Sunday, November 29, 2009

Penny for your thoughts...?


Fantasies play an extremely important role in our sex lives. They help fuel desire, get us excited, and keep things interesting for us. But many people have misconceptions as to what is a healthy fantasy life or what is considered normal.

It has been found that between 80-90% of people at one point fantasize about someone else other than their current partner. It's part of the natural way that our mind works to constantly keep us stimulated and tell us about ourselves. But many people are disturbed by their sexual fantasies and they either resist having them, or feel unnecessarily guilty for having them. With sexual fantasies, it's not so much what you fantasize about, it's how you use that fantasy that makes the difference. Do you use it positively in your sexual relationship or is it a negative factor? Do they bring more pleasure, or do they cause increased guilt and conflict? Are you using them to enhance your sex life with your partner, or are you using them to drive a wedge between you?

The first step in having a healthy and balanced fantasy life is recognizing that if you are thinking about someone other than your partner, that is ok. You may even be thinking about several different people together or at different times. What gets people confused is that they wonder "If I'm fantasizing about someone else, does that mean I don't want my partner ?" The answer is no, it doesn't necessarily mean you don't want your partner (or vice versa). It just means that you have a normal, active mind that is presenting you with lots of fantasy material to keep you excited and stimulated. But if we don't realize that this is normal and misinterpret our fantasies, then we may bring conflict, frustration, and unhappiness into our relationship.

Balance means that we decide what is appropriate and productive to share with our partners and what isn't. You don't always need to know what your partner is fantasizing about and sometimes, you may not want to know (especially if you're going to use it to fuel your insecurities or doubts). The reality is that fantasy is a necessary part of a healthy sex life. Do you think that fantasizing about the same scenario over and over again every time for your entire life is going to keep you stimulated? Do you think that when you are 80 years old you would prefer to fantasize about your partner at 80, or would you rather fantasize about the way they looked when you first met them? Which will get you off best? And if both you and your partner benefit from the arousal and excitement that your fantasies bring, isn't that positive for your sex life?

Sometimes sharing fantasies between you can be electrifying. But sometimes, we're better off not asking what we don't want to know. Good communication, stability in the relationship, and understanding of what makes up a healthy fantasy life are prerequisites for sharing fantasies with your partner. So spend your pennies wisely.



(Let me state that I am speaking about 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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Thursday, November 26, 2009

Thanksgiving Thoughts

I want to share my gratitude exercise for the day with you:

I am grateful that my mother required me to pick some sort of physical sport that required practice at least 3 times a week from elementary school until the end of high school. I am also grateful that she would not let me take French in high school, but instead made me take Spanish for Spanish speakers as well as typing. Boy, that turned out to be huge!

I am grateful that I finally started learning how to breathe. That certainly has improved my running, my swimming, but also my orgasms. It's amazing how that works.

And I am grateful that I learned to give myself pleasure early in life - 11 or 12 years old. I found that I could give myself orgasms in several different ways. And best of all, I could give myself multiple orgasms. All this happened long before I ever had a boyfriend. Not only was I able to discover what my body enjoyed and responded to, but I was able to learn without a doubt that I alone was responsible for my sexual pleasure. I am grateful I learned that no one is in control of my sexual pleasure but me and that makes all the difference for my happiness in my sex life now.

And finally, I am grateful that I became a sex therapist - not only because I love to teach and help increase other people's health and happiness, but because I see that your sex life is continuously evolving and being reinvented. I still masturbate pretty regularly today and every once in awhile, I discover something new that I can bring to my relationship with my partner or just enjoy by myself. For all these things and more, I am grateful.

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Monday, November 23, 2009

Blogging is to Sex as . . .

I've often been accused of interpreting everything in a sexual way. So I was tickled when I was reflecting on the starting of this blog, the blogging process itself and one's relationship with blogging - and immediately drew parallels to a sexual relationship. I thought I would share these thoughts with you as they are often topics of discussion with couples that come in with questions about what is normal or to be expected of one's sex life over time.

In the beginning, the idea of starting a blog is exciting and promising. It's a time for high energy, high expectations and a flood of ideas. Anything could happen! The same is true for starting off a new sexual relationship. I think this needs no explanation. Then little things happen that are irritating and threaten your idealistic view of the whole thing: no one can find it to read it, and the search function doesn't seem to work. But those are minor things, it feels good, and you believe that you can commit to it.

And each time you post, it's like having sex. Sometimes the feeling just hits you and you just want to write - no matter what you're doing. And sometimes, you can think of 24 different things you want to do and wish you could blog 3-4x a day, but of course, you can't do everything at once. And sometimes, what you thought would be a great idea turns out to be just ok, while something that you weren't really excited about in the beginning turns out to be much more than you expected. You will get the most pleasure out of it and the least amount of frustration if you just go with it.

Then there are periods when time just passes by and you really don't feel like doing anything at all. Nothing coming comes to your mind, or you're just too busy with other things. Life happens and you're too busy living it. But it's normal to have periods of more activity and periods of less activity. It's not always that we have the energy to keep up the same pace or intensity in anything. And it's important that we don't beat ourselves up about it or become insecure about the relationship just because we may not be not be at the same intensity as other times. We should establish our own comfort level with our partner and not try to compare ourselves to other stories we've heard about this one or that one.

Of course, depending how much of yourself you really put into it - how much you open up to it, will determine how much it is a reflection of your true self. Your essence comes through in the way you express yourself, your allowing intimacy in the process. This invites you to grow as a person and become a better blogger (lover). And finally, in order to keep things interesting, you have to have some variation as well as something that you know the other person will get excited about. Changing it up and trying something new to keep you and the other person smiling.

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Friday, November 20, 2009

What is sex anyway?

I like to say that we are living in The Golden Age of Rationalization. It seems that there isn't anything that we can't deny or fool ourselves about. And sex is no exception. After all former President Bill Clinton did it on national television! "I did not have sex with that woman."

Let's get something straight here. You don't want to think that you're 'not really having sex', or you want to pretend to yourself that you haven't 'really' cheated on your partner, but the truth is - there is a lot more to sex that just a penis in a vagina. (Just ask anyone having homosexual sex!) Sex starts with fantasies and desire. As soon as you start to share those fantasies and desires with another person, you are inviting them to engage in sex. Sex involves a multitude of activities that jump-starts a person's desire and arousal. And there are so many ways to reach orgasm - oral sex, masturbation, stimulation of the breasts, telephone conversations to name a few. You can even come in your sleep!

I consider that all sexual activity falls under the category of sex because I think that it's part of the erotic and intimate relationship that one shares with their partner. To have a long, healthy sex life that is satisfying through the years, a person needs to have some variation to keep it interesting and fresh, as well as some flexibility to allow for adjustment to life changes. If our sexual repertoire is very limited, it increases the chance that we will become bored or frustrated. Psychologically, the more activities we consider to fall under the realm of sex, the more we can happily share with our partners in a sexual way to enhance that sexual relationship. After a woman gives birth for example, it may be several weeks before she may be ready to have any penetration. But she can receive enjoyment from giving her husband oral sex or a hand job, or she can get stimulated on other areas of her body. Similarly, if a man has prostate surgery, he may have transient or permanent erectile difficulties, but can still find ways of giving his partner sexual satisfaction with manual or oral stimulation, or even in combination with sex toys such as a dildo or a vibrator.

But if we have a very rigid idea about what sex is, we limit ourselves and create for ourselves dissatisfaction and frustration. We would then create the reality that we could not be happy unless we had penile-vaginal intercourse just so. For your health and happiness, leave that definition to the religious texts and reproductive biologists. Instead, consider that you can have happiness and sexual pleasure with a multitude of variations of activities. Just remember, if the world ran out of pumpkins, we could still have pecan pie on Thanksgiving. (I just love nuts!)

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Knowledge is Power

To have health and balance in our lives, we have to be able to give ourselves permission to have pleasure and fun, but at the same time be aware of and take responsibility for our actions. Because of this, when we have knowledge, we are in a position of power to make the best decisions for ourselves. This is true for every aspect of life including our sex lives and decisions related to it. And I would briefly like to comment on how this relates to new recommendations announced today from the American College of Obstetrics and Gynecology for PAP smears (unfortunately timed just after the new recommendations for mammograms).

The ACOG is 'simplifying' PAP guidelines by stating that women do not need to get their first PAP until age 21 years old. Furthermore, they are recommending that now women only need to have a PAP smear every 2 years (instead of yearly) if their test results have been normal. There used to be additional recommendations related to the age that a woman becomes sexually active, but these are now being touted as 'confusing.' The new recommendations have been established after years of studies and data collection and there is validity to the points being made by the ACOG. But what I see missing here is the element of patient education and information.

We know that girls are becoming sexually active at an earlier age than a decade ago. We also have studies that show increasing incidence of Chlamydia and even Syphilis (up 36% in women in the US!). Also, a recent study from the Univ. of Waterloo in Canada found that an increasing number of seniors are contracting HIV from unprotected sex - possibly because they don't believe that they are at risk for such STDs.

Women need to know the facts about sexual activity and how it related to cervical cancer risk, as well as risk for all STDs and complications that accompany them. They need to be told (repeatedly) that the more sexual partners they have, the increased risk for developing cervical cancer. Education is the key for them to understand their risk so that they can make smart decisions both about their sexual activity and their medical care related to it. If teenage girls are starting to have sex at an earlier age (sometimes 7 years before they hit the age of 21), they need to know that they should be going to the ObGyn for a pelvic exam and a PAP smear. And girls who have received the HPV vaccine should not consider themselves 'protected' since the injection does not protect against all strains of HPV known to cause cancer. I do not think that we can teach abstinence with the hope that it will work. So instead, we need to have an over-abundance of education about risks and responsibilities that come with being sexually active. Knowing when your need for PAP is increased because of your sexual activity is one of those responsibilities and leaving it up to statistics is dicey.

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Thursday, November 19, 2009

Tough Titties!

Although I was working on a completely different post for today, I felt compelled to write about the recommendations made yesterday by the U.S. Preventive Services Task Force regarding routine mammography screening and breast exams.

Yesterday, the USPSTF changed the recommendations from yearly mammographies starting at age 40, to every other year after age 50 until age 74. This does not include women who have actually found a lump that needs to be evaluated or those women with known increased risk factors for breast cancer. They will still be sent for mammography.

The part that doesn't really make a whole lot of sense to me is that they are now discouraging clinicians from teaching women how to do self-breast exams. But in their statement, they say that women should be aware of any breast changes. How they expect women to be aware of any changes without putting their hands on their breasts is beyond me. Maybe it will be like magic? Maybe it will come to you in a dream? Maybe you will get a little postcard in the mail telling you that you now have a breast lump that you don't know about yet that you should get checked out?

But in their infinite wisdom (yes, sarcasm), they have determined that self-breast exam causes unnecessary "anxiety and breast cancer worry" and may lead to "repeated visits and unwarranted imaging and biopsies." But I applaud them for trying to keep health care costs down. They feel that saving the life of 1 out of every 1904 women is not worth the money or the trouble.

I'll tell you what, if it's my life, I would want to risk the extra radiation exposure, and extra doctor's visits, and risk of scarring from biopsy or surgery to find out. So I say, "Tough Titties!" I'm going to keep checking myself in the shower and keep encouraging other women to do so as well.

You can read the actual USPSTF statement here:
http://www.annals.org/content/151/10/716.full

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Wednesday, November 18, 2009

I've got you under my skin.

Touch is such an importance aspect of how we relate to the world and how we relate to each other. As infants, it is the first way that we experience our world and learn to make decisions about what is good and what is not good for us. And as adults, it is one of the most prominent ways that we have in communicating with our partners (if we take advantage of it). The mechanism of touch is known to be an important way of feeling calm, secure, and comfortable - a way of telling our brain that everything is ok. This happens by way of C-tactile fibers found over the surface of the arms, legs, back, and forehead. These respond to a slow, light caress - a typical soothing type of behavior. More research is being done specifically in this area to elucidate the importance of these fibers.

The types of nerve endings in our skin that we associate most with sex, however, are the classic ones of light touch, vibration, pressure, temperature, and pain. Because of the many different types of sensations we can experience, our skin can be considered our own personal playground. We have so many options in how to touch our partners to give them pleasure - from our hands, lips, tongues - or maybe from feathers, silk, wax, metal, leather, glass, you name it! This holds true for most of our skin that covers the outside of our bodies. It's a little different on the inside (i.e. vagina or anus). For those areas, we can normally only sense pressure and/or pain, which is interesting since a lot of emphasis is placed on the 'penetration' part of sex, even for women. But it is really the rest of the body that gives us more sensation. This is why masturbation (mutual or single) and oral sex can be so mindblowing!

So the question is, how much do we touch our partners to find out what ways excite them and what gives them pleasure? And of course, do we increase our intimacy by allowing ourselves to be touched? Do we follow a particular basic routine within our sex life, or do we occasionally take an excursion outside the realm of the familiar to experiment with new sensations and scenarios? You may find that ways you thought would be exciting for your partner to be touched are more irritating, and what you thought was unbearable is actually the cat's meow.

Now generally men are more focused on their genitals than the rest of their bodies in comparison to women, but that doesn't mean that their skin is not worth exploring. And gentlemen, did you know that many women can have orgasms from having other parts of their bodies stimulated (backs of knees, back of the neck, behind ears, scalp, between the shoulder blades, or thighs, to name a few). So get out there and experiment! Find a new use for an old pair of gloves or an old tie. Let your skin be your playground.

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Tuesday, November 17, 2009

Reclaiming your sexuality

It's not just about having good sex...although who would complain about that? It's about understanding yourself and your sexual nature. It's about feeling energized and vitalized by your sexuality. It's about learning how to develop your sexuality and sharing it with others. It's about the connection between physical and mental health and our sexuality. The purpose of this blog is to reach out to others to stimulate conversation about sexuality and how it is balanced into our lives. It is to be educational, stimulating, informative, and non-judgmental. That being said, please no abusive language or attacks on others. Any inappropriate or illegal content will be removed. Otherwise, we will discuss relationships, sexual health, masturbation, sexual dysfunction, fantasies, desire, or any other topic related to one's sex life.

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