Archive for February, 2010

Eastern practices of sexuality

Friday, February 26th, 2010 by Shannon Bertha, ACS, DHS

Eastern practices of sexuality

The Western world is dominated by preconceived notions about what is normal sexuality.  Often in the west, we tend to focus just on orgasm and the organs that may bring about orgasm (i.e. the penis, the clitoris).  However, there are many different parts of the genitals that enjoy sensation and touch and often they get forgotten about.  Eastern practices of sexuality, like Tantra are a bit different.  Although the practices of Tantra may be difficult for some, I think everyone can take something from this practice and make it applicable for their lives.  Eastern practices focus more on sensuality, having to do with the five senses.  The focus is on the intimacy, sensations and connection of the couple.  The focus is not on the orgasm, so there is no race to finish.  Try this in your own sex life.  Try to make the focus about the touch and sensations and not so much on penetration and orgasms.  Go into your own body and evaluate how this makes you feel.  Although I think having a light on during sex can be fun so you can see what is exactly happening, if the light is off, you have fewer distractions.  Partners can go into their own body and really experience the encounter.

Sexual Disorders? Here’s what the new DSM-V says..

Monday, February 22nd, 2010 by Bat Sheva Marcus LMSW MPH PhD

 The  Diagnostic and Statistical Manual of Mental Disorders, (or the DSM as it is lovingly referred to by those of us in the profession) is the basic guide for psychological and psychiatric diagnoses. Put out by the American Psychiatric Association  it catalogues “disorders.” Often there is much debate about the legitimacy of labeling something a “disorder.” For example for many years homosexuality was considered a disorder by the DSM. In the most recent addition, however, it has been removed.

 So in the field of sex it is a common game we play to see what things the APA has labeled as a disorder today…. Liking sex too much? Having it too often? Getting turned on by high heels? The new DSM (the 5th) is slated to come out with its changes in the next few months. Here’s a great article on the general concerns regarding what is included and what’s not:

http://www.advocate.com/Society/Commentary/Sex_Disorders_According_to_the_APA/

 

Feel free to put your two cents in!

The Whole Picture

Thursday, February 18th, 2010 by Bat Sheva Marcus LMSW MPH PhD

Good Housekeeping recently had an article Your Sexiest Self – Get It Back (February, 2010). It poignantly described one woman’s loss of libido for all of the usual reasons: overwhelmed with life, kids entering the picture, relationship getting “old,” she was getting older.

So the writer and her husband saw noted psychologist and sex therapist David Schnarch for a three hour session.  Presto! Whammo! In one afternoon  their primary issues were identified and addressed and she was back in the game.

Okay, so I’m oversimplifying things. But the author did comment on the fact that once her husband was able to be “real” with her and get “angry” and not always be “so nice,” she experienced real desire for him for the first time in a long while.

That is great.

I mean it.

I’m skeptical it will last, though. Really intense emotions and sudden epiphanies and moment of deep connection are important and no doubt do wonders for the short term sex drive. They really help. And some times, honestly, kick-starting the sexual relationship with a short term energy blast can make all the difference and turn things around again.

But I think that often, when the ongoing, slow simmer of a regular sex drive is gone, it’s important to get the whole picture, that is the physical stuff as well as the psychological stuff.

So if you’re one of those people who’ve been able to  create moments of deep passion through sex therapy, but have wondered why these moments don’t seem to sustain themselves, don’t give up. Get the whole picture.

Children and masturbation

Monday, February 15th, 2010 by Shannon Bertha, ACS, DHS

Most people agree that masturbation is a normal part of live and as humans, we can choose to participate in this behavior, or avoid it if necessary.  Although it is normal, often parents are uneasy about what to do if they catch their child masturbating and even more uneasy if they had to talk to them about it.  Masturbation is a healthy sexual expression for both adults and children.  Some researchers would even go as far as to say that masturbation should occur during childhood to help build neuropathways in the body for orgasm, because ultimately that is what an orgasm is, a neurological response. 

 

If you catch your child stimulating him or herself, don’t overreact!  Masturbation will not cause psychological harm to your child; however, your reaction might.  So take a deep breath, and address it when they are not masturbating.  Explain that this is okay for them to do, but in the privacy of their bedroom or home. 

No one wants their kid masturbating in the cereal aisle in the grocery store.  Talk about privacy and you may be able to equate it to going to the bathroom, which kids are able to understand.  Explain that just like we go to the bathroom in private and take a shower/bath in private, this (masturbation) should also be done in private.  Although discussing sexuality with your kids can be uncomfortable, it is essential for their development.  At the medical center, though we only treat female sexual dysfunction, we have a number of resources for kids and parents on how to open up this conversation.  Some book recommendations: It’s So Amazing and Our Bodies, Ourselves.

Maintaining cervical health

Wednesday, February 10th, 2010 by Melissa Ferrara FNP

We happened upon this easy-to-read article on maintaining cervical health and found it to be a reasonable answer to the question of how often should a woman get a Pap smear.  This is particularly relevant given the report in the September 2009 Journal of Obstetrics and Gynecology suggesting some women can wait three years in between Pap smear tests.

Women who come to the Center generally have their own primary gynecologist for routine cervical screening.  That said, when we treat women with vaginal pain, painful intercourse or  vaginismus (a condition that results in extraordinary pain when anything is inserted  into the vagina) one of the first things that crosses our mind is, “how long ago did she have a Pap smear?”.  Women with vaginal pain or vaginismus often avoid pelvic exams and Pap screening because they fear the pain it may cause. 

If you or someone you know is avoiding a Pap because it’s impossible to imagine a speculum entering the vagina without intolerable pain, there is help.  There are different kinds of treatments – from creams to dilators to Botox injections under general anesthesia – that can help a woman take care of her health in every possible way.

http://www.annarbor.com/health/understanding-the-guidelines-for-maintaining-your-cervical-health/

New Treatment for Vaginismus – Botox

Friday, February 5th, 2010 by Bat Sheva Marcus LMSW MPH PhD

Our team just went up to New Hampshire to learn a new treatment for severe vaginismus from a wonderful Doctor. He (and his caring staff) have developed a procedure which uses general anesthesia and botox in order to help women over the first, most frightening hurdle of treatment.

When I am lecturing and trying to explain vaginismus , the analogy I use to describe how a patient feels is to compare it to what your reaction might be if I told you I was going to put a pen into your eye. 

If I said to you,”Listen, I am going to put this pen in your eye. Not to worry, it won’t hurt a bit and actually it will feel good,” you would look at me as though I had three heads and run for your life.

Patients with severe vaginismus feel that way. Often with anti anxiety medications, behavior medication, relaxation exercises we can work with a woman to help her get those first dilators in. Sometimes it just doesn’t work and it’s just too hard.

 This new procedure has the women under general anesthesia while a physician injects Botox (stops the muscles from going into spasm) local anesthesia(so that there is absolutely no initial pain) and put in a large dilator. The patient wakes up having the dilator in and that really is jumping the first few hurdles. There is still significant work for the patient. She has to work with dilators, get comfortable with the idea of inserting something into her vagina, internalize the idea that there is really no pain and then make the  transfer to intercourse.

It doesn’t solve the whole problem, but it can be a big help and relief for the right patient and we are so glad that we will be able to offer  it in our office as well.

Vaginismus

Wednesday, February 3rd, 2010 by Bat Sheva Marcus LMSW MPH PhD

If you’ve perused this website you know that vaginismus is a condition where there is involuntary spasm of the entry muscles to the vagina, causing either pain or, in extreme cases a complete inability to penetrate.

I hope you also know that it’s very treatable and you shouldn’t’ t feel like you have to live with it. One of things I’ve noticed with vaginismus patients is that they are often scared to come  in for treatment and therefore put things off for a very long time – and suffer needlessly.

Sometimes they put things off and put things off until there is some crises, a partner leaves, they stop dating  etc.

But if that’s you— here’s something to think about:

more often than not, the fear is way worse than the treatment. Most patients say that once they got in the door, the rest was easy.

So maybe  it’s time you treated yourself!