explanation. Two behavioral neuroendocrinologists, Michael Baum from Boston University and Kim Wallen from Emory University in Atlanta, tell Science that Pavlićev and Wagner misinterpret some previously published results and do not have the details about the hormonal changes during ovulation and orgasm correct. “Their hypothesis remains a good hypothesis,” Wallen says. “But I’m not very convinced by the data they marshal.”

Lloyd says the work drives home how much more we need to learn about female sexuality in other organisms. Wagner and Pavlićev concede that more data are needed to firm up their theory, though for now they have no plans to follow up themselves. Cohn predicts others will pick up the baton. “Pavlićev and Wagner have taken a fascinating, creative, and thoughtful approach to a problem that has been investigated by many but resolved by few,” he says. “I suspect that many investigators will be stimulated to further test the hypotheses raised in this paper.”

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