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.)

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.

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.

How Do You Initiate Sex With Your Partner?

How do you communicate to your partner that you want to have sex or are open to having sex? This may seem like an obvious question to some, but really think about it for a moment. How does your partner know when you are ready to have sex? Many times couples find that they are not sure what their partner is thinking, what they are in the mood for, and they don't really know how to ask.

This often becomes an issue after a couple has been together for awhile and their relationship is strong and healthy. As your partner becomes more and more important to you, and as you depend more on their happiness for your own, you may find yourself taking a back seat to their needs. This is to be expected, especially in situations in which you do not want to add to their stress or demands. The result for many may be that they take a "wait and see" approach to initiating sex. This means that they try to take their cues from their partners before making their desire known. But what if your partner is doing the same thing? You may never ask each other for sex, and the tension of how to communicate this grows heavier.

One exercise that a couple can do is to ask each other, "How can I tell if you are in the mood? How will you let me know?" This opens the door of communication so that you are not attempting to guess what your partner is trying to tell you. It also puts each person at ease to more freely communicate when they are thinking about or desiring sex.

Another wonderful exercise that couples can do is to ask each other "Under what circumstances do you let yourself get turned on?" At first, this may seem like an odd question because most people think that getting turned on depends on someone else doing something to you. But the reality is that our mind controls our level of sexual arousal by either being open to what's happening around us and our own erotic thoughts, or by keeping us shut off from potentially exciting events, thoughts, or stimulation.

One complaint that I have heard often is that people's expectation is that sex should happen spontaneously - the feeling just comes over you, and magically it works out, like in a romantic movie. But such expectations are unrealistic and do not take into account the reality of busy schedules and stressful lives. A good sex life takes work, planning, and a little risk taking. So if you find yourself in that uncomfortable position of playing Chip and Dale (the Disney version! - "What do you want to do? I don't know, what do you want to do? I don't know, what do you want to do?") try having a few conversations about sex. The results might surprise you!

Your Sexuality During Pregnancy

If there is ever a time that your body is going to experience a great deal of changes in a short period of time, pregnancy is it. Not only does a woman have significant physical changes in shape, size, weight, and energy level - but she undergoes a considerable fluctuation in hormone levels. This affects everything from mood, to physical well-being, to those huge nap attacks that come daily. So what happens with a woman's sexuality during her pregnancy? What should a couple expect or be concerned about during pregnancy?

There are three basic factors that determine how much sexual activity a woman can have during her pregnancy: what her doctor recommends, any incidence of blood or spotting, and most importantly, how she feels. In certain situations, a doctor may recommend bed rest or just to hold off from having sexual activity/orgasms. It is important that a couple follow their doctor's recommendations to prevent any difficulties with the pregnancy. Similarly, if there is any blood or spotting, they should also wait on having sex until she is able to get examined by her doctor.

How a woman feels is probably the biggest determining factor in a couple's sexual activity. Nausea in the first trimester makes it very difficult to feel sexy and aroused, although this varies from woman to woman. Some women are very uncomfortable and experience some vomiting, while other women never experience this and don't even know that they are pregnant until they are almost into their second trimester. Energy level also impacts a women significantly during pregnancy, especially in the third trimester when naps are almost obligatory. Her body begs her for sleep in order to conserve calories and encourage growth hormone needed by the fetus to grow.

Although it can vary considerably from woman to woman, pregnancy can be a time of heightened physical sensitivity. Not only do woman's breasts and genitals increase in size, but they become much more responsive to touch. Because of this, a couple should proceed slowly when engaging in sexual activity in order to determine the woman's comfort level and optimal amount of physical stimulation for sexual arousal. Keep in mind that some women may find direct touching of their clitoris overwhelming because of the increased sensitivity. If this is the case, spend a little time exploring the area close to, but not directly on the clitoris to see how she responds. Keep in mind how this will translate into what sexual positions you engage in and how these create contact or friction over her vulva. Other women may find that the increased sensitivity allows her to have orgasms more easily. This includes having orgasms from stimulation over other parts of her body as well, such as her breasts, back of her scalp, back of knees, inside of thighs, etc.

There is a great deal of variation from woman to woman (and even from pregnancy to pregnancy) in how a woman responds, how she feels, and what she desires. Keeping an open mind and allowing yourself to be flexible and adjust to the many changes usually brings the most happiness and makes it easier to deal with stress. You can find ways to take advantage of the heightened sensitivity during pregnancy to continue your lifelong exploration of your sexuality.

How to Give a Woman Oral Sex

Oral sex is often a topic of much interest because so many women enjoy it greatly, and so many men are curious as to how to use oral sex to please their female partner. Although there is quite a bit of variation from woman to woman as to what they like and what their preferences are, there are some guidelines that a person can follow to maximize the oral sex experience for their partner.

The best approach to learning how to give a woman oral sex is to ask her "Teach me . . ." Women often have a sense of how they like to be touched, where, with how much pressure and speed. Remember that when you are asking a woman to teach you, it's about finding out what she likes. This does not necessarily translate to another woman, so even if you have had a previous partner that likes oral sex a certain way, it is worthwhile to find out what your current partner likes.

Next, when performing oral sex, you should try your best to be relaxed. Any hesitation or anxiety may be interpreted negatively by your partner and can be a source of distraction or turn off. If a woman thinks that you are not into it, she is not going to be into it. The best is when you can let yourself go and really eat her out. Attitude and enthusiasm are important.

Remember that women's sexual arousal builds up gradually, and it can progress more slowly than a man's arousal. For that reason, it is always best to start giving a woman oral sex slowly and softly. She may be very sensitive, especially at the start, and going too hard or too fast can be overwhelming. Some women cannot tolerate direct contact with their clitoris and need to have the area pretty wet for it to be comfortable. Others will prefer that you always lick across the clitoris over the skin that covers it so that you don't have direct contact with it. Some will prefer that you incorporate licking over the U-Spot as well. By going slow you have a chance to explore the area and find out just what she likes and where. A good example to follow is thinking about how you would lick an ice-cream cone. You can start off with a wide, soft tongue and take it from there. This is also less tiring, so you can go on for a longer period of time. If she wants you lick harder or have a pointier tongue, she will let you know.

Men, do not underestimate the amount of razor stubble on your face and how this feels. If a man has not had a shave in over 8 hours, his razor stubble could approximate the grain of 120 grit sandpaper, which is pretty abrasive. Sometimes a little pressure from the chin or upper lip can feel nice, but not if you're exfoliating the top layer of musocal tissue. If you think back to the ice-cream example, it may help you remember: while eating an ice-cream cone, you wouldn't stick your chin in it. So if you have razor stubble, make sure it's only lips and tongue are contacting the area.

Once you have found the right spot, women need repeated stimulation in the same area in order to reach orgasm. Remember that orgasm alone should not be the only focus of oral sex. Heightened arousal, lubrication, and pleasurable sensations are all important whether or not she reaches orgasm. Because good oral sex means spending a little time downstairs, make sure to find yourself a comfortable position that you can maintain for at least ten minutes. Don't just lick for one minute then move on. If the position she prefers is too hard on your neck, try lifting her hips up by placing a pillow underneath them, or by having her on her side and resting your head on the inside of her thigh. Also, you do not have to tolerate being suffocated or having your head squeezed by her legs, so use your hands on the inside of her thighs to remind her if needed.

Every woman is different, so let her be your guide and don't hesitate to communicate with her for a mutually pleasurable experience. May you eat heartily and regularly!

Conceptualizing the G-Spot

What is a spot? The dictionary says that a spot is a small area different from the main area of which it is a part. Not a big deal really. But leave it to us humans to make things complicated. Whenever we are told that there is something bigger and better, we must have it, do it, own it. The G-Spot is no exception. Once we learn that there may be a G-Spot, we go hunting for it, trying to push on it, stroke it, finger it, rearrange our positions so we can hit it. We want to get enough credits to win the G-Spot Merit Badge. At least this is the way that I see a lot of people approaching sexuality. To all of you who may fall into this category, I say "Would you cut it out? It's very annoying and it takes the sensuality out of sex, and instead makes it a treasure hunt or a competition." So let's see how we can break out of this idea of the G-Spot as a discrete structure and see the G-Spot as part of a much larger picture.

Whenever I talk to patients about the G-Spot, I invite them to think of it conceptually instead of a discrete anatomical structure. I would like to describe to you how I understand it so that you can getter a better understanding as well. This requires that we think about the anatomy of the area in a 3-D way. If you would like to see a straight-forward, 2-D, cross-section diagram of the female anatomy, you can find one here (very high school biology). Let me describe how I conceptualize the G-Spot.

First to consider is that the female urethra has spongy erectile tissue surrounding it which has been known by different names from Skene's glands, to paraurethral glands, and even called the female prostate. You can get a 3-D image of this by imagining that you are holding a cup in front of you with both hands. The cup represents the urethra going from the bladder above and opening below between the labia minora. Your hands represent the erectile tissue (obviously not the exact shape or thickness), and the space between your arms represents the vagina. Imagine that the area of your thumbs is down towards the opening of the vagina. In our makeshift model, if something were to reach up between your arms and push on the area of your thumbs, it would be pressing onto the erectile tissue from inside the vagina. The erectile tissue actually fills the space between the wall of the vagina and the urethra, so although the erectile tissue is not in the vagina, you can stimulate it by pressure from inside the vagina.

Interestingly, scientists have found that this area of the vagina next to the erectile tissue has the greatest number of nerve endings of the entire vagina. There is a mix of different nerve endings, but a very large percentage of them are from the Pudendal nerve that also gets sensation from the labia, the PC muscle, the anus, and the clitoris. So when this area is stimulated, it adds to any other stimulation a woman may be receiving at the same time in any of those other areas. It is this area precisely that is also known as the G-Spot.

When a women begins to get sexually aroused, there is increased blood flow to the area which can fill up the erectile tissue. This expands the erectile tissue and can push the area of the G-Spot further into the vagina. Women have reported that when they have been aroused for awhile, this area of the G-Spot becomes more noticeable in the vagina and feels good with stimulation. If a woman is not yet aroused, the erectile tissue is not filled with blood and pressure on the area of the G-Spot can be uncomfortable, give a sensation of having to pee, or can even be painful for other women. This explains why the G-Spot tends to feels better after some time of sexual stimulation and excitation, but not necessarily before.

So I do believe the G-Spot does exist. If we can conceptualize this 3-D view of the G-Spot, it helps us understand where it is located, and also helps us better understand how it functions and responds to sexual arousal and stimulation. It is not to be seen as an independent structure by itself, but instead an area of anatomical opportunity for pleasure.

Learning to Masturbate

The nature of things is that life isn't fair, and different circumstances of life can either be a benefit or a difficulty for us. When considering masturbation, whether your family is more anxious, or more religious, or whether you have your own room or not, or even being born a girl rather than a boy, contributes to if, when, and how you may learn to masturbate.

The reality is that men tend to have nature on their side because they have much more occasion to touch their genitals than girls. When they go to the bathroom, they touch themselves. When they get an erection and have to adjust their clothing, they touch themselves. Even just finding a comfortable position to sit or lay down, they may need to touch themselves. This brings many more opportunities for a boy to discover the pleasurable sensations he can experience from rubbing or stroking himself. Oftentimes, infants or toddlers discover this early on and engage in some form of masturbation without any instruction or direction from the outside world. We know that it is a natural activity and should not be viewed in a negative way.

For adolescent boys and men, one of the difficulties related to learning about masturbating is time and location. Many times, a man does not have the privacy that he wishes to explore his fantasies or his physical sensations, and instead rushes himself to finish the job before he is discovered or interrupted. Because of this, sometimes men teach themselves to masturbate in an anxious way that can translate to anxiety around orgasm and ejaculation in later sexual relationships. When masturbating, it is beneficial for a man to have times in which he allows himself the opportunity to explore different sensations, different intensities, different speeds, and also focus on how it feels physically in addition to focusing on his fantasy material.

With women, it is a little trickier. Women do not usually touch their genitals throughout the day except when involved in personal hygiene - and that doesn't usually bring any sexy thoughts to mind. Some girls find that certain objects or ways of sitting can produce pleasant sensations, and some even explore with their hands and fingers. Regardless, these are also a natural part of growth and development and are best approached as such.

For adolescent girls and women learning to masturbate, patience and curiosity are the keys. Nothing interferes more with sexual arousal and pleasure than performance anxiety. There is so much variation in what can bring a woman pleasure - from different materials, to different positioning of fingers or toys, to different speed and intensity. In some instances, it is a matter of time. When learning how to masturbate, it is not uncommon for a woman to be touching herself for 20 minutes or more before reaching a point where she finds an orgasm. But with women, orgasm does not have to be the goal, and many women enjoy the pleasure of masturbating for long periods without reaching orgasm. The curiosity about one's own body, the sensual nature of stimulation, and the eroticism of the exploration are the most important points. You will increase your pleasure if you allow yourself to explore your fantasies as well as your entire body, because your mind and your body work together for sexual satisfaction and pleasure.

Exercising Your Concentration for a Better Sex Life

Most people have heard about the use of meditation for relaxation. We first learn to focus on our breath, which grounds us in the present and helps quiet our mind of all other thoughts for the moment. It is a wonderful practice that becomes easier to do with repetition and time. By concentrating on your breath - the way it feels to draw the breath in, the fullness of holding it for that split second, then the feeling of the exhalation and release of tension - all other thoughts are momentarily suspended and cannot affect you. This reduces anxiety and allows the brain to relax.

In sex, we often have a multitude of anxious thoughts running through our mind - "Does my partner think I'm attractive?", "Am I going to be able to get as excited as I need to?", "Is my partner going to be happy with me?" Such thoughts are the brain's attempt to control the experience and achieve success. The paradox, however, is that these attempts of controlling the experience increase our anxiety, which short-circuits our sexual arousal. For some people, this is experienced as difficulty attaining or maintaining an erection, or difficulty lubricating, or excess muscle tension not allowing for penetration. If you are able to quiet these thoughts, and instead focus your attention on the pleasurable physical sensations you are experiencing, or fantasies that excite you, then you allow yourself to continue to have heightened sexual arousal.

This is where concentrations exercises can be of benefit. By practicing exercises in concentration and focus daily, you can enhance your brain's ability to focus and quiet your anxious, racing thoughts. First, pick a time and place where you will not be disturbed for a few minutes. It should be relatively quiet or have noise that fades in the background. In front of the tv or with music on is not conducive to focusing your attention. Once you have a few minutes free, you can start off by taking a simple object, nothing too complex, and placing all of your attention on it. You can either hold it, or just watch it where it sits. Next, you will notice the color of it, and the texture. You can notice any shadows or changes in reflection. Pay attention to its shape and edges. Continue to focus on this object and breathe normally.

If you notice that your mind wants to wander to something else, just calmly bring it back to focusing on the object. At first, practice doing this for about 3 minutes at a time each day. Once you feel comfortable with that amount of time, increase it to 5 minutes at a time every day. Eventually, you can work up to 10 minutes at a time or more. By doing this, you are retraining your mind to focus and you are improving your ability to concentrate. With practice, your ability becomes stronger and it becomes easier for you to quiet your mind and focus on the present moment. With this ability, you can translate it into increased enjoyment and sexual satisfaction by placing more of your attention on what's actually happening in the moment, rather than have your brain occupied by past experiences or future worries. Not only does it heighten your sexual pleasure, but it also increases your connection with your partner, really opening the door to great sex.