Tag: sex and relationship advice

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I’m a Sex Coach in a Monogamish Relationship

— Here’s How I Handle the Fear and Jealousy That Can Come With Non-Monogamy

By Quean Mo

Even if you know wholeheartedly that you want to be non-monogamous, actually engaging in that relationship structure can elicit a variety of complex emotions. At the same time that you feel desire, you might also feel fear and jealousy—and I’ve experienced this firsthand, as both a person in a monogamish relationship (a form of non-monogamy that allows for agreed-upon sex acts outside of an otherwise monogamous relationship) and a sex coach who works with clients looking to navigate the complexities of such relationships.

When my husband James and I first got together eight years ago, it was in a monogamous relationship. But after we built a loving, trusting partnership—one that alleviated the emotional baggage I carried from a prior abusive relationship—I found that I was able to access parts of myself that I’d previously closed off. I discovered that I was a cuckquean (a woman who is aroused by her partner having an affair with another woman) and that I wanted to open up our relationship.

The idea of James sleeping with other women drove me mad with jealousy, and yet that jealousy felt so intensely good. The best way to describe this experience is that, because I felt emotionally secure within my relationship, I could sit in the fiery sensation that jealousy conjures without burning alive; it warmed and exhilarated me rather than consuming me.

The prospect of actually engaging in this fantasy, however, sparked loud, conflicting voices in my head. One voice promised that this lifestyle would make our relationship all the more fulfilling, while the other warned of the opposite. I was fighting with myself, but one feeling remained consistent: I loved James, and I also wanted to explore pleasure beyond ourselves.

Over the past four-plus years together, we’ve done just that, carefully weighing the pros and cons of non-monogamy and crafting a version of it that suits us both. The process has been a gateway to personal and relationship growth and enhanced pleasure. But it certainly hasn’t always been easy or linear.

Mainstream society tends to reinforce a primarily monogamous relationship structure and offers little guidance on anything outside of it, much less the nuanced feelings that non-monogamy can spark.

I’ve noticed non-monogamy becoming increasingly popular, but even so, mainstream society tends to reinforce a primarily monogamous relationship structure that offers little guidance on anything outside of that, much less the nuanced feelings that non-monogamy can spark. Below, I share how I’ve learned to navigate the fear and jealousy that can arise with non-monogamy and the advice I offer clients who aim to do the same.

5 tips to manage fear and jealousy when embracing non-monogamy with a partner

1. Discuss both the upsides of non-monogamy and of your individual relationship

Clear communication is a cornerstone of any healthy relationship, but it is especially important when you’re aiming to open up a relationship or fundamentally change its structure. By talking candidly about why you have the desire for a particular version of non-monogamy or a monogamish relationship with a partner, you also have the chance to address the what-ifs, which can help quell fears that arise naturally because of what is still unknown.

Here are a few questions that my husband and I considered when we discussed opening our relationship:

  • What sides of non-monogamy interested me? And why?
  • Was he interested in a monogamish relationship? If so, why?
  • What were our biggest fears when it came to embracing non-monogamy?
  • What role would each of us play?
  • What boundaries needed to be established?

In figuring out how you and a partner could both stand to benefit from non-monogamy, it’s equally important to reiterate what you value in the relationship you share with each other, according to sex and intimacy coach Rebekah Beneteau. “Maybe you two nest and co-parent really well together, but sexually you’re both dominant,” she says. “You may then want to get that need met somewhere else, while still recognizing that you have these other terrific connection points.”

The clear recognition that your current monogamous relationship has real value can help mitigate some of the natural fear and jealousy that can come with inviting others into the fold.

2. Define how you’ll each continue to be included in each other’s pleasure

When my husband and I were first embracing non-monogamy, I felt jealousy at the realization that I would no longer be the singular or even primary source of his sexual pleasure.

Beneteau defines this type of jealousy with an equation: turn-on + exclusion. “You don’t get jealous if your husband is doing their taxes with someone else,” she says, of exclusion without the turn-on.

Because our version of non-monogamy would involve sex acts with others, the antidote to jealousy was in figuring out how we could reduce feelings of exclusion and continue to be included in each other’s pleasure, both sexually and otherwise. This involved adopting the fundamental understanding that love and sex aren’t innately or always connected, and setting clear boundaries around our sexual relationships with others, so each of us felt included in those decisions.

3. Use self-reflection to examine the true source of your fears around non-monogamy

Typically, pain and fear are survival mechanisms that spring from perceived threat. The important thing to note, though, is that many of our perceptions of threat in relationships aren’t rooted in actual danger so much as they are in societal conditioning around monogamy—that “real” love is monogamous love, that we should search for “the one,” or that we should be able to have all our needs met by one person.

Many of our perceptions of threat in relationships aren’t rooted in actual danger so much as they are in societal conditioning around monogamy.

By taking “an intellectual look at the fears we feel [surrounding non-monogamy],” or following them with an objective lens, we can determine whether they’re actually true to us or are just stemming from the monogamous narratives that have been imparted onto us (and no longer serve us), says sociologist and relationship consultant Elisabeth “Eli” Scheff, PhD.

To do that, try implementing a self-reflection practice, such as journaling, to track your fears to their cores, and decide whether or not they have real merit. Understanding that the root of my fears around non-monogamy was in the societal narratives I once harbored has helped liberate me from those stories—and it could do the same for you.

4. Take small steps toward non-monogamy

Trial and error can feel intimidating when it comes to transitioning a monogamous relationship into a non-monogamous one—which is why gradual steps are key to success. Here are a few exercises from my personal tool kit to help you test the waters when you’re managing feelings of fear and jealousy:

  1. People-watch with your partner with the intention of sharing whom you find attractive.
  2. Have an ethical porn date during which you watch porn and play together or separately (be it in different rooms or through mutual masturbation).
  3. Explore online dating apps, either as a couple or separately. Start by chatting only, increasing engagement as you both see fit.

These items are meant to be entry-level actions you can take, with low emotional risk, to gauge how each of you feel when your partner is thinking about or engaging with someone else. The point is to communicate at every stage what works and what doesn’t so you can either continue forward or recalibrate accordingly. This way, you don’t risk accidentally pushing things too far too quickly in a way that leaves one or both partners feeling hurt.

5. Remember that *you* are always your primary partner

Being your own primary partner means “you are not willing to lose yourself for the sake of any relationship, and that anybody coming into your space just has the power to enhance it and bring something juicy, new, and fun,” says Beneteau.

What I love about this concept is that it shifts the focus from feelings of fear and potential inadequacy to individual empowerment.

The structure of your relationship has less to do with the success of it than the quality of the relationship itself.

When my husband and I transitioned from monogamous to monogamish, I navigated some frustration. I could feel that this was the right path for me, and yet, I was terrified of the consequences. What I learned, however, is what you bring to a relationship—trust, honesty, communication, love, respect—will best determine the longevity of that partnership and how satisfied you are within it (not whether it’s monogamous or non-monogamous or somewhere in-between).

As a result, it’s especially important to tend to your relationship with yourself if you find that you’re facing fear and jealousy in the pursuit of non-monogamy. “The relationship you have with yourself is foundational in how you move through the world,” says Beneteau.

One way to strengthen that relationship to self is to set your own pleasure as your compass. By reflecting on your desires for non-monogamy and following the path that you believe will bring you the most pleasure—even in the face of your fears—you’ll move toward your authentic self and a more fulfilling relationship, too. The journey will likely involve ample communication and trial-and-error, but remembering that it’s ultimately all in the name of your pleasure can help mitigate emotional setbacks and make it that much more rewarding in the end.

Complete Article ↪HERE↩!

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From scheduling sex to being selfish

— 10 ways to improve intimacy

By

1. Talk about any problems

Things seem to work well without really thinking about it. Then, when it starts going wrong, you don’t quite know how to talk about it, so the situation gets to a point where you’re stuck and you don’t know how to deal with it. The first stage in addressing this is for each person to spend a couple of days thinking about what they see the problem is, and then agreeing to sit down together for a discussion. Take turns saying: “This is what I think the problem is, and this is how it is affecting me.” Out of this comes the opportunity to really get to the heart of the matter and work out what is needed.

2. Look for the reasons why sex might have changed

How did sex use to be? What was intimacy like? What has changed? What are the blocks to sorting it out? There may have been occasions when you might not have wanted to be sexual or you might not have been in the mood, and that got misinterpreted, or there were a few times when you got rejected. And then you get into a pattern of not having sex or avoiding it.

3. Talk about how you first met. And make an effort to look nice

Spend an evening chatting about what you liked about the other person. You can remind each other of what drew you both together. Do that on the first night, then on the next night, dress up, go out for a meal and make an effort to feel and look special. What you’re likely to find is that you’re feeling much more connected and that can lead to noticing desire, feeling sexual, and you can reignite something that has perhaps been lost for a while.

4. Every time you leave the house (and come back) make a point of having a kiss or a cuddle

There is no intention that it is going to lead to sex, you just get used to the idea you can reclaim intimacy. Make a point of saying, “I like what you’re wearing”, send texts to each other throughout the day saying “missing you” and “look forward to seeing you”. In this way you’re recreating some of the behaviours you probably did at the beginning of your relationship and you are giving the message, “I’m noticing you and I like you”, so that the sense of feeling closer to the other person, the emotional intimacy, starts creeping back in.

5. Schedule regular time to be intimate

This is making a commitment to maintaining the relationship by saying: even though sometimes we don’t feel like it, we realise the importance of this and will try to be sexual. It is about not letting gaps appear so then it starts becoming more normal to not have sex. What your scheduling says is that Friday nights are your night, you’ll put some effort into making it special and this can lead to greater intimacy. Perhaps this means having a shower together, or maybe dressing up – above all it is about making a statement that your physical relationship is important, and you are prepared to put in the groundwork, instead of saying it is just about sex.

6. Write down on pieces of paper what really works for you both

Then fold them up and put all of the bits of paper in a jar. I encourage couples to sit down and work out some of the things that each person particularly likes when they are being sexual. Then, whenever you’re going to have some intimate time, pull out a piece of paper and whatever’s there, you’ve got the chance to try. It enables an element of fun and excitement to return into the relationship which can be helpful to maintain the spark.

7. If there is a high level of anxiety attached to sex, introduce mindfulness

I always suggest pelvic floor exercises, because this makes you focus on your genitals, so you become much more tuned into your body. For a man, this can increase the quality of his erection and the chances of more ejaculatory control. For a woman, it is likely to help her to regain a bit more feeling within the vaginal walls and it might help towards arousal.

8. For older couples, slow everything right down

Try having a bath together, so you feel good and in tune with each other. Pay more attention to what position feels comfortable. If there are issues of mobility and flexibility it can be useful to try out positions first. You might want to do this while you’re still dressed when it can feel easier (and warmer).

9. Take turns to be selfish

Say, “I’d really like it if you could give me a back rub”, or “I just really want the opportunity to touch you”. I often suggest couples go to bed and have a period of time when you’re both naked without needing to be sexual. Just lying next to each other, feeling the other person’s skin on your skin can be a very intimate and nourishing moment.

10. Rediscover how to be intimate with each other

There are many reasons why intimacy can change in a relationship. Pregnancy and birth, ageing, body shape, resentment, arguments not being resolved, anxiety, the menopause, erectile problems … It is important to understand why you’ve reached the point where things are dysfunctional, but it is always possible to make changes. I’ve worked with couples who haven’t had sex in six years and it has been a privilege to help them rediscover how to be intimate with each other.

Peter Saddington is a clinical supervisor and a relationship and sex therapist working for Relate.

Complete Article ↪HERE↩!

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How To Reclaim Your Sexuality After Sexual Assault

— According to Trauma-Informed Sex Educators Who Are Also Survivors

By Erica Sloan

If you think of the body like a circuit system, “sexual trauma has a way of rewiring things,” says trauma-informed sex educator Jimanekia Eborn, founder of Tending the Garden, a support organization for marginalized sexual-assault survivors that offers a quarterly subscription care package. In the aftermath of endured sexual trauma, things that once sparked pleasure or arousal, like a certain kind of touch or even the words of a loved one, might instead trigger pain, setting off a negative chain reaction circuit-wide, says Eborn. Rebuilding that circuit—not necessarily into what it was, but into a version that lights up just as brightly—can help survivors reclaim their sexuality after assault.

The circuit metaphor is particularly apt for describing the effects of sexual assault because of the ways in which the trauma can infiltrate your whole system. “It isn’t just something that happened to our bodies; it isn’t just something that happened to our brains,” says Eborn. “It is all-encompassing.”

“It’s not that you’re broken, but you have to navigate yourself in a new way.” —Jimanekia Eborn, trauma-informed sex educator

That reality can make it easy to feel like you’re broken. But the switchboard isn’t dead; it’s more accurate to say it needs some reconfiguring. “Sometimes, I have days where my body feels very disconnected from me, or I feel like I’m existing at an angle,” says Eborn, of healing from her own sexual trauma. “It’s not that you’re broken, but you have to navigate yourself in a new way.”

What that path looks like will be different for every survivor, says somatic coach and restorative-justice advocate Marlee Liss. “There’s no one-size-fits-all roadmap to reclaiming your sexuality and pleasure after assault, and it isn’t a linear process either,” she says, “but I think realizing that is a really big part of the healing.”

How sexual trauma can disconnect you from the experience of pleasure and your own sexuality

Though the body can respond to trauma in a number of ways, any response is “an attempt at protecting you and helping you to feel safe,” says Liss. (And it’s helpful to see it through that lens in order to find some self-compassion if your body’s response isn’t what you’d like it to be.)

In terms of a person’s relationship to sexuality, two opposite responses are the most common, says Liss: hyposexuality and hypersexuality. The former is an aversion or fear of sex that typically looks like shutting down desires, rejecting sexual feelings, or numbing out in sexual circumstances “often so that you can feel a greater sense of control over your body and your decisions,” says Liss. It’s the body’s way of compensating for a loss of that control in the past.

The latter, however, is a compulsion toward sex, when “someone hyper-sexualizes themselves more than their typical amount, perhaps because they’ve internalized sexual objectification that’s been imposed upon them or because they’re trying to deny or minimize the reality of the trauma they’ve experienced,” says Liss.

This hypersexualization response may make it seem, on the surface, as if the person has fully learned how to reclaim their sexuality after assault when, in reality, they’re sexualizing themselves purely as a result of trauma, and not because they’re in tune with their body or seeking pleasure.

It’s also possible for sexuality to ebb and flow post-trauma. “Perhaps, one day, all the switches on your circuit are off, and you just want to stay in bed all day, and the next, they’re all on, and you’re craving a sexual experience,” says Eborn. “I think there’s so much shame and blame placed on both sides [of that spectrum] that people struggle figuring out where they fall. But in a healing journey, there’s room for all of it.”

The key to reconnecting with an honest expression of your sexuality after trauma is to be able to observe the way your body responds to different sensory inputs and then listen to its cues.

The key to reconnecting with an honest expression of your sexuality after trauma is to be able to observe the way your body responds to different sensory inputs and then listen to its cues. “Our bodies are constantly telling us in many different ways whether we’re feeling safe, whether we’re feeling unsafe,” says Liss. But when you go into a hyposexual or hypersexual state, or enter another kind of trauma response, it’s easy to miss those cues, she says.

Learning how to turn back toward your own body’s senses and sensations, notice them, and value your right to feel however you feel is the core process of sexual reclamation.

5 strategies that can help you learn how to reclaim your sexuality after assault

1. Release yourself from shame and blame

While it may seem obvious that the survivor of sexual assault is never to blame, the reality is that trauma can get twisted in retrospect.

“There’s a lot of shame that can come with experiencing sexual assault,” says Eborn. And when you consider that the brain is our biggest sex organ, it’s no wonder that holding onto all that shame can distance you from sexual pleasure. “If you’re constantly thinking, ‘This is my fault,’ or ‘I could’ve prevented this,’ it’ll be very difficult to reclaim your sexuality,” says Eborn.

Her advice? Remember that shame is a feeling put upon you by other people, other things, or other circumstances. “Instead of owning that shame as yours, think about it like, ‘This feeling is not mine, and it’s not of my creation,’” says Eborn. Yes, you have to deal with it now, she qualifies, but the important thing to remember is, you didn’t ask for or deserve this.

2. Take yourself on pleasure-focused “self dates”

It’s essential to carve out solo time on your calendar that’s designated just for your pleasure while you’re on the journey of learning how to reclaim your sexuality after assault. Eborn and Liss both call these pockets of time “self dates.” They can be any length of time—whether three minutes or 60, depending on what you can swing—and the only rule is that you use the time to feel good.

Notably, that means you’re not going into these self dates with a particular goal to accomplish or sexual act to achieve. “I think that there can be this kind of capitalist, productive approach to healing from sexual trauma that’s like, ‘I need to be okay again, and I need to be like I was with sexuality, and I need to get there by tomorrow,’” says Liss. “But that kind of pressure can lead us to cross our boundaries and just put ourselves in re-traumatizing places.”

Instead, the point of the self-dates is to focus purely on pleasure—and not necessarily orgasm or masturbation or even anything sexual at all. While you certainly can use the time for a solo sex session, you might also use it to take a hot bath, dance with reckless abandon, or savor a piece of pizza.

“Ask yourself, ‘What would bring me pleasure right now?’ or, ‘What would allow me to connect with 1 percent more pleasure right now?'” —Marlee Liss, somatic coach and sex educator

To figure out which route to go, Liss says to ask yourself the deceivingly simple (yet often overlooked) question, “What would bring me pleasure right now?” Or, if that feels too inaccessible, even just, “What would allow me to connect with 1 percent more pleasure, or peace, or comfort right now?”

This practice can help increase your awareness of your own body and senses, allowing you to practice self-consent, says Liss: You’re asking yourself what would feel good, and then you’re acting upon that, which is a beautiful reclamation of power over your physical being.

Indeed, allowing yourself to answer the question honestly is a reminder of an essential truth: “You know yourself better than anyone else does, no matter what anyone tells you or tries to talk you out of or talk you into,” says Eborn.

3. Reimagine the physical or mental context you’ve created around sex

Simple changes to your environment or approach to sexual pleasure can make a world of difference in how you perceive it in the wake of trauma.

On the physical side of things, consider how you might rid your space from as many triggers as possible, says Liss. Toss any objects that take you to an uncomfortable space, remove triggering songs from playlists, adjust anxiety-provoking lighting, and the like. And at the same time, consider how you might add glimmers—aka the opposite of triggers—into your physical space. Perhaps these safety cues include a particularly calming sound or smell, or a comforting blanket.

When it comes to the mental context you’ve constructed around sex, Eborn also suggests dropping preconceived notions and starting fresh by taking the Erotic Blueprint quiz, which sexologist Jaiya Ma created. The five categories it includes—energetic, sensual, sexual, kinky, and shapeshifter—each encompasses unique sexual turn-ons (for example, soft and wispy touch for the sensual people and something that feels personally taboo for the kinky people).

“By taking the quiz, you can see what might feel connected to get you back in your body,” says Eborn. That answer certainly may have changed as a result of experiencing trauma—and that’s not a bad thing so much as something important to notice. “It’s okay if you no longer want or feel comfortable doing that one thing that was once a turn-on,” says Eborn. “There’s so much body, there are so many ways to touch it, and sex is about far more than penetration.”

4. Redefine your sexual boundaries

Part of learning how to reclaim your sexuality after assault is identifying and honoring your own sexual limits. One way to do this is by creating a Yes/No/Maybe list, says Eborn. Just like it sounds, this involves categorizing any number of different sex acts, fantasies, toys, and positions as “Yes,” “No,” or “Maybe,” based on your interest (or lack thereof) in trying them.

This way, you have a reference—“a cheat sheet of sorts,” says Eborn—for what you enjoy, what you don’t, and what you’re open to exploring, which you can also share with a current or future sexual partner, if relevant. Though it might seem like TMI to share it, it’s important to remember that “most people actually want to know how to have sex with you, rather than guessing,” says Eborn.

You can also explore where your sexual boundaries fall during one of your pleasure-focused self dates, above. If you’re tuned into what feels pleasurable, you’ll also be able to better identify what doesn’t (or when something stops feeling good). “A key piece that’s easy to miss is that sometimes, the most liberating breakthrough is you being like, ‘That’s enough for today,’ and knowing where to draw a boundary,” says Liss. “That, in and of itself, can be an experience of pleasure.”

5. Know that sexual reclamation post-trauma isn’t all or nothing

In the headspace—and body-space—of healing from sexual trauma, accessing pleasure of any sort can sometimes feel like a stretch. Which is why, Liss says it’s important to remember that two things can be true: You can feel grief or sadness or pain or anger (or all of the above) about the experience of sexual assault, and you can also reclaim pleasure. “Different feelings can coexist,” says Liss, “and the journey to healing is really about allowing that coexistence to happen without denial.”

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For cancer survivors, sexual intimacy can pose unexpected issues

— ‘I feel as if my body has betrayed me,’ one survivor says

Brenna Gatimu and her husband, Nimmo Kariuki, tend to their youngest son, Kylian, in Casper, Wyo. Gatimu was diagnosed with Stage 3 breast cancer in 2020.

By Netana H. Markovitz

Brenna Gatimu, 34, of Casper, Wyo., was diagnosed with Stage 3 breast cancer in 2020. She quickly had chemoradiation, and both her breasts and ovaries were removed. She now takes a medication that suppresses any remaining estrogen in her body.

“I feel as if my body has betrayed me, like all the things that make me biologically a woman — the estrogen, the progesterone, my ovaries and my breasts — everything had to be removed and stopped,” Gatimu said.

Gatimu’s experience is not uncommon. As cancer survival rates in the United States improve, many survivors are left with permanent changes to their body — outwardly and functionally. Some feel particularly unprepared for persistent changes in their sexual functioning.

“Sexuality is a very big issue, and unfortunately, the avenues to get help are often limited because people are concentrating on helping [patients] live through cancer, and really concentrating on quality of life but devoid of sexuality,” said Don Dizon, a professor of medicine and surgery at Brown University and the founder of the Sexual Health First Responders Clinic at the Lifespan Cancer Institute.

Sexual health and quality of life

In 2022, approximately 18 million people with a history of cancer were living in the United States. The number is expected to increase over time.

“As people live long lives after cancer … these questions on the permanent, long-term side effects of treatment are something we have to address,” said Sharon Bober, founding director of the sexual health program at the Dana-Farber Cancer Institute and an associate psychiatry professor at Harvard Medical School.

“I feel as if my body has betrayed me, like all the things that make me biologically a woman — the estrogen, the progesterone, my ovaries and my breasts — everything had to be removed and stopped,” Gatimu says.

“We are looking not just at what people do functionally, but we’re also thinking about people’s experiences of themselves being whole, having a sense of integrity in their body — even after things change,” Bober said. “We’re talking about an experience of how people relate to a partner, we’re talking about dating, we’re talking about emotional and sexual relationships that undergo changes themselves.”

“We’re also thinking about people’s experiences of themselves being whole, having a sense of integrity in their body — even after things change.” — Sharon Bober, founding director of the sexual health program at the Dana-Farber Cancer Institute

Some cancer centers have created programs dedicated exclusively to sexual health for patients with cancer — such as Massachusetts General Hospital and Memorial Sloan Kettering in Manhattan. These centers are still relatively rare, but their numbers are increasing.

Those without access to a comprehensive center should consider seeking out “specific practitioners who have relevant expertise, such as certified menopause specialists, urologists or urogynecologists who specialize in sexual medicine, pelvic floor physical therapists or certified sex therapists in the community,” Bober said in an email.

Gatimu holds some of the medications she takes while Kylian asks if he can have the pills, too.
A family portrait on Gatimu’s wall shows husband Nimmo Kariuki, stepdaughter Paisley Grundhoffer, and sons Malcolm, James and Kylian. The family had the photo taken the day Gatimu completed chemotherapy.

Patients can also access a growing body of information.

“There are really more resources now than there ever have been and there are a lot of organizations that now have really good information and education on their websites,” Bober said. “I would just say people should feel free to access the growing amount of supports that are out there. And that’s the case both for patients and providers.”

For example, the Scientific Network on Female Sexual Health and Cancer has a host of resources, including webinars, a page with links to several online resources and a “find a provider” page to search for help by location. The American Cancer Society also has a fairly comprehensive overview of navigating sex and cancer.

Jacob Lowy in his living room in New York.

Even before intimate encounters, body image can be an issue. Jacob Lowy, 31, a fourth-year medical student at the University of Michigan, was diagnosed with metastatic sarcoma in 2021. Since then, he has had to deal with dating.

“It definitely messed with my psyche a lot to talk to people because it feels like you’re hiding something at first,” Lowy said. “But there’s no real advice for how to do it properly.”

Besides fatigue and surgical complications from his two abdominal surgeries, he has experienced decreased libido and erectile dysfunction.

“I went from feeling … invincible and very strong to my body feels like a wreck on the inside,” Lowy said.

Physicians often don’t discuss sexuality with patients for many reasons, Dizon said. “Partly it’s because I don’t think oncologists are trained in talking about sexuality,” he said.

Lowy spends time with friends on the Lower East Side in New York on March 4.

When sexuality is discussed, much of the talk often focuses on what’s safe — for example, when it is safe to have sex during chemotherapy. Bober said “potential sexual side effects and sexual rehabilitation really is not routinely incorporated into care. So a lot of people struggle on the other side of treatment and feel pretty isolated.”

“I went from feeling … invincible and very strong to my body feels like a wreck on the inside.” — Jacob Lowy

But when the topic is broached, doctors often have treatment recommendations.

Sarah E.A. Tevis, an assistant professor of surgery at the University of Colorado, recently started asking her patients about sex after a patient questionnaire she distributed flagged the issue.

“This wasn’t a common thing I talked to all of my patients about, and ever since I’ve started bringing it up, I feel like almost every single patient I talk to is having some problem that we can probably help with,” Tevis said.

Ask for help or a referral

Even if your oncologist does not know how to help, someone is probably out there who can.

“This is something that people should be empowered about — that as with other aspects of our health, if you’re having issues, give it voice, ask for specific assistance,” Dizon said. “And if your doctor doesn’t know or doesn’t want to discuss it, then ask for a referral.”

For Gatimu, she has done her best to adapt to a new normal but still struggles.

Since treatment, she has experienced vaginal dryness, difficulty achieving orgasm and lack of libido. She also has no sensation in her reconstructed breasts. Gatimu has sought advice through a combination of doctors and friends who are cancer survivors.

Gatimu helps Kylian wake up to get ready for day care on March 1.
Gatimu’s son Malcolm walks past a photo wall his mom and dad put together of past family moments, photos and sayings as he gets ready for school on March 1.

“I still have times where I really struggle with the comparison or the wishful thinking of ‘Oh my gosh, if only this didn’t happen and I didn’t have to live through this, where would [I] be?’ On the positive side, I have gained such a self-awareness and such a self-confidence within myself,” Gatimu said.

One 44-year-old man who was diagnosed with Stage 3 rectal cancer in 2018 underwent chemotherapy and radiation before having surgery that resulted in an ostomy pouch, a bag that collects stool outside the body.

“It’s tough for me not to view my body as … broken,” said the man, who asked not to be named for privacy reasons.

For him, sex with his partner now involves going to the bathroom to empty out the ostomy pouch and ensuring that it is as flat as possible so it does not get in the way. He also takes Viagra for the erectile dysfunction he has had since treatment.

A photo of Gatimu and Kariuki attending an adult prom in Casper, Wyo., that raises money for childhood cancer research.

“I am very fortunate that I have a loving partner who loves me for who I am and we’ve adjusted, but now sex is really tough to have spontaneously,” said the man, who lives in Chapel Hill, N.C.

A common misconception is that only certain cancers affect sex.

“We tend to think of sexual health as an issue [only] for people treated for sex-related cancer,” Dizon said. “But that’s actually not true. There’s a growing literature that even people treated for, say, colon cancer and lung cancer — they actually have issues related to sexuality.”

He points out, for example, that chemotherapy itself can affect the vaginal mucosa, which can cause pain with sex.

Unfortunately, many cancer patients feel alone in their struggles.

No one mentioned sexuality to the Chapel Hill resident, except for a brief, awkward conversation with his radiation oncologist regarding the possibility of infertility after treatment.

“People often will equate sexuality and fertility, but those are very different conversations,” Dizon said.

Lowy organizes his pills for the week.

“Their goal is to save a life.” the Chapel Hill resident said. “And they were very good at doing that. I willingly put my life in their hands, but sex was an afterthought.”

Once he got the courage to broach the subject, he was prescribed Viagra, which has been working well.

“I think the biggest advice I would give is, do not be afraid to ask questions,” he said. “If something isn’t right, talk to the doctors about it.”

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‘When people can talk about sex, they flourish’

— The rise of sexual wellness

Advice on sex is available on myriad apps, sex toys are for sale on the high street, and the science of sexual fufilment is blossoming. Will this focus on sexual wellbeing have the desired effect?

By

Tina was 52 when her long-term relationship ended. She had experienced low libido throughout her perimenopause years, and her relationship had become “pretty much sexless by the end”, so reigniting her sex life felt like a daunting prospect.

But rather than closing the book on her sexuality, Tina turned to a sexual wellness app called Dipsea, and began listening to erotic stories, as well as learning about different self-pleasure and communication techniques.

“I’ve never hugely enjoyed visual pornography and this sounded like something different and worth trying out,” she says. “The app enabled me to explore my sexual wants and fantasies as well as use some of the wellness-focused content, which helped me to feel more confident when dating and navigating having sex again.”

She’s not alone. As attitudes to sex have liberalised, and people increasingly strive for greater physical, mental and social wellbeing, a growing industry in sexual wellness has sprung up. Whereas sex toys only used to be available from sex shops or porn magazines, they can now be bought from high street chemists. Subscription-based apps and websites are offering erotic content alongside relaxation exercises and relationship advice from trained sex counsellors. Sex is no longer taboo, but an integral part of our general wellbeing. But while investors in this industry may have hit the financial G-spot, what does it mean for the rest of us?

Precisely who conceived the term “sexual wellness” is hazy, but the actor Gwyneth Paltrow is credited with catapulting it into the mainstream. In 2015, her lifestyle website Goop.com recommended that women steam-clean their vaginas for extra energy and to rebalance female hormones. Since then, Goop has sparked debates about the pros and cons of jade vaginal eggs, an “aphrodisiac warming potion” called Sex Dust – not to mention the infamous “This Smells Like My Vagina” candle.

Gwyneth Paltrow’s Goop has been credited with initiating the sexual wellness trend – but claims made about the benefits of some of the expensive products it sells lack evidence.

“With the launch of things like Goop, there’s been a much broader, holistic sort of view on what sexual wellness means, and how it can benefit you to be a happier, more confident and satisfied human being,” says Mei-lin Rawlinson, chief of staff at OMGYes, an educational website about female pleasure.

Around the same time Paltrow was preaching the benefits of vaginal purification, OMGYes’s founders were setting out on a mission to use science to help crack a similar nut. Sparked by conversations between friends about how women like to be touched, they realised there was a dearth of academic research on the subject, and little vocabulary for the specific things women find pleasurable.

They partnered with sex researchers to conduct in-depth interviews with more than 3,000 women from across the US, using these insights to develop a trove of educational videos, infographics and how-to’s, designed to educate fee-paying members on how to access greater sexual pleasure.

“Sex is such a core part of life for many people, but it is also a really vulnerable, charged area of life, with lots of taboo. We think that if people can talk about it, learn more about it, learn more about themselves, they can flourish so much more,” Rawlinson says.

In the coronavirus lockdowns, sales of adult toys increased by 25%. Superdrug’s website promotes sex toys with the line: ‘Masturbation is self-celebration’.

Launched in 2015, OMGYes was one of the first sexual wellness platforms, and it now has more than a million users. Research conducted by the platform, in collaboration with Devon Hensel, a professor of sociology and paediatrics at Indiana University, suggests that the benefits of membership aren’t just physical.

They gave 870 women access to the website, and asked them to complete pre- and post-questionnaires to assess their sex-based knowledge and communication skills.

The research, published in the Journal of Sex Research, found that after a month, women reported they had developed a wider repertoire of ways to talk about what they liked sexually and that they felt more positive and confident about understanding what felt good. “These are skills not only important for sex, but also in the context of women’s everyday lives,” Hensel says. Indeed, some of the women also reported an increase in overall agency – such as voicing their thoughts or ideas at work – as a result of this training.

It’s not only educational platforms that are growing in popularity. The global sexual wellness devices market – industry speak for sex toys – was estimated to be worth $19bn in 2021.

With everybody stuck at home due to Covid restrictions, this market experienced a boost. During the first two weeks of UK lockdown alone, orders for adult toys reportedly increased by 25%. But while sales of other consumer categories, such as cycling products, that experienced a “Covid boost” have since fallen back, the sexual wellness market continues to experience accelerated growth.

“I think that’s a good data point to suggest that it is earlier in its life stage. There is more to go for in terms of the number of people who buy these products, and the number of products any one person uses,” says Jacqueline Windsor, UK retail leader for PwC.

She recently co-authored a report on the sexual wellness devices market, and believes several factors may be at play. Interest in general wellness has increased over the past decade, and sexual health and wellbeing are increasingly viewed as central to this. Attitudes to sex are also liberalising, and there has been a shift in sex-toy design away from explicit brands, and towards more discreet and ergonomic models primarily targeting women and couples.

“Commercially, it’s big business, but I think it makes a big statement when we see sex toys and pleasure products on high-street shelves like those in Boots and Selfridges,” says Kate Moyle, a psychosexual therapist and host of the Sexual Wellness Sessions podcast. “It makes the statement that sexual wellbeing should be there, and shouldn’t be taboo or hidden away, and this can have a huge forward impact on how we think and talk about sex, helping us to break away from its links to shame.”

Pleasure isn’t the only benefit: doctors are increasingly recommending vibrator use as a way of treating and preventing conditions such as vaginal dryness and atrophy. Some of these new generation products could go a step further and enhance scientific research into sexual health and orgasm.

Ergonomically designed, the Lioness vibrator is a modern iteration of the classic “rabbit” toy. What really sets it apart though, is the incorporation of sensors to measure pelvic floor movements, such as the rhythmic contractions that accompany orgasm. Paired with an app, this allows users – and (with users’ consent) sex researchers – to better understand how sexual function is affected by factors such as caffeine, alcohol, childbirth, menopause, or medical conditions such as concussion.

“I always tell people that knowledge is pleasure,” says Anna Lee, co-founder and head of engineering at Lioness. “It’s an empowering tool to be curious about your body, and to learn about things that might be changing our pleasure or sexual wellness.”

But the plugging of sexual wellness could also have some pitfalls. Lee worries about the potential for misinformation in the marketing of certain products, and their promotion by social media influencers. For instance, in 2018, Goop was forced to pay $145,000 in civil penalties for making the unsubstantiated claim that jade love eggs were used by women in ancient China to increase sexual energy and pleasure.

“Jade is a porous material that you should never insert [into] your body, and there’s no evidence to indicate that this technique was ever used in ancient China,” Lee says. “We have to be so mindful of how we create this information that so many people are desperately seeking – because they will grab on to anything, it is such a hard topic to talk about.”

Also, whereas novelty and exploration can be a turn-on for some people, for others, it can have the opposite effect. “Some people are much more comfortable with what’s familiar,” says Emily Nagoski, a sex educator and the author of Come As You Are.

Another risk is that the focus on sexual wellness mounts pressure on people to do things they don’t want to do. “Everywhere you look, whether it’s on social media, telly, movies, the emphasis seems to be on the importance of sex – everyone’s having great sex, and if you’re not having great sex there’s a problem,” says Ammanda Major, head of clinical practice at Relate and a trained relationship counsellor and sex therapist.

“Sex toys historically, and some of the new apps, are kind of promoting the idea that you should be having amazing sex. You should be having an orgasm. But having worked with clients for 25-30 years, what they are often asking for is they just need [the sex] to be good enough.”

What these clients are really seeking, Major explains, is intimacy: the emotional closeness and trust that ideally accompanies sex. “A lot of these apps and products focus on the physical stuff, as opposed to what sexual intimacy means for individuals. I think we sometimes put a lot of pressure on people to be sexual, when actually sex isn’t that important to them.”

In other cases, couples genuinely want to have more sex, but struggle to find the time and motivation to achieve this. Here, technology could help. In early 2022, Mark (not his real name) and his partner began using an app called Intimacy to track their sex life – logging both the number of encounters and their orgasm count. “We had reservations, but set ourselves a target of having sex 104 times in the year – or twice a week,” Mark says. “Rather than putting pressure on ourselves, and recognising it won’t be for everyone, we revelled in the experience – we are obviously both target-oriented.

“We rapidly found ourselves ahead of our target, and reset it to 2.5 times a week, or 130 times in the year – and we ended on 134. We had a good sex life before, but this gave us the motivation to be more intimate.”

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1 in 4 Americans Are Disabled and They Deserve Intimate Relationships

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

By Kelly Kling

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

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

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

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

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

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

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

It all comes down to communication

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

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

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

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

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

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

It’s time to get creative

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

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

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

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

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

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

Celebrating our differences

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

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

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

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

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

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A beginner’s guide to being a ‘brat’ in BDSM

— If you like disobeying daddy, this one’s for you.

By Gigi Engle

Make me.

This is the trademark saying for brats. A “brat” is a delightfully disobedient sub within the Dom/sub dynamic in BDSM. “Brats enjoy questioning dominance, as well as like for dominance to be proven to them,” says Emerson Karsh(opens in a new tab), a kink educator.

Why would you want to be a brat during sex? Why wouldn’t you? Being cheeky, disobedient, and naughty is fun. It creates a sense of playfulness that is often missing in sex. Being a brat is a very fun way to engage with your submissive side, without being a stereotypical sub. Brats are mouthy, badly behaved, and keen on punishment.

In BDSM, not all submissions look the same. Playing with power dynamics gets very creative in the kink world. “Brats get great enjoyment from playing [a game of] cat and mouse, defying authority, and in turn receiving a ‘punishment’ from their Brat Tamer,” explains Julieta Chiaramonte(opens in a new tab), a kink instructor and sex expert.

If you’re turned on by disobedience, this might be something you want to explore.

Let’s break down what it means to be a brat in BDSM, how you can approach it safely and consensually, and some tips to get you started on your merry way.

What it means to be a ‘brat.’

The brat is a very fun, quite cheeky submissive persona. It’s a submissive with a twist, Chiaramonte says.

A brat intentionally misbehaves in order to get a rise out of their Dom, often eliciting “punishments.” The brat enjoys driving the Dom a bit mad with their naughtiness. It’s all centered around defying authority, which can be very hot.

This all happens with enthusiastic consent. Everyone is on board.

The brat “may taunt, push boundaries, and really test their partners’ limits in hope of causing a reaction,” Chiaramonte explains. “This is very playful, and can be adjusted to your needs.” This all happens with enthusiastic consent. Everyone is on board. We’ll get into the nitty gritty of consent a bit later.

You might be asking how this is submission because, well, you’re being quite the brat. Karsh tells us that “brats express their submission in a way that is amusing, consensual, and done for a reaction.” You’re not being obedient in the classic Dom/sub way, but the brat will submit when their Dom decides to punish them.

The Dom is the ‘brat tamer.’

The brat tamer? You guessed it: This is the Dominant partner. They may choose to go by a different name (like sir, daddy, mommy, etc.), but the brat tamer is their style of Domination.

“Their ‘role’ is to put their brat in their place, remind them of the rules, and enforce punishments/order that they have created together,” Chiaramonte explains. “This is an authority role, and a brat tamer must be comfortable with taking control and being taunted by their bratty partner.”

Dr. Lee Phillips(opens in a new tab), a psychotherapist and certified sex and couples therapist, offers an example of the Brat/Brat Tamer dynamic in a scene: “In a role play, the sub (a brat) takes on the role of a subordinate to a moody boss. The ultimate goal is for the brat tamer to earn the brat’s respect because the brat enjoys pushing the brat tamer’s buttons by provoking them. In order to earn this respect, [the] Dom needs to tame or control the brat.”

This role is anything but soft, Karsh says. “A brat tamer is not afraid to put their foot down,” she says.

This role takes a lot of skill and development. Karsh continues, “A brat tamer is skilled in giving their brat space to be a brat and figuring out how to express and prove their dominance to their brat in response to their bratting — whether that be a punishment, orders, ignoring the behavior, or something else.”

Of course, all of this provoking and giving out punishments is 100 percent consensual in this dynamic.

How brats ‘act out’ (and how they get punished).

There is no clear-cut way to fully express the breadth of punishments and behaviors that can go into the brat dynamic, but we can certainly distill a few common examples.

Bratty dialogue.

Brats use “bratty” language with the explicit intention of provoking their Dom. Some common phrases include:

  • Make me.
  • That’s all?
  • You can do better than that.
  • You can’t make me.
  • Oh, yeah? What’s the worst that can happen?
  • Prove it.

Additionally, Philips says “a brat may act out by talking back to them by calling their tamer names, turning down a command, have a temper tantrum, ignore the tamer to provoke them, and speak when they are supposed to remain quiet.”

Bratty behavior.

Bratty behaviors run the gamut, but they’re usually done in a lighthearted, naughty way, Karsh explains. For example, if a Dom told the brat to “Come over here right now.” The brat might just sit down on the ground and refuse to move. Another example could be defying authority, Chiaramonte tells us. A brat tamer may tell their brat to be home at a certain time and the brat purposely comes back late. To be a brat is to be disobedient. And it’s all part of the fun.

Punishments for bratty little brats.

The ways a Dom can punish their brat are truly expansive. Punishments are negotiated before play takes place and everyone is always on the same page about what is on and off the table.

Some example of punishments:

  • Spankings.
  • Orgasm denial.
  • Forced silence.
  • Getting walked like a puppy.
  • Forced orgasm.
  • Bondage.
  • Tickling.
  • Being put in a cage.

How to engage in brat play in a safe way.

Do your research.

We can’t just jump into a role play without knowing what we’re doing. This can be a disaster. “Read articles and speak to others who are brats and submissives in your BDSM community,” Philips says. “If you are seeing a kink and BDSM-affirming therapist, they can help you explore BDSM as a part of your sexual identity or an aspect of sexual exploration.”

If you’re looking for a qualified therapist to help you explore this side of yourself, search for a kink-affirming therapist on the COSRT website(opens in a new tab). Be sure to check out their website and confirm that they are explicit about their work with kink.

Communication and consent.

If you want to have a good brat/Brat Tamer experience, you have to be on the same page as your partner. “Talk about your expectations, boundaries, limits, and what you hope to get out of this dynamic,” Chiaramonte says. “When you create this structure, you can play within the ‘lines’ and avoid unnecessary hiccups.”

Communication and consent are at the heart of positive BDSM dynamics. Scenes need to be thoroughly discussed so that everyone feels respected and taken care of. This takes a lot of trust.

“Talk to your Dom about your bratty interests first and discuss what the play will look like,” Philips says. “For example, will you be consenting to spanking if you misbehave? How hard do you want to be spanked for acting out? Do you want to be spanked over your tamer’s lap?”

Pick a safe word.

A safe word is a non-sexual word used in kink to denote that a boundary has been met. If you’re in a brat/Brat Tamer scene and something has crossed the line, you can invoke the safe word and stop the play. This gives you time to reconnect and figure out how you’d both like to move forward.

“All kink is a marathon, not a sprint.”

Go slowly.

This one truly cannot be emphasized enough. “All kink is a marathon, not a sprint,” Karsh says.

If you’re a brat beginner, you have to be willing to take your time and figure out what does and does not work for you. “Think and explore how brattiness will show up in your relationship. Being a brat can often come naturally [to some], so use that energy in exploring this in BDSM play.”

Don’t be afraid to get creative.

Your brat/Brat Tamer dynamic may grow and shift over time. Once you start getting comfortable in your role, you can test new and exciting ways to play with your brat side. “Don’t be afraid to get funky with it — your turn to do the dishes tonight? Have your partner find you drinking a glass of wine on the couch instead,” Chiaramonte says. As long as everyone is aware that this is role play, it’s all good.

BDSM is all about exploring different sides of yourself and having fun. If you want to embrace that bratty side of yours, go for it. There is no wrong way to play as long as everyone is having a good time.

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4 ways weed can impact your sex life and relationship

Consuming weed could lead to more satisfying orgasms, some small studies suggest.

By Julia Naftulin

  • Cannabis has the potential to boost a person’s sex life, small studies suggest.
  • Weed may lower anxiety and sexual shame and make for more satisfying orgasms.
  • Still, using weed could also lead to a partner being more critical in their relationships.

Weed is everywhere.

According to the CDC, an estimated 48.2 million people, about 18% of Americans, used weed at least once in 2019, the most recent year the government agency collected data on the matter.

Celebrities like Lady Gaga and Pete Davidson, fitness enthusiasts, and even mothers have recently spoken about how they use cannabis to calm down, find motivation, or relieve pain and nausea. Despite their positive anecdotal reports, some research suggests cannabis could have negative effects like increased anxiety and an increased risk of heart disease.

Cannabis use could potentially impact your sex life and relationship too, whether you’re a regular user or just enjoy indulging in a vape or edible before a date or intimate experience.

Some findings suggest weed can lead to more mind-blowing orgasms and increased feelings of intimacy during sex, while others suggest the substance could kill an erection or make someone more likely to act irritable in their relationships. Still, cannabis isn’t widely studied yet, so research is often inconclusive.

Boosting feelings of intimacy during sex

According to one small study of 41 non-straight men, cannabis could boost feelings of closeness during partnered sex.

For the study, published May 2020 in the journal Culture, Health & Sexuality, researchers interviewed men who were 15 to 30 years old about their experiences using cannabis before or during sexual encounters. Three of the men were transgender, 36 were cisgender, and the remainder didn’t identify with a particular gender.

Through interviews, researchers found that participants often reported that cannabis use lowered feelings of anxiety and shame during sex, particularly anal sex.

“I’m actually enjoying this for like the first time, solidly, like a nine out of ten [after taking the edible]! And then the next time I had sex without an edible, I was enjoying it as an eight out of ten. I’m like, ‘Huh?!’ So it changed something in me,” one the study participants said.

Stronger orgasms and better sex overall

Researchers in Spain found that using cannabis before sex could potentially lead to more satisfying orgasms compared to drinking alcohol before sex.

For the study, published in January 2022, researchers at the University of Almeria enlisted 89 male and 185 female volunteers who either used cannabis, alcohol, or neither in their personal lives.

Both male and female participants who used cannabis regularly were more likely to report better sexual function than those who didn’t use weed at all. When the researchers broke sexual function out into more specific categories of desire for sex, physical sexual arousal, and orgasms, they found cannabis users reported more arousal and better orgasms, but not more desire, than non-users.

A potential erection-killer

Though cannabis could act as a sexual aid, consuming too much could kill someone’s erection, according to Dr. Jordan Tishler, an internal medicine physician and the president of the Association of Cannabis Specialists,

He said that patients regularly ask him about how they can incorporate cannabis into their sex lives. Before treatment with him, they cite issues like difficulty with sex drive and arousal, pain on penetration, anxiety and PTSD, and difficulty achieving orgasm.

If you want to infuse weed into your sex life without losing your erection, it’s best to start with a small dose and see how your body reacts, said Tishler. Consider talking to your doctor about the best course of action before proceeding, he said.

Tishler suggests newbies start with 5 milligrams and choose a strain with between 15% and 20% THC. Any more could heighten your anxiety and ruin the experience, he said.

Less confrontational during fights, which could lead to unresolved conflict

When it comes to weed and relationships, a study published in June 2022 suggests it could make someone more irritable or avoidant during relationship conflicts.

To study this, researchers at Rutgers University interviewed 232 cannabis users and their partners who live together in Massachusetts, where recreational cannabis is legal. They asked them how often they use cannabis and how they felt about their overall commitment and satisfaction in their relationships. They also measured each participant’s resting heart rate and breaths per minute.

They also videotaped the couples while they discussed a relationship conflict for 10 minutes, then watched the videos back. They found that weed users were more likely than non-weed users to avoid disagreements or react to them negatively. When later questioned, cannabis users were also more likely to say they were satisfied with how they resolved the conflict than non-cannabis users.

“This suggests that users may be unaware, or perhaps unbothered by, negative relationship dynamics during and after conflict. This can be harmful to relationships in the long-run to have chronic, unresolved conflicts,” Salvatore told Insider.

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Sex after menopause doesn’t need to hurt

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

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

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

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

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

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

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

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

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

Causes of vaginal pain during sex

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

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

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

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

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

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

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

What can be done?

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

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

Complete Article ↪HERE↩!

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I’m a bi woman with a husband.

— How do I explore my identity?

Can I be married to a man and still fancy women?

By Alice Snape

“It was probably BDSM,” my friend Laura* smirks. We’re at a school reunion, standing outside a bar in my hometown smoking a cigarette. Passing it back and forth in that intimate way we used to. I don’t smoke anymore, but the occasion seems to invite it.

She was my best friend, in that all-consuming way that teenage girls can be. Now we’re looking back at what we used to do with each other — perhaps we were in a relationship, we just didn’t know we could be, no words to define how we felt.

During my twenties, I slipped on the uniform of heterosexuality easily. Hungrily kissing men on sticky dance floors and taking them back to mine for one-night stands. When I’d snog Laura, put my fingers in her knickers and run my hands over her arse, I thought I was performing for the men watching from the dark corners of the dingy nightclub we went to every weekend. I wanted to turn them on.

But there were no prying eyes when we got home. I’d tell her what to do and she’d comply with a submissive giggle. A kinky sort of power play. I now know — when we touched, kissed, explored — that it was sex. My ’90s education meant I thought it was only sex when it was penis-in-vagina sex. I remember being given a book about “where babies come from.” I didn’t understand the nuances of women’s sexuality. I wish I’d known then what I know now.

I love looking at women. I fancy women. I want to acknowledge Laura as one of the first great loves of my life, more than just an old schoolmate. But what can I do now that it’s 20 years later and I’m in a monogamous marriage with a man, outwardly heterosexual to those who look in? I decided to set on a journey — meeting experts and others on sexual re-awakenings along the way — to find out.

Am I bisexual?

I started my quest as so many have before — online. Furiously typing questions like, “can I be bisexual if I’m married to a man?” “What even is bisexuality?” “I’m married to a man but I fancy women too, is this okay?” I briefly wonder how it might have been different for my 16-year-old self as I discover other sexually curious women hiding in corners on Reddit, Twitter, Instagram. There’s communities of women just like me.

Women like 39-year-old Cassie Brooks, too. She’s been happily married to a man for 15 years. When we start chatting, it feels like an outpouring. “I think about women often and have deep friendships and connections with the women in my life,” she confesses. But Cassie grew up in a deeply religious family, although she’s since walked away from her Christian faith.

Her realisation — a sort of epiphany — came when she was in a swimming pool with one of her mates. “She wrapped her arms around me from behind. It elicited warm, fuzzy feelings inside me,” Cassie tells me. “It felt charged, magnetic. I turned in her arms and asked, ‘do you feel this?’ She nodded and giggled and splashed me with water.” Cassie struggled with these feelings because she loves her husband. It felt like she was “cheating,” even though they hadn’t kissed.

This sexual fluidity — identifying as straight, then fancying someone of the same gender — has also shown up in research, too. When I contact sociologist and psychosexual psychotherapist Jordan Dixon(opens in a new tab) to help me unravel how I am feeling she points me towards a study by psychologist Lisa Diamond. ‘Female bisexuality from adolescence to adulthood’(opens in a new tab) was conducted on 79 women over the course of ten years. Two-thirds of the women changed the identity labels they’d claimed at the beginning, with a third changing multiple times. By the end, more women identified as bisexual or chose to have no label at all, rather than say they were straight.

Another study(opens in a new tab) found that women are often influenced by romantic opportunities rather than being rigid in their attractions. “Women’s sexuality may be more flexible and adaptive than men’s,” commented the study’s author Elizabeth Aura McClintock, an assistant professor of sociology at the University of Notre Dame. “Having flexible sexual attractions may grant greater importance to contextual and experiential factors when it comes to sexual identity.” These findings were also reflected in the 2020 census in the UK(opens in a new tab), more women than men said they were bisexual – 1.6 percent of women compared to 0.9 percent of men.

Embracing the bi side of me

“I’m not straight, I just love dick,” when the character Arabella (Michaela Coel) uttered those words in BBC drama I May Destroy You(opens in a new tab), I’d never felt so understood. I roll them over in my mind as I fill in the application to Skirt Club(opens in a new tab) — a private network for straight and bisexual women who are sexually curious. When the form asks about my sexuality, I tick the box that says: mostly straight but more than incidentally homosexual. I don’t even know if that fits how I feel.

Skirt Club was founded by Genevieve LeJeune in 2014, mostly because she was looking for other women like her. “Bisexuality is this grey area,” she tells me over Zoom, “a huge taboo attached to it. When I started using the label bisexual, people kept asking me the same questions: what’s wrong? Why can’t you choose?”

“When I started using the label bisexual, people kept asking me the same questions: what’s wrong? Why can’t you choose?”

I tell LeJeune how I’ve been feeling. I’m compelled to reveal my past with Laura and that I’m with a man but I think about women. That I’ve never really said out loud that I think I’m bisexual. She invites me to one of Skirt Club’s signature parties at a secret location in London. “Women act differently without men,” LeJeune says.

And I can see that as soon as I step into this new world, wearing a silk dress and knee high boots. One of the hostesses attaches a key to my wrist. It shows that I’m new (usually around 70 percent of those attending are there for the first time) and unlocks the start of a journey.

I sip on a glass of bubbles and settle in a corner to observe. A woman in a tight red dress gives me the eye. She also has a key dangling down her hand. Her fingertips graze my thigh. She’ll never date a man again, she tells me with vitriol. She’s clearly experienced too much hurt.

After an orientation speech stating the importance of consent, the bar area clears quickly and I wonder where everyone’s gone. I head upstairs to the bedrooms. There’s a smell of sex — sweet and sensuous — and a mass of writhing naked women that looks like some kind of Pre-Raphaelite painting come to life, reimagined in 2023 for a female gaze.

Most of the women hadn’t met until that moment. I think about all those myths that are rammed into us, that women need an emotional connection to climax. Maybe what they actually needed was to be in a room full of other women. I didn’t join in. I didn’t have to, to enjoy it. Just being there was enough. I felt seen, understood.

A coming out, of sorts

I realised how much I’ve internalised myths and stereotypes, inhaled them as facts that I need to let go. That key from Skirt Club has unlocked something. My friend tells me about a book that blew her mind and urges me to read it. Untrue by writer and social researcher Wednesday Martin unravels why nearly everything we believe about women and lust is false. In a chapter called “Women Who Love Sex Too Much,” Martin introduces us to Dr. Meredith Chivers who did a study on women’s and men’s reactions to porn. Predictably, self-identifying straight men had the strongest reaction to guy-on-girl action. In contrast, women — even those who said they were straight — had physical responses to everything: a woman having sex with a woman, man-on-man action, and even bonobos getting down to it.

Mostly, what I’ve discovered is that sexual identity is complex. “Some women may be attracted to other women, but they may not wish to act upon it,” says Dixon, who implores anyone reading this to ask themselves: What would labelling mean to you? What do you want? Why? What would it mean for your partner to bear witness to that? “For those in hetero relationships, whether we decide to tell our partners or not, it can help to know that this doesn’t mean our decision is always fixed,” she assures.

Having experience doesn’t define sexuality.

According to research by Pew Research Center(opens in a new tab) in the U.S., only 19 percent of bisexuals are “out.” And although I’m writing this, I don’t think I feel the need to explicitly “come out” to anyone. According to therapist Chris Sheridan(opens in a new tab), the act of coming out can actually be disempowering to some. “It implies there’s a secret or it’s owed to heteronormative society,” Sheridan explains. Instead, do it on your terms. “Some people choose not to come out, others opt for coming out to some people and not others. It’s up to you.”

For Cassie, this looks like telling her husband how she feels. “To my relief, he said ‘I know.’ He asked me if I still loved him and I said yes.” Their marriage is monogamous but Cassie knowing this about herself is enough for now — having experience doesn’t define sexuality. “I 100 percent consider myself bisexual,” she says. “It took me a little while to associate that as part of my identity because I didn’t have experience. But the definition is attraction to both genders — I definitely fit that.”

As for me, I’m holding on to the advice from the therapists I spoke to: “Give yourself permission to fully fantasise about different genders during solo sex,” Sherdian told me. And “personal intimacy with ourselves means creating a private zone,” says Dixon, “it’s a space – physical, emotional, intellectual – that belongs only to us and we can play with whoever we like in our minds. Everyone can cultivate a secret erotic fantasy garden to play in.”

And what I witnessed at Skirt Club, just conjuring it in my mind makes me wet. So does lesbian porn. So does having sex with my husband. So, too, does a plethora of other things. Holding this knowledge about my shapeshifting sexuality feels powerful. I can’t be all parts of myself to everyone at all times. And those fragments of myself are also constantly in flux. This is a moment in time and right now I’m bisexual — regardless of my relationship status. I can’t wait to see what comes next… but I doubt I will ever say I’m straight again.

*name has been changed

Complete Article ↪HERE↩!

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This four-minute foreplay game could help spark excitement in the bedroom

This game is ideal for reigniting some passion

By

By now, we all know that foreplay is the most important aspect of intercourse, particularly for women, who typically need 20 to 30 minutes of warm-up time before they’re able to orgasm. 

But it can be easy to get into a bit of a sex rut – especially if you’re in a long term relationship – and foreplay can become monotonous. 

If you feel like you and your partner(s) are just going through the motions, why not try something new?

This four-minute foreplay sex game can reginite some excitement in the early stages of intercourse. 

All you have to do is spend four minutes each doing whatever foreplay you want to your partner, within their bounds of consent, of course. 

Sex coach Vernita Griffith shared the tip on TikTok, explaining: ‘Set the timer on your phone for four minutes.

‘Then I want you to take turns, for four minutes each, to do whatever you want to your partner – you have to agree to do whatever you want to each other.’

She goes on to say that, hopefully, what you choose to do to your partner will also be pleasurable for them, but the excitement comes from the unknown. 

@triteamunlimited #asktiktok #games #partnerfun ♬ I Can Feel It v3 – Nick Sena and Danny Echevarria

Melissa Stone, sex and relationships expert at Joy Love Dolls, approves of this game.

‘Four minutes of foreplay can be beneficial because it gives both partners time to become aroused and can help to reduce the risk of premature ejaculation,’ she says.

‘Additionally, it can help to build anticipation and excitement and can help partners to connect emotionally and physically.’

This game, which focuses on building the heat, can be followed up with some good old-fashioned foreplay if four minutes isn’t enough to get your wheels turning.

Or, if you’re really into it, you could even set the timer for a little longer.

If you do try this game, be sure to try it with someone you trust, and make sure to let them know your sexual boundaries beforehand.

Then, get ready for your four minutes in heaven.

Complete Article ↪HERE↩!

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Unequal Chore Division Is Killing Women’s Sex Drives, Research Shows

By Kelly Gonsalves

You’re probably familiar with this story: Man and woman meet, fall in love, have fabulous sex. They move in, maybe get married, maybe have kids. Her interest in sex starts to drop; his doesn’t. Tension ensues, spoken or unspoken. He’s always initiating; she’s always turning him down.

While that narrative actually isn’t as universal as many people make it out to be (more on that in a minute), some research has shown that women are indeed more likely than men to experience a decrease in sexual desire over time in long-term relationships.

There are many theories as to why that might be, but one recent study published in the 1 has revealed one significant piece of the puzzle: women are getting turned off by male partners who refuse to do their share at home.

How an unequal division of household labor impacts women’s sexual desire

In the study, psychology researchers Emily A. Harris, Ph.D., Aki Gormezano, Ph.D., and Sari van Anders, Ph.D., surveyed over 1,000 women currently in relationships with men, all of whom were living together and had kids. They asked questions about the women’s levels of sexual desire, the division of housework with their male partners, and how they felt about that division.

The results? Women who performed a larger proportion of the household labor had significantly lower desire for their partner, compared to women in relationships where the men were more involved at home. In other words, women were much more sexually excited by men who cooked, cleaned, and took charge with the kids.

But the most telling part of the findings was the why: It wasn’t just that women’s libidos tanked in response to doing a bunch of chores, and it wasn’t just because women were busy and exhausted from it all. Rather, the researchers found two specific mediating factors that explained exactly why the unequal division of housework had such an impact on women’s desire.

Blurring the roles of partner and mother

Firstly, the study found that women shouldering more of the housework were also likely to perceive that dynamic as unfair—and that feeling of unfairness in the relationship was part of what was leading to lower desire for their partner.

This is important, the researchers note in the paper, because it refutes the argument that women take on more domestic tasks because they want to or because they simply enjoy caregiving. While that might be true for some, this study found women in imbalanced partnerships were actually often resentful of the situation. And it’s pretty hard to be turned on by someone you kinda resent.

Secondly, the researchers found that women dealing with an imbalance at home were more likely to feel like their partner was dependent on them. That feeling—that is, feeling like your man relies on you to take care of him and perform basic life tasks for him—was the other factor associated with lower sexual desire.

As Harris and the team point out in the paper, doing someone’s laundry, cooking for them, cleaning up after them, and planning their social calendar are tasks people typically perform for children. So, when a woman has to perform these tasks for her husband with no real reciprocity or recognition, the relationship “more closely mirrors that of a mother and a child.”

Unsurprisingly, that’s not very sexy.

“The inequitable proportion of household labor may contribute to a burdensome blurring of mother and partner roles, whereby partners are perceived as recipients of caregiving, akin to dependent children,” they write. “As a result, women may experience lower desire for partners who are perceived in dependent-like ways.”

There’s a common joke married women make where, when asked how many kids they have, they include their husband in the count. That dynamic is often laughed at and accepted as the norm between men and women, but as this study shows, it comes with direct consequences for a couple’s sex life. It’s very hard to be sexually attracted to someone who you feel like you need to mother.

Challenging a popular myth about women’s libidos

That common anecdote we mentioned up top—about the wife who is constantly rebuffing her husband’s sexual advances—is tied up with the idea that women are always or inherently less interested in sex than men are. It’s a popular narrative, though of course, reality is much more nuanced.

For one thing, you’ll find varying levels of sexual desire across all genders: Some women want lots of sex, some men can take it or leave it, and most people have libidos that regularly fluctuate depending on all the other things happening in their life. While different studies2 estimate anywhere from 10 to 55% of women deal with “low libido” compared to between 1 to 28% of men, some research3 on mixed-gender couples finds men are equally likely to be the lower-desire partner as women are.

The current study also offers another challenge to the idea that women just naturally lack interest in sex by demonstrating that women’s lower libido actually seems to be directly tied to the role they’re often relegated to in long-term, heteronormative relationships.

“Our findings challenge the assumption that low sexual desire in women is necessarily located in women, in their bodies or minds,” Harris and the research team write. “Instead, we find support for a socio-structural explanation for at least some considerable portion of low desire in women, whereby the system of heteronormativity brings about gender inequities in household labor that are associated with lower desire.”

Meaning: Maybe women would be more interested in sex if they weren’t so often forced into such inequitable, libido-killing roles and relationships.

The takeaway

So, what does this all mean for the average couple trying to navigate their home and sex life?

Particularly in relationships between men and women, prioritizing creating a fair division of housework is well worth the effort for many reasons. Studies like this one suggest that, in addition to creating a more functional, balanced partnership, addressing the inequities at home may also boost a woman’s sexual desire.

More broadly, this research reminds us how important it is to be thoughtful about the various factors that might be contributing to you or a partner’s interest in sex. For example: Resentment gets in the way of connection of any sort, physical or otherwise. And a partner who pitches in, pulls his weight, and treats you like a teammate and an equal? That’s sexy as hell. 

Complete Article ↪HERE↩!

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Why Are STI Cases Soaring?

— We Asked the Experts

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

By Korin Miller

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

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

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

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

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

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

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

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

Why are STIs increasing across the country?

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

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

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

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

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

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

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

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

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

Why are syphilis cases jumping up so quickly?

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

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

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

How to lower your risk of getting an STI

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

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

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

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

Complete Article ↪HERE↩!

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Abused gay men don’t see they are victims – study

— Gay and bisexual men being abused by romantic partners is the subject of a research brief being presented to the Scottish government

Gay and bisexual men being abused by romantic partners is the subject of a research brief being presented to the Scottish government

By Mary McCool

Gay and bisexual men are being abused by romantic partners but face multiple barriers to support, according to recent studies.

Research from Glasgow Caledonian University found that one in four men experienced violence in same-sex relationships.

It heard from victims who shared sometimes harrowing accounts of abuse including physical violence, rape and psychological abuse from both casual and longer-term partners.

Academics have called for more awareness around the subject and improvements to support services to help prevent “generations” of men facing the same problems.

Warning: This story contains details some readers may find upsetting

Dr Edgar Rodriguez-Dorans is a counsellor and lectures in counselling and psychotherapy at the University of Edinburgh.

Originally from Mexico, he has lived in Scotland since 2013 and has dealt with a number of gay and bisexual clients who have suffered a wide range of traumatic experiences in relationships.

Dr Edgar Rodrigez-Dorans of the University of Edinburgh
A common factor among those who have experienced sexual abuse, he said, is the issue of consent being understood by either victim or abuser.

One client told Dr Rodriguez-Dorans he repeatedly allowed his boyfriend to have sex with him when he did not want to because he felt “he needed to be available” to him.

Another man, he said, told of an experience at a “chemsex” party – where people use drugs such as methamphetamine, mephedrone (“meow meow”) or GHB (gammahydroxybutrate) to enhance sex.

“The drugs were too strong so he was unable to be fully conscious,” said Dr Rodriguez-Dorans. “He didn’t want to continue in the party.”

After refusing sex from the men present, the man was raped.

Dr Rodriguez-Dorans said because his client was an immigrant, he did not think police would believe him if he reported the incident.

“It’s something he has realised is part of his domestic life,” he said. “Partners have taken it as some sort of kink – like they say no, it’s a bit forceful, it’s fun.”

Part of the problem, according to the counsellor, is that the lives of gay men have been “hyper-sexualised” and they often relate to each other through sexual activity.

He said: “Feeling empowered by sexuality, that is fine, but it can create a dynamic where they are not sure whether they’re having sex when they want to.”

‘He was terrified to leave his home’

Another man told Dr Rodriguez-Dorans he reported his violent ex-boyfriend to police, but was told there was “not enough evidence to suggest he was in danger”.

The abuser initially refused to move out of the man’s flat and sent him threatening messages – which the man showed to officers.

He also repeatedly stood outside the victim’s flat, which Dr Rodriguez-Dorans described as “overt intimidation”.

“We were working on agoraphobia,” he said. “He would not be able to go out at night – he would be terrified and go back to the safety of his home. He was also dealing with panic attacks on a regular basis.

“We are still working on this and it’s been years since the client left the relationship – that’s very important, the relationship might have ended years ago but the effects continue.”

In terms of access to support services, Dr Rodriguez-Dorans said the barriers were complex.

Many are targeted towards women, which he said gives the narrative that women are “more prone to be victims” of abuse.

Meanwhile charities and mental health services for LGBT people are also overstretched.

But perhaps most pervasively, many of Dr Rodriguez-Dorans’ cases are affected by misconceptions on masculinity.

“Men don’t see themselves as objects of abuse,” he said. “People who have been victims of sexual abuse can take up to 20 years to actually seek help.”

On those perpetrating the abuse, he added: “Many might be dealing with internalised homophobia, shame, isolation from their families and emotional illiteracy – which is quite widespread among men regardless of their sexuality.

“Exercising power against their partner might put them in position where they feel like their masculinity is asserted.”

Prof Jamie Frankis and Dr Steven Maxwell
Prof Jamie Frankis (left) and Dr Steven Maxwell (right) will present their findings on abuse in LGBT relationships to the Scottish government

Similar experiences of abuse among gay and bisexual men have been demonstrated in two pieces of research by Glasgow Caledonian University, which will be presented to the Scottish government’s LGBTI+ cross-party group later this month.

The first, published in 2020, was a UK-wide survey which found one in four gay or bisexual men experienced intimate partner violence (IPV).

The second study, published last year, interviewed 10 men aged between 26 to 47 in Scotland on their experiences of domestic abuse.

It highlighted that the “absence of a rape narrative” for men in same-sex relationships made it difficult for some to recognise when they had been sexually assaulted.

It also said men with big muscular bodies worried that “appearing ‘acceptably’ masculine” might make others doubt that they were victims of IPV.

‘Change at a national level’

Lead academics Prof Jamie Frankis and Dr Steven Maxwell have called the problem an “urgent public health issue”.

Dr Maxwell said: “IPV experienced by GBM and wider LGBTQ+ folk is an issue that many are unaware of. Our research found that IPV has a detrimental impact on an individual’s health, both in the short and long term, and can cause mental ill health including anxiety, PTSD, depression and suicidality.

“We hope that this research will help bridge the knowledge gap, increase public awareness and lead to policy change at a national level.”

Dr Rodriguez-Dorans added that more training was needed to help police officers recognise signs of domestic abuse in same-sex relationships.

“If we don’t address these issues, it won’t change,” he said. “We’ll end up with generation after generation going down the same path.”

Det Ch Supt Sam Faulds of Police Scotland said tackling domestic abuse remains a “significant priority”.

She said the force responds to all reports, adding: “Whilst we recognise the disproportionate impact on women and girls, the definition of domestic abuse is not gender specific.

“It is a despicable and debilitating crime which affects all our communities and has no respect for ability, age, ethnicity, gender, race, religion or sexual orientation.”

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‘It just didn’t enter my mind to initiate sex;’

— Low sex drive in men linked to chemical imbalance

By Sandee LaMotte

While hanging out with his college roommates, Peter (not his real name) realized he felt differently about sex than other heterosexual men.

“I’ve never been somebody who was interested in pornography, but I’d laugh along with their jokes,” said Peter, now 44, who is British. “Of course I never mentioned that … as a man, you’d be kicked out of the herd.”

As he developed “proper, serious relationships” with women, Peter discovered he didn’t have the sexual drive many of his partners did.

“I would make excuses around getting tired or feeling stressed, that kind of thing,” he said. “It wasn’t an issue with attraction to my partner. It just didn’t enter my mind to initiate sex.”

In 2021, Peter saw an ad recruiting male volunteers for a new study on hypoactive sexual desire disorder, or HSDD. Researchers planned to inject the study’s participants with kisspeptin —a naturally occurring sexual hormone — to see if it increased their sex drive. Kisspeptin plays a key role in reproduction; without adequate levels of the hormone children do not go through puberty, for example.

In a long-term, committed relationship with a woman he says has a higher sexual appetite, Peter signed up, intrigued by the thought that a biological imbalance might help explain his behavior.

In the week after the final session, Peter said, something amazing occurred.

“All of a sudden, I wanted to initiate intimacy. I can only presume it was driven not by my mind remembering something, but my body wanting something,” he said. “I did initiate sex more and it improved things with my partner incredibly.”

Experts believe HSDD affects at least 10% of women and up to 8% of men, although those numbers may be low, said Stanley Althof, a professor emeritus of psychology at Case Western Reserve University School of Medicine in Cleveland, Ohio and executive director of the Center for Marital and Sexual Health of South Florida.

“Men are embarrassed to go to the doctor to begin with, and you’re supposed to be a macho guy,” said Althof, who was not involved in the kisspeptin study.

“So it’s difficult for men to say, ‘Hey, I’ve got a problem with my sex drive.’ That’s why the majority of male patients I see with HSDD are sent in by their partners.”

To be diagnosed with the disorder, a person must have no other issues that might cause a change in libido, such as erectile dysfunction or premature ejaculation.

“Losing interest due to performance issues is common, but HSDD is its own thing,” Althof said. “It’s an absence of erotic thoughts and a lack of desire for sex that has to be present for six months. It also cannot be better explained by another disorder or other stressors: It can’t be due to depression. It can’t be due to a bad relationship. It can’t be due to taking an antidepressant.”

One more key point: A man or woman must have clinically significant distress to have HSDD, said clinical psychologist Dr. Sheryl Kingsberg, a professor in reproductive biology and psychiatry at Case Western Reserve University, who was also not involved in the kisspeptin study.

“Some people aren’t bothered by their lack of interest in sex, so we wouldn’t treat them for HSDD,” said Kingsberg, who is also chief of behavioral medicine at MacDonald Women’s Hospital and University Hospitals Cleveland Medical Center.

“The women coming into my office are deeply distressed,” she said. “They tell me ‘I used to have desire but it’s gone. I could be on a desert island with no pressures, but I just don’t have the appetite. I want it back.’ Those women have HSDD.”

Dr. Waljit Dhillo, a professor in endocrinology and metabolism at Imperial College London, has been studying the relationship between low sexual desire and the hormone kisspeptin for years, first in animals, then in people.

Prior studies by Dhillo of healthy men with no libido problems found giving them kisspeptin boosted levels of testosterone and luteinizing hormone, which is important for gonad function.

His newest study, published in the journal JAMA Network Open in February, enrolled 32 men with verified HSDD. Peter was one of them.

“So many people say to themselves, ‘It’s just me. I’ve got a problem.’ But actually, HSDD may be how your brain is wired,” said Dhillo, who is a dean at the United Kingdom’s National Institute for Health and Care Research Academy in Newcastle upon Tyne.

“The biology is telling us there’s increased activation of inhibitory areas in the brain — the same areas that tell us it’s not OK to walk around in public naked — and those areas are switching off sexual desire. How can we tackle that? We give a hormone that would naturally give you increased sexual desire, essentially hijacking the normal system.”

The men participating in the new study visited Dhillo’s lab twice. On each occasion, they were fitted with a device to objectively measure arousal, given an injection and asked to watch pornography while their brains were scanned via functional magnetic resonance imaging (fMRI).

Neither the subjects or the researchers knew if that day’s injection was kisspeptin or a placebo.

“It was extraordinarily surreal, lying there with something resembling a hangman’s noose around your bits and watching a mixture of ’70s to modern-day pornographic images and videos,” Peter said. “You’d get about five or six seconds of one type of image or video, rate your arousal for the researchers, and then move on to the next.”

Brain scans showed a significant dual effect after the kisspeptin injection, Dhillo said. Activity in the areas of the brain that inhibit behavior slowed, while areas of the brain connected to sexual interest lit up.

“As a group, the men had a 56% higher sexual response to sexual images after the kisspeptin than the placebo,” Dhillo said. “And we found no side effects at the very, very small dose that we are using.”

Peter noticed a difference immediately after finishing the treatments. His sex life was so robust, in fact, that it wasn’t long before his partner was pregnant with their first child.

As published, the study did not follow the men long-term to see if the effects of kisspeptin lasted. For Peter, however, its impact has been life-changing.

“I have found there’s been a lasting effect for me,” he said. “I do find I have a much better sexual appetite even now some years after the treatment.”

Even the arrival of a baby boy didn’t deter his new interest in sex.

“The cliche is when you have kids, your sex life takes a bit of a hit,” he told CNN. “But that hasn’t been the case for us. In fact, we’re pregnant with our second child, due in July.”

While Peter had a positive long-term result, it’s too soon to say kisspeptin injections were the reason, Althof said.

“When you hear dramatic results like Peter’s, I would be cautious in saying that is the typical outcome. While it’s wonderful that it happened for him, these fMRI studies are difficult to interpret and not conclusive,” he said.

“Sexual desire is very complicated — I say it’s a combination of brain function, hormones and love, wine and roses,” Althof added. “This study is promising, but it needs replication in larger groups.”

And even if future research does confirm kisspeptin’s benefits, medical treatment is not a substitution for healthy communication about sex between partners and with health care providers, Dhillo said.

“These are society’s taboos, but actually, the more we talk about real (sexual) issues that affect real people, the more we find it’s actually quite common,” he said.”If you’re not troubled by low libido, it’s not an issue at all, but if you are troubled by it, this can lead to marital breakdown, unhappiness and reduced quality of life.”

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