Sex after giving birth

Written by Dr David Delvin, GP and family planning specialist and Christine Webber, psychotherapist and lifecoach

Will childbirth affect your sex life?

Yes, it certainly will! So please don't expect that everything will instantly return to normal. Men are particularly likely to believe this; a lot of young blokes think that they'll be able to have intercourse as soon as their partner gets home from hospital. But that just isn't true.

You see, childbirth is a pretty traumatic process for a woman. Having a baby pass through her vagina is almost like having a small explosion go off inside her. The delicate vaginal tissues are inevitably strained, bruised and torn – and it takes some weeks for these injuries to heal up.

Furthermore, childbirth involves very considerable hormone changes hormone changes – as well as emotional stresses. Therefore, very, very few women feel rampagingly sexy until a long time after they have given birth.

Therefore, it's important for both mother and father to realise that lovemaking may not go brilliantly in the first six months or so after Baby arrives. So be prepared - and be patient!

How soon can you resume having sex?

In general, a woman shouldn't consider having full sex (ie intercourse) until after her postnatal check-up. This examination usually takes place about six weeks after the birth.

Even then, she may not feel ready to 'go all the way' - particularly if she has had stitches and the opening of her vagina is sore.

If you're in any doubt about whether to resume sex, ask the doctor who does your postnatal examination for advice – particularly about using additional lubrication..

Can you go in for any other sexual activity before resuming intercourse?

Yes – and it can be a good way of 'letting off steam'. Couples do often get very frustrated when they're waiting to resume sexual intercourse. This applies particularly to men!

So, in the meantime, you can go in for loveplay - though there is one danger, which we'll explain in a moment.

Can both of you go as far as the point of climax? Definitely! It will do the postnatal woman no harm at all to have orgasms if she wants to.

So, things you can do include:

• hand petting on the man by the woman - what's often called a 'hand job'.
• hand petting of the woman by the man - using his fingers to stimulate her clitoris. But he should not put his fingers inside until she has had her postnatal examination and the doctor has said that everything has healed up. So, just stick to stroking and rubbing the outside of her sex organs. It's quite safe to pay plenty of attention to her clitoris, which is well away from the area where stitches are put in.
• oral sex performed on the man by the woman. This type of loveplay - termed 'fellatio'- often proves a great boon to a male who is desperate for sexual release.
  
• mutual caressing of various other parts of each other's bodies.

Is there anything we should avoid?

Yes. Please heed this important warning. You'll note that in the section above we have not recommended oral sex performed by the man on the woman (ie 'going down ' on her).
This activity - often termed 'cunnilingus' - is definitely off limits during the first few of months after childbirth.
Why? For two reasons:

• it could introduce infection into the vagina and womb.
  
• even more seriously, it has occasionally led to death.

These tragedies have occurred because the man has (often accidentally) managed to blow air into the vagina. Air can very easily get into the blood vessels of the newly-delivered womb - and cause an often fatal illness called 'air embolism'. Not long ago, the British newspapers reported an appalling case in which a man forced his wife into cunnilingus shortly after she came home from hospital, puffed air into her – and killed her.

Is it OK to handle the breasts after childbirth?

Yes, it is OK - provided the woman feels happy about it. But don't go in for 'boob play' if she develops any kind of breast disorder, such as a nipple crack or an abscess.

Do feelings for the new baby affect your sex life?

Absolutely! You'll find that a great deal of time has to be spent taking care of the new baby. Most new mothers - and plenty of new fathers too - feel exhausted because they are never able to get sufficient sleep. This may go on for months - or even a couple of years.
During this time, a man can feel as if his partner is pushing him away. He may think that she is lavishing all her attention on the baby and this may make him feel jealous, or left out.

After watching a partner go through pregnancy and birth, some men gain a new respect for the female body. These guys find it easier to articulate the emotions they feel about the new phase of their relationship and become more considerate of their partner's changing needs.

But a few men who have been at the birth of their child are quite distressed by what they have seen. Indeed, some of them feel so guilty at the pain their partner has gone through that they are unable to even consider the idea of making love with her again. This is usually just a passing phase, but not always. And such a man should seek help from a counsellor to discuss his feelings.
To create and maintain a good atmosphere in the home, your relationship has to be one of trust and mutual respect. Both partners need to try to understand the other's point of view. It is vital at this time that the couple can still do things together without the baby being involved so that they can enjoy the feelings they had for each other before they became parents.
We do urge new parents to take advantage of any offers of babysitting that come their way from fond grandparents, aunts, uncles and friends so they can go out together - or even just retire to bed for a sleep and perhaps a spot of sex!

What happens to the female sex drive after birth?

Most women don't feel very keen on sex for at least a few weeks after childbirth and the main reason for this is simply exhaustion. If the delivery was long or difficult, the woman may also feel anxious about getting pregnant again.
Generally, women start getting their desire back within a couple of months of having a baby. If your libido doesn't return, then you should seek help from a doctor. Female medics at family planning clinics are particularly good at helping to deal with this problem because they see it all the time.

What do you do when you want to resume sexual intercourse after the birth of your child?

When you're both ready to have intercourse after the birth, you should begin gently. If possible, try and find a time of the day when you are not too worn out. Also, try to find a time when the baby is not likely to wake up - so you can have some peace and quiet.

Hormone changes and worry can lead to some women experiencing vaginal dryness for the first three months after giving birth. But you don't take hormones for this. Instead, buy lubricants over the counter from a pharmacist. Try K-Y Jelly, Liquid Silk, or Pjur. Some condoms have a built-in lubricant that may help.

For the first few sex sessions after childbirth, it's a good idea to choose a position in which the woman can control the pace and depth of penetration. A position with her on top, or one where both partners lie side-by-side facing each other, may be more comfortable.

Don't forget contraception. It's very easy to become pregnant again - far sooner than you intended. Try and decide on some form of family planning by the time your baby is four weeks old. If in doubt, ask the doctor at your postnatal examination about contraception.
What do you do if the woman doesn't regain her interest in sex?This is quite common. Please bear in mind that it could be a symptom of postnatal depression (PND). If the woman is at all depressed, she should see her GP.
Otherwise, the best thing is for the couple to get some counselling from an expert in sexual problems, for instance at:

• Relate
  
• Couple Counselling Scotland
  
• A Family Planning Clinic.
  With commonsense advice, a loving couple can usually gets things sorted out – though it may take some months.
  During 2005, certain new treatments for increasing female libido are due to come onto the market. They include:
• a testosterone (male hormone) gel.
  
• a testosterone skin patch.
  
• alprostadil gel (ALISTA) – a jelly intended for application to the clitoris and surrounding area.
  
• Eros – a vibrating suction device which is already available, but not on the NHS.

Unfortunately, Viagra and similar drugs have not so far been convincingly shown to help new mothers who are having difficulties with sex. However, in mid-2005, doctors from St Mary's Hospital, London, published a very small series of cases in which women with poor libido seemed to be helped by using Viagra. But as this treatment is not licensed, it is not available from your GP.

from http://www.tiscali.co.uk/lifestyle/healthfitness/health_advice/netdoctor/archive/000327.html

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Better Sex for a Better Marriage

Better sex in your marriage can lead to a better marriage. While everyone knows that “it’s not just about the sex,” sex is still a very important part of most marriages. But how can you have better sex in your marriage? How can you and your spouse talk about sex? And how do you know what’s okay as far as sex goes in your marriage?

Better Sex in Your Marriage – Tips

Better sex in a marriage starts with communication. It takes constant open communication to understand what your spouse desires. Unfortunately, many couples never talk about sex, either out of fear or embarrassment. A good rule of thumb is to presume your partner doesn’t know how to satisfy you, and vice versa, so you need to ask each other. It is important to discuss sex because men and women have fundamentally different sexual needs. These needs, if left unaddressed, can lead to disagreements and frustration. Keeping these sexual differences between men and women in mind can help open the door to better sex for a marriage.

Better Sex in Marriage – What Women Want

Women do not separate sex from the emotional aspects of the relationship They want a sense of connection and intimacy that starts well before sex is initiated. Therefore, men, it’s critically important for better sex in your marriage that you light the spark outside the bedroom to make sure you have fireworks inside the bedroom. Also, take note of what may dampen your wife’s sexual fire: tiredness, hurt feelings or negative body image are all factors that can take a toll on her sexual drive, so do your best to help minimize these distractions.

Better Sex in Marriage – What Men Want

Men often view making love as a primary way to connect with their mates. Men are more prone to visual stimulation and instant gratification. Seize the moment with your husband – he may get turned on while watching you get ready to go out, and won’t be satisfied with just a simple kiss. Remember, better sex in your marriage doesn’t have to follow a schedule. Be ready for the unexpected and embrace his spontaneity!

Better Sex in Marriage – Add Spice

Better sex in your marriage can’t just be all talk – you have to take action. Many couples find sex most enjoyable when they both know what to expect. Predictability can be either positive or negative. If you find you have a sexual routine but both you and your spouse satisfy each other’s needs consistently, then it’s positive. However, routine sex habits can be negative if they could keep you from exploring new ways to satisfy each other.

1. Have better sex in your marriage by trying something new:

When you communicate as a couple, you may find out your spouse would like to try something new…or you may find that you want to try something new. But how do you know what’s right for you both? Generally speaking, as long as you both feel comfortable with and respected by each other, it is okay to venture out a bit. Add spice to your love life by experimenting with the frequency, duration or time of day you have sex, or by adding foreplay or using sex toys.

2. Have better sex in your marriage by trying out new positions:

One of the best ways to enliven the sex in your marriage is to try different positions, which is even recommended by sex therapists. You could also think about where you have sex. The bed is the most common place, but it’s not uncommon for couples to make love in other places like the kitchen, backyard, bath or shower, or even in the backseat of the car as if you were still dating.

Many people can be shy or embarrassed about trying new things sexually, depending on what they might have learned or been taught about sex. While we don’t want to challenge personal beliefs, we encourage you and your spouse to become comfortable with your bodies and desires, and to consider stepping out of your comfort zones to fully enjoy all the possible sexual gratification and intimacy your relationship has to offer.

Better sex in your marriage begins with open communication. Each spouse should ask what the other desires, and explore these desires together. Research shows that this is the key: in one study, 88 percent of women who reported always discussing their sexual feelings with their husbands described their sex life as good or very good, while those who didn’t talk about it reported just 30 percent and wanted better sex for a better marriage.(1) Just asking these important questions starts a good habit of open discussion which leads to a better marriage through better sex in your marriage.

from http://marriage.eharmony.com/advice/marriage-problem-9.html

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Rough Sex

My boyfriend likes to have rough sex. When we first had sex he pulled my hair and since I didn't say anything he kept doing it. I started liking it and he went further and started biting and spanking me while we had sex. He also puts his hands over my mouth and holds my arms down sometimes, almost like a rape fantasy for him. He is a very gentle person other wise. I am just curious about this and wonder does he have rape tendencies toward other women?

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Dr. Allan Schwartz, LCSW, Ph.D. Responds

One of the major components of human sexuality is that people have fantasies before and during sexual activity. Many couples decide to "enact" these fantasies because doing so enhances their excitement. One must be made very clear is that there is great human variation as to what is considered sexually exciting versus what is disgusting, violent, victimization or intolerable or forcible pain and rape.

There are those sexual partners who gladly and willingly enact rape scenes, and many other types of scenarios. This does not mean that they have "rape tendencies." If he is scaring you or acting in ways you do not like then you must put a stop to it.

The bottom line is that as long as two people are mutually consenting to their sexual practices there is nothing wrong.

Having stated that I want to add something that strikes me about your question: It seems that you and your boyfriend have not discussed what you are doing during sexual activity. If you have any concerns, anxieties or worries about what he is doing with you sexually, then it is imperative that it be talked about.

It is always interesting to me that couples engage in the most intimate of acts, sexuality, but are so fearful of discussing it that they avoid the topic. Talk to him and resolve any issues you or he may have.

One more thing: I am somewhat concerned that your boyfriend puts his hand over your mouth. Breathing is vital to life. Accidents can happen and no one could blame you if you wanted him to stop doing that. If he cannot tolerate that then he is not the right boyfriend.

Thank you for your interesting question.

- Dr. Allan Schwartz, LCSW, Ph.D.

from http://www.mentalhelp.net/poc/view_doc.php?type=advice&id=2937&at=7&cn=10

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Talk Fantasies to Partner

When discussing fantasies with your lover the question of whether you wish the fantasy to become a reality, or just keep it a fantasy, must be asked. Many fantasies involve some risks & often include behaviour that are outside the realm of some people's "norm". Then again, there are many fantasies that are very easy to fulfil & well within every couples reach.

When discussing these fantasies some sense of each others limitations must be kept. As with all of the other discussions you have, or will have, about the various aspects of your sex life, an open mind & a nonjudgmental attitude must be held. This applies more so to fantasy talk than any of the other topics we have covered.

Some fantasies may be taken out of context & create an illusion of a sexual act that may appear on the surface as one thing when in fact that is not at all what the person had in mind. The most common example of this misconception is the rape fantasy. No person in the world would truly enjoy being raped, it is a sick & sadistic crime, but many have fantasies about what we could call, a controlled rape. Of course this would be with a person they knew & trusted & would not include any violence of any kind.

There are several other fantasies of this nature that must be cautiously examined but that is for another section. The point of this all is to make you realize that not all fantasies are within the grasp of a normal couple & some are meant to stay just that, a fantasy.

What should be considered a fantasy?

When talking about your fantasies with each other you must be able to openly discuss & listen to what each other is saying. I repeat LISTEN TO WHAT EACH OTHER IS SAYING! A fantasy is someone's special place where they are usually the center of attention. These can also be a hidden desire longing to be fulfilled. A persons fantasy is something that belongs to them & is usually very special to them, kind of like a child's special "pretend world".

Tread lightly when talking about anyone's fantasy so as not to criticize. Belittling a persons fantasy can have serious emotional effects! Fantasies can be anything from candlelit bathes with wine & oils to bisexual curiosities. As with all of our discussions in this section the level of trust & comfort with your partner will dictate the amount of information you are willing to share. Start gradually & allow these talks about fantasies to go forward at their own pace. Never force someone to divulge something they are not quite ready to tell you. Give it time & practice, it will come to you both as you become closer in your relationship.

Are there Any Taboos?

There are several subjects that may be considered a fantasy, but in reality are not what most couples would consider acceptable. Telling your lover that you fantasize about your secretary at work or the pool boy are not what we are going for here. These fantasies are better left in the closet until your relationship is utterly bulletproof, but I wouldn't count on it.

Fantasies may include other people in such manners as threesomes or swinging. Many women fantasize about two or more guys at one time & I don't think there is a man alive who hasn't dreamt about two women. These are healthy & completely normal fantasies that may be within your grasp, once your relationship is strong enough. Bisexual fantasies are also very prevalent & require this same stability in the relationship.

Our philosophy is this, anything two people do in the privacy of their lives, with or without other people, that doesn't harm the other partner or damage the relationship in any way is healthy, BUT, it takes complete trust, respect & a healthy relationship to allow it. Communication, once again will help you explore these fantasies in a non threatening manner to see if you wish to proceed. Jumping into any of these fantasies without completely discussing them in advance may cause irreparable harm.

from http://www.have-better-sex.com/communication/taling-about-fantasies.html

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Sensual Biting

Bite her erogenous zones

If sensual biting is new terrain for you, start with the nape of the neck. Most women find the area highly sensitive and absolutely love being kissed here. This makes for an easy transition once you have her purring with delight. The inner thigh is equally deserving of your attention, and will often result in her begging for clitoral stimulation. If you really want to drive her wild, don’t give in to the request; continue nibbling a trail along the edge of her thigh until she loses control. And she will. Other areas you’ll want to pay special attention to include the curve of her waist, her lower back, the area just below her breasts, and her bottom.

Create buildup

It won’t do to just sink your teeth in before her body’s ready for it -- that could really be painful. You want her in an aroused state, both physically and mentally. Start with the foreplay you’ve already mastered: kiss her, caress her, talk dirty to her. If you’d like to up the ante, try something new and unique. Once the desire is obvious, gently drag your teeth across a shoulder, thigh or hip -- anywhere fleshy to ensure minimal pain in case she doesn’t like it. If she shudders with pleasure, consider it a green light to continue -- but tread lightly. You want to find her pain threshold without crossing it. Keep an eye on her facial expressions and she’ll let you know when to say when.

Keep it quick

The secret to keeping real pain out of the sensual biting equation is to keep it quick. The longer you maintain the bite, the more pain is registered. Therefore, the ideal nip really shouldn’t last more than a few seconds -- unless she asks for something more intense, of course. You’ll also want to make sure you don’t spend too much time in one spot; this could get painful fast. You don’t want her to feel like she’s in bed with Dracula!

biting don’ts

Don’t bite random areas

No matter how much she enjoys this kind of play, random sensual biting can result in a very turned-off woman. In other words, don’t bite the first thing you see, unless it’s one of the areas we’ve already discussed. Biting the wrong place could really freak her out and ruin an otherwise sexy evening -- especially if she’s never been bitten by anyone before. We want her moaning with pleasure, not agony.

Don’t make noises

She may love it when you turn into an animal, but that doesn’t mean she wants you to sound like one. Certain noises simply have no place in the bedroom -- slurping and smacking of the lips are particularly disgusting. No matter how skilled you are at nibbling her neckline, toss a slurp in there and that’s the end of that. Silliness can have the same effect, so avoid comments like “Yummy!” or other sayings one might hear on a playground while you practice sensual biting.

Don’t gnaw

It goes without saying, but the more you nip one particular area, the less pleasurable the sensation becomes. The same goes for anything resembling a chewing motion: There’s nothing sexy about feeling gnawed upon. Keep your sensual biting crisp, clean and quick to prevent her feeling like a chew toy.

love bites

Sensual biting can be a very pleasurable experience for a woman, and it’s something many of them secretly yearn for. Unfortunately, men often hesitate to experiment with the idea, fearing they might be thought of as too animalistic. Rest assured, biting is a natural instinct that arouses even the most vanilla of women. Take these sensual biting tips to bed and watch how quickly she melts in your mouth.

Article Suggested By: Ben P., Bethlehem, PA

from: http://www.askmen.com/love/love_tip_300/365_love_tip.html

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Cycling may cause sex problems, expert warns

Cyclists could suffer sexual problems if they do not have the right bike, according to a specialist doctor.

Vinod Nargund, a surgeon from St Bartholomew's Hospital in London, said that cycling restricts blood flow and generates excessive heat. This could result in men having difficulty with erections.

Cycling puts pressure on the nerves which can also affect a man's sperm.

More than 60 per cent of male cyclists experience genital numbness, according to Mr Nargund, a urology consultant.

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He said: "The bicycle saddle makes contact where the nerves and blood vessels enter the back of the scrotum and penis.

"Numbness is common because the pressure of the saddle can impair the blood supply to this area. This can also affect the man's ability to get an erection."

Mountain bikers run a particular risk, as do those riding with too much pedal resistance.

Mr Nargund did not establish a clear link between cycling and male infertility, but said it is recognised as a possible side effect.

Cyclists must choose the right bike to avoid sexual problems, while a padded saddle and shorts are essential, he said.

"The male cyclist should know his bicycle well. An appropriate frame should be selected and adjustments made considering posture, height and balance," Mr Nargund said.

Regular rest periods and cycling in a lower gear are also advised in the article, published in the online urology journal BJU International.

from: http://www.telegraph.co.uk/news/uknews/2267939/Cycling-may-cause-sex-problems,-expert-warns.html

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Changes in Your Sex life

The most uncomfortable stuff to talk about is probably your sex life and the changes that have taken place with your illness. You may not know what needs fixing or how to fix it, but you know things are different.

Many women report having less sex than before their illness, for several reasons:

• The breast cancer experience slows down your body. It takes longer to do lots of things, including getting interested in and starting and finishing sexual intercourse.
• Sex may be uncomfortable or even painful if you've been thrown into sudden-onset menopause. No surprise that you tend to have less sex, for now. Many women may have had little or no sex from the time of diagnosis through treatment.

Most people have wild ideas about what goes on in other people's bedrooms. Give yourself a break: The carefully researched book Sex in America (by Michael, Gagnon, Laumann, and Kolata) tells us that Americans have a lot less sex than the movies, television, and the guys in the locker room would have you believe. The averages reported in that book are:

• seven times a month between ages 30 and 40
• six times a month between ages 40 and 50
• five times a month between ages 50 and 60

For people over 60, the numbers continue to decline. But although you may assume that no one in their 70s and 80s has a sex life, that's just not so.

Molly, 78, described her sex life after breast cancer treatment: "I stopped the action for a while, and then we went back at my request. He was waiting for me to give him the go-ahead." Hilda, an 82-year-old breast cancer survivor, explained that she didn't have a lover "at the moment." Sex goes on even into the 90s for some. And now with Viagra, who knows what new limits will be set?

Don't let the myths about other people's sex lives get in the way of what's happening in yours. And remember that there are exceptions to every pattern.

If your sex life is not working the way you want it to, your doctor or nurse may be able to referee these issues with your partner and you. You can cue your doctor in advance, since he or she has most likely already touched on delicate issues with you. Maybe he or she can be the tour guide for the two of you. If your partner is there when you talk with the doctor who's managing your care, you and your partner both get a chance to air and dispel fears, and replace myths and false information with facts.

Help from a pro

Not all doctors and nurses are comfortable discussing sexual issues and practices. Most doctors don't routinely ask about your sex life. And patients don't usually begin to discuss their love life with a doctor who hasn't mentioned it. Nobody's talking!

Someone has to break the pattern. A trained social worker, sex therapist, psychologist, or psychiatrist can help you open up communication with your partner and get around to talking about intimacy and sex issues.

A support group may be more helpful than you might realize. Women in these groups often share advice that extends to the bedroom, including ways to increase sexual pleasure that are explicit and specific for women who've had breast cancer.

Meeting needs in other ways

Most marriages have problems that don't get fixed. Marriage is a package deal, and in marriages that work, the good things outweigh the bad. But as a survivor, you may find that breast cancer highlights the problems in your marriage. Can you live with those problems? Can you enjoy your marriage even as you contemplate what's missing? Can you capture the missing pieces in other ways? Give serious thought to your needs and how to meet them.

Other ways to meet your needs:

• Fantasy can enrich your life. Countless women read to fill the vacuum (romance novels are enormously popular).
• Join a book club, a church or synagogue, or a group that meets to discuss investments, movies, or local politics.
• Do more with individual friends, like walking, shopping ("retail therapy"), or travel.
• Make a bigger deal of birthdays and anniversaries.
• Expand your involvement in community or spiritual activities.
• Get politically active in the breast cancer movement: camaraderie for a cause close to your heart.

from: http://www.breastcancer.org/tips/intimacy/changes.jsp

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Better Sex Through Yoga

by Jennifer Langheld and Garvey Rich (Directors)
Yoga Craze, 2004
Review by Christian Perring, Ph.D. on Apr 4th 2006

Yoga instructor Jacquie Noelle leads viewers through all three of these DVDs promising Better Sex Through Yoga. As you would expect, they are labeled "Beginner," "Intermediate," and "Advanced." Each DVD has a workout session: on the first and second DVDs these last about 48 minutes and 45 minutes respectively, while on the third one it is about an hour. Each DVD has the same extras. The "Special Features," include a short piece on how yoga can improve your sex life, and a collection of out-takes and bloopers. There's also a trailer for the DVD and a written biography of Jacquie Noelle. The "Additional Instruction" section has a short piece by Jacquie again explaining the sexual benefits of yoga, and a more useful selection of yoga poses which gives hints about how best to do them, with writing on the screen accompanying the poses.

The yoga workouts feature Jacquie along with two other people. They are all youthful, attractive and very fit. They do the yoga in a gym of some kind with curtains draped around them and some potted palm trees standing in the corner and lit candles placed around the space. Jacquie speaks out loud explaining what to do, and there are occasional instructions in writing on the screen or added in voice over in post-production. There is some rather cheesy and extremely repetitive electronic music in the background.

Readers may be relieved or disappointed to learn that there's nothing particularly sexual about the yoga workouts. The Jacquie and her co-presenters are clothed at all times, although occasionally the man takes off his top to reveal a glistening sweaty chest. Jacquie wears clinging tops and tight short shorts. Once or twice the camera seemed to linger unnecessarily long on Jacquie's crotch as she leans back. The background music occasionally has some sort of groaning sound that is somewhat sexual. The voice-over gives frequent instructions to tighten and relax your sexual core, which seems to involve a clenching of the pelvic muscles. But apart from that, the yoga workout is rather similar to most other DVD yoga workouts. Maybe there is a little more emphasis on hip movements and pelvic flexibility, but not much more. The sequence of poses, starting with a warm up, then going through standing poses and abdominals, and ending with relaxation is similar to most yoga flows.

The production feels rather home-made: while the yoga instruction seems proficient, the sound quality is not great, and occasionally it is hard to hear exactly what Jacquie is saying. The voice-over is wooden and not particularly helpful, especially since the whole idea of breathing into or tightening your sexual core is not well explained. There's not enough difference between the three DVDs to really justify having three of them, and although the third one has some challenging poses, it is not really advanced compared to other yoga DVDs.

Nevertheless, these DVDs provide a good yoga workout. I don't see that they will be any better at improving your sex life than any other yoga DVD, and some people may prefer a workout made with higher production values and a more Eastern approach. However, I expect that some people will welcome a yoga workout with an attractive instructor using simple language without any foreign language. The promise of better sex may well be fulfilled if the yoga exercises improve flexibility, strength and bodily self-confidence.

from http://www.mentalhelp.net/poc/view_doc.php?id=3065&type=book&cn=10

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Paraphilias

Definition

A paraphilia is a condition in which a person's sexual arousal and gratification depend on fantasizing about and engaging in sexual behavior that is atypical and extreme. A paraphilia can revolve around a particular object (children, animals, underwear) or around a particular act (inflicting pain, exposing oneself). Most paraphilias are far more common in men than in women. The focus of a paraphilia is usually very specific and unchanging.

A paraphilia is distinguished by a preoccupation with the object or behavior to the point of being dependent on that object or behavior for sexual gratification.

Paraphilias include sexual behaviors that society may view as distasteful, unusual or abnormal. In descending order, the most common are pedophilia (sexual activity with a child usually 13 years old or younger), exhibitionism (exposure of genitals to strangers), voyeurism (observing private activities of unaware victims) and frotteurism (touching, rubbing against a nonconsenting person), while fetishism (use of inanimate objects), sexual masochism (being humiliated or forced to suffer), sexual sadism (inflicting humiliation or suffering) and transvestic fetishism (cross-dressing) are far less common. Some of these behaviors are illegal and those who are under treatment for paraphilias have often encountered legal situations surrounding their behaviors. There is also a category called Paraphilia Not Otherwise Specified to cover paraphilias not falling into the already named diagnoses such as those involving dead people, urine, feces, enemas and obscene phone calls.

Symptoms

Although many paraphilias seem foreign or extreme, they are easier to understand if one thinks of those behaviors that, in less extreme versions, are quite common. For instance, having a partner "talk dirty" may be a "turn-on" for some people, but when talking dirty is the only way that sexual arousal or satisfaction can occur, it would be considered a paraphilia. Others want to be bitten, or spanked, or become aroused by watching their partner. Viewing a nude person or watching sexually explicit videos can be arousing for most people. Paraphilias are magnified to the point of psychological dependence.

Causes

It is unclear what causes a paraphilia to develop. Psychoanalysts theorize that an individual with a paraphilia is repeating or reverting to a sexual habit that arose early in life. Behaviorists suggest that paraphilias begin through a process of conditioning. Nonsexual objects can become sexually arousing if they are repeatedly associated with pleasurable sexual activity. Or, particular sexual acts (such as peeping, exhibiting, bestiality) that provide especially intense erotic pleasure can lead the person to prefer that behavior. In some cases there seems to be a predisposing factor such as difficulty forming person-to-person relationships.

Behavioral learning models suggest that a child who is the victim or observer of inappropriate sexual behaviors learns to imitate and is later reinforced for the behavior. Compensation models suggest that these individuals are deprived of normal social sexual contacts and thus seek gratification through less socially acceptable means. Physiological models focus on the relationship between hormones, behavior and the central nervous system with a particular interest in the role of aggression and male sexual hormones.

Treatment

Treatment approaches have included traditional psychoanalysis, hypnosis, and behavior therapy techniques. More recently, a class of drugs called antiandrogens that drastically lower testosterone levels temporarily have been used in conjunction with these forms of treatment. The drug lowers the sex drive in males and reduces the frequency of mental imagery of sexually arousing scenes. This allows concentration on counseling without as strong a distraction from the paraphiliac urges. Increasingly, the evidence suggests that combining drug therapy with cognitive behavior therapy can be effective.

Regarding medication for paraphilias, level of sex drive is not consistently related to the behavior of paraphiliacs and also high levels of circulating testosterone do not predispose a male to paraphilias. That said, hormones such as medroxyprogesterone acetate (Depo-Provera) and cyproterone acetate decrease the level of circulating testosterone thus reducing sex drive and aggression. These hormones result in reduction of frequency of erections, sexual fantasies and initiations of sexual behaviors including masturbation and intercourse. Hormones are typically used in tandem with behavioral and cognitive treatments. Antidepressants such as fluoxetine (Prozac) have also successfully decreased the sex drive but have not effectively targeted sexual fantasies.

Research suggests that cognitive-behavioral models are effective in treating paraphiliacs. Aversive conditioning, for example, involves using negative stimuli to reduce or eliminate a behavior. Covert sensitization entails the patient relaxing, visualizing scenes of deviant behavior followed by a negative event such as getting his penis stuck in the zipper of his pants. Assisted aversive conditioning is similar to covert sensitization except the negative event is made real most likely in the form of a foul odor pumped in the air by the therapist. The goal is for the patient to associate the deviant behavior with the foul odor and take measures to avoid the odor by avoiding said behavior. Aversive behavioral reversal is commonly known as "shame therapy" as the goal is to shame the offender into stopping the deviant behavior. For example, the offender might be made to watch videotapes of their crime with the goal that the experience will be distasteful and offensive to the offender. Vicarious sensitization entails showing videotapes of deviant behaviors and their consequences such as victims describing desired revenge or perhaps even watching surgical castrations.

There are also positive conditioning approaches that might center on social skills training and alternate behaviors the patient might take that are more appropriate. Reconditioning techniques center on providing immediate feedback to the patient so that the behavior will be changed right away. For example, a person might be connected to a plethysmographic biofeedback machine that is hooked to a light. The person is taught to keep the light within a specific range of color while the person is exposed to sexually stimulating material. Or masturbation training might focus on separating pleasure in masturbation and climax with the deviant behavior.

Cognitive therapies described include restructuring cognitive distortions and empathy training. Restructuring cognitive distortions involves correcting erroneous beliefs by the patient, which may lead to errors in behavior such as seeing a victim and constructing erroneous logic that the victim deserves to be party to the deviant act. Empathy training involves helping the offender take on the perspective of the victim and in identification with the victim, understand the harm that has been done.

Sources:

* American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised

* Nathan, P. E., Gorman, J. M., & Salkind, N. J. (Eds.). (1999). Treating mental disorders: A guide to what works. New York: Oxford University Press.

Last Reviewed: 16 Aug 2006
Last Reviewed By: Laura Stephens

from: http://psychologytoday.com/conditions/paraphilias.html

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Viagra

How it works

Taking Viagra relaxes the blood vessels in the penis. This allows blood to flow into the penis causing an erection. However, it will only help you get an erection if you're sexually stimulated. Viagra isn't an aphrodisiac and it doesn't increase your sex drive.

How to take it

Viagra is available in three doses: 25mg, 50mg and 100mg. Your doctor will select the dose most suitable for you. The tablet should be swallowed whole with some water about an hour before sexual activity.
Viagra works better on an empty stomach, so it's best to avoid having a large meal or a lot of alcohol before taking the tablet.
It takes about 20 minutes to an hour to work and is effective for about four hours. Within this four-hour period you should be able to get an erection in response to sexual stimulation.

Possible side effects

Side effects are generally mild and brief, with the most common side effects being headaches and facial flushing. Less often, men have reported indigestion, a runny nose and a blue tint to the vision.

Does it work for everyone?

Although a safe and effective drug, Viagra isn't suitable for everyone and doesn't work in all cases. If you fall into either category, your doctor can advise you of other effective treatment options.
Viagra reduces blood pressure slightly, which isn't a problem in most men. However, this effect is greatly exaggerated if taken with nitrate treatment, which is prescribed for angina (chest pain). Viagra taken with this will cause a large drop in blood pressure which could prove fatal. If you're taking nitrates, you shouldn't take Viagra.
Viagra isn't licensed for use in women and its safety in women hasn't been established.
If you have a heart condition it's important that you discuss your condition and medication with your doctor before taking Viagra. Men who have any of the following conditions should also avoid taking it:
- severe heart or liver problems
- recent stroke or heart attack
- low blood pressure
- certain rare inherited eye diseases

Take care!
Remember: it's dangerous to get Viagra through the internet or other advertised sources. Drugs from unknown sources may be fake and if taken with some medicines (as mentioned above) the result could be fatal.

from: http://www.bbc.co.uk/relationships/sex_and_sexual_health/probs_viagra.shtml

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Sexual Addiction

Introduction

The term "sexual addiction" is used to describe the behavior of a person who has an unusually intense sex drive or an obsession with sex. Sex and the thought of sex tend to dominate the sex addict's thinking, making it difficult to work or engage in healthy personal relationships.

Sex addicts engage in distorted thinking, often rationalizing and justifying their behavior and blaming others for problems. They generally deny they have a problem and make excuses for their actions.

Sexual addiction also is associated with risk-taking. A person with a sex addiction engages in various forms of sexual activity, despite the potential for negative and/or dangerous consequences. In addition to damaging the addict's relationships and interfering with his or her work and social life, a sexual addiction also puts the person at risk for emotional and physical injury.

For some people, the sex addiction progresses to involve illegal activities, such as exhibitionism (exposing oneself in public), making obscene phone calls, or molestation. However, it should be noted that sex addicts do not necessarily become sex offenders.

Behaviors associated with sexual addiction include:

• Compulsive masturbation (self-stimulation)
• Multiple affairs (extra-marital affairs)
• Multiple or anonymous sexual partners and/or one-night stands
• Consistent use of pornography
• Unsafe sex
• Phone or computer sex (cybersex)
• Prostitution or use of prostitutes
• Exhibitionism
• Obsessive dating through personal ads
• Voyeurism (watching others) and/or stalking
• Sexual harassment
• Molestation/rape

Generally, a person with a sex addiction gains little satisfaction from the sexual activity and forms no emotional bond with his or her sex partners. In addition, the problem of sex addiction often leads to feelings of guilt and shame. A sex addict also feels a lack of control over the behavior, despite negative consequences (financial, health, social, and emotional).

How is sexual addiction treated?

Most sex addicts live in denial of their addiction, and treating an addiction is dependent on the person accepting and admitting that he or she has a problem. In many cases, it takes a significant event—such as the loss of a job, the break-up of a marriage, an arrest, or health crisis—to force the addict to admit to his or her problem.

Treatment of sexual addiction focuses on controlling the addictive behavior and helping the person develop a healthy sexuality. Treatment includes education about healthy sexuality, individual counseling, and marital and/or family therapy. Support groups and 12 step recovery programs for people with sexual addictions (like Sex Addicts Anonymous) also are available. In some cases, medications used to treat obsessive-compulsive disorder may be used to curb the compulsive nature of the sex addiction. These medications include Prozac and Anafranil.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.

Reviewed by Daniel Perlman, MD, on September 24, 2007.

Portions of this page © The Cleveland Clinic 2000-2003

Last Editorial Review: 12/26/2007

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The Male G-spot

By Isabella Snow

You’ve probably spent a considerable amount of time studying the female G-spot: How to find it, how to stimulate it and how to turn a woman into putty with a G-spot orgasm. What most men are far less familiar with is their own male G-spot. That’s right; some of you may be surprised to learn that the prostate is, essentially, the male equivalent of a woman’s G-spot -- and yours is far, far easier to find. We realize that, for some, the idea of exploring this area may be taboo, but if you keep an open mind while reading this article, our advice could lead you to one of the best orgasms you could ever hope for.

Read on as we give you the lowdown on the male G-spot and what it can do for your sex life.

Discovering your G-spot

The male G-spot isn’t all that difficult to find, but it does require a little patience. Lying on your back is generally considered to be the most comfortable position for this, so you’ll probably want to make use of the bed or perhaps a large sofa. The process will be easiest with your legs elevated, which you can do by simply leaning your legs against the wall behind the bed or draping them over the back of the sofa. If you’re still having difficulty reaching the perineum from this position, you can lift your backside further by sliding a pillow or two under your bum.

Once you’ve made yourself as comfortable as possible, start by gently massaging the area surrounding your anus. Most men enjoy having their taint (also known as the perineum) stimulated, and that can certainly be incorporated into this process. Use the soft pad of your index finger while exploring, and be gentle. As you relax further, lube your finger up and let it gently brush across the surface of your anus. Repeat this move several times, each time increasing the pressure slightly. When you’re comfortable enough to begin probing, you should keep things slow and gentle, taking care to relax your sphincter during the process. Once you’ve come in contact with the male G-spot, you’ll recognize it as a small, chestnut-sized bump situated approximately two inches inward.

Stimulating your G-spot

The first step in stimulating the male G-spot is making oneself comfortable. Bathing beforehand can put a man more at ease with the process, so we recommend starting out with a nice hot shower. If you’d like to take that one step further, enemas are not at all uncommon and you may choose to add this to your regimen. Once you’re ready for stimulation, there are a number of methods you can utilize, though we recommend keeping it simple if you’re a novice; a finger will be sufficient for beginners. Regardless, you’ll want a good supply of lubrication on hand, and you’ll want the type specifically created for anal play.

It will take some experimentation to discover what works best for you in terms of stimulation. Return to one of the positions we mentioned earlier (lying on your back with your legs and backside elevated) and repeat the steps you used to located the prostate. As you prepare to stimulate your G-spot, keep in mind that techniques vary greatly. Some men enjoy gentle thrusting movements, and some prefer intense, constant pressure on the prostate itself. You might prefer a mix of the two or something entirely different. The key is to give your body the chance to react and respond; take your time, the orgasm is worth it. It’s also important to note that you may not find any of these methods pleasurable during the first exploration, and that’s perfectly normal; you can always try again in the future.

Don't be ashamed of stimulating the male G-spot; the results can be explosive...

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