Thursday, July 8, 2010

We've Moved to

I am pleased to announce that this blog has been redesigned and expanded. Please see the new and improved version here. Also, don't forget to update your bookmarks, feeds, readers, and little scraps of paper sitting next to your computers. See you there, and have a sexy day!

Sunday, July 4, 2010

Want to Change Your Partner? - Change yourself.

How many times have I seen it day in and day out - a couple is not happy about the way things are progressing (or not progressing) in their relationship. They have theories, a list of faults the other partner has committed, a wish-list of things that partner doesn't do that would easily (ideally) solve their problems. Already before coming to see me, they are pointing their finger at their partner's shortcomings with dissatisfaction. Problem is, you cannot change anyone. Period. People that try to force their partners to change often find that it only increases anger, insecurity, and resentment.

But that doesn't mean that our partners can't change, or won't change. Everyone has the option to change something about their behavior, their thoughts, their life. The trick is they will only change if they want to, or if it suits them to do so. The secret to change in your partner, however, is less about focusing on them, and more about focusing on yourself.

When we are in a relationship, we tend to create patterns of behaviors that define how we interact with each other. Our relationship has its own equilibrium that is made up of how we each behave and how we respond to our partner's behavior. The longer the relationship goes on, the more entrenched these patterns become. But the patterns can always change - and that change depends on us. Here's why:

Einstein said that insanity is doing something over and over again and expecting different results. Such is the case with the way we interact with our partners. By focusing on our own thoughts, actions, and words, we can change the equilibrium of our relationship, even if only just a little. If we act differently, then our partner will have to respond to this change. So by creating a different set of variables in yourself, you set the stage for a different response in your partner.

For example, if your partner is watching television instead of following you into the bedroom, you might try starting to pleasure yourself without them ("I'm just going to go touch myself a little.") and see if they don't say "Hey wait for me." Or if you wish that your partner would initiate sex more often, instead of waiting around for it, start talking to them about your latest fantasy.

Now, this does not guarantee that your partner will change the way you would like them to, or even change at all. How you respond, however, is up to you. Some people keep trying different things, some people give up trying. Some even decide to end their relationship, depending on the nature of the issue in question. Change involves risk, and that means that the change may not always be in the direction you were hoping for. It is this risk of the unknown that keeps so many people from trying something new. But regardless of your partner, you always have control of yourself. Some of you may ask "Why should I have to change?" and my answer is, it's not about should or shouldn't. And you don't have to change. But then don't expect anything else to change either.


Saturday, June 26, 2010

The Skinny on Condoms

Safe sex is synonymous with using condoms. Whether you choose to use a traditional condom (for men) or the larger female condoms, a barrier method is the only way to currently protect against bacterial or viral infections being passed from one partner to another. Remember that sexual contact even one time with a partner can result in a sexually transmitted infection, and you can't always tell who has an infection or who doesn't. Sometimes a person may not even know if they themselves have an infection (such as HPV, Chlamydia, Gonorrhea, trichomonas, or HIV) when they meet a new partner, so you should be responsible to protect yourself.

Although condoms are the gold standard for STI prevention, there are several things that cause people to shy away from using condoms. Some of these complaints are decreased sensitivity, difficulty in keeping an erection while using a condom, discomfort in wearing a condom, and irritation during or after using a condom. It may take a little trial and error, but most of these issues can be overcome with some practical information and practice.

Firstly, in order to put on a condom, a man should already have an erection that is satisfactory. If you attempt to put on a condom before a man has a complete erection, the pressure from the condom could actually prevent having sufficient blood filling the penis for a good erection. Once a man has an erection, however, this pressure does not effect the hardness of the erection. Some men, however, find that they start to lose their erection when they put on a condom. This is usually related to their thoughts about condoms which can cause anxiety or negative ideas, or is a combination of those psychological factors combined with physical factors.

If a condom does not fit well, it can result in decreased sensitivity, discomfort, or even pain. For most men, finding a condom that has the proper width (yes they vary in how wide they are as well as how long) makes all the difference. If a condom ring is too tight around the shaft of the penis, it may be too uncomfortable to get lost in the moment and really enjoy sex. If the width seems to be ok, but there is still a considerable decrease in sensitivity, try using condoms that have a wider area around the tip, so that there is movement around the most sensitive part of the penis during penetration, which feels more natural. Regardless of what style of male condom you choose, you should leave some extra space at the tip of the condom to give room for the semen to collect after ejaculation. If your erection is a little shorter than the condom, it is better to leave more extra space at the top, since you should be able to unroll the condom completely for comfort and effective use. With practice, you will know just how much to leave for yourself.

If you are finding that male-style condoms are too constricting for comfortable sex, then you may benefit from trying female condoms. They are condoms designed to be inserted into the vagina and stay put with a ring that holds onto the cervix. They are inserted all the way into the vagina with the outer ring covering part of the labia first, then pushing the rest of it up as far as it will go and having the inner ring surround the cervix. The outer ring always stays on the outside and actually provides more coverage of the labia, which can decrease those sexually transmitted infections that are passed on with skin to skin contact (like genital warts and Herpes). Since the female condom is much wider, it doesn't cause the squeezing that is uncomfortable for men who are very wide. The female condom does take some practice to use effectively, and you must ensure that the outer ring doesn't slip into the vagina during penetration (sometimes you may need to adjust it).

One of the great drawbacks of using condoms is that people may experience more irritation during or after sex. It is important to use lubrication on the outside of the condom and should be reapplied regularly during sex. Keeping the lube within arm's reach during sex helps keep the action moving right along. Since condoms are destroyed by oils, choose only water-based lubricants. Also, keep in mind that many people find glycerin to be be irritating to their mucosal tissues, so finding a glycerin-free lube is always best. Never use lotions, creams, or any other type of lube not specifically designed for sex since they may contain oils in them and can be very irritating inside. Stay away from condoms that contain nonoxynol-9 spermicide, since this is particularly irritating.

If you find that latex condoms are the cause of your irritation (or you just don't care for the taste, smell, or feel), find yourself condoms made of polyurethane or polyisoprene. Both of these are thinner than latex, so provide a more natural feel. Polyurethane is much less stretchy than polyisoprene (which is a great plus for some people), but transfers body heat pretty well. These are all options to consider when finding the condom that you like the best. By finding the condom that works best with your anatomy and preferences, many of the complaints often heard with condom use can be eliminated for a safe, pleasurable sexual experience. And don't forget your "Kiss of Mint" for safe sex while giving a blowjob!

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Monday, June 21, 2010

Too Tired for Sex?

In our busy schedules, it is easy to have our sex life take a back seat to our other responsibilities. But your mindset about sex can dramatically change your desire and your energy level for sex. If you think about sex as an obligation or a chore, you will be hesitant, avoid your partner, and feel drained of motivation. If, however, you see it as a way to be pampered and given pleasure, many often conjure up the energy to be frisky even in the face of a long day. On other occasions I have spoken about the importance of regular aerobic exercise for maintaining your energy and health, getting proper sleep, learning to reduce stress, as well as the importance of communication to avoid having relationship conflicts from creating anger or resentment. Here are some other practical things to consider if you find that you are often too tired for sex.

The first thing to consider is what you are putting into your body. Diet and water intake directly affect your energy level, and too often they are areas that people ignore. Being dehydrated automatically makes you feel fatigued even if you have a good diet. Remember to drink water throughout the day and to replenish after any caffeinated drinks like soda, coffee, or tea. If you feel thirsty, you are already low on water. The next thing that many people skimp on because of their busy schedules is their diet. Oftentimes, people will skip a meal or two, then have one large meal, or they may eat snacks of easily accessible junk food instead of more nutritious choices. Not only does this leave you without the necessary ingredients to continue with your day, but with that pattern of eating, your body will eat away at your muscle tissue and take up all the energy stored up, but keep your body fat up. This results in low energy reserves and fatigue. Three regular meals of moderate portions is the best way to regulate your body's energy stores. Since caffeine causes your body to release the energy stored in your muscles, limiting your caffeine intake to one drink (coffee or tea) per day helps your body keep these intact.

Because our diets are usually not sufficient for our stressful lives, most people would benefit from taking vitamins. A multivitamin usually does not provide enough B vitamins for optimal energy, therefore most people would benefit from taking a B-100 Complex, which has 100mg of each of a combination of B vitamins. Our modern diet and environmental factors (such as medications) can leave us with low levels of B vitamins. These are important because they help with metabolism and help normalize energy levels.

One sex tip you can use to combat fatigue is to initiate sex in a place other than your bed. Since your brain already connects being in bed with sleeping, this becomes much more difficult to resist once you are already tired from the day. Once you slide into the covers and you get horizontal, the desire for sleep overshadows any desire there may be for sex. But starting off on the couch or another area of the house may keep those zzzz's from taking over. You may try talking to your partner about this and start your foreplay or flirtation before you get to the bedroom. Related to that is the time of the night that you or your partner tries to initiate sex. I would recommend that you not wait until bedtime to start communicating to your partner that you want to have sex. This may require some creative planning with your family's schedule, but can certainly pay off. Instead of staying up watching tv until your lids are heavy, start kissing and caressing early, and maybe forego that tv show for some real live action!

Keep in mind that many women require some physical stimulation before they actually are aware of any sexual desire. If they are feeling too tired, they may not even be able to focus on what the pleasure of sex could feel like at that moment. A tip for these women is to give yourself permission to explore some gentle stimulation, either by your partner or by yourself, before you make up your mind about having sex. This may help awaken a stronger desire for sex, even if it was previously masked by feeling tired. So much of a woman's desire has to do with what she is focused on, and some actual physical contact and stimulation helps shift that focus.


Wednesday, June 16, 2010

Sexual Fantasies

One element of our sex life that adds to our arousal and sexual pleasure is sexual fantasy. These can be images, scenes, or stories that can range from very simple, to very complex and involved. They are shaped by several different factors including early experiences, ideas about ourselves, and how we interpret the sexual meaning of certain acts or images. How our sexual fantasies develop is also influenced by what we are taught by our families or society about what is appropriate or not appropriate. Regardless, sexual fantasies are a natural part of the way our thinking mind works to give meaning to our actions and heighten our arousal.

Since sexual fantasies can include all different kinds of images, they are often misunderstood, or become a source of anxiety. Oftentimes, a person will be sufficiently uncomfortable with their sexual fantasies that they block them out or distract themselves with other thoughts in order to keep from thinking about them. If this happens repeatedly, you may teach yourself to ignore sexual fantasies altogether, or at least those fantasies that contribute the most to your arousal. This can result in difficulty becoming aroused, excited, or reaching orgasm.

Learning a little about sexual fantasies may help you feel more comfortable with your own fantasies. Many times, fantasies can be symbolic or their meaning may not be obvious at first. This can cause some people to become upset with their fantasies and try to block them out. For example, a fairly common fantasy for some women is that might be ravished or raped. For many women, this fantasy represents the desire to be so attractive and desirable that their partner (or others in the fantasy) would not be able to resist them. It does not automatically mean that a woman wants to be raped or would enjoy being raped. So you see how this type of fantasy could be confusing and upsetting for both men and women alike.

Sexual fantasies are what give our sex lives their gusto. If you do not allow yourself to get lost in your fantasies and explore your own sexual nature, you are short-changing yourself out of pleasure and a better understanding of who you are as an individual. There are many things that people fantasize about that they would not look to carry out in real life. But that does not mean that you cannot use those fantasies to heighten your experience for yourself or with your partner. Fantasy is just that - fantasy, not reality. It is a creative space in your mind that you can use to pretend and create exciting stories, and have fun.

(This article refers to fantasies that do not involve harm towards yourself or another person, or fantasies that involve inappropriate partners - such as children or animals. If you are having such fantasies, they should be discussed with a therapist to prevent any dangerous or harmful behavior or any anxiety or depression that result from them.)

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Tuesday, June 8, 2010

Meds Affecting Your Erection - Blood Pressure Medications

There are literally hundreds of different prescription medications that can interfere with your sex life. In this post, I am going to focus on medications prescribed to control blood pressure and how some of these may be having undesired effects in the area of erectile functioning. Please be advised that high blood pressure is a serious medical condition that requires proper treatment. Because of this, you should never stop taking your medication without consulting your doctor for advice or adjustments to your prescription. Information here is not tailored to any specific case and cannot be taken as individual medical advice.

Sexual arousal depends on a series of different mechanisms working in conjunction with each other in response to physical and/or psychological stimulation. Successful sexual arousal and performance relies on the participation of your brain, your nerves, your hormones, and your blood vessels. Since medications that are used to control high blood pressure have their effect primarily on blood vessels, they can easily cause sexual side effects. Here are some of the more common anti-hypertensive medications broken down by type:

1. Diuretics - These medications work to lower your blood pressure by causing the body to eliminate excess fluid. By doing so, the actual volume of blood is decreased, which leads to a decrease in your blood pressure. Studies suggest that there is a high prevalence of erectile dysfunction (ED) in men taking diuretics for blood pressure, especially in the first few years of treatment. What is interesting is that after several years, the amount of men reporting ED who weren't taking diuretics almost matched those men who were taking diuretics. This suggests that the diuretic itself is not directly causing the ED, but the lowered blood volume is uncovering another existing problem with the blood vessels needed for an erection. These medications also lower zinc levels, which leads to a decrease in testosterone production and negatively affects sexual desire and performance. An example of diuretics are the thiazides.

2. Beta Blockers - In order for an erection to occur, there has to be activation of beta-receptors in the tissues of the penis and arteries of the penis. Some beta blockers bind to many different type of beta-receptors and can often block those receptors(beta-2). That does not allow the blood vessels to relax enough to allow the penis fill up with blood for a proper erection. Propanolol, timolol, and nadolol are non-selective beta blockers and have the most potential for interfering with an erection. Beta blockers that are called 'cardio-selective' are those that only block the beta-1 receptors and do not tend to cause ED. Examples of cardio-selective beta blockers are metoprolol, acebutalol, esmolol, and atenolol. Some beta blockers also block certain alpha receptors as well, which can cause ED. Examples of these are carvedilol and labetalol. But there are some beta blockers that can actually help erectile function by increasing nitric oxide (NO) levels with their alpha-blocking properties, such as nebivolol. Interestingly, studies have shown that just having anxiety about having side effects is enough to produce the side effect. Studies also have demonstrated a placebo (sugar pill) worked just as well as Viagra to get rid of the ED associated with beta blockers.

3. ACE Inhibitors - These blood pressure medications do not tend to cause ED, and in some instances, can even improve erectile functioning. Examples of these medications include losartan, candesartan, and valsartan.

4. Calcium Channel Blockers - These medications do not seem to adversely affect erectile functioning. Men taking this type of anti-hypertensive medication had the same rate of ED as those men of similar age not taking them. Examples of calcium-channel blockers are amlodipine, nifedipine, diltiazem, and verapamil. Some people have reported a decreased libido on these medications, however.

As always, prevention is always preferred over treatment of a condition. Maintaining an appropriate weight, getting good sleep, learning how to respond rather than react to stress, practicing aerobic exercise at least 3-4 x/week, and lowering your salt and fatty food intake are all lifestyle choices that keep your body's functioning more in balance. If you can put these into practice early in life, you decrease your chances of having ED from any vascular disease, as well as decrease your chances of having to be on blood pressure medications later in life.

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Wednesday, June 2, 2010

Create Your Own Porn

Pornography is misused, misappropriated, and misunderstood. With the advent of the internet, YouTube, and other forms of streaming media readily available, there has been an exponential growth in the viewing and downloading of porn over the last 20 years. Consequently, there has also been a backlash to this increased use with fixation on labels such as "sexual addiction" used by some to accuse and others to rationalize. But despite the paranoia surrounding it, pornography can be a very useful tool for increasing sexual arousal, as well as exploring your own sexuality.

Pornography is defined simply as anything that is created with the intention of arousing sexual desire - artwork, writing, pictures, etc. We can see that pornography in and of itself is not necessarily a bad thing. But as with most things in life, it can get out of control or be unhealthy for us if we do not use it in a way that is balanced. Pornography can be very useful for individuals or couples to increase their sexual arousal and excitement. But it does take discipline. It is easily misused to get continuous sexual stimulation, but eventually can lead to boredom and the search for higher and higher levels of stimulation.

The way our minds work, we need some variety to keep us interested. This is true for sex as it is for most areas in life. Couples that have been together for some time may become discouraged if they do not have the same level of excitement with each other, unless they realize that need to work at creating that excitement through variety. Pornography can be very helpful in providing erotic material to spice things up. But just as with a favorite movie or book, if we continuously see it over and over again, we can get bored with it as well. This is why taking a step back and creating our own porn can make all the difference in the world.

Creating your own porn consists of taking images that you might have seen in a porn movie or magazine, or read about in an erotic story, and then practicing having variations on that theme in your own mind. Instead of going back and watching a movie again, for example, you may whisper to your partner what was particularly exciting for you. Or you can keep it to yourself and replay a particularly exciting idea or scenario. You can practice making up different scenes or images related to it. In this way, you work with your own brain's creativity to increase your capacity for sexual fantasy, and you have less opportunity to become desensitized, or bored, with that particular theme.

Remember that fantasies are a natural way that our mind works to create exciting thoughts for us and get us aroused. Fantasies can consist of almost anything, but are usually images related to the time of our sexual awakening and (believe it or not) our anxieties. Sometime people are embarrassed or feel guilty about having certain fantasies, but it is important to remember that it is very common to fantasize about something that we don't necessarily want to do in real life. When we create our own porn, we also give ourselves artistic license to explore what images and themes are particularly exciting to us. And because our sexuality is constantly evolving throughout our life, you may find that your images and themes may morph, or shift, or go in cycles. It's all fair game.

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