Archive for March, 2008

Monogamy or why do we need to look in other people's bedrooms?

Wednesday, March 19th, 2008 by Bat Sheva Marcus LMSW MPH PhD

Hey did you see yesterday’s Times article — In Most Species, Faithfulness Is  a Fantasy?

Basically, in order to find a species that was always faithful, Natalie Angier had to resort to citing the “flatworm that lives in the gills of freshwater fish.” So who are we kidding and why are we all so prurient in our need to follow other people’s sex lives, and so incredibly judgemental when we find out about other people’s affairs (which are none of our business.)

Look, I’m a fan of monogamy. I like having sex with one person. I think it’s comfortable, fun, reliable, allows me to be more experimental, allows me to be totally trusting and sometimes it’s, let’s face it, just plain cozy. And I know a whole bunch of other people that feel the same way. My husband would say it’s morally and ethically correct. That having been said I think it’s probably an unrealistic expectation for many people and to set it up as the gold standard for our judgement of others may not be either realistic, practical or wise. And maybe, it’s none of our business. Why are we all so fascinated by what’s happening in everyone else’s bedroom?

Find your Clitoris

Monday, March 17th, 2008 by Bat Sheva Marcus LMSW MPH PhD

I was having a conversation with a 72 year olf friend of mine. Me: “So, you never thanked me for that vibrator I sent you.” She:”I had no idea what to do with it.” Me: “hey, I sent it with that great book Sex For One” (the book’s by Betty Dodson, in case any of you want to look for it.) She: “Now how am I supposed to get that big thing inside of me.” Me: (slightly horrified)”Sweetheart, it’s not meant to go inside of you!” (I had given her the Hitachi Magic Wand — for those of you who have seen it, it looks like a BIG microphone for singing divas.) “You’re supposed to put it on your clitoris.” She: “Well how am I supposed to put on it, without going insided.” Me: “Uh… here, let’s pull out a picture.” I was dumbfounded… and maybe a more apt word would be “dumb” — why, oh why, did I assume that just because someone is 72 they know where their clitoris is!!

We need pictures. We need education. We need girlfriends!

Article on Female Sexual Dysfunction

Saturday, March 15th, 2008 by Melissa Ferrara FNP

Here is a thoroughly written article from the Washington Post about Female Sexual Dysfunction.  It gives great information on current treatments and research. However, I find it discouraging that there are professionals out there that still believe FSD is not a “real” medical condition.  My patients are so relieved when they hear from us that their could be a physiologic cause to their FSD.   I do not deny that there can be psychological components to FSD, but we have to look at the whole person when treating this condition, especially the physical aspect. 

Birth Control Pills and Low Libido

Saturday, March 15th, 2008 by Melissa Ferrara FNP

Did you know that your birth control pills could be the cause of your low libido?  Ironic as it may seem, the little pills you started because you were having sex, are now what could be the reason you don’t want to anymore.  Birth control pills suppress hormones in your body to prevent you from ovulating, thus preventing pregnancy.  But, they also suppress your natural production of androgens, specifically testosterone.  They also increase production of SHBG (sex hormone binding globulin), a protein which will bind to testosterone and make it unavailable for your body to use.  Testosterone is the hormone most closely linked to driving a women’s libido.  The birth control pills destroy your testosterone levels.  (This is also why birth control pills will help clear your skin.) 

Women are starting birth control pills at younger ages.  It is not uncommon for women to be on birth control pills for 10-15 years. It is perfectly safe for women to stay on birth control pills for many years, but it is unclear what kind of damage this long term use can do to a women’s libido.  Some research has shown that even after discontinuing use of birth control pills, women still have not regained their libido.

Women are told many side effects of birth control pills, but loss of libido is rarely, if ever mentioned. 

Sexual Dysfunction in Adolescents

Friday, March 14th, 2008 by Michael A. Werner MD

I see many adolescents these days with erectile dysfunction (ED).  To their credit, most of them discuss this with their parents and then come in to see me.  Most of the time they have seen another specialist and are told that it is all psychological and that if they just relaxed it will go away.  Unfortunately, this rarely works.  90% of the time in men, ED is physical.  Though in men under 35, 90% of the time it is psychological.  Thus most likely it is primarily psychological, but there is that 10% as well.

My approach has been to do a full evaluation.  If there is no physical component found, we then discuss our options.  Most of the time, this is not an indication of severe pathology or even of sexual ambivalence etc.  Often, it is an isolated problem, which gets worse over time because of the anxiety it creates.  I will usually treat it physically (though obviously not surgically.)  Most of the time it will correct itself over time with treatment, and he can wean himself off treatment.  It has been a very successful approach, and one that the parents (if involved in their son’s care) have been very accepting of and pleased with.

I've had it on penis size!!

Wednesday, March 12th, 2008 by Bat Sheva Marcus LMSW MPH PhD

Okay. Listen up folks.  The only time penis size really matters is if the penis is too big and hurts the women. In all my hundereds of patients I HAVE NEVER had a woman complain to me that her partner’s penis was too small. Never! I have, however, had a number of women whose partner’s penis was so big as to make intercourse really, really uncomfortable. This is a fairly complicated problem to solve. A “small” penis is truthfully not something most women are going to care about (or even notice, frankly). The vaginal canal is not a big space. As a matter of fact, it’s not a space at all. It’s just “potential space” and it will open up to whatever size penis is introduced. And it will get the same amount of friction no matter what the size. So women, embrace the penis size of your partner. (If it’s too big, you may want to come see us though.) Men, let it be. Your penis is PERFECT.

Is hiring a prostitute really worse than driving 91mph in a 60 mph zone?

Tuesday, March 11th, 2008 by Bat Sheva Marcus LMSW MPH PhD

I know it’s an unpopular position, but somehow I can’t help feeling that Eliot Spitzer is being attacked in a way that is not comensurate with his crime. And, as always, I feel like the rather puritanical society we live in, has a double standard when it comes to sex.  Yes, what he did (which by the way was hiring a prostitute, not- as is being declaired on all the airway – becoming “involved in a prostituation ring” which sounds like he was chief organizer and madam) was illegal. Yes, what he did is immoral by most couple’s current standards. But hey… he was having sex with a consenting adult and he wasn’t hurting anyone. Compare that to Governor Corzine who’s car was traveling 91 in a 65 mph zone and could have killed any number of people. No one called for his resignation. So it seems to me that this “crime” he committed is being judged, rather than on it’s own merits, on other standards and I’m curious what they are. Is it that Eliot Spitzer has just alienated too many people during his long tenure as a public servant and it’s “payback time.” Or is it that somehow everyone feels holier than thou when they hear about extramarital sex… of any sort. And it makes people feel good to cluck their tongues and talk about morals and ethics. Maybe this should be seen as what it is, a private issue that he needs to work through with his wife. But unless there is serious reason to believe that hiring a prostitute will directly effect the job he was hired by the people of NY to do, I say “leave him alone and let him get back to the job at hand!”

10 Things Every Woman Should Know

Monday, March 10th, 2008 by Ilene Rosenthal, Marketing

Bat Sheva Marcus, LMSW, MPH, PhD, clinical director of The Medical Center for Female Sexuality, recently put together a list of 10 things every woman should know.  We thought this was important enough to share with our readers.

1) You are entitled to a great sex life no matter what your age.

2) You are entitled to a great sex life no matter what your size, shape, or physical condition.

3) There is no one right way to have a sex life.  Your sex life just needs to work for you (and your partner, if you have one).

4) You dont need to have a partner to have a great sex life.

5) Knowing your body and its reactions is the first step to a better sex life.

6) Your partner is probably not a mind reader.

7) Intercourse does not equal great sex.
8) If you are having problems, they very well may not be all in your head.

9) Vibrators are not “kinky sex toys,” they are your friend.

10) Sex should be fun.

While some of these entries may sound like common sense, you would be surprised at how many women don’t keep them in mind.

Talking to Kids about Sex

Friday, March 7th, 2008 by Bat Sheva Marcus LMSW MPH PhD

Some people are really uncomfortable talking to their kids about sex. In some ways they are sometimes ahead of the game because at least they know that their not having productive conversations with their kids about sex. I can’t tell you how many people I know who think they are perfectly comfortable talking about sex (and in some cases they actually are) but don’t have any conversation because “my kids haven’t brought it up.” Guess what? It’s more than likely that at some point you are going to have to bring it up.

A great resource for all you parents is a book called: Everything you NEVER  wanted your kids to know about Sex (but were afraid they’d ask) by Richardson MD and Schuster MD. The book is GREAT and one of my few regrets in life is that I did not write it first! It’s funny, warm, realistic, not preachy and provides a range of options for parents who fall in a range of comfort levels.
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Welcome to www.Bettersexblog.net

Friday, March 7th, 2008 by Ilene Rosenthal, Marketing

Welcome to www.bettersexblog.net.  This blog was created by some of the world’s leading experts in the field of sexual health.  Michael A. Werner, MD, FACS, a board-certified, fellowship-trained urologist whose practice is limited to sexual dysfunction and male infertility; Bat Sheva Marcus, LMSW, MPH, PhD, clinical director of The Medical Center for Female Sexuality; Melissa Ferrara, FNP, associate medical director for The Medical Center for Female Sexuality; and Shoshana Bulow, LCSW, psychotherapist and certified sex therapist. 

We believe that everyone deserves a satisfying sex life and what’s more, a satisfying sex life is within everyone’s reach. There is so much misinformation, confusion and hoopla, however when it comes to sex, that sometimes the simple basics get lost in the shuffle. Hopefully this blog will include down to earth advice, realistic responses to the latest trends and links to useful information for you, your spouse, your kids and maybe even your best friends.