DHEA…we thought so all along

January 3rd, 2012 by Bat Sheva Marcus LMSW MPH PhD

A new small scale study out of Italy seemed to show that DHEA can be helpful with menopausal symptom and can also positively affect a woman’s sexual desire.

http://www.healthnews.com/en/news/DHEA-Hormone-Therapy-May-Be-Menopause-Magic/0UuHws6wf6pBU1vtwcDIcD/

So why is anyone surprised? The truth is that DHEA is a precursor hormone (or a “mother hormone” – but that title might suggest that it yells at you if you don’t clean your room and DHEA definitely does not do that!) which converts in your body to estrogen, progesterone and testosterone. So yes, taking DHEA every day is going to have an impact on your hormones. The fact that it is a hormone that is identified by the FDA as merely an “herbal supplement” is what should be surprising.

Be that as it may, for women who are suffering from the effects of low hormones, either with menopausal symptoms, low libido, dry skin or memory loss, DHEA might indeed give them relief. But keep in mind one caveat. It really and truly is a hormone. Don’t mess around with it alone too much. If you are serious about using it see your doctor, or better yet, see a specialist. Make sure you are having regular blood tests and someone is monitoring your hormones to make sure you are in a normal range and checking you regularly for side effects.

And keep your eyes out for more studies – it will be interesting to watch as DHEA comes of age.

The year in clinical sexuality, 2011

December 29th, 2011 by Stephen Snyder, MD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

As we get ready to leave 2011 behind, I would like as always to express my gratitude to family, friends and colleagues for your support and encouragement over the past year; and to my patients for your trust and confidence.   May we all merit much happiness in 2012.

Here’s my list of 2011′s most interesting happenings in clinical sexuality and related disciplines.


Vampire love

This year, in Twilight:  Breaking Dawn Part 1, Bella finally consummated her relationship with Edward, after three years of cinematic foreplay — and immediately ended up pregnant.  By the end of the movie, she’d become both a mom and a vampire.    Shows what can happen.

In SexualityToday at the Movies:  Breaking Dawn, we continued the discussion of the “integrative” aspect of ordinary female desire that we began in Twilight and the Art of Foreplay and in The Nine Rooms of Happiness:  What Does a Woman Want?

Elsewhere on the paranormal sexuality front, The NY Times Magazine featured a cover story on the new MTV series Teen Wolf —  “We Are All Teenage Werewolves.”  In Wolf Love in the New York Times, I discussed how the human-to-werewolf transformation works as a metaphor for sexual arousal — especially its primal, selfish aspect.

Australian writer Katherine Feeney picked up on the idea in Unleashing the Animal Within.  And Cosmo ended up interviewing me for an article in the December issue entitled “The Fierce Sex Every Couple Should Try.”    Shows what can happen.

 

What can we learn from Google about sexual motivation?

This year saw the publication of A Billion Wicked Thoughts, an interesting report on what must be the world’s largest sex experiment — an analysis of 55 million sex-related Google searches.   The book has a new and rather interesting theory of human sexual motivation, but the theory gets lost in its popular book format.

As I wrote in The Simple, the Complex, and the Still-ForbiddenA Billion Wicked Thoughts hasn’t had an easy time in print so far.  The New York Times Book Review assigned the book not to a sex researcher but to a cultural critic, Wesley Yang, who called it a “farrago.”   And most sex therapists I’ve spoken to so far have been unwilling to read it.

I’ve argued that  it would be foolish to ignore the book’s’ ambitious theory of sexual motivation, or the huge and unique set of data that supports it.    I’ve attempted, in a series of articles loosely based on A Billion Wicked Thoughts, to place the work in cultural and scientific context and to show its applicability to the practice of sex therapy.

It’s turned out to be a larger project than anticipated, and one I still haven’t completed.   But for anyone with the time and interest, Lessons from the World’s Largest Sex Experiment contains the links to the series of eleven articles I’ve written so far on the subject.

It’s still politically tricky to discuss the ordinary differences in sexual psychology between men and women.   Yes, I know, there’s lots of intra-gender diversity as well.   But that doesn’t make the inter-gender differences less important.

So I was pleased recently to find that Dr Meredith Chivers’  Sexuality and Gender Laboratory (Sagelab) at Queens University in Kingston, Ontario, a leading center for research into gender differences, has also taken up the challenge of communicating the results of this new research to the public – both on the web and on twitter.    That’s good company, and good news for the rest of us working in this politically slippery area.

 

The male of the species

Even now, 13+ years since Viagra was introduced, few people understand the physical/psychological complexities of male sexual arousal.   In Diary of a Manhattan Sex Therapist:  The Other Side of Saturday Night we discussed some of the psychological issues in younger men with erectile dysfunction (ED.)

The past year saw publication of two important professional articles highlighting the risk of sexual side effects from the chemical finasteride, used in the hair-loss medication Propecia and the prostatism medication Proscar.   In Diary of a Manhattan Sex Therapist:  Propecia, and Another Look at Sex and Propecia we discussed the common and often devastating side effects that can occur in men who take finasteride.

Premature Ejaculation (PE),  the most common sexual problem in young men, still gets surprisingly little publicity despite the significant impact it has on men and their partners.   Johnson&Johnson’s PE drug Priligy (dapoxetine) was rejected by the FDA in 2006, but has been approved in many other countries now worldwide.

Will the FDA be considering Priligy again?    It doesn’t seem imminent.    In the meantime, men seeking medication  for PE can be treated off-label with any of the Prozac family of so-called SSRI’s (Priligy is just a short-acting SSRI).   But until a medication is specifically approved for PE here, few MD’s in the US will be motivated to become skilled in doing this kind of treatment.

Take a look at 2010′s  The Latest News About Premature Ejaculation.   Not much has changed since then.

 

More on monogamy and near-monogamy

Problems with monogamy continue to fascinate modern readers.  In the wake of the Anthony Weiner episode, The Search for Sexual Sanity Continues  discussed the controversy over how to evaluate and treat what one might call ”Impulsive/Compulsive Courtship Behavior.”

Is strict monogamy often not worth the emotional cost?  That’s the opinion of Dan Savage, quoted in Mark Oppenheimer’s Married, with Infidelities in The New York Times.  In What’s So New About the New Non-monogamy? and Still Further Along the Road Less Traveled, we responded to the Oppenheimer piece, as did Ross DouthatRabbi Shmuley Boteach, and many others.  

Sex at Dawn, whose lead author Christopher Ryan has claimed that monogamy for humans is about as natural as a Big Mac and fries (and about as healthy), continues to be the decade’s most interesting and talked-about sex book, and clinched the Society for Sex Therapy and Research‘s Consumer Book Award for 2011.

Will Sex at Dawn influence sex therapy? Well, at least it might increase our empathy for people who find monogamy particularly difficult.

We reviewed the related book Bonobo Handshake by Vanessa Woods in Sex in the Wild, discussed some of its implications for our era in Empathy’s Magic, and ventured a bit into the evolutionary psychology debates with Eros, Thanatos, and Sunday Afternoon.

 

On loving your Blackberry

The most interesting sex article of the year, in my opinion, was Jonathan Franzen’s New York Times article about the sensual charms of his new Blackberry device.

As Franzen notes, electronic machines can now supply some of the self-affirmation that humans have traditionally only been able to obtain though intimate relationships.   He writes, “our technology has become extremely adept at creating products that correspond to our fantasy ideal of an erotic relationship, in which the beloved object asks for nothing and gives everything, instantly, and makes us feel all powerful . . . a world so responsive to our wishes as to be, effectively, a mere extension of the self.”

In the past, one of the few ways an adult could experience this kind of automatic, effortless self-affirmation was through the magic of really good sex.   But that’s no longer entirely the case.  As I discussed in Eros and Technology, Franzen’s essay alerts us to the still-difficult “problems of actual love” – including the challenge of relating long-term to someone who, unlike a piece of electronic equipment, was not designed specifically to meet our needs.

 

What’s ahead in 2012?

Well, obviously, I don’t know.   I’m hoping to finish the long series of articles loosely based on A Billion Wicked Thoughts that I began this year in Lessons from the World’s Largest Sex Experiment.

For the sake of my many patients with adult ADHD who keep asking me for reading materials (OK, it’s usually their spouses who ask for the reading materials), I’d like to continue the series on adult ADHD that began with ADHD, Marriage, and the New York Times, Alvin?  Alvin?  Alviiin!!!!,  and  Dr Laura Muggli on ADHD in Women — plus deliver my long-promised reviews of The ADHD Effect on Marriage,  and Is It You, Me, or Adult ADHD?

Plus we’ll continue the series on sex therapy fundamentals that began with Some Open Secrets About Sexual Arousal,  Sexuality, Simmering, and the B Train Back From the Beach, and Sexual Arousal for its Own Sake.

That’s assuming nothing else comes along in 2012 to distract us.   A dubious assumption, I know.

 

Four years old is WAY too old to start talking about sex!

December 28th, 2011 by Bat Sheva Marcus LMSW MPH PhD

So it turns out I was wrong. When I give Sex Ed talks to parents and they ask when a parent should start talking to their kids about sex, I usually say… “it’s never too early. You should start when the kids are three or four”. Well, it turns out that four may be on the later end.

There’s a new book out by Robbie Harris, one of my absolute favorite sex educators/authors. It’s called Who Has What, and it’s an introduction to the body and sex for kids. Don’t worry though, in classic Robbie Harris style it’s age appropriate, sensitive and best of all, warm and funny. Her pictures (as always) are amazingly sweet. And guess what? It’s aimed at children two and a half and older.

I always tell parents that at any age, books are the best way to start a conversation and educate your kids. I also always say that if you read to them when they are little, you get nice and used to using real terminology with them, you know that they have the basics and, trust me, it makes it so much easier to talk to your kids about sex when they get older.

So now you have absolutely no excuse. Get the book, cuddle up on the sofa with some hot cocoa and start that long overdue sex conversation.

Kissing Part 3 – Why Stop?

December 22nd, 2011 by Barbara Gross, LMSW

I have been actively looking   for the answer to why people stop kissing. I love research, particularly medical and psychological  journals, because I love to read and I really like to know the answers to why things are the way they are. After searching literally everywhere, I found almost nothing. I can find statistics on how often people have intercourse at any age, single or married and on virtually every continent, but why people stop kissing is not a topic most people, researchers included, really consider. I really think they should.  Sex generally slows down and lessens over time, and the intensity certainly will, which I understand.  But why kissing, which many find even more intimate than intercourse, lessens and ends is unknown.

I think the reason is because intimacy between two people over time is really the hardest thing on earth to achieve. The statistics on divorce are widely known, the statistics on miserable marriages or even marginally miserable marriages are not. Staying close to another human being over time is extremely difficult. And when it is done successfully I honestly think it is one of life’s miracles. Hopefully a relationship starts out with a bang, hormones, and fireworks and fun. Some do not… some grow stronger over time.. but just about all relationships require tremendous work and energy to maintain closeness.

We know the reason why most versions of intimacy struggle and fail: exhaustion, children, financial stress, time stress, illness, etc. etc. So how do people keep it together? Not only the passion, but the connection.  It is a lot of work, yet with the right match, enough fun, humor and compatibility  the work of it hopefully becomes less arduous. I couldn’t find any research to explain the demise of kissing, but I can tell you from personal experience and logging countless hours listening to people talk about their relationships…that staying “connected” whether through kissing or other means is the best way to stay happy.  Kissing is just one aspect of connection. My boss says “if you don’t use it you lose it”, usually in reference to sex, but I would say the same is true for kissing. If you don’t keep doing it…… soon enough….you just won’t want to.

More About Orgasms

December 20th, 2011 by Bat Sheva Marcus LMSW MPH PhD

Mary  Roach, author of Bonk (which you should read if you have the time… I have a review of the book somewhere on this blog!), does a 15 minute review of 10 Things You Should Know About Orgasm.

Okay… you might be able to live without all 10 but I found the clip amusing and yes… a tad informative (especially if you are fascinated by the clitoris of a pig). But once again it makes the point that orgasm is a complicated and fascinating topic that sometimes boggles the mind.

Enjoy it.

http://www.ted.com/talks/mary_roach_10_things_you_didn_t_know_about_orgasm.html

Kissing Part 2 – Anatomy of a Kiss

December 15th, 2011 by Barbara Gross, LMSW

Human lips enjoy the slimmest layer of skin on the human body, and the lips are among the most densely populated with sensory neurons of any body region. When we kiss the neurons, along with those in the tongue and mouth, rocket messages to the brain and body, setting off delightful sensations, intense emotions and physical reactions…Kissing unleashes a cocktail of chemicals that govern human stress, motivation, social bonding and sexual stimulation.” This quote is taken from an article in Scientific American Mind, written about kissing (published in 2008).

Many studies have shown that physical affection in general and kissing in particular can reduce stress, but it seems to me that  kissing is  a forgotten art. Not only is it fun… it reduces stress, reduces cholesterol, burns calories and…. but it can help you and your partner stay together! I can certainly hypothesize on why many couples stop kissing but that was the subject of my last entry. In this entry I just want to encourage all of you to start doing it again.

If you or your partner really has forgotten how to kiss, there are always kissing lessons. You can  contact  William Cane (I have not met him and can not vouch for him professionally but I really like the idea), who has a book and a web site called “The Art of Kissing”.  He also teaches lessons in kissing technique. A private lesson including 30 romantic techniques is just $155.

I generally treat women who have become disconnected from their partners. At The Medical Center for Female Sexuality we offer treatment in many ways, some of it is hormonal, with medication or with behavioral changes. We also offer couple’s therapy. Regardless of how we try to help, the intention of our treatment is to help people stay connected to themselves and to each other.

Kissing is a form of communication. Sex is another form. I don’t think it matters how you stay connected but I think it is vitally important that couples do stay connected. I have seen over and over again that with disconnection comes dissatisfaction and unhappiness – kissing is just one way to connect.  Ultimately you must find the way that works for you.

Men Think About Sex Every 7 Seconds and Other Fairy Tales

December 13th, 2011 by Bat Sheva Marcus LMSW MPH PhD

Sunday’s NY Times article “When Thoughts Turn to Sex, or Not”, reported on the results of an Ohio State University study which debunked the myth that men think about sex every 7 seconds.

All my life (both personal and professional), I have heard that statistic bandied about… men think about sex every 7 seconds. To be honest, it always rang a bit hollow to me. Really? Every 7 seconds? How on earth do they get anything else done? I must say I am really not all that crazy about the idea of, let’s say, my cardiac surgeon thinking erotic thoughts 1542 times during a 3 hour surgery – are you?? Also, I always wondered what men they were talking about. 15 year old HS students? 35 year old investment bankers? 75 year old retirees? Really? All of them? They are all thinking about sex 8228 times a day (that’s based on a day with a generous 8 hour sleep budget)? Even for someone like me who works in the sex field and thus thinks about sex a lot, that strains the limits of credibility.

So I think it was extremely clever of the researchers at Ohio State to give 283 men and women on campus hand clickers and have them click off every time they

a)thought about food,

b)thought about sleep, and

c)thought about sex.

So, how often did men actually think about sex in one day? Well, anywhere from 1-388 times. And women? 1-140 times a day.  Obviously, with ranges like this, it’s awfully hard to come up with the average. The median, however, was 19  for the guys and 10 for the women. Now those are numbers I can live with.

So let’s take away a few lessons from this study:

1. Men (even college co-eds) aren’t thinking about sex all day long.

2. Women think about sex too – perhaps more than we initially thought. And the most important lesson of all…

3. People are individuals, each with their own appetites, need for sleep and sex drives. Let’s focus more on the individual and a little less on the aggregate and we’ll have a happier, sexier society!

Kissing Part 1 – How Often do You Kiss?

December 8th, 2011 by Barbara Gross, LMSW

A recent survey conducted by the British Heart Foundation found that, “one in five (18%) married people don’t pucker-up with their partner for an entire week, while two in five married people (40%) kiss for just five seconds or less when they get it on.  Apparently Scots kiss the longest, for 28 seconds. And  East Anglians ( those from the East side of England) kiss the most.”

Kissing is the first thing to go in a relationship. I have seen it over and over again, in relationships and marriages. I am not exactly sure why. Is it because it is too intimate? Is it because it takes time? Is it something that happens as a relationship progresses? Does it have to do with one’s age? What about where you live? Do people from certain places kiss more than others? I don’t know the answers to these questions, nor do I think that matters.  What matters is how kissing or not kissing affects you and your partner.

The survey also said, regarding statistics in England, “Young lovers in the 18 to 24 age group are making out an average 11 times each week”. Stereotypically, younger people are hooking up more often and they have the time and energy and hormones to be kissing more often.

Sadly, only, “5% of people aged over 45 are managing over 31 snogs (or kisses) each week.” 31 kisses a week, averages out to be slightly over four kisses a day. Two in the morning and 2 at night? And only Five percent?! That is awful! So according to this survey,  95% of Brits over 45 are not kissing much at all, not even four kisses a day. If you are not into kissing I guess this doesn’t matter a bit , but if you are and you have just gotten lazy or busy or disconnected from your partner, then put it right back into your life. Kissing can make you feel better, but more on that next week.

Do you enjoy kissing? How often you do it? How long you have been in your relationship?

I want to hear from you!

The Glee Controversy

December 7th, 2011 by Bat Sheva Marcus LMSW MPH PhD

Amy Schalet, Assistant Professor of Sociology at the University of Massachusetts, Amherst, has a great post responding to the Glee episode where two of its main characters decide to have sex for the first time.

http://www.huffingtonpost.com/amy-schalet/glee-virginity_b_1089983.html

Quote taken from the post, “Why did it takes us so long to arrive at a positive media portrayal of first sexual experiences — planned, protected yet ignited by romantic passion? And why has the Glee episode sparked such a controversy? After all, the so-called sexual revolution took place more than three decades ago, and a majority of our young people experience sexual intimacy of some sort before leaving high school.” Ms. Schalet makes the case that the reason is the parent’s discomfort with their own sexual history and that they are trying to steer their kids in a way different from theirs.

I think she’s right, but perhaps there is another  element to this. In one way or another, every woman I interview thinks that there is something “wrong” with her sex history. She feels as though she had too many partners or she had too few partners. Essentially we, the adults, have to come to terms with our own level of sexuality before we can be truly useful and helpful to our kids.  When I speak to parents I usually point out to them that at least some of their discomfort talking to their kids about sex is that they don’t really know what it is they want to say! Wait until your married? Engaged? In love? Dating for at least 6 months? And is oral sex the same as intercourse? Is using your hands on each other OK? Until the parents have these issues clear, it’s really hard for them to provide guidance to their kids.

The absurd irony here is that parents try to close their eyes to the fact that their children are sexually active. Instead, they should accept the fact and try to be as helpful as possible and give guidance and advice when it is perhaps most needed.

It seems Glee did its job properly here. Now it’s time for us to do our jobs as parents, properly as well!

Faking It

December 1st, 2011 by Barbara Gross, LMSW

Many theories exist about why one might fake an orgasm. In a recent study discussed on CBS News, a researcher at Columbia University found that women fake it to retain their mates. Dr Kaighobadi, who conducted the study (the study can be found in the November issue of the Archives of Sexual Behavior), calls it “mate retention manipulation”. She suggests that “faking an orgasm to keep a mate from straying may be an evolutionary adaptation. Previous research suggests when a woman has an orgasm; it may cause her body to retain sperm for childbearing”. The evolutionary theory suggests faking an orgasm unconsciously might help a woman retain the sperm of a man with “good genes,” giving her the best chance to have a healthy child.  This is certainly one theory.

In my opinion, faking an orgasm is not the right choice. Although you may retain your mate in the short term, you could very well jeopardize the health of your relationship for any long term possibilities. Most people don’t like to be lied to, and in simple terms, faking it is to lie. It creates a breach in honesty, which can hinder intimacy and be hard to repair. A couple’s sexual health and compatibility always contains an element of communication, and  if your partner has no information about what you like, it can be exceptionally hard to make you feel good or have an orgasm.

I often see women who have been lying to their partners for years leading to two problems in their relationships as opposed to one; first we have to deal with the betrayal and only then can we face the orgasm issue. Why not just tell the truth from the beginning? In this case the truth can set you free.  If you are honest with your partner, you will be freed up to have authentic satisfying orgasms. Doesn’t that sound better than practicing “mate retention manipulation”?