Why We Need To talk About Sex

Love+Medicine Pillows

The Pelvic Health Collaborative invited me to present a lecture about the importance of talking about sex with patients. I passionately believe it should be an integral part of an evaluation of an individuals’ overall health and well-being. Any discussion with adult patients tends to be site/disease specific, i.e., after prostate surgery or heart attack. But what about patients with Crohn’s disease, arthritis, anxiety or obesity that are not considered directly related to sex? Are we asking these patients about their sex lives? We need to be. Because everything can affect sex and sex can affect everything.

An article was published in the New York Times entitled “When Did Porn Become Sex Ed?” Kids are not talking to their parents, their friends, or their doctors, so they turn to the Internet. The access is so easy and anonymous – straight from the smart phone. This is where they are learning how it is done. Is it any wonder performance anxiety is on the rise? What happens to expectations after watching internet porn? While some strides were made during the last administration in promoting comprehensive sex education, it was removed from the 2018 federal budget.

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Ask Dr. Annie K: Sex and Aging

My husband, who is 78, can’t climax. He has the desire but loses the urge after a short time. He has had ed for several years but could still finish up to the last year or so. Is this age related? Any hope?
– Anonymous

Love+Medicine

 

Thank you for this great question. I assure you that many of my readers are interested.

This is a condition called Delayed Ejaculation (DE) or Anorgasmia. The erection is there but no climax. The answer to your first question, whether it is age related is yes. About 1/3 of men your husband’s age have problems reaching climax.

Let’s take a look at the science behind the male sexual response to understand what is going on. It is a cascade of events originating in the brain but involving the entire body. One system relaxes the body allowing for blood flow to the penis (erection), the other follows up with contractions necessary for ejaculation. These processes are sweetly choreographed to reach the big O.

What can cause DE?

Drugs – It is well known that antidepressants cause sexual dysfunction. Here are some others:
Alcohol
Diphenhydramine (Benedryl)
H2 blockers (Tagamet, Zantac, Pepcid)
Hydrochlorothiazide
Atenolol
Opiates
Furosemide (Lasix)
Triamterine (Maxzide)
Estrogen
NSAIDs (Ibuprofen)
Pseudoephedrine (Sudafed)
Finasteride (Propecia, Proscar)
Lipid-lowering agents
Digoxin
Levodopa (Sinemet)

Heart Disease – The arteries of the penis are often the first to show atherosclerosis.

Weak Pelvic Floor – These muscles weaken as we age.

Infection – Urinary tract infections, STDs and prostatitis.

Endocrine Conditions – Diabetes, hypothyroidism, low testosterone levels.

Psychological and Spiritual Factors – Anxiety, depression, relationship issues.

Consultation with a primary care physician AND a urologist are recommended to rule out these and other medical conditions. They may provide treatment options as well. Studies are limited but there are promising reports of acupuncture as a treatment for DE.

Sex is different as we age – biology we have to accept. I like to describe it as a quieter sex. Just as hot but more simmering than full boil. Pleasure comes equally from giving and receiving. Orgasm may not be the goal every time. Going through the natural changes and seeing them as normal may bring you closer as a couple.

 This is advice for all my sexually active seniors:

  1. Get in shape.
  2. Make love early in the day, when testosterone levels are highest.
  3. Eat healthy – What is good for your heart is good for your penis.
  4. Maximize oral stimulation.
  5. Fantasize about sex.
  6. Do Kegel exercises.
  7. Use your imagination.

Age is not a disease. Do everything you can to OPTIMIZE the functioning of your body and mind. In answer to your second question, there is definitely hope!

Are You Due For A Tune-Up?

Dr. Annie K’s Spring Sex Tune-up

 

The human body is an absolute wonder. The way it bends and stretches, responds to pain and pleasure, protects us. It is upon us to take the time to honor and respect our bodies – by both daily words of gratitude and royal treatment. Like any intricate machine, our bodies require maintenance.

Here is my proposed sexual health checklist for men and women. My guess is that your doctor isn’t asking these questions (but should).

 

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Happy New Year!

Love+Medicine - Anne

As this year comes to an end I want to thank my Love and Medicine readers. With so much out there to read, I’m happy you choose me.

You never know what you’re going to get when you read my blog. That will continue in 2018.

Here’s a look at what we’ve been talking about. Kick back and browse. I’m different from a year ago. You’re different too. Take a second look. Enjoy!


FASHION

The Men’s Outerwear Conundrum
Lovely Brazilian Workout Leggings
I love my Turkish Towel…and here’s why


POETRY

Object of Desire
Steady Hand

There was a Space. Part 1
1217 Miles
Most of All
Shadow Cookies


ENTERTAINMENT

The Psychiatrist in Film
What I’m Watching


LOVE

Love and Medicine - Candy

Let’s Talk About VD
Unconditional Love:A Murder- Suicide Mystery


ASK Dr. Annie K.

Are Your Ears Ringing?
Being There for a Friend

Transition in Parenting
Transitions From Nervous to Excited
Cannabis Oil


SEX

Sex and Familiarity
Why We Need To Talk About Sex
Got Passion?
Don’t Give Up on Sex


HEALTH

Hello darkness, my old friend
Lung Cancer: A Lonely Place

5 Tricks An Old Dog Can Teach You
It’s Just Like Riding A Bicycle
The Paradox of Water
Walking (guest blogger)


FOOD

410 Calories of Magic
Gogi Berries

Spending Time in Napa Valley got me thinking about Wine
Sociology and The Lemon Bar


TRAVEL

Yes, Look Back
10 Reasons to Visit Japan (that you won’t find in the guide book…)

Studenthue – The Student Cap
Love and Medicine Goes Global!


LIFE

Love+Medicine Meteor Shower

Life As a Gypsy
Hula Hoops

My Son bought Bitcoin…
What Happens in Vegas Does NOT Stay in Vegas
16 Things You Don’t Know About Me
The Winter Solstice and Other Musings
The Weekend is Almost Here
Things I’ve Learned this Week
12 Things I Want to Do This Summer
My Summer List Update


RELATIONSHIPS

Platonic Love
The Winter-Spring Romance


SPORTS

Somebody Turn On The Game

Don’t Give Up on Sex

Maslow’s Hierarchy of Needs was first published in 1943. He based his research on observations of rhesus monkeys at the University of Wisconsin. He established that the most basic physiological needs are the solid platform from which one can reach higher goals. Without satisfying basic needs of food, drink, sex, air and sleep, we are unable to move towards self actualization. This does not change as we age. 

As a psychiatrist, I have noted that while we take care of eating and drinking pretty well, sex is often given up, relegated to the young. Relationships are in mayhem because of it. One partner may need it to feel safe and secure, while the other feels like if it never happens for the rest of life, that would be just fine. 

I would like to make a case for the fact that giving up on a sex life- in whatever form you see it- is not a wise option, especially as we age. I’m focusing on the medicine side of Love + Medicine in this post. Putting on my white coat.

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