Raising the Topic of Sex in Health Consultations

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published in HealthSpeak magazine,  Summer 2014, Issue 6, p24
(a publication of North Coast NSW Medicare Local for health professionals)

raising the topic of sex with your doctor

 

 

 

 

 

 

 

 

 

Doctors, do you routinely ask patients about their sexual function?
Research suggests most patients won’t tell you about their sexual problems unless you ask.

Doctors are often the first point of contact when a patient has a sexual concern. However many people do not feel comfortable talking about their sexual function unless their doctor is comfortable discussing sexual matters and invites them to speak openly.

In Australia, research indicates:

  • 56% of people are dissatisfied with their sex life
  • 22% of men over 40 in monogamous relationships report no sexual activity in the past year
  • 30% of men experience erectile dysfunction (impotence)
  • 25% of men report lack of sexual desire (libido)
  • 24% of men report ejaculating too quickly
  • 16% of men & 17% of women report performance anxiety
  • 55% of women report lack of sexual desire (versus 30% in USA)
  • 30% of women report difficulty reaching orgasm (versus 7% in Denmark)
  • 27% of women report little or no sexual pleasure

 

What this means is that many Australians are struggling with sex. Much of this is due to poor sex education, poor understanding of their bodies, and people’s unrealistic expectations of their partners.

And we are an ageing society, where:

  • 70% of women over 60 and
  • 92.7% of men over 60 are sexually active

The majority of people with concerns about their sexual function are not seeking treatment. And when they do, they are often not referred to a sexual health physician or sex therapist.

In a US study of 1,682 people conducted in 2004, 15% of respondents reported they sought treatment for problems related to sexual functioning from their personal physician, while only 7% sought treatment from a psychologist or sex therapist. Across all age brackets, men are more likely than women to report having sought treatment from their personal physician or a specialist physician for their sexual functioning-related problems.

In my own practice, I am often hearing anecdotal stories about the range of responses given by GPs to patients’ sexual concerns. To give you some examples –

  • The inexperienced 18 year old man who was so keen to make his girlfriend’s first experience perfect that he consulted his male GP about his inability to achieve an erection ‘on demand’. He was prescribed Cialis, but was not educated about how it works and when to take it. The result was a high level of distress when his penis didn’t perform.
  • The medical practice waiting room with prominently displayed signs saying ‘this practice does not prescribe contraception or give referrals for terminations’.
  • The 24 year old man who ceased having erections, even during his sleep, and was told ‘it’s all in your head, go talk to someone’ but was not given a referral.
  • The 50 year old man who tentatively raised the subject of his low libido with his young female GP and was hurriedly prescribed Viagra without any further discussion or a medical history being taken.

And on a more positive note-

  • The young female GP who openly enquires about her patient’s sex lives while performing routine pap smears, giving them permission to speak freely.

One obvious reason why GPs don’t invite discussion of a patient’s sexual function is the time limitation of a standard consultation. Many GPs feel they’ll be opening ‘a can of worms’ that will lead to a time blowout they can’t afford in an already busy day. Many also report inadequate training when it comes to sexual functioning since the majority of medical degrees devote very little time to the understanding of sexual function.

GPs cannot afford to ignore or dismiss sexual concerns. Evidence shows that sexual dysfunction is often an early indicator of many serious health conditions, cardiovascular disease being the most common.

If you have patients with any of these conditions, they probably also have sexual issues they need help with:

  • Anxiety / depression
  • Diabetes
  • Cardiovascular disease
  • Chronic  pain
  • Spinal injuries
  • Prostate or gynaecological problems
  • Recent childbirth
  • Menopause

Likewise, patients taking a variety of medications suffer sexual side effects. The most common of these are SSRI anti-depressants, anti-anxiety and anti-psychotic medications. New research also indicates that sudden cessation of SSRI medications can permanently remove sexual desire and the ability to orgasm.            

To find a sex therapist to refer to in your area, go to The Society of Australian Sexologists (http://assertnational.org.au/) for more information. Sex therapists have extensive sexual health training and come from a variety of fields, including doctors, nurses, psychologists and counsellors.

 

Alison Rahn        
M.Hlth.Sc(Sexual Health)

 

Bio
Alison Rahn is a sex therapist based in Mullumbimby. She has a Master of Health Science (Sexual Health) and is a member of SAS (Society of Australian Sexologists). Alison is the only sex therapist practising between Coffs Harbour and the Gold Coast. For more information, contact Alison on 0432 599 812 or go to www.alisonrahn.com.au

 

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References

AARP (2004) Sexuality at Midlife and Beyond: 2004 Update of Attitudes and Behaviors. http://assets.aarp.org/rgcenter/general/2004_sexuality.pdf

Gott M, Hinchcliff S & Galena E (2004) General practitioner attitudes to discussing sexual health issues with older people. Social Science & Medicine, 58, pp 2093–2103

Laumann  E et al (2005) Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. International Journal of Impotence Research 17, 39–57

Richters J & Rissel C (2005) Doing It Down Under: The Sexual Lives of Australians. Allen & Unwin, Crows Nest

SmithA, Rissel C, Richters J, Grulich A & de Visser R (2003) Sex in Australia_ Australian Study of Health and Relationships. Australian and New Zealand Journal of Public Health, 27, 2

Sex After Menopause

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Romantic CoupleMenopause doesn’t have to spell disaster for your intimate sex life. In actual fact it can open doors to deeper and more intimate relating. It all depends on your attitudes, beliefs and behaviours.

When Do Women Stop Having Sex?

When they no longer have a partner! This is the number one reason why women stop being sexual.

In Australia we’ve been fed a myth that a woman is no longer sexy or sexual after menopause. Some believe it is ‘unseemly’ for an older woman to be having sex, as if she has a ‘use by’ date! This is simply not true.

For many women, SEX GETS BETTER WITH AGE!

According to research, the MAJORITY of women report being sexually satisfied in their relationships after menopause, even if they experience physical changes. And many choose to remain sexually active into their 70’s and 80’s.

There was an old European couple interviewed a few years ago. She was 116 and he was 120, and they’d been married 100 years (really!). She commented that ‘the first 50 years of the relationship was the hardest’ and the ‘sex just got better in her 80’s’!

Is it TRUE? Do women go off sex after menopause?

  • One third DO
  • One third DON’T, and
  • One third experience INCREASED interest in sex!

Why?

It turns out, whether or not a woman remains sexually active has nothing to do with menopause and everything to do with whether she feels attractive! Self-criticism and feeling ‘frumpy’ or overweight is what turns women off sex.

And for women who’ve always feared pregnancy, menopause gives them the freedom to enjoy sex, often for the first time.

Other women remain completely unfazed by menopause. They felt good about themselves before and they still feel good about themselves. They feel sexy and desirable no matter what they look like, because they choose to.

Physical Changes After Menopause

There are definitely some physical changes that take place during and after menopause, but this is only a problem if you or your partner make it a problem! The main changes are:

  • Delayed arousal and vaginal lubrication
  • Thinning of vaginal walls
  • Loss of vaginal elasticity

All of these changes can work to your advantage. The trick is to adapt your sexual style. The general rule of thumb is slow down, take your time. Many women experience an increase in pleasurable sensations resulting from thinner vaginal walls, especially if sex is slow and gentle.

Sexual Problems in Older Women

A minority of Australian women report some problems after menopause:

  • Lack of sexual interest (32%)
  • Lubrication difficulties (27%)
  • Inability to orgasm (25%)
  • Sex not pleasurable (21%)
  • Pain during sexual intercourse (14%)
  • Orgasm too quickly (10%)

If you’re experiencing any of these problems, seek help now and nip it in the bud! Contact me now at www.alisonrahn.com.au or phone 0432 599 812                                     

In a recent survey of 13,882 women aged 40–80 years, it revealed that a woman’s age has little to do with her sexual function or her enjoyment of sex.

More important ingredients are:

  • How well a couple communicates
  • Having low expectations about the future of the relationship
  • Financial stress
  • Infrequent sex

What Can I Do to Enjoy Menopause?

Menopause is a transition, a rite of passage, from one stage of life to another. Every woman’s menopause experience is unique. Some transition quickly, some take years. Some experience discomfort, others do not.

Many of the ‘symptoms’ of menopause are the same as the symptoms for stress and/or malnutrition. Make your transition smoother by:

  • Eating a nutritious diet
  • Seeking dietary and lifestyle support from a naturopath or Chinese medicine practitioner
  • Regularly relax and have fun
  • Make changes to eliminate stress from your life
  • Maintain regular sexual activity (use it or lose it)
  • Educate your partner about your changing sexual needs

This is the time to establish good communication with your partner if you haven’t already! If you need help, contact me at www.alisonrahn.com.au or phone 0432 599 812


What Can I Look Forward to after Menopause?

Freedom!

  • Freedom from the emotional roller coaster and sexual urges from fluctuating hormones
  • Freedom from the fear of pregnancy
  • A more mature, no-nonsense sense of self, AND
  • A juicy, sexual old age, if I choose it!

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References

Koch PB et al (2005) “Feeling Frumpy”: The Relationships between Body Image and Sexual Response Changes in Midlife Women. The Journal of Sex Research, 42

Laumann EO et al (2005) Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors.International Journal of Impotence Research,17

Laumann EO et al (2006) A Cross-National Study of Subjective Sexual Well-Being Among Older Women and Men: Findings From the Global Study of Sexual Attitudes and Behaviors. Archives of Sexual Behavior, 35

Mansfield PK & Bracken S (2003) The Tremin Program: Sixty-Eight Years of Research on Menstruation and Women’s Health. Women’s Studies Quarterly, 31

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Alison Rahn © Copyright 2013 www.alisonrahn.com.au

Are Anti-depressants Affecting Your Sex Life?

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Are you experiencing sexual problems since taking anti-depressant medication? If so, you’re not alone.

The most commonly prescribed anti-depressants are SSRIs (selective serotonin re-uptake inhibitors). More than 50% of people on SSRI medication experience sexual side effects.

Sexual Side Effects
SSRIs work by changing brain chemistry, in particular by raising serotonin levels in the brain to improve mood. Because serotonin is also a key player when it comes to being sexual, this can lead to a variety of sexual side effects, including:

  • reduced or absent sexual  desire ( low libido)
  • lack of arousal (poor erections, lack of lubrication) and
  • difficulty and or inability to reach orgasm

Most people regain their sexual function after changing or stopping medication however a growing number of people are reporting ongoing sexual problems years after ceasing medication, particularly if medication is ceased abruptly.

New research is currently being undertaken in Australia to find out how many people are experiencing sexual side effects from SSRI medications.

I interviewed Cathy O’Mullan, Lecturer in Health Promotion at University of Central Queensland to talk about this. Click on the link below to hear this interview:

Alison Rahn interviews Cathy O’Mullan about the sexual side effects of SSRI anti-depressants

Commonly prescribed SSRI anti-depressants by brand name:

  • Celexa
  • Aropax
  • Lexapro
  • Prozac, Prozac Weekly, Sarafem
  • Paxil, Paxil CR, Pexeva
  • Zoloft
  • Symbyax

If you believe your anti-depressant medication is having a negative impact on your sex life please see your doctor. And if you want to improve your mood naturally, try changing your diet. Click on this link to read about the relationship between diet and depression: SMH, January 15, 2010 – Unhealthy Diet Could Fuel Depression in Women

Getting the Sex You Want

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To get the satisfying sex life you've always wanted, all you have to do is ask, writes SUNI GOLIGHTLYTo get the satisfying sex life you've always wanted, all you have to do is ask, writes SUNI GOLIGHTLY

To get the satisfying sex life you’ve always wanted, all you have to do is ask, writes SUNI GOLIGHTLY

IF you feel you don’t have the sex life you want, you are not alone. A study by La Trobe University in Melbourne found that 27% of Australian women do not find sex enjoyable.

And it’s not just women who have complaints. Similar studies have found a high percentage of men are also unsatisfied with their sex lives.

Sexual dissatisfaction affects people of all ages and sexual orientations, and can lead to self-esteem problems, social insecurity, and relationship breakdowns.

Alison Rahn is a highly qualified sex therapist and sex educator in Mullumbimby, who works with individuals and couples to resolve sexual problems and improve sexual satisfaction.

“I see people for a wide variety of reasons, from those who desire to create more intimacy and improve partner communication to questions of sexual identity, teenage negotiation skills, and mature-age dating,” Alison says.

Alison has found that a lack of communication is at the root of many sexual problems.

“A common theme is that many people feel rejected or unloved by their partners, often as result of little or no communication.

“Often one partner experiences a challenge, keeps it to themselves and opts to avoid sexual intimacy, leaving the other partner feeling rejected without knowing why.

“Another common theme is that people feel there is ‘something wrong’ with them when compared to others.”

Timing and frequency of sex are also issues that many couples, both heterosexual and homosexual, face.

“It’s quite common for one partner to have a stronger desire for sex than the other, which can leave one feeling pressured and the other feeling rejected,” Alison says.

“In some couples, sex is used as a tool to manipulate or control the other.

“Both men and women often treat sex as a performance that they either pass or fail.”

We often associate sexual confidence issues with older men and women, but this isn’t always the case. There are so many sexual images available to young people, many of them completely unrealistic. These images, combined with online social media, where sexual bragging (much of which, if not fictional, is certainly exaggerated) are helping to create great insecurity in the younger generation.

“Many younger women have difficulty reaching orgasm and are not able to express what they need, sometimes resulting in both partners feeling like failures.

“And many men find sex stressful and have difficulty maintaining erections or not ejaculating too soon. Young people are struggling with who and what to say ‘yes’ to.”

Getting the sex you want

Sex is supposed to be fun, right? We’re supposed to enjoy it, and feel good about ourselves afterwards, aren’t we? So how do we get past all the insecurities and miscommunications and seemingly endless parade of issues, and start having some fun?

Alison says there are common behaviours in people who have sexually satisfying lives and relationships. And the good news is, you don’t have to start chanting or sacrifice small animals to a Roman god. All you have to do is lighten up.

“These people (who are sexually satisfied) don’t take things too seriously,” Alison says.

“Being light-hearted and playful means you’re both more likely to want to do it again.”

“There’s no such thing as ‘getting it right’. Experimenting and playing with each other is key.”

“If something doesn’t work, it’s no big deal, try something else.”

“Sexually satisfied people are also good communicators. They’re able to ask for what they need and want.”

Pretty easy, right?

Okay so it may be easier said than, well, said, but it’s a practice you can build on. And the best part is it gets better and easier with age.

“Sexual satisfaction increases with age,” Alison says. “Numerous studies provide evidence of this. Having some life experience and becoming more relaxed about your body and appearance leads to more relaxed, enjoyable sexual experiences.”

Alison says in heterosexual relationships, recognising the differences between men and women will help you get the sex life you want.

“Men and women both change over time. Men’s and women’s brains are wired differently.

“Once sexual desire kicks in most men are not easily distracted, whereas women are very easily distracted and generally need much more time to bring their attention inward and get in touch with their bodies to get in the mood. This changes with age. Men learn to slow down and be more emotionally connected and women become quicker to arouse.”

Depending on your age and upbringing, you may have been raised with the idea that sex, and seeking sexual satisfaction is somehow dirty or at the very least unimportant. This couldn’t be further from the truth.

Numerous studies from around the world, involving people of all ages and walks of life have proven that a healthy sexuality is an important part of life.

“Sexual activity is an essential part of a healthy life,” Alison says.

“This doesn’t require a partner. Just allowing yourself to have sexual feelings releases a variety of chemicals into the bloodstream that are good for your health. Numerous scientific studies show that sexual activity reduces stress, increases lifespan, reduces pain, cancer, and cardiovascular disease.

“When you look at it this way, being sexual with yourself or with a partner becomes a gift you give each other to stay vibrant and healthy.”

For more on Alison’s work go to alisonrahn.com.au

Sights and Sounds that Turn Us On

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Sensuality part 3:
Sights & Sounds that Turn Us On
an interview with Alison Rahn on Audio Chocolate, BayFM radio



Click on the link above to listen to Alison talking about the the role sight and sound play in turning you on (part 3 of a 3 part series discussing Sensuality on BayFM 99.9 Radio, Thursdays at 2.30pm Australian Eastern Standard Time).

Part 1: 18 Aug: The Importance of TOUCH
Part 2: 1 Sept:  TASTE & SMELL: How Taste & Smell Influence Sex Appeal
Part 3: 15 Sept: SIGHT and SOUND: Visual and auditory cues that turn us on

How Taste & Smell Influence Sex Appeal

By | Couples, Female Sexuality, Male Sexuality | No Comments

Sensuality part 2:
How Taste & Smell Influence Sex Appeal
an interview with Alison Rahn on Audio Chocolate, BayFM radio

Click on the link above to listen to Alison talking about the the role smell and taste play in your sex appeal and choosing a mate (and the importance of liking your partner’s smell and taste) as part of a 3 part series discussing Sensuality on BayFM 99.9, Thursdays at 2.30pm Australian Eastern Standard Time.

Part 1: 18 Aug: The Importance of TOUCH
Part 2: 1 Sept:  TASTE & SMELL: How Taste & Smell Influence Sex Appeal
Part 3: 15 Sept: SIGHT and SOUND: Visual and auditory cues that turn us on

Does Penis Size Matter?

By | Male Sexuality | No Comments

I regularly receive enquiries from men who are concerned about the size of their penis. Generally, these men believe their penis is too small and are worried about their ability to pleasure (and keep) a partner.

In the media, a man’s penis size is equated with his power and masculinity.  Unfortunately, the mass media marketed to men (in the form of pornography and popular magazines) promotes unnaturally super-sized penises. The message being promoted is that having a large penis = being a ‘real man’ and being more desirable.  This type of marketing lowers men’s self esteem and creates a growing industry feeding off men’s fears and insecurities, touting a variety of gadgets, pills, and surgery to ‘enlarge your penis’.

If men continue to equate penis size with masculinity, they will continue to feel unnecessary sexual anxiety. The irony of this vicious circle as that, over time, this anxiety may lead to difficulty achieving erections (thus creating more anxiety).

It is a man’s perception of his penis size, relative to other men’s, that causes problems, NOT his actual penis size.

Views about penis size were assessed in an Internet survey of 52,031 heterosexual men and women. Most men (66%) rated their penis as average, 22% as large, and 12% as small.

Whereas 85% of women were satisfied with their partner’s penis size, only 55% of men were satisfied with their penis size, 45% wanted to be larger, and 0.2% wanted to be smaller.

Interestingly, researchers have found that men tend to report their penis is larger than it actually is. When measured under laboratory conditions, penis size (both flaccid and erect) was found to be smaller than reported.

Penis size varies a lot, both in thickness and length. An average sized penis is approximately 8.9 centimetres (3.5 inches) long when flaccid and 13.5 centimetres (5.3 inches) long when erect.  However, most men fall in the following range:

The typical length of an adult flaccid penis       = 7.6 cm to 13.0 cm (3 – 5 inches) in length
The typical girth of an adult flaccid penis         = 8.5 cm to 10.5 cm (3.3 – 4 inches) in circumference

The typical length of an adult erect penis         = 12.7 cm to 17.7 cm (5 – 7 inches) in length
The typical girth of an adult erect penis           = 11.3 cm and 13.0 cm (4.5 – 5 inches) in circumference

When measuring erect penis length, studies show men fall into the following ranges:

Centimetres Inches Percentage of men
under 9.4 cm under 3.7 inches 2.5%
9.7 cm to 11.4 cm 3.8 to 4.5 inches 13.5%
11.7 cm to 15.2 cm 4.6 to 6.0 inches 68%
15.5 cm and 17.3 cm 6.1 to 6.8 inches 13.5%
Over 17.5 cm over 6.9 inches 2.5%

Women are must less interested in penis size than men. If there is an interest, they are generally more interested in a man’s girth (thickness) than his length, particularly if they have not adequately exercised their pelvic muscles to restore muscle tone after childbirth.

Fortunately nature has designed us all perfectly. The genital variety in men perfectly matches the genital variety in women. For every man or woman there are plenty of partners who are a perfect fit.

So my suggestion to men who are concerned about their penis size is to stop worrying how big it looks and start focussing on how you use it (and every other part of your body).  Most women are more interested in having a skilful lover, not a big dick

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References

Lever J, Frederick DA & Peplau LA (2006) Does size matter? Men’s and women’s views on penis size across the lifespan. Psychology of Men & Masculinity, Vol 7(3), 129-143.

Sengezer M, Ozturk S & Deveci M (2002) Accurate method for determining functional penile length in Turkish young men. Annals of Plastic Surgery, 48, 381–385.

Vardi Y, Harshai Y, Gil T & Gruenwald I (2008) A Critical Analysis of Penile Enhancement Procedures for Patients with Normal Penile Size: Surgical Techniques, Success, and Complications, European Urology, 54, 1042–1050.

Wessells H, Lue TF, & McAninch JW (1996) Penile length in the flaccid and erect states: Guidelines for penile augmentation. Journal of Urology, 156, 995–997.

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Alison Rahn © Copyright 2011 www.alisonrahn.com.au

 

Sensual Touch Transforms Our Lives

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Sensuality part 1: The Importance of Touch
an interview with Alison Rahn on
Audio Chocolate, BayFM radio

Click on the link above to listen to Alison talking about the benefits of touch to our health and wellbeing as part of a 3 part series discussing Sensuality on BayFM 99.9, Thursdays at 2.30pm Aust EST.

Part 1: 18 Aug: The importance of TOUCH
Part 2: 1 Sept: Choosing a mate by SMELL & TASTE
Part 3: 15 Sept: SIGHT and SOUND

How often do you lovingly touch your partner, children, friends or family?

Have you ever wondered why people who don’t want to be touched seem unhappy or stressed?

Or why some cultures, no matter how poor, seem incredibly happy?

Our happiness is connected to the quality of touch in our lives.

Touch is the first of our five senses to develop. In fact, it develops when we are still in the womb. Scientists say the earlier a function develops, the more fundamental it is to life.

Touch is the most important of our five senses. It is the only sense we cannot survive without.

Human beings are incredibly adaptable. We can survive blindness, deafness, and the absence of taste or smell. But we cannot survive without touch. Touch is how we communicate with the world. Without it, we would severely burn or injure ourselves, without even knowing.

Touch is our first form of communication.

When we are born we have to rapidly adapt to bright light and deafening noise, and breathe air for the first time. It’s an overwhelming experience. However touch calms us. Our mother’s first touch communicates we are safe. It is our anchor in this strange new world. So the first role touch plays in our lives is to reduce stress.

Relaxed, caring touch always reduces stress. No matter how old we are.

Hugs, kisses, holding hands, close body contact, stroking of skin or hair ….. these all reduce our stress levels and bring us back into our body.

Sex is the highest form of touch we experience as adults because it’s where we have the most skin on skin contact.

When the touch we receive communicates we are cared for, the ‘feel good’ hormone, oxytocin, is released into our bloodstream. Oxytocin is responsible for feelings of wellbeing, emotional bonding, orgasm, and birth contractions.

The presence of oxytocin reduces the stress hormone, cortisol.

Whenever we feel any form of pleasure, oxytocin levels rise and our stress levels decrease.

When an infant is breastfed, the breast stimulation releases oxytocin into the mother’s bloodstream. Both mother and child get a dose, and both feel more bonded as a result.

Likewise, for the baby, the skin on skin contact with the mother stimulates the baby’s suckling response and normalises baby’s breathing (from shallow to deeper breathing).

Simultaneously, the oxytocin released into the mother’s bloodstream stimulates contractions, helps expel the placenta, reduce bleeding, and begin the process of reducing her uterus to it’s normal size. This release of oxytocin also initiates the secretion of breast milk.

You can see how mother and child are designed to nourish and support each other. In fact all human relationships involving loving touch provide this support. We are designed to touch and be touched. This keeps us healthy and reduces stress and disease.

Oxytocin triggers the contractions we experience during orgasm (and childbirth). So the more loving touch we receive during everyday life, as well as during foreplay, the stronger our orgasms.

During orgasm, the brain and body are flooded with feel-good chemicals (including oxytocin) which then increase our receptivity to more pleasure (and more orgasms) and make us feel more bonded with our partner.

The skin is the largest organ in our body. Skin cells evolve from the same embryonic cells as the central nervous system. You could say the skin is the exposed part of the nervous system. The skin and the nervous system have a shared purpose, to inform us about the world around us.

Cells in the outer layers of the skin replace themselves every 4 hours. Receptors in the skin register touch, heat, cold, moisture, pressure, pain and pleasure. Our skin sensitivity depends on the stimulation we receive, ie ‘use it or lose it’. Less stimulation requires less receptors.

There are approximately 5 million sensory receptors in the skin of an adult male, all crying out to be touched.

For all of us, the number of touch receptors in the skin reduces with age. At 3 years old we have approximately 80 touch receptors per square millimetre of skin. This reduces to 20 per mm2 as a young adult and 4 per mm2 in old age.

This says 2 things:

  • our need for touch is highest in the first few years of life
  • the less touch we receive, the less touch we are able to receive (because the body doesn’t waste energy continuing to create cells which are never used).

The opposite is also true. The more we expose our bodies to pleasure, the more pleasure pathways are created in the brain and nervous system.

Ever noticed your skin feels tingly during sex?

There is a relationship between touch and breathing. During sexual activity, deeper breathing washes carbon dioxide (CO2) out of the blood. This changes the ionic balance of body fluids, creating increased nerve excitability, felt as a tingling of the skin. So active breathing increases the pleasure we receive from touch.

Women are generally more responsive to touch than men and are much more dependant on touch for erotic arousal. Men are more visual.

It is well documented that relaxed people enjoy more frequent and enjoyable sexual activity.

Relaxation opens us up to receive pleasure. Pleasure stimulates the release of oxytocin.

Warm, physical contact (with feelings of intimacy and belonging) leads to:

•Higher oxytocin levels in men and women

•Lower blood cortisol in men and women

•Lower blood pressure in women

Men and women reporting greater partner support show higher oxytocin levels.

Higher oxytocin levels reduce stress, heart disease, and breast cancer risk.

So start lovingly touching your partner (without expectations) to improve your relationship and your health. Touch in a way that communicates you care.

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References

Grewen KM et al (2005) Effects of Partner Support on Resting Oxytocin, Cortisol, Norepinephrine, and Blood Pressure Before and After Warm Partner Contact. Psychosomatic Medicine, 67

Insel TR et al (1998) Oxytocin, vasopressin, and the neuroendocrine basis of pair bond formation. Advances in Experimental Medicine and Biology, 449

Kiecolt-Glaser J & Newton T (2001) Marriage and health: his and hers. Psychology Bulletin, 127

Light KC, Grewen KM, Amico JA (2005) More frequent partner hugs and higher oxytocin levels are linked to lower blood pressure and heart rate in pre-menopausal women. Biological Psychology, 69

Montagu A (1986) Touching: The Human Significance of the Skin (3rd ed.). New York, Harper & Row

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Alison Rahn © Copyright 2011 www.alisonrahn.com.au

Sex after Endometriosis

By | Female Sexuality, Sex Therapy | 2 Comments

by a reader

Short Bio
Dealing with endometriosis has been one of my greatest challenges. I’ve had 3 surgeries, the last being a hysterectomy with ovaries still intact. My doctor removed my uterus and cervix. The road to recovery has been long and painful, but I am happy now and feel the need to share my experience.

Endometriosis caused debilitating pain and it impacted my quality of life in many areas, but I want to focus on how it impacted me sexually as this is not often talked about.

I’m now 35 and was first diagnosed at age 26. With endometriosis, the pain during sex was unbearable. I literally couldn’t have sex prior to my second surgery because the endometriosis had grown over my organs. Sex was not pleasurable. Instead I felt sharp, very intense pain with any insertion or thrusting. I would cry because I felt like I was being kicked in the stomach. I am an athlete and this was pain beyond anything I’d ever felt in my life.

I wasn’t having orgasms, my vaginal muscles were so tight and clenched from years of endometriosis, and the stagnant blood in my pelvic organs caused overall malaise and stomach pain.

Road to Recovery
After my second surgery I found a pelvic physical therapist (also known as a continence physiotherapist). She would use a glove, insert her fingers into my vagina, and massage the tight areas of my PC muscle (pubococcygeus) and pelvic floor. I also did biofeedback, practicing kegels (pelvic floor exercises), so I could see on the monitor how much I was able to contract and relax. This helped my brain and body re-synchronise.

Everything felt backwards, I could see on the monitor that I needed to relax more, but my PC muscle already felt relaxed to me. I had to make an effort to “push” down again and then my muscles were fully relaxed. I would practice everyday, lying in bed, and do these exercises.

Every moment, doing dishes, running errands, I would try to breathe and “push” down, knowing from biofeedback that this was actually the sensation I get with a relaxed pelvic floor. This took a lot of time and conscious awareness on my part.

I also used a dilator (given to me by pelvic physical therapist) which I inserted at home to help stretch my vaginal and pelvic floor muscles. I gave myself belly and vaginal massages with oil and aromatherapy.

I started using a vibrator, but I wasn’t having orgasms. My fingers were not enough, I barely felt anything, maybe because my nerves were so used to feelings of pain, I couldn’t feel the subtler sensations. I was so frustrated and angry, nothing was happening!

I would spend 45 minutes or longer using the vibrator at a high speed with pressure (not a good idea). I was forcing things and this didn’t help. I decided to back off using the vibrator, just using it on a slow speed and for a shorter time even though I didn’t orgasm.

Emotional Aspects
Looking back, I was being very hard on myself. I was dealing with many emotions: anger, feelings of not being enough, less than a “woman”, shame that I couldn’t be with my boyfriend, not to mention his frustration that he wasn’t able to “please me”, pressure to “perform”. I was so frustrated at the state my body was in.

Not only were clitoral orgasms difficult for me, but deriving pleasure from my g-spot was also stunted. One of the side effects of my endometriosis was having to empty my bladder constantly, feeling urgency and frequency. I was exhausted physically and stimulating my g-spot made the urge to urinate worse.

Additionally, the pain of endometriosis was depressing for me and this also affected my sex-drive. It was a vicious cycle on all levels. I had to really practice self love and acceptance. I decided to back off and let my body go at it’s own pace.

I was still having painful, heavy menstruation and some residual pain following the second surgery. After careful deliberation and various treatments (medically and naturally) I decided to have a hysterectomy. I was really worried that the hysterectomy would negatively affect my orgasms permanently.

After the hysterectomy, I continued my rehabilitation, went to pelvic physical therapy a few more times and finally my muscles normalized.

I made “date nights” with myself. I’d light candles, play music, use a body pillow to elevate my pelvis, and continued with the Kegels and belly rubs. I would use a hot water compress vaginally while I used oil and fingers to self-pleasure. The heat helped me relax further and increased blood flow…I began having orgasms again, but it only happened with a vibrator.

Eventually, I used a combination of vibrator and fingers, I’d self-pleasure with fingers and once I was close to climax, used the vibrator to have an orgasm. I continued to do this regularly (practice, practice, practice) and orgasms were gradually coming easier and becoming more intense.

Once I was having orgasms this way, I stopped using the vibrator and only used my fingers. I did this for about 3 months. I didn’t want to be soley dependent on the vibrator for orgasms. I still wasn’t able to orgasm with just my fingers and then I had a breakthrough.

Now, I orgasm regularly with just fingers and have strong contractions during my orgasms. My PC muscles are once again healthy and strong. I am now a year post-op and feel great. I still have to adjust my body during certain positions, most likely due to adhesions, but this is manageable. My sexuality has opened and expanded like never before. I’ve since experienced female ejaculation and am having orgasms easily through intercourse.

The issue of endometriosis and its impact on sexuality is significant. I think many women are not comfortable talking to their doctors about this. I would look at the message boards for sex/endometriosis and found limited sharing on the topic. Often, the posts were prefaced, with I hope this isn’t “too personal” or offensive, etc. I felt very alone in this one aspect of my health.

The road to my sexual recovery was long, but with patience, self-love and persistence I got on the other side. Sexuality is such a gift! It is a beautiful, pleasurable aspect of life. It’s also necessary for overall health and well being. I’m so grateful to feel connected to my body again!

___________________________________________________________

Alison’s comment:

Thankyou K for your story of such courage, determination, and self-love. I was so inspired by Kelly’s letter to me that I asked her permission to share it, in the hope that it would inspire other women who may have given up.

Just a few points in Kelly’s story need to be clarified in case you’re on a similar journey. Kelly described learning to ‘push down’ in order to relax her pelvic floor. This was true for her but may not be what you need. Please consult a physiotherapist (physical therapist) to become familiar with what your body needs.

And notice how important it was for Kelly to learn to love herself, accept her emotions,  and allow her body to respond at it’s own pace rather than forcing something to happen. Sensitivity does not come with force.

Female Orgasm & the Pelvic Floor

By | Female Sexuality | 2 Comments

Orgasm

Orgasms come in all shapes and sizes and are good for your health. Regular sexual activity and orgasm reduces cancer, heart disease, depression & anxiety.

The Pelvis & Pelvic Floor

Pelvis =         ‘bowl’ or container made of bone, wider in women than men

Pelvic floor =         woven platform of muscles, ligaments & sphincters at the base of the pelvis that supports internal organs (bladder, vagina, uterus, bowel), attached to the pubic bone, coccyx & sit bones (buttocks), slung between them like a hammock, trampoline mat, or webbing.

Arnold Kegel’s Figure 2

The Three Lower Diaphragms of the Pelvic Floor.  The most superficial muscles are shown in green, the muscles of the urogenital diaphragm are in yellow, and the puboccygeus is colored red.

Source: Kegel, AH (1952) Stress Incontinence and Genital Relaxation.  CIBA Clinical Symposia, Vol. 4, No. 2, pp 35-52. (Image source: http://www.incontinet.com)

Functions of the pelvic floor

Like a trampoline, the pelvic floor is meant to be springy, not slack. Its role is to:

  • Lift & support internal organs, especially when under load (when exercising, lifting, coughing, sneezing)
  • Prevents urinary & bowel leakage & controls emptying
  • Protects the spine, by triggering abdominal muscles
  • Provides resistance to the vagina. The vagina is designed to respond to pressure, not friction. Resistance from the pelvic floor increases sexual sensation & heightens orgasm.
  • Works in tandem with the diaphragm to pump air & provide vocal power (eg opera singers)
  • In men, the pelvic floor helps maintain erections (as effectively as Viagra)

What Can Damage the Pelvic Floor?

  • Repeated heavy lifting
  • Poor posture
  • Chronic (long-term) coughing (eg asthma)
  • Inappropriate exercise
  • Straining during bowel movements
  • Poor birthing positions (eg lying on back, forceps or vacuum delivery)
  • Surgery (eg caesarean, episiotomy) or muscle tearing
  • Being overweight

Changes As We Age

As we age, oestrogen declines, less collagen is produced, and muscles become less supple. Greater care of our pelvic floor is required, especially post menopause.

Pelvic Floor Dysfunctions

Pelvic floor muscles can become non responsive if too:

Weak:   resulting in incontinence, organ prolapse, loss of vaginal sensation, weak (or no) orgasms, or

Tight:    resulting in constipation, urinary urgency, or pain during intercourse. Muscle tightness is usually due to stress. Relaxation is key.

Women with pelvic floor dysfunction often feel ashamed and are at risk of depression.

What’s Good for the Pelvic Floor?

1. Good posture

Don’t suck in your belly! This increases downward pressure on the pelvic floor.

When sitting, rotate your pelvis so that sit bones take your weight, sit up tall.

2. Diet

Vitamin C helps maintain collagen & prevent pelvic floor deterioration. Cranberry juice helps prevent urinary tract infections. Vitamin E in your diet reduces vaginal dryness. Phyto-oestrogens (in soy products, legumes etc), Omega 3 fatty acids (found in oily fish & nuts), pro-biotics (plain yoghurt), zinc, & selenium are also good for vaginal and reproductive health.

3. Maintain a healthy body weight

A healthy Body Mass Index (BMI) is between 18.5 and 25. (BMI is calculated by dividing your weight (kgs) by the square of your height (in metres), and is a general guide to help you know if you’re within your healthy weight range).

4. Correct exercise

Avoid over-training. Stop when tired. Avoid exercises that increase downward pressure on the pelvic floor (eg sit-ups, abdominal ‘crunches’). Squeeze PC muscle before lifting.

5. Pelvic Floor Exercises

Pelvic floor muscles should be trained every day, both passively (good posture) & actively (refer to Mary O‘Dwyer‘s book ‘Hold It Sister‘). It is essential you train the right muscles.  A variety of exercise ‘tools’ have been developed to help women locate and exercise these muscles .

6. Bladder Training

Learn to hold at least one cup (250mls) of fluid before urinating. This will also reduce the likelihood of urinary tract infections

7. Being Conscious

Consciously activate your PC muscle before coughing, sneezing, or lifting. If your pelvic floor pushes down when lifting, your load is too heavy.

8. Orgasm: a WIN-WIN situation

Orgasm involves the rhythmic expansion and contraction of the vagina, uterus, urethra, rectum, as well as pelvic floor muscles (the equivalent of an exercise workout). Pelvic floor exercises intensify your orgasms & your orgasms strengthen your pelvic floor.

A WIN-WIN!

9. Vibration

Vibration helps switch on inactive muscles & relax tense muscles. So a motor bike or a vibrator is a girl’s best friend! And you might be lucky and have an orgasm at the same time. (Alison of course sells vibrators too…but not motor bikes!)

Orgasm and the Pelvic Floor
Orgasm
Orgasms come in all shapes and sizes and are good for your health. Regular sexual activity and orgasm reduces cancer, heart disease, depression & anxiety.
The Pelvis & Pelvic Floor
Pelvis = ‘bowl’ or container made of bone, wider in women than men
Pelvic floor = woven platform of muscles, ligaments & sphincters at the base of the pelvis that supports internal organs (bladder, vagina, uterus, bowel)
= attached to the pubic bone, coccyx & sit bones (buttocks), slung between them like a hammock, trampoline mat, or webbing
Functions of the pelvic floor
Like a trampoline, the pelvic floor is meant to be springy, not slack. Its role is to:
????
Lift & support internal organs, especially when under load (when exercising, lifting, coughing, sneezing)
????
Prevents urinary & bowel leakage & controls emptying
????
Protects the spine, by triggering abdominal muscles
????
Provides resistance to the vagina. The vagina is designed to respond to pressure, not friction. Resistance from the pelvic floor increases sexual sensation & heightens orgasm.
????
Works in tandem with the diaphragm to pump air & provide vocal power (eg opera singers)
????
In men, the pelvic floor helps maintain erections (as effectively as Viagra)
What Can Damage the Pelvic Floor?
????
Repeated heavy lifting
????
Poor posture
????
Chronic (long-term) coughing (eg asthma)
????
Inappropriate exercise
????
Straining during bowel movements
????
Poor birthing positions (eg lying on back, forceps or vacuum delivery)
????
Surgery (eg caesarean, episiotomy) or muscle tearing
????
Being overweight
Changes As We Age
As we age, oestrogen declines, less collagen is produced, and muscles become less supple. Greater care of our pelvic floor is required, especially post menopause.
Pelvic Floor Dysfunctions
Pelvic floor muscles can become non responsive if too:
Weak: resulting in incontinence, organ prolapse, loss of vaginal sensation, weak (or no) orgasms, or
Tight: resulting in constipation, urinary urgency, or pain during intercourse. Muscle tightness is usually due to stress. Relaxation is key.
Women with pelvic floor dysfunction often feel ashamed and are at risk of depression.
What’s Good for the Pelvic Floor?
1. Good posture
Don’t suck in your belly! This increases downward pressure on the pelvic floor.
When sitting, rotate your pelvis so that sit bones take your weight, sit up tall.
2. Diet
Vitamin C helps maintain collagen & prevent pelvic floor deterioration. Cranberry juice helps prevent urinary tract infections. Vitamin E in your diet reduces vaginal dryness. Phyto-oestrogens (in soy products, legumes etc), Omega 3 fatty acids (found in oily fish & nuts), pro-biotics (plain yoghurt), zinc, & selenium are also good for vaginal and reproductive health.
3. Maintain a healthy body weight
A healthy Body Mass Index (BMI) is between 18.5 and 25. (BMI is calculated by dividing
your weight (kgs) by the square of your height (in metres), and is a general guide to help
you know if you’re within your healthy weight range).
4. Correct exercise
Avoid over-training. Stop when tired. Avoid exercises that increase downward pressure on the pelvic floor (eg sit-ups, abdominal ‘crunches’). Squeeze PC muscle before lifting.
5. Pelvic Floor Exercises
Pelvic floor muscles should be trained every day, both passively (good posture) & actively (refer to Mary O‘Dwyer‘s book ‘Hold It Sister‘). It is essential you train the right muscles. A variety of exercise ‘tools’ have been developed to help women locate and exercise these muscles (visit http://www.alisonrahn.com/category.php?id_category=9 to see some of these products).
6. Bladder Training
Learn to hold at least one cup (250mls) of fluid before urinating. This will also reduce the likelihood of urinary tract infections
7. Being Conscious
Consciously activate your PC muscle before coughing, sneezing, or lifting. If your pelvic floor pushes down when lifting, your load is too heavy.
8. Orgasm: a WIN-WIN situation
Orgasm involves the rhythmic expansion and contraction of the vagina, uterus, urethra, rectum, as well as pelvic floor muscles (the equivalent of an exercise workout). Pelvic floor exercises intensify your orgasms & your orgasms strengthen your pelvic floor.
A WIN-WIN!
9. Vibration
Vibration helps switch on inactive muscles & relax tense muscles. So a motor bike or a vibrator is a girl’s best friend! And you might be lucky and have an orgasm at the same time. (Alison of course sells vibrators too…but not motor bikes!)
For more information, go to: www.alisonrahn.com.au
Alison will be offering a forum for women to learn more about their bodies and female sexuality, beginning Wed 15, September:
Secret Women’s Business
what our mothers never told us!
Wednesdays 6-8pm
Beginning 15 September
@ Temple Byron
Arrive at 5.45pm to register
Cost: $50/adult per night (teenagers free)
A guided journey of discovery through the female body
from conception to post menopause
-8pght.
Alison Rahn, Sex Therapist, presents little known information about female sexuality, run as a discussion group over 4 weeks
for women only & their daughters
This is the sex education you never got at school!
Topics include:
? The female brain and how it defines us
? Female anatomy in detail
The role of the labia, clitoris, vagina, g-spot, cervix, uterus, and pelvic floor in sexual pleasure and orgasm
? The mind-body connection … understanding the female sexual response cycle & all the places women can get de-railed (we are oh so different from men!)
? was that an orgasm?……………… they come in all shapes and sizes
? Sexual changes throughout life Learn about hormonal cycles & how to enjoy your body through menstruation, motherhood, menopause and beyond
See images (some not yet in anatomy textbooks) showing the enormous variety in female genitalia …… and what those differences tell us about our preferences
Contact Alison: 0432 599 812 or
www.alisonrahn.com.au/secretwomensbusinessOrgasm

Orgasms come in all shapes and sizes and are good for your health. Regular sexual activity and orgasm reduces cancer, heart disease, depression & anxiety.

The Pelvis & Pelvic Floor

Pelvis          =         ‘bowl’ or container made of bone, wider in women than men

Pelvic floor =         woven platform of muscles, ligaments & sphincters at the base of the pelvis that supports internal organs (bladder, vagina, uterus, bowel)

= attached to the pubic bone, coccyx & sit bones (buttocks), slung between them like a hammock, trampoline mat, or webbing

Functions of the pelvic floor

Like a trampoline, the pelvic floor is meant to be springy, not slack. Its role is to:

?         Lift & support internal organs, especially when under load (when exercising, lifting, coughing, sneezing)

?         Prevents urinary & bowel leakage & controls emptying

?         Protects the spine, by triggering abdominal muscles

?         Provides resistance to the vagina. The vagina is designed to respond to pressure, not friction. Resistance from the pelvic floor increases sexual sensation & heightens orgasm.

?         Works in tandem with the diaphragm to pump air & provide vocal power (eg opera singers)

?         In men, the pelvic floor helps maintain erections (as effectively as Viagra)

What Can Damage the Pelvic Floor?

?         Repeated heavy lifting

?         Poor posture

?         Chronic (long-term) coughing (eg asthma)

?         Inappropriate exercise

?         Straining during bowel movements

?         Poor birthing positions (eg lying on back, forceps or vacuum delivery)

?         Surgery (eg caesarean, episiotomy) or muscle tearing

?         Being overweight

Changes As We Age

As we age, oestrogen declines, less collagen is produced, and muscles become less supple. Greater care of our pelvic floor is required, especially post menopause.

Pelvic Floor Dysfunctions

Pelvic floor muscles can become non responsive if too:

Weak:   resulting in incontinence, organ prolapse, loss of vaginal sensation, weak (or no) orgasms, or

Tight:    resulting in constipation, urinary urgency, or pain during intercourse. Muscle tightness is usually due to stress. Relaxation is key.

Women with pelvic floor dysfunction often feel ashamed and are at risk of depression.


What’s Good for the Pelvic Floor?

1. Good posture

Don’t suck in your belly! This increases downward pressure on the pelvic floor.

When sitting, rotate your pelvis so that sit bones take your weight, sit up tall.

2. Diet

Vitamin C helps maintain collagen & prevent pelvic floor deterioration. Cranberry juice helps prevent urinary tract infections. Vitamin E in your diet reduces vaginal dryness. Phyto-oestrogens (in soy products, legumes etc), Omega 3 fatty acids (found in oily fish & nuts), pro-biotics (plain yoghurt), zinc, & selenium are also good for vaginal and reproductive health.

3. Maintain a healthy body weight

A healthy Body Mass Index (BMI) is between 18.5 and 25. (BMI is calculated by dividing

your weight (kgs) by the square of your height (in metres), and is a general guide to help

you know if you’re within your healthy weight range).

4. Correct exercise

Avoid over-training. Stop when tired. Avoid exercises that increase downward pressure on the pelvic floor (eg sit-ups, abdominal ‘crunches’). Squeeze PC muscle before lifting.

5. Pelvic Floor Exercises

Pelvic floor muscles should be trained every day, both passively (good posture) & actively (refer to Mary O‘Dwyer‘s book ‘Hold It Sister‘). It is essential you train the right muscles.  A variety of exercise ‘tools’ have been developed to help women locate and exercise these muscles (visit http://www.alisonrahn.com/category.php?id_category=9 to see some of these products).

6. Bladder Training

Learn to hold at least one cup (250mls) of fluid before urinating. This will also reduce the likelihood of urinary tract infections

7. Being Conscious

Consciously activate your PC muscle before coughing, sneezing, or lifting. If your pelvic floor pushes down when lifting, your load is too heavy.

8. Orgasm: a WIN-WIN situation

Orgasm involves the rhythmic expansion and contraction of the vagina, uterus, urethra, rectum, as well as pelvic floor muscles (the equivalent of an exercise workout). Pelvic floor exercises intensify your orgasms & your orgasms strengthen your pelvic floor.

A WIN-WIN!

9. Vibration

Vibration helps switch on inactive muscles & relax tense muscles. So a motor bike or a vibrator is a girl’s best friend! And you might be lucky and have an orgasm at the same time. (Alison of course sells vibrators too…but not motor bikes!)

Men Want Sex, Women Say No …..what to do?

By | Couples, Female Sexuality, Male Sexuality, Sex Therapy | No Comments

As I sit listening to my clients stories each week I am constantly aware of how little understanding men and women have of each other.

It’s not surprising, given how little we’re taught about relationships. It’s natural to assume that how you think and how you view the world is the same for everyone. But it simply isn’t so. Men’s and women’s brains and bodies are wired differently.

One theme I see repeatedly is the woman saying ‘he just wants to have sex all the time’ vs. her male partner who’s saying ‘she’s never interested’. There is a grain of truth here, since men are more likely to think sexual thoughts more frequently than women.  However, if both men and women understood that:

  • most adult women feel sexual desire AFTER sexual activity has begun (the foreplay stage)
  • loving men need a sexual connection in order to feel emotionally connected with their partner
  • women need to feel emotionally connected in order to feel sexually interested
  • women need considerably more time than men to become fully aroused, and
  • both partners are equal players in the process

they might treat each other differently.

Women, realise that men do not feel loved by you unless you connect with them sexually. Sex helps men to access their hearts. It doesn’t matter how good a cook you are, or how beautiful the house looks.  If you reject him sexually, he doesn’t feel loved. If saying ‘no’ is your default position, catch yourself before you do. Be willing to be open and receptive to him. Tell him (gently) what you need in order to respond to him. Set whatever limits you need in order to relax.

And men, realise that women do not feel loved (or sexually aroused) if you pester, whinge, complain, blame or pounce on them. Criticising your partner’s appearance or body shape will not endear her to you. Why would she let you in to that same body you’ve just criticised? If you blame her for your lack of sex, look at yourself first. Where are you going wrong? Here’s a hint…She needs a loving approach and she needs to trust you. Take your time. Offer her something that she likes. Respect her wishes.

One woman who’s helping men and women understand each other is Alison Armstrong. She’s developed great tools for couples to learn how to work together as a team & communicate more effectively. That’s how you get your needs met. To learn more, go to: http://www.alisonrahn.com.au/products/pax-books/

Alison Rahn © Copyright 2010 www.alisonrahn.com.au

Dating Older Men

By | Sex Therapy | One Comment

Here’s what Alison Armstrong had to say recently on the topic of dating men aged in their 50s and 60s:

Question:
What are the specific challenges that woman face dating men in their 50’s & 60’s+? In my personal experience, there seems to be new areas arising that didn’t exist in dating when I was younger, extra baggage around children, ex’s, work, etc. that seems to get in the way of starting and continuing to date the same person.

Answer:
Not only do older men have histories, exes, children and long-standing routines, they also have changing brains, abundant opinions and evolving priorities. To be specific:

a) As testosterone and estrogen levels drop in men and women, respectively, our brains literally “re-wire.” The barriers that create Single Focus come down, creating more connections from the verbal centers to every other part of the brain, making men more expressive and emotional.

The connections that give women Diffuse Awareness weaken, causing them to be more focused and ambitious. These changes confuse everyone – especially the person involved! For more information about the ways that hormone levels effect thought, emotion and action. I recommend Dr. Louann Brizendize’s The Female Brain and the newly released The Male Brain. I am ecstatic to have nearly two decades of observation and conclusions ratified by this industrious neuro-psychiatrist.

b) A man’s opinions are consciously formulated by combining his dearly-held values with trusted information. As men age, the amount of information they have collected and validated grows exponentially and their values become rock-solid. Hence more opinions!

Women have to “Listen to Learn” (taught in Celebrating Men, Satisfying Women) to have a man’s opinions become a source of invaluable information instead of causing distance and disconnection.

c) Older men become ever more clear about what exactly they want to provide and receive in relationships. Women need to ask about this, apply the imaginary duct tape, listen with interest, and take everything he says at face value. A mismatch in your priorities with what he’s looking to give and to get will end the relationship sooner or later. You can learn more about this in In Sync with the Opposite Sex.

A Vagina is Like a Penis

By | Couples, Female Sexuality, Male Sexuality, Sex Therapy | One Comment

Did you know a vagina is like a penis?

What do I mean?

As you know, when a penis is flacid it’s limp. It’s also smaller. A penis only reaches its full size when a man becomes aroused and his penis fills with blood.

This happens for women too.

A woman’s vagina is often thought of as a hollow canal. But when not in use, it is actually collapsed flat, like an empty glove. In this resting state, the the vaginal walls touch. There is no space in between.

Like a penis, when a woman becomes aroused her vagina fills with blood. This gives the vagina its 3-dimensional shape, much like pumping a balloon full of air.

As the vagina expands, the vaginal walls thicken, and the vagina becomes longer. Like men, women vary in length. Vaginas range from 7.5cm (3 inches) to 13 cm (5 inches) long at rest. This length gradually increases another inch or two as the vagina becomes engorged.

But this is where women differ from men……………

When a man becomes aroused, his erection happens quickly. Women take longer!

Women vary in how long they take to get turned on. This depends how happy they are, if they trust their partner, and whether they anticipate pleasure. It can take 20 minutes or more for a woman to become fully aroused, for her vagina to reach it’s full length and width.

That’s not all that happens. Besides the vagina becoming 3-dimensional and longer, the walls of the uterus also fill with blood. This pulls the uterus upward and tips the angle of the uterus, shifting the cervix out of the way.

Ladies, does it ever feel like the guy’s penis is banging on your cervix during sex? If so, he has entered you too soon, before you’re ready. Men, you should know that banging a woman’s cervix is the female equivalent of being kicked in the balls!

How else is a vagina like a penis?

As you know, the most sensitive part of a penis is the head. That’s because there are more nerve endings in the head than in the shaft of the penis. It’s similar for women.

The outer third of the vagina has the most nerve endings, and is most sensitive. This area includes the labia and the internal prongs of the clitoris, which are extremely sensitive to touch.

Like the shaft of the penis, the inner two thirds of the vagina have few nerve endings. Lots of friction simply doesn’t work. Touching or rubbing this area is hard for a woman to feel.

The entire vagina is sensitive to pressure.

Sustained pressure, without friction, is very pleasurable for women. This is why most women prefer men with a thick penis, or a slower lovemaking style.

So now that you understand these differences, you can make whatever adjustments you need to improve your sexual style.

Alison Rahn © Copyright 2010 www.alisonrahn.com.au