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MALE SEXUALITY AND AGING: SEX AFTER A HEART ATTACK

admin — Wed, 23 Mar 2011 15:30:59 +0000

A surprisingly frequent precipitant of psychologically induced impotence is a heart attack. After a heart attack, people tend to turn off to sex, afraid that if they get aroused or have intercourse they will have another. In fact this celebrated way to go is highly overrated. In one study of a large group of men with heart conditions who died suddenly, fewer than one-half of one percent died during sex, many more died in their sleep. Eighty percent of post-coronary patients can go back to normal sexual activity a few weeks after a heart attack. The other 20 percent don’t have to give up sex totally but can adjust their lovemaking to the level of exercise their hearts can tolerate.
The steamiest sexual encounters are less straining on the heart than they appear. Even the peak pulse rate during the few-second heat of orgasm is likely to be lower than the maximum the average person experiences each day. Walking up stairs, running for the bus, even worrying about personal problems are just as likely as sex to make our hearts race. The physical exertion involved in intercourse is also lower than for many forms of exercise. Walking up two flights of stairs or its equivalent probably puts more strain on the heart than having sex. Here are some tips from Sex over Forty for resuming sex comfortably after a heart attack.
You and your sexual partner (who is likely to be just as anxious as you) should discuss with your physician the sexual activities your heart can and cannot tolerate. If your doctor ignores the issue, you bring it up. If he or she seems uncomfortable talking about your fears or gives unsatisfactory answers, get a consultation. Have every concern answered fully, or you will keep worrying and your sex life will suffer.
Learn your exercise tolerance by taking the appropriate medical tests. You might also undergo a physical conditioning program for cardiac patients so your heart will not have to work as hard when you do have sex.
When you resume sex, start slowly, with a week of caressing and petting without having intercourse. This will ease you into lovemaking without your getting too worried. Always take care to have sex under optimal conditions, not when you are very tense or tired.
Experiment with “safer” intercourse positions. Try changing from the man-on-top position to the woman-on-top position (it does take slightly less energy). Try the “spoon position” – you curl up sidewise and enter her from behind. Or if you still are worried about the sex act being too strenuous, make love without having intercourse. Use oral or manual stimulation to bring each other to climax.
Explore medications that may lessen angina. If you have heart pain during intercourse, consult your doctor. Is there a medication to take before having sex?
Avoid sexually impairing medications. Some heart medicines have sexual side effects. If you have lost your sex drive or if having erections becomes noticeably more difficult after the heart attack, ask your doctor if your medication may be to blame. Is there another drug you can take?
Treat depression. Depression, a common reaction to a heart attack, also dampens desire. If you are depressed – an understandable emotion given what has happened – get professional help.

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PROBLEMS HINDERING SEXUAL FUNCTIONING: ORGASM AND SEXUAL PAIN DISORDERS

admin — Wed, 16 Feb 2011 15:14:16 +0000

Orgasm Disorders
Up to 50 percent of the male population is affected by premature ejaculation at some time in their lives. Premature ejaculation is ejaculation that occurs prior to or very soon after the insertion of the penis into the vagina. Treatment for premature ejaculation involves a physical examination to rule out organic causes. If the cause of the problem is not physiological, therapy is available to help a man learn how to control the timing of his ejaculation. Fatigue, stress, performance pressure, and alcohol use can all be contributing factors to orgasmic disorders in men.
When a woman is unable to achieve orgasm, termed female orgasmic disorder, she often blames herself and learns to fake orgasm in order to avoid embarrassment or preserve her partner’s ego. Contributing to this response are the messages women have historically been given about sex as marital duty rather than as a pleasurable act for both parties. Like men who experience orgasmic disorders, the first step in treatment is a physical exam to rule out organic causes. However, the problem is often solved by simple self-exploration to learn more about what forms of stimulation are arousing enough to produce orgasm.
Masturbation is usually a primary focus in teaching a woman to become orgasmic. Through masturbation, a woman can learn how her body responds sexually to various types of touch. Once a woman has become orgasmic through masturbation, she learns to communicate her needs to her partner.
Sexual Pain Disorders
Two common disorders in this category are dyspareunia and vaginismus. Dyspareunia is pain experienced by a female during intercourse. This pain may be caused by diseases such as endometriosis, uterine tumors, chlamydia, gonorrhea, or urinary-tract infections. Damage to tissues during childbirth and insufficient lubrication during intercourse may also cause pain or discomfort. Dyspareunia can also be psychological in origin. As with other problems, dyspareunia can be treated with good results.
Vaginismus is the involuntary contraction of vaginal muscles, making penile insertion painful or impossible. Most cases of vaginismus are related to fear of intercourse or to unresolved sexual conflicts. Treatment of vaginismus involves teaching a woman to achieve orgasm through non-vaginal stimulation.
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SEXUALITY: SEX AMONG COLLEGE-AGE YOUTH

admin — Wed, 22 Dec 2010 15:08:10 +0000

A random survey of health risk behaviors of undergraduate college students published by the Centers for Disease Control revealed that college youth are engaging in multiple behaviors that put them at high risk for illness, injury, and even death. One area that they studied was sexual behavior. Here are some findings:
- The vast majority (86.1 percent) of college students have had sexual intercourse at least once.
- More female students, nearly 88 percent, have had sexual intercourse than male students, of whom 84 percent have had sexual intercourse.
- Nearly 40 percent of males and over 30 percent of females had had sexual intercourse with more than five partners.
- Nearly 80 percent of students said that either they or their partner used some form of contraception (e.g., condom, birth control pills, withdrawal) the last time they had had sexual intercourse. Note, however, that these contraception methods include withdrawal, which provides minimal protection against pregnancy.
Birth control pills were used by almost 35 percent of students surveyed or their partners prior to the most recent experience of sexual intercourse.
- Only about 30 percent of students used condoms during the most recent experience of sexual intercourse, and close to 30 percent used condoms most or all of the time.
- Over 35 percent of college students reported that either they or their partner had gotten pregnant.
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CONTRACEPTION AFTER CHILDBIRTH – THE IMMEDIATE PUERPERIUM

admin — Tue, 07 Apr 2009 07:25:12 +0000

The joy, happiness and sense of achievement in the birth of the baby may be inhibited by recent memories of traumatic delivery, a painful perineum, difficulties with breast feeding or postnatal depression. Sexual matters seem an irrelevance. Several studies have shown that women experience a marked reduction in sexual activity and enjoyment in the third trimester and for up to three months postpartum. This may be nature’s way of ensuring the maximum preservation of the infant by giving it the mother’s undivided attention during the most vulnerable period of its life. Such a view is borne out by the tradition of primitive societies that the newly delivered woman remains with the other women until the baby is seen to thrive. In some races and some religions sexual intercourse is forbidden until the lochia ceases, or while breast feeding continues, although these tend by inference to be polygamous societies.

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THE SECOND BABY – INTRODUCTION

admin — Tue, 07 Apr 2009 07:18:57 +0000

Many couples who have had problems conceiving their first baby have found no trouble in becoming pregnant for a second or subsequent time. But what about the agony of those whose second baby does not materialize? The women themselves often say, ‘I suppose I shouldn’t be making such a fuss because I am so lucky to have one baby.’ For those setting up infertility self-help groups, one of the first questions always seems to be, ‘Do we have separate groups for those with and without children?’ Couples with trouble conceiving a second child are certainly not recognized in the statistic which says that only 4% of women remain involuntarily childless at the menopause, but fortunately they have been included in Hull’s figures of one in six couples seeking help for infertility at some stage in their lives (Hull, Glazener, Kelly et al., 1985).

The reliance on the efficacy of birth control is so great that a woman’s expectation of control over her own reproductive capacity is equally high. When contraception, pregnancy and contraception again have followed in an easy sequence, the non-occurrence of the expected pregnancy comes as a great shock.

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COUNSELLING THE PATIENT WITH THE UNPLANNED PREGNANCY – DEPENDENT WOMAN

admin — Tue, 07 Apr 2009 07:12:29 +0000

Difficulties may arise from the fact that other people are nearly always involved. If a woman is to have a baby, she is likely to become dependent on those around her and the influence of husband, boyfriend or parents is likely to have an important bearing on her decision, even if she chooses in the end to defy them. It is a brave woman indeed who decides to go ahead with a pregnancy totally unsupported, or to have an abortion if that is against the ethics of the people she most loves and would risk losing. Sometimes the picture is so dominated or confused by others that it can be difficult for the woman to sort out her own feelings. This is particularly so with the very young who are still emotionally and physically dependent on their parents, and where the maternal grandmother would often have greatest responsibility in rearing the baby.

Miss E. was aged 1 5 and was brought to the clinic by her mother. Mother appeared to be a caring woman who felt it would ruin her daughter’s life to have a baby, but she was also concerned because she herself worked full-time and a new baby in the house would be a major disruption. Miss E. sat sullenly and said very little. The doctor asked her mother to leave the room while she examined the patient and tried with little success to find out what her real feelings were. She felt very aware of the generation gap, but an abortion did seem for the best so arrangements were made. Miss E. went in to see the nurses to arrange for her admission. Only then did she say she wanted the baby. The nurse did not book her in but suggested she think things out and come back the following week. She came back this time by herself. She wanted the abortion as she wanted to carry on at school. She had made her own decision now.

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CARE OF THE YOUNGER PATIENT – HOW SHOULD ‘YOUNGER’ BE DEFINED WHEN CONSIDERING PATIENTS SEEKING CONTRACEPTION?

admin — Tue, 07 Apr 2009 07:03:53 +0000

Should it be by chronological age or by sexual and emotional maturity? If the latter is the yardstick, then the younger patient may be 13 or 30. The emotional tasks of adolescence, and the normal ages at which they are accomplished, have been described by Christopher (1992). The degree of emotional maturity, and the speed with which it is reached, varies widely between individuals, so that the professional offering help needs to be constantly aware that a consideration of the actual age of the patient is not enough to understand the emotional, sexual and contraceptive needs and difficulties.

For the main body of this chapter, the younger patient will be taken to mean the teenager or adolescent. Among these, doctors will see very few who are under 15 years old. These very young girls will be dealt with separately at the end of the chapter. It is estimated that 18 000 15-year-old girls took formal advice on contraception in 1990 in England. In total, all those under 16 years comprise less than 4% of the total workload of what is regarded as a young person’s clinic in a large city (Brook Advisory Centre, 1990). However, they are an important group, not only in terms of health care in its widest sense, but because they fall into a special category as regards legal and ethical considerations.

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THE IMPORTANCE OF MOTHERS – INTRODUCTION

admin — Tue, 07 Apr 2009 06:57:19 +0000

Girls whose own mothering has been inadequate may be very uncertain of themselves and of their sexual identity. They may have particular fears about the effect of contraception on their fertility, and they may need to establish their femininity by becoming pregnant. For some girls, once pregnancy is confirmed and the reality of coping with a baby is faced, abortion may be requested. For others, having a baby not only establishes their identity but increases their self-worth by providing someone of their own to love. Girls who have been in the care of the local authority are especially vulnerable in this respect.

Getting pregnant and having a baby is at some level both identifying with one’s own mother and also rivalling her. This can cause anxiety, both for having the temerity to attempt such competition, and also from fear of an envious attack from mother. There may be a wish to triumph over mother, to outdo her or the siblings. There may be the idealization of motherhood with consequent fear of not being so good at the job as mother had been.

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KEEP YOUR POTENCY: SMOKING CAN DAMPEN YOUR FIRE

admin — Fri, 27 Mar 2009 07:54:52 +0000

It’s not just the immediate negative effects of smoking that you should worry about when you light up. The long-term results of smoking can be even worse—overtime smoking can silently sabotage your sex life.

Smokers’ arteries are harder, thicker and more clogged than those of nonsmokers. And smoking seems to mess up peripheral arteries even more than those supplying the heart That means it may be particularly bad for the arteries in you penis. Smoking can also cancel the positive effects of exercise leaving you at square one.

Our best advice: What is good for your lungs and heart is also good for your penis. So don’t smoke. If you do, stop. There are many programs that help people give up tobacco. Don’t hesitate to get help if the thought of going cold turkey make you tremble.

The Power of Potent Thinking

The most important factor in lifelong sexual success is attitude. All the information and medical advice in the world won’t help you unless you want it to. If you feel that sex is important and you want it to be a vital part of your life, chances are you’ll find a way to make it so.

Remember: About 90 percent of men with erection problems can find a solution.

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THE IMPLANT SURGERY: MAKING THE CHOICE

admin — Fri, 27 Mar 2009 07:17:32 +0000

Deciding if a penile implant is right for you is a complicated personal and medical decision. Of course, your feelings are crucial. But so are your partner’s. Both of you need to have realistic expectations of what the surgery will and won’t do. The more your partner participates, voices her concerns, asks questions and gets answers, the more comfortable she is likely to be with the process—and the more satisfied with the outcome.

When doctors talk about a “good” candidate for implant surgery, they’re referring to someone who is likely to be satisfied and happy with the results, can withstand the physical and emotional stress any surgery can bring and can effectively deal with the recovery process.

Gary, for example, a 46-year-old, lost his erections to a combination of diabetes and high blood pressure medication. Unfortunately, he couldn’t change his medication and he had trouble managing his diabetes as well as he might have. A series of job and financial setbacks compounded the stress on his body and his emotions. On those rare occasions when he was able to become erect, he quickly lost potency. Five years after he first noticed any sexual problem, Gary was completely unable to have intercourse. He was, understandably, very frustrated by the situation. And he was depressed. The potency problem nagged at him, eroding his self-confidence.

Throughout this difficult period, however, he tried to remain close to his wife, Dottie. They remained physically affectionate, touching often, and continued to have sexual contact. And Gary and Dottie did several things that helped them during this stressful time: They did not blame each other for Gary’s lack of erection, and they discussed the difficulty, but they didn’t make it a point of argument. “We were very supportive of each other; we had a good relationship,” Dottie explains.

Gary had a very clear reason for getting an implant: Plain and simple, he wanted to have intercourse with Dottie. She was concerned that the operation might pose a risk to her husband’s health, but she also was eager to get their sex life back on the track.

Gary and Dottie made several visits to the doctor, and discussed the options in detail. In the end, Gary chose the inflatable implant (discussed later), partly because it was more natural in appearance and he belonged to an athletic club. “I didn’t want anyone to know I’d been impotent and had an implant.”

Now, about a year later, Gary and Dottie are quite happy with the results of his surgery. Gary is enthusiastic: “Satisfied! I could not even begin to describe it. If it broke, I’d be at the hospital tomorrow. I would get it replaced even if I had to get it done weekly!”

In a separate conversation, Dottie echoes her husband’s pleasure. “Yes, I’m pleased. Very pleased. Sex is as good as— maybe even better than—when we first married.”

Gary had several characteristics that are crucial to success. Based upon research and clinical experience, we’ve summarized the factors which make a man a good candidate for an implant. Gary had many of them. You should too before having the surgery.

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