Cannabis Can Help Women Reach Orgasm

— But It’s ‘More Than Pleasure’

By Sarah Sinclair

Over half of women have faked an orgasm. Surprised? Probably not.

But while some women fake it from time-to-time, for others the lack of ability to reach orgasm is a far more debilitating issue.

Female orgasm disorder/difficulty (FOD), sometimes referred to as orgasm dysfunction, occurs when an individual has difficulty reaching orgasm, even when they are sexually aroused.

It affects millions of women worldwide and yet remains drastically under-studied.

“FOD is an under-recognized and under-treated serious public health issue,” says Dr Suzanne Mulvehill, founder of the Female Orgasm Research Institute, in written correspondence.

“The purpose of the Female Orgasm Research Institute is to identify proven pathways to female orgasm, conduct female orgasm research, bring awareness to the persistently high percentage of women affected by female orgasm difficulty, and provide an online female orgasm research library.”

According to Mulvehill’s research, the condition affects up to 41% of the female population, a statistic that has remained unchanged for 50 years.

She puts this down to a number of reasons that include “shame, stigma, lack of research, and lack of treatments”.

A quick search of clinicaltrials.gov and you’ll see that there are currently no clinical trials recruiting or in the early stages of development on FOD and only 13 completed studies.

This is compared to 363 completed studies on erectile dysfunction and 88 in the early stages.

Dr Mulvehill says: “When I was conducting my dissertation research, I was shocked to discover that there is only one empirically validated treatment for FOD and that is only for women who never orgasmed, or rather, have not yet orgasmed, and this is called directed masturbation and was developed in the 1970s.

“There are no empirically validated treatments for the largest group of women affected by FOD which is women who have what is referred to as Situational FOD, meaning women who can orgasm in some situations but not others, such as orgasm from masturbation but not during partnered sex.”

There is one potential treatment which is showing significant promise though.

While previous research has suggested cannabis could have therapeutic potential in a number of female sexual disorders and could enhance pleasure for both men and women, the latest study to be published by the Female Orgasm Research Institute is the first to specifically evaluate the effects of cannabis in treating FOD.

What The Study Found

The observational study conducted among almost 400 women between March-November 2022, evaluated baseline demographics, sexual behavior, mental health, cannabis use, and the orgasm subscale questions of the Female Sexual Function Index (FSFI), evaluating orgasm frequency, orgasm satisfaction, and orgasm ease, with and without cannabis before sex.

The majority of women in the study who reported difficulty reaching orgasm were between the ages of 25–34 (52%), reported their race as white (75%) and were married or in a relationship (82%).

Among those respondents reporting orgasm difficulty, cannabis use before partnered sex was found to increase orgasm frequency (72.8%) improve orgasm satisfaction (67%) or make reaching orgasm easier (71%).

According to the findings, the frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women with FOD, while orgasm response to cannabis depended on the reasons for use.

These findings echo 50 years of research, Dr Mulvehill says.

“I honestly do not know of any other condition that has more of a research history than cannabis and sex, and in particular female orgasm,” she continues.

“What we do know is that 50 years of research shows cannabis helps women orgasm and helps women who have FOD. In the 1970s Dr Eric Goode speculated that it helped women release sexual inhibition.

“Aldrich found that cannabis has been used since ancient times to enhance sexual pleasure, and extensively documented the tantric use of cannabis in India from the seventh century onward to aid sexual pleasure and enlightenment.

“In 2020, Kasman et al. found that for each step up in cannabis use, female sexual dysfunction declined by 21%.”

FOD: The Bigger Picture

It starts to make sense when you look at the bigger picture around FOD.

Dr Mulvehill’s study also examined the mental health difficulties experienced by women with FOD. Those with the condition reported 24% more mental health issues, 52.6% more PTSD, 29% more depressive disorders, 13% more anxiety disorders, and 22% more prescription drug use than women without FOD. Women with FOD were also more likely to report sexual abuse history than women without.

“Rabinak et al found that hypervigilance, anxiety, and PTSD are responses of the amygdala while studies from 2007 and 2015 found that trauma responses commonly impair sexual response,” she explains.

“We also know that orgasm difficulties are the number one sexual complaint of sexual abuse survivors. When we start to put the research puzzle together, we see cannabis medicine helping women overcome FOD.”

Dr Mulvehill and her research partner, Dr Jordan Tishler, have been trying for three years to secure the funding to conduct a randomized controlled trial to examine cannabis as a treatment for FOD in more depth.

Among as yet unanswered questions such as why it works first-time for some and not others, this is an issue about “more than just pleasure” and could have a much wider impact on health.

FOD has a well-documented link to anxiety, childhood sexual abuse, PTSD, and cognitive distractions.

Studies have shown that THC, one of the main cannabinoids found in cannabis, can significantly reduce rates of anxiety and traumatic memories related to trauma and PTSD by reducing activity in the amygdala and reduces cognitive distractions by inhibiting activity in the prefrontal cortex.“

“As it turns out, orgasm is way more than being about pleasure. It is about a human right, a sexual right, and mental and physical health,” says Dr Mulvehill.

FOD has been linked to heart disease and cardiovascular issues, while a 2009 study found that of the sexually active women with type 1 diabetes, 51% of women reporting female sexual dysfunction had problems with orgasm.”

“If we start to actually ask women if they orgasm or not when screening for medical conditions, we may find out that lack of orgasm is linked to other health conditions. We know that during orgasm massive amounts of oxytocin are released.

“And what condition is related to a lack of oxytocin? Alzheimer’s disease. We also know that women in their 60’s are twice as likely to develop Alzheimer’s. We will not know until we start asking the questions.”

FOD And Public Policy Changes

Dr Mulvehill began researching this area following her own experience of overcoming FOD with the help of cannabis. And she’s not alone.

The study comes as four U.S. states are now considering adding FOD to the list of qualifying conditions for a medical cannabis prescription.

This month, the Illinois Medical Cannabis Board approved adding FOD and endometriosis as conditions of treatment with medical cannabis and is now awaiting final approval from the state’s director of public health.

Dr Mulvehill’s personal testimony has been submitted as part of the Illinois public comments process, alongside that of other women.

Meanwhile, Ohio’s State Medical Board also recently announced that FOD, along with autism spectrum disorder, would move forward for expert review and public comment following petitions submitted online.

New Mexico and Connecticut are also reported to be considering the issue.

Dr Tishler, founder of the Association of Cannabinoid Specialists and president of inhaleMD, already prescribes cannabis for FOD and other sexual disorders, and has also submitted a letter of support to regulators in New Mexico.

He highlights the importance of women having access to legally prescribed cannabis and clinical guidance when using it to manage these conditions.

“Cannabis is a medicine and as such must be treated as a medication,” he comments over email.

“It has risks as well as benefits and best practices that lead to better outcomes. This is certainly true for the treatment of FOD. Using cannabis in a recreational manner is more likely to lead to no benefit and higher risk of misuse. Further, as cannabis overuse can worsen anxiety and depression, it can worsen FOD. Women who have FOD, like any other illness, deserve proper treatment from a knowledgeable and caring cannabinoid specialist.”

Despite the lack of robust scientific evidence through RCTs, Dr Mulvehill highlights how this hasn’t prevented other conditions being approved for medical cannabis treatment. PTSD was approved in New Mexico in 2009, with no published studies and only case reports.

“The 50 years of research, combined with doctors prescribing medical cannabis for FOD, therapists recommending it, and women using cannabis before sex, tells me there is enough evidence for FOD to become a condition of treatment with medical cannabis,” she says.

“Just google cannabis and orgasm and you will see all of the articles on it. It is not new news. What is new is getting a public policy change to add FOD as a condition of treatment with medical cannabis. Just like PTSD has dealt with stigma through awareness and education, the same can be said for FOD.”

Dr Mulvehill adds: “FOD is a medical condition that deserves proper medical treatment. It is not something that women should have to ‘figure out on their own’.”

Complete Article HERE!

Maintaining an Active Sex Life With Prostate Cancer

— A fulfilling sex life is still possible during and after treatment for prostate cancer.

By Larry Buhl

Every type of prostate cancer treatment has the potential to negatively affect sexual function and may impact fertility. But there is good news: A variety of therapies make it possible to have an active and fulfilling sex life during and after prostate cancer treatment, even if it means slightly reimagining what it means to have good sex. If your sex life has been altered by prostate cancer treatments, some unwanted side effects like erectile dysfunction have been known to improve over time, according to Johns Hopkins Medicine.

How Does Prostate Cancer Affect Sexual Function?

Strictly speaking, prostate cancer itself doesn’t affect sex, and you likely won’t have sexual side effects from prostate cancer, at least in the early stages, according to the American Cancer Society. But you could have some frustrating side effects from the treatments for prostate cancer.

The prostate is surrounded by nerves, muscles, and blood vessels that help produce an erection, but the prostate isn’t required for an erection or orgasm. However, the prostate and seminal vesicles are required for ejaculation and fertility. Some cancer treatments may affect the ability to get an erection and ejaculate.

Sexual Side Effects of Prostate Cancer Treatments

Prostate Surgery

It’s important to understand that orgasm and ejaculation are different physical reactions, although they often happen at the same time. Because the prostate and seminal vesicles are removed in a prostatectomy, no ejaculation can happen, but an erection and orgasm can happen. Sometimes the climax is called a dry orgasm because there is no semen.

Typically, a surgeon will attempt a sparing prostatectomy to save the neurovascular bundles on the side of the prostate that are necessary for erections and orgasms. But sometimes these nerves are damaged in surgery, which could diminish the ability to get erections or keep them.

If there is nerve damage, erectile dysfunction can improve over time even without intervention, according to Raevti Bole, MD, a urologist and specialist in men’s health at the Cleveland Clinic. “In general, patients notice the biggest impact on their erections right after surgery, then start to see improvements for up to two years after surgery,” says Dr. Bole.

There’s also the potential for another frustrating side effect of surgery: climacturia, or orgasmic incontinence. This is when a bit of urine leaks out during arousal. It is treatable through bladder training and exercising the pelvic floor muscles, or Kegel exercises.

Radiation

Although the goal of radiation therapy is to deliver the treatment to only the areas affected by cancer, sometimes it affects nearby nerves as well. When this happens, the nerves may not send a signal to have an erection. Unlike a prostatectomy, for which the biggest impact is right after surgery, the effects from radiation, if they happen, may occur over the course of years.

“Patients who have radiation can still orgasm and ejaculate, but often their ejaculate is diminished because, over time, the seminal vesicles in the prostate don’t produce semen like they used to,” says Scott Shelfo, MD, the medical director of urology at City of Hope in Atlanta.

Chemotherapy

Chemotherapy is unlikely to cause erectile dysfunction, though it does have other side effects, such as fatigue and hair loss. Chemotherapy can, however, lower testosterone levels during the treatment period, per the National Cancer Institute, which leads to decreased libido. Chemo is always given in conjunction with hormonal therapy.

Hormone Therapy

Hormone therapy is used to stop the progression of cancer by significantly reducing testosterone, which can affect libido. With lower testosterone, the desire to have sex decreases. Low testosterone, or low T, can also affect the quality of erections, even though it isn’t physically affecting the sensory nerves. Testosterone is important for maintaining rigidity as well.

But patients with prostate cancer aren’t likely to be on hormone therapy for life. The length of time depends on the aggressiveness of the cancer. If you’ve been on hormone therapy for a while and the cancer is under control, you might have a discussion with your oncologist about taking a “hormone holiday,” according to Bole. “But there will still be intensive monitoring to make sure you’re doing it safely,” Bole says.

Common Questions About Sexual Side Effects of Prostate Cancer

Can You Function Sexually Without a Prostate?

There is life after prostate cancer, and you absolutely can have sex after a prostatectomy, although the quality of the sex depends on how well the nerves that stimulate erections and lead to orgasms survive the surgery.

Regardless of any possible damage to the nerves around the prostate, the sensory nerves, which are different from the ones that control erections, remain untouched by surgery. This means that the process that leads to arousal, but not necessarily erections, shouldn’t change.

Can You Get an Erection if You Have Prostate Cancer or Had Your Prostate Removed?

Yes. The nerves that control erections run along the back of the prostate. As long as the cancer has not invaded those nerves, your surgeon will make every effort to peel the prostate gland from those nerves without doing damage to them.

“If the surgeon does a good prostatectomy, and the patient had good erectile function before it, they have a better chance [of avoiding erectile dysfunction],” says Dr. Shelfo. Of course, if you had erectile dysfunction before prostate removal, chances are that you’re still going to have it after the procedure.

Can You Ejaculate After Prostate Removal?

No. Once the prostate is removed along with seminal vesicles, you can’t ejaculate.

Does Sex Feel Different After Prostate Removal?

Sex after prostate removal might feel different for some people. People with intact prostates often ejaculate and orgasm at the same time, although they are actually different processes. With prostate removal, erections and orgasms should be unchanged, unless the nerves around the prostate are damaged.

But Bole, who surveys patients after surgery, found that some patients find a dry orgasm after prostate surgery less satisfying, adding that same-sex couples may have issues if one partner is lacking a prostate. “For men having receptive anal intercourse, where the prostate is a source of pleasure, having the prostate removed definitely changes the sexual experience,” Bole says.

Can Prostate Cancer Affect Fertility?

Prostate cancer itself won’t necessarily affect fertility, but prostate removal definitely will. When the prostate and seminal vesicles are removed, there can be no ejaculation, which is necessary for fertility.

Sperm is still being produced, however. It’s possible to retrieve sperm surgically though a testicular biopsy for use in assisted reproductive procedures like in vitro fertilization.

Because the average age of prostate cancer diagnosis is 66 years old, according to Cancer.Net, many patients with prostate cancer will be past the age of wanting to conceive.

With other treatments that leave the prostate in place, there may be an impact on erections, depending on whether the nerves that lead to arousal are damaged. However, if you have a prostate, it is possible to ejaculate without a full erection, according to UCLA Health.

Treating Erectile Dysfunction Caused by Prostate Cancer

Nearly all patients will experience some erectile dysfunction after a prostatectomy. How long it lasts depends on age, overall health, and the amount of damage done to the nerves surrounding the prostate, says Johns Hopkins Medicine.

Some erectile dysfunction treatments include the following:

  • Medications Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) will help if the issue is getting blood to the penis but won’t be effective if the nerves have been damaged by surgery or radiation. This class of drugs won’t help with low libido.
  • Vacuum Erection Device Also called a penis pump, the device pulls blood into the penis. It can be effective for men who can get an erection but can’t maintain it.
  • Penile Injection Therapy You give yourself a shot at the base of the penis with a mixture of alprostadil, phentolamine, and papaverine (Trimix) to open the blood vessels in the penis and help achieve an erection.
  • Penile Implants These devices placed in the penis to get an erection are sometimes recommended when other treatments for erectile dysfunction fail.

“I always tell my patients, When there’s a will, there’s a way for you to get a firm enough erection for sex,” says Shelfo.

In addition to these interventions, lifestyle changes such as quitting smoking and cutting back on drinking can improve the ability to get an erection, per Cancer Research UK. This is also true for men with erectile dysfunction not related to prostate cancer treatment.

Reimagining Good Sex

Many men believe that good sex involves an erect — and constantly erect — penis, as well as an orgasm and ejaculation. But Bole says that if there are unwanted sexual side effects of prostate cancer treatment, it’s possible to imagine different ways to be sexual.

“Sexual therapy, psychology [experts], and couples counseling can help patients communicate with their partners about what they’re going through and explore other ways to be intimate and express affection,” she says.

Any kind of treatment for cancer can affect not just your anatomy and sexual function but also the way you feel about yourself. Bole says that it’s important to speak with doctors before treatment for prostate cancer about what kinds of sexual changes can be expected. “A lot of times, when the oncologist identifies a problem, they are good at reaching out to get the patient a consultation with someone like myself or one of my partners who specializes in talking about some of the [symptoms] that might not be brought up during an oncology-focused visit,” says Bole.

Complete Article HERE!

What doctors wish patients knew about getting a vasectomy

By Sara Berg, MS

When discussing reproductive health choices, one procedure has been gaining attention—especially since the fall of Roe v. Wade—for its effectiveness: the vasectomy. As individuals and couples explore long-term contraception options, vasectomies have emerged as a popular choice for those seeking a permanent solution—rates have increased by 26% in the past decade. With its relatively low risks and high success rates, this procedure is reshaping conversations about family planning.

The AMA’s What Doctors Wish Patients Knew™ series provides physicians with a platform to share what they want patients to understand about today’s health care headlines.

In this installment, three physicians took time to discuss what patients need to know about getting a vasectomy. These AMA members are:

  • Jason Jameson, MD, a urologist and chief of urology at the Phoenix Veterans Affairs Medical Center, who serves as a delegate for the American Urological Association in the AMA House of Delegates.
  • Amarnath Rambhatla, MD, a urologist at Henry Ford Health and director of men’s health at the Vattikuti Urology Institute in Detroit.
  • Moshe Wald, MD, a urologist at the University of Iowa Hospitals & Clinics and an associate professor in the department of urology at Carver College of Medicine in Iowa City.

Henry Ford Health and University of Iowa Hospitals & Clinics are members of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

There are seasonal spikes in vasectomies

“We sometimes see seasonal spikes in vasectomies. We see it in March and then also in November and December before the end of the year,” Dr. Rambhatla said. “We think it spikes at the end of the year because everyone has met their deductible for the year.

“In March, it’s been loosely associated with March Madness, he added, noting “the running joke is that men get their vasectomy around the NCAA basketball tournament and ask their wives for permission to lay on the couch for four straight days so they can watch the basketball tournament.”

“The other interesting thing we’ve seen is with the Roe v. Wade reversal. There are studies showing an increase in Google trends, searches and consultations for vasectomies after that,” Dr. Rambhatla said. “So, it seems like some men are more inclined to be in control of their fertility status after that ruling.”

It’s a minor surgical procedure

“A vasectomy is a minor surgical procedure, which is aimed at eventually achieving permanent birth control,” said Dr. Wald, noting “the procedure is typically performed in a clinic setting under local anesthesia, which means injection of numbing medication into the area.

“However, in some cases, based on anatomy and on the patient’s preference it could also potentially be done in the operating room under sedation or general anesthesia,” he added. “But the vast majority are being performed  in the clinic under local anesthesia.”

“The procedure involves the surgical interruption of a tube called the vas deferens. The vas deferens is the tube that drains sperm from the testicle outwards and a man typically has two of them, one on each side,” Dr. Wald said. “So, the idea is to interrupt these tubes, and then allow enough time for  the sperm that at the time of the vasectomy was already beyond the vasectomy site to wash out.”

The procedure “usually takes about 20–30 minutes. One or two small cuts are made in the scrotum with a scalpel or no-scalpel instrument,” Dr. Jameson said, noting “the vas deferens are cut and tied or sealed with heat. The skin may or may not be closed with sutures.”

But “if the vas deferens are not easy to feel due to body characteristics—obesity, previous scarring—the procedure may be more challenging to perform,” Dr. Jameson noted.

It’s OK to drive yourself home

“Most of the time patients are OK to drive themselves home after the procedure. Occasionally I’ll have some patients who are a little nervous or anxious about getting a vasectomy,” said Dr. Rambhatla. “So, we can prescribe them medication to help calm down their anxiety for the procedure.

“In those situations, they need to have a driver with them because that medicine can alter their ability to drive,” he added. “Otherwise yes, you could drive yourself home.”

Don’t be nervous, it’s straightforward

Patients “should definitely relax. It’s a straightforward, easy procedure,” said Dr. Rambhatla. “The most common feedback I get from men after the procedure is: Oh, I thought it was going to be a lot worse than that.”

“Sometimes their friends will mess with them before the procedure and say it’s going to be a terrible experience and it is just good old fun,” he said. “But most of the time, people say it wasn’t so bad and they had nothing to worry about.”

Follow up requires a semen test

A vasectomy is “not immediately effective. If you can imagine a tube through which sperm is passing, the vasectomy is basically occluding that tube so sperm isn’t passing through anymore, but there’s still sperm on the other side of that tube we’ve occluded,” said Dr. Rambhatla. “And so, all that old sperm needs to be cleared out for men to become sterile.”

“We check a post-vasectomy semen analysis about three months after the procedure to make sure all that old sperm has been cleared out,” he said. “And sometimes some men may take longer, so it can take up to six months or so to clear out all the old sperm.”

Vasectomy is very effective

It is important to note that a “vasectomy would never provide a 100% guarantee. The only way to reach a 100% guarantee of no pregnancy is simply to avoid sexual intercourse altogether,” said Dr. Wald. “Even after a man gets a vasectomy and later gets a semen test that will show no sperm cells in the semen, there is still a very small risk for an unwanted pregnancy in the future.

“That risk is estimated in many studies at one in 2,000, which is, for example, much better than condoms. But it’s not zero and never will be,” he added. “That risk of roughly one in 2,000 by most series is after a man has a post-vasectomy semen test that showed no sperm. If somebody had unprotected sexual intercourse after a vasectomy before having such semen test at all, his chances for pregnancy could be close to 100%.”

This is meant to be permanent

“The best candidates for a vasectomy are couples who are done having kids or men who may be single and know that for sure they do not want any kids in the future,” said Dr. Rambhatla. That is “because we do consider it a permanent form of sterilization. It can be reversed, but really we want people going into it with the idea of permanent sterilization.”

Dr. Wald agreed, emphasizing that “If there’s any question about that, then I would advise against the vasectomy at that particular time.”

Vasectomies don’t always work

“There is a risk of failure. Even if done by an experienced physician, vasectomies could fail. Not necessarily due to surgical error—which is a possibility,” Dr. Wald said, noting “there have been multiple studies that showed the potential reconnection that can happen.”

“Sometimes there could be microscopic channels that can sprout from one end of the interrupted tube and at least in a transient manner allow for some sperm to sneak into the other side,” he said. “The risk varies a lot depending on if the patient had or did not have a semen test following the vasectomy that was negative for sperm. If he did that, his risk for such failure is very small.”

It may be covered by insurance

“Most private insurers cover some or all of the cost of vasectomies,” Dr. Jameson said. “For men without coverage, various self-pay options may be available in certain local facilities.”

“It’s a lot cheaper for insurance to pay for men to have a vasectomy than pay for them to have another child,” noted Dr. Rambhatla, emphasizing “most insurance companies are happy to cover a vasectomy.”

Vasectomy reversals are complicated

“Vasectomies are theoretically surgically reversible. The problem is that vasectomy reversals are a very different thing,” Dr. Wald said, noting that “vasectomy reversals are true surgery performed in the operating room. It is very expensive if not covered by insurance and it does not always work, even if done by an expert.”

The success of a vasectomy reversal “depends on various factors such as how long it’s been since the vasectomy, what your fertility status was prior to the vasectomy and what your partner’s fertility status is,” said Dr. Rambhatla. “Because sometimes we see men with new partners who may have different fertility potential than their previous partner or now their same partner is older, and her fertility potential has changed.”

“And the closer you are to the vasectomy period, the better success rates with the reversal,” he said. “Generally, if this is done within 10 years, there’s a good chance that we can get sperm back in the ejaculate. But sperm in the ejaculate doesn’t necessarily translate to a pregnancy.”

There is a risk of bleeding

“From the surgical standpoint, this is a fairly small procedure, so the risks are not to the magnitude of anything life threatening, but there are certainly risks that are worth mentioning,” Dr. Wald said. “There are the most obvious risks of bleeding and infection. Bleeding, if it happens, is not even close to being anything life threatening.

“Such bleeding happens not externally, but rather internally into the scrotal sac and it could cause bruising, swelling and patient discomfort, and it can take a few weeks to gradually absorb,” he added. “It typically involves the surgical wound or the skin, but sometimes can be deeper and even involve the testicle. These are almost always managed by antibiotics, but it’s a risk.”

“The risk of bleeding with vasectomy increases with blood pressure,” Dr. Jameson said. That’s why it is important to have blood pressure controlled before getting a vasectomy.

Watch out for abnormal pain

“What is not that obvious is the risk of chronic testicular pain. I’m not referring to the obvious post-procedural pain, but a chronic condition that can last months, years or even be there for life,” Dr. Wald said.

According to the American Urological Association, about 1% to 2% of men may experience ongoing pain or discomfort, explained Dr. Jameson. The pain is often treated with anti-inflammatory medications such as ibuprofen.

“This chronic type of pain is a treatable condition, but in some men such treatment could involve surgery that could be bigger in its magnitude than the original vasectomy,” Dr. Wald said.

Men can develop antibodies to sperm

“Not all, but most men who undergo a vasectomy do develop antibodies to sperm. This is because sperm is typically separated from the immune system,” Dr. Wald said. “However, a vasectomy is one of the most common causes where sperm is exposed to blood  and the immune system, and that could lead to the formation of anti-sperm antibodies.”

“This is not something that is posing a general health concern and patients will not feel it,” he said. “But the problem is that if somebody does seek fertility later in life and undergoes a vasectomy reversal, even if the vasectomy reversal works, these antibodies do not go away and can coat sperm, slow sperm down and impair its function.”

It should not affect sex

“A vasectomy does not change sexual function. It does not protect against sexually transmitted infections,” said Dr. Rambhatla. “It’s simply a way to prevent sperm from coming out in the ejaculate.”

Additionally, Dr. Jameson noted, according to the Urological Care Foundation, that a vasectomy should also not cause any erection problems—ejaculations and orgasms should feel the same. And while there is no sperm, the amount of semen does not decrease more than 5%.

Avoid extensive activity

“Typically, if the procedure is done towards the end of the week, then the patient can simply take a long weekend and then plan to go back to work Monday,” Dr. Wald said. “It’s not something that requires you to be in bed, but definitely avoid extensive physical activity.”

That means “no heavy lifting, running. Any gym type activities should be refrained from,” said Dr. Rambhatla, noting that “walking is OK. Just no strenuous activity.”

Additionally, “men with more activity and heavy lifting at work may need more time off as you should avoid heavy lifting for a week,” Dr. Jameson said.

Address pain control

“In terms of pain control, usually most people do well with alternating between Tylenol and ibuprofen as needed,” said Dr. Rambhatla, adding that icing for the first couple days also helps.

Patients can “resume sexual activity once the pain and swelling have resolved,” he explained.

Wear snug underwear and ice area

After a vasectomy, it is common to have swelling and minor pain in the scrotum for a few days, Dr. Jameson said, noting that “wearing snug underwear or a jockstrap can help ease discomfort and support the area.”

Additionally, “patients are typically asked to wear a jock strap with a pretty bulky dressing for 48 hours, and also to ice the area intermittently for 48 hours,” Dr. Wald said.

There are other forms of contraception

“Other birth control methods include condoms or birth control pills for females,” Dr. Jameson said, noting “both of these methods are effective but must be consistently used, and the one-time cost of a vasectomy may be cheaper over time than the cost of other birth control methods.”

Additionally, “tubal ligation in females is another surgical option for birth control and is performed by gynecologists,” he said.

Complete Article HERE!

I’m not surprised women prioritise sleep over orgasms

— A survey has found that more than 85 per cent of women would choose a good night’s sleep over having an orgasm. I understand why

By

My friends and I have a game that we like to call “Eight Hours’ Sleep Or…” It’s not a particularly imaginative name and certainly won’t keep the creators of Pictionary or Scrabble up at night, but it’s as good a way as any to while away the spare two and a half minutes we tend to catch between work and parenting.

The idea of the game is to find something you would rather have than eight hours’ sleep a night. It goes something like this:

“Eight hours’ sleep or being best friends with Taylor Swift?”

“Eight hours’ sleep.”

“Eight hours’ sleep or being pursued by Brad Pitt?”

“Eight hours’ sleep.”

“Eight hours’ sleep or an end to mansplaining?’

“Eight hours’ sleep.”

“Eight hours’ sleep or being able to eat all the cheese without any negative impact on your health?”

“Eight hours’ sleep.”

“Eight hours’ sleep or an unlimited supply of confidence and money?”

“Eight hours’ sleep.”

And so on and so forth until you realise that nothing on God’s Earth will ever trump the idea of eight uninterrupted hours of sleep, of waking up feeling rested, recovered and raring to go into the day ahead.

It has been a relief, then, to discover that my group of friends and I are not alone. A major survey of bedroom habits by Good Housekeeping magazine has found that more than 85 per cent of women would choose a good night’s sleep over having an orgasm. Only 52 per cent of men feel the same way, perhaps because of the “gender sleep gap” –  yes, there is such a thing! – with 61 per cent of women saying their sleep quality varied, compared with 53 per cent of men.

Anyway, I think what we can all take from this is that sleep is very, very hard to come by these days. Stress, hormones, the lure of sitting up late at night scrolling through a little screen that sits in the palm of your hand and contains all of the horrors of the world… and then there’s the fact that sleeplessness has become a sort of status symbol, a way of telling people to back the hell off and go easy on you without actually having to tell people to back the hell off and go easy on you.

Saying “I’m tired” over and over and again is the most wonderfully passive-aggressive way of signifying you are busy and pressurised and do not have time for the trifling trivialities everyone seems to be bringing to your doorstep. We say we want eight hours’ sleep, but do we really? If we had eight hours’ sleep a night, then what would our excuse be?

Personally, I’m done with being sleepless in south London. It’s so boring talking about how tired I am all the time, such a waste of energy in itself. And in the past year, I have realised how counter-productive my obsession with sleeplessness is. The more I worry about sleep, the less I actually sleep.

I realised this last spring, when I spent a couple of hundred quid on an Oura ring, which is a sleep tracker that wellbeing experts swear by. Every night, I went to bed in it, and got annoyed by the flashing red and green lights that seemed to emanate from it in the dark. Every morning, I woke up and looked with horror upon the graphs that told me how exhausted I was, and what this might mean for my long-term health (nothing good). Eventually I realised that the presence of the tracker was in itself having a detrimental effect on my sleep. It was fuelling my insomnia, so I took it off, and decided to take radical steps to actually prioritise sleep, as opposed to just talking about the lack of it in my life.

Now, I devote the evening to sleep. I have sacrificed what remained of a social life for it. I don’t go out. I refuse all dinner invitations, choosing instead to eat early with my 10-year-old. I am in bed before her, my phone switched off and on charge, a good book in my hands as I get comfortable in my 200-thread-count Egyptian cotton linen. My friends know that if they text me after 8pm, they are unlikely to get an answer until the next morning. I spend at least 90 minutes reading, and have usually drifted off by 11pm.

I have rules: no more than one coffee a day, and never later than 11am; if I wake in the middle of the night, reading for 15 minutes is a much more effective tool than simply closing my eyes and trying to get back to sleep; my own duvet is essential, as I like to turn it round again and again to find the cool side; and if my husband starts snoring he is immediately out and into the spare room. 

This may seem draconian, but I don’t care. Because nothing – and I mean nothing – is more important than a decent night’s sleep.

Indeed, now I am in my 40s and in menopause, I can see that it is the most important thing of all when it comes to emotional well-being. You can go on anti-depressants, you can sign up for therapy, you can do as much exercise as you want: but if you are not prioritising rest, the chances are you will not start to feel better. It doesn’t have to be eight hours. But in my experience, anything below six and you are going to struggle. You are going to be cranky, short-tempered and extra sensitive. Any resilience you have will be gone by mid-morning. There will likely be tears. This is nothing to be ashamed of: it’s just simple, human biology.

Of course, I suspect many women would sleep much easier if they knew they lived in a world where they were entitled to both eight hours’ kip a night and an orgasm. But that’s another column entirely, and until that moment comes (pardon the pun), you’ll find me of an evening tucked up in bed in my nightie, sipping on a nice mug of Ovaltine.

Complete Article HERE!

The 3 most important steps to achieving orgasm, according to an expert

— Tried and tested

By Adriana Diaz

If there’s one thing the internet is not lacking, it’s unsolicited advice about how to improve your sex life. Not sure how to cut through the noise? Here are three simple tips according to an expert.

Orgasms aren’t just a way to finish getting freaky in the sheets – they have physical and mental benefits too. Yet the mystery of the Big O has eluded men and women for centuries.

Many surveys suggest that about half of women are not satisfied with how often they reach climax – and 10% to 15% of women have never had an orgasm in their lives, as reported by the National Library of Medicine.

Men have less trouble – only about 5% to 10%, according to a study published by Sexual Medicine – but that still leaves millions of Americans who can’t reach climax, or feel insecure when their partner can’t get off.

Everybody is different, but research and experts agree these three factors are key to reaching the finish line.

#1. Stimulation

It may seem intuitive, but what does “stimulation” really mean?

“The whole thing about the type of stimulation that you need is a combination of pressure and rhythm,” Dr Laurie Mintz, LELO Sexpert and author of Becoming Cliterate, told The Post.

Applying the right amount of pressure to erotic zones, such as the clitoris, the penis or the ears, helps build sexual arousal and eventually activates the muscles to contract, a necessary physical step.

Pressure also needs to be applied with a good rhythm – which some suggest is the key to orgasm claiming.

Experts, including Dr Mintz, agree that a great way to find the sweet spot for the G-spot is to bring a vibrator into the bedroom.

Getting into the flow of a good rhythm can focus attention so intensely that it overtakes any other thoughts and self-awareness nearly putting the person in a trance and allowing for a sufficient intensity of experience to trigger the mechanisms of climax, according to a study published in Socioaffective Neuroscience & Psychology.

#2. Mindfulness

To reach a sexual trance, you have to hone in on the sensations of the sexual experience and achieve mindfulness.

“Mindfulness is putting your mind and body in the same place at the time,” Dr Mintz, a LELO ambassador, explained. “And most of us don’t do that in our life, let alone our sex life.”

“When we’re having sex we’re in our head, ‘What do I look like? What am I doing? Am I doing okay?’ And you can’t orgasm when you’re not in your body. You have to learn how to be in your body.”

She advises everyone to try meditation or yoga to practice mindfulness in their daily lives or play music during sex.

“A myth about mindfulness is that it takes a lot of practice and that you have to meditate every day. No. You can practice being mindful in your daily life,” Dr. Mintz insisted.

An easy way to begin practising mindfulness is when brushing your teeth, Dr Mintz shared.

“The next time you brush your teeth, really focus on the sensations. When your mind wanders, bring it back to the sensations. You can learn mindfulness in daily activities and then apply it to the bedroom,” she suggested.

#3. Communication

Once you’ve used mindfulness to discover what pressure and rhythm are getting you to the finish line, you have to communicate that to your partner.

“Couples – no matter if it’s a hook-up or a relationship – who, communicate about sex and talk about what they need during sex are much, much more likely to orgasm,” Dr Mintz said.

“A common myth is that your partner should know what you want without asking. Nobody reads minds. That’s where communication comes in.”

While moaning and groaning can help guide your partner, verbally directing them how to help you cum is the best way to get over the finish line.

Complete Article HERE!

How My Sex Life Changed After My Breast Cancer Diagnosis

By Molly Longman

On Dec. 2, 2015, Erin Burnett was two days out from her wedding and existing in the buzzy state of bliss that’s reserved for people who are very much in love. That morning, as she was happily daydreaming in the shower, she noticed something was different about her left nipple. She took a closer look — it seemed to be inverted. She felt an immediate chill; the sudsy water suddenly felt like ice.

She called her doctor, who said Burnett could come in during her lunch break to get her breast checked out, just as a precaution.

After some testing, the doctor told Burnett to come back after her wedding day. She tried to put the experience out of her mind until after the ceremony. Just 12 days after tying the knot, at 28 years old, Burnett got the call. She had stage II, triple-positive, invasive ductal carcinoma. Her honeymoon would be cut short.

The diagnosis impacted Burnett’s life in myriad ways — but a major factor was the impact on her sex life. “I had a brand-new marriage, with no honeymoon phase,” she remembers. “I used to joke around with my friends and say: ‘You guys are having these crazy sex lives where someone pulls your hair, while my husband’s picking my hair up off the ground.'”

Burnett underwent a double mastectomy and a hysterectomy, which induced what’s known as medical menopause. “I didn’t know until it happened that I was gonna have vaginal atrophy, vaginal dryness, pain with intercourse, lack of lubrication, and lack of libido [following the hysterectomy],” she says. She also faced emotional hurdles, especially as she coped with losing her breasts and went through painful attempts at reconstruction.

Throughout the treatment process, Burnett and her medical team were so focused on saving her life that her quality of life often took a backseat. In particular, the quality of her sex life was not top of mind for her or her providers.

This is a common refrain from cancer survivors, who say that the medical establishment tends to leave out or breeze through conversations about the ways cancer can impact your sexual health, especially because they’re rightfully so laser-focused on keeping you alive. But this can have serious ramifications for people’s sexual health, mental health, and relationships, says Ericka Hart, MEd, a sex educator and breast cancer survivor. “They’re usually not concerned about the ways that you are gonna experience pleasure in the future, they just want to fix you — and in their mind, cancer is the issue they’re fixing,” they say.

This often puts the onus on patients to bring up questions about how their diagnosis and treatment will affect their sexual health.

Anna Crollman, a 37-year-old breast cancer survivor from North Carolina, remembers feeling incredibly nervous about asking her provider about the sexual side effects, such as painful intercourse, she was experiencing during and after her treatment. “I like to call it the ‘doorknob question’ that you squeeze in right when they’re about to leave and their hand’s almost on the door,” she says. “You say: ‘Hey, just one more thing.'”

But if sexual health is brought up earlier and more often by providers, it’s not only easier for patients to discuss their issues when they’re ready to do so, but also for them to find more satisfaction with sex in the long run — and to feel less alone, says Don S. Dizon, MD, a professor of medicine at Brown University and director of the Sexual Health First Responders Clinic at Lifespan Cancer Institute.

It’s common, especially for women and nonbinary people, to blame themselves for sexual health issues and feel they have to suffer alone. “Most of the people I see feel like they’re the only ones going through this,” he says. “When I tell a person, ‘This is really common,’ there’s a weight lifted off their shoulders because [until then,] they think they’ve done something wrong.”

But patients shouldn’t be deterred from seeking information about improving their sexual health, despite cancer, and they shouldn’t have to work up extra courage to get answers. As Dr. Dizon puts it: “everyone deserves a sex life.”

The Physical Impacts Cancer Can Have on Sex

Breast cancer treatments can dampen physical desire in several ways. Breasts are an erogenous organ, Dr. Dizon says, and oftentimes a mastectomy is required as part of treatment. “The loss of breast-specific sensuality is something everyone will go through to some degree,” he says. “The process of naming that is really important, because people don’t consciously think of the breast as a sexual organ, and it is.”

Meanwhile, for those with hormone-positive breast cancer, doctors often prescribe drugs called aromatase inhibitors that lower estrogen levels, causing medically induced menopause. “These notoriously have a negative effect on sexuality, whether it’s vaginal dryness, painful activities, or loss of desire,” Dr. Dizon says. “Chemotherapy can also harm body image, because people gain a lot of weight, and it can cause neuropathy and physical side effects like nausea and diarrhea.”

As patients know, these physical impacts can take a real toll.

Shonté Drakeford, a nurse practitioner and patient advocate in Maryland, was diagnosed with stage four metastatic breast cancer in 2015, after being dismissed by providers for six years when she presented with symptoms. Drakeford says that before her diagnosis, her sex life with her high school sweetheart was “amazing.” For the first two years of treatment, she had no major sexual side effects, though she had to be careful about what positions she took part in, as the cancer had spread to her lungs, lymph nodes, ribs, spine, and left hip. “I asked my doctor what I could do that wouldn’t harm me, physically, because I was fragile,” she remembers. “He got all red and was embarrassed to answer.”

About three years into treatment, Drakeford noticed that her libido had lessened, and she was experiencing vaginal dryness. “Even though, mentally, I wanted to [have sex], my mind and vagina didn’t connect,” she says. “It was like a slow transition into a menopausal state.” This was due to her treatments, which she couldn’t stop. “I’ll be on treatment forever; this is lifelong for me,” she says. “I wish they had Viagra for women.”

Drakeford’s doctors told her that vaginal estrogen therapy — which some menopausal people use to help with some sexual side effects — wasn’t an option for her; her cancer was hormone-positive, so it essentially fed on hormones like estrogen. “It’s all about safety,” Drakeford says. “Am I willing to risk my health for sexual satisfaction?”

Cancer Can Cause Mental Health Barriers to Satisfying Sex, Too

Beyond these physical questions, mental hurdles are also prevalent amid cancer treatments. Many of us have ideas about what sex “should” look like, and those are challenged by a life-changing diagnosis like cancer, says Emily Nagoski, PhD, a sex educator and author of “Come as You Are” and “Come Together.”

Hart says that they felt “disconnected from their body” after their cancer diagnosis, something that they believe to be common for other survivors, but that looks different for everyone. As they were being treated for breast cancer in 2014, they struggled with how their body was constantly being touched, especially by white medical staff. Hart, who is Black, found that this challenged their understanding of bodily autonomy and lead to them distancing themself from their romantic partner, who was white. “I didn’t want a white person to touch me sexually,” they remember.

Hart says that something else shifted following their mastectomy: they felt like people could no longer see them as a whole person — they only saw Hart’s illness. At one point in their healing process, Hart went topless in public, baring their double mastectomy scars to end “the lack of Black, brown, LGBTQIA+ representations and visibility in breast cancer awareness.” As important as this messaging was, Hart felt “de-sexualized” by some of the responses their display elicited. “People would see my topless pictures and respond: ‘Oh my God, you’re so inspiring,'” they say. “But if anybody with nipples went topless on the internet, that would not be the response.”

This is a commonly felt sentiment among breast cancer patients — they feel society begins to see them only as patients, rather than sexual beings. Hart points out that you rarely see sex scenes with cancer patients in the media. FWIW, the only one I could think of was in “Desperate Housewives,” which involved a somewhat superficial plot about Tom feeling uncomfortable having sex with Lynette when she wasn’t wearing her wig, and Lynette fearing it meant he was no longer attracted to her. (This is a real fear among patients, though Dr. Nagoski notes: “In a great relationship, we’re attracted to the human being we chose to be with, not to the body parts of that human. It’s normal to have feelings about changes to our bodies and our partners’ bodies, of course, but a strong relationship adapts to those changes with love and trust.”)

Meanwhile, Crollman, who was diagnosed with cancer at 27, adds that the mental barriers to sex after cancer were “the hardest part.” “The pain, of course, is physically uncomfortable, but even though my partner and I tried so hard to stay in open communication, the reality was, we went through a very, very dry spell,” she says. “I was feeling really lost, mentally. I went through a deep depression, and I was seeing a therapist to cope because I really didn’t feel comfortable in my body.” After having a double mastectomy, Crollman felt “vulnerable” being in front of someone else while she was still “struggling to come to terms with the body that I had.”

Plus, not being intimate for a period due to these understandable challenges led to “more physical triggers and trauma around that experience — around the fear of it, around the pain that was related to it because of the side effects,” Crollman remembers. “So it was kind of this multileveled, emotional, psychological challenge.”

Finding Pleasure Again Post-Diagnosis

The physical and emotional stressors surrounding sex are very real, but reframing can help cancer patients to work through them. “The stakes around treatment certainly may be high, but the stakes around sex are not” — or at least, they don’t have to be, Dr. Nagoski says.

Although our culture tells us we can somehow “fail” sexually, especially “if we don’t perform according to some external, bullshit standard, the reality is there is nothing to lose, there is no way to fail,” Dr. Nagoski says. “We only imagine we’re doing it ‘wrong’ when we compare our experiences to some bogus cultural script of what sex ‘should’ be like — a script that was always irrelevant to our lives, but after a cancer diagnosis is just an absurd, pointless, and even cruel standard against which to assess our sexual connections. There is nothing at stake with sex; you have nothing to lose, only pleasure and connection to gain.”< Pleasure can look different to different people, and sex is just one piece of it. In order to maximize satisfaction for all parties involved, Dr. Nagoski says you first need to get on the same page as your partner — and that means getting curious. "If your partner wants sex, ask each other these important questions: What is it that you want, when you want sex with each other? And what is it that you don't want? When don't you want sex with each other? And, perhaps most importantly, what kind of sex is worth having — as in, what makes sex worth not spending that time watching 'Parks & Recreation'?"

Also, “You could decide to take all sex entirely off the table,” Dr. Nagoski says. “That’s a legitimate choice.” Hart adds that some couples may decide to open up their relationship amid cancer.

However, many people with cancer do want to try to explore sex and pleasure again, whatever that looks like for them. But because there are so few good resources out there and so much stigma around the topic, they may do so with varying levels of success.< Hart, for example, discovered that kink and BDSM was a sexual space of healing for them. "After being poked and prodded and having surgeries and chemotherapy literally once a week with a giant needle, I wanted to go into spaces where I could reclaim that pain," they say. "So doing things like impact play — being consensually spanked and hit — I could reclaim the pain after years of feeling like I didn't have a choice of opting into it." Hart also recommends working with a sex therapist to find pleasure again, which may include finding ways to incorporate chest play after a mastectomy, whether you still have nipples or not. Dr. Nagoski recommends the book “Better Sex Through Mindfulness” by Lori Brotto, who specializes in sexual health interventions for those with cancer and for survivors of sexual trauma.

Dr. Dizon adds that some healthcare providers might be more comfortable pointing their patients to resources rather than giving them actual advice about their sex lives, so asking your doctor if they have recommendations for something to read or a support network you could join might be a smart tactic for finding the support you seek.

Drakeford says she hasn’t been shy about asking for resources but still hasn’t felt satisfied with the level of pleasure she’s experienced since her diagnosis. She’s tried vaginal moisturizers, lube, and sex toys and hasn’t seen much success. “I even tried that slippery elm herb — it did nothing. Not a thing!” Drakeford says. “I’ve been going on nine years without things improving. I hope researchers can get on this and find something that actually works for people like me . . . even if it’s not during my lifetime.”

Burnett, for her part, has tried to be intentional about pleasure from the very beginning — though it hasn’t been easy.

While she was undergoing chemo, Burnett says, she and her partner scheduled sex around treatments. “The first couple of days after chemo, your body’s pretty toxic, so you aren’t going to be intimate,” she says. “Then seven to 10 days after is when you’re at your sickest. So for us, it was usually around that two-week mark that we’d schedule time to be intimate, before the next round.”

Since going into medical menopause, Burnett’s tried multiple tactics to make sex post-breast-cancer more pleasurable with her partner, including lubes, moisturizers, and laser therapy. (Dr. Dizon notes it’s important for those with breast cancer to find options that have specifically been studied in people with breast cancer, not the general population.) She also had to mentally get used to the changes in her breasts — though getting a mastectomy scar tattoo helped her regain some confidence, both in general and in the bedroom.

Although Burnett didn’t get the honeymoon phase she’d always dreamed about, she did learn quickly that she’d found a partner who’d keep every word of his vows. “There is something really intimate about someone who can be there for you and hold your hair back as you’re throwing up, and pick it up as it’s falling out,” she adds, nodding to her old joke about her friends having their hair pulled.

The couple’s 10-year anniversary is coming up next year, and they’re planning to finally take that honeymoon they never got. “It’ll be a different kind of honeymoon, because my body is just different from most other 36-year-olds’ out there. But it will also be a celebration of surviving 10 years.”

Complete Article HERE!

My Cervical Cancer Diagnosis Changed the Way I Think About Sex

— I’ll never approach sexual risk the same way again

By Andrea Karr

I’ve long been a fan of condom use and STI testing. I’m the woman who carries a rubber in her wallet *just in case* and heads to the lab a couple times a year to have my blood and urine screened for gonorrhea, syphilis and other sexually transmitted infections.

Occasionally, I’ve foregone the condom. I’d like a guy and we’d sleep together a few times. One night, he’d suggest that it would feel way better if we skipped protection. He’d keep the conversation light but would make it clear that we’d both have more fun if I’d loosen up. I wouldn’t want to come off as a killjoy or prude, so sometimes I’d give in. Each time it happened and I received a clear STI test afterward, I’d sigh with relief and go on with my life.

But then I was diagnosed with cervical cancer after a routine Pap test when I was 35. The fastest increasing cancer in females in Canada and third most common cancer in Canadian women ages 25 to 44, cervical cancer is almost always caused by human papillomavirus (HPV), an STI with more than 200 strains that can also cause vaginal, vulvar, penile, anal and oropharyngeal (a.k.a. throat, tonsils, soft palate and back of the tongue) cancer. HPV often has no symptoms, and cervical cancer can take one or two decades to develop after infection. Though condoms don’t guarantee protection, they reduce the risk of transmission.

Cervical cancer is no joke for a woman’s wellbeing and fertility. I was very lucky that my cancer was caught at the earliest stage: 1a1. I required two small surgical procedures (called LEEPs) to remove the cancerous cells, and now I get checkups every three months. If it was caught later, I might have needed a hysterectomy, radiation and/or chemotherapy, which could have harmed my eggs or put me into early menopause.

The phrase “it’s cancer” is something we hope to never hear in our lifetime. Those little words changed my life. As a result, I spent a lot of time looking back on my sexual relationships. I regretted ever having sex at all at first. Sex is what gave me cancer! But then I realized that just being alive carries risk, and I don’t want to avoid intimate relationships, which can be so crucial to physical, emotional and mental wellbeing, just because I could get hurt.

Instead of abstaining from sex, I decided I wanted to get educated about my risk, then develop clear boundaries that I can confidently communicate to a partner. I also want to break down the guilt or shame I feel about being a “killjoy” or “prude.” I have a great justification: a history of gynecological cancer. But no one should need a life-altering event to justify having sexual boundaries.

Still, it’s not easy. “As a woman, you’ve been told your whole life that if you stand up for yourself, if you don’t go with the flow, you are difficult, and that it’s not feminine to be difficult,” says Frederique Chabot, sexual health educator and acting executive director at national organization Action Canada for Sexual Health and Rights. She’s referring to the way most girls and women are socialized growing up. “In romantic or sexual scenarios, there are many things that can put you at risk of retaliation, of reputational damage, of harassment. There is the pressure put on women to say ‘yes,’ people asking, asking, asking, asking. That’s not consent. That is getting pressured into doing something you’re not willing to do.”

A woman's legs and a man's legs intertwined in bed

I’m now comfortable with having a detailed chat about sexual history, STI testing, HPV vaccination and condom use before I get into bed with someone. Of course, it’s not only on me. Men are at risk for HPV and other STIs too.

So far, I’ve had this conversation with two guys. One responded badly; now he has no place in my life. The second agreed to have a fresh STI test before we had sex. He also looked into the HPV vaccine, which he ended up getting, and he is okay with consistent condom use. We’ve been dating for almost a year.

I know that every woman in the world won’t share the same boundaries as me. That’s okay. But there are potential risks to sexual contact, even though our hook-up culture likes to pretend otherwise. It’s about deciding how much risk you can live with and then feeling empowered to communicate that. I won’t let my desire for acceptance compromise my sexual health going forward. I hope, after hearing my story, no one else will either.

“Instead of abstaining from sex, I decided I wanted to get educated about my risk, then develop clear boundaries that I can confidently communicate to a partner.”

Ways to be proactive

HPV vaccination

In Canada, Gardasil 9 is the go-to HPV vaccine and it protects against nine high-risk strains of HPV that cause cancer and genital warts. Health Canada currently recommends it for everyone aged 9 to 26, and it’s offered for free in schools sometime between grades 4 and 7, depending on the province or territory. Though it’s most effective when administered before becoming sexually active, it can still have benefits later in life. I wasn’t vaccinated at the time I was diagnosed with cervical cancer, and all my healthcare practitioners told me to get vaccinated immediately. The Canadian Cancer Society recommends the HPV vaccine for all girls and women ages 9 to 45Regular Pap tests

In Canada, most provinces and territories rely on Pap tests to check for cellular changes that, if left untreated, may lead to cervical cancer. Generally, the recommendation is to go to your doctor or a free sexual health clinic every three years (if everything looks normal) starting at age 21 or 25. I had no symptoms for cervical cancer; it was caught early thanks to a routine Pap test. You still need to go for regular Pap tests even if you’ve been vaccinated, you’ve only had sex one time or you’re postmenopausal.

HPV testing

Free STI tests that you can get through your family doctor or a sexual health clinic do not check for HPV. They usually test for chlamydia and gonorrhea (and maybe also syphilis, HIV and hepatitis C). If a sexual partner tells you they’ve had a clear STI panel, they’re probably not talking about HPV since it’s a test that comes with a fee.

P.E.I. and B.C. are transitioning from Pap testing every three years to HPV testing every five years. HPV testing is more accurate than Pap testing. It can detect certain strains of high-risk HPV with about 95 per cent accuracy, while Pap tests are only about 55 per cent accurate at detecting cellular changes on the cervix, which is why they need to be done more frequently.

The shift to provincially covered HPV screening in other provinces is slow. Ontario, for example, may be years away from the transition.

DIY testing

Canadian company Switch Health has launched a self-collection HPV test that can be ordered online for $99. You do your own internal swab, mail your results to the lab and get your results from an online portal—it can take as little as a week. It screens for 14 high-risk strains of HPV, including types 16 and 18, which cause 70 per cent of cervical cancers and precancerous cervical lesions. If you test positive for one of the strains, you should see your family doctor, and if you don’t have one, Switch “will work to set you up with one of our partners for a virtual or in-person appointment,” says co-founder Mary Langley.

The cost may be a barrier, plus privately purchased DIY tests aren’t supported by the infrastructure that there is for Pap testing. “There are quality control checks in place. There’s evidence review on a regular basis. Many people will receive letters from [their provincial health agency] telling them they’re due for their Pap,” says Dr. Aisha Lofters, a scientist and family physician at Women’s College Hospital in Toronto. But if you aren’t getting regular Paps because you don’t have easy access to a doctor or you’re uncomfortable going in for the test, it’s a lot better than nothing.

Complete Article HERE!

The Lesbian Bed Death could be plaguing thousands of women

Lesbian Bed Death is a contraversial term used to describe gay couples’ sex lives

By

It may be 2024, but one controversial term from the 1980s is coming back from the grave.

Lesbian Bed Death is, simply put, the idea that lesbian couples have less sex.

It’s a sweeping generalisation of the gay community, but why has it gained traction?

‘Research by Blumstein & Schwartz in 1983 showed 47% of women in long term lesbian relationships (two plus years) reported having sex zero to one times per month. There was a sharp decline after two years,’ Miranda Christophers, psychosexual and relationship therapist for menopause platform Issviva tells Metro.co.uk.

Further studies including a literature review by Peplau & Fingerhut in 2007 found that lesbian couples have sex less frequently, on average, than other couple configurations.

Miranda also points to a recent 2021 study, by Chapman University in California, which found women in five-year relationships or longer have less frequent sex than their heterosexual counterparts.

About 43% of the coupled lesbian participants had sex zero to one times per month, while the findings for the heterosexual women was 16%, implying more straight women had more frequent sex.

There is research which suggests lesbian couples have less sex than heterosexual couples
There is research which suggests lesbian couples have less sex than heterosexual couples

While we certainly aren’t going to buy into the idea that all lesbian women have, and are content with, sexless relationships, Miranda explains why sex could die out.

‘Lesbian couples, but broadly speaking, anyone of any sexual orientation, do see a change in the frequency of sex over long term relationships,’ she adds.

‘Earlier on there is more sexual drive and exploration, regardless of gender identity – especially when you live together and experience that domesticity and familiarity.’

But why is this the case for lesbian women specifically?

Miranda says that hormonal changes can really impact the frequency with which women choose to have sex.

‘The hormonal fluctuations may play a big part, people have periods where they might feel more desire than others,’ she explains.

‘Studies have shown that responsive desire occurs more commonly in females than spontaneous desire, which is definitely something I see in my clinical work.

‘If you’ve got two people together who experience more responsive desire, they might be less inclined to have sex because they aren’t wanting to initiate.’

Miranda believes one of the reasons lesbian couples could have less sex is because of hormonal changes
Miranda believes one of the reasons lesbian couples could have less sex is because of hormonal changes

Emily Nagoski, in her book Come As You Are, estimates that around 75% of men and 15% of women experience spontaneous sexual desire, which is exactly what it suggests.

Meanwhile, 5% of men and 30% of women experience responsive desire, which is when arousal only happens after stimulation.

How to navigate responsive arousal:

Sex therapist Laura’s top tips for dealing with responsive arousal (and recognising when you actually want to have sex) are as follows:

  • Understand that there’s nothing wrong with you and that you’re normal.
  • Try different things to spark your sex drive. You have no desire for sex until you are in the process of receiving some physical stimulation so you need to find out what works for you.
  • Understand how you get turned on. The point is to find out if you notice any sign of sexual arousal in response to stimulation and when exactly it happens.
  • Practice orgasm breathing. It can really help to relax, increase sensitivity, and switch off the brain. This practice helps bring arousal and orgasm closer.
  • Work on external factors – if a person is not aroused by erotic thoughts or fantasies, some other factors can do their part – preparing an intimate setting or practicing with various erogenous zones, toys.

Everybody’s libido is different, so enjoy getting to know yourself without the pressure, and have fun doing it!

The other thing women experience which can wreak havoc on their hormones, and subsequently affect their sex drive, is the menopause.

‘The menopause affecting sex drive is definitely a thing. When women hit perimenopause they can notice changes in their sexual desire. It’s a really, really common presentation in the women I see,’ Miranda explains.

Some menopause symptoms that could impact your sex life are breast tenderness, low mood, worsening PMS, vaginal dryness and changes in discharge, thrush, BV, low libido, urinary infections, sexual dysfunction, fatigue, increased period frequency and insomnia – to name a few.

‘How women are feeling in themselves changes… body image changes,’ Miranda adds. ‘They may experience sexual discomfort, or they may be less sexual, there may be less sensitivity.

‘There may also be less lubrication or increased dryness and the vaginal tissue might thin and become more painful.

‘These sorts of things are obviously going to have an effect on [your sex life] because if sex isn’t feeling as enjoyable, or is feeling painful, then you are less inclined to want to do it.’

When you have two women experiencing these changes (assuming couples are of a similar age) this could in theory lead to lesbian women having less sex, Miranda explains, although there are plenty of women who still have sex despite the menopause and with HRT, hormones can be balanced for some women.

Ultimately lesbian bed death isn't applicable for a lot of lesbian couples and as long as a couple is happy with their sex life, the frequency of sex doesn't matter
Ultimately lesbian bed death isn’t applicable for a lot of lesbian couples and as long as a couple is happy with their sex life, the frequency of sex doesn’t matter

Why we should reject the Lesbian Bed Death

This ‘drop off’ of sexual intimacy certainly won’t be the case for all lesbian couples though. It’s also important to remember that our sex lives sit on a spectrum, according to Miranda.

Largely, Lesbian Bed Death should be a term taken with a pinch of salt – after all, to reduce lesbian women in long term relationships to cohabiters is plain wrong.

In fact, a study has shown that while lesbian women were found to have less frequent sex, the sex they did have was ‘more prolonged, intense, and orgasmic’, than those in heterosexual relationships.

The Chapman University study also found women in same-sex relationships were found to be more likely to experience orgasm at 85%, versus 66% in heterosexual relationships.

Lesbian women also had sex that lasted more than 30 minutes (72%), versus 48% for heterosexual women.

What areas did lesbian couples have more frequent sex in?

  • Oral sex: lesbian (53%), heterosexual (41%)
  • Deep kissing: lesbian (80%), heterosexual (71%)
  • Stimulation by hand: lesbian (90%), heterosexual (83%)
  • Use of sex toys in partnered sex: lesbian (62%), heterosexual (40%)
  • Discussed erotic fantasies: lesbian (44%), heterosexual (36%)

Percentages were higher for lesbians when it came to mood setting activities including using music, candles, saying ‘I love you’, scheduling time for sex and arranging romantic breaks.

Miranda also says that the implications of a death bed are pretty dire, when actually some lesbian couple’s sex lives may not suffer at all.

‘This concept of lesbian bed death, is it’s almost this idea sex is going to drop off completely,’ she explains. ‘It sounds like it’s going to meet an abrupt ending at some point, doesn’t it? I think that’s a complete misconception.’

She adds: ‘It’s a bit scare mongering. For some couples, if neither party is bothered, then less or no sex is not an issue – it’s an issue when one wants to have sex and the and the other doesn’t.

‘That’s also regardless of whether it’s a same sex couple or an opposite sex couple.’

While Miranda does see plenty of women struggling with a lack of desire, a lack of sex or intimacy but that’s because she only sees people who are struggling with their relationships in her line of work.

There are countless lesbian couples who aren’t experiencing Lesbian Bed Death and are have sex as and when they want.

‘I see both same sex and opposite relationships who are experiencing desire discrepancy so my observations are that desire, interest, frequency and enjoyment of sex is not determined by gender, sexuality or relationship configuration,’ Miranda says.

Complete Article HERE!

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

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

By Sophie Saint Thomas

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

Top 10 drugs that may contribute to sexual dysfunction

By Naveed Saleh, MD, MS

Key Takeaways

  • A variety of prescription medications, along with the conditions they treat, may contribute to sexual dysfunction.
  • Some of these drugs are known to interfere with sexual health, such as antidepressants and beta blockers; lesser known culprits include thiazide diuretics or opioids.
  • Clinicians can help by being aware of medications that may affect sexual function, having open discussions with patients, and adjusting medications where needed.

Sexual dysfunction can be an adverse effect of various prescription medications, as well as the conditions that they treat. Some of these treatments, such as antidepressants and certain antihypertensives, likely come as no surprise to the clinician. Others, however, are not as well-known.

Here are 10 types of prescription medicines that contribute to sexual dysfunction.

Antiandrogens

Antiandrogens are used to treat a gamut of androgen-dependent diseases, including benign prostatic hyperplasia, prostate cancer, paraphilias, hypersexuality, and priapism, as well as precocious puberty in boys.

The androgen-blocking effect of these drugs—including cimetidine, cyproterone, digoxin, and spironolactone—decreases sexual desire in both sexes, as well as impacting arousal and orgasm.

Immunosuppressants

Prednisone and other steroids commonly used to treat chronic inflammatory conditions decrease testosterone levels, thus compromising sexual desire in males and leading to erectile dysfunction (ED). 

Sirolimus and everolimus, which are steroid-sparing agents used in the setting of kidney transplant, can mitigate gonadal function and also lead to ED.

HIV meds

The focus of dolutegravir (DTG)-based antiretroviral therapy has been on efficacy, as measured by viral load. Nevertheless, these drugs appear to affect sexual health, which can erode quality of life, according to authors writing in BMC Infectious Diseases.[1]

“Sexual dysfunction following transition to DTG-based regimens is common in both sexes of [people living with HIV], who indicated that they had no prior experience of difficulties in sexual health,” the study authors wrote. “Our findings demonstrate that sexual ADRs negatively impact self-esteem, overall quality of life and impair gender relations. DTG-related sexual health problems merit increased attention from HIV clinicians.”

Cancer treatments

Both cancer and cancer treatment can impair sexual relationships. And cancer treatment itself can further contribute to sexual dysfunction.

For example, long-acting gonadotropin-releasing agonists used to treat prostate and breast cancer can lead to hypogonadism, resulting in lower sexual desire, orgasmic dysfunction, erectile dysfunction in men; and vaginal atrophy/dyspareunia in women.[2]

Hormonal agents given during the course of endocrine therapy in cancer care lead to a sudden and substantial decrease of estrogens via their effects at different regulatory levels. Selective ER modulators (SERMs) are used to treat ER-positive breast cancers and bind ERs α and β. These receptors are crucial in the functioning of reproductive, cardiovascular, bone, muscular, and central nervous systems. Tamoxifen is the most common SERM used.

In females, reduced estrogen levels due to endocrine therapy can lead to vaginal dryness and discomfort, pain when urinating, dyspareunia, and spotting during intercourse.

Antipsychotics

Per the research, males taking antipsychotic medications report ED, less interest in sex, and lower satisfaction with orgasm, with delayed, inhibited, or retrograde ejaculation. Females taking antipsychotics report lower sexual desire, difficulty achieving orgasm, anorgasmia, and impaired orgasm quality. 

“The majority of antipsychotics cause sexual dysfunction by dopamine receptor blockade,” according to the authors of a review article published in the Australian Prescriber.[3] “This causes hyperprolactinaemia with subsequent suppression of the hypothalamic–pituitary–gonadal axis and hypogonadism in both sexes. This decreases sexual desire and impairs arousal and orgasm. It also causes secondary amenorrhoea and loss of ovarian function in women and low testosterone in men,” they continued.

Antipsychotics may also affect other neurotransmitter pathways, including histamine blockade, noradrenergic blockade, and anticholinergic effects.

Anti-epileptic drugs

Many men with epilepsy complain of sexual dysfunction, which is likely multifactorial and due to the pathogenesis of the disease and anti-epileptic drugs, per the results of observational and clinical studies.[4]

Specifically, anti-epileptic drugs such as carbamazepine, phenytoin, and sodium valproate could dysregulate the hypothalamic–pituitary–adrenal axis, thus resulting in sexual dysfunction. Carbamazepine and other liver-inducing anti-epileptic drugs could also heighten blood levels of sex hormone-binding globulin, thus plummeting testosterone bioactivity.

Both sodium valproate and carbamazepine have been linked to disruption in sex-hormone levels, sexual dysfunction, and changes in semen measures.

Antihistamines

Allergic disease is commonly treated with antihistamines and steroids, with both drugs potentially interfering with sexual function by decreasing testosterone levels. In particular, H2 histamine receptor antagonists can disrupt luteinizing hormone/the human chorionic gonadotropin signaling pathway, thus interfering with the relaxation of smooth muscles at the level of the corpus cavernosum.[5]

ß-blockers

ß-blockers contribute to ED likely because they suppress sympathetic outflow.

“Non-cardioselective ß-antagonists like propranolol have a higher incidence of ED than cardioselective ß-antagonists which avoid ß2 inhibition resulting in vasoconstriction of the corpora cavernosa,” per investigators writing in Sexual Medicine.[6] “Nebivolol has the greatest selectivity for ß1 receptors as well as endothelial nitric oxide vasodilatory effects, and has been shown to have a positive effect on erections.”

The authors cite a double-blind randomized comparison in which metoprolol decreased erectile scores after 8 weeks, whereas nebivolol improved them.

As well, he selective β-blocker nebivolol inhibits β1-adrenergic receptors, which may protect against ED vs non-selective β-blockers.[7]

Opioids

The µ opioid receptor agonist oxycodone not only inhibits ascending pain pathways, but also disrupts the hypothalamic-pituitary-gonadal axis by binding to µ receptors in the hypothalamus, thereby resulting in negative feedback and resulting in ED, as noted by the Sexual Medicine authors.

Consequently, less  gonadotropin-releasing hormone is produced, which results in lower levels of  gonadotropins and secondary hypogonadism. 

Loop diuretics

Results of a high-powered study demonstrated that men taking thiazides were twice as likely to experience ED compared with those taking propranolol or placebo. It’s unclear whether furosemide also causes ED. It’s also unclear why thiazides cause ED. Nevertheless, the Sexual Medicine authors stress that prescribers should remain cognizant of the potential for thiazide to interfere with sexual function.

What this means for you

It’s important for clinicians to realize the potential for a wide variety of drugs to contribute to problems in the bedroom. If a patient experiences trouble having sex, they may discontinue use of the drug altogether. Consequently, physicians must tailor treatment plans with patients and their partners in mind.

The key to assessing sexuality is to foster an open discussion with the patient concerning sexual function and providing effective strategies to address these concerns.

Complete Article HERE!

How to Have Less Awkward Shower Sex

— These are the best positions (and toys) to try for less awkward sex in the shower.

By Brianne Hogan

The fantasy of shower sex (hot and steamy) typically doesn’t live up to its reality (damp and slippery, and maybe even a little dangerous). Like sex on the beach, shower sex sounds sexy in theory but is more often than not an uncomfortable and awkward experience.

“A lot of people see shower sex in the movies and think it looks great, but when they try it, they feel a bit let down,” erotic film director Erika Lust of ERIKALUST says. “From personal experience and through directing sex scenes in my films, there are a couple of reasons as to why it may get a bad reputation. One, the setting isn’t right. The shower may not have any handles or anywhere to lean or grab, making it a bit awkward and restricting positions. Two, It’s too built up. It’s better to not have any expectations and go with the flow. Don’t get caught up on what it should look or be like. And three, foreplay is skipped. People can get too excited with all that’s going on around them that they skimp on foreplay. Foreplay is a really important step to build intimacy and excitement, and shouldn’t be skipped.”
But still, all this yearning for toe-curling shower sex can’t be all for nothing.

“Taking a shower together is a really intimate and sometimes vulnerable moment,” Lust says. “Especially washing each other. And intimacy is hot. It’s also, for many, something new and exciting—there is something about the water, the skin-on-skin contact and the closeness that just makes shower sex so hot.”

Maybe it won’t be as seamless as movies make it out to be, but according to experts, shower sex can still be an orgasmic experience for some with the right preparation and positions.

How to have safe shower sex

Before you rub soap all over your partner’s body as foreplay, intimacy expert Kiana Reeves says the biggest key in making any sexual experience enjoyable is communication and comfort with your partner(s). “You want to make sure you and your partner feel comfortable with a shower sex session, and it can even help to discuss beforehand any positions that would make you uncomfortable, along with any potential safety considerations,” she says.

Also, if you’re in need of birth control, Zach Zane, sex and relationships expert at Fun Factory, says IUDs and daily birth control medications are effective for birth control in the shower, and while condoms can indeed be effective too, “they are more likely to tear or break if you are not using silicone-based lube, so we highly recommend using silicone lube for shower sex.”

Speaking of lube, Zane says what most people are doing wrong in the shower is not using any lube or using the wrong kind of lube. “Water is actually not a lubricant,” he says. “Think about it; when you use water-based lube, it’s not just a bottle of water. There are other ingredients in there that make it more viscous and last longer. When having shower sex, you really need to use lube, and you should consider using silicone-based lube (or oil-based) lube because the shower water won’t wash those types of lubes off easily. Shower water will quickly wash away water-based lube.” However, he notes that “oil-based lubes are not compatible with condoms.”

Best positions for sex in the shower

Because you’re working in a tight space with less surface area to balance on, finding a good position can be awkward for most of us. “I’ve found it’s helpful to go into the experience with an exploratory mindset, so it gives you the freedom to try out different positions and explore what works and what doesn’t,” Reeves says. “It’s totally normal for it to take a few positions or pleasure seshes to find one that feels ‘right,’ so going in with that mindset can help alleviate any awkwardness or self-consciousness you might feel. But it’s still normal for things to need some practice to work themselves out!”

No matter how you’re positioning yourselves, Lust recommends using a non-slip mat, and to make use of shelves or handles to grab onto for extra stability. Also, “Use the shower head,” she says. “Most of us are no stranger to using a shower head for pleasure; in fact it was probably a lot of peoples first sex toy. If possible, detach the shower head and use it to pleasure the other person and lightly tickle their genitals.”

To help get you started, Lust suggests try standing. “It’s simple but very enjoyable,” she says. “Have one person lean against the shower wall while the other penetrates from behind. This is great because you can position the shower head to trickle water down the back.”

If possible, she also suggests taking a seat. “Whether on the edge or on the shower floor, this will allow one person to straddle the other with minimal risk of slipping,” Lust says. “Maybe position the shower head slightly away so it isn’t restricting anyones eyesight.”

Finally, if you find that you can’t find a position that feels good for penetration, Reeves suggesting trying oral or hand sex.

Best toys to use when having sex in the shower

Toys can be another great way to experiment with shower sex. Zane recommends the BOOTIE RING, which is a butt plug connected to a cock ring. “I’d insert the toy before heading into the shower. And then, the cock ring portion of the toy will help you sustain an erection,” he says. Additionally, he likes the B BALLS DUO, “a weighted butt plug that you can insert before having shower sex for additional pleasure.”

For those into pegging, Lust suggests trying SHARELITE. “It is completely waterproof as it is made out of body-safe silicone,” she says. “The beauty of SHARELITE, is that it is a harness-free dildo so there are no straps getting wet and potentially chafing.” Another toy Lust recommends is Maya by Love Not War. “It is a recycled bullet that is 100% waterproof, with a tapered tip made for exploring,” she says. “Since this toy is made of aluminum, it is great for temperature play too. The head unscrews and can be submerged in hot or cold water.

Complete Article HERE!

33 ways to have better, stronger orgasms

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

By , and

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

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

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

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

What’s an orgasm, exactly?

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

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

What are the different kinds of orgasms?

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

Clitoral Orgasm

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

How to have a clitoral orgasm:

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

Vaginal Orgasm

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

How to have a vaginal orgasm:

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

Cervical Orgasm

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

How to have a cervical orgasm:

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

G-Spot Orgasm

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

How to have a G-spot orgasm:

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

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

    How to have a nipple orgasm:

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

    Anal Orgasm

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

    How to have an anal orgasm:

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

    Blended Orgasm

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

    How to have a blended orgasm:

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

    Oral Orgasm

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

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

    How to give an oral orgasm:

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

    A-Spot Orgasm

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

    How to have an A-spot orgasm:

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

    U-Spot Orgasm

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

    How to have a U-spot orgasm:

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

    Exercise-Induced Orgasm, or Coregasm

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

    Can I have multiple orgasms in a short time period?

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

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

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

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

    How to have an orgasm:

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

    1. Prioritise cuddling.

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

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

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

    2. Don’t skip right to penetration!

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

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

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

    3. Focus on positions that favour the clit.

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

    4. Use a vibrator.

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

    5. Think about your cycle.

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

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

    6. Make sure you have lube on hand.

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

    7. Whip out a fantasy.

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

    8. Try sensation play.

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

    9. Feel yourself up in the shower.

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

    10. Take an orgasm ‘break.’

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

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

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

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

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

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

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

    13. Be present.

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

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

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

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

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

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

    15. Practice positive handwriting.

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

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

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

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

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

    17. Try yogic breathing.

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

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

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

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

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

    19. Make it a full-body experience.

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

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

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

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

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

    21. Lean into pregnancy sex.

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

    22. Remove judgment.

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

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

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

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

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

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

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

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

    25. Combine types of touch.

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

    26. Embrace the mini Os.

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

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

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

    28. Invest in a new toy.

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

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

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

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

    30. Maintain stimulation throughout the entire O.

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

    31. Tighten your pelvic muscles.

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

    32. Try edging.

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

    33. Know your body.

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

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

    Frequently Asked Questions

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

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

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

    What is the ‘orgasm gap’?

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

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

    There are a few things to get you started.

    Get psychological.

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

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

    Consider your lifestyle choices.

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

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

    Hydrate, hydrate, hydrate.

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

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

    Complete Article HERE!

Why Viagra has been linked with better brain health

By

Viagra can be a wonder drug for men with erectile dysfunction, helping them maintain their sex lives as they age. Now new research suggests the little blue pill may also be beneficial to aging brains.

The findings are based on a massive study of nearly 270,000 middle-aged men in Britain. Researchers at University College London used electronic medical records to track the health of the men, who were all 40 or older and had been diagnosed with erectile dysfunction between 2000 and 2017. Each man’s health and prescriptions were tracked for at least a year, although the median follow-up time was 5.1 years.

During the study, 1,119 men in the cohort were diagnosed with Alzheimer’s disease.

The researchers noticed a distinctive pattern. The men who were prescribed Viagra or a similar drug had an 18 percent lower risk of developing Alzheimer’s disease, compared with men who weren’t given the medication.

The researchers also found an even larger difference in men who appeared to use Viagra more often. Among the highest users, based on total prescriptions, the risk of being diagnosed with Alzheimer’s was 44 percent lower. (Men with erectile dysfunction are instructed to only take Viagra before sex, and no more than once a day.)

“I’m excited by the findings but more excited because I feel this could lead to further, high-quality studies in a disease area that needs more work,” said Ruth Brauer, a lecturer in pharmacoepidemiology at the University College London School of Pharmacy and the principal investigator of the study.

There’s a limit to how much we can conclude from the study results. The findings show an association between lower Alzheimer’s risk and Viagra use, but don’t prove cause and effect. For instance, it may be that Viagra use is a marker for better overall health, and that men who have more sex also are more physically active as well. Physical activity is independently associated with a lower risk of Alzheimer’s disease, Brauer said.

Why Viagra may be linked with a lower risk of dementia

Sildenafil, the generic name for Viagra, was never supposed to be a sex drug. Pfizer had developed the drug as a cardiovascular medication to treat hypertension and chest pain called angina. The company had been conducting clinical trials using sildenafil as a heart medication when some patients reported an unexpected side-effect — erections.

Viagra is part of a class of drugs known as phosphodiesterase Type 5 Inhibitors, or PDE-5 drugs. The drugs work by dilating blood vessels and increasing blood flow throughout the body, including to the penis. Since its discovery as an erectile dysfunction treatment, sildenafil also has been used to treat pulmonary arterial hypertension for both men and women.

The link between heart health and sexual health is strong. Erectile dysfunction can be an early warning sign of coronary artery disease. And an unhealthy vascular system is one of the reasons men start having problems with erections.

Vascular risk factors have also been linked to certain types of dementia, including Alzheimer’s disease, so researchers have been intrigued about whether erectile dysfunction treatments can affect brain health as well.

Animal studies of PDE-5 inhibitors have shown the drug may help prevent cognitive impairment by, in part, increasing blood flow in the brain, but researchers who conducted a review of the available research say the efficacy of the class of drugs “remains unclear.” And Brauer said the findings in animals are only “possible mechanisms” in humans.

“There is an idea that if we can help with improving blood flow in the brain, maybe we can also reduce the risk for Alzheimer’s disease,” said Sevil Yasar, an associate professor of medicine at Johns Hopkins University and the co-author of an editorial that accompanied the study in Neurology.

Other reasons for the effect

Stanton Honig, a professor of urology at Yale School of Medicine, said the newest study is far from definitive. “You can’t draw any conclusions” from the study because “there are so many other factors” at play besides whether a man takes a pill for erectile dysfunction.

“Someone who is more likely to take a pill like that at 70, they’re probably more active, they’re more likely involved with their partners, things like that,” Honig said. “There’s too many confounding variables to make a definitive statement that it’s the pills or it’s the patients that are taking the pills that are less likely to be neurologically impaired.”

Brauer said the average “pack” per prescription is four tablets. But it’s not clear if the men took all the tablets prescribed and, if so, how often.

“We do not know if people used the prescribed drugs as intended nor could we measure sexual activity or physical activity levels,” Brauer said. “We need further studies to show if our results would hold up in a group of men without erectile dysfunction and — even better — it would be better to run our study in a group of men and women.”

Previous studies on different populations have come to somewhat contradictory conclusions. A Cleveland Clinic study found a significantly reduced risk of Alzheimer’s disease among those using sildenafil, said Feixiong Cheng, the director of the Cleveland Clinic Genome Center and the principal investigator of the study. But a study by researchers at Harvard Medical School and the National Institute on Aging found “no association” between the use of sildenafil, or other PDE-5 inhibitors, and the risk of Alzheimer’s disease, said Rishi Desai, an associate professor at Harvard Medical School.

More study is needed

Rebecca Edelmayer, the senior director of scientific engagement for the Alzheimer’s Association, said in an email that it remains unclear whether Viagra and similar drugs have an effect on Alzheimer’s risk. “Further research and specifically designed, randomized clinical trials are a necessary step,” she said.

For now, the findings don’t suggest that men should start taking Viagra if they don’t need it. But we do know that Viagra is an effective treatment for erectile dysfunction, and men who are experiencing the problem should see a doctor and discuss both their sexual health and cardiovascular health.

“You should not take Viagra to reduce your risk,” Yasar said. “You should eat healthy. You should exercise. There’s plenty of evidence for that.”

Complete Article HERE!

How to Close the ‘Orgasm Gap’ for Heterosexual Couples

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

By

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

[CLIP: Music]

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

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

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

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

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

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

McDonough: To “orbiting …”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Klein: Sex doesn’t exist in a vacuum.

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

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

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

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

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

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

Complete Article HERE!

6 Questions to Ask Your Doctor About Sex after 50

— Vaginal dryness, erection challenges, safe sex and more

By Ellen Uzelac

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

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

Starting the conversation about sexual health

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

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

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

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

1. What can I do about unreliable erections?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!