Archive for February, 2012

Bat Sheva Marcus on CBS – Sex and Aging

Thursday, February 23rd, 2012 by CBS News


(CBS) - Forty years of research is turning conventional wisdom on its head when it comes to the issue of women and sex. The experts say it gets better with age.

“Your husband wants it and you kind of go along with it,” said Susan Courtney, who is 56-years-old. Sex was never really at the top of her priority list.

“You’re running around and car pooling,” said Susan. But now that this mom is in her 50’s, her feelings towards sex have drastically changed.

“I look forward to it more,” said Susan. She isn’t the only woman whose sex life is getting better with age, according to a new study from the University of California.

“This is not a part of your life that shuts down,” said Bat Sheva Marcus, a Sexual Dysfunction Specialist.

The study followed 800 women over forty years, and looked at all aspects of their sex lives from desire to frequency. The majority say they had increased sexual satisfaction as they aged – findings that come as no surprise to Marcus.

“What irritates me is we as a society think, ‘Oh, sex only lasts until your 29 and you know after that, it’s just going to be downhill from there,’” said Marcus. She says there are so many stereotypes when it comes to women and sex, like women are rarely ‘in the mood’ especially as they age and have to deal with physical changes, like menopause.

“I think that’s a horrible myth,” said Marcus. She says there are several reasons why mature women have better sex.

“There’s less guilt. There’s less distraction as your kids get older. There’s more emotional stability,” said Marcus.

Ann Karrick, who’s in her forties, says so many aspects of life improve with age, why not sex too?

“If you know yourself better, almost everything I think becomes better,” said Ann.

Ultimately Marcus says most women with more life experience have no problem asking for what they want.

“There’s nothing embarrassing about a 65-year-old woman who wants to have a vibrant sex life,” said Marcus.
Susan says she’s looking forward to being one of them.

“I don’t see myself as getting to be an aged person, who can’t be sexual. I don’t see that,” said Susan.

Some experts say sex lives get better because older women also have more time to feel good about themselves, in a way they didn’t have when they were 30.

Low Libido While You’re Nursing

Tuesday, February 21st, 2012 by Bat Sheva Marcus LMSW MPH PhD

Yes, I know… you had a baby months ago and sex is still the last thing on your mind. Will it ever change?

I get the questions a lot from nursing moms and they are often so confused as to whether their low libido is something that needs to be addressed or if they should wait it out. They are exhausted, over touched, dripping from every orifice, feeling unattractive and so overwhelmed that they can’t imagine every feeling sexy again.

Unfortunately, I can’t say there is any one right answer for every mother. And  when women call and ask “should I come in and see you?”, my answer is in so many shades of gray.

Here’s what I recently said to a new mother who asked me that very question:

There is very little we would do hormonally while you are breast feeding and some women really do “correct themselves,” over time. So sometimes it pays to just wait things out.  Then again, many others don’t start improving, and you don’t want so much damage done to your relationship in the meantime that it’s that much harder to dig yourself out.

I guess I would say that you should ask yourself how badly this may be affecting your marriage, your own self-esteem, how long you plan on breast feeding, etc.  In the end those are questions that will affect your answer.

Coming in and seeing us always helps to some degree, because it puts the issue on the table and doesn’t let you ignore it; we can work on the pain with you and give you homework so that at least you feel like you are doing something. On the other hand, if your exhausted and overwhelmed, you just might not have the bandwidth to deal with this now and you might want to ignore it – and that might be FINE for the short term. Only you and your husband can really figure this out.

One thing I would say is don’t let this drag on too long.  If it’s been a year since the baby’s born and things are still not working, you probably should seek help. The last thing your baby needs is a couple of parents who are struggling in their relationship more than they have to be!

Happy nursing.

Better Sex: How Do You Choose a Mate?

Thursday, February 16th, 2012 by Barbara Gross, LMSW

“Females use kissing to provide information about the level of commitment of their partner if they happen to be in a continuing relationship”, Gallup told the BBC in September.  “Locking lips is thus a kind of emotional barometer: the more enthusiastic it is the healthier the relationship. Because women need to invest more energy in producing children and have a shorter biological window in which to reproduce, they need to be pickier about whom they choose for a partner-and they cannot afford to get it wrong. So, at least for women, a passionate kiss may help them choose a mate who is not only good at fathering children but also committed to sticking around and raising them.” This may also explain why kissing is more frequent and more passionate at the beginning of a relationship. Possibly, at that point, the selection process is occurring. And once it has occurred the biological imperative is not as intense.

I do not believe a kiss is an indicator of paternal abilities. The ability to father well is so complex and multifaceted; I am not sure what could test for such an intense and important role. I do love the idea that such a test could exist, though. I have basically found in my work with women that a good kiss is mostly indicative of a good kisser. However, kissing is very intimate and I think that one’s ability to be intimate and stay connected is certainly an important part of both partnering and fathering. So maybe the desire to kiss is not such a bad litmus test after all. I think the desire to kiss and the talent of kissing well defines two different things. I have a friend who says her husband wants to kiss all the time, but he is not great at. He tries anyway,she loves him and he is a good father!

Write me and let me know if you have a partner who is both a good kisser and a good dad. Let’s see what we find out!

Natural Family Planning

Tuesday, February 14th, 2012 by Tara Ford, RPA-C

We have long known that hormonal birth control (pill, ring, or patch) can have an adverse effect on sexual functioning for some women.  Hormonal birth control can decrease testosterone levels and increase a protein (SHBG) that binds to testosterone, inhibiting its function.  Having sub-optimal testosterone levels can negatively affect sexual functioning.   Therefore, we often recommend that women stop taking hormonal birth control and either opt for an IUD (intra-uterine device) or use a barrier method (condom, diaphragm, cervical cap) with a spermicide (gel, film, foam, sponge) if tolerable.

I would like to focus on yet another method that can be used in conjunction with barrier protection.  It is often referred to as Natural Family Planning.  There are several different methods that fall under the Natural Family Planning category, all focused on preventing pregnancy by abstaining from unprotected intercourse at peak fertile times of a menstrual cycle.

The one method I found easiest to comprehend and utilize is called the Standard Days Method.  This method is ONLY appropriate for women with regular menstrual cycles, lasting between 26-32 days.  Simply put, a woman will not have unprotected intercourse from day 8 through day 19 of their menstrual cycle.

Research shows this method is 95% effective in preventing pregnancy, which means that 5 out of every 100 couples who use Standard Days Method correctly for one year will have a pregnancy.

For more information about Standard Days Method and how a product called Cycle Beads can assist you with this method, click here:  http://www.cyclebeads.com/

 

What IS a Girl To Do?

Thursday, February 9th, 2012 by Bat Sheva Marcus LMSW MPH PhD

I found Caitlin Flanagan’s  January 22, 2012 essay  “What’s  A Girl To Do”  http://www.latimes.com/news/opinion/la-oe-flanagan-girls-and-sex-20120122,0,2565148.story?track=rss both intriguing and moving, and although my initial reaction was enthusiastic because what she wrote aligned so well with my personal values , I found I was challenging myself on her very thesis.

Basically, she made the case that the book Forever was horrifying to the adults in her life when she was a young teen because it espoused the viability of  sex without marriage. She felt those values were antiquated and that the book was actually a potentially positive force since it still espoused sex within the context of a loving (albeit young and thus very possibly, superficial) context.

But now she is bemoaning the sexual activity of the current younger women because they have gone one step further and divorced sex from emotional commitment. What she is observing among her daughter’s peers is that they often take part in sex as merely a physically pleasurable activity, or perhaps one with short-term emotional pay-outs.

Caitlin, maybe it’s time we “older women” (the mothers) challenged ourselves and examined our need for a “meaningful relationship” attached to sex as another version of the “needed marriage. “ Maybe the current view of sex is okay, Caitlin. Maybe it’s just another step in the road to demystifying and taking away some of the over-dramatizing of sex.

I can already feel the angry eyes upon me. “What????? You are suggesting that sex be so casual that it is OKAY outside the context of a meaningful relationship”? Well…. Maybe. Maybe that’s not what I want. Maybe in the long term most of us are looking for a meaningful relationship and love that includes passion and sex, but maybe, just maybe, sex can also exist in a context outside of a meaningful relationship for its own sake – and maybe that’s not such a terrible thing.

Persistent Genital Arousal Disorder (PGAD)

Tuesday, February 7th, 2012 by Tara Ford, RPA-C

 

In my opinion, persistent genital arousal disorder is one of the most frustrating syndromes that I’ve faced while practicing at MCFS.  Typically, a patient complaining of PGAD symptoms presents to us after some time of suffering.  Since this syndrome affects each woman differently, a careful history must be taken.  Although more research is being dedicated to this syndrome, standardized treatment protocols do not exist.

Typically, PGAD patients are post menopausal women, however, we have seen patients of all ages.  The most common complaint is of a persistent, torturous feeling of arousal in her genitals that is not relieved by orgasm. The arousal is unsolicited and conscious sexual desire or sexual stimulation is absent. Some patients complain that they feel like their clitoris is constantly engorged and throbbing, other patients complain of constant vaginal contractions.  Some patients experience both symptoms at the same time.  Symptoms typically wax and wane, however, they remain present for most of the day, interfering with their activities of daily living and prevent them from getting restful sleep.

Perhaps the most debilitating aspect of this syndrome is the isolation that our patients experience.  They are usually embarrassed by their condition and understandably are afraid to disclose to others what they are experiencing in fear of being misunderstood or mislabeled as sex-crazed nymphomaniacs.  Unfortunately, this disorder is also grossly misunderstood by the greater medical community.

Although there is no known cure for PGAD, we have been very successful in providing emotional support and a safe place for our patients to express themselves.  Online support groups can be very helpful, but some of our patients have reported feeling hopeless after being on them for a long time.  Our trained therapists keep our patients focused on hope;  our medical providers stay abreast of every published research study and present all treatment options to our patients to help them make an informed decision about their care.

We are hopeful that one day soon PGAD will become a temporary, treatable condition.  We are committed to standing by our patients until that time comes.

Birth Control Recall

Friday, February 3rd, 2012 by Tara Ford, RPA-C

Pfizer announced the recent recall of Lo/Ovral-28 (norgestrel and ethinyl estradiol) birth control pills.  28 lots of the brand name and generic tablets were recalled in total.  Apparently, there was a mix up at the processing plant and some of the packs have tablets that are out of sequence and contain an inexact count of inert or active ingredient tablets therefore increasing the risk for unintended pregnancy.

To avoid an unintended pregnancy it’s imperative to use a back up form of birth control anytime you miss a dose of your birth control pill.  Condoms (male and female), spermicides and the sponge (yes, it’s back on the market) are readily available at drugstores or online at drugstore.com.  Although it’s unfortunate for a mistake like this to happen, it’s important to pass along this information to all the women in your life to help avoid unintended pregnancies.

If you use this brand of birth control pill please check the link below for the list of lot numbers affected.  If you find your lot number listed, Pfizer recommends returning your prescription to the pharmacy as well as contacting your prescribing health care provider.

Click here for the FDA press release and Lo/Ovral-28 lot numbers:  http://www.fda.gov/Safety/Recalls/ucm289770.htm

All The Single Ladies – Part Three – A New Ism

Thursday, February 2nd, 2012 by Barbara Gross, LMSW

 

As I wrote about in my previous blog entries, I read a very interesting article by Kate Bolick, who cites Bella DePaulo. DePaulo, a social psychologist, created the term singlism, which is the “stigmatizing of adults who are single [and] includes negative stereotyping of singles and discrimination against singles”.  In her book, Singled Out,  she argues that “the complexities of modern life and the fragility of the institution of marriage have inspired an unprecedented glorification of coupling”. I don’t agree with this conceptually.  I think the primary complaint of my single friends and patients is not that they feel stereotyped, but rather that they feel lonely.

De Paulo feels that singlism is an ism like any other, like racism or sexism, or ageism. In that light, I can see DePaulo’s point that any form of discrimination adds other shades to an already possible painful situation. From my perspective as a  therapist, the aspect of the single experience that interests me most is the opportunity to develop a deeper connection to oneself, and thus to others, whether those connections are romantic or not. In my practice, I have women who have been married all their lives and never had a variety of partners.  I also have women who have had many partners and desire a long-term, monogamous relationship. Either way, one’s connection to oneself is the point from which all intimate relationships spring, so I think that must be nurtured first.  Being single is a great way to start and nurture that relationship with the self.