Men's Health & Tips

10 Tips for Good Relationship

2009-06-22T11:52:00.002+07:00

Relationship in couples takes a lot of effort. Following are some tips to remember in making your relationship work with your couple.

1. Quality time

If you want to make a difference in your relationship, make time for you love one. The quality and exclusivity of it will really make it count, not just about how much time is spent together. Go with the flow and the mood of the day, you may surprise yourselves.

2. Compromise

To any couple, a healthy dose of give and take is a good recipe. Getting it right takes time and practice. Used as ai integral building block in a healthy relationship, it can give a couple balance and a sense of security.

3. Dependence and Independence

Maintaining a sense of individuality without disregarding a partner is always a good idea. It’s socially unattractive to become something of an appendage to a partner. Accepting your own and your partner’s shortcomings can be difficult but putting in the effort will, no doubt, make a significant difference.

Many thrive on the feeling of being needed. The trick is not to become needy and clingy. Having a clear idea about who you are, goals and ambitions are all important factors that not only draw a couple together, but can also help to maintain interest.

4. Communication

No good can come out of unspoken resentments or discomfort. Open communication can help to eliminate the build up of discontentment that often finds its way into sparking fights and rifts. “The only way out is through” at the end of the day.

5. Money

Borrowing, lending, over-indulging and impulse buying. Often a thorn in the side of many a couple, finances are high on the list causing conflict. Whether joint or independent from one another, finances should be addressed early on, particularly where the interests of both parties are concerned.

6. Acceptance and Forgiveness

Some things about a person are inherently part of their make-up. They simply won’t change. If they’re bad enough, it’s possibly a good idea to give the relationship the boot. Not everything is worth living unhappily with. Some little annoyances or character traits that are not so desirable in a partner cannot and should not be changed. Forcing a hand will only cause damage. Forgiveness, too, can be liberating in a relationship. Where possible, it can truly change the level of respect each has for one another.

7. Growing Pains

It’s only natural for each phase of a person’s life to develop and change. Most of all, it’s meant to be. This is where communication and open observance play a huge role. Making an effort to continuously get to know 1 another every so often can help couples to remain in tune with each other, growing as individuals and together.

8. Surprise!

Getting creative from time to time can not only be fun but also help to strengthen a special bond with a partner. Surprise him / her with thoughtful gifts, messages or quality time together. It’ll give the redundancy of routine a much-needed facelift.

9. Affection

A showing of affection can provide great assurance to a couple, strengthening the bond between them. It’s a process of discovery and it is important to remember this is personal to every individual.

10. Praise

Showing interest and expressing praise every so often can do wonders for the strengthening of a bond between couples too. Celebrate each other’s achievements whether great or small. These shows of support will invariably bring the 2 of you closer together.

In Conclusion

Many will offer advice and all sorts of ideas, even when not having been asked to provide it. The tried and true way to maintain any healthy relationship is to focus on the one at hand and experience it. Experiences differ and each will tell a slightly different version. Learn, respect and embrace each experience, and who knows, relationships could very well prove to go the distance.

Leaving Him Breathless: What Men Like in Oral Sex

2009-05-25T19:39:00.001+07:00

Oral sex is exactly that — using your mouth, including your lips, tongue, and teeth, to give your partner sexual satisfaction.

Not too long ago, many people considered oral sex a perversion, while today more and more people are engaging in oral sex. Many young people even consider it an intermediary step to sex, rather than the real thing.

Oral sex performed on a man is called fellatio. (It doesn’t matter whether a man or woman is performing this act on the man.) This licking and sucking of a man’s penis can be used as a precursor to intercourse (to arouse a man so he gets an erection), or it can continue until he has an orgasm.

Though a common word for an erection is a hard-on, and certainly an erect penis is harder than a flaccid one, you must remember that a penis is not actually hard, but is made of flesh and blood, and so it can be damaged. If a penis is handled too roughly, the man could develop what is called Peyronie’s disease, which means that a kink may develop, or even several kinks. So anyone performing fellatio has a duty to be relatively gentle.

Not sure what to do? Try this basic approach and improvise as needed (I suggest a few fun techniques to try along the way):

1. Both partners should be in comfortable positions.

You may have seen pictures of a woman on her knees while the man stands above her, and this position has its advantages, as I explain below. But if a woman is uncomfortable in this position and this is a way of the man proving his domination, then that’s not a good idea. However if she’s kneeling on a pillow, this position can work comfortably for both partners.

2. The partner giving oral sex starts by gently fondling the man’s penis with his or her hands.

Some men will have an erection just from the expectation of receiving oral sex, while others, particularly older men, use oral sex as a means of obtaining an erection. In the latter cases, oral sex may be thought of as foreplay to intercourse.

3. After the man starts to get an erection, lick the penis or place it in your mouth.

While the tongue is certainly an important part of the process, you can lightly nibble the penis with your teeth, give light kisses with your lips, or suck the penis with your mouth. But please, no biting.

The movie Deep Throat put pressure on partners to swallow the man’s entire penis while not gagging. Of course in the movie, the penis was particularly large, but real life is not the movies, and no one should feel pressured into trying to copy what they see on-screen. Because the most sensitive part of a man’s penis is the head of the penis, deep throating his penis isn’t going to give him much more pleasure and is really more an act of humiliation than anything else. I’m not saying that couples shouldn’t do this if both partners are willing to try, but one’s abilities to perform fellatio don’t depend on being able to perform circus tricks.

4. Stimulate the underside of the head of the penis, the place where he has the most sensitivity.

If you’re facing the man, as you are when on your knees while he is standing, then your tongue will be in the right place to do this. If you’re upside down, such as in the 69 position, you may want to use your fingers to add arousal to that area.

5. Continue using your hands to touch the penis, stroke the shaft, and gently fondle the testicles.

Don’t be reserved about exploring beyond the head of the penis while performing oral sex. These touches are not only permitted but encouraged.

Be careful when it comes to his testicles because they are sensitive. Too much pressure causes him pain, which puts a quick end to these activities. If the man enjoys it, you can also insert a finger into his rectum.

6. If oral sex is not being used as foreplay, the man is going to ejaculate as a result of oral sex.

There’s no harm if he ejaculates in your mouth, but it’s also not necessary. If you don’t want that to happen, the man should tell you that he is about to ejaculate and you can use your hands to help him reach his climax.

Communication is key to doing a good job, as it is with any sexual position. You can’t guess what feels best to your partner. You have to ask him, and he has to be able to articulate his needs.

If you’re not ready to perform oral sex on your partner yet, but you think it’s something that you want to try, you can simulate the real thing by practicing on an ice cream cone. By licking the ice cream sensuously you’ll develop a good understanding of what you should do when the flavor goes from vanilla to male appendage.

What Women Like in Oral Sex

2009-05-21T08:44:00.002+07:00

Oral sex performed on a woman is called cunnilingus, though not by many people cause the average person prefers terms that are easier to pronounce. Like fellatio, oral sex can be done as part of foreplay, or it can be done to bring a woman to climax. If you use oral sex as foreplay, both partners must be in synch with regards to where the woman is on the orgasmic scale. The woman has to let her partner know when she is very close to having an orgasm. When she gives him the signal, he should stop oral sex and begin intercourse.

As I’ve said, women require direct stimulation to their clitoris to have an orgasm, and the tongue and lips offer an excellent means of doing just that, better than fingers, which can be rough. In fact, some women can only have an orgasm from oral sex. Here’s what to do:

1. Both partners should be in a comfortable position.

Many women are most comfortable lying on their backs with their partner kneeling or lying in between their legs so he can easily put his head between her thighs.

2. The partner giving oral sex should begin by rubbing the woman’s legs, thighs, and vulva with his or her hands.

These caresses tell your partner’s body that some really amazing stuff is about to happen, so she should begin getting aroused. As a result of her excitement, she should start producing lubricant, which helps prevent irritation to the delicate clitoris and vagina. But your saliva is also a lubricant.

3. Spread the lips of the vulva and find the clitoris. Gently begin licking.

The tongue can be used in many different ways, from short rapid thrusts to long, slow licks. The tongue can be thrust into the vagina as well as used all around its edge.

Although the human tongue is nowhere as rough as a cat’s, after a few minutes of performing oral sex, your tongue may become dry and will seem much rougher to the very sensitive clitoris. When performing oral sex, make sure that your tongue is well coated with saliva.

Between the saliva and a woman’s natural lubrication, which should be flowing if she’s very aroused, quite a puddle can form under her after a long session of oral sex. Rather than worry about it, I suggest placing a towel underneath her.

4. Try sucking the area around the clitoris or some light nibbling (but teeth shouldn’t play a large role in performing oral sex on a woman).A sudden puff of air may be pleasurable, too.

The seat of a woman’s orgasm is her clitoris, but the clitoris can sometimes become overstimulated so that a woman won’t want it to be touched directly. You need to be mindful of that if she complains, and either lessen the strength of the stimulation or stop any direct simulation altogether.

5. Ask her what she likes.

Perhaps even more so than with men, communication is the key to doing,a good job at oral sex on a woman. A woman’s ability to orgasm is more delicate than a man’s, and she may require very specific types of stimulation in order to have an orgasm. So you have to pay careful attention to her directions, which may be verbalized, with commands such as “harder” or “softer,” or done by moving your head to a certain part of her anatomy.

6. Take a short break if your mouth and tongue become tired.

Try using your nose as a stimulator while the other muscles get a chance to relax. Or reach up and stimulate her breasts for a little while. Many women enjoy having a finger or two inserted into their vagina during oral sex, but some may find it too distracting. The same is true with anal stimulation.

7. Adjust your stimulation as she approaches orgasm.

Some women, as they’re near orgasm, find that their clitoris becomes extra sensitive. You may assume that more stimulation should be pro- vided to her clitoris as she reaches this point, but sometimes just the opposite is true, and only the area around the clitoris should be licked. Make sure that you don’t get so lost in the heat of the moment that you stop communicating.

You may have heard rumors about the danger of blowing into the vagina during oral sex. This danger only comes into play if the woman is very pregnant. When everything is distended down there, it becomes technically possible to blow an air bubble through the wall of a vein or artery that has been stretched superthin, which could be deadly. I don’t know whether this has ever happened, but some doctors warn pregnant women about this, and so I’m passing it on, mostly so that all of you performing oral sex on nonpregnant women don’t have to worry about it.

A man will usually have an erection when he begins giving oral sex to a woman, but if the process stretches out a bit, there’s a good chance that he will lose his erection. That’s only natural because he’s concentrating on her pleasure, not his. Some men, who worry that an lost erection won’t return, may want to engage in intercourse the moment they feel their penis start to soften. But if the man hasn’t ejaculated, in most cases with a few tender ministrations from his partner later on, his erection should come back, so men don’t need to react to a shrinking penis.

Dealing with Some Delicate Details

If even after reading everything in this article, you’re still hesitant about trying oral sex, I can guess why. I address some common concerns in the following sections.

Tidying up down there

More people might engage in oral sex if the organs involved weren’t also the organs from which people urinate. Some people don’t give that fact a second thought and dive right in, so to speak, while others think about this dual role and that gives them the heebie-jeebies, even though urine is actually more germ free than saliva.

My advice to people who worry about cleanliness is to begin oral sex in the bathroom. Oral sex doesn’t have to begin there, but a thorough cleaning ofthe genitals should take place. I’ve found, in advising patients, that many who object to oral sex discover that their objection goes down the drain after they’ve thoroughly washed the potentially offending sex organ. The above advice may be particularly important when the man hasn’t been circumcised. A buildup under the foreskin, called smegma, can develop, which definitely isn’t sexy. All uncircumcised men need to be careful when cleaning their penis to make sure that they do a good job under the foreskin, but this attention to cleanliness is especially important to any man expecting his partner to give him oral sex. (Women should also clean under their clitoral hood because a smegma-like substance can also collect there.)

Whether it’s because women are having more oral sex or because women are just wearing smaller and smaller bikinis, it’s become more common for women to shave or wax their pubic hair. Most men who perform oral sex on their partner probably appreciate this.

Of course, men with beards or mustaches may cause the sensitive area around a woman’s genitals to become chafed while performing oral sex. Any man with facial hair, or even just stubble, should be careful not to hurt his partner.

To swallow or not to swallow

Some women are concerned about getting the ejaculate in their mouth. Now, a few drops of Cowper’s fluid will be secreted at the head of the erect male penis, but most women worry about the actual quantity of ejaculate that is propelled from the penis upon orgasm. Nothing in a man’s ejaculate is harmful (assuming that he is disease free), and to anyone who complains about the calories, I say “Enough!” But you don’t need an excuse to want to avoid this.

If you really want to avoid coming in contact with ejaculate, try the following:

Ask your partner to let you know when he is close to having his orgasm. This is the best way to avoid the ejaculate. When he lets you know his orgasm is imminent, you can move your mouth out of range while continuing to help him climax with your hands and fingers.

Watch for the signs of impending orgasm. A man’s erection strengthens when he is near orgasm and his scrotum will tighten up, pushing his testicles up against his body. When you notice this, duck out of the way. Keep a towel or tissue close by. If your partner does ejaculate into your mouth, you can easily spit it out without swallowing it.

Many people ask me whether they can do anything to change the taste of their or their partner’s semen. Although anecdotal evidence indicates that what you eat plays a part in what your ejaculate tastes like, I haven’t seen any scientific research that proves that. On the other hand, nothing is stopping you from doing your own research. Not only might it be educational, but it could also be a lot of fun. If a partner really objects to the taste but wants to proceed, I suggest having a breath mint handy so she can quickly change the taste in her mouth.

The porn industry has introduced a new facet to oral sex: the facial, where the man ejaculates onto his partner’s face. In my opinion, this is humiliating and not sexy. Each individual must set his or her limits, but I wouldn’t want the average person contemplating oral sex to think that a facial is a necessary part of the act.

But I’m having my period

Most men avoid performing oral sex on a woman who is menstruating, but the fact is that nothing dangerous is present in menstrual blood (unless she has an STD). If you and your partner want to engage in oral sex at that time of the month, you have no reason not to go ahead (pun intended!).

Avoiding lockjaw, lip languor, tongue tiredness

Oral sex may be becoming part of the norm, but it’s still not entirely a “normal” activity because the mouth must engage in vigorous movements for a length of time that it’s not often called on to do. In other words, oral sex can be tiring.

Most men don’t require extended oral sex, though some do, especially as they get older. But some women require extended stimulation in order to have an orgasm. Although they can’t do anything about that, women must not lose focus of their partner’s well-being. Their partner will need a break after a while because lengthy tongue and lip action can become uncomfortable, if not painful. I understand that a woman who is close to having an orgasm won’t want to stop receiving stimulation, so she may want to give her partner a break before she reaches that point. The couple should talk about her needs and how to best arrive at the destination they both seek.

Simplifying sexual slang

Because I’m always telling you not to be boring, I thought I’d help you out by including some other phrases you can use when talking about the activities described in this article.

Cunnilingus: canyon yodeling, carpet munching, dining at the Y, eating hair pie, egg McMuff, going down, going way down south in Dixie, making mouth music, muff diving, scarfing down, sipping at the fuzzy cup, sitting on one’s face.

Fellatio: blowing, deep throating, frenching, getting a facial, giving head, giving lip service, hoovering, putting lipstick on one’s dipstick, señoreata, soiling one’s knees, sucking off, talking into the mike, worshipping at the altar.

Assuming the Position in Oral Sex

2009-05-20T09:02:00.004+07:00

I haven’t given you many specifics about the positions that you can use for oral sex. Certainly there is no right or wrong position. One partner can be seated or standing and the other on his or her knees, or the recipient can lie on his back while his or her partner leans in over the genitals. Just choose whatever is most comfortable. If the woman kneels down and straddles her partner’s head while he is lying on his back, she will gain some control over how much stimulation she is getting because this position allows her to pull back or push forward. To make sure that her partner doesn’t have to strain his neck, he should place as many pillows as necessary under his head until he can reach her clitoris without straining.

Although you’re free to name any position you may use during oral sex, one position already has a name of its own — 69, which refers to partners performing and receiving oral sex at the same time. The name comes from the shape of the two bodies as they lie on top of and upside down to one another.

It really doesn’t matter which partner is on top, but the man usually gets on his hands and knees because he is likely to have to strain his neck more if he is on the bottom. (Although, as I said above, a pillow under his head can help.) The 69 position may be most comfortable for both partners if done while lying on their sides.

Oral sex, especially fellatio, offers a couple the opportunity to give orgasms without removing any clothing. All a man has to do is stick his penis outside of his zipper and his partner can perform oral sex. This allows couples to perform a sexual act in places not normally thought of as appropriate, such as hallways and park benches. Although I know this goes on, I urge you to exercise some caution. You may think that no one can see you and be very, very wrong. So if you give in to this temptation, do it cautiously.

And although I know the thought of giving a man an orgasm while driving in a car may be tempting, please don’t ever do anything as distracting as that while in a moving vehicle.

Addressing the Safety Issue
Many people have the erroneous notion that oral sex is completely safe because no one ever became pregnant through oral sex. But oral sex is not entirely safe when it comes to sexually transmitted diseases, although oral sex is safer than intercourse or anal sex in terms of transmitting germs and viruses. I offer more information on STDs, but here I want you to know that diseases can be transmitted orally. With more and more people engaging in oral sex, the transmission of disease through oral sex is rising, so much so that now doctors are finding cases of genital herpes that were caused by the virus for oral herpes, something that had not been noted before.

A partner performing fellatio can protect herself or himself by making sure that a condom is placed on her or his partner’s penis. But when performing oral sex on a woman, preventing the transmission of disease is much more difficult. Some people recommend using dental dams, which are small squares of latex, or a sheet of plastic wrap held over the woman’s vagina during oral sex. But the odds of keeping the dental dam in place, so no bodily fluids are exchanged during passionate sex, seem pretty remote. And plastic wrap, which is so thin, seems likely to break, although some brands are stronger than others. Very thin underwear (you can even get an edible variety that comes in flavors) can also act as a barrier.

Although it’s tempting to say that using either dental dam or plastic wrap is better than nothing, I think that would be an error. If you think you’re protected when you’re not, you’re much more likely to do something that you shouldn’t. So the only way to make sure that you won’t get a disease when performing cunnilingus is to only do it with a partner who has been tested for STDs (and given a negative result). I could add “or who is a virgin,” except that so many teens who consider themselves virgins have had oral sex and may have already gotten an STD. Virginity these days is not necessarily a form of protection.

Skin Care Tips: Natural Skin care 4 Natural Hair Loss Remedy

2009-04-29T21:15:00.007+07:00

There are many products on the market that claim to help regrow hair but for one reason or another, you may not want to deal with having to take pills or deal with surgical treatments. Natural hair loss treatments may be the answer you are looking for. Going with natural treatments doesn't have the risks that can be involved with pills or surgery.

Eating a healthy diet is one natural treatment that can be used right away. Certain vitamins and minerals actually help to promote healthy hair growth such as B-vitamins, iron, Vitamin E, zinc, and many more. You can get your daily recommended allowance from healthy foods (fruits, vegetables, lean meats) as well as a multivitamin supplement.

Herbal remedies and nutritional supplements are also an option for natural hair loss treatments. Flaxseed oil is known to improve hair texture and keep hair from drying out. Folic acid and silica may help to maintain the thickness and color of hair.Essential oils are also known to help prevent hair loss and actually regrow hair. Essential oils of thyme, rosemary, lavendar, cedarwood, and jojoba oil are some examples that can be combined and applied to the scalp. The oils are massaged into the scalp for 3 to 5 minutes. They should not be consumed but only used externally.

Traditional Chinese medicine is another option. You can visit a Chinese medicine shop and inquire about hair tonics or other tonics that may help with hair growth.As you can see, you have several options for natural hair loss treatments. They are relatively safe to try and can be done right away to prevent anymore hair loss and increase hair growth.Hair loss can occur in men and women for any reason and at any time. Most of the time there is no way to figure out what is exactly causing hair loss. Many times it is hereditary or caused by an unhealthy lifestyle. Whatever the reason, there are ways to prevent hair loss and get your hair growing again.
The following tips will provide some simple tips that you can begin using to help prevent further hair loss and promote healthy hair growth once a gain. The best part is you can implement these tips right away.

Get Your Vitamins - It's crucial to maintain a healthy lifestyle but most of all, it's important to get your daily recommended allowance of vitamins and minerals.

Avoid Harsh Chemicals - While you may be tempted to color your hair or use chemicals to curl or straighten it, try to avoid it as much as possible. Harsh chemicals damage hair and cause breakage.

Avoid Heating Tools - Hair dryers, curling irons, flat irons, and hot combs can all cause hair breakage from overheating the hair. Try not to use these tools much if at all.

Exercise Regularly - Exercise stimulates circulation which in turn stimulates your scalp. Scalp stimulation can help promote hair growth.

Avoid Stress - Stress can play a role in hair loss among other health problems so it's important to avoid it as much as possible.

You can prevent hair loss and promote hair growth by keeping the tips above in mind and by maintaining a healthy lifestyle.

If you have found the loss of your hair to be something you just can't seem to control, then you may want to consider how to stop hair loss naturally.

It can be one of the most rewarding things you can do for your hair, as many hair loss products on the market often are way too expensive and lead to side effects. No one wants to have to pay a ton of money or risk their health right?

So one of the things that I've found that must be done in order to see added hair growth naturally is by attacking one of the main root causes of thinning hair. This root cause is due to a hormone called dihydrotestosterone , or DHT for short.

DHT comes about from a loss of estrogen in women and a loss of testosterone in men. It will bind to your hair follicle cells and eventually weaken them till they no longer are able to produce more hair for you. Instead of relying on those products that you know are a waste of time and money, one way to reduce DHT in the scalp is by taking herbs.

Two great ones that have been found to reduce DHT and treat hair loss are saw palmetto and green tea. Drinking four cups of green tea daily has scientifically been proven to cut DHT in the body.

Saw palmetto when taken as part of your daily supplement routine produces some amazing effects in blocking the formation of this hormone. Both herbs provide a very fast solution to those who are losing their hair.

There's a dirty little hidden secret that 90% of those losing hair have no idea exists.

Osteoporosis

2009-04-28T06:57:00.002+07:00

What is it?

Osteoporosis means ‘porous bones’. Inside the thick outer shell, bones are like a honeycomb. Osteoporosis occurs when the holes in the honeycomb get too big and bones can break.

What are the symptoms?

A broken bone after a minor bump or fall is the most obvious sign of osteoporosis. Other warning signs include height loss and curvature of the spine.

What's the risk?

It can effect people of all ages but although it’s not an inevitable result of ageing, it does become more common as you get older and affects 1 in 5 men over 50.

What causes it?

Genetic factors are very important – some 80% of the risk is hereditary.

It may be a side-effect of another disease such as hyperthyroidism (an over-active thyroid gland), hyperparathyroidism (too much of the parathyroid hormone) or coeliac disease or Crohn’s disease or other medical conditions which affect the absorption of nutrients from food.

Other factors include low levels of testosterone, drug side-effects (particularly from corticosteroids) and alcohol.

How can I prevent it?

- Keeping up calcium intake in the diet (best done through a balanced diet that includes low-fat milk, cheese and yoghurt, leafy green veg, fish bones and dried fruit which are all good sources of calcium rather than supplements)

- Keeping up vitamin D levels – vitamin D helps the body absorb calcium and is most easily found in the natural sunlight (but don’t get sun-burned),

- Avoiding smoking

- Taking plenty of exercise – bone is living tissue and needs weight-bearing exercise to maintain its strength. This doesn’t mean you need to lift weights – your own body weight will do so walk. jog, dance etc. Check out our online gym.

Should I see a doctor?

If you have any of the symptoms, risk conditions or a family history, it is worth seeing your GP.

What are the main treatments?

The main treatment are drugs called bisphosphonates, one of which (alendronate) is licensed for men. Calcitonin, which comes as a nasal spray or an injection, may also be prescribed for pain relief.

Testosterone replacement therapy is possible for men in which low testosterone levels are the cause of their osteoporosis.

Supplements of calcium and vitamin D might also be recommended if you have diagnosis of osteoporosis

Who else can help?

National Osteoporosis Society

Camerton, Bath BA2 0PJ

tel: 01761 471771

fax: 01761 471104

helpline: 0845 450 0230 (Monday to Friday 10am to 3pm)

website: www.nos.org.uk

e-mail: info@nos.org.uk

Hair Loss

2009-04-25T12:29:00.004+07:00

Most men don't need to be told – it's the loss of hair resulting in decreasing coverage of the scalp.

What are the main symptoms?

Male pattern baldness (also known as genetic hair loss or alopecia androgenetica) is the most common form of hair loss in men. It usually develops very gradually, typically involving the appearance of a bald spot on the crown of the scalp accompanied by thinning at the temples. Although this problem can strike any man at any time, many first become aware of it as they approach their thirties.

What's the risk?

· Two-thirds of all men will eventually be affected by male pattern baldness – in the UK, this means that 7.4 million men are losing their hair at any one time.

· There are racial differences, however, in the incidence of male pattern baldness. The highest rates are found among Caucasians, followed by Afro-Caribbeans. Chinese and Japanese men have the lowest rates. For some unknown reason, this form of hair loss is does not occur among Native Americans.

· Male pattern baldness runs in the family. If your grandfather, father or brothers went bald early, the chances are that you will too. The strongest influence is on the mother's side: if your maternal grandfather went bald, that's probably a better indicator that you will too than if your father's father lost his hair.

What causes it?

There is only a tiny grain of truth in the myth that bald men are more virile because they have more of the male sex hormone testosterone.

This idea probably grew from the observation that eunuchs never became bald and, having being castrated, they didn't, of course, produce very much testosterone.

Yes, testosterone is involved in male pattern baldness, but its relationship with hair loss is complicated and not completely understood. Testosterone is naturally converted in the body to a related sex hormone, dihydrotestosterone (DHT). This stimulates the growth of facial and body hair, as well as acting on the prostate gland. There is good evidence that male pattern baldness results from an over-sensitivity of scalp hair follicles to DHT, rather than raised levels of either sex hormone in the blood.

How can I prevent it?

You cannot prevent male pattern baldness, although there may be ways of slowing down the process or disguising the problem.

Should I see a doctor?

· To get advice and treatment for hair loss, you should always start with either your GP or a professionally qualified trichologist.

· Until very recently, male pattern balding was seen as a natural process and you may find your doctor to be neither sympathetic nor helpful if you consult him/her about it. But things may be changing. An increasing number of doctors realise that hair loss can have psychological consequences that significantly diminish quality of life, especially for younger men, and they may be more willing to take the problem seriously.

If you are lucky enough to have an enlightened GP, by all means seek their advice – at the very least, you'll get a referral to a reliable trichologist (although you'll probably have to pay for any treatment you receive).

A trichologist, by the way, is a hair specialist whose training covers both the cosmetic and the medical aspects of the subject. Some trichologists are also trained hairdressers, but they are not usually medically qualified. The Institute of Trichologists keeps a register of properly qualified people: look for the letters AIT (Associate), MIT (Member) or FIT (Fellow) after their name.

Other types of hair loss, such as alopecia areata, are taken seriously as medical conditions and you should seek your GP's advice as you would for any other medical problem.

What are the main treatments?

There is no cure for male pattern baldness, but there are both drug and surgical treatments available which may lead to some improvements.

Minoxidil (sold as Regaine)

· This is the only topical treatment (one that you rub into the skin) which is actually licensed for the treatment of male pattern baldness in the UK. It was originally developed (in tablet form) as a drug for high blood pressure. Doctors noticed that people on minoxidil sometimes grew new hair, so the drug was reformulated for this purpose.

· Regaine comes as 2% or 5% lotions which you rub, daily, into your scalp. It is best to start with the 2% lotion and after three months, if you have not seen significant growth of hair, upgrade to the 5% lotion. In the UK, Reagine is a Pharmacy Only medicine, which means you can obtain it from a pharmacy without a prescription, but only when a pharmacist is on the premises. The pharmacist should check that Regaine is appropriate for you before selling it (for instance, you shouldn't use it without medical supervision if you have high blood pressure).

· Regaine cannot work miracles. About one-third of men using it get good hair growth on the bald patches, one-third get a fine, downy regrowth, while the rest will get little or no response. The majority of men using it find that at least they don't lose much more hair – but as soon as you stop using it, hair loss resumes its course.

· Expect to wait up to four months before you get any response from Regaine (be patient), but if nothing happens after, say, a year, you may as well give it up. Incidentally, never pay large sums of money to a private trichologist or over the internet for Regaine – the usual price is around £30 for a month's supply.

Finesteride (marketed as Propecia)

· This is a treatment for male pattern baldness which is licenced in the UK but only on private prescription, not on the NHS. It is one of a class of drugs called 5-alpha-reductase inhibitors. Since 5-alpha-reductase is the enzyme which causes the conversion of testosterone into DHT, inhibiting this with finesteride should, in theory, stop hair loss. In fact, finesteride was originally developed for the treatment of benign prostatic hyperplasia (BPH), a condition in which the prostate gland becomes enlarged through the action of DHT.

· Although there have been no clinical studies directly comparing low dose finesteride and Regaine, the data suggests that the two products may be similarly effective as a treatment for hair loss. Finesteride can lead to side effects in up to 2% of users such as impotence, reduced sex drive and reduced semen volume. (These side-effects are reversible when the treatment stops.)

· Propecia can be obtained from your GP or dermatologist on private prescription.

Anti-androgen therapy

· Another way of tackling male pattern baldness is to directly block the action of DHT using a variety of hormonal drugs. Some of these are similar to oral contraceptives and female hormone replacement therapy. They should only be applied under the supervision of an endocrinologist (hormone specialist) or a dermatologist with expertise in hormone therapy.

Hair transplant surgery

· Surgery offers the possibility of a longer-term solution to your hair loss problem. But it doesn't come cheap and it can be hard to find a skilled and reputable surgeon. Put simply, hair surgery involves rearranging your scalp skin so as to minimise the bald areas and maximise those where hair is still growing.

· In the UK most hair surgeons use grafts, which involves transferring skin from the hair-bearing area at the back of the head to the bald parts at the front. Hair grafts work because the section of skin transferred retains its own characteristics (i.e. hair grows) rather than acquiring those of the place it is transferred to (where hair does not grow).

· The most natural results come from transferring plugs of skin bearing 3–6 hairs (minigrafts) or just one hair (micrografts). The surgeon makes tiny slits or pinholes in the recipient area into which the plugs are inserted. A new hairline can be built up by using rows of micrografts at the front and minigrafts a few rows further back.

· When considering surgery, you must remember that your hair loss could well continue around the reconstructed areas. This may look unsightly unless you're prepared to invest in further surgery in a few years time.

· Hair surgery usually involves considerable financial investment and you are also involving yourself in a medical procedure. So choose your surgeon carefully, preferably via personal recommendation or through the Institute of Trichologists. He or she should carry one or more of the following qualifications:

1. FRCS (Fellow of the Royal College of Surgeons)

2. BAAPS (British Association of Aesthetic Plastic Surgeons)

3. BACS (British Association of Cosmetic Surgeons)

Remember, a good hair surgeon probably doesn't need to advertise.

Other treatments

As far as other treatments are concerned, be very wary. There are many bogus operators out there who are only too keen to exploit people with hair loss.

How can I help myself?

Making changes in your hair care routine and overall lifestyle may help minimise the appearance of hair loss.

· Treat your remaining hair with a bit more respect. Most people are too rough with their hair. It's better to use a comb, not a brush, and to avoid tightly fitting caps or hats. Hair is more fragile when it's wet, so handle it with care.

· Some shampoos and other hair cosmetics can make your hair look thicker and fuller. Ask your hairdresser for advice.

· Short hair minimises the contrast between balding and non-balding areas. Long hair has the reverse effect and is very ageing. It shouldn't need saying, but combing hair over a bald spot is not a good idea.

· Include sufficient protein in your diet, especially if you are vegan or vegetarian (hair loss sometimes starts when people give up meat). Ensure that you do not become anaemic by eating plenty of iron-rich foods like liver, eggs and green vegetables.

What's the outlook?

There's no cure for male pattern baldness, although other forms of male hair loss are often reversible.

Exploring the Mythology of Masturbation

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For any of you who haven’t heard the myth about hairy palms, let me explain. People have long frowned upon masturbation (stimulating your genitals until you have an orgasm), and in ancient times viable reasons existed for this attitude, besides the fact that no one had yet invented Vaseline.

If people, particularly men, masturbated, then they wouldn’t have sex with women as often. And, in the early days of mankind, when infant mortality was high and life expectancy low, making babies was important for the survival of the species.

The elders of the tribes disapproved of masturbation because they believed that each man was born with only a certain amount of sperm, and if he wasted that sperm masturbating, he’d have none left to impregnate a woman. (I wonder what their attitude would have been if they’d knownthat a man can make 50,000 sperm a minute. Let the good times roll?)

The story of Onan

The early Jews certainly were against the spilling of seed (an old-fashioned term for mas- turbating). You can read about their concern in the story of Onan in Genesis in the Bible, out of which came the word onanism as a synonym for masturbation. Actually, Biblical scholars now believe that, rather than masturbating, Onan practiced coitus interruptus (withdrawing before ejaculation) so he wouldn’t impregnate his brother’s widow, as customs and religious law dictate he do. If Onan had known what everyone who’s reading this book knows about the sperm in pre-ejaculatory fluid, he would have stuck to the original version and masturbated instead.

Over the years, society never completely lifted this ban on masturbation. During the Victorian era in England, for example, the crusade against masturbation grew to a fever pitch; the list of ills that people claimed masturbation caused included insanity, epilepsy, headaches, nosebleeds, asthma, heart murmurs, rashes, and odors.

Worse than the supposed symptoms of the Victorian era were the methods that parents used to try to curb their children’s masturbatory activities. These included restraints of all kinds and medical procedures such as circumcision, castration (removal of the testes), and clitoridectomy (removal of the clitoris) — a terrible practice that is still widely used throughout Africa and performed on millions of women, not only to curb masturbation, but all sexual pleasure.

But, whether cultural or religious beliefs caused the ban on masturbation, the elders knew (from their own experience, no doubt) that young boys and girls don’t always listen to their elders (surprise, surprise). Therefore, they invented some myths about masturbation that would have the persuasive powers that laws wouldn’t.

Many of the myths against what people labeled “self-abuse” were based on the notion that the consequences of masturbating included a physical signthat revealed to the world that the individual was a masturbator. This threat of public exposure was supposed to coerce potential “self-abusers” to keep their hands away from their genitals. Among these scare tactics was the mythof the hairy palm, but, because the possibility of having to comb your palm every morning wasn’t always scary enough, the elders also threw in things such as going blind or insane.

Neither the bans nor the myths have stopped in the new millennium. Many religions forbid masturbation, and the ad agency for an acne treatment got into the picture and suggested that masturbation causes pimples. (“Oh no, a zit, now everyone at school will know why I close the door in my room!”) All these myths are, of course, nonsense.

Avoiding Too Much of a Good Thing

Okay, so how much masturbation is too much? People often ask me that question, but I can’t answer it directly. You see, you really have to turn this question around to get the right answer. In other words, if you live a satisfying life, if you have friends, do well at work or in school, are in a loving partnership with someone, and you’re both satisfied with your sex life together, then how often you masturbate really doesn’t matter. On the other hand, if you’re lonely and out of sorts, and you rely on masturbation to make yourself feel better instead of going about the business of making your life work the way you want it to, then you may be masturbating too much, no matter how rarely you actually do masturbate.

Masturbation is a good form of sexual release, but sometimes you need that sexual tension to get you going, to give you the incentive to find a partner, seek out new friends, look for a new job, or whatever. So, if you need to get your life in order and do masturbate a lot, I suggest you cut down. You don’t have to stop altogether, but if you can reduce the number of times you do it, you may find that you can begin to add some other positive aspects to your life.

What you’re looking for is a happy medium. If you’re single and actively seeking a partner, then masturbating to keep yourself from feeling sexually frustrated is fine. Just don’t do it so much that you wind up being more attached to your genitals than to the world outside. And, of course, masturbation is a lot safer than a one-night stand in terms of protecting you from catching a sexually transmitted disease.

If your partner is satisfied with your sex life, and you would like more orgasms than the two of you have together, then masturbating when themood strikes you is okay. But make an effort to see if your partner would be willing to engage in sex with you more often. Don’t be lazy and rely on masturbation to satisfy all your sexual needs because a sexless relationship is not fulfilling and will likely not last very long.

Masturbation Education

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Although I’m sure that most of you already know how to masturbate, I don’t want it said that I left out such a basic part of good sexual functioning, so here are some different methods.

Before I get into specifics, let me say loud and clear that the best tip that I can give you is to do what feels best to you. There’s no right way or wrong way. You can use your left hand or your right hand or both hands. Whatever turns you on, as the saying goes . . . and those words can’t be more appropriate than in the case of masturbation.

For men: Do-it-yourself techniques
A common word for masturbation is a hand job, and the hand is certainly the most popular instrument used by men for masturbation. What are the alternatives, you ask?

Some boys masturbate by rubbing up against the bedsheets. Some men masturbate by putting their penises inside of a specially made, life-size rubber doll. Sex shops also sell devices that simulate a vagina. Many, though not all, of these devices look like a vagina, and the man can add lubrication to make the rubber feel more like one too. I don’t know how popular these alternatives are, although my guess is that the vast majority of men rely on their own two hands.

Some men put a lubricant, such as Astroglide, either in their hand or on the shaft of their penis. Some men prefer to masturbate lying down, others standing up, and others don’t care what position they’re in. Most men enjoy looking at erotica of some sort while they masturbate, so the only kind of atmosphere they require is enough light to see the foldout properly.

Younger men sometimes practice group masturbation, nicknamed a circle jerk because the guys involved usually sit in a circle. Although this activity may appear to have homosexual overtones, it really doesn’t for most of the males involved.

Mutual masturbation between two young men is not all that uncommon either; again, it doesn’t mean that either of the participants is gay. Research shows that about 25 percent of heterosexual males engage in such activities in their early teens, while 90 percent of homosexual teens do.

Fantasy: It’s All in Your Head

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Men are definitely stimulated by visual images, which is why 99 percent of the magazines that show naked people are aimed at men. Although women certainly appreciate a good-looking guy, seeing a close-up glimpse of his genitals won’t generally serve as a turn-on. What most women prefer as erotic stimulation is fantasy.

Now men fantasize also, and many men fantasize while masturbating, but the method of choice for men is still visual. Women, on the other hand, usually spend more time masturbating to reach their orgasm, so they can leisurely construct a nice, long fantasy that will get them in the right mood for an orgasm.

Stories to get you started
If fantasies interest you, and you want specific ones, I suggest you buy one of Nancy Friday’s books. She has assembled several collections of women’s and men’s fantasies (My Secret Garden, Women On Top, and so on) that most definitely make for interesting and highly arousing reading.

Although I wouldn’t be upset if you became aroused while reading this book, excitement’s not my main purpose, so I leave the recounting of other people’s fantasies to Nancy Friday and stick to giving you advice — and I do have advice to give you concerning fantasies.

Anything and anyone goes
First of all, no fantasy is wrong. In fantasy, you don’t have to worry about safer sex, what the neighbors may say, or anything else. If you want to make love to Alexander the Great and his whole army, be my guest. If you want to fantasize about Hannibal and his elephants, go ahead. Literally, whatever turns you on is A-OK.

“But Dr.,” people always ask me, “if I fantasize about someone of the same sex, doesn’t that mean that I’m gay?” The answer to that question is no. But it doesn’t mean that you’re not gay either. Now, if you can only have an orgasm while fantasizing about someone of the same sex, even when you’re with a partner of the opposite sex, that’s a different story. But if you occasionally fantasize about someone of the same sex, that doesn’t mean you’re gay.

Sharing your fantasies
Another question people often ask me is, “Should I share my fantasies with my spouse or lover?” The word that comes to mind here is caution. Some partners don’t mind hearing their lovers’ fantasies; some even get aroused by them, but some get very jealous. If you feel the need to talk about your fantasies with your partner, do it very carefully. Here are some tips:

Make the first one very tame. Maybe your favorite fantasy is being a Dallas Cowboys cheerleader caught naked in the locker room with the whole team. That’s fine, but tell your partner that your fantasy is him finding you naked in your office after hours. If he reacts positively, then you can work your way up to telling him your real fantasies down the road.

Use common sense. If your husband is built like Adam Sandler, and you tell him you’re always fantasizing about George Clooney, how do you think that information will make him feel?

Remember the Golden Rule. If you tell your partner about your fantasies, be prepared to hear his or her fantasies back. If you think that you may get jealous, then don’t open that Pandora’s box in the first place.

A fantasy is a fantasy is a fantasy . . .
I’ve run into people who were intent on making their fantasy become a reality, and most of the time that does not work. Obviously, if your fantasy is rather simple, such as being covered in whipped cream and having your partner lick it off, then having your dream come true may be possible. (And yes, the pun was intended.) On the other hand, many fantasies can either get you into trouble (the kind that have to do with making love in public places, for example), or make you very disappointed (your Adam Sandler may wreck his back carrying you over the threshold).

My last piece of advice regarding fantasies holds true for nonsexual fantasies as well as the sexual ones — remember that they’re fantasies. Some people trick themselves into believing that their fantasies are real. If your fantasy lover, for example, is a movie or TV star, that’s great. Plenty of people have fantasies about their favorite stars. But if you’re single and you go so far as to turn down dates because they’re not with that famous movie star, then you’re in big trouble. In your fantasies, you can make love to anyone; in real life, you have to find a partner who wants you. Fantasies are wonderful tools; just be careful how you use them.

Cybersex: Sights for Mature Minds

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Cybersex is the exchange of sexual conversations or images over the Internet. Sometimes it results in masturbation, either in front of erotic images on a computer screen or while communicating with another person in a chat room or on an instant messenger service (IM’ing). Cybersex is not the same as phone sex — where two people who know each other but can’t be together masturbate while on the phone. Cybersex usually involves someone you’ve never met.

Computers as sex objects: Turned on all the time
One of the few areas where investors have actually made money on the Internet is in the business of sex. Sex sites abound online, offering seemingly infinite amounts of hard-core pornography. I have long said that using erotica (literary or artistic works having erotic content) can increase arousal, but the extensive categories of explicit material offered on the Web give even me reason to pause.

Looking at pornography can become addictive, especially when a person sees such vast quantities of material. Imagine what would happen to alcoholics who found a secret passage into the basement of a liquor store. Could they resist going back for more and more? Of course not, and for similar reasons, many men wander into the world of cyberporn and then can’t escape. I hear about some of the married ones because their wives complain to me, but imagine all the single guys out there who turn to their computers for sexual gratification. If you bring home a porno magazine, you can spend only so much time looking atit before you get bored. But if you have literally millions of images available on the Web, then you can spend all of your free time surfing. And with a broad- band connection, you can download full-length, X-rated movies.

Directing your own X-rated show
Not all the sex on the Net has been filmed. You can find sites that offer a live person whom only you can see and talk to. You can tell that person exactly what you want him or her to do and then listen to what he or she says. If you want two people to act out your fantasies, these sites can accommodate you as well. Partaking in this activity costs a lot more than simply watching prerecorded material, but some people find directing a fantasy with real people well worth the cost.

Sites to satisfy every fetish fantasy
The Internet has been a great resource for individuals and couples who have unique sexual interests. The abundance of material offered on the Net canalso help people to discover sexual appetites that they may never have suspected they had. For example, the types of material available on one site fall into categories such as old, ugly, fat, blood, spit, menstrual, medical, zoo, pee, poo, enema, and fart. It doesn’t bother me that you can find the Top 100 sites for foot fetishists — www.footfetishdirectory.com and www.foot zilla.com to name two. After all, the various types of fetishists (I knew about rubber fetishists, but I only found out about balloon fetishists by looking on the Web) can’t help themselves, so why shouldn’t companies cater to them as well? But when material of every possible description is labeled “erotic” and placed on one site, the resulting combination can distort people’s views — especially young people who may never have dreamed that such practices existed. Yet young people are precisely the ones who have the most curiosity about sex and are most likely to go nosing around these sites.

For adult eyes only
Many of the really hard-core sites require an age check, or even a credit card because they charge their users. That limitation doesn’t seem to deter most young men, however, and other sites offer similar material without these checks. Parents need to consider adding whatever software they see fit to keep teens from exploring such hard-core sites. However, if the parents of only one teen on the block don’t add such protection to their computer, you may lose all control over whether or not your child gets a peek at these sites.

While most sites (especially those looking to make money) force you to register in some way, plenty of sites, often called “amateur” sites, don’t require you to do any more than click on the word “Enter.” By doing so you “swear” to be over the age of 21. You don’t have to bring your wallet or even your ID to surf the wildest waves on the Web.

Finding sexually explicit material on the Net
Some of you who’ve never tried turning your computer screen into a virtual swingers’ club may wonder how you go about locating sexually explicit material on the Web. Actually, tumbling down this particular rabbit hole is very simple, though getting back out isn’t always as easy — and not just because the pornography is addictive. These sites often link back to each other so when you open one site, the only other place you can go is another sex-related site. The process is spooky. When you’re caught in one of these whirlpools of naked flesh, the only thing you can do is to shut down your Internet connection. Even then, half a dozen screens showing women performing various sex acts may still be decorating your computer’s desktop. (The data also can inhabit your computer’s memory long after you’ve left these sites. If you don’t want anyone to know what sites you’ve been visiting, at the very least delete the contents of your History folder on your hard drive.)

If you go to any search engine (like Yahoo! or Google) and type in the word “sex” or “porn,” your computer will return screen after screen of links that lead to very graphic images. If you want some guidance in this area, check out www.JanesGuide.com, which rates various erotic sites.

Getting kinky with a keyboard: Chatting online
While the erotic images on the Web mostly target men (even the pictures of naked men are shown for the gay Net surfer), you can find another entire universe aimed at both women and men — chatting. What is chatting?

Basically, chatting or IM’ing (instant messaging) is sitting at your computer and sending messages back and forth to someone in real time, unlike e-mail where you have to wait to get a reply.Just as only a fraction of the Web deals with sex, most chatting or IM’ing goes on between people who know each other and has nothing whatsoever to do with sex. Any teens who have access to a computer spend inordinate amounts of time chatting with their friends about anything and everything. Many lonely people, on the other hand, sit at their computers looking to meet someone “special.” Sometimes they succeed, and sometimes they merely fall prey to someone whose sole purpose is to deceive.

Nameless, faceless: Anonymity online
Because people use nicknames instead of their real identities when chatting, you can easily remain completely anonymous. That anonymity has good points and bad points. Keeping your privacy is good, but the person with whom you’re chatting may turn out to be a serial rapist. Therefore, I advise you to be very, very careful before agreeing to give any personal information to a stranger with whom you chat.

I know that some people have found the man or woman of their dreams on the Web, but someone else’s good fortune doesn’t offer you any protection whatsoever. If you decide to forge ahead and make direct contact with someone you’ve only chatted with online, please take every precaution.

If you want to give out a phone number, give your work number, or maybe a cell phone number, so your home address can’t be traced. (Consider giving your office address when registering a cell phone.)

If you decide to meet, do so in a very public place such as a crowded restaurant or busy bar where you can easily get up and leave. Make sure that a friend or relative knows that you’re going on this date and ask her to call your cell phone while you’re out with the person. Leave your cell phone on during the date, and if you don’t answer when your friend calls you, she should feel free to call the proper authorities.

Protecting yourself from Cyber Sex

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Putting safety first

What really scares me is when I get letters or e-mails from people who say they’re going to meet their cybersex buddy for the first time and they want tips from me about how to make it the greatest sex ever. My reaction is —hold it! You shouldn’t even think about having sex with this person until you actually meet and get to know each other. Even if the person seems to be per- fectly honest and even if you’ve had cybersex, you can’t know a person well enough to have sex with them just from chatting. We discover so much about each other from body language and voice inflection that thinking you can possibly know someone well enough to have sex with them based strictly on an electronic relationship is ludicrous.

If you’ve agreed to meet and have sex, you may have a very hard time saying no if you start to get the wrong signals from that person. For this reason, you should agree only to meet, and to do so only in a public place where you can quickly and safely exit.

Is chatting cheating?
A very common question that I get these days comes from someone whose spouse has developed a relationship with someone on the Web and who wants to know whether their spouse is cheating. As I say throughout this book, I am in favor of a married person masturbating if that person has a stronger desire for sex than their mate does. As long as the couple is having sex, neither party should be ashamed to masturbate if he or she feels the need when their partner either doesn’t want to engage in sexual relations or isn’t around. But that type of masturbation is a solo activity. If you masturbate while chatting with someone in a very sexual way, and the other person does the same, then you aren’t acting alone. I consider such an activity to be cheating. You’re develop- ing a very close relationship with this other person on the computer, using activities that are very personal and should be shared only with your spouse.

Friends first
What if you have developed an online friendship with someone of the opposite sex but don’t engage in cybersex? Is that cheating? I don’t think a clear-cut answer to that question exists. Consider a similar scenario not involving the computer. Say that you have lunch with a co-worker of the opposite sex once a week. Is that cheating? Not necessarily. What if the two of you have lunch every single day? Now the ground gets a little shakier. If your relationship with your spouse has some small cracks, and if you find the person with whom you’re lunching sexually attractive, then you may be flirting with danger.

You must apply the same principles to online chatting. If you rush home every evening and can’t wait to log on to the computer to chat with this other person, especially if you’re pouring your heart out to them, then you’re defi- nitely taking time away from your spouse, which verges on cheating. On the other hand, if you find someone online with whom you share a common inter- est, such as a TV show, and you chat every week after watching the latest episode, then I don’t think that you’re cheating.

Only the chatter knows
In reality, only the chatter knows whether he or she is cheating. Say, for example, you are friends with the couple who lives across the street. And say that you have sexual fantasies about the person of the opposite sex in that couple. You know the signs — you purposely cross the street and make excuses to talk to that person one on one whenever you can, or you go over just to be “neighborly.” If you keep everything out in public, that type of relationship can go on for years and nothing sexual may develop from it.

But now put that same relationship inside a computer. Instead of keeping a picket fence between the two of you, you’re communicating in a very private way and may be passing on some very private comments.

Chatting in a private way can build an intimacy that definitely falls under the banner of “cheating.” So, while I have no precise answers, I will say that if you’re honest with yourself, you will know when you’re crossing that line. And you should stop right there and then, unless you don’t intend for your marriage to last forever.

Sex forums: Any topic goes
The big advantage computer sex forums offer is that they’re organized according to subject matter, which means that you can quickly find other people who share your tastes and communicate with them, passing on ideas, places to go, and things to do. Because the Internet is without guidelines, when I say that you can chat about any topic, I mean any topic. Some of the names of these forums should give you a clue as to what you can find: “Pumps, Leather, S&M,” “Water Sports,” “Piercing,” “Dressing for Pleasure,” “Dominance and Submission Only,” “Loop and Lash B&D,” “Zoo Animal Lovers,” “Ten Things Every Lesbian Should Know About Love and Sex,” “Penis Names,” and “Below the Ankles — Feet.” Had enough?

As those names imply, not all chatting is innocent and not everyone wants a long-lasting relationship. Some people go online looking only for cybersex, which may frequently result in masturbation. When that’s the main aim of a particular computer forum, it is called a J/O (for jerk off) session. The people who inhabit these forums regularly call themselves cybersluts (see www. cybersluts.org) — and who am I to disagree? Such chatting starts with people talking dirty to each other. Eventually the two people may exchange nude pictures of each other.

E-mail erotica
It seems like the entire world has access to e-mail — and love letters have never been the same. Just be careful to whom you send your letters!

And e-mail also allows you to send pictures along with text. Just be careful about what kind of pictures you send where. For example, if you send an e-mail to someone at his or her office, chances are an employer may be able to see your message. Not only can you be embarrassed, but the person onthe receiving end can lose his or her job.

Off-line viewing
You don’t necessarily need to have your computer connected to the Web to view erotic images. You can get CD-ROMs that contain hundreds of erotic images, from the Playboy-type to vintage postcards to . . . whatever. Some of these CD-ROMs have video games that also appeal to prurient interests.

Computers can play DVDs, too, so if you want to spend your next airplane ride looking at an X-rated movie on your laptop computer, and no one is sitting in the seat next to you or behind you, you can do that too. And for those of you with video iPods, porn can be viewed on those small screens, as well as on cell phones. I suppose the day will come when you’ll be able to download porn directly into your brain.

Sex and the Telephone: Aural Sex

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Because sex is a form of communication, it’s only natural for the telephone to play a part in our sexual activity. The anonymity of communicating by phone quickly made it the ideal way of asking someone out for a date. On the phone, the physical reaction of both parties remains secret, which makes the process a little easier on everyone.

That anonymity also encourages many people to flirt over the phone (as they do over computer lines). In most cases, that flirtation never goes any further, especially because a great distance may separate the two people. And, although some people may “give great phone,” you may be sorely disappointed in them if you see them in the flesh.

These forms of sexual contact are basically innocent, but Alexander Graham Bell would probably have buried his invention if he’d foreseen some of the other ways that people have transformed his telephone into a sex toy.

Obscene phone calls have long been a problem, although innovations such as Caller ID may soon make them a thing of the past. Some of these calls are merely pranks pulled by rambunctious teens looking more to shock than to actually excite anybody, least of all themselves. However, some people do become addicted to making obscene phone calls. A college president lost his job because of his habit of making such calls.

Pay to play — 900 or 976 numbers
Recently, people have used the phone lines more and more for conversations that have, as a goal, one or both parties reaching an orgasm. Some peoplehave always “talked dirty” to each other while masturbating. I even recommend such behavior to couples who are separated by long distances and want to keep their sexual relationship going while living apart. But what made the use of such behavior explode in popularity was the commercialism that came after the breakup of the Bell telephone system and the deregulation of the industry.

Nowadays, you can find hundreds of phone numbers that are exclusively used for sex (most are 900 numbers or have 976 exchanges). A person cancall and speak to someone who will fulfill whatever phone fantasy he or she may have — talking about sex to a woman or a man, ordering a submissive slave on the other end to obey one’s every command, or being dominated by a cruel master — all accompanied by the masturbation of the callers, who can make the fantasy last and pay the additional costs, or hang up as soon as they find the relief that they were seeking.

Because we are in need of safer sexual outlets, I suppose that these phone sex companies fill a need, but they also bring some drawbacks that disturb me:

I don’t believe that children are adequately protected. In theory, you have to be 21 or older to call, but do they really check? Even if callers are supposed to use a credit card number, what if a child, even a teenage child, uses a parent’s number?

Another drawback is the cost. Some people have gotten addicted to phone sex and ended up with astronomical bills. I have to admit that, if these people are adults, they make these calls of their own free will, but it still bothers me.

I just called to say . . .
Does phone sex belong in a relationship between two people? If they’re in a long-distance relationship, sure. But if they live nearby and they regularly have telephone sex as a means of safer sex, I’m just not sure. How realistic is it that two people who go out and date will continue to have sex only when they have a telephone line between them? Eventually, they will want to get together, so they had better be prepared for that moment and not rely on phone sex to keep them safe. However, I can’t really criticize any couple who does have phone sex because, in this day and age of AIDS, no measure that you take to remain healthy can be regarded as extreme.

The phone can be a helpful tool to spice up your sex life, even if you’re married. When you talk on the phone, you’re speaking right into the other person’s ear. Whispering “sweet nothings” — or “hot somethings” — into the phone, so only your lover and you can hear them, can let you get up closeand personal at any time of the day or night. You can use these moments as part of your overall strategy for foreplay. And, if the circumstances are right, once in a while you can even have real phone sex, with one or both of you masturbating, just to throw in some variety.

Cell phones: Sex on the go
Cell phones have been a boon to people who work and want to stay in touch with a loved one. If your workplace doesn’t allow personal phone calls, or if you have something to say that you don’t want the people in the adjoining cubicle to overhear, then all you have to do is grab your cell phone and go for a walk. Voilà! Instant privacy. All I ask is that you please don’t talk in your car while holding a cell phone. Not only is it illegal in many places, but it’s downright dangerous. If you must talk, use an earpiece, but even then, try to limit the amount of time you spend so you can concentrate on driving.

And when cell phones that could display pictures came along, so did the purveyors of pornography. I have to admit that I don’t quite understand what guys get out of seeing tiny little pictures of naked women. Can’t they wait until they get to a computer monitor?

Finally, some cell phones are also cameras. Some people can’t resist showing off parts of their naked body and then sending the picture to all their friends via cell phone. This is mostly harmless play, except when someone bares his or her body while intoxicated and discovers the next day that the image has been sent to every one of his or her friends, and maybe even posted on the Net. The idea isn’t so playful when you’re sober.

Sex and Television: A Different Meaning

2009-03-06T23:19:00.002+07:00

Television always had the potential to bring sex directly into people’s homes, but in the early days, even married TV couples such as the Petries on The Dick Van Dyke Show had to sleep in separate beds. Broadcast television in

America

stayed fairly tame for many years because, like radio, it was available to everyone, children as well as adults.

Nudity appeared on European TV long before it did on the American tube, and the furor over Janet Jackson’s naked breast during the Super Bowl halftime show in 2004 has actually made it less likely that you’ll be seeing nudity on broad- cast TV any time soon. But TV soon branched out way beyond network television, which is where sex has played a big role.

Cable took television off the public airwaves and out from under the scrutiny of the government. R-rated movies quickly made their appearance, and certain public access shows, especially in big cities, took advantage of the new freedom and began to air both raunchy talk and naked bodies. But the producers of even these shows were always a little worried that they may go too far; as a result, while the shock value was certainly there, much of the erotic content was missing. As time went on, pay cable networks branched out beyond showing just movies. HBO, for example, developed series with sexual themes, most notably Sex and The City, which received much publicity. And The Playboy Channel is, as you would expect, devoted to soft porn and has lots of people who pay money to take a peek. You can now see truly eroticmovies on pay cable, but those are still tame compared to the type of materials available on video, DVD, or the Web.

Renting films to view alone or together
Although I would object to some X- or NC-17-rated movies in America because of their violent content, in general, I’m in favor of people renting erotic films. For the single person, erotic films provide an outlet for masturbation that, considering the dangers posed by going to a prostitute or having a string of one-night stands, almost makes the availability of these films a public service. And, for couples, viewing such films can provide some added spice and maybe even the knowledge of some new positions or techniques. European films are much more sophisticated in this respect, providing truly artistic treatment of sexual subjects.

Starring in your own sex flick
On the heels of the videocassette player came the camcorder, which now enables couples to star in their own versions of Deep Throat. Again, if filming your sexual escapades adds a boost to your sex life, then I’m all for it. But I must advise certain precautions:

Don’t pressure your lover into doing something that he or she doesn’t want to. If one partner wants to film lovemaking, and the other objects, that’s the end of it — no filming.

If you want to keep the recordings, remember that you always have a risk that they’ll fall into the wrong hands. My advice is to watch them a few times and then erase them.

Now I know that some people actually take recordings of themselves and post them on the Internet at various sites. My opinion of that? It’s downright stupid. It’s almost guaranteed that somebody will see them who shouldn’t, such as your kids, your parents, your boss, or your biggest customer. And it may not happen this year or next year, but five years down the road, and then the consequences may be even worse. You may no longer be with the person in the film, and your new partner may not be so open-minded.

If you really want the extra thrill that comes from knowing that other people are watching you have sex, then tape your lovemaking while fantasizing that the camera is connected to NBC and is broadcasting to millions of homes, or take digital pictures and imagine what they’d look like inside the pages of a magazine. But don’t ever actually let such material leave the confines of your house. And I would also urge you to delete or destroy them after a short timeto ensure that they never fall into the wrong hands.

Pulp Nonfiction
I suppose I would be unfair to my friends Hugh Hefner and Christie Hefner (Hugh’s daughter and president of Playboy) if I failed to mention the granddaddy medium of porn — print. Despite all the competition from computers and videos, Playboy, Penthouse, Hustler, and similar magazines still sell mil- lions of copies every month. The magazines remain popular for several reasons, including their portability and the articles and jokes, which offer an excuse to buy such publications. I actually like reading Playboy from time to time because of the articles, so that’s a legitimate excuse.

Although magazines that show pictures of naked men, such as Playgirl, have failed to attract a large audience of women (the ones aimed at homosexuals, of course, are another story), the romance novel is an industry unto itself. These novels fall into several categories, some of which have very little actual sex and others that let off a little cloud of steam every time you turn a page. They all follow a formula, which is why many people turn their noses up at this literary genre, but the formula is the same as what you find in a men’s magazine, and no one who buys these novels is looking for great literature anyway. I would like for both sexes to stop criticizing the other’s erotica, but I suppose as long as a battle of the sexes exists, this front won’t enjoy any peace either.

I am somewhat upset at the explicit novels aimed at black audiences, not because of their erotic content, but because they’ve become so dominant. Erotica is supposed to be enjoyed from time to time, not as the only topic of your reading list.

Sex with Multiple Partners

2009-01-06T06:45:00.003+07:00

Where Do All of These Body Parts Go?
Before the printing press existed to print pornographic literature, or the camera to take lewd pictures, or camcorders, phones, computers, and so on, men and women still found ways to enjoy elicit pleasures. The most common was to have more than one sexual partner. Some cultures, such as parts of the Middle East, gave this act official sanction by allowing men to take more than one wife, which probably took half of the fun out of the practice.

To some degree, adultery in ancient times was more forgivable than today. Some marriages arranged by parents worked, and some didn’t. If someone got stuck with a sexually incompatible partner or one whom he or shehated — and especially because divorce was almost nonexistent — it’s easy to understand why some people looked for greener pastures.

The lure of adultery
The statistics about how many people commit adultery may not be reliable, but you don’t need statistics to know about something that takes place under your very nose. Incidences of adultery abound all around us, be they among the rich and famous whom we read about in the news, or among our neighbors and co-workers whom we hear about through the grapevine.

Cheating comes in all different forms, from the man who goes to a prostitute while on a business trip, to the woman who sees an old boyfriend every Wednesday afternoon, to adulterous couples who see more of each other than they do of their respective spouses. But, whether quickies or lifelong affairs, all cheating tears at the bonds of marriage.

One recent development that has impacted this type of behavior is the risk of disease.

Nowadays, I find that more and more people try to patch up their marriages and work things out simply because they fear the health consequences that fooling around on their spouses can bring. To the extent that people try to have better sex with their spouses, I applaud this movement. Nevertheless, I do wish that it had arisen in greater part because of the spread of knowledge about good sexual functioning rather than out of fear of disease.

Wife swapping, swinging, and group sex
Of course, not all sex that married people have outside their marriage involves cheating. Some couples make the conscious decision to have sex with other people.

Some couples bring a third person into their bedroom, be it a man or a woman, which is called a ménage à trois.

Sometimes two couples get together and trade partners, which is called wife swapping. (I think that the fact that it’s not called husband swapping is significant, but more on that in a minute.)

Sometimes a larger group of regulars meets in someone’s home to exchange partners, which is called swinging.

And sometimes a group of strangers just gets together, usually at a club, and has sex with anyone else who happens to be there, which experts label group sex and people used to call an orgy.

All of these activities grew in popularity in the late 1960s and early 1970s. I believe this practice mostly resulted from the development of the birth control pill, which allowed people to have sex without the risk of pregnancy. But this type of behavior has been going on for a long time (for example, the notorious Roman orgies or the scenes depicted in Angkor Wat, the temple in Cambodia), and the behavior will never totally disappear.

Throughout this book I say that sex becomes better as the couple learns to communicate on a higher level and further their relationship. So why do people want to have sex with people they barely know? What’s the attraction?

A little bit of exhibitionism and voyeurism lives inside us all. Some people are appalled at those feelings and do the best they can to hidethem, while others enjoy giving into them, and you can certainly do that at an orgy.

Another attraction is the promise of strong visual stimulation that comes from watching new partners or other couples engage in a variety of sexual activities.

How fulfilling are these exchanges sexually? For many men, to whom visual stimuli are very strong, these scenes can do a lot for their libidos. On the other hand, many women need to concentrate to have an orgasm, and these situations aren’t conducive to their sexual functioning. Therein lies theanswer as to why the practice is called wife swapping — because men usually derive the most pleasure from these situations and push their wives or partners into them.

Although the men are usually the instigators, I’ve seen situations where they’ve also been the ones to most regret having started their wives on this path. As Phil and Betty found out, wife swapping can cause unexpected emotions and unintended results.

Betty and Phil
Betty and Phil were married for about five years when someone Phil knew at work — I’ll call him Gary — invited him to go to a wife-swapping party. Phil was very eager to go, but Betty wasn’t. He kept begging and pleading, and eventually she consented, but she kept to herself the real reason that she had said yes. Betty had met Gary at the company Christmas party and found herself attracted to him. She would never have acted upon that

attraction, or at least that’s what she told me, but when Phil begged her to go to the party, she decided that maybe the chance to be with Gary was an opportunity not worth passing up.

In fact, Gary had caught Betty looking at him, which is why he asked Phil to join the group in the first place. Naturally, when things started getting hot and heavy at the party, Betty and Gary gravitated toward each other and wound up having sex. Phil had sex with someone at the party and then went looking for his wife. When he saw her going at it with Gary, he at first dismissed it, but after a while he started feeling jealous. This jealousy affected his ability to have a second erection, and so he became really upset. On their way home, Phil lashed out at Betty, who fell back on the argument that going to the party had been his idea.

Eventually Phil’s jealousy calmed down, and he started fantasizing about the party. When the next one rolled around, he decided that they should go. Betty tried to talk him out of it, but he swore up and down that he wouldn’t be jealous, and so they went.

I’m sure that you can guess the ending of this story. Betty came to me to see whether I could help her repair her marriage, and I did try. But it was really too late. Gary aroused much stronger sexual feelings in her than Phil did, and because she and Phil had no kids, she finally decided that she’d prefer to spend the rest of her life with Gary.

So, while Betty did find the experience of wife swapping pleasurable, her focus all along was really on one man, Gary, and not having sex with a variety of different men. I think that many women who enter into this scene have similar experiences to Betty’s. Even if, initially, a woman does have sex with a lot of men, she doesn’t necessarily have to be sexually aroused for that to happen. Eventually, however, she fixes her focus on another man, not her husband. And then, when her husband realizes this, the trouble begins.

Of course, couples for whom swinging works out don’t go to see a sex therapist such as myself, so perhaps this sort of lifestyle works for more people than I know. But I’ve seen enough people who’ve had problems with these situations to know that the risks to a marriage are great. You see, the libido is very strong, but it’s also easily satisfied. There’s no such release as an orgasm for jealousy. Jealousy is the type of emotion that tends to build and fester over time, and that usually spells trouble. The only advice I can give you now is to keep thoughts about group sex as your fantasy and don’t try to live them out.

Male Changes in Sexual Capability

2009-01-05T12:52:00.002+07:00

Some people may say that the phrase “sex in the golden years” is simply putting a positive spin on a mostly negative issue. Others may even say that the phrase is an oxymoron because they think that as soon as people get their first Social Security check, sex goes out the window.

I must be honest with you and tell you that experiencing negative aspects of sex as you grow older is common. After all, many other physical attributes begin to grow dimmer, so why should your sexual apparatus remain perfectly fit? And, in fact, it doesn’t. But not all the aging factors that relate to sex are negative. And let me make one thing absolutely clear: You can continue having sex right up into your 90s.

This article addresses the ups and downs of sex and the aging process — menopause, soft or nonexistent erections, and more freedom to make love when the mood strikes.

Every woman goes through menopause and, although every man does go through certain changes, the results aren’t always the same. Some men merely have a decrease in their sexual prowess, which I get into in a moment, while others become impotent. Obviously, impotency is a serious problem, but it doesn’t have to spell the end of a sexual relationship.

The spirit is willing, but the penis is weak: Fewer psychogenic erections
Let me begin with the early symptoms of a man’s aging in regards to sex. A younger man can have an erection merely by thinking about something that turns him on, called a psychogenic erection. He sees an erotic photograph or thinks of the last time he and his wife made love and, voilà, his penis becomes hard and erect.

As a man grows older, a time may come when he can no longer have an erection merely by thinking about something sexy. Now, this change doesn’t happen overnight. He still has psychogenic erections for a time, but they become fewer and fewer and need more and more stimulation to take effect. Then, at some point, they stop altogether.

Does this spell the end of his sex life? Absolutely not! (Unless, of course, he doesn’t realize what has occurred.) The following sections provide options for achieving an erection and maintaining a healthy sex life for years to come.

Responding to a woman’s touch
When a man can’t achieve an erection by his thoughts alone, his partner can help by touching him. By stroking a man’s penis with her hands, a woman provides the stimulation he needs to have intercourse.

Some men know that they can still get an erection because they masturbate to relieve their sexual frustration, but they refuse to touch themselves in front of their partners to get an erection. So these men have very useful information, but refuse to share it with their partners.

I encourage you to talk to your partner about what you need. Yes, you’ll have a period of awkwardness to get through, but would you rather never have sex again? Because your penis no longer is a reliable indicator of when you want to have sex, you’ll need to develop a new set of signals that tells your partner that you’re interested in having sex. The signal can be anything from whispering a certain phrase in her ear to strutting around in a goofy pair of boxers. Just be sure your partner knows the signal, too!

The lack of an erection doesn’t mean you don’t want to make love. If you tell your partner you’re interested, and she shares that interest, your partner simply needs to stimulate your penis with her hands (or mouth) to help you get an erection.

Oral sex: Always an Effective Solution for Older Man

2009-01-05T12:48:00.003+07:00

As a man gets older, he may require greater amounts of stimulation to get an erection. Some men find that oral sex works better than the use of hands. If your wife has always been willing to perform fellatio, you have no problems. If she has never performed fellatio, however, then problems can occur. Not only may she feel disgusted by the idea, but if she feels that she is being forced into performing oral sex, she may be more resentful about having to start.

I get many letters from widows who face this problem. A woman’s sex life with her husband may have dwindled slowly over the years, and both partners had become used to it. But then, after her husband passes away, she meets a man who isn’t interested only in companionship — he wants to have sex with her. The problem is that he can’t have an erection all that easily and requests oral sex. The woman is in a quandary. At her age, men may be hard to find, so she doesn’t want to lose his companionship because of the oral sex issue. And because she knows that so many other widows would be happy to do whatever an interested man wanted done, she feels she doesn’t have a lot of leverage in this area. So she writes to me and asks what she should do.

This question is tough for me to answer. On the one hand, I don’t believe that anyone should do anything under pressure. But if the alternative is to lose the man and be lonely, that option’s no good either. I usually suggest a compromise, which is to have the woman try oral sex.

Maybe she won’t find fellatio so horrible after she gets used to it. She may even learn to like it. Don’t be surprised by that, because I do get women who report exactly that turn of events to me. Or maybe she’ll hate fellatio and have to give up on this man. But it’s worth a try.

Impotency: Don’t ignore it; bring it up

2009-01-05T12:43:00.003+07:00

Just as a man’s inability to have a psychogenic erection comes on slowly, so does the onset of impotency. An impotent man first finds that his erections become softer and don’t last as long. At some point, he can’t have an erection at all. Impotency is the second most common type of erectile dysfunction (ED).

Until the advertisement campaigns for drugs to treat ED arrived on the scene, many men were too ashamed to ask their doctors about problems with impotency. They just figured that sex for them was over. But since the development of drugs, such as Viagra (sildenafil), to treat ED, that attitude has changed dramatically. But while Viagra, or one of the other such pills, may solve the problem, the medication brings up other issues about communication with one’s spouse.

You should always check with your physician about impotency, especially if you take any kind of medication. Different medications have different side effects. Sometimes, if you complain to your doctor about problems with impotency, he or she can put you on a different type of drug, and the impotency will go away. Impotency may also be an early indication of circulatory problems, so by reporting problems with your erections to your doctor, you may end up preventing a serious health issue.

These ED drugs don’t work for every impotent man. Some men who are on certain heart medications aren’t allowed to take them. And others have physical problems too severe for even one of these drugs to help. But if a man is just not able to have an erection any longer, that doesn’t mean that he can never perform sexual intercourse again. Medication isn’t the only solution to impotency; a variety of implant devices are available to allow a man to have erections whenever he wants them.

A benefit of aging: No more premature ejaculation
Many men who suffer from premature ejaculation (when a man ejaculates before he wants to) when they’re younger find that, as they age, that particular problem often goes away. If their wives really enjoy intercourse, this can signal the start of a whole new phase of their sex lives.

The Psychological Bonuses
The effects of aging go beyond physical changes for both partners. Their attitudes about sex may change for the better as well.

When two people first get married, their libidos are so high that they make time for sex even if time is short. As the years go by, and particularly as children arrive on the scene, finding time for sex can become more difficult. And in these days when both men and women are in the workforce, not only is time often in short supply but energy is as well.

In the so-called golden years, time suddenly grows in much larger supply. The kids are out of the house (I hope), and even if both partners aren’t fully retired, in all likelihood they’re not working full time. These changes allow the couple to make love at various hours of the day, and in various places — not just at night in the bedroom with the door locked.

Making love in the morning isn’t only advisable because it adds variety. The male sex hormone, testosterone, is at its highest level in the morning; if a man has problems with impotency, they are least likely to show up in the morning. Also, after a good night’s rest, energy levels may be higher.

Just as during any other period in your relationship, the more effort you put into better lovemaking during your golden years, the more you get out of the experience.

Same-Sex Relationships

2009-01-03T09:38:00.005+07:00

Sexual arousal is a very personal matter. Each of us has a different set of interests that excite us sexually. But there are also some broad strokes that cover larger groups of people. One of those applies to people who become aroused by people of the same sex. They are not in the majority, but because the smaller strokes that color our personal arousal truly define us, no matter what overall group we fall into, we are all equally human and deserving of respect. This article explains sexual orientation, talks about how a person reveals his or her orientation, and lists the different ways homosexuals engage in sex.

Considering Sexual Orientation
Homosexuality is when men or women are sexually attracted only to others of the same sex as themselves. (Hetero means different, and homo means the same.) Which one you are — heterosexual or homosexual, that is, straight or gay (male homosexual) or lesbian (female homosexual) — is called your sexual orientation.

What determines sexual orientation?
I’m often asked why some people desire to have sexual relations with members of their own sex instead of with the opposite sex. From the letters I get, I know that many people believe that homosexuals choose the homosexual lifestyle over heterosexuality. They think that a gay person makes a conscious choice at some point in his or her life to be gay, and so they also believe that gay people can just as easily change their minds and switch to heterosexuality. Of course, the implication is that they should change back to the more “normal” sexual orientation.

The truth is that we don’t know for sure the etiology of homosexuality — the reasons that some people are gay while most others are not. However, current scientific research leans toward the idea that people are born with the capacity to be either gay or straight and that the environment may have some influence as well. In spite of the research done on the subject, scientists have not found any conclusive results.

For many years, homosexuality was defined as a mental illness, and treatment was aimed at restoring “normal” sexuality. It wasn’t until 1973 that the American Psychiatric Association recognized that homosexuality wasn’t a mental illness. Here is what modern science has to say about homosexuality: Research with twins has demonstrated that a genetic component to homosexuality exists, but genetics isn’t thought to account for all cases.

Anatomical studies of the brain have shown some apparent structural differences between homosexuals and heterosexuals, but to date this research, while continuing, is still speculative.

Although humans have been contemplating the issue for eons, we still can come to no conclusion about what determines sexual orientation. All we know is that homosexuality among men and women has existed for as long as history has been recorded, that homosexual lifestyles are no more likely to disappear than heterosexual ones, and, as far as I’m concerned, that homosexuals should be treated with the same respect as every other human being.

Keeping religion and government out of the bedroom
Is knowing why some people live a different lifestyle important? In a perfectly open society that attached no consequences to one’s sexual orientation, knowing what caused different sexual orientations may not be important. But, because some people in our society publicly advocate that homosexual men and lesbians be prevented from — or even punished for — living their lifestyles, I think that understanding the reasons behind homosexuality is relevant.

You see, if gay people have a choice in their lifestyles, then some can perhaps legitimately argue that society should try to control how they live. (Some lesbians say that they chose lesbianism for political reasons, but that subject is beyond the scope of this book.) Society singles out a number of different modes of behavior to restrict. Some think that because we ban things such as prostitution and sex with minors, we could also ban homosexuality. Sodomy (a term that refers to anal sex but can also include oral sex) was illegal across the country for many years and is still outlawed in some states.

But what if sexual orientation is beyond our choice? What if we’re born with our sexual orientation and can’t change it? Should society pass laws forbidding homosexuals from having sex if that’s the only way that sex is pleasing to them? And the other question is, do we want the government telling us what to do in our bedrooms, no matter what our sexual orientation?

Now, as a Jew, I know that the Bible specifically bans homosexual acts, and therefore many believers in the Bible consider homosexuals to be sinners. The problem with relying on the Bible is that so much of what it says is open to interpretation. For example, just a few pages from where the Bible bans homosexual acts, it admonishes us not to wear clothes made from different types of cloth. How many of us follow that regulation? Some religious denominations, such as the Episcopalians, voice support for homosexual priests despite these Biblical injunctions. Many Christians also support our armed forces despite the fact that one of the Ten Commandments says “Thou shalt not kill” and Jesus instructed his followers to turn the other cheek. The only thing we know for certain is that we are all here on this Earth together.

In America, we believe in the separation between church and state. Believers in the Bible are certainly free to stop themselves from committing certain sexual acts, but under the U.S. Constitution, their beliefs don’t confer on them the right to force others to believe or behave as they do.

Although gay sexuality may not fit the mold used by most people, I believe that we shouldn’t criticize gays for behavior over which they may really have no control, and which doesn’t harm anyone anyway. Nobody forces anyone to be gay, and neither should anyone force someone not to be gay.

Behaving responsibly, no matter what orientation you are
What two consenting adults, whatever their sexual orientation, do in the privacy of their home is their own business. Now this doesn’t mean that I give blanket absolution to every form of homosexual behavior. For example, I believe that some of the activities that take place in public areas, like at gay bars and bathhouses, go too far — especially in this era of AIDS.

Homosexuals are as capable of responsible sex as are heterosexuals — and they’re just as capable of irresponsible sex as well. Considering that heterosexuals have a 50 percent divorce rate and often have multiple sexual partners over time, expecting homosexuals to be any different by picking one partner and staying with him or her for a lifetime is unreasonable.

A person in either lifestyle should make a serious effort to form a relationship before having sex. And all sexually active people — gay and straight — should employ safer sex practices.

Where does bisexuality fit in?
There are a few areas in my field where the jury is still out. I’ve already mentioned one of these, the G-spot orgasm. Another is the issue of bisexuality. There is no doubt that there are people who have sex with both the opposite sex and their own sex. What is open to question is whether this is a permanent state or a transitional one. Now, to people who consider themselves bisexual at any given point in time, it will seem as if this is how they will always feel, and yet research has shown that some bisexuals do end up becoming either heterosexual or homosexual. By the way, I’m not talking about who their specific partner is at the moment, but rather how they feel on the inside. Someone could never have had sex with a person of the same sex, say, but still feel the attraction.

Some people label themselves as bicurious, meaning that they want to try sex with both sexes, and may even have done so, but haven’t made up their mind as to their sexual orientation. What gives me pause about this concept is that there appears to be some peer pressure with regards to this, so young people are engaging in sexual acts just to be thought of as cool, rather than because they are really unsure of where they stand. Because I strongly believe that you should only have sex with someone with whom you share a romantic relationship, and because having sex with multiple partners incurs risks, I would urge you not to experiment simply out of curiosity.

Just as we don’t know everything there is to know about homosexuality, we also can’t close the books on bisexuality either. I hope that one day conclusive research will be done on the remaining open issues so we can help people to not only understand, but accept people’s various sexual orientations. Determining Your Orientation: What Turns You On I’m sure that many heterosexuals are reading this chapter out of curiosity, and that’s great. Some straight readers may even get turned on by reading about gay sex, which may confuse them. They may suddenly start to wonder whether they themselves are gay. So, before getting to the sexual part of this discussion, I’d like to familiarize you with the very beginning of the process — uncovering your sexual orientation. Getting excited by reading about homosexual sex, or even having fantasies about engaging in sexual relations with a member of your own sex, doesn’t mean that you’re gay. A homosexual definitely knows whether he or she is attracted to members of their own sex, and that identification doesn’t come because of an occasional gay fantasy. In addition to gay fantasies, a common occurrence among young teen males is to sexually experiment with another male. This experimentation may take the form of masturbating together, or actually masturbating each other.

This may occur among females, too. This type of behavior doesn’t usually go any further than that. Again, sexual experimentation among teenagers is pretty common and doesn’t indicate any homosexual tendencies.What does indicate that a young person is actually a homosexual? The best indicator of homosexuality is if you can get sexually excited only by thinking about having sex with someone of your own sex (even if you have sex only with members of the opposite sex).

Revealing Your Sexual Identity
Sexual orientation goes beyond just engaging in sexual acts. A person’s sexual identity will cover a broad range of areas, some of which may because by sexual orientation, or may simply be a way of fitting in with others in a group. Is being a football fan primarily a straight man’s hobby, or having a flair for fashion primarily a gay man’s interest? I don’t know the answers, but I do know that some people behave in particular ways so they can blend in with their chosen community. So sexual identity affects many aspects of a person’s life, including sexual behavior, sexual attraction, affection, safety, socialization, and so on.

Living in the closet
Saying that someone is in the closet has a range of meanings. Basically, the phrase refers to someone who doesn’t openly admit that he or she is gay. Some people who get married, have children, and spend an entire lifetime living with and regularly having sex with a member of the opposite sex are really not heterosexual at all. To get excited, these people have to fantasize about having sex with a member of their own sex.

People who appear to be openly heterosexual may actually lead clandestine gay sex lives in several different ways:

Some people visit gay bars when the opportunity presents itself, go to areas where gay prostitutes are known to hang out, or merely masturbate while looking at gay magazines.
Some people lead a gay lifestyle only when in the presence of other gays, but put on a front of being heterosexual in other settings, such as at work or school.
Some people may never actually engage in any form of gay sex, but, nevertheless, deep down inside, are gay.

Many of these people, especially in today’s more liberal atmosphere, do end up “coming out of the closet” at some point in their lives. Others box themselves in so tightly that they just don’t feel that they can survive the revelation, and so they hide their homosexuality for their entire lives.

Coming out
Before 1969, few gays publicly revealed their sexual orientation (also called coming out), but a riot in New York — caused by a police raid of a gay bar called The Stonewall — politicized many gays and started what was called the Gay Liberation Movement. This movement insists that those in society treat the homosexual lifestyle the same as the heterosexual one, and that people give gays rights equal to those of everyone else. Since then, federal, state, and city legislatures have passed many laws that give gays much more freedom than they once had to practice their lifestyles. Nevertheless, many members of our society still frown on gays — oftentimes, including the people who are closest to gays: their families.

Coming out to family and friends
The adolescent years are never easy for anyone, but they’re certainly a lot more difficult for gay young people. Not only do gay teens have to confront their own emerging sexuality, which is different from that of most of their peers, but they must then face the rebuke that their sexuality often brings from their immediate families. Revealing one’s homosexuality is never easy — for young or old — but the process can be particularly difficult for teens, who are dependent on their families and have not yet established their own private lives with their own place to live and a job to provide financial support. In fact, the rates of suicide for young homosexuals are much higher than for heterosexuals of the same age, in great part because many can’t cope when faced with rejection from their families.

No two families react the same way when a son or a daughter comes out of the closet.

Some parents may have suspected their child’s homosexual orientation for a while and learned to accept it, so they have a general sense of relief that the subject is out in the open.

Other parents react very negatively, upset that many of their expectations for their child — the traditional heterosexual marriage followed by grandchildren — have suddenly disappeared. They may also react negatively, in part because they feel that their child’s homosexuality reflects badly on them (and the way they raised that child) in the eyes of the rest of the family as well as friends and neighbors.

In some families, the reaction is split, with one parent accepting the son or daughter’s announcement and the other going so far as to cut off all contact.

Teens should understand that being a parent isn’t easy, and because the expectations of most parents are turned topsy-turvy by the announcement that their child is gay, it’s normal for them to have some mixed emotions in the beginning. Getting past those feelings and working with your parents, and perhaps a counselor, to rebuild family unity is the key, and I don’t believe that you can help do that without some preparation. If you’re forewarned about how your family may react, and have been told ways to handle these reactions, you’re much more likely to end up being accepted by your family.

The most important advice I can give to those of you who are gay and who haven’t revealed your sexual identity to your family is to immediately find a counselor who has worked with other gay people facing this problem to give you. The counselor’s experience in this area can be invaluable to you in obtaining the best possible results from your circumstances.

Coming out to the world
Most gay people come out to a potential sex partner first. That experience itself can be very scary. What if that person turns out to be straight? Rejection is always traumatic, but especially if the other person is actually repulsed by the offer, as a straight person approached sexually by someone of their own sex often is.

Eventually, most gay people meet others who share their lifestyle, and the support that they get from others helps them to then declare their sexual orientation to their families and friends. One new way of discussing the topic that is helping many teens come out are Internet chat rooms. Using this method of communication, teens can find out about the gay lifestyle without having to reveal their own identity until they’re ready to do so.

Coming out in your profession or on the job can be much more risky. Openness about one’s sexual orientation doesn’t always translate well in the business world. Because of this, many gay people who don’t hide their status at home are very careful about whom they tell at the office. Some companies won’t hire a homosexual simply because of the strain that a potentially HIV-positive person may put on their health benefits program. In other cases, some employers are becoming less tolerant of their homosexual employees, either because of their own fear of AIDS or because of a concern that their other employees may react negatively. Even though this discrimination is often illegal, it doesn’t stop it from occurring, no matter how abhorrent.

This on-the-job discrimination against homosexuals can backfire in the battle against AIDS. For appearance’s sake, a gay employee may avoid forming a relationship, which forces him or her into the dangerous world of anonymous sex, where the risk of getting and spreading AIDS is so much higher.

Because a gay person can never know exactly what the outcome of his or her coming out will be, the decision is always a heavy burden. If everything goes right, gay men and women may feel as though a tremendous weight has been lifted from their shoulders because they no longer have to lead dual lives. On the other hand, if they end up losing contact with certain family members and friends or losing their job, many people may find the loss a heavy price to pay for admitting their true identity.

Coming out when you’re married, with children The gay man or woman who marries someone of the opposite sex and also has children faces a double burden if he or she decides to reveal a different sexual identity. In addition to his or her own suffering, his or her partner and children undoubtedly suffer tremendously.

Although the gay person certainly feels a sense of loss at leaving the spouse and children, the gay person will likely eventually blossom within the gay community. However, for the partner who is left behind, the grieving process can be worse than that caused by the death of a spouse. That person now has not only lost a spouse, but has also had his or her own sexual worth badly damaged. The partner whom they loved, and whom they thought found them sexually attractive, may have never actually felt that way. This realization comes as a crushing blow. (However, some women are relieved to know that they were being rejected for reasons that had nothing to do with them as individuals.) Straight spouse support groups can help people come to terms with their thoughts about themselves and their gay spouses. Still, many abandoned spouses end up facing their loss alone.

These negative consequences don’t result from the gay people making a bad decision by coming out. Rather, I believe that these gay people make a bad decision when they marry in the first place. By allowing society to pressure them into leading a lifestyle that doesn’t suit them, they end up causing many other people a lot of pain and suffering later on — in addition to the suffering they endure themselves while leading a life not truly their own.

Outing by others
Some people within the gay community believe that all gay people should reveal their homosexuality. These people sometimes act on this belief and reveal the secretly gay person’s sexual orientation to the world at large in a process called outing.

I am totally against outing. I have seen the pain and suffering that gay people go through when they freely decide to reveal their true selves, and nobodyhas the right to force someone else to undergo that process.

Finding support
Not long ago, left-handed children were forced to learn to write with their right hands. Society has since learned to accept lefties, and in some endeavors, such as sports, many lefties actually have an advantage.

I hope one day we will feel the same way about gay people that we feel about lefties. The pressures that our society puts on gays to keep their sexuality hidden causes untold damage. And the guilt for this lies not on gay people, but on all of us for trying to force them into adopting a false sexual identity.

Although everyone focuses on the AIDS crisis among homosexuals — and the disease certainly has had a horrible effect on this population — at the same time, gays have been building networks to help each other live more satisfying lives. They’ve organized politically, with groups such as the National Gay and Lesbian Task Force, so that in major cities with large gay communities, homosexuals have gained many, if not most, of the same civil rights as heterosexuals. Gay resorts have sprung up where homosexuals can gather without feeling different.

All of these changes have made life a lot more pleasant for homosexuals since the Stonewall incident, but far too many people still remain ignorant and discriminate against others because of their sexual orientation.

Sexual Practices among Gay Men

2009-01-03T09:32:00.003+07:00

Homosexual men practice a wide array of male-to-male sexual activities — Many of them identical to heterosexual activities. And, in a gay relationship, the feelings of love and caring can be as strong as in any heterosexual relationship.

Because of the traumatic effect that AIDS has had on the gay community, I am listing gay sexual practices in order of their safety — a major concern for both gays and straights. I particularly want young homosexual males to hear this message about safer sex. Although the older gay population, which has seen so many of its members suffer and die, has adopted safer sex practices, reports indicate that young gay men are still flirting with danger. I can only hope that they use safer sex before it’s too late.

At the safest end of the spectrum is voyeurism; that is, watching other people have sex. This activity may be compared to straight men going to topless clubs; although, because of the atmosphere of the gay bar and bath scene, masturbation more likely accompanies voyeurism among homosexuals.

Group masturbation is another common practice in certain homosexual communities. This may either be solo masturbation done in the presence of others, or mutual masturbation, which is sometimes done in circle jerks where one man masturbates the next, who masturbates the next, and so on. Because of the dangers of AIDS, most major cities have developed J/O Clubs (the J/O stands for “jerk off” or “jack off”), which are places where gay men may masturbate together. These clubs usually have strict rules against other, dangerous forms of sex.

Frottage is the term applied to the practice of two men rubbing their bodies against each other, usually until climax. This is considered a safe form of sexual activity.

Fellatio, oral-penile sex, is considered to be the most common form of sex between men.

Because the risks of transmitting an STD are greater if one person ejaculates into the mouth of the other, ejaculating in the mouth is often avoided. Because of the leak of Cowper’s fluid, however, oral sex still has some danger to it unless the person on whom fellatio is being performed wears a condom. Kissing other body parts includes little risk, except for anal kissing, or rimming, from which many STDs can be passed on.

The most risky form of gay male sex is penile-anal sex. This is when one man inserts his penis into the anus of his partner and thrusts until he achieves orgasm. The person whose anus is being penetrated (the bottom) may also find pleasure from having his prostate and rectum stimulated in this manner. The transmission of STDs is at its highest during anal sex because the ejaculate can contain the viruses. Because the rectal lining is often torn or abraded during this sexual practice, the viruses then gain easy access to the bloodstream.

The use of condoms is a must for safer penile-anal sex; although, because of the amount of physical activity, condoms are more likely to break during anal sex than during vaginal sex. So, even with a condom, anal sex remains a risky activity.

Marriage between Same-Sex Partners
Although our society condemns gay people for being promiscuous, it also puts roadblocks in front of gays who want to make a commitment to each other. Many people want to limit the concept of marriage to the union of a man and a woman. Because I want to wish a healthy life to all human beings, I believe we must encourage all people, including gays, to form long-term relationships.

Sex When You’re Physically Disabled

2009-01-02T17:02:00.002+07:00

Saying that terrific sex is possible and desirable for people with physical disabilities isn’t the same as saying it’s easy to come by.

Perhaps the most difficult part of sexuality for many people with disabilities is finding a partner. Some people who were once physically fit and had a partner lose that partner after they become disabled. No one can say whether losing a partner is worse than not having one in the first place; both are very, very difficult circumstances. If the disabled person’s partner does leave, adding an emotional loss to the physical one, this combination can prove unbearably painful.

Finding a partner
Persistence and open-mindedness are the most important characteristics for a person with disabilities to have in finding a partner. You have to learn to have faith in the fact that some people decide whom they want to have as a partner based on the inner person, not a person’s physical attributes or financial well-being. These individuals can look beyond physical problems because they fall in love with others based on who those people are as human beings.

For such a person to discover the inner you, you must allow your inner being to shine through. This isn’t easy. Often people with disabilities tend to hide themselves in shame or to cover their weaknesses with anger. Although these two common responses are quite understandable, you must let as many people as possible see the real you, the happy you, the sensitive you, the sexy you. Then, hopefully, you’ll find a partner.

Some people who become the partner of a person with disabilities are themselves disabled and may even have the same disability. But if you act unpleasant and make it especially difficult for someone to love you, then whether the person you meet has a disability or not doesn’t really matter. There are many wonderful people to whom a disability isn’t an impediment to opening up their heart, but that doesn’t make them want to spend time with a self-absorbed grouch.

Most disabled people have to struggle every day just to get by, so I know that you possess plenty of strength and courage. I also know, however, that giving up on something long-term, such as finding a partner, is easy to do when just getting down to the street is an effort. But you can’t let yourself give up. You have to persevere because finding someone to share your life with is a goal worth every ounce of determination you put into realizing it.

One benefit to showing your bright side is that, even if you never find a partner with whom to form a loving and sexual relationship, you will certainly make new friends. People can’t help but be attracted to a sunny disposition.

If you smile, if you give people compliments, if you tell a funny joke, if you give them a big hello, they will respond positively. On the other hand, if you have a sour face, if you mumble, if you complain, you will turn people off.

Many of you may be saying, “But I have a disability — I have enough troubles. Why do I have to reach out? Why do I have to be the first one to smile?”

Well, you know what? I give the exact same advice to a physically able person who wants to find a partner. Your disposition does play a role in attracting others, and just because you have a good excuse for feeling rotten doesn’t change the fact that negative feelings repel people. That’s just the way it is; if you want to attract people, then you have to act attractive.

Partnering the person with disabilities
Comparing pain is impossible, so I would never make a comparison between the hurt felt by those who become disabled, in whatever way, and the suffering of their partners. Nevertheless, I must acknowledge the partners’ pain. Without warning, a marriage that included a long list of activities that both partners enjoyed (such as skiing or tennis or making love on the dining room table) becomes one full of obstacles instead. Yes, the physically fit partners still have their health, but their hopes, dreams, aspirations, and fantasies can be just as damaged as those of their disabled lovers.

Sadly, but often understandably, many of these partners leave the marriage. They refuse to accept the limitations put on their lives by living with a disabled person. Sure, the world would be a great place if everyone could be heroic, but not everybody can. We shouldn’t condemn these people because we don’t know for sure what we would do if we were in their shoes.

Keeping the relationship alive
Some couples, when one partner’s health first fails, swear that they will stay together and work things out. Keeping that promise isn’t always possible, however. Sometimes the relationship ends because the healthy partner just can’t find the strength any longer to take care of a disabled partner and still manage his or her own life. In other cases it ends because the disabled person places too many demands on the partner with too little consideration.

No matter how difficult having a disability is, a person with physical challenges must be willing to give his or her partner a hand. Yes, you may have lost certain faculties, but you have to be willing to exercise the ones you still have to your fullest.

Because this is an article about sex, let me address that particular subject. If a man has an accident and, as a result, loses his ability to have erections, his wife doesn’t have to spend the rest of her life sexually frustrated. If he can still move his fingers, if he can still use his tongue, if he can hold a vibrator, he owes his wife sexual fulfillment. If the man abandons his wife sexually while at the same time asking her for all sorts of other help, then she may not be able to bear all those burdens. The same holds true for a disabled woman who withholds sexual favors.

An inspiring man
On one of my television programs, I interviewed a man who was quadriplegic, and he was willing to talk on national television about the great sex life he had with his wife. He did the best that he could with what God left to him, and he had a very successful marriage.

He is definitely inspirational, and thankfully he is not alone. Many people with physical disabilities have great sex. Coming Home, a 1978 movie (now out on DVD) about a soldier who returns from Vietnam in a wheelchair, offers a moving example of how sexual and sexy the relationship of a disabled man and a healthy woman can be. A disability doesn’t have to put an end to a couple’s sex life, although it will almost definitely mean that they will have to put more effort into seeing that the fires do keep burning brightly.

If the healthy spouse of a disabled person who refused to engage in any sex came to me, I wouldn’t necessarily advise that person to stay in such a marriage. I may feel bad saying it, but I just might have to say that the healthy person has to think of themselves too.

You should also remember that, besides sex, many other things form the glue that keeps a loving partnership together. You have to tell your partner how much you love him; you have to thank her for putting in the extra effort that your disability may cause; in short, you must nurture your entire relationship if you are going to have a successful marriage.

If you and your partner face a disability, I can’t recommend too strongly that you speak to your doctor about sexual functioning. These days, medical help is available. For a man who can’t have an erection, Viagra (sildenafil), penile implants, or Caverject (alprostadil) injections may be effective. In the case of spinal injuries, the man may not feel an orgasm the same way he used to, but he may be able to have an erection, ejaculate, and feel pleasure from the experience. If your doctor doesn’t have the information you require on this subject, be advised that facilities exist that have helped disabled men with their sexual functioning, and make an effort to contact the one nearest you.

I also recommend that you see a sex therapist or marriage counselor — in particular, one who has experience working with disability issues. Both you and your partner may have worries and fears that play a role in your sexual functioning — maybe even a bigger role than the actual disability. You both need to talk these problems out, and rarely can a couple accomplish this communication without professional help. The same is true of strains other than sexual ones, which can tear at your relationship. Undergoing such trials is never easy, so don’t be ashamed to seek help in overcoming them.

Sex After You’ve Had a Heart Attack

2009-01-01T16:03:00.002+07:00

When most people hear the term disabled or physically challenged, they immediately think of someone with an affliction that you can easily see, such as a person who is in a wheelchair, who uses a cane, or who signs instead of speaks. Not every ailment is visible, however, and one of the most common problems that affects sexual functioning is a heart attack.

Overcoming fear
You may have heard rumors of famous men who died because of a heart attack while in the throes of passion. I can’t attest to the truth of any of these stories. But I can tell you that, for the average person who suffers a heart attack or undergoes heart surgery or even has angina, problems with sex almost always result. Not that these people don’t want to have sex, but they’re afraid. They worry that, as a result of engaging in intercourse or having an orgasm, they will trigger another heart attack — this time, a fatal one.

This isn’t an absolutely foundless fear, but studies show that the increased risk is really minimal. For healthy people, the risk of having a heart attack after sex is about 2 in a million. For people with heart conditions, that figure rises to 20 in a million. Even though the number increases by tenfold, you can see that the risks remain very small.

Certainly, for a time after you’ve had a heart attack, your doctor will forbid you from having sex. And just because the doctor gives you the green light doesn’t mean that you will feel ready. It doesn’t take much to make a man lose his ability to have an erection, so you can imagine that the fear of provoking a heart attack can certainly cause impotence. For women, the usual problem is anorgasmia, the inability to have an orgasm, and it is equally understandable that a woman who normally gets little enjoyment from sex may be reluctant to participate in the act.

The best treatment for fear of sex after a heart attack is reassurance from your physician or cardiologist. I believe that this reassurance should take place in the hospital while you are still recuperating. Sexual performance is almost always a concern of someone who has had heart problems, and having your fears alleviated as quickly as possible can help speed up your recovery. If you need further tests to determine what you can and can’t do, then, by all means, you should get them. No doctor should consider the loss of sex as no big deal because it is a big deal — not only for the patient, but also for the patient’s partner.

By the way, the patient may not be the only one who suffers from impotence or anorgasmia. The partner, who is just as afraid of causing a crisis with his or her lover’s heart, can also suffer. The partner may need just as much reassurance as the patient.

One way to overcome the fears associated with sex is to make masturbation the first step and slowly work your way up to intercourse. You can also perform masturbation on your partner so he or she doesn’t have to be sexually frustrated during your recovery.

It may not all be in your head
Fear isn’t the only factor that can cause impotence. Vascular problems usually accompany heart problems, so — because a man’s erection results from blood flowing into the penis — sometimes the impotence a man experiences after a heart attack has physical rather than mental causes.

Angina, shortness of breath, and palpitations are problems associated with heart conditions, and, although they may not be deadly, they can certainly put a crimp in your sex life. Very often these symptoms show up after you’ve had an orgasm, when your heartbeat is on its way down. Now, if you get an angina attack (a sharp pain in the chest area) every time you orgasm, these attacks won’t improve your desire for sex. Here, again, you should consult with your physician or cardiologist. Don’t be ashamed to ask specific questions. Your doctor may have suggestions that will help you have a relatively normal sex life, and you have every right to find out.

What can you do?
Here are some specific tips that may help you if you have heart trouble.

If you have a heart condition, don’t engage in sexual activity when you’re angry or under a lot of stress. At these times, the heart already beats faster, and sex would only tax its abilities even more.
See if your doctor can prescribe drugs such as calcium channel blockers or beta blockers for you. These drugs can make sex easier on your heart.
Some heart patients decide for themselves to take their heart medication, such as Inderal (propranolol) or nitroglycerin, before having sex, thinking that they can prevent heart troubles.
Do not attempt such techniques without first checking with your physician. (Propranolol is used on a schedule, so taking it out of schedule can be risky.) Men suffering from impotence may consider taking Viagra or another drug used to treat erectile dysfunction. This can be deadly, however, so don’t ask for a prescription from another doctor without first checking with your heart specialist.

The medications that are prescribed for heart conditions, such as beta blockers, antihypertensives, and diuretics, can cause sexual functioning problems of their own. Sometimes your doctor can prescribe alternative medicines that will still be effective without getting in the way of your sexual functioning, so ask questions of your cardiologist.

Both the medical profession and the patients share the responsibility for the lack of communication between them. Some cardiologists gloss over the sexual aspects, but many times the patients are simply too shy to discuss their sexual problems with their cardiologist. This embarrassment especially holds true for older people, who form the biggest proportion of heart patients. They may believe that, at their age, sex isn’t important. But sex is important,and it can play an important role in your recovery. Don’t ignore sexual problems; speak out.

I believe that consulting with a sex therapist who is trained in working with people with heart ailments is also a good idea. Sex therapists aren’t shy about speaking to you about your sexual functioning, and, if necessary, they can act as an intermediary and speak to your doctor to find out exactly what sexual activities you can perform safely.

Sex When You Have Diabetes

2009-01-01T15:56:00.002+07:00

Diabetes is a disease in which the body doesn’t properly use or produce sufficient amounts of insulin, which is a hormone needed to process sugar and starches. This disease has many side effects and can be deadly. Diabetes currently affects 7 percent of the population, and sadly the number of people with diabetes grows every day.

One of the side effects of diabetes in men can be impotence. The fact that so many people know about this possibility means that many men who are diabetic suffer needlessly with impotence. In these cases, the impotence is caused not by the disease, but by the anxiety they feel.

If you’re a diabetic having problems with your erections (either a softening of the erections or no erections at all), I suggest that you visit a sex therapist for several reasons:

The therapist may be able to help restore some or all of your lost functioning, if the cause isn’t physical.
Even without a firm erection, sexual enjoyment and ejaculation can still be satisfying. A therapist can help you explore these possibilities.
You should visit this sex counselor with your spouse because she may need reassurance that you are having these problems because of the disease, not because you no longer find her attractive or have taken an outside lover.
You should also consult with your doctor because some products on the market may be able to restore your ability to have an erection, chief among them Viagra. If you’re not a candidate for Viagra or one of its competitors, then a penile implant may be the solution you require.

Drugs that can affect your sex life
Many drugs have side effects that pertain to your sex life. The following is a list of drugs that can affect various sexual functions. Take note: These drugs will not affect everyone the same way, but if you are taking one or more of these drugs and you notice that it is affecting your sexual functioning, speak to your doctor about it. The doctor may prescribe a different drug, or perhaps a different dosage, which can restore your sexual functioning. Drugs that have been on the market for a long time are more likely to affect your sexual functioning because when pharmaceutical companies first developed these drugs, their main concern was treating the symptoms involved. Only later, as these companies tinker with the dosages, have they eliminated some of the negative side effects.

Drugs that can affect sexual desire (names in parentheses are generic names):
Antihypertensives, antidepressants, hypnotics, antipsychotics, ulcer medications, birth control pills, and antianxiety drugs such as Aldomet (methyldopa), Anabuse (disulfiram), antihistamines, barbiturates, Catapres (clonidine), estrogens (used in men to treat prostate cancer), Inderal (propranolol), Librium (chlordiazepoxide), Lopressor (metoprolol), Serpasil (reserpine), TADs (tricyclic antidepressants), Tagamet (cimetidine), Tenorim (atenolol), Thorazine (chlorpromazine), Trandate (labetalol), and Valium (diazepam).

Drugs that can affect ejaculation:
Aldomet (methyldopa), anticholinergics, barbituates, Catapres (clonidine), Dibenzyline (phenoxy-benzamine), estrogens, Ismelin (guanethidine), Mellaril (thioridazine), MAOs (monoamine oxidase inhibitors), Serpasil (reserpine), thiazide diuretics, Thorazine (chlorpromazine), tricyclic antidepres- sants, and selective serotonin inhibitors, such as Prozac, Zoloft, Paxil, and Celexa.

Drugs that can affect erections:
Adalat (nifedpine), Aldomet (methyldopa), Antabuse (disulfiram), anticholinergics, antihis- tamines, Banthine (methantheline), barbiturates, Calan (verapamil), Cardizem (diltiazem), Catapres (clonidine), digitalis, Dilacor (diltiazem), estrogens, hydroxyprogesterone (for prostate cancer), Ismelin (guanethidine), Isoptin (verapamil), Librium (chlordiazepoxide), Lithonate (lithium), MAOs (monoamine oxidase inhibitors), Mellaril (thioridazine), Procardia (nifedpine), Serpasil (reserpine), Tagamet (cimetidine), Thorazine (chlorpromazine), Trecator-SC (ethionamide), tricyclic antidepressants, Valium (diazepam), and Verelan (verapamil)

Drugs that can affect orgasm in women:
Aldomet (methyldopa), anticholinergics, Catapres (clonidine), MAOs (monoamine oxidase inhibitors), tricyclic antidepressants, and selective serotonin inhibitors, such as Prozac, Zoloft, Paxil, and Celexa.

Diabetic women can also suffer from diminished sexual functioning. The intensity of the orgasmic response is sometimes lessened, and she may develop a greater need for increased manual or oral stimulation of the clitoris to have an orgasm. Again, a sex therapist can help you deal with these symptoms.

Sex and People Who Are Mentally Disabled or Ill

2009-01-01T15:49:00.001+07:00

Some people with mental disabilities, such as Down syndrome, have only the intelligence of a child. Many people believe that these people should be treated like children with regard to all of their abilities. They believe that these adults should be “protected” from sex the way we protect children. As a result of such policies — especially if the person lives in a group setting — family or staff make an effort to eliminate any form of sexual interest or expression from these people’s lives. They get no privacy and aren’t even allowed to masturbate.

In many cases, this restrictive attitude toward sex conflicts with reality because, although a person’s mental level may be stuck in childhood, physically, he or she goes on to become an adult. The men have erections, nocturnal emissions, and a fully developed libido (sex drive) with all the attendant sexual desires. The woman’s sex drive also can develop fully, and physically she will have to adapt to having her menstrual periods.

Although, for some mentally impaired individuals, sex education can be limited to teaching them not to undress or touch their genitals in public, many others would benefit from learning about safer sex practices and how to handle a relationship.

Because the degree of mental proficiency differs for each individual, how much they should be taught, and how much freedom regarding sex they should get, depends on the individual. Some mentally disabled people marry and have children; for others, such activities aren’t appropriate.

Anyone — parent, relative, or caretaker — dealing with a mentally disabled person who reaches adolescence can’t ignore sex. As the mentally disabled person grows up physically, his or her hormones kick in, causing a variety of changes, such as the growth of pubic and underarm hair, breasts, and so on. Just as with average teenagers, someone must teach mentally disabled teenagers that these changes are normal. Girls must learn to use a pad or tampon. Boys must be told about wet dreams. Both sexes have to understand the sexual feelings that they are starting to have. Both have to learn about masturbation and that they should do it in private.

Another point to consider is companionship. Everyone needs companionship, and so people pairing off is only natural. Sometimes that companionship develops into a romance, and then a sexual relationship. Some institutions allow this activity to take place, making sure that contraception is used, while others do not. But even keeping men separated from women can’t ensure that sexual contact won’t take place.

The best approach is to offer all mentally impaired people sex education so they can learn to deal with this aspect of their lives. They will benefit from it, and so will those who take care of them. We can’t deny people who have mental impairments the right to fulfill the same needs the rest of us have, and so we have an obligation to help them learn as much as they can absorb.

While some people are born with a mental disability, far more people at some point in their life encounter a mental illness, such as depression, which affects 19 million people in the United States. I encourage anyone who suffers from a mental illness to seek treatment from a mental health professional. Most of these therapists will ask patients about any effects their condition has on their sex life. If someone with a mental illness is encountering sexual difficulties because of their illness and their doctor doesn’t ask about it, they shouldn’t hesitate to bring up their concerns. Sexual functioning is an important part of life, and if help can be offered (which may simply be a change in medication), such remedies should be explored.

Sex and People Who Are Living in a Long-Term Care Facility

2009-01-01T15:46:00.002+07:00

Just as people who take care of the mentally disabled must accept the sexuality of those under their care, so must those people who tend to any person who is permanently living in an institutional setting, including those with chronic disabilities and the elderly who are in nursing homes. For the vast majority of these people, whatever disabilities they do have, sexual dysfunction didn’t place them in the facility.

Individuals living outside of their homes deserve respect for both their sexuality and their privacy. If they need the door closed to masturbate, caretakers shouldn’t disturb them. Many times, people confined to a nursing home form romantic relationships. In these cases, I believe that facilities should designate dating rooms, with clear “Do Not Disturb” signs, so residents can enjoy their companionship in whatever way they see fit. Remember, even if a couple doesn’t have intercourse, the pleasure of touching each other, hugging, or kissing is intensified if the couple is permitted to be alone.

In some cases, a couple can’t have sex without assistance. In these instances, I advocate that the staff should be trained to help disabled individuals enjoy the benefits of sex in much the same way that the staff is trained to help these people bathe or use the restroom. Sex isn’t only for the young and beautiful, but for everybody, and this assistance should be provided in a nonjudgmental way.

To create an environment where healthy sexual relationships can flourish in these settings, the staff must receive the necessary counseling to handle such issues just as competently as they give other types of care. Because of our society’s values, helping people to have sex doesn’t always come naturally, but I believe that, given the proper guidance, we can make our institutions a little warmer than they are now by including as much loving as possible.

Uncompromising Compromised Sex
In all probability, sex for a person with disabilities or a medical condition will involve some compromises. Not every position will be possible; maybe even some very basic sex acts, such as intercourse, are impossible. Those limitations don’t mean, however, that the two people having sex can’t derive a lot of pleasure from their activities. The important thing is not to look at your sex lives as limited, but to try to make the most of the sexual performance that you can have. Discuss your situation with your doctor to find the full range of what is possible for you.

Remember that sex isn’t just orgasms. The pleasure that comes from making love (and here, I think, using that term is very important) comes also from touching each other, kissing each other, and caressing each other.

The human body and the human spirit are amazing things. Very often, the body of a disabled person compensates for one loss through the development of other senses. A blind person may find that his or her sense of hearing has improved considerably. A deaf person may develop a keener sense of smell. And so people with disabilities may well find that the parts of the sex act that are available to them become exquisitely pleasurable.

For this reason, you should never give up. Try to enjoy sex to whateverextent you can and make sure that your partner enjoys it, too. You may find that you gain as much enjoyment as any nondisabled person does and, by fully appreciating the sensations that you do have, maybe even more so.