Syphilis

Syphilis was first noticed in Europe in the 15th century, coinciding with the return of Christopher Columbus from the New World. No one knows for sure whether the disease came from America or West Africa, but it caused a tremendous epidemic with a high fatality rate.

Syphilis is caused by a spiral-shaped, snail-like microscopic organism called Treponema pallidum. Because syphilis resembles so many other diseases, it is known as “the great imitator.” The disease progresses over a long period of years with different stages along the way.

The primary syphilitic lesion is the chancre: a circular, painless, and firm sore that appears at the site of the invasion either on the lips, mouth, tongue, nipples, rectum, or genitals anywhere from 9 to 90 days after infection.

Symptoms

There are three distinct stages of syphilis. During the first stage, a large open sore called a chancre forms. It is a painless sore that occurs at the point of contact with the bacteria. In women, chancres can be found on the inside or outside of the , on the cervix, or inside the urethra. In men, the sores can be found anywhere on the penis. For both sexes, chancres can also occur inside the mouth, or around it, on eyelids, chest, face, fingers, breasts, perineum, or anus. These sores only last a couple of weeks, but the disease is still infecting your body.

Six to ten weeks later, the chancre heals by itself, followed by a symptomless time (latent period) of anywhere from six weeks to six months before symptoms of secondary syphilis appear.

Secondary syphilis is marked by rashes of various types that don’t itch and that heal without scars. These rashes indicate that the microbes have traveled through the bloodstream and lymphatic system to every organ and tissue in the body.

Secondary syphilis is followed by another symptomless period, which can last a lifetime, or the disease can reappear after a number of years.

Tertiary syphilis attacks the nervous system and can destroy skin, bone, and joints as well as interrupt the blood supply to the brain. Syphilis can be deadly in this last phase.

Syphilis is passed from one person to another during vaginal intercourse, anal intercourse, kissing, and oral/genital contact. The disease is especially contagious while the sores are present in the primary stage.

Medications

Treatment with long-acting forms of penicillin is effective for primary, secondary, and latent syphilis; however, the damage caused by tertiary syphilis can’t be reversed by penicillin therapy. For people allergic to penicillin, tetracycline or erythromycin may be taken.

The number of syphilis cases in the United States has fallen dramatically. In fact, syphilis is now confined to only 1 percent of U.S. counties. Sadly, 65 percent of the cases of congenital syphilis occur among African Americans, and this is also believed to be a contributing factor to the spread of HIV among this same group.

Read More......

Pubic lice

Pubic lice, also called crabs or cooties, can be spread not only by sexual contact but also by coming in contact with infected bedding, clothing, and toilet seats. Their bites cause intense itching. Because they are visible to the naked eye, you can check yourself if you have any symptoms. The lice are the size of a pinhead, oval, and grayish, unless they are filled with your blood, in which case they are more orange.

You can treat pubic lice yourself with over-the-counter medications including Kwell, A-200, and RID. In addition, you should thoroughly wash or dry-clean all bedding and clothing that has come into contact with the lice.

Symptoms

Itching is a prevalent symptom. The scabies can lay eggs in your skin, but lice bite into your skin to blood. Both ways, itching and redness occur. With scabies, there will be little bumps, blisters, and crusting where the itching occurs. Whit lice, the insects and their eggs should be visible in your hair or your skin may be red and scaly.

Medications

Scabies can be treated in just a few days using kwell (a lotion) applied to the entire body. The itching may take up to a month to stop, but the scabies will be gone. Pubic lice can be completely cured with the same lotion rubbed into the affected pubic hair.

Read More......

Molluscum Contagiosum

Molluscum contagiosum is a common skin disease caused by a virus which affects the top layers of the skin. The name molluscum contagiosum implies that the virus develops growths that are easily spread by skin contact. Similar to warts, this virus belongs to the poxvirus family and enters the skin through small breaks of hair follicles. It does not affect any internal organs.

The Molluscum contagiosum virus can cause a small, pinkish-white, waxy-looking, polyp-like growth in the genital area or on the thighs. It is spread by sexual intercourse but can also be spread through other intimate contact. Doctors can usually treat it by removing the growths either with chemicals, electric current, or freezing.

What do mollusum look like?

Molluscum are usually small flesh-colored or pink dome-shaped growths that often become red or inflamed. They may appear shiny and have a small indentation in the center. Because they can spread by skin-to-skin contact, molluscum are usually found in areas of skin that touch each other such as the folds in the arm or the groin. They are also found in clusters on the chest, abdomen, and buttocks and can involve the face and eyelids.

In people with immune system diseases, the molluscum may be very large in size and number, especially on the face. To confirm the diagnosis of molluscum, a dermatologist might scrape some cells from the growth and look at them under a microscope.

How do you get molluscum?

The molluscum virus is transmitted from the skin of one person who has these growths to the skin of another person. It occurs most often in cases where skin-to-skin contact is frequent, in young children — especially among siblings, or in swimming pools. If growths are present in the genital area, molluscum can be sexually transmitted.

Who is most at risk to get molluscum?

People exposed to the molluscum virus through skin-to-skin contact have an increased risk of developing these growths. Children tend to get molluscum more often than adults. It is common in young children who have not yet developed immunity to the virus. Molluscum also seems to be more common in tropical climates where warmth and humidity favor the growth of the virus.

Does molluscum contagiosum need to be treated?

Many dermatologists advise treating molluscum because the growths are easily spread from one area of the skin to another. Some growths may appear as others are going away. However, molluscum will eventually go away on it’s own without leaving a scar. It may take from 6 months up to 5 years for all of the molluscum to go away. They may be more persistent in people with a weakened immune system.

How do dermatologists treat molluscum?

Molluscum are treated in similar ways that warts are treated. They can be frozen with liquid nitrogen, destroyed with various acids or blistering solutions, treated with an electric needle (electrocautery), scraped off with a sharp instrument (curette), treated daily with a home application of a topical retinoid cream or gel, a topical immune modifier, or other topical antiviral medications. Laser therapy has also been found to be effective in treating molluscum. Some discomfort is associated with freezing, scraping, using the electric needle, and laser therapy. If there are many growths, multiple treatment sessions may be needed every 3 to 6 weeks until the growths are gone. An option, especially with young children, is not to treat molluscum and wait for the growths to go away.

What if the molluscum comes back after treatment?

It is always possible for a person’s skin to get infected again with the molluscum virus. The condition may be easier to control if treatment is started when there are only a few growths.

Is there any research going on about molluscum?

New drugs are being developed to treat viral infections. The molluscum infection has improved in some patients with AIDS who were taking certain antiviral drugs. If new and effective antiviral drugs can be developed in a topical form, perhaps they may be of benefit in the treatment of molluscum in the future.

Read More......

HIV (AIDS)

Researchers now believe that herpes lesions act as an entryway for HIV, so that people infected by herpes are much more likely to become infected with HIV if they come in contact with the virus. So although herpes itself may not be deadly, having herpes can have deadly consequences. Human immunodeficiency virus (HIV) and AIDS.

If you’ve heard of only one sexually transmitted disease, that one is the acquired immunodeficiency syndrome (AIDS), which is linked to infections by the human immunodeficiency virus (HIV). Why is so much more attention given to this disease than to any other STD? The answer is quite simple: AIDS is deadly, and it has no cure and no vaccine.

HIV now infects less than 1 million people in the United States but close to 40 million people worldwide. Of the nearly 6 million new cases expected in 2006, about 40,000 will occur in the United States, while 25 percent of all new cases will occur in sub-Saharan Africa. In 2005, 2.5 million people died of AIDS.

HIV is most commonly passed on through sexual activity or by shared needles.

In Africa, 60 percent of HIV transmissions occur in women through vaginal intercourse. HIV can also be passed through transfusions of contaminated blood products (though since 1985 all blood is screened for HIV in the United States), from a woman to her fetus during pregnancy, and through breastfeeding.

Although HIV has been detected in small quantities in body fluids such as saliva, feces, urine, and tears, to date no evidence exists that HIV can spread through these body fluids, despite extensive testing. You can’t contract AIDS by touching someone who has the disease, by being coughed or sneezed on by that person, by sharing a glass with that person, or through any other routine contact that may take place.

But if you think that you’re safe from AIDS because you’re not a homosexual man, you’re wrong. Because anal sex — a form of sex most common among homosexual men — is more likely to allow the transmission of the disease,this plague decimated the homosexual community first in the Western world. But in Africa, where AIDS is most common, it’s primarily a heterosexual disease. Even in the West, the incidence of AIDS is rising faster among heterosexuals than among homosexuals, among women as well as men. AIDS poses a risk to everyone.

HIV infections weaken the body’s ability to fight disease, causing acquired immunodeficiency syndrome (AIDS) and other health problems.

A person can be infected by HIV and not show any symptoms for up to ten years.

If AIDS develops, a variety of different ailments may attack the body, leading to death.

Two known human immunodeficiency viruses exist, HIV-1 and HIV-2. They both cause disease by infecting and destroying blood cells called lymphocytes that protect the body against infection. HIV-1 is most common in Western countries; HIV-2 occurs most frequently in Africa, where the disease is thought to have originated.

The first case of AIDS in America was reported in 1981. By 1994, more than 300,000 cases of AIDS had appeared in the United States, resulting in more than 200,000 deaths.

Diagnosis, symptoms, and treatment

Doctors diagnose HIV infection with tests to detect HIV antibodies in the blood. These antibodies usually appear in the bloodstream three to eight weeks after infection, though it may take as long as six months for these antibodies to show up. Because of this window of time, a person can have a negative HIV test and still be able to pass the disease to others. In addition, the first 60 days after being infected with the virus is a period of high contagion. For that reason, you should always use a condom; it’s impossible to really know whether or not a partner can infect you.

Initial symptoms of HIV infection may resemble those of a common nonsexual disease, mononucleosis: high fevers, swollen glands, and night sweats. After that you may go through a period, which commonly lasts for years, during which you have no symptoms. Eventually, as the body’s immune system weakens from fighting HIV, some opportunistic microbe — an organism that the body’s immune system would normally dispose of — causes an infection, such as pneumonia, that just won’t go away. At this point, a doctor usually discovers that the person is infected with HIV and diagnoses a case of AIDS.

In the United States, 50 percent of people infected with HIV will have AIDS after ten years; the median life expectancy from the time of infection is about 12 years. Life expectancy is shorter for those people infected by transfusions of blood or blood products and for people who don’t get good medical care.

Medical science has, as yet, produced no vaccine against AIDS, nor has it found a cure. The medical field has developed many different drugs that can now help prolong the life of a person with HIV and manage the various symptoms. Three basic categories of drugs exist. First are the antiretroviral drugs that inhibit the growth and multiplication of HIV at various steps in its life cycle. Doctors prescribe these drugs in groups known as cocktails.

Other drugs fight the opportunistic infections that may occur because HIV lowers the immune system’s ability to fight them. A third group, which is more experimental and has not proven very successful, helps to boost the immune system. And although no vaccine is imminent, microbicides, which women could apply to their vaginas, seem to offer some protection for women, though their approval and availability are still years away.

Could circumcision prevent AIDS?

Many studies have been done to see whether a man’s penis being circumcised affects his risk of getting HIV, but no connection was found. Then in 2006, a study in Brazil showed a clear correlation. The theory is that the virus grows in the warm, moist environment under the foreskin of an uncircumcised penis. Although this one test isn’t enough to prove that circumcising at risk men, particularly in Africa, would reduce the rate of transmission, perhaps further study will do just that.

Read More......

Herpes

Herpes, which is caused by the herpes simplex virus (HSV), is another incurable STD. Herpes actually has two forms: herpes simplex–type 1 (HSV-1) and herpes simplex–type 2 (HSV-2), although HSV-1 is most often associated with cold sores and fever blisters “above the waist.” About 80 percent of American adults have oral herpes. Estimates state that 25 percent of adults have genital herpes, though most are not aware of it, and their symptoms are too mild to notice, but they can still pass the disease on.

The most common symptoms of genital herpes arise from a rash with clusters of white, blistery sores appearing on the vagina, cervix, penis, mouth, anus, or other parts of the body. This rash can cause pain, itching, burning sensations, swollen glands, fever, headache, and a run-down feeling.

The first symptoms may be more severe than the symptoms of later outbreaks because the immune system is not as well prepared to fight off the disease the first time around. However, a person may have no symptoms whatsoever, and his or her first outbreak may occur months or even years after exposure. HSV-2 symptoms can occur on the thighs, buttocks, anus, or pubis. People who suffer only mild symptoms may mistake them for some other condition, such as insect bites, jock itch, yeast infections, hemorrhoids, or ingrown hair follicles. Some lesions may be so small that they remain invisible to the human eye. And if a small lesion appears inside a woman’s vagina, she will never see it.

These symptoms may return at regular intervals, sometimes caused by stress, menstrual periods, or other factors that aren’t well understood. Although these symptoms can lead to discomfort, they aren’t dangerous, and herpes doesn’t affect the immune system or lead to other health problems.

Because of the increase in oral sex, doctors are finding that some cases of genital herpes are actually caused by HSV-1, the virus that causes oral herpes, and that some cases of herpes located on the mouth have been caused by HSV-2, genital herpes. For those who believe oral sex is safe sex, this should serve as proof that it’s not.

Most people think that herpes is contagious only when the sores are present, but studies have shown that some people may spread the disease during the few days just before an outbreak called prodrome, when they have no sores.

An infected person may figure out how to recognize the warning signs that occur during prodrome, which may include itching, tingling, or a painful feeling where the lesions will develop.

During pregnancy, herpes may cause miscarriage or stillbirth, and the disease can be passed on to newborns, especially if the mother contracts the disease during her third trimester. A mother who has herpes before this usually passes on her antibodies to the baby.

If the sores are active during childbirth, they pose serious health consequences for the babies. To avoid these consequences, doctors usually perform cesarean sections when active sores are visible during the time of childbirth.

If you have herpes, you should always use a condom when having sex, unless your partner already has the disease.

Although you should always use a condom, you should know that condoms can’t entirely protect you from herpes. If the man has the disease, and the only sores are on his penis, then a condom offers some protection to the woman. However, because vaginal secretions may leak over the pelvic area not protected by the condom, the condom doesn’t protect men as much. And if the herpes virus is being shed from another part of the body, such as the hips or buttocks, a condom offers no protection at all.

Herpes can spread beyond genital contact to other parts of the already infected person’s body. If you touch a herpes sore, always wash your hands thoroughly before touching anyone else or any other part of your body.

Be aware that oral herpes can be transmitted by kissing, sharing towels, or drinking from the same glass or cup.

Recent developments in the treatment of herpes include new, more accurate tests, and although doctors still have no cure for herpes, new medications are effective at keeping the virus in check. Zovirax (acyclovir) has been available since the 1970s and can now be obtained in generic form. Valtrex (valacyclovir) and Famvir (famciclovir) have a more active ingredient and are better absorbed and need to be taken less frequently. See a doctor if you suspect that you have the disease, both to make sure that herpes really is the cause of the symptoms and to learn how to live with herpes and not spread it to others. If you are infected, the doctor can give you a set of rules to follow to help keep you from contaminating other people or other parts of your body. Studies also have shown that if someone whose partner has herpes takes Valtrex, their chances of becoming infected are much less.

Read More......

Hepatitis B

Hepatitis B is one of two sexually transmitted diseases for which a preventive vaccine exists. (A vaccine is available for human papillomavirus [HPV]. See the “Gential warts and HPV” for more details.)

Hepatitis B is very contagious, 100 times more so than HIV. Hepatitis B can be transmitted through intimate contact as well as sexual contact, so kissing, sharing the same toothbrush, or sharing needles can transmit the disease. Health-care workers are particularly susceptible and almost always get vaccinated.

Hepatitis B can cause severe liver disease or death, but the virus often has no symptoms during its most contagious phases.

While reported cases number about 240,000 a year, estimates show that 1 American in 20 will get hepatitis B at some point during his or her lifetime, and the disease can remain active throughout that person’s life.

No medical treatment exists for hepatitis B, but in 90 percent of cases, the body’s own immunological response causes the disease to fade away. It is particularly important that people with multiple sex partners get vaccinated.

Read More......

Gonorrhea

The number of reported cases of gonorrhea has been steadily declining in the United States. In fact, the latest figures show that only 330,000 new cases develop every year. Fifty percent of women and 10 percent of men with the disease show no symptoms, so they don’t know they have it. When symptoms do occur, women may have a green or yellow-green discharge from the vagina; frequent, often burning urination; pelvic pain; swelling or tenderness of the vulva; and possibly arthritic-like pain in the shoulder. Men may have pain during urination or a puslike discharge from the urethra.

Gonorrhea can be spread through vaginal, anal, or oral sex. Gonorrhea can cause sterility, arthritis, heart problems, and disorders of the central nervous system.

In women, gonorrhea can cause pelvic inflammatory disease, which can lead to ectopic pregnancies, sterility, or even the formation of abscesses.

Penicillin was the treatment of choice for gonorrhea, but because more recent strains of the disease have become penicillin-resistant, doctors now use a drug called ceftriaxone. Gonorrhea is often accompanied by chlamydia, and so doctors often treat them together.

Read More......

Genital warts and HPV

Approximately 5.5 million people are infected in the United States every year with genital warts, which are caused by the human papillomavirus (HPV).

HPV has become so common that it is estimated that 80 percent of sexually active people contract it at some point. Among people between the ages of15 and 49, only one in four Americans has not had a genital HPV infection, though in most cases the virus is harmless and exhibits no symptoms. Genital warts are spread through vaginal, anal, and oral intercourse. They can also be passed on to infants during childbirth.

Not always visible, the warts are soft and flat; they grow on the genitals, in the urethra, in the inner vagina, in the anus, or in the throat.

The warts often itch and, if allowed to grow, can block openings of the vagina, anus, or throat, causing discomfort.

Because genital warts can be microscopic and therefore unseen by the naked eye, they can easily be passed to sexual partners.

High-risk strains of HPV do exist and can cause cervical lesions, which, over a period of time, can develop into cervical cancer if untreated. Doctors can detect HPV lesions with annual Pap smears, which is why all sexually active women should have yearly Pap smears. The use of Pap smears has drastically reduced the incidence of cervical cancer.

The U.S. Federal Drug Administration has approved a vaccine against some of the types of HPV that cause 70 percent of cervical cancer and 90 percent of genital warts. Developed by Merck, the vaccine is called Gardasil, and health officials recommend that all girls and women between the ages of 9 and 26 be vaccinated. (No vaccine is currently available for boys and men, although a link between HPV and anal and penile cancer may exist.) But because this vaccine doesn’t protect against all types of HPV, women, especially those who have multiple partners, should continue to have yearly Pap tests, even if they have received the vaccine.

Doctors can treat genital warts in several ways, including topical medical creams, some of which require a prescription and some of which don’t.

Over-the-counter medications for other types of warts should not be used on the genitals.

In cases of either large or persistent warts, other treatments may include surgical removal, freezing using liquid nitrogen, or cauterization by electric nee- dles. Because doctors have no cure for HPV, genital warts can reoccur, and the virus can remain in the person’s cells indefinitely, though often in a latent (or not active) state. Most people who have reoccurring genital warts have only one more episode. Even in rare cases of people with multiple reoccurrences, the body’s immune system usually develops immunity within two years. On the other hand, removing a person’s genital warts does not mean that he or she can’t transmit the disease.

Although condoms offer some protection against the spread of HPV, they provide no guarantee against its transmission because they don’t cover the entire genital area.

Read More......

Chlamydia

Chlamydia is the most common STD in the United States, affecting 3 million people every year.

Chlamydia often has no symptoms in women; in men, the first symptoms are usually painful urination and pus coming from the urethra. Symptoms may start within a few days after sexual exposure.

In women, the disease can cause scarring of the fallopian tubes, sterility, infertility, ectopic pregnancy, or chronic pelvic pain.

In men, the organism is thought to be responsible for half the cases of epididymitis, an infection of the epididymis (a series of tiny tubes that lie on top of the testicle), which can cause painful swelling of the testicle.

Although doctors can successfully treat chlamydia with doxycycline or other antibiotics (a single-dose version is available), they often have difficulty diagnosing the disease because of the lack of visible symptoms. People who have chlamydia and don’t take all the medicine for the full time that it’s prescribed often get the disease again (because they aren’t fully cured the first time). Because gonorrhea often accompanies chlamydia, doctors usually treat the two together.

Although most people who have chlamydia have no symptoms and thus don’t even know they have the disease, they can still suffer the long-range consequences. Because chlamydia is so common, people who have sex with multiple partners, especially if they don’t use a condom, should be tested whenever they change partners or after any unprotected sex with a new partner.

Read More......

Candidiasis

Often called a yeast infection, candidiasis is actually caused by a fungus, candida, that normally lives in people’s mouths and intestines, as well as in the vaginas of many healthy women. When the body’s normal acidity doesn’t control the growth of this fungus, an overgrowth can occur.

Candidiasis is the result. Its symptoms can include a thick, white, cottage cheese-like vaginal discharge; itching or irritation of the vulva, penis, or testicles; a yeasty odor; and, sometimes, a bloated feeling and change in bowel habits.

The fungus, candida, can also appear in the mouth, throat, or tongue; when it does, the disease is called thrush.

Candida is not usually spread as an STD, but it can be — more likely through oral sex than intercourse. Unfortunately, some couples transmit it back and forth in what can seem to be a never-ending cycle.

Among the factors that can lead to abnormal growth of candida are birth control pills, antibiotics, pregnancy, diabetes, HIV infection (or any other immune system dysfunction), douching, a woman’s monthly period, and damp underwear.

Prescriptions for antifungal creams, ointments, or suppositories are the normal cures. Single-dose oral antifungals have also recently become available and are highly effective. Over-the-counter products may work, but should only be used by women for vaginal yeast infections. If you’ve never had a vaginal infection before, don’t assume that it’s a yeast infection, but instead go for a checkup.

Some of the medicines used to treat a yeast infection may weaken latex condoms or diaphragms. If you use either of these birth-control methods, consult with your pharmacist or doctor.

Read More......

Sexually Transmitted Diseases (What You Can Catch and How to Prevent It)

In a perfect sexual world, terrific partners would be easy to find, everyone would have great orgasms easily, and no one could get sick from having sex. Of course, we don’t live in a perfect world, sexually or any other way, and so one out of four Americans between the ages of 15 and 55 will catch at least one sexually transmitted disease (STD). (Some people now refer to sexually transmitted diseases as sexually transmitted infections, or STIs. I’m sticking to the old term, but they’re interchangeable.)

“Did she say at least one?” Yes. Because more than 30 sexually transmitted diseases exist, oftentimes the people who engage in the behaviors that lead to getting one disease wind up getting more than one. In case you haven’t heard already, the sexual revolution of the previous decades, in which people suddenly felt free to have sex with a number of partners, is over. With so many diseases around, you can say that society is now in the middle of a sexual invasion, with the result that having multiple partners can lead to mucho trouble.

If you have had sex many times with many partners, don’t assume that you are disease free just because you don’t have any symptoms:

- Many people with STDs, especially women, don’t show any symptoms at all.

- Other people with STDs have only a slight fever, which they don’t connect with an STD, and no more symptoms for years. Although having an open sore certainly means that you’re highly contagious, the fact that you have no symptoms at all doesn’t mean that you can’t give someone else the disease.

- Just because your partner has no outward signs of having a sexually transmitted disease doesn’t mean that your partner is disease free; because your partner may never have had any symptoms, he or she can pass something on to you in all innocence.

Did I say something about the sexual revolution being over? If you want to remain healthy, you must act as though the sexual revolution is dead and buried.

STDs: Battle Scars No One Wants after a Night of Sex

Because the sexual invasion encompasses so many different STDs, it’s a complicated battle to fight. Furthermore, since the arrival of AIDS, the consequences of failure could be deadly. My advice, therefore, is to find yourself one partner, have yourselves tested for all the major STDs to make sure that you’re both healthy, use condoms if you have any doubts about your respective health, and practice safer sex.

Because this advice may come too late for some of you, or because accidents happen no matter how hard you try to prevent them, I’m going to give you a list, in alphabetical order, of some of the diseases that you may run across. Although the figures used in this book apply to the United States, which keeps careful statistics, they generally hold true throughout the developed world. Developing countries vary widely in the incidence and prevalence of STDs. As they say, to be forewarned is to be forearmed; read this list carefully so you can become as familiar as possible with the enemy. Before I go into the list itself, a few other words of advice.

Because AIDS, which has grabbed all the headlines, hit the gay male population first in the United States, you may think that men are more likely to suffer from STDs. But taking all the STDs together, the consequences of this sexual invasion are worse for women than for men. Here’s why:

- Women tend to get STDs more easily than men, probably because they receive fluids during intercourse.

- Many of these diseases do not show any initial symptoms in women.

- Treating a woman who has an STD is often more difficult than treating a man.

- More often than not, the woman ultimately suffers the more serious consequences of STDs, such as infertility, ectopic pregnancy (pregnancy that occurs outside the uterus), chronic pelvic pain, and even cancer.

If you do have a sexually transmitted disease or even think that you have one, see a doctor. This advice may sound obvious, but too many people don’t seek medical help, probably because of embarrassment. They may be embarrassed because they don’t want to reveal their sex life or because they don’t want to submit to an exam of their most private parts, or both.

An all-too-common form of treatment adopted by young people is to self-prescribe medication. If a doctor has prescribed a medication for one person, a friend of that person with similar symptoms may use that medicine too.

Sharing prescriptions is a bad idea. Even doctors sometimes have difficulties diagnosing which STD is which. By taking the wrong medication, you may make your situation worse.

Let’s Get Serious

Doctors have no vaccine against AIDS. They have no cure for herpes. You can get STDs that have no symptoms but can later leave you sterile. Are you scared of catching an STD? If you’re not, you should be — scared enough to practice safer sex.

I use only the term safer sex. Truly safe sex means celibacy. Safe sex can also mean monogamous sex with an uninfected partner, but, sorry to say, one mistake by one of you (perhaps even before you met because some of these diseases don’t make themselves known for years) can lead to both of you becoming infected, so we’re really back to safer sex.

Certainly the fewer partners you have, the less risk you have, but catching a disease can happen in only one instance with an infected partner.

Remember, when you go to bed with someone, you’re also going to bed with the germs of every partner that this person ever had.

Condoms give good, not great, protection

And what about condoms? Condoms offer protection — that is absolutely true. But condoms do not offer absolute protection against AIDS or the other STDs. Why?

- Condoms sometimes break.

- Condoms can break down in the presence of oil-based products.

- Condoms sometimes leak when you take them off.

- People sometimes forget to use condoms.

Even people who do use condoms for intercourse often don’t use them for oral sex, which, while less risky, is not safe.

Some STDs are spread through contact with other parts of the genitals, including any leakage of vaginal fluids.

So the best preventive measure is a combination of responsible sexual behavior and condom use.

Have a relationship before you have sex

I know that finding one person to fall in love with when you’re young and sticking with that person for the rest of your life is difficult. That situation is ideal — for preventing AIDS and a lot of other social ills — but it’s unrealistic to assume that everybody can do that. Most people have multiple partners, and so most people are at risk.

But just because the vast majority of people have more than one partner is not an excuse for you to have as many partners as you can. I believe it’s just terrible that people out there still engage in very risky behaviors, especially among the gay population that has been devastated by AIDS.

I don’t like to preach because I know it doesn’t do any good, but I can’t avoid saying one more time to all of my readers — please be careful, your life is at stake.

Don’t be a silent partner

In our society, more people are willing to engage in sexual activity together than to talk about it, and a good deal of the blame for sexually transmitted diseases comes from this failure to communicate.

You all know the Golden Rule about doing unto others as you would have them do unto you. If you planned to have sex with someone, and they had a sexually transmitted disease, wouldn’t you want them to tell you in advance? The same applies to you: If you have a sexually transmitted disease, you have to tell any potential partners. Notice that I said potential because I won’t hide the fact that, if you tell somebody that you have an STD, that person may suddenly run in the opposite direction. If you have a disease such as herpes, which never goes away, you will face not only a lifetime of outbreaks, but also difficulty in finding partners. You have to accept that. You cannot go around infecting other people.

By the way, One U.S. woman was awarded $750,000 in court from her ex-husband because he gave her herpes, and the legal trend is to make people accountable.

But I don’t want you to be up front about your disease merely to keep the law away from your bank account. I want you to do it because you have sex only with people whom you care about, with whom you have a relationship, and to whom you don’t want to pass a sexually transmitted disease.

Some of you may want to be honest but are saying to yourselves right now, “How do I talk to a potential partner about STDs?”

The answer is very simple: You just do it. If you have the gumption to have sex with somebody, then don’t tell me that you can’t work up the courage to open this subject. I’m not saying doing so is easy. I am saying it’s not impossible, and that you have to do it.

Timing your AIDS and STD talk

Because not everybody waits to form a strong relationship before having sex, the issue of STDs can come up before the two people involved are really a couple. They may have to ask some very intimate and personal questions of each other before they really know each other all that well.

Now you may believe that if a couple is ready to have sex, then they should be ready to at least talk about it. But these days sex can precede real intimacy so that a discussion about STDs must also be inserted at an earlier stage than it used to be. If both parties clearly want to go to bed together and really look for a simple assurance of probable good health, then this conversation may be no more than a speed bump on the way to the bedroom. But if one person is not confident of the other person’s desire to have sex, how should the discussion of AIDS and other STDs be handled? Let me give you some possible scenarios.

Paul and Juliette

Paul and Juliette have had five dates, and they haven’t had sex yet. Their last date was with another couple. They’d gone out dancing, and during the last few slow dances, Paul had held Juliette very close. He’d had an erection, and rather than pull away from him, Juliette had pushed her pelvis into his. To Paul, it was a clear sign that Juliette was ready to go to bed with him, but because their friends were driving, Paul had to content himself with a goodnight kiss when they dropped Juliette off at her place.

During the week, he called Juliette and asked her to dinner. He picked a place that was about six blocks from where she lived. When he arrived, he parked his car and suggested they walk. After a little bit of banter, he sucked in his breath and asked her: “Do you think it’s too early in our relationship to be talking about AIDS testing?” She answered, “No, Paul, I don’t,” and the discussion that needed to take place did.

By posing the question this way, Paul didn’t presume that they were going to have sex. He left it to Juliette to decide. If she’d wanted to wait longer, she could easily have told him so. But, because she was ready to have sex with him, the discussion was able to proceed smoothly. They were both interested in the same goal.

Fran and Tony

Fran met Tony the day after he moved into her apartment complex. She saw him again later at the grocery store, where he was stocking up on supplies. She ended up cooking him dinner that night. He was very busy those first few weeks setting up his apartment and starting a new job, but they did get together for a drink a few times and once for a quick dinner at a local Mexican place.

Tony finally had a weekend off. This time he offered to take her to this fancy French restaurant that Fran really loved. They had a great meal and shared a bottle of champagne that went to Fran’s head a little bit. When they got back to the apartment complex, instead of heading their separate ways, as they’d done previously, Tony invited Fran inside and she accepted. They had some brandy while sitting on his new sofa, and soon Fran found herself wrapped in his arms. Her clothes started coming off, and not too much later he was leading her to the bedroom, their clothes scattered over the living room floor.

As they lay down on the bed, Fran asked Tony: “You don’t have any . . . uh. . . diseases, do you?”

“No way,” he said, “I’m not one of those guys who’ll sleep with just anybody.” A little voice inside of Fran started to whisper something, but at that point she was somewhat tipsy, very aroused, and totally naked, and so she didn’t bother listening.

What that little voice inside of Fran was trying to tell her was that, although Tony was saying that he wasn’t that kind of guy, here he was going to bed with someone he barely knew. Was that really the first time he’d done that?

Most people in Fran’s position would have done exactly what she did — give in to the moment. That’s why you must have the AIDS discussion long before that moment arrives. Don’t wait until you’re in a situation where it would not only be embarrassing to suddenly pull back, but also almost emotionally impossible to resist going ahead. Especially exhibit caution when drugs or alcohol are involved. You have to be realistic about sex and know that your ability to resist temptation is not infinite. You have to protect yourself in many ways, not just with a piece of rubber.

Speaking of rubber, what if Tony had added, “And anyway, I’m using a condom”? Would that have made it okay?

Not necessarily, because condoms can break or fall off or leak. Even if a condom stays on in one piece, a condom still may not be enough to protect you from STDs.

Whether or not you listen to my advice about forming a relationship before jumping into bed, definitely never put yourself in the type of situation that Fran did. How do you avoid that? Simple . . .

Make yourself a resolution that you will never get undressed until you’re sure that doing so is safe. If he starts to unbutton your blouse or she grabs hold of your zipper, tell your partner to stop and explain why you’re stopping him or her. Tell him or her that your reluctance isn’t because you don’t want to become intimate — assuming that you do — but because you need to talk about safer sex first.

After having this conversation, you may both decide to renew your activities, possibly stopping at a prearranged point or maybe going all the way, depending on what you said. Whatever the final outcome, at least you’ll know that the decision was calculated and not left to chance.

Steve and Betsy

Steve and Betsy were in college. They started going out in September, and by October they were in love. They would often wind up in each other’s rooms for the night and would masturbate each other to orgasm, but Betsy wouldn’t let Steve penetrate her with his penis. Steve, who wasn’t a virgin, wasn’t sure exactly what was going on, and then it hit him: Betsy knew about Steve’s sexual relationships with other girls and was worried about AIDS.

One night, after they had dinner together in the cafeteria, he took her for a walk to a quiet part of the campus. They sat down on a bench and Steve sprung his surprise. “I’ve made an appointment to be tested for AIDS tomorrow.” Betsy looked at him for a few moments, not saying anything. Finally she said, “Steve, I hope you’re not doing this for me. I love you, I really do, but I’m not going to have intercourse with you, or anybody, until I get married.”

Steve’s brilliant piece of deduction had been dead wrong. Betsy wasn’t worried about AIDS. She simply intended to keep her virginity until she married.

In this case, Steve needed to have a different sort of conversation with Betsy before bringing up diseases — one about their relationship. Betsy hadn’t said anything about her commitment to wait because she’d been a little afraid that Steve might leave her over it. She was willing to offer him sexual release and was happy with the orgasms he gave her, but that was as far as she was willing to go.

Betsy should be applauded for wanting to wait. But maybe, because she was the one putting on the brakes, she should have brought the subject up earlier and saved Steve the embarrassment he felt that night on the bench.

Again, you can never assume that the other party wants to have intercourse with you. That’s why raising the subject of testing can be so embarrassing in the first place. But, if you use the approach that Paul did (in the first scenario), putting the question within a context from which the other person can gracefully back out, you’ll find that you’re less likely to stumble the way Steve did.

Discovering a potential partner’s character

I know it’s difficult to have the STD talk, but besides protecting yourself from disease, you gain another benefit from having this talk, and that’s what you’ll learn about this potential partner’s character. I’m sure that you want someone with whom you’re going to have a physical relationship to be honest aboveboard, and caring. I want to tell you that when you bring up the subject of being tested for STDs, you’re going to learn a lot about how honest, above board, and caring this person really is. By the time the conversation is over, you will know whether you want to get extremely intimate with this person.

And there’s one more benefit that comes from being able to talk openly about STDs. As I’ve said over and over again in this book, to have terrific sex, you and your partner have to be able to communicate about your sexual needs. That, too, is a difficult subject, but it’s nothing compared to the STD talk. So if you can get over the STD hurdle, you’ll have opened the lines of communication and should have a much easier time telling each other what you like and don’t like when it comes to the pleasurable side of sex.

Minimize your risks

After reading the descriptions of sexually transmitted diseases earlier in this article, you’ve probably had the thought that maybe sex isn’t worth the risk. The problem with that reaction is that it will fail you when you most need it.

What do I mean by that? At some point, you’ll be with somebody you’re very attracted to sexually, and that person is attracted to you. Maybe you’ll be in your apartment, or maybe in the other person’s. And you’ll be kissing, hugging, and stroking each other. Temperatures will start going up. Clothes will start coming off. An erection and a lubricated vagina will be on the loose. A comfortable bed will be nearby. You’ll both be absolutely ready to have sex, and you won’t have a condom nearby.

In that scenario, will you remember these pages and all these nasty and deadly sexually transmitted diseases? Will you be willing to say no, or to put your clothes back on and go find a 24-hour drugstore? Or will you say to heck with the risks and jump into bed?

Although some of you may have the fortitude to place caution ahead of passion, many of you won’t. For that reason, you have to be prepared ahead of time. Carry a condom in your purse or pocket or keep one in your glove compartment or bedside table.

You all know my reputation. I don’t try to scare people away from having sex. Instead, I want to make sure that you have the best sex possible. But an integral part of great sex is healthy sex, protected sex. Although, in the heat of passion, you may well be willing to take any risk, afterwards, if you catch one of these diseases — especially AIDS — you’ll regret that orgasm for the rest of your life.

Have great sex, but be careful. In fact, have terrific sex and be very careful.

Read More......

Retarded Ejaculation

Premature ejaculation and impotence are the two main male sexual problems, but some men encounter other, rarer problems, such as retarded ejaculation, also known as male orgasmic disorder. Unlike premature ejaculation, where a man can’t stop himself from ejaculating, retarded ejaculation means he can’t make himself ejaculate.

Now, although being able to last a long time is something our society puts great value on, retarded ejaculation is definitely a case of too much of a good thing, at least for the man . . . even if he brags about his lasting powers to cover up the problem. Obviously, a man who can’t ejaculate winds up feeling frustrated and angry and may actually begin to turn off to sex.

Sometimes a medical problem causes retarded ejaculation, in which case only a urologist can help. Sometimes the cause is psychological, and a sex therapist can treat the problem. A relationship problem can be one of the psychological causes, which may lead to a man unconsciously holding back his ejaculation. In that case, fixing the relationship is key to curing the problem.

Priapism — The Case of the Permanent Erection

Like retarded ejaculation, priapism is another one of those too-much-of-a-good-thing conditions. In priapism, a man develops a permanent erection.

This erection can result from the man taking or injecting himself with medication because he suffers from impotency, or from some disease that thickens the blood, making it impossible for blood to leave the penis after it has entered. Sickle cell anemia is one such disease.

Although priapism was named after the Greek god of fertility, that fact certainly doesn’t make the man afflicted with this problem feel good about his masculinity for very long. Priapism is not only painful, but the man usually ends up in the emergency room. (An erection that lasts more than four hours definitely calls for a trip to the hospital.) Doctors can now treat priapism without surgery, but the condition still requires medical care.

The Bent Penis

Peyronie’s disease inflicts some men with their worst possible nightmare —they go to sleep with a functioning penis and wake up the next morning witha penis that bends so severely when it becomes erect that intercourse becomes impossible (see Figure 1).

The cause of Peyronie’s disease is unknown; in many instances, it arises as a result of an injury. In early stages of the disease, men usually experience pain associated with having an erection. Sometimes that pain begins before the actual curvature starts and serves as an early indicator of the problem.

Figure 1:
Peyronie’s disease throws a curve in men’s sex lives.

How bad can Peyronie’s disease get? Bad enough for doctors to describe severe cases in which the erect penis looks like a corkscrew. On the other end of the spectrum, the bend may be very slight, not affect the man’s ability to have intercourse, and not cause any concern. In mild cases of the disease, if the man has any pain, it usually goes away on its own; all the doctor has to do is reassure the man that in two to three months all will be well.

Sometimes the curve disappears on its own. Because the disease is basically a scarring process, some men have reported positive results from taking vitamin E, although no scientific proof exists that this technique works.

Surgery can sometimes remove the scarred tissue, but surgery can also result in a loss of the man’s ability to have an erection, so he would then need to have a prosthetic device implanted.

The best advice I can pass on to any of my readers who have Peyronie’s disease is to visit a urologist who can help you. Some men are so embarrassed by their condition that they refuse to get help, but urologists have helped many men with this problem, so you have no reason to be shy.

I’ve received letters from men or their wives saying that they’ve lived with Peyronie’s disease for years, and some have even consulted physicians. So let me add here that if the first urologist you consult can’t help you, look for another one. Doing so is worth the effort.

Lack of Desire

Another problem I’d like to tackle is lack of sexual desire. One of the most common causes of this prob- lem these days is stress. You come home late every night from work, or you’ve lost your job, or whatever, and sex is the last thing on your mind. If your partner is amorous and then starts to complain about being rejected, you become even tenser and want to have sex even less. A vicious cycle builds up, and your sex life can deteriorate down to nothing.

Can you fix a problem such as this by yourself? Maybe, but it’s not easy. One of the components of this problem is usually a lack of communication. And breaking down the barriers that have been set up can be very hard to do. My recommendation is to visit a sex therapist or marriage counselor.

Some of the causes of loss of sexual desire aren’t emotional but physical. A good sex therapist always asks that the man see a medical doctor first to rule out any medical problems.

Read More......

Erectile Dysfunction

Erectile dysfunction (ED), also called impotence, is the term used when a man is unable to have an erection, and is the second most common male sexual problem. The causes of ED can be either psychological or physical, while the degree of ED can vary from a simple loss of rigidity to a total inability to have an erection. Although ED can strike at any age, it becomes much more common as men grow older. Among men in their late 70s and beyond, some symptoms of ED are almost universal.

Because I know how much importance you men put into your erections, let me say right away that ED doesn’t necessarily mean the end of a man’s sex life. Depending on the cause of the problem, several possible solutions are usually available, so take heart.

The precursor: Loss of instant erection

I can say a lot on the subject of impotence, but the most important point has to do not with actual impotence, but with its precursor. The reason its precursor is so important is that it affects every man, at least every man who reaches a certain age in life, so pay careful attention to this section.

It sneaks up on you

Young men get erections all the time, often when they least expect to and at embarrassing times. A variety of stimuli can cause these erections — something visual, such as the sight of a pretty girl in a short skirt; a fantasy about that girl in the short skirt; or even just a whiff of perfume that reminds the young man of that girl in the short skirt. This type of erection is called a psychogenic erection, meaning it is stimulated by something that triggersthe brain to release hormones that cause an erection.

At a certain age — and that age differs with every man, but ranges from his late 40s to early 60s — a man loses his ability to have a psychogenic erection. That ability usually doesn’t disappear all at once; he begins to get fewer psychogenic erections and may not even notice at first. But eventually the decrease becomes apparent to him, and at some point, his psychogenic erections cease altogether.

This change can be a precursor to ED, but it’s not ED because the men experiencing this change can still have erections. The only difference to a man’s sexual functioning at this stage in life is that he needs direct physical stimulation to his penis to get an erection. He has to either use his hands or have his partner use her hands or mouth to make his penis erect.

Spreading the word

The loss of psychogenic erections wouldn’t prove much of a problem if men expected the change, the way that women expect the hot flashes that accompany the start of menopause. Surprising, at least to me, is that so many people still have no idea that this change is part of the natural progression of growing older. This lack of knowledge causes the real problem.

Many men think that they must be impotent when they can no longer get erections the way they used to. Rather than seeking help, they begin avoiding sex. When this happens, wives think that their husbands either are no longer attracted to them or that they are having an affair. Some couples fight over this problem; others withdraw from each other.

This breakdown of a relationship is so sad to me because it’s not necessary. All that these couples have to do is include foreplay for the man exactly the way they have used foreplay for the woman’s benefit all along. If they do this, then they have no problem.

I think that one of the reasons the loss of psychogenic erections isn’t so widely known is that the condition doesn’t really have a name. People may call it a symptom of so-called male menopause, but men don’t like that phrase (and I really don’t blame them) because it’s really not appropriate. We need to coin a catchy phrase for this syndrome; then the media will pick up on it, and a lot of unhappiness can be prevented. I think a good name would be The Male Cooling Off Period. (Why don’t you send your suggestions to me by going to www.drruth.com and clicking on “Ask Dr. Ruth.” Maybe together we can make some real progress toward helping men and women understand this change that causes so much unhappiness.)

Dealing with ED in older men

As a man gets older, his erections begin to get weaker and weaker, and he may need more and more stimulation to get an erection. Some older men can get an erection but can’t keep it long enough to have intercourse. Sometimes they can get an erection, but the erection isn’t stiff enough to allow for penetration.

These are all real, physical problems, but they don’t necessarily spell the end of a man’s sex life. If men understand that age causes these problems, and if they’re willing to take appropriate action, like Mike was in the following example, many men can continue to have sexual relations through their 90s.

“Mike”

I was holding regular clinics in the department of geriatrics at New York University Hospital in New York, and many of the men who came to see me had problems with impotence. I remember one man in particular, I’ll call him “Mike.” He was well into his 80s, and he hadn’t had sex in about a dozen years. When Mike’s erections began to peter out on him, he just gave up.

The only reason this man came to the clinic to see me was that he had started seeing a woman, and she wanted to have sex. When he told her that he couldn’t, she told him that he had to at least try, and so, to please her, Mike sought help from me.

I had him checked out by a urologist and, physically, Mike was fine. I worked with him for about a month, and one day he came to see me in the clinic, beaming. Mike and his lady friend had had intercourse the night before, and he couldn’t have been happier. I’ve helped a lot of people over the years, but I have to say that the morning that man reported to me his newfound success made me the happiest of any.

The morning cure

For many men, the best solution to their problem with impotence is just to change their sex habits to suit their age. The easiest suggestion I can offer older men is to have sex in the morning instead of at night. Because you’re probably retired and have no children at home, you have no reason to always try to have sex at night, except the force of habit. However, here are good reasons that illustrate how changing your routine can help you to become better lovers:

Older gentlemen are often tired after a long day. Getting the blood to flow into the penis is what an erection really is, so the more tired you are, the more difficult it is for this process to work correctly. In the morning, you have more energy, and so you can get erections more easily.

The male sex hormone, testosterone, is at its peak level in the morning and at its weakest at night. Because this hormone is instrumental in effecting erections, trying to get an erection in the morning makes a lot of sense.

Now, I don’t recommend trying to have sex first thing in the morning because the older you are the longer it takes you to get your body warmed up for “action” such as sex. Because you probably don’t have to be on a rigid schedule, I suggest waking up, having a light breakfast, getting your blood flowing, and then taking your partner back to bed for a sexual interlude.

Some older men resist this suggestion at first. For some reason, doing all that planning doesn’t suit them. But if they listen to me, many men find that the fires that had died down start burning once again.

The stuff technique

Now, if some men think having sex after breakfast is strange, imagine how hard-headed some men are when it comes to getting them to try to have sex without first having an erection. But sometimes this technique works the best.

The stuff technique is just what it sounds like. The man, with the help of his partner, stuffs his nonerect penis into her vagina. Sometimes, after a man begins to thrust, the blood flows into his penis and that elusive erection finally rises to the occasion. The best position for doing this will depend on the physical condition of both partners. If the man has any difficulties holding himself up in the missionary position, it may be better to use the side-by- side position. And because this technique doesn’t always work — or may never work for some men — try it for a few minutes, and if it doesn’t seem like an erection will occur, then drop it.

Managing short-term impotence

Unlike ED, short-term impotence is almost always psychological in nature. Many, many men, at one time or another, suffer from impotence — meaning that they can’t have an erection when they want one. In fact, sometimes because they want an erection so badly these men fail, as Jimmy discovers in the following example.

Susan and Jimmy

Susan was a transfer student, and Jimmy spotted her the very first day he returned to college in his senior year. She had the type of looks he’d always dreamed of, and, to his amazement, when he struck up a conversation with her, she responded.

Jimmy had slept with a few other girls during his college years, but the thought of actually going to bed with Susan drove him wild. He managed to play it casual for a while, and, after a week went by, he asked her out on a date. She accepted, and they had a great time. They had a few more dates, each one advancing further than the last, so that, on his fifth date with her, Jimmy was pretty sure that they were going to have sex.

The anticipation was almost torture to Jimmy, and he had an erection for much of the day. They went to a dance and, with their bodies clinging to each other during all the slow dances, Jimmy felt that he was as ready for sex as he ever had been.

Jimmy had never had problems getting an erection, but as they were walking back toward his dorm, he started having doubts about his ability to please Susan. He was sure that someone as good-looking as Susan had had sex with all kinds of guys, and he began to question whether or not he could stand up to the test. By the time they got back to his room and took off their clothes, Jimmy was in a state of pure panic, and his penis reacted accordingly by staying limp. Jimmy was more embarrassed than he ever thought possible.

Anticipatory anxiety has caused many a Jimmy to experience similar problems. Anticipator y anxiety means the fear or expectation of a possible failure causes an actual failure. If a man starts worrying about his erection, usually doing so is enough to prevent him from having one. And the more he worries, the more likely that he will fail the next time he tries. Many men, because of one failed erection, have suffered through years of misery.

Visit a urologist

In younger men, having erectile difficulties is more often than not psychological rather than physiological, so curing the problem is usually easy with the help of a sex therapist.

If a young man comes to my office with a problem such as this, the first thing I do is send him to visit a urologist, which is a medical doctor who specializes in the care of the genitourinar y tract, the urinary tract in men and women and the male genital tract.

One reason I send men who experience impotency to a urologist is to make sure that their problem isn’t physical, which I can’t handle because I’m not a medical doctor.

The other reason I send them off to have their physical plants checked out is that just getting that clean bill of health is often enough to clear up the problem.

You see, many of these men worry so much about something being wrong with them that just hearing from a doctor that they’re A-OK is enough to give their penises the psychological lift they need. Even if the doctor’s visit itself isn’t sufficient, it’s a very good first step.

Build confidence

After sending an impotent client to a urologist, my next job is to build the man’s confidence in his penis back up to what it was before he ran into trouble. Sometimes just getting him to masturbate does the trick. Sometimes I have to get him to do certain confidence-building exercises with his partner.

These exercises usually involve prohibiting intercourse for a while, but allowing the couple to engage in other sexual activity. The man can usually get an erection when he doesn’t have the pressure of needing an erection to penetrate the woman. After he gets his erection back, transferring that confidence to having erections when he plans to have intercourse is usually easy. In the majority of cases, if he’s willing to work at it, I can get him back to his old self.

Study sleep habits

If the man is physically sound but doesn’t respond to treatment, the next step is to find out whether he has erections while he’s asleep.

During the course of the night, a healthy man gets several erections during REM or “dream” sleep. He’s not necessarily having an erotic dream or any dream at all, but having erections is definitely part of the male sleep pattern. This phenomenon even has its own name, nocturnal penile tumescence, and initials, NPT. Having initials means it’s really official.

Because a man usually doesn’t have performance anxiety while he’s asleep, a man who suffers from impotence while he’s awake but doesn’t have a physical problem usually has erections while he sleeps.

The simple, at-home test to find out whether you’re having erections during your sleep is to wrap a coil of stamps around the base of your flaccid penis. (A few turns around the penis should be enough to keep it in place.) If you find the circle of stamps broken when you wake up, you probably had an erection. (Once in a while the tooth fairy goes astray, but usually she’s too busy putting coins under children’s pillows.)

If the coil of stamps doesn’t work, and I still suspect nighttime erections, a sleep lab is the next step. At a sleep lab, physicians substitute the stamps with plastic strips and Velcro connectors, which are more reliable indicators than postage stamps. And doctors have even more precise devices, if needed.

If all this testing doesn’t turn up any sign of erections, then I have to send the client back to the medical community because I can’t do anything for him.

But for many men, these tests do uncover some erectile functioning, which probably indicates that the problem is psychological in nature. This is not true 100 percent of the time, but it certainly deserves following up. The basic aim is to build back the man’s confidence to the point where he can have erections while he is awake — and even with a woman around.

Monitoring your erections as a clue to your health

As most people know, smoking and obesity increase the risk for heart disease. But studies have proved that long before troublesome symptoms present themselves, a man is likely to notice differences in his ability to have an erection, which can be caused either by being out of shape or from smoking. So this leads to a few conclusions:

- If a man notices any changes to his erections, he should immediately consult with his physician to be checked for any signs of heart or circulatory disease.

- If a man would like to keep ED at bay and he smokes, he should stop.

And while exercise is good for many reasons, a man who strengthens his heart through cardio workouts also maintains his ability to have erections. A recent study showed that men who expended energy equivalent to running 1.5 hours a week reduced the chances of encountering problems with ED by 30 percent as compared to men who didn’t exercise.

That same study found that men who didn’t exercise and were also overweight were 21⁄2 times likelier to develop ED than men who led active lifestyles and were of normal weight. So by keeping your weight down,you can help to keep you know who up.

Giving Mother Nature a boost

If none of the techniques discussed in the previous sections helps you to deal with your impotence, then you may have to help Mother Nature with medical or mechanical assistance. In fact, 80 percent of erectile dysfunction (ED) problems occur as a result of serious medical conditions including diabetes, hypertension, or prostate cancer surgery. These conditions are much more common in older men, though they can happen in men of any age.

Oral medications

The FDA’s approval of the drug Viagra in 1998 significantly enhanced the med- ical world’s arsenal of weapons for treating ED. Developed by the drug company Pfizer, this little blue pill is effective in 75 to 80 percent of men who suffer from ED. The biggest exception is men with heart conditions who take nitrates such as nitroglycerin because the combination of the two drugs can be deadly.

Viagra, the brand name given by Pfizer to the drug sildenafil, must be taken one to four hours before sexual activity and requires sexual stimulation to take effect. Patients who take Viagra may have some mild side effects, such as headaches or seeing halos around objects, but they don’t seem to bother most men who take the drug. Viagra has become very popular, and, disturbingly, not only with men who suffer from ED, but also with men who believe it will increase their sexual pleasure even if they can have erections without the drug. The following are some of the reasons taking Viagra may be dangerous for men who can have erections:

Viagra is a prescription medicine. Men who don’t have ED and take it do so without a prescription.

Viagra has side effects. Men with ED may be willing to endure those side effects as a trade-off for having erections. But because the FDA hasn’t given Pfizer approval to use Viagra on men without ED, it’s not yet known what those side effects can do to them over the long term.

Some men get priapism, a permanent erection, from taking Viagra. Although no concrete studies have been done, men who can normally get erections and still take Viagra may be more prone to this condition than men who can’t have erections naturally.

Other pharmaceutical companies have developed drugs that have the same function, including Levitra (vardenafil) from Bayer & GlaxoSmithKline and Cialis (tadalafil) from Lilly ICOS. Cialis can be effective for up to 36 hours, which is why some call it the “weekend drug.” Because I’m not a medical doctor, I’m not going to say which of these pills may be right for you. Please don’t try to order any of these online without first checking with your doctor.

They all have side effects and you don’t want to do any serious harm to yourself.

But because these pills aren’t right for up to 30 percent of all men who suffer from ED, let me give you some information on other options.

Penile implants

Penile implants are either hydraulic or non-hydraulic. The non-hydraulic prostheses are basically semi-rigid rods that doctors surgically implant within the erectile chambers. Although they are reliable, they have one major drawback — after the surgery, the penis is always in a rigid state. You can push your penis down when you’re not having sex, but the erection may still be visible, which can be embarrassing.

The surgery required for the penile implant does leave soreness in the area, and you can’t have sex for several weeks. But most men report very good results and are quite happy. The only men who seem to complain are those whose hopes were too high, and who expected to have erections as strong as the ones they had in their youth. This won’t — and can’t — happen because the erection is permanent, and it needs to be at least somewhat concealable.

The hydraulic prosthesis has a fluid reservoir and a mechanical pump that a man uses to fill the prosthesis and create an erection when he wants one. Men report liking the system, and recent improvements have made the devices very reliable. Like the non-hydraulic implant, it requires a surgical procedure. Unlike the non-hydraulic implant, you only have an erection when you want one, which is more like the natural erection.

Injection therapy

Another method that was developed in the 1980s is self-injection therapy. The latest product is Caverject (alprostadil), which is similar to the oral medication used to treat ED. A man injects his penis with a medication that relaxes the muscles, thus allowing blood to flow into the penis and cause an erection. Although the thought of injecting yourself in that particular spot may not sound appealing, the penis is relatively insensitive to pain, so you can barely feel the injections. Most men who use this system have reported good results. Possible side effects include scarring and, rarely, priapistic erections — sustained erections that won’t go away without medical treatment. Because Caverject is injected right into the penis and doesn’t affect other organs as much as oral medications do, this method may be appropriate for men who can’t take a pill. Check with your doctor.

Caverject takes between five and twenty minutes to become effective and lasts for about an hour. Men should not use it more than three times a week, and always wait 24 hours before using it again.

Vacuum constriction

Another method of relief for impotence is the use of vacuum-constriction devices. Basically, a man places a vacuum pump over the penis, and as the airis pumped out, blood flows in, creating an erection. He then places a ring at the base of his penis to hold the blood in place.

I do receive letters from men and their wives saying that vacuum pumps work wonders (and at least these devices don’t require surgery). But certain side effects have kept vacuum-constriction devices from becoming popular:

- The erections these devices produce aren’t as rigid as those produced with a prosthesis.

- Sometimes mild bruising occurs as a result of using these devices.
- Some men have difficulty ejaculating after using these devices.

But vacuum-constriction devices are a possible alternative for someone who doesn’t want to, or can’t, undergo surgery or use a drug, and who doesn’t care to stick a needle into his penis every time he wants to have sex. Also, giving your penis an erection is actually good for it because an erection brings fresh blood into the arteries of the penis. So for men who no longer have nighttime erections, the use of a vacuum device can be looked at as a means of exercising their penis.

The down side of these “up” therapies

Whether a man takes a pill, injects himself, or uses a vacuum pump to get his erection, the fact that he can have an erection doesn’t necessarily mean his partner will be ready to have sex. If a man without ED approaches his wife for sex and she turns him down, he may be frustrated but he also knows that he’ll have plenty of additional erections, perhaps even during the course of that same day. But a man who pops a pill or injects himself may be a lot more demanding because he has gone to some “lengths” to obtain his erection. If he doesn’t consult with his better half, then she may not enjoy any resulting sexual interplay. So, a couple should decide together which method will work best for them and when to use one of these ED therapies, instead of the man making the decision on his own.

Some couples, the ones who have always had a good sex life and look at ED as a major problem, don’t mind using one of the oral medications. But some women, who have either never enjoyed sex very much or have lost interest in their later years, consider their husband’s inability to have sex a godsend.

Their attitude may seem wrong, but no one can know what their married life has been like, so one can’t jump to conclusions.

For these reasons, I believe that no man should use one of the methods for overcoming ED without first having a long talk with his spouse. Men should decide ahead of time how to deal with the physical and psychological changes that such therapies will bring into their lives. In some cases, men may need to undergo some sort of psychotherapy — sexual or marital — to successfully make this transition. So, although society should praise the development of Viagra, people must exercise some caution as well.

Read More......

Premature Ejaculation

The subject that people ask me about most often is premature ejaculation. Men who suffer from the problem seek my help, as do their partners, who also suffer as a result of the problem. (I’ve yet to hear from any family dogs, but I’m sure that even they can suffer from the problem, because ill-tempered masters aren’t as generous with their treats.)

People have all sorts of ideas about why a man can’t keep his erection as long as he wants to and what he can do to make himself last longer, but I don’t think most of these so-called treatments are effective. I give you a surefire solution for premature ejaculation in the section, “The real cure: Recognizing the premonitory sensation.”

Defining the dilemma

First, we have to define premature ejaculation. The definition that I use is that a man is a premature ejaculator when he can’t keep himself from ejaculating before he wants to. Notice that I said before he wants to, not she. That distinction is important. And the cause is not physical, but mental. In other words, it’s not the man’s penis that is “malfunctioning,” but his brain.

Because not every woman can have an orgasm through sexual intercourse, a man can possibly keep his erection all night and still not satisfy the woman he’s with if all the couple does is have intercourse. But because most women want to feel the sensations of sexual intercourse, no matter how or if they reach their orgasms during intercourse, most men need to do all they can to figure out the techniques that allow them to last for a certain period of time.

Just how long is the period of time a man needs to last? Now we have to go back to my definition — the time frame depends on the man. If your partner reaches her orgasm after 20 minutes of intercourse, you want to aim for that amount of time. If she doesn’t climax through intercourse at all, then maybe you only want to last for 10 minutes. What’s important is that you learn how to gain control of when you have your orgasm, so you can decide when to ejaculate instead of ejaculating because of circumstances beyond your control.

As with many sexual dysfunctions, different degrees of premature ejaculation exist. Some men are so severely afflicted that they can’t last long enough to penetrate a woman for intercourse. Some men even climax in their pants at the very thought that they may have sex with a woman. But even a man who can penetrate his partner and last 15 minutes may fall under the umbrella of premature ejaculator if he wants to last 5 extra minutes and can’t do so.

Does circumcision make a difference?

The penis of a man who hasn’t been circumcised is often more sensitive than a circumcised man’s. The reason for this is that the glans, or head, of a circumcised penis gets toughened by coming into contact with the man’s underwear all day without the protection of the foreskin.

I don’t know of any scientific study on the effect of circumcision, but for most men who ejaculate prematurely, the problem is in their heads — not the heads of their penises. So I don’t believe that circumcision makes a significant difference. Most certainly a man who isn’t circumcised can learn how to prolong his climax just as effectively as a man who is.

The age factor

A young man’s libido (sexual drive) is stronger than an older man’s, and so premature ejaculation is a problem that sometimes disappears, or at least decreases, with age. Mind you, I said sometimes. I’ve heard from men in their 80s who’ve suffered from premature ejaculation all their lives. And when I say that the problem lessens, I’ve also heard from men who were able to last 3 minutes instead of 2, so how much better is that? My advice is not to wait for age to take care of this problem, but rather to act as soon as possible.

Home remedies

You all know men who refuse to stop and ask for directions when they’re lost, so it shouldn’t come as a surprise that many men decide that they can handle the situation by tinkering with their technique, rather than by seeking professional help. As you may expect, the results are mixed, so although I don’t recommend any of these ideas, here they are:

The “slide” technique

Probably the most common method that men use to control their orgasmic response is to think of something that isn’t sexy. Woody Allen immortalized this technique in a film where, in the middle of making love, he yelled out, “Slide!” He was thinking about Jackie Robinson running the bases, instead of the woman he was with, in an attempt to delay his orgasm. (By the way, the film is Everything You Wanted to Know About Sex But Were Afraid to Ask.)

This technique can work to some degree, but it’s not a good way of making love. This method makes a chore out of the sex act, rather than something pleasurable, and your partner may sense that wall you put between you and the act and think that you want to distance yourself from her.

Rubber love

Condoms do cut down on the sensations that a man has, and some men can control their premature ejaculation by using condoms. If one condom doesn’t work, they put on two or more.

I certainly recommend that people use condoms — sometimes I sound like a broken record about it — but my goal is to prevent the spread of STDs. Using these same condoms as a crutch, lessening your pleasure, is a shame when you have a better way.

Snake oil

You can find products on the market that supposedly lessen the sensations in the penis so the man can last longer. In the first place, I don’t know whether these over-the-counter products really work, although you can buy prescription medications that deaden whatever body part on which they’re applied. But, even if that does the trick, just as with condoms that lessen sensation, why go for the quick fix when you can have a permanent cure?

Masturbation: Taking matters into your own hands.

A method adopted by some young men is to masturbate before going out on a date that may lead to sex. The object here is to decrease the intensity of their desire for sex in the hopes of gaining some control. Although this method sometimes works, it has several drawbacks:

Masturbation may not always be possible. What if the two of you are living together or married? Or what if the woman pays a surprise visit to your dorm room?

Another drawback is that of timing. What if you masturbate in anticipation of having sex after the date, but she wants to have sex before you go out, and you can’t get an erection?

And then there’s your enjoyment. The second orgasm may not be as pleasurable as the first, and, with all the worrying about when to masturbate, the sensory experience of sexual intercourse ends up being diminished.

When it comes to curing premature ejaculation, my advice is to keep your hands to yourself and practice some self-control.

Different positions

Some men say that they have more control over their orgasms in one sexual position or another. The missionar y position (when the man is on top) is probably the one in which men have the most problems, but not always. I even had one man write to me saying that he could control his climaxes if he was lying on his right side but not his left.

Some researchers have found that greater muscular tension can increase the tendency toward premature ejaculation, which means the missionary position, in which the man holds himself up with his arms, may accentuate premature ejaculation. But, because I really believe that this condition is a psychological one rather than a physical one, some psychological factors, different for each individual, may also come into play regarding positions.

If you find you have more control using some positions than others, then sticking to those positions is a possible solution — but not the most satisfactory one. If you limit yourself to that one position, sex may become boring.

Why not try to discover how to take control of the situation altogether so you can engage in any sexual position and still have control?

The real cure: Recognizing the premonitory sensation

The real cure for premature ejaculation is for you to be able to recognize the premonitor y sensation. What is that, you ask? The premonitory sensation is that feeling that a man gets just before he reaches the point of no return, also called the moment of inevitability.

Each man has a certain threshold of pleasure; after he crosses it, he can’t stop his orgasm. A fire engine may go through the bedroom, and he would still have an orgasm and ejaculate. But, right before he reaches that point, if he so desires, he can cool the fires and not ejaculate. And if he wants to abandon his status as premature ejaculator, he must learn to identify this sensation.

How do you learn to recognize this premonitory sensation? By treating your orgasm with kid gloves and approaching it very carefully. You can’t imitate the Road Runner, heading for the edge of a cliff at full throttle, and then apply the brakes and stop just before you fall off the edge. With that approach, you’re more likely to wind up like Wile E. Coyote, who always chases right after the Road Runner. He can never seem to stop in time and ends up racing over the cliff and plummeting into the canyon.

The idea, then, is to learn how to slow down the process before you get too close to the edge. Exactly how you do this depends on several factors, the biggest being whether you have a cooperative partner, with the emphasis on cooperative. Someone you’ve had sex with only a few times, and not very satisfactory sex at that, may not be willing to be as supportive as you need. But if you have someone who loves you, and who wants to make your sex life together better, then you’re probably well on your way to curing the problem.

Although curing premature ejaculation as a couple may be easier, making progress alone isn’t impossible. In other words, you can practice recognizing the premonitory sensation through masturbation and begin to develop some control. (Not every man can learn this control by himself because a woman’s presence causes some men to get overexcited in the first place.) Practicing this technique alone probably takes more effort and more self-control, but it’s certainly worth your time.

The start-stop technique

In 1955, Dr. James Semans, a urologist at Duke University, developed a simple technique (which he learned from a prostitute) for treating premature ejaculation. This treatment was later propagated by the noted sex therapist Dr. Helen Singer Kaplan, under whom I trained at Cornell University–New York Hospital. It’s called the start-stop technique and involves learning how to recognize the premonitory sensation and stopping before you get to the point of inevitability. You do this by slowly increasing your level of arousal, stopping, allowing yourself to calm down, and then heading back upward again. Some people advise assigning numbers to the levels, from 1 to 10, with 10 being the point of no return. If that numbering system helps you, fine. If it distracts you, then just concentrate on the sensations.

When a couple comes to me looking to solve a case of premature ejaculation, I usually forbid them from having intercourse for a set time, as a way of removing the pressure from the situation. I don’t want them to remain sexually frustrated, so I allow them to give each other orgasms after their lessons, but not through intercourse.

During a couple’s first lessons, the woman uses her hand to arouse the man and stops the motion when he signals her to. Slowly, he begins to exercise more and more control. Depending on the man, this whole process can take a few weeks or a few months, but the process is almost always successful.

Masters and Johnson squeeze technique

The noted sex researchers Masters and Johnson developed a variation of the start-stop technique, called the squeeze technique. With this method, rather than merely stopping stimulation to the penis, the man’s partner gently squeezes the frenum of the penis (the strip of skin connecting the glans to the shaft on the underside of the penis) until the man loses his urge to ejaculate. Because the start-stop technique is usually effective, the squeeze technique isn’t as commonly used.

Another useful aid in controlling premature ejaculation can be the pubococcygeus (PC) muscle, which, when squeezed, has a similar effect to the woman squeezing the base of the penis. The first thing you have to do is find this muscle. Put a finger behind your testicles. Pretend that you’re going to urinate and then stop yourself. You’ll feel a muscle tighten, and that’s your PC muscle. If you exercise this muscle regularly, by squeezing it in sets of ten, it will get stronger, and you can then use it to help control your ejaculations.

Is it really that simple?

When I describe the treatment to some men, they look at me and say, “Is it really that simple?” The answer to their question is yes and no. The technique itself is very simple, but it involves some discipline, and that discipline’s not always so simple.

Some men, when they first start doing the exercises, are all gung-ho. They look forward to solving this problem, and if their partners are equally excited, they apparently make a lot of progress, at least during the initial stage. But then they get impatient. They don’t listen to Dr. Ruth, and they decide to try what they’ve learned before I give them permission. Sometimesit works, and sometimes it doesn’t. When the technique doesn’t work, they’re disappointed, and some men even give up entirely.

Learning to exercise control isn’t always easy. Look at all the people who can’t stop themselves from overeating or smoking cigarettes. If premature ejaculation is a habit that has become highly ingrained, you can’t assume that you can make it go away without some effort on your part. But, or should I say BUT, if you do put in the necessary time and effort, you can gain control over when you ejaculate.

Going for help

This section tells you enough that, if you suffer from premature ejaculation, you can try to cure yourself on your own. As I said, this process works much better if you have a partner who wants to help you. Although trying on your own is okay, that method doesn’t work for everyone. Some men need the extra guidance provided by a sex therapist. In that case, my advice to you is to go and find one.

Read More......

Avoiding Sexual Relationship Pitfalls

When two people first fall in love, usually nothing can get in the way of their relationship. They only have eyes (and hands) for each other, and the bonds between them, including a sexual bond, are extremely tight. But as time passes, it’s only natural for that initial burst of devotion and sexual energy to dim a bit. And in the growing shadows, wedges can develop that drive the couple even further apart.

What’s particularly dangerous about these wedges is that they’re mostly invisible. If you’re not on the lookout for them, they can begin weakening your relationship — and your sex life in particular — without either of you having any idea that serious damage is occurring. And if the two of you aren’t having good sex (or bad sex), then this too will definitely have a detrimental effect on your relationship.

In this chapter, I outline some of the more common wedges so you can see through their invisibility shields right away. After you know what to look for, you can protect your sex life against them.

1. Making Time for Alone Time

A laundry list (including the laundry) of forces hacks away at your days, cutting into the time you could be having sex. Just look at the demands that adults are expected to juggle:

Your job: This takes up 40 to 50 (or more) hours a week, not to mention commuting time and any work you bring home.

Your kids: Not only must you attend to their basic needs, but you may also be ferrying them around to countless activities and helping with science projects that could pass muster at NASA.

Your partner: Many of your demands may be the same, but you have to include spending time with each other on your to-do list.

Your parents: Because people are living longer these days, you may find yourself helping care for your aging parents.

Household chores: You have to do the laundry, wash the dishes, and clean the bathroom at least a couple of times a year.

Electronic communication: Checking your e-mail, surfing the Internet, taking calls on your cell phone, watching the latest hit TV show, and listening to an endless library of music may not be necessities in your daily life, but many people devote a great deal of time to these activities.

Whew! No wonder people feel that they don’t have time for sex!

2. Connecting through meaningful conversations

For a relationship to remain healthy, the two of you need time to communicate your thoughts and feelings, one on one. You may not need more than ten minutes a day, but you need at least that to keep the relationship from turning from that of two lovers to that of barely two friends. Here’s how to approach these daily conversations.

Look at the big picture. Realize that every minute you spend putting in extra hours at work or in front of an electronic gizmo is a minute you’re not spending with your partner.

Schedule daily time together. I know a couple who every night watch the sunset while having a glass of champagne. I suggest you do something similar. You can make your tête-à-tête for the same time every day, like right before you go to bed, or you can vary the time from day to day. But you must stay committed to these daily private conversations to maintain a closeness that enhances your sexual experiences.

Ignore distractions. Record the TV shows you may miss during these conversations, let phone calls go to voice mail, and tell the kids, the dog, or the neighbors that for the next ten minutes you can’t be bothered unless there’s an emergency. Privacy is important because you want to be able to share your emotions.

Talk about your thoughts and feelings. These conversations should not be about PTA meetings and whose checkbook has enough to pay the rent. For those ten minutes you set aside, I want you to talk about your feelings for each other, a hobby that you share, or an article that you read. These brief moments are to help your souls connect, not your PDAs.

Don’t ignore your sex life. Because sex is the glue that holds your relationship together, you have to make sure that you talk about how your sex life is going too. And even if you have complaints, try to keep the overall feeling positive, suggesting ways to make sex better rather than simply criticizing.

Can these moments of togetherness be on the phone? I don’t recommend it for daily use unless you live in different time zones or work different shifts, but there may be times when that’s your only means. In that case, make sure that you have privacy, which with cell phones can be easy to accomplish, such as on a lunch break when you can step away from nosy co-workers.

Bill Gates, the richest man in the world, takes off once in a while to give himself time to think. Running your life may not be as lucrative as running Microsoft, but you also need time to think. If you’re constantly running at top speed, and never take the time to assess your life, especially your relationship with your partner, by the time you discover you’ve been running in the wrong direction, it may be too late to do anything about it.

So I urge you to spend an hour, every six months or so, thinking about your relationship, in every context: romantic, intellectual and sexual. Look for weak spots. Talk to your partner about them and try to repair any damage that has already been done. And if you think that you can’t handle the damage, what- ever it is, protect your relationship by getting professional guidance.

3. Scheduling sex dates

In addition to moments of private conversation, you also need to find the time to express your love sexually.

The same forces that make it hard for you to find time to bond verbally and emotionally can also wreck havoc with your sex life. I know that spontaneity is important to some people when it comes to sex, but if the only thing that happens spontaneously is that the time for sex is sucked away, then it’s time to pull out your calendars and make dates to have sex.

The advantage to scheduling your sexual encounters is the added anticipation it creates. If you know ahead of time that at 11 that night, or maybe 5 the next morning, you’re going to have sex, you can think about that upcoming lovemaking and allow yourself to get aroused. Because women take longer than men to become aroused, this type of sexual planning can actually be quite beneficial to their overall enjoyment of sex.

Let me distinguish here between making love and having a “quickie.” Yes, you will have times when one or both of you are in need of sexual satisfaction but can’t fit in more than ten minutes for sex. There’s nothing wrong with taking care of those needs. But when I say that you need to put aside time for sex, I’m speaking of making love, caressing, hugging, and kissing, as well as having genital contact, so your soul gets satisfied as well as your libido.

4. Fighting boredom in and out of the bedroom

The biggest danger that most couples face is boredom. I include sexual boredom, but more basically I’m speaking of relationship boredom. The two of you could install enough sexual equipment in your bedroom to produce a small circus and still be vulnerable to the dangers of boredom if the rest of your time together is yawn-inducing. Your most important sex organ is your brain and keeping it engaged will take some effort from both of you. The cure is to share intellectual pursuits. Force yourself to go to museums, read books on stimulating subjects, explore the world, and talk about matters that are not just personal. And in case you think I’m turning you into intellectuals, that’s not the case. If you want to volunteer together at a nursing home and later discuss what went on, that’s fine too. Or you could both get involved in a political campaign or join a local theater group. I’m not suggesting you choose areas that require a graduate degree, only that they force your brains to engage a little more fully than when discussing why the laundry wasn’t done.

Here’s one suggested topic of conversation: travel plans. Fantasizing together about places you’d like to visit whets your appetite in many ways. But even if you don’t actually take a trip, I still want you to plan for one. (If the thought of not being able to afford the time or money to go is too frustrating, you can choose a place in the past, such as ancient Rome.) Study the culture of this place; learn about its language, geography, and people; find out about its politics; in short, become experts to some degree. If you get to go, then you’ll have a fabulous trip because you’ll be so well prepared. But even if you don’t, the shared intellectual pursuit of this knowledge will upgrade your relationship to first class.

Naturally you also don’t want to be boring in bed. Look at Chapter 12 for ideas about what you can do differently. But I assure you that if your partner is bored with you outside the bedroom, you’re going to be challenged to add much variety to your sexual encounters. But if you’re stimulating each other’s brains, your sex life will get a real boost from that as well.

5. Making the Most of a Long-Distance Relationship

No one wants to be in a long-distance relationship, but sometimes there’s no choice. Luckily, these days it’s not quite as onerous as when it took a letter three months to cross the ocean. And some of the following suggestions even allow you to keep the fires of your sex life at least glowing, if not blazing.

Focus on a fixed point when you’ll be together. This is the most important thing you can do. “Counting the days” isn’t just a saying, but a good way to keep yourselves from drifting apart.

Use every method of communication available. Even if you e-mail each other daily, also sit down and write a letter in your own hand. That’s one piece of communication that your lover may carry around with him orher, knowing that you actually touched the piece of paper.

Masturbate while you’re communicating. If opportunities exist for you to masturbate while you’re on the phone or chatting on a computer (this second option is called cybersex), go ahead.

Keep your privacy (and dignity) intact. Whatever you do, be careful that you don’t offer up your private moments to the world. Many companies check employees’ e-mail, as do the armed services, and if you send each other sexy pictures, you want to be sure those are only for each other.

Create a secret language. If you can’t always have privacy when speaking or e-mailing, make up your own set of code words so you can let your partner know how much you desire him or her without having to say or write anything that could get you into trouble.

6. Dealing with Addictive Behavior: Hooked on Porn

One common roadblock to a healthy sexual relationship these days is when one partner is consumed by the need to peruse pornography. X-rated pictures and videos are a quick mouse click away, which makes for easy access right in your own home. According to the medical definition, being hooked on erotica may not qualify as an addiction, but it can easily ruin a relationship if one half of a couple devotes all of his or her sexual energy to masturbating while in front of the computer rather than having sex with his or her partner.

Although the lure of pornography may always have been a problem, the latest methods of distribution have undoubtedly raised the danger level.

More men and women watch erotic movies in the comfort of their own living room or bedroom, an activity once limited to very few venues. But the vast pipeline offering porn that comes with every broadband connection to the Internet has pushed the problem of porn addiction to new heights.

7. Surfing for a thrill

Viewing pornographic images on the Internet is mostly a male preoccupation, and I believe men engage in this behavior for two reasons. The first is the purely sexual one. Men are definitely aroused by seeing erotic images. But I also think that this activity strongly appeals to men’s hunting instincts. Surfing for images is not just about looking for ways to become aroused, but it’s also a search for forbidden fruit. For example, a man may think that he’ll stumble on the nude picture of an old girlfriend, or at least someone who reminds him of that girlfriend. And if a man has a predilection for something on the kinky side that he’s not going to find at home, he can satisfy those desires, at least virtually.

Whatever he is searching for, and he may not know himself if it’s a subconscious desire, the combination of the hunt and sexy images can be just too strong for many men to limit themselves to occasional use. Instead, they get so hooked that any free moment (which usually means when their wife isn’t looking) is devoted to this activity. And because the logical conclusion is masturbation to orgasm, which drains all the man’s sexual energy, the couple’s sex life plummets.

Women, too, can fall into a similar trap, though it’s more likely to be chatting with someone in a sexual way rather than looking at images. That chatting can be just as dangerous to a relationship, or even more so if it evolves from merely cybersex (masturbating while chatting) to an actual physical affair.

8. Deciding if porn is a problem

How can you tell if a porn addition is affecting your relationship? Here are some clues:

• Your sex life has taken a nose dive and your partner offers only lame excuses.
• You wake up at night and no one’s sleeping next to you
• You check your computer’s History and find a long list of X-rated sites.
• When your partner does want sex, his appetites are far more kinky than they ever were.
• Your partner calls you by another name, but she’s never out of the house, so you know she doesn’t have a real lover.

9. Stopping destructive habits

The problem with addictive behavior is that although the addicted person doesn’t want to put his or her relationship at risk and will avow that they love their partner, they end up not being able to help themselves. They know it’s wrong but as soon as they have an opportunity to view these images or chat with their cyberlover again, they grab it.

You can easily put an end to the viewing of Internet porn: Install software on your computer that will filter out all of this type of material. Be warned: The addicted partner is going to have a problem going cold turkey, and you may even need a counselor to get you through this period. If the addicted person refuses to allow such software to be loaded onto your computer, then you’ll know how serious the problem is. But without such software in place, you and your partner are unlikely to overcome this problem.

A different type of software can help people who must fight the urge to chat with a cyberlover. Software is available that allows a person to check every keystroke that has been hit on the computer. By installing such a program, the addicted chatter will know that he or she can’t hide conversations. That may give this person the needed backbone to adhere to a promise to stop. Again, if that doesn’t work, seek professional guidance.

10. Staying Close to Avoid the Empty-Nest Syndrome

A common misconception is that when a couple’s children leave home, Mom and Dad develop empty-nest syndrome. Yes, they may have an empty nest,but for some couples, their love life blossoms during this period of their lives. The victims of the syndrome are the couples whose relationship falls apart when they’re the only two left at home.

If your children haven’t left home yet, you may think that you don’t need to read this section, but actually the exact opposite is true. Most couples who are affected by empty-nest syndrome can’t be helped. Even if they manage to stay together, the relationship remains in tatters. But if a couple is aware ahead of time of the dangers of empty-nest syndrome, then they can do something about it while the kids are still home.

Empty-nest syndrome takes years to develop. It starts when a couple begins to drift apart but stays together because of the children. Couples like this may appear to have “the perfect marriage,” but it’s actually a façade, and the only level on which they connect involves their children. They certainly aren’t having sex. All of their conversations revolve around the children, as do many of their activities together. When that connection disappears because their children have set off on their own, they are left with an empty relationship. More often than not, anger takes the place of the emotions they spent on the children, and such couples divide their time between not talking and fighting.

When couples facing this issue come to my office, I know that I probably can’t do much for them. They may choose to stay together, but they’d be better off separated. Too much damage has been done to their relationship for it to be repaired. And as far as getting them to have sex, the likelihood is very, very small, unless the motivation is only for their own satisfaction. But as far as “making love,” forget about it.

Empty-nest syndrome is caused by the traps I’ve talked about in this article. If two people have spent little time interacting outside of activities involving their children, have become completely bored with each other, or have been torn apart by addictive behavior, then they are undoubtedly going to suffer from empty-nest syndrome. But if a couple can recognize these traps, they can take the necessary steps to repair their relationship so as to avoid becoming victims of this syndrome.

Is there any hope for a couple affected by empty-nest syndrome? I would say only if both partners really have the will to overcome the distance between themselves. Usually at this point they resent almost everything about their partner. Overcoming such a hurdle is difficult. My suggestion is for them to take an extended vacation and see if they can rediscover the love they first had for each other. If they can light a small spark, they may have a chance.

But if all they do is fight the whole time they’re away, then rather than waste time in a relationship that’s going nowhere, they may as well split up and begin a new phase of their lives.

Read More......

Ten Dumb Things People Believe about Sex

The key to good sexual functioning is to be sexually literate, and one important way of earning your master’s degree in sexual literacy is to do a little housecleaning upstairs and sweep away any sexual myths that have been hiding in the corners of your brain.

1. If I Haven’t Had Sex by the Time I’m 18, I’m a Loser

When you’re 85 years old and you look back at your life, the age at which you first had sex will be absolutely irrelevant. You won’t care, and neither will anybody else. But for many younger people who are still virgins, the weight of this sexual status seems to grow heavier by the hour. Somehow, they feel that the fact that they’ve never had sex is written across their foreheads for all to see, and that everyone is laughing at them.

If you’re in this category, please don’t put any added pressure on yourself. If you feel sexually frustrated, you can masturbate. Be grateful that you can give yourself orgasms rather than resenting the fact that someone else isn’t doing it for you. And to defend yourself against those who tease you, I suggest a white lie, so they no longer can accuse you of being a virgin.

Remember, many people start having sex when they’re very young, but because the situation isn’t right, they never discover how to become great lovers and never have terrific sex lives. Rather than rushing into sex just because you reach a certain age, find out how to give your feelings time to grow and develop.

2. The More I Score, the More Pleasure I’ll Have

I’m not one of those who say that you should absolutely never have a one-night stand. In some instances, the chemistry between two people is very strong and passing up such a moment is very hard. If you are very careful about protecting yourself and are fully aware of the risks involved, then a one-night stand may be something that you indulge in once, or maybe twice.

But some people make one-night stands a part of their lifestyles. They don’t want a relationship but prefer a string of sexual partners. To them, sex is about quantity, not quality.

If you’re one of those people who think that more sex is better than good sex, all I can say is that this attitude is dumb, dumb, dumb.

With AIDS spreading and other sexually transmitted diseases already rampant, you multiply the risks when you multiply your partners, and that’s asking for trouble. Safe sex between two people simply doesn’t exist — only safer sex. Although you may not catch an STD the first time you have a one-night stand, each time you have one, you increase the odds — in particular, because those people with whom you have these one-night stands are obviously also prone to risky behavior.

And what if you’re a woman and a mistake happens and you wind up pregnant? What kind of support do you think you’ll get from someone you barely know?

Apart from the risks, one-night stands just do not make for the best sex. What makes having sex with another person better than masturbating is the intimacy, the shared feelings, the romance attached to the moment. None of these circumstances exists during a one-night stand.

And then you have to deal with the next morning. If you want to see the other person again and they’d rather not, imagine how much worse the feeling of rejection will be than if they’d said no in the first place. And if you’re the one doing the rejecting, well, how good could the one-night stand have been if you never want to repeat it?

Putting another notch on your bedpost isn’t as satisfying as exchanging the full range of emotions that pass between two people who make love.

3. Me Immune to AIDS

Because the AIDS epidemic struck the gay community first, many straight people refuse to admit that they can catch this deadly disease. In Africa, where AIDS is the most widespread, the disease primarily affects heterosexuals. And the fastest growing rate of AIDS in Western countries is among heterosexuals, not homosexuals. The pool of heterosexuals who have AIDS grows every day and, therefore, so do the risks to every other heterosexual. Chapter 19 discusses sexually transmitted diseases, including AIDS, in detail. Believing that AIDS can happen only to homosexuals is a prejudice that can cost you your life.

4. The Grass Is Always Greener in the Neighbors’ Bedroom

Some people think that they’re missing out by staying within the bounds of marriage. When it comes to having an affair, these people believe that the grass is greener in the next pasture. Although sexual boredom is certainly something to watch out for in your own life, maybe you ought to remove those green-colored glasses when looking over the neighbor’s fence.

In my opinion, most people exaggerate about their sexual escapades. So when you read how often people are having sex, or how many partners they’ve had, or any of the other statistics that float around, and then you look at your own life, yours may seem inadequate. But if those numbers are all inflated, then you’re really not losing out, are you?

Don’t believe every poll you read. When people answer all those questionnaires, do you really believe that they tell the truth? Would you be completely honest, or would you exaggerate a bit?

Most people can improve their sex lives, and I’m certainly an advocate of that. But if you try to make those improvements only because you want to keep up with the Joneses, then you’ll only be setting yourself up for disappointment. (Besides, the Joneses may be trying to keep up with YOU!)

5. Having Sex Will Make Everything All Right

Sex isn’t a cure for a lousy relationship. That fact may seem obvious, but many people don’t seem to know this. A woman may be in a relationship with someone who mistreats her, and instead of running for the hills, she agrees to go one step further and have sex with him. Why? She thinks that, because he seems to want sex so badly, he’ll change into a pussycat after he’s had his way with her.

This idea is a prime example of putting the cart before the horse. You have to work on the relationship — build it up and make it into something worth sharing together — before you add the final ingredient, which is sex.

Sex is like the whipped cream you put on an ice cream sundae. Without the ice cream to hold it up, the whipped cream alone isn’t satisfying. But mixed in with the rest of the ingredients, that whipped cream tastes absolutely delicious.

Sex by itself can’t make up for all the other inadequacies of a relationship, so before you have sex with someone, build the foundation first.

6. A Good Lover Must Be an Open Book

When you first meet somebody, you probably try to sweep parts of yourself under the carpet. If the two of you hit it off, slowly but surely you begin to peel away the layers and reveal your true selves. Part of that revelation certainly takes place if you have sex together. This process is wonderful and vital to building a relationship, but you can also take it too far.

If you love the other person, but you think that his nose is too big, there’s no point in telling him that again and again, or even once.

If, when you’re making love, you fantasize that you’re actually in the arms of Halle Berry or Brad Pitt, don’t tell your partner that, either. The information serves no purpose other than to hurt your partner.

And if you’ve always fancied making love in the center ring of the circus but your partner is a prude, then don’t bother revealing this side of yourself. If you do, your partner likely will think less of you.

Yes, you should be as honest as you can with your partner, especially if you’re married to him or her. But honesty isn’t the best policy if all it accomplishes is to cause pain to the one you love.

7. I Should Always Compare Sexual Partners

I can understand comparing certain things, such as restaurants or CDs. But comparing partners, sexually that is, can be a lose-lose situation. Now I’m not talking about comparing two people whom you casually date. I mean when you and someone you’re serious about end up becoming lovers. If, at that point, you begin to compare the way this person makes love to the way your previous partner did it, you’re asking for trouble.

Although you may think that your sexual feelings happen only between your belly and your knees, in fact, they chiefly reside in your brain. And that means it’s easy to distract your mind from the business at hand.

So if you start the comparison process, even if your new lover comes out on top, the fact that you’re comparing instead of letting your mind go and partaking of the pleasure of the moment lessens your enjoyment.

So play down those urges to compare lovers and keep your mind focused on what’s happening to your body right then and there. On the other hand, if you’ve learned any skills or acquired any knowledge from a past relationship, make sure to incorporate those techniques into any new relationships.

8. I Can’t Become a Better Lover

If you ever read the life story of someone at the top of their field — a professional athlete, a famous actor, a great artist — you always find that those individuals worked very hard to get where they are. Sure, natural talent has something to do with how good you are, but seeking to improve your skills is just as important, because the more you train, the better you become.

This idea is just as true with sex. Everyone can become a better lover. Some of the most common difficulties that people experience can be easily alleviated if you work at it.

9. Lovers Want and Need the Same Things

You and your lover probably have some tastes in common, but certainly not in everything. And why should you?

Although I’m sure that you both enjoy orgasms, how many you need in a particular period may vary, as well as your likes and dislikes for the methods you use to achieve those orgasms.

If you accept that you’re different, and if you agree to make compromises, then you shouldn’t have any problems adapting to each other. You may have to learn how to satisfy your partner when you’re not interested in having an orgasm. But learning that skill isn’t that difficult, and doing so can help make your relationship a lot better.

However, having unrealistic expectations can get you into trouble. So don’t expect your partner to think and act exactly the way you do. You’ll be a lot happier for it.

10. I’m Too Old to Have Sex

Human beings find that many of their faculties grow weaker as they grow older, but none that so many people give up on as easily as sex. If your eyesight gets weaker, do you go around squinting, or run to the eye doctor? If your hearing becomes impaired, do you go around saying “What?” all day long, or get a hearing aid? So if your sexual apparatus diminishes, why would you give up on it entirely?

That sexual functioning declines with age is a given, but that it disappears altogether is most definitely not. As you grow older, you go through certain stages, which are different for men and women. Men may need their partners to stimulate their penises or to use a drug such as Viagra. Women stop producing natural lubricants and have to apply the store-bought variety.

If wearing glasses doesn’t interfere with your enjoyment of reading a book, then adapting to the necessities of age when it comes to sex shouldn’t be a big deal either. Keep having sex as long as you physically can, and sex will help keep your life worth living.

Read More......

Ten Tips for Safer Sex

There are no absolute guarantees when it comes to having safe sex between two people, but you can enjoy safer sex if you’re careful to follow the guidelines that the experts have developed.

If you can’t remember the following ten tips, then write them down with a felt marker on your wrist every time you’re in a situation where you may have sex. Do this until they’re indelibly etched in your brain — right next to the spot where the law of always backing up your computer files sits.

1. Learn to Say No

No one ever died from sexual frustration, but you can’t say the same thing about sexually transmitted diseases.

Just because you haven’t had sex in a long time and the opportunity presents itself doesn’t mean that you should give in to those urges. The less you know about a person, the greater the likelihood that he or she can infect you with a disease. So learn to say no to casual sex.

Yes, you can try to protect yourself, but you have no 100 percent sure way of doing that. Remember that I’m talking about your life here. Isn’t it worth being cautious?

2. Limit Your Number of Partners

Have you ever seen the trick that the clowns do in the circus with the little car? The car drives around the main ring, looking like it has barely enough room for one person inside; the next thing you know, 25 clowns, big feet and all, come pouring out. Well, you have to conjure up that exact image when you look at a potential partner. The more sexual partners a person has had, the more trouble that spells for you.

When you have sex with someone, not just the two of you are in the bed. Hiding under the covers is every partner with whom that person has everhad sex, and the partners of those partners. Although you may not be able to see their large red noses glowing in the dark, you can be sure that any viruses those partners may have left behind inside the warm, naked body lying next to you are making a beeline for any openings in your body.

To a virus, you’re nothing more than a host — the perfect place to reproduce and multiply — and if the virus destroys you, well, all I can say is that its conscience isn’t as well developed as its ability to reproduce.

3. Don’t Rely Solely on Your Instincts

Some people have honesty written all over their faces. You just know that if you lend them your car, you’ll get it back exactly at the time they say they’ll bring it back. But what if they have a split personality, and the half of them who’s the thief takes off with your car for parts unknown? You trusted your instincts and you got burned, that’s what.

The problem with trusting your instincts when it comes to sexually transmitted diseases is that many people out there really believe that they’re disease free when, in fact, they’re not. Some sexually transmitted diseases invade a host’s body and cause absolutely no symptoms, so when these people tell you they’ve never had any diseases, they give the appearance of being absolutely honest because they are being absolutely honest. The difficulty that your never-failing instincts face in such a situation is that these people’s honesty isn’t worth a hoot. They have a dark side that they’re unaware of having. They truly believe that they can’t infect you, but in fact they truly can.

When dealing with sexually transmitted diseases, it’s much better to be safe than sorry. Instead of trusting your instincts, follow the rules of safer sex. In the long run, you won’t regret it.

4. Never Dull Your Senses When You’re with Strangers

I often recommend to people that they have a glass of wine or two to help them loosen up, which can then lead to better sex. But that suggestion only applies when the two people involved are already a couple. In certain situations, any dulling of the senses caused by alcohol or drugs can prove very dangerous.

Many people have wound up having sex because they were high, under circumstances that they would never have said yes to had they been sober. If you’re in your local pub with a few friends and you have a few beers too many, the likelihood of the situation turning into a sexual scene is slight. But if you get invited to a party at somebody’s house and you don’t know the host that well or many of the guests, and you then start to imbibe too much, you may regret the consequences.

If a bedroom is just down the hall, you may well find yourself in it, with your clothes off and somebody doing some very intimate things with you. Under such circumstances, you won’t be thinking safer sex, assuming you’re capable of thinking at all. And the same goes for the person you’re with, too.

To practice safer sex you have to be responsible. And to be responsible, you have to have all, or at least most, of your faculties operating. So if the situation calls for keeping your wits about you, order a soft drink — or one of those nonalcoholic beers, if you don’t want anybody to realize that you intend to remain sober.

5. Discuss Safer Sex in Advance

If you’re dating someone and the relationship is moving forward, don’t wait to talk about safer sex. The closer you get to the point where having sex is just on the horizon, the harder delaying going ahead will be.

Certainly if you already have your clothes off, it’s far too late to suddenly think about safer sex. But I believe that you should have that safer sex discussion long before you reach that point. If you plan to insist that this potential partner get tested for AIDS, then you can expect a six-month waiting period before you can engage in intercourse. So the sooner you bring the topic to the table, the sooner you can begin having sex.

I’m sure that you find many aspects of a person’s character, such as his sense of honesty or her ability to give of herself, so important that you wouldn’t consider getting involved with that person without knowing them. So just add sexual history to that list, and you’ll wind up a lot safer.

6. Use Condoms

Condoms don’t offer absolute protection against sexually transmitted diseases. If used improperly, they can leak. Once in a while, they break. And certain viruses, such as hepatitis B, can actually pass through the latex.But compared to having intercourse without a condom, they’re like the brick walls the third little piggy used to keep the wolf away.

You have no valid excuse not to use a condom. Men don’t lose their ability to have an orgasm by wearing a condom. They may like sex better without a condom — I can’t deny that — but having intercourse using a condom is still better than not having intercourse at all. When it comes to safer sex, youcan’t make any exceptions to this rule.

To use a condom, you have to have one with you. Although young men have long stuck one in their wallets for “emergencies,” you should know that heat and age affect condoms, so make sure that any condom you use is fresh. But in this day and age, not just men should carry condoms. Any woman who is sexually active should be prepared to keep herself safe, not only from an unintended pregnancy, but from sexually transmitted diseases as well.

7. Develop a Relationship Before You Have Sex

Some people get paranoid about safer sex, and I don’t blame them for taking every precaution imaginable. But many people just don’t give much thought to safer sex. If they’re in a special situation, if the stars are shining very brightly, if the chemistry is just perfect, and no condom is available, well, they may give in to the moment. Scolding someone who does that is pointless; face it, sex is part of human nature. None of us is perfect, and everyone gives in to temptation now and then, whether it involves a moonlit night or a container of Häagen-Dazs.

The key to safer sex is to not have sex with anyone until you have developed a relationship with that person. If you get to know someone really well, if you’ve been dating for a while, if you’ve had long talks about life and love and know their sexual history — if, after all that, you really believe that having sex (using a condom, of course) is reasonably safe for the two of you, then you may decide to go ahead.

Sadly, some people are liars, and every day they infect innocent people with dreadful diseases. Even a marriage license is no guarantee against sexually transmitted diseases. But you have no absolute guarantees in life, and every day you must make choices, the outcome of which you can’t know in advance. You can’t let the unknown paralyze you entirely. Sometimes you just have to take a leap. However, if you take every possible precaution, the odds of success are a lot higher.

8. Don’t Engage in Risky Behavior

The chance of passing on HIV during anal sex is greater than during other types of sex. Unprotected oral sex is not safer sex. Having sex with someone you meet at a bar or bathhouse is dangerous. Going to a sex club is far from risk free. Wife-swapping does not promote good health. Sharing needles is an invitation to sharing HIV, the virus that causes AIDS.

Most people don’t even think about trying such risky behavior, but others are attracted to living on the edge. These people seem to dare the fates to strike them down, and, more often than not, the fates oblige.

At the time that you engage in risky behavior, a certain thrill may come with the moment. But when you’re lying in a hospital dying, that thrill won’t be a happy memory but a nightmare that you’ll live through over and over until the end.

If you can’t keep yourself from going to a gay bar or bathhouse, masturbate while watching others, but don’t do anything risky. If seeing what goes on at a sex club is too much of a temptation for you to resist, go with a partner and don’t have sex with anyone else. If you’re a drug addict, go get help right this minute.

You can find the willpower to avoid risky behavior — I know it. If you can’t do it by yourself, then go for help.

9. Don’t Forget about the Other STDs

Although AIDS has grabbed all the headlines, AIDS is only one of many sexually transmitted diseases. Most of these STDs have been around for hundreds of years.

Some think that Columbus may have brought syphilis back to Spain with him from the New World. Whatever the exact method of its spread throughout the world, syphilis has plagued mankind for a long time, and it killed many people before medical science found a cure.

Some forms of syphilis and gonorrhea have become resistant to the normal types and doses of antibiotics, which means that they’re no longer illnesses that you can just shrug off. Hepatitis B is much more contagious than most STDs; luckily, you can get a vaccine that prevents you from catching it.

Doctors have no vaccine against herpes, nor do they have a cure. Usually, the partner of the person who has herpes ends up getting the disease as well.

Some STDs, such as chlamydia, are raging across the country. And now that cervical cancer has been linked to HPV infection, women need to remember that having sex with a high-risk partner can put them at higher risk for developing cancer.

Although you may be with somebody who you suppose doesn’t have AIDS — and you may even be right — that doesn’t mean that you’re safe from catching an STD. The sexual scene is a bit of a war zone, so be careful. Please.

10. Don’t Sell Your Other Options Short

If the main reason that you have sex is to have a baby, then intercourse is surely the only way for you to go. But if you seek pleasure and not progeny, then you have plenty of other ways to get sexual satisfaction without undertaking the risks of intercourse.

What makes intercourse dangerous is the exchange of bodily fluids, which can contain viruses of various sorts. But orgasms don’t depend on an exchange of fluids. You and your partner can both wear full rubber body suits, so not even a drop of sweat would be exchanged, and still give each other orgasms.

Hands and fingers are wonderfully agile and can give a lot of pleasure. (Oral sex, while safer than intercourse, can’t be considered a form of safer sex because people exchange bodily fluids.) If you want to be creative, you can even substitute your big toe. A man can rub his penis between a woman’s breasts, and a vibrator can give fabulous orgasms without passing on a drop of anything liquid.

If you really feel the need for sexual release, but you don’t know the person all that well, don’t sell these safer-sex practices short. You can get sexual satisfaction without having any regrets later on.

Read More......

Ten Things Women Wish Men Knew about Sex

It amazes me that many men say that they want to have sex so badly, but then don’t put any effort into finding out what it takes to have good sex with a woman. So all you guys who complain that you don’t get enough of “it,” read the following tips closely. I know how you men often resist asking for directions, but if you’ve lost that loving feeling, read on for some guidance on how to get to the Tunnel of Love.

1. Chivalry Isn’t Dead Yet
Apart from a handful of ultrafeminists who get insulted if a man holds the door for them or offers her his seat in a crowded room, I believe most women still enjoy being treated like ladies. Bringing a woman flowers or chocolate, taking her out to dinner, calling her during the day — all these little details are important because they show that you care.

Now some of you men have discovered how to make all the right moves, but your hearts aren’t really in it. You have one goal in mind — getting the woman into bed. If you’re one of these men, you’re not looking for a relationship but are only putting another notch in your bedpost. Although you may be proud of your conquests for a while, a time will come when you realize what a lonely life you have led.

Empty gestures aren’t chivalrous, and they won’t earn a man his rank of knighthood, either. You not only have to show you care, you have to feel it.

2. Appearances Count

Although many men worry about their hair (mostly because they know that their relationship with it may be rather fleeting), when it comes to the rest of their appearance, many men aren’t so careful. Now I understand that if you have to wear a tie and jacket all day for work, you’ll be eager to fling them off the second you walk through the door. Working women are just as eager to remove their heels and business suits. But always putting on the same ripped T-shirt and paint-stained jeans turns women off.

As a man, you’re probably very conscious of how the women around you look, whether that woman is your partner or not. True, you may be more concerned with the length of her hemline than whether her shoes match her bag, but you pay attention. Although most women take care to look as presentable as possible to their men, many men don’t return the favor.

Perhaps you’re one of those men who doesn’t perceive yourself as being sexy, but you are — especially to your partner — so try to look the part.

If you’re the type of guy who complains that your wife doesn’t make love to you enough, my guess is that you’d have more success in that area if you started dressing more like Daddy Warbucks than Hagar the Horrible.

3. You Can’t Hurry Love

The notion that men get turned on a lot faster than women do is very true. Women need time to prepare themselves for sex, and I’m not just talking about the type of foreplay that goes on when you already have your clothes off and you’re in bed (or in the hot tub or on the kitchen floor).

What women wish that men would realize is that if a man wants to have sex, he has to put romance first. While dinner at the best restaurant in townwould be great, so would any opportunity for some quiet conversation, a moment to throw off the worries of the day to let her get in the mood for lovemaking. So even if you’re champing at the bit, you have to be a tad more patient.

If you’re like most men, you had no problem giving your partner some of this quality time before you got married or moved in together. You would call ahead, make appointments (called dates), go out to dinner, take her for long walks, and look into each other’s eyes. As a result, she’d begin to get in the mood to have sex with you. You men have to realize that those patterns of romantic behavior must continue after you’ve said “I do” — not necessarily every time, but often enough to show that you really do care.

4. A Clitoris Is Not Just a Small Penis

Although the fact that men and women are built differently should be obvious, many men think of a clitoris as just a small penis. They’ve grasped the point that the clitoris is the seat of a woman’s ability to have an orgasm, but they haven’t figured out that a clitoris is a lot more delicate than a penis.

Many women can’t bear to have the clitoris touched directly because it hurts. They need only to have the area around the clitoris caressed and rubbed to give just enough stimulation without causing pain. So guys, store this fact away in your memory banks: Just because a clitoris grows bigger and harder when the woman gets excited doesn’t make it a penis.Some men take the same attitude toward a woman’s breasts as they do to the clitoris. They knead them as if they were dough, forgetting that they’re made of tissue, are sensitive, and can even be bruised. The partners of these men would also appreciate it if they took a little more care with their knees and elbows, and if they’d make a serious effort not to lean on her hair. Otherwise, both partners can end up bald.

For the vast majority of women, rough sex is a total turn-off. If you’re concerned with giving your woman an orgasm, work at it gently, and you’ll have a great deal more success. And never forget that communicating with your partner is the best way to know what she really likes.

5. Women Need to Bask in the Afterglow

Women have many different complaints about the way men make love, but the one that gets the most votes is that men are too quick to go to sleep right after sex. Women take longer to get aroused than men and longer to come down from that aroused state. If you roll over and fall asleep (or get up and go home, or go to the basement to watch the ball game), she’ll feel abandoned. And leaving her feeling alone is not a good way to end a love- making session.I’m not asking you to spend as long on afterplay as on foreplay. But, admit it, if right after “doing it” you got a call from a friend with tickets on the 50-yard line to a game starting in an hour, would you tell him you were too sleepy to go? Of course not. So isn’t your wife or partner worth an extra ten minutes of consciousness? (Hint: The answer to that question is yes.)

Afterplay has an extra benefit — if you play your cards right, the afterglow will last right up until the next day and become the start of foreplay for the next session. And don’t tell me that you’ll be too tired then!

6. Kinky Sex Isn’t Sexy Sex

I receive many letters from women asking why men always want them to do something kinky. Probably the most frequently asked request is for the husband to watch his wife make love to another woman. Some men just want to watch, while others plan on joining in. Some men don’t care whether the other person is a man or a woman; they just want to take part in a threesome. Other men want to join a wife-swapping group or visit a sex club.

Now I’m not saying women never instigate this type of behavior because they do. But for the most part, men are the ones who have these unusual sexual appetites.

One thing the wives of these men want to know is why, and I can’t give them a good answer. It may be that men have more active imaginations, or maybe they’ve watched too many porno movies. Whatever the reason, most women want no part of these scenes. They’re quite content with having sex with their man, without anyone else looking on or joining in.

I’m all in favor of fantasies, so I’d never tell you men to stop fantasizing. And if you want to ask your wife or girlfriend about a particular fantasy, go ahead. Just don’t try to pressure her if she says no. Instead, pretend you’re doing whatever turns you on when you’re with her. If you keep pestering her, you’ll just turn her off and, rather than getting kinky sex, you’ll have no sex at all.

7. Wandering Eyes Mean Less Sex

Men like to look at women, and women usually don’t mind being looked at. But there’s a time and a place for everything. If you’re out on a date, and you see a beautiful woman walk by, and you gawk at her so your date or wife can see your tongue hanging out, that situation won’t sit well with her. She’ll get angry at you, you’ll have a fight, and for the next few hours the odds of the two of you having a sexual encounter will be slim to nil.

Women like attention, and when they’re with a man with whom they’re having sex, they expect as much of his attention as possible. Women don’t find fighting for your attention particularly sexy, and that includes competing against televised ball games, sports cars being driven down your block, and, most of all, pretty women walking by.

Your lover wants to think that you consider her the most desirable woman on earth. Can she really be expected to think that when you’re busy staring at another woman’s body?

8. Slam-Bam-Thank-You-Ma’am Doesn’t Cut the Mustard

Okay, now I’m getting down to the real nitty gritty. Obviously, if women need time to get sufficiently aroused to have an orgasm, a man who can’t “keep it up” (that is, sustain an erection) will cause them problems.

Premature ejaculation is the term used in the sexological literature for this particular affliction, but you really have nothing to worry about if the label premature ejaculator applies to you because the condition is nothing more than a learning disability.

If you’re wondering whether you fall into this category, don’t go pulling out a stopwatch. I don’t classify a man as a premature ejaculator by some predefined amount of time that he can last before ejaculating. All you need to ask yourself is whether you’re dissatisfied with your performance.

9. Changing Diapers Is Sexy

How many of you fathers do or did change diapers? I’m sure that you never thought of it as a sexy experience. But if you never realized how important a role changing a baby’s diaper has in your sex life, then you don’t deserve the title “terrific lover” just yet.

Mommies change a million diapers, but just because they do doesn’t make the task any more pleasant. Too many Dads think that because Mom changes diapers all the time — even if she works at a full-time job outside the home — she likes doing it. Believe me, changing diapers is not a job anybody can really like. Oh, sure, babies are fun, but some element of the diaper-changing chore is offensive to all of us.

So when Dad offers to do the dirty job — key word, offers, and with a smile on his face too — that makes Mom feel very good. So good that later that night she’ll still remember it, and Daddy may get his reward.

Now, of course, this idea applies to any task that always seems to fall on Mom — doing the dishes, folding the laundry, dusting the bookshelves. Don’t do it just because you expect something; but if you volunteer for some of the dirty work, I guarantee that you’ll earn your reward.

10. Just Because You Can’t Doesn’t Mean You Won’t

I want to talk to you older gentlemen. I know that you can’t always perform the way you used to. That doesn’t mean that your sexual life is over, but you do need more time to get ready for the next sexual episode. Remember this truism that many of you either don’t want to admit or just never realized: You don’t need an erection to satisfy your wife.

Very often, if a wife feels “in the mood” and the husband doesn’t, he’ll either ignore her desires, or he’ll try to have an erection. Then, when he can’t, he’ll give up on the idea of sex altogether. But no law says that you have to have an erection to have sex. You can please your wife in a variety of ways. You can give her fabulous orgasms with your fingers, your tongue, or a vibrator.

Don’t be selfish. Just because you’re not in the mood doesn’t mean that she has to be frustrated. And remember, no good deed goes unrewarded. So if at another time you need a little more help from her to obtain an erection, your helping her during her hour of need will go into an account that you can draw on later.

Read More......

Eleven Things Men Wish Women Knew about Sex

Ladies, if any of you still believe that the way to a man’s heart is through his stomach, then you have a lot to figure out about men. Between fast-food franchises, pizza, and Chinese takeout, men can easily feed themselves. But they’re not so crazy about taking care of some of their other needs by themselves — and I’m not talking about sewing on buttons. So pay attention to the tips in this chapter if you want to get the most from your relationship.

1. Try Not to Give Mixed Signals

Turning men on doesn’t really take much; if you’re not careful, you can do it accidentally. Although, as a woman, getting in the mood takes a while, a man can have an erection in what seems like milliseconds. And with those lightning reflexes hard-wired into his brain, it’s easy to confuse a man by some gesture that you aren’t even aware you made.

Imagine that you just had a tough commute home on a hot day. You walk through the door feeling sweaty and confined, and, without thinking, you kick off your shoes, hike up your skirt, and pull down your pantyhose. Ahh, relief. Now, your partner watches all of this. To him, what you’re doing is not a cooling-off gesture, but a striptease . . . and right in his living room, no less.

He may be conditioned to seeing you change clothes in the bedroom without getting excited by it (or maybe not), but seeing this sudden exposure of bare flesh where he least expected it will definitely get his blood surging south of the border.

Now he’s thinking hot while you’re thinking cold, as in shower. He starts sidling over; you see that look in his eyes, think “What is he, crazy?,” give him a stiff arm, and make a beeline for the shower. If you’re really in miscommunication mode, after your shower, you start thinking about “it” and come out of the shower wearing only a towel to see what reaction you get. But having just been rejected, he figures that if he reaches out, he’ll only get his hand slapped. So instead he plays King Couch Potato and asks what’s for dinner, which makes you furious.

Mixed signals such as this happen to couples all the time. You can’t always prevent them, but it helps if you’re aware of what type of behavior can trigger them.

2. Lack of Sex Really Can Hurt

The term is blue balls, and whether a man’s testicles actually turn any colors I don’t know, but they can absolutely ache from the need for sexual release. Now, the pain isn’t so acute that a man can’t stand it, and, if no one else is around, all he has to do is masturbate to bring needed relief. But he’s also not putting you on when he says that his testicles hurt.

This is another reason not to give mixed signals. If you get a man that excited and then change your mind about giving him sexual release, he won’t be pleased. Men really don’t like women who tease because not only do their egos suffer, but their testicles do as well.

3. Sometimes Wasting Electricity Is Okay

As demonstrated by the success of magazines such as Playboy, men get turned on visually, which is why they’d really appreciate it if you would cover up a bit less when the time comes to make love. I know that you like to cuddle and be cozy, and that a dark room with the covers drawn up to your chin helps you feel safe enough to get aroused, but for the sake of your man, how about leaving the lights on once in a while?

Now, I’m not asking you to cover your room with mirrors because I understand that you have to be able to look your mother-in-law in the eye when she visits. But as long as the room temperature is warm enough not to cause goose bumps, give your man the visual stimuli he desires.

4. Teamwork Is Important

So many of you women are sick of sports. Having your man spend Sunday afternoons watching other men hitting each other may seem boring, but I believe sports can teach you a lesson about sex.

To you women, verbal communication is very important. Because men, in general, don’t talk as much — especially the strong, silent type — it seems as if they don’t communicate to each other. But many men prefer to bond not by talking but by doing something together, as a team. Having played sports as young men and discovered how to appreciate the benefits of teamwork, men find that watching sports has a great attraction.

So how does this idea affect your love life? For one thing, the more teamwork you have in your sex life, the more communication you’ll have between the two of you, and the happier you’ll both be. Here are some suggestions to get the action started:

• The simplest thing you can do is to initiate sex once in a while if you tend to leave that task to him.
• Buy some sex toys, edible underwear for example, and present them to him one night.
• Suggest writing up a game plan for the night’s sexual activities. Include starting time, which positions, and which room of the house.
• Buy a team uniform, maybe matching T-shirts, that can serve as a secret signal between the two of you that — if you’re both wearing them —then that night, or that afternoon, is reserved for sex.
• Take an active part in sex and score some points that put you right at the top of his standings.

5. The Playboy Playmate Is Not a Threat

I actually do like the articles in Playboy, but I know that many women wouldn’t care if every issue won a Pulitzer Prize for journalism; they still don’t want to see that magazine — or any other publication, video, or Web site that features naked, nubile women — in their homes. Such women feel threatened by these pictures because they themselves aren’t a “perfect” 36-24-36, they don’t get the benefits of an airbrush around their cellulite, and they refuse to shave their pubic hair into a well-shaped “V.”

Now, I don’t want you to do anything that makes you feel threatened, so you must decide whether these magazines have a place in your bedroom. But this chapter is here to let you women know how your men feel, and I would be remiss to omit this common complaint just to preserve your feelings.

In reality, Playboy is just the opposite of a threat. Very few men ever get to even meet a centerfold, much less go to bed with one. The man who gets turned on reading — or, if you prefer, ogling — Playboy isn’t going to rush out of the house looking for Miss October. Instead, he’s going to come over to your side of the bed and look for you. He knows you don’t look like a centerfold, but he loves you for all your qualities, one of which may even be that you don’t look like Miss October, whom he may actually be too scared to go to bed with, fearing he couldn’t live up to the moment.

You certainly don’t want little children peeking at erotic images, but if your man is discreet about his habit, I know that he would really appreciate your tolerance — if not understanding — of his choice of literature.

6. The Day I Stop Looking Is the Day I’m Dead

In my tips for men, I tell you that women hate it when they’re out with a guy and he gapes at other women. Although men should definitely exercise caution when they’re with a partner, that’s not the same thing as saying that they shouldn’t ever look.

Men will always look at other women; you can’t stop them, so don’t make a big fuss when your man looks, unless he’s being obnoxious about it. Remember, if your man stops looking at other women, it probably means he’s also stopped looking at you. It may mean that he has lost all interest in sex, and that’s certainly not a bonus.

As far as two partners in a close relationship are concerned, looks aren’t the only thing that keeps them together, so looking around is really not such a big deal. The key to keeping both partners happy is not to force anyone to wear blinders but, instead, to use discretion.

7. If You Really Loved Me, You’d . . .

I admit I felt a little prudish about putting what this tip is about right in the title, though most of you ladies can guess what I’m talking about. And certainly many of you keep your man happy by performing that certain act. Right, the topic here is fellatio — oral sex on a man.

8. Women Knew about Sex

Now, although I’m speaking on behalf of men here, I must state categorically that I absolutely do not want any woman to do anything that really repulses her. But before you ignore this section, ask yourself: Is oral sex really that repulsive? I’m not saying that you have to necessarily swallow his semen,but is just kissing and licking his penis that big of a deal?

If you’re concerned about cleanliness, then go get a washcloth and clean his penis. He won’t object, unless you use cold water.

I really do not believe that men who crave this sex act see it as degrading to women. Rather, they want it because they enjoy the sensations. And maybe you do, too, when he does it to you. Even if fellatio never becomes a regular part of your sexual repertoire, you can at least make his birthday special.

9. The Way to a Man’s Heart Is Not through His Stomach

I don’t know where that saying that the way to a man’s heart is through his stomach started, but unless you only asked men living in a retirement community, I don’t think you’ll find the majority in agreement. And I’m not sure that even the seniors would give their vote.

Men like to eat, but if they have to do something for themselves, they’d prefer to feed themselves. Some women, after a few years or a few kids, seem to withdraw from sex. A wife may think that as long as she feeds her husband and maybe irons his shirts, that’s all he really needs from her.

That idea may work for a while, but then he’ll get a new secretary, or go to a convention in Las Vegas, or just look differently at the neighbor’s wife, and all of a sudden his attention is permanently drawn elsewhere.

As a man ages, his sexual urges may come further apart, but they’re still there. If, for some reason, you seem to have lost your sexual desire, don’t just assume it happens because you’re a woman. That’s nonsense. Loss of sexual appetite is almost always caused by something specific, so find a specialist — a sex therapist or marital therapist — who can help you overcome this problem.

10. To a Man, Sex Is Different than Love

I don’t want to make any excuses for men who fool around, especially in these days when he can catch a deadly disease and then infect his innocent wife. But in general, men and women are different when it comes to sex. Most women need romance to become aroused, which means that their emotions are almost always involved, but most men can have sex without the act triggering an emotional response in them.

This is the reason that prostitutes have always been doing business with men on a quickie basis, while the few gigolos (male prostitutes for women) that exist almost always perform for a long term.

You need to understand this fact because if you ever catch your man having sex with another woman, you shouldn’t throw away a long-term relationship without doing a careful evaluation. If it really looks like he was only in it for the sex, and if you both love each other, you may be able to save your relationship. I’m certainly not advocating sticking around with a philanderer, the guy who does it over and over again. But in some instances you’d be better off forgiving and forgetting (although you can never totally forget).

11. The Older a Man Gets, the More Help He Needs

Not every man knows that, at some point in his life, he loses the ability to have a psychogenic erection — an erection that comes by itself, without any physical manipulation — but it’s a fact. This problem doesn’t signal the end of your love life; instead, it means that your partner now needs foreplay as much as you do.

Some of you women may decide that this is the moment to pay him back for all the times that he didn’t give you enough foreplay, but I’m telling you not to play those games. When this change first starts to happen to a man, he gets pretty upset about it. The first few times he runs across a situation where his penis used to take off for the races by itself and now just lies there can be downright scary. So have mercy on him and don’t add to his plight.

Read More......

Ten Tips for Truly Great Lovers

Anybody can teach you how to make love, but I, Dr. Ruth, want you to become a great lover. I want you to have terrific sex, and to do that you have to find out how to roll your Rs and heed the following tips.

1. Don’t Make Love on Your First Date
Sex feels great, doesn’t it? But sex isn’t a toy. Sex is a serious act to be shared by responsible adults. A great lover integrates sex into an overall relationship and never has sex with someone he or she barely knows.

Giving into the temptation of having sex before you really know each other can only lead to problems, such as catching a sexually transmitted disease. But even if you do escape with your health intact, you won’t be having great sex.

If you wait until you’ve developed a relationship with someone, if you devote your energies to finding out enough about that someone so you grow to admire, respect, and love the person, then — and only then — can you have great sex.

2. Set the Mood as Far in Advance as Possible
A common myth says that great sex has to be spontaneous sex, but in most cases, the reverse of that is true. Now, I’m not saying that spontaneous sex can’t be great, but rarely do two people hit their peak sexual mood at just the same time without some planning.

One reason is that women take a longer time to get aroused. So the sooner you set the mood for lovemaking, the more aroused she can become. Don’t be in such a rush. The more planning and preparation you invest in making the evening (or morning or afternoon) as romantic as possible, the better the sex will be.

Give your full attention to your partner the moment you walk through the door, not just before you get into bed. Spend time caressing and massaging the rest of her body before reaching for her clitoris. And afterward, don’t feel as if you have to go right to sleep or head back to your apartment as soon as you’ve had your orgasm.

Ladies, if you know that you want to have sex with him, don’t be coy about it. Let him know that the answer will be yes as soon as you know it yourself. That way he can feel free to give you the best foreplay he can without worrying about whether he’s going to have his advances rejected.

3. Find Out What Your Partner Needs
Sex isn’t a selfish act. Just because no one else can feel your orgasm doesn’t mean that they can’t share in your pleasure, or you in theirs. If you want to have the strongest orgasms — the kind that make your heart beat wildly,your breath grow short, and your toes curl — then you have to work together and give as much of yourselves to each other as you can.

To be more giving, you have to know what the other person needs: more foreplay, a certain touch around the anus, the sensations of oral sex, maybe a thousand little kisses. Find out how to please your partner by asking directly, trying out variations, and seeing how they are received; and if your partner does the same, your team can score great sex every time.

To be the best lover you can be, do ask and do tell each other what you want. You’ve taken your clothes off, so what’s the big deal about stripping away some of that shell still covering your psyche? Sex isn’t a private act; it’s an act of sharing — and the more you share, the more there will be to share.

4. Protect Yourself and Your Partner
Sex has never been risk free. Having an unintended pregnancy carries serious consequences. And in this era of AIDS, the risks have multiplied tremendously. If you’re not careful, you may actually be putting your life on the line.

If you have the misguided notion that protecting yourself takes away from the pleasure of sex, then you’ve been missing out on truly great sex.The most important sex organ isn’t below your belt, but between your ears.

I’m talking about your brain. If you’re worried about an unintended pregnancy or whether you’ll catch some disease, you won’t enjoy yourself. These types of worries can keep some men from having an erection and some women from having an orgasm, and they can lessen the pleasure for anyone.Safer sex isn’t only less dangerous, it’s also more enjoyable. So if you want to be the best lover you can be, always practice safer sex.

5. Don’t Fall into a Rut
The first 10, 20, or maybe even 100 times you have sex with someone, you’ll experience a certain excitement that comes from the newness of it all. But after a time, that newness begins to wear off.

For some people, familiarity may be comforting, but for others, the sameness makes sex begin to wear thin. Instead of anticipating a certain caress, they begin to dread it. And so, instead of wanting to have sex, they start avoiding it, which can spell not only the end of a couple’s sex life, but the end of their entire relationship.

Even if you find yourself going back to your old ways, because they do bring you a lot of pleasure, force yourself to try something new once in a while: a different sexual position, making love at a different time of day, having sex someplace you’ve never done it before, doing it fast when you usually take your time, making a point of prolonging the act as long as you can possibly stand it. If you try some new things, you may appreciate the old ways even more. And perhaps you’ll find some new ways of having sex that will make sex better than ever.

Make a point of initiating these changes together. Sometimes surprises are nice, and sometimes they can shock the other person into losing the desire for sex altogether. Talk ahead of time about the different ideas that you may want to try, and have those discussions outside of the bedroom. If you need help coming up with new ideas, look at a book (maybe even this one) together, or watch a DVD, and then talk over which of the new positions that you just discovered may be fun to try. Never put pressure on each other to do something that the other person really doesn’t want to do, but also don’t be so quick to say no.

6. Fix the Potholes of Love
Nobody is born a perfect lover. Everybody needs to practice and work at being the best lover he or she can become . . . even you.

Whatever problems you may have, be they major ones that keep you from enjoying sex altogether or minor ones that prevent you from reaching your peak sexual performance, don’t ignore them, don’t expect them to go away by themselves, and don’t spend your whole life suffering needlessly.

For some problems, you can find the answer in this book and work it out by yourself or with your partner’s help. If that approach doesn’t solve the problem, make an appointment to see a specialist. And don’t dillydally. Do it today.

When it comes to most physical problems, be it a toothache or the need for new eyeglasses, you don’t hesitate to go for help. But if the issue is sexual, you become too embarrassed to talk about it. But take it from me, we sex therapists have heard it all. Sex is what we talk about all day long, and we won’t think you’re strange because you have a sexual problem.

And if you’re worried that going to a sex therapist will bleed you dry, the techniques we use are short term. Sometimes even only one or two sessions can work wonders and would be well worth the investment.

7. Use Your Sense of Touch
Researchers have done experiments in which they’ve left baby monkeys alone in a cage without any other monkeys, and the baby monkeys soon went crazy. Just giving those monkeys a soft cloth doll that they could cuddle up to was sometimes enough to get them through this solitary confinement. You’re not a monkey, but you and your partner do have the same need to be touched.

Part of that touching should take place while you’re having sex. Remember, though, that the art of arousing your partner through foreplay doesn’t mean just touching the genitals. You should pay attention to every square inch of your lover. Touch her hair, stroke his back, caress her legs, rub his feet. You can both enjoy the tactile sensations.

But this touching has to be a continuous process. You have to touch each Other every day, several times a day, without any thought to having sex. You have to hug each other. Hold each other’s hands. Rub each other’s shoulders. Wash each other. All of that touching will bring you closer, so when the time comes to actually engage in sex, the experience will be heightened for both of you.

Don’t limit this touching to your hands. Play footsie and feel how sensitive your feet can be. Lie on top of one another and feel your lover with your whole body. Put your cheeks together — both sets! Don’t be afraid to explore.

8. Become a Great Kisser
You may have noticed that in the “Use Your Sense of Touch” section, I didn’t mention touching your lips together. The reason is that the lips deserve a section all to themselves.

The sensations caused by kissing can feel so good, so intense, that some people can kiss each other for hours. Many people have a pleasure zone centered on oral activity.

Kissing, by the way, is a gentle art. Oh, you have moments when passions run high, and you may even feel like nibbling on each other, but for the most part, being too rough with your kisses can spoil the moment rather than enhance it. Also, although many people enjoy French kissing (that is, deep-mouth kissing), some do not. You shouldn’t try to force your way into these people’s mouths because doing so only breaks the mood.

Kissing is an important part of sex and one that you shouldn’t neglect, especially because you can do it almost anytime and anywhere. So go for it!

9. Satisfy Your Partner Even If You Don’t Feel Like Sex
Each person has a different sexual appetite, so no couple is perfectly matched. One person always wants more sex than the other. And as the years go by, those roles may even switch, and then switch back again.

What can you do about this? Help each other out, that’s what. You’re supposed to be lovers, so just because you aren’t in the mood for an orgasm doesn’t mean that you can’t help your partner reach sexual satisfaction. No law says that both of you have to have an orgasm every time.

Now, some women “fake it.” But you don’t need to fake it. You can very simply, out of love for your partner, help him or her have an orgasm in whichever way suits you best. If you’re a woman, and you want to just lie back, that’s fine. If you’re a man, you can use your finger, or your tongue,or a vibrator.

The point is, don’t force your partner to be sexually frustrated on a regular basis just because your sexual appetites are different. Remember, the Golden Rule applies to sex just as much as to every other aspect of life.

10. Adjust to Changes Caused by Aging
If you put on some weight, do you go around with your pants unbuttoned or do you buy a new pair? If you’ve reached the limit of how far your arms can hold the newspaper, do you stop reading or get reading glasses?

As the years go by, your body changes, and some of those changes can affect the way you have sex. You can refuse to adapt; you may say, “If I can’t have sex the way I used to, I won’t have it at all.” But that’s just as ridiculous as wearing your pants around your knees. You can continue to have good sex, even great sex, up into your 90s, but you’ll have to make some changes in your sex life.

As they grow older, men lose their ability to have psychogenic erections,which means you’ll no longer have erections just by thinking about something sexy, and instead will need physical stimulation. But is asking your wife to fondle your penis really that bad? Instead of being ashamed, let yourself get carried away by it, learn to enjoy it, and work it into being a pleasant part of foreplay.

Post-menopausal women no longer lubricate the way they used to, and this problem can cause intercourse to become painful for them. This lack of lubrication is no calamity, however, because every drugstore sells very good products that can take the place of your natural lubricants and make sex just as enjoyable as it was before menopause.

No matter how well the years treat you, your body will undergo changes. But instead of letting those changes negatively impact your sex life, find out how to adapt to them and make sure that you continue to enjoy great sex your whole life through.

Read More......