MOMENTUM

Momentum is everything.

Most of my readers know how much I love football. During the recent playoffs, I don’t know how many times I said/texted/tweeted the word “momentum”, but it was a lot. That sense that the team with the momentum is unstoppable, fueled by the roars from the fans in the stands. With positive momentum, the magic happens.

Momentum is a term from physics. It refers to the quantity of motion that an object has. Objects at rest do not have momentum.

Momentum runs high at the start of a romantic relationship. It is fun, playful and carefree. Both of you are reflecting over-idealized versions of each other so powerful that instincts of hunger and thirst are ignored. You believe you could live with this person in a tent until the end of time. Spending glorious days in bed in a delirious state makes it easy to ignore the tedious responsibilities of reality.

While society prioritizes this phase, the challenges of long-term relationships leave us wondering: is that all there is? The little quirks you loved at the start are now the most annoying. The two of you need to make grown-up decisions, face health and financial concerns, and cope with the drudgery of everyday life. Staying in bed all day is no longer an option and, if given the choice, many would rather be in bed alone.

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Has longevity made long-term relationships a mathematical impossibility? Are relationships designed for planned obsolescence?

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Don’t think I’m down on long-term relationships. They have great value. We just need to learn how to make them more fun.

Think about it: What made it so compelling in the beginning?

The criteria that made you an attractive mate remain the same 20, 30, and 40 years later. We do not lose our desire for adventure, spontaneity and passion. Within the context of a decades-old relationship these seem impossible. So we either accept this as is, or blame our partner or complain.

Why bother with this challenge if you have a partner and no plans to leave?

Why bother? Because not only can it save a marriage, it can enhance your life journey and lead to happier aging.

For this to happen, focus needs to shift to ourselves. It’s not about fixing the relationship. Paradoxically, stronger individuality is the catalyst for momentum.

With a long term relationship, you have the basics down. Food, protection, sleep, sex, security. As a team you navigate the tasks of raising a family, aging parents, health scares and mortgages. It feels cosy, like an old shoe.

Once the basics are stable, humans have the remarkable adaptive ability to move beyond to create music, art and literature. The key to momentum is keeping things moving.

This means men and women must be comfortable with changing it up, even in mini ways. Try out a new exercise and talk about it. I find just listening to music changes me. Recognize culinary ruts. Spend time on your own. Talk to wise elders and share stories. Consider role playing in bed. Bring more to the table. Keep the focus on yourself, not your partner.

With positive momentum we are unstoppable. At any age.

Imagine all the benefits of the stable relationship with a sprinkling of fantasy dust!

HAPPY NEW YEAR💜

loveandmedicine.com has had a great year. In case you may have missed something, here are all of the posts from 2019.

Read and reread! This year I’d love to see more comments and dialog.

ASK DR. ANNIE K. is open 24/7 and is 100% anonymous.

I know there is a lot of crap out there to read. There is an epidemic of pseudo-science and medical BS being read by millions. Would you go to a plumber to fix your teeth? Don’t go to a celebrity for medical advice. I’m guilty of it too – remember when I bought Sex Dust? That was the old me 😉. Let’s not do that. In this blog you will find facts, not fads. I do my homework.

If you are curious, the most popular post this year was How Hard Can It Be? Understanding Erectile Dysfunction. A sign I need to focus more on sex and sexual dysfunction.

Most importantly, my readers, continue to be smart and skeptical. Stay strong and open to change. Kick-ass this decade! Remember:

“It’s the small habits. How you spend your mornings. How you talk to yourself. What you read. What you watch. Who you share your energy with. Who has access to you. That will change your life.”

Anne Koplin, Author of Love and Medicine

ASK DR. ANNIE K

Post Menopause
Legitimizing Mental Illness
Breaking the Cycle
Ovulation
Pain
B12 Injections
How Mental Health Can Affect Relationships

SEX
Magic Dust and Artichokes
Understanding Sexual Dysfunction
The Lifeguard

LIFE
The Best Weekend of the Year
Hello June
Celebrate Independence
Eat A Peach
Mercury Retrograde and What Does It Have to Do With You
Hula Hoops
Friday the 13th
7 Fool Proof Tips for Fall
The Weekend
Have a Peaceful Weekend

HEALTH
Sugar, Sugar
Stopping Antidepressants
The Secret Killer in Your DNA
Self-Love

FAMILY
Intercontinental Parenting
Am I the Only One Who Thought The Marriage Story was Lousy?
How To Throw a Great Wedding
The Way to a Man’s Heart
I’m Changing My Name Again and Here’s Why
Yes, Look Back

POETRY

Inspiration

Ask Dr. Annie K.: Pain

I’m 22 years old and haven’t had sex yet. I’ve had close encounters, but every time I try I experience a lot of pain. Actually any sort of penetration brings severe pain and discomfort (tampons, fingers etc). i’ve had a basic exam from my gynecologist who reports everything is healthy and normal down there. What can I do to finally have an enjoyable sex life?

Over 75% of women experience pain from vaginal penetration at some point in their lives. You are not alone. 12% have severe pain the first time having intercourse. Many women will benefit from you asking about this very important (and painful) topic. Thank you for not being afraid to ask – Dr. Annie K is here for you.

What you are describing is called primary dyspareunia, a.k.a. painful penetration. From your gynecologic exam (which I bet was painful) it sounds like there was nothing visible externally that would indicate an infection or some kind of skin problem.

So what could it be and what to do? When it comes to painful sex, it is never “all in your head.” There is always a cause.

When I hear women talk about pain from inserting a tampon or finger as you describe, my first thought is vaginismus. Vaginismus is is considered a vagina in panic. There is an involuntary tightening of the muscles around the vagina, usually in response to penetration, or even from expecting penetration. Some women describe it as a ripping feeling or a sharp burning pressure that can last for hours or days. Anxiety is common along with frustration.

Although it may sound unusual, the first treatment recommendation is physical therapy. There are therapists specifically trained in pelvic floor anatomy. The entrance to the vagina is through pelvic floor muscles – there is no way around them! The treatment has a very high success rate in women like you who are highly motivated.

When talking sex let’s not forget the basics.

When the time comes, be sure you are with a partner you feel close to. Communication with your partner can be a game changer when a women has pain. This is a medical problem – you are working on it and sex is a priority. This may even bring you closer as a couple.

Technique is important. Allow for adequate foreplay – that part is fun! Most women achieve orgasm by stimulation of the clitoris, not penetration. No medical therapy can make up for a sexual partner who doesn’t like to play.

Lubrication can help many women who have pain with sex. Inadequate lubrication happens. It is ok to use K-Y jelly or go natural and use organic coconut oil or saliva.

Women who have experienced trauma may have painful sex as it may trigger PTSD. Work with a therapist is crucial in solving those issues and being able to move on to have a fulfilling sex life.

Whatever your age, when you have sexual pain, it can affect your self-esteem. Know that it is treatable but may take time. Start with finding the right physical therapist.

Unfortunately the first time is rarely like it looks in the movies. But it gets better! You are on your way to a healthy sex life.

The Lifeguard

In honor of the end of summer, here is a little short story about summer love.

The Mediterranean sea is unusually rough. The waves vigorously clap the sand, sending a salty mist into the ocean breeze. The white sand, like sifted flour, surrenders to the harsh waves, and is enslaved by the powerful water. Sailboats in the distance struggle their way toward the horizon. Topless women casually soak up the sun’s rays. Conversations and reading are light, as the scenery takes precedence.

She never tires of watching him as he scans the crowded beach. His eyes alert as he concentrates, to discern any hint of danger amid the playful sounds resonating from the water. Her eyes follow his large footprints sinking in and molding the sand. She marvels at his bronzed muscular calves laboring under his broad, sculpted torso. How gracefully he strolls along the beach, for such a large mountain of a man.

Every few minutes, without a pattern, he breaks his intense focus on the surf and glances back at her. Aware of the stirring she provokes, he fights the distraction and his gaze returns to the water, back to his duty.

A quickening of her breath and a flash of warmth envelop her body each time their eyes meet. Images of previous meetings bring a rosy tinge to her cheeks. Her body is aching, alert, wanting. She lusts for the physical closeness, so different from the touch she is familiar with at home. She craves the full weight of his body on hers, allowing her to feel small and protected.

She is suddenly ashamed. Her actions and their unspoken implications flood her mind, trap her and suffocate her. A revolting taste of guilt fills her mouth and her body grows limp. A glance from him reins her in and she allows herself once again to feel and not to think. She chooses expansion over contraction, upheaval over order, and freedom over settling.

When the crowd thins out and darkness creeps in, she carefully climbs the steep steps to the lifeguard station, clutching her sarong tightly. It feels like a treehouse -secluded and private. It is their sacred space. When the beach is clear he joins her, carrying two small glasses of Arak. Their lovemaking is slow and deliberate. The air swells with the scent of sex, salt, sweat, anise, and desire.

How Hard Can It Be? Understanding Erectile Dysfunction

As part of my series on the Aging Male, Love and Medicine will tackle erectile dysfunction (ED) – failure of the penis to remain erect in order to reach sexual satisfaction. Most men have experienced this at one time in their lives.  Men are embarrassed, anxious and depressed when their penis isn’t working.  They report frustration because they can’t please their partner. For men in healthy relationships, their partner’s needs matter a lot.

I interned in a sleep lab in graduate school. Sleep studies were used to differentiate psychogenic ED from physiological ED. A normal man spends about two hours in a tumescent state while asleep, having three to four erections a night. A man with psychogenic ED would probably be not far from the norm; a man with physiological ED would remain soft. Diabetic men spent nights in the sleep lab while erections were recorded and it was there that the first correlation between ED and diabetes was discovered.

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