The landscape of information sharing has changed dramatically over the last several decades. Whereas individuals once got their information via textbooks, newspapers, encyclopedias, and word of mouth, almost all information is now obtained online.

Sex therapy is a specialized form of psychotherapy aimed at helping individuals and couples overcome their sexual difficulties utilizing behavioral, cognitive, and psychodynamic principles. Sexual dysfunction can be caused by a medical condition, medications, or a physical issue, but it can also be caused by and/or compounded by related mental health issues or relationship problems.

A person’s gender identity refers to their inner sense of self with regard to their gender. One might identify as a man, a woman, a combination of genders, or no gender at all.

Smoking cigarettes has long been considered an important independent risk factor for erectile dysfunction (ED). Nevertheless, approximately one-third of men worldwide are active smokers, and many are unaware that smoking can contribute to ED.

The cervix is the lower, narrow part of the uterus. It is the passageway between the uterus and the vagina, allowing for sperm to enter the uterus for conception, sealing the womb during pregnancy, and widening (dilating) to allow the baby to pass through the birth canal during childbirth.

The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.  

Depression is all-encompassing and multi-faceted. Although its symptoms are similar across the board, they can also vary by individual. The way depression manifests is unique and personal — much like sex. Depression can affect every aspect of your life, including your sexual function.

Sex has many physical and emotional benefits. In most cases, it is supportive of good cardiovascular health. It can also improve a person’s mood, enhance their connection with their partner, and improve their overall quality of life. As such, people may be understandably motivated to remain sexually active for as long as it is safe and does not pose a danger to their health.

Prostate cancer and its treatments can result in discouraging sexual health changes for both patients and their partners. Radical prostatectomy, a surgery to remove the prostate and some of the surrounding tissues, can result in erectile dysfunction (ED), altered penile sensation, changes in orgasm, penile shortening, and possible incontinence during sexual activity.

Pansexuality refers to sexual, emotional, or romantic attraction to people regardless of their gender identity or sex. A person who is pansexual may be attracted to some people and not others, but the gender or sex of the people who they are attracted to does not matter.

A sexually transmitted disease (STD), also known as a sexually transmitted infection (STI), can be passed through vaginal, oral, or anal sex. Anyone who has sex can be exposed to and become infected with an STI.

Spinal cord injuries (SCI) can lead to changes in a person’s sexual health. Depending on the severity of the injury and its location on the spine, it can lead to a loss of motor function, the inability to perceive touch or respond to stimuli, and/or the decline or absence of sexual response reflexes.

Currently, the research on the effects of vitamins and vitamin deficiencies on sexual health is very limited. Nevertheless, given that vitamins are organic compounds that are essential for normal growth and for regulating bodily functions, it follows that a person’s vitamin levels could affect their sexual functioning as well. The following is what is known thus far about vitamins and their potential impact on sexual function.

Chemsex is a form of sexualized drug use for which participants take recreational drugs to enhance, extend, or strengthen a sexual experience.

Penile Mondor’s Disease (PMD) is a rare condition that involves thrombophlebitis (inflammation of the veins that can lead to blood clots) in the penis. Usually, it occurs in the superficial dorsal vein, which is located along the top of the penis. While it can be aggravating, PMD is not a serious or harmful disorder, and it generally resolves on its own.

Perhaps unsurprisingly, many people are hesitant or even reluctant to seek help for sexual problems. In fact, several population-based studies have demonstrated that just up to one-third of people experiencing a sexual health issue consult a medical professional and sometimes even less than that, depending on the region and other circumstances.

Although sex and sleep may seem unrelated, the quality and consistency of a person’s sleep can actually have a big impact on their sex life. The following is a quick reference guide on the ways that sleep can affect a person’s sexual function and satisfaction, as well as ideas for improving your sleep habits and, hopefully, your sex life by extension.

Erectile dysfunction (ED) is the inability to get or maintain an erection that is firm enough for satisfactory sexual activity. Many men are affected by ED, and it becomes more common as men age because of its relation to other health conditions, certain medications, and the natural decrease in a man’s testosterone levels as he gets older.

A person’s sexual desire will naturally fluctuate over the course of their lifetime, increasing in some periods and decreasing in others. However, if an individual finds that they are consistently lacking desire and are generally uninterested in sex, they may have hypoactive sexual desire disorder (HSDD).

Locally advanced cervical cancer (LACC) can be treated with chemoradiotherapy (CRT) or neoadjuvant chemotherapy (NACT) and radical hysterectomy (RH), and there is much debate about which treatment strategy is best for preserving individuals’ sexual functioning and quality of life. CRT has demonstrated drawbacks when it comes to cancer patients’ sexuality and quality of life, but less is known about the long-term effects of NACT-RH as a treatment for LACC.

Polycystic ovary syndrome (PCOS) is a condition that can affect women of reproductive age. Women with PCOS experience a hormonal imbalance that can cause irregular, infrequent, or prolonged periods, acne, increased facial and body hair, and sometimes infertility.

Endometriosis is a condition that affects women who have menstrual periods and can cause painful intercourse, heavy periods, and infertility, among other symptoms. It occurs when tissue similar to the tissue that lines the uterus (the endometrium) begins to grow outside of the uterus. Because this tissue behaves like the endometrium, it thickens and breaks down each month during a woman’s menstrual cycle, just like the tissues in her uterus. However, because it does not have a means of exiting the body, it irritates the surrounding tissues, creating scar tissue, causing pelvic pain, and sometimes resulting in cysts and/or adhesions (the term for when separate organs become stuck together).

The idea of seeing a sex therapist may seem intimidating, but it can be a practical, low-risk step toward improving your sex life. People go to sex therapy for many different reasons, but the goal of any sex therapy session is fundamentally the same. Sex therapy seeks to identify and address any biological, psychological, interpersonal, or other life factors that may be impacting sexual satisfaction so that individuals and couples can move past these challenges and have a fulfilling sex life.

Contrary to what it may say on the internet, there is no magic food or supplement that can prevent erectile dysfunction (ED). Even so, diet and other lifestyle factors can play a role in contributing to or protecting against developing ED. The following are the ways in which a person’s diet may affect their likelihood of acquiring this condition.

Fecal incontinence, or the involuntary leakage of stool, is an anorectal dysfunction that can affect men and women of all sexual orientations. Though it is a condition that can negatively impact a person’s quality of life, it is thought to be underreported due to patients’ embarrassment and the historically taboo nature of the topic.

Congenital penile curvature (CPC) and Peyronie’s disease (PD) are two conditions which can lead to penile curvature. Although the curvature itself may appear similar at times, the two conditions are very different in many ways. In men with CPC, curvature is often first noted during the teenage years. It is currently not known if the condition is present since birth in all cases, or if it develops during puberty in some men. Congenital penile curvature is a rare condition that is estimated to affect less than 1% of men.

Most health care providers in a urologic practice are well aware that urologic conditions and sexual issues often go hand in hand. Conditions such as urologic cancers and lower urinary tract symptoms can impact a person’s sexual function, sexual desire, and ability to enjoy sex. Even so, a recent study of urologic oncologists revealed that 75% of the providers surveyed did not routinely address their patients’ sexual function during visits.

Lichen sclerosus is a rare skin condition that usually occurs in the genital or anal area. It creates white, patchy areas of skin that may be thinner and tighter than other areas of skin. Skin affected by lichen sclerosus is often more susceptible to bruising and tearing, which can lead to painful sex when it is located on the genitals.

Post-traumatic stress disorder (PTSD) is a psychiatric condition that can be brought on by witnessing or experiencing a traumatic event like a serious accident, physical or sexual assault, or war and conflict. It is often characterized by intrusive, distressing memories, flashbacks, or nightmares about the event; avoidance of people, places, or things that remind one of the event; heightened emotional and physical reactions to stimuli; and negative changes in mood or thinking.

Past research has indicated that eating disorders and sexual disorders are more prevalent in women than in men. Moreover, eating disorders and sexual disorders have been shown to co-occur in individuals, meaning that a person can have both conditions at the same time. (When two or more medical conditions occur in an individual at the same time, they are known as comorbid conditions).

Those who believe that sex ceases to play a significant role in people’s lives as they age may want to reconsider their opinion. A 2017 national survey of senior citizens conducted at the University of Michigan revealed that 40% of men and women between the ages of 65 to 80 are still having sex. For those who were in relationships, this rate rose to 54%. Sixty-one percent of the survey participants indicated that sex is still an important factor in their quality of life.

Erectile dysfunction (ED) and female sexual dysfunction (FSD) are complex conditions that negatively impact one’s ability to experience satisfying, consensual sexual activity. A person’s sexual function can be influenced by physical and psychological factors, so ED/FSD often occur at the same time as other medical conditions such as diabetes mellitus, high blood pressure, cardiovascular disease, and depression.

A woman’s body undergoes several major changes over the course of her lifetime, many of which can have an impact on her sexual health and overall wellbeing. For example, when a woman enters menopause, her estrogen levels and those of her other steroid hormones decrease. This can lead to changes in her vulvar and vaginal tissues that can result in vaginal dryness, less vaginal elasticity, and burning or pain during sexual intercourse – a condition known as vulvo-vaginal atrophy (VVA)/genitourinary syndrome of menopause (GSM).

Interstitial cystitis (IC) is a chronic condition that causes pain, pressure, and/or discomfort in the bladder. Although IC is not caused by an infection, its symptoms may feel like a bladder infection. To be considered IC, symptoms must persist for at least six weeks. Sometimes, when a person is experiencing bladder pain but there are no visible abnormalities in the organ, the condition is referred to as painful bladder syndrome (PBS). Together, IC and PBS are classified under the umbrella term: bladder pain syndrome (BPS).

The SMSNA periodically receives and publishes ‘guest editorials’ by sexual medicine specialists.  The current article was submitted by Mark Goldberg, LCMFT, CST, a certified sex therapist and SMSNA member who specializes in sexual medicine in Maryland and hosts the Erectile Dysfunction Radio Podcast.  The content has been reviewed by the SMSNA Website Committee for accuracy. 

Erectile dysfunction (ED) is a complex medical condition which includes both physical and mental components. The paradigm of what causes ED and how it is treated has shifted over the past 50 years from a mental focus to a physical one.

There are several factors to consider when it comes to finding a provider who is knowledgeable about transgender health care needs and who can support transgender patients by providing high-quality gender-affirming care, primary care, or other specialty care. Dr. Maurice Garcia, transgender surgeon and director of the Cedars-Sinai Transgender Surgery and Health Program, and Dr. Sheryl Kingsberg, psychologist and chief of the division of behavioral medicine at MacDonald Women's Hospital/University Hospitals Cleveland Medical Center, shared advice for transgender patients on this topic.

According to a new study in The Journal of Sexual Medicine, having a partner may protect against depression in men with Peyronie’s disease, while a history of depression and higher Peyronie’s Disease Questionnaire (PDQ) scores may be predictive of depression.

As anyone who has ever tried to navigate health care coverage can attest, it is all too often a frustrating, fruitless endeavor characterized by multiple phone calls, numerous transfers, and invariably long hold times. This cumbersome process creates an obstacle for those seeking medical treatment and may disproportionately affect transgender individuals seeking treatment for gender dysphoria.

For individuals suffering from a condition that affects their sexual function, receiving an accurate diagnosis is an important first step in the process of pursuing treatment. This may seem simple, but unfortunately, many sexual disorders have overlapping symptoms and manifest themselves in similar ways, sometimes making it difficult to identify the root of the problem. Stuttering priapism (SP) and sleep-related painful erection (SRPE) are two rare disorders that have similar symptoms and can cause painful erections at night, but they are distinct conditions that should be managed and treated in different ways.

Hard flaccid syndrome (HF) is a sexual disorder that has not yet been formally recognized and defined by the sexual medicine community. Nevertheless, internet forums, chat groups, and social media groups have formed to support patients who suffer from the symptoms of this disorder, indicating that it is a relevant condition that affects one’s health and sexual function.

Concealed penis (also known as buried or hidden penis) is a condition in which the penis is partially or fully covered by the skin of the abdomen, thighs, or scrotum and does not fully protrude from the body. Unlike micropenis, a concealed penis is typically average in length but hidden under skin. It is an uncommon condition that can be congenital (present at birth) or acquired later in life.

For women who suffer from chronic pelvic pain due to endometriosis, non-coital sexual activities such as petting and oral sex may provide an effective alternative to penile-vaginal sex for reaching orgasm and achieving a more satisfying sex life. In a recent study that surveyed 868 women from Switzerland, Germany, and Austria (434 women with endometriosis and 434 women who were part of a control group), researchers found that although the women with endometriosis were less likely than those in the control group to reach orgasm during sexual intercourse, there was no significant difference in orgasm rates during masturbation and non-coital partnered activities between the two groups of women.

Getting older? If you’re a man, the size of your prostate might become a concern.

Have you ever thought about seeing a sex therapist for help with a sexual problem?

When you’re finished with cancer treatment, you might feel relieved and excited to start a new chapter in your life. It can be a hopeful time.

WHAT WILL THE CHEMO/RADIATION/SURGERY DO TO PARTS OF MY BODY THAT HAVE NOTHING TO DO WITH THE CANCER?

CAN YOU TELL US, HONESTLY, HOW TREATMENT MIGHT AFFECT OUR SEXUAL FUNCTION?

On SexHealthMatters, we often discuss how cancer and its treatment affect one’s sexual health. (See the links at the bottom of this post to learn more.) Often, a supportive partner plays an important role in sexual recovery after cancer. Usually, the partner has been there from the beginning and has some idea of what to expect going forward.

Sex can be especially exciting when you’re trying to start a family. You and your partner can enjoy your time together, bond as a couple, and smile to yourselves, wondering if your most recent bedroom encounter will result in a new family member nine months from now.

Mention a penile implant to a man with erectile dysfunction (ED), and you might get a squeamish look. The idea of having surgery on his private parts is likely to make any man squirm. And, naturally, there are questions. Will the implant work? Will there be complications? Will sex feel the same? What do partners think?

How do healthcare professionals make decisions when diagnosing and treating illnesses? Certainly, their continuing medical education helps, and most attend conferences and keep up with research in their field’s peer-reviewed journals.

If you’re a woman going through cancer treatment, you’ve probably had to adapt to a lot of changes in your life. You might have seen some dramatic changes in your sex life, too – changes you might not have been prepared for.

After a cancer diagnosis, it’s not unusual to have questions swirling through your mind. How far has the cancer progressed? What is the prognosis? What will treatment be like? How will my family and I cope?

The American Urological Association (AUA) is a professional organization for urologists. Founded in 1902, the organization now has over 21,000 members. One of its many roles is to provide guidelines on various aspects of urologic health so that doctors can best serve their patients.

You and your partner probably have a lot in common. Or if you’re not partnered, you likely seek common traits in a prospective mate. Whether it’s a love of baseball, camping, or rock concerts, these commonalities help keep you close as a couple.

Like many aspects of sex, orgasms are always changing. You might have one night of passion that feels like an out-of-body experience. You might have another that is pleasant, but not necessarily powerful. And you might have another that is just humdrum. Should you worry?

Back in December, we started covering an interesting Finnish study about women’s orgasms. A team of researchers compiled the results of five different sex surveys taken over four decades starting in the early 1970s. Over 10,000 men and women participated, and the researchers focused on women’s orgasms. They published their findings in October 2016 in the journal Socioaffective Neuroscience and Psychology.

In August 2017, the European Journal of Cancer Care published a comprehensive review by Canadian researchers that involved over 100 medical studies concerning women, cancer, and sexual health. The authors delved into the physical and psychological aspects of cancer that can affect sexuality. They also discussed some of the ways patients and their healthcare team might approach sexual problems during and after cancer treatment.

For most people, enjoyable sex is sex without pain. But even small discomforts can make sex less pleasurable. While sexual pain can have many causes, the clue to resolving it can start with our mindset.

Earlier this year, the American Cancer Society estimated that about 15 million Americans were living with cancer in 2016.

Orgasm is sometimes described as an out-of-the-body experience. We’d add that it’s a full-body experience, too. Think about the body parts involved: Your eyes see your partner’s smile; your skin receives touch. Your brain sends signals through your nervous system, telling your genitals to start getting ready for the main event. Your blood pumps harder. Your breathing quickens. And then, if things go as planned, you and your partner climax – sometimes together, but more often separately.

Low sex drive can be puzzling. Sex is supposed be pleasurable, so why would anyone lose interest?

Here on SexHealthMatters we often talk about the role of the brain during sexual activity. While the genitals may seem more involved with the “action,” the brain is a great coordinator. It takes in sexual stimuli (like a provocative smile or a touch), processes them, and sends messages to the genitals to start getting ready, either through erection or vaginal lubrication.

Would it surprise you to learn that an estimated 10% to 40% of women have trouble reaching orgasm? And that some women have never had an orgasm at all?

A dry orgasm?

For men, it sounds like a contradiction, doesn’t it? Men ejaculate semen at orgasm. Doesn’t that make orgasms, by definition, wet?

When his doctor mentioned the prostate biopsy, Stan’s heart sank. What did this mean? Did he have cancer? And if so, how would his life change?

An erection is a complex process. It may not seem that complicated – a man can be sexually turned on by his partner’s smile, an erotic fantasy, or a beautiful person who passes him on the street. An erection might even seem automatic.

Orgasm is a complex, mysterious process. But that hasn’t stopped scientists from trying to learn as much as they can. In fact, some volunteers have brought themselves to orgasm inside an MRI machine in the name of science.

As we get older, it’s inevitable that our bodies change. Our hair might turn gray, our skin may become wrinkled, and we might put on a little weight. These are changes we can usually expect.

Justin was the new guy at the office and he was looking forward to the company’s annual summer party, always held at the boss’s ritzy estate by the ocean. These parties were legendary, he’d been told. People from all over the region came to play volleyball on the beach, have bonfires after the sun went down. And it wasn’t uncommon for couples to wander off, claiming that what happens at the party stays at the party.

How do you know if you’re ready to have sex?

If you or someone you care about has been diagnosed with prostate cancer, it can be an unsettling time. There’s so much to learn while you cope with feelings of uncertainty and anxiety.

Men, have you ever had your testosterone levels checked?

Considering the media buzz about testosterone these days, many men wonder if they should.

Two weeks ago on the SexHealthMatters blog, we discussed three types of drugs that can decrease a person’s sex drive: antidepressants, birth control pills, and finasteride (a drug that can treat an enlarged prostate or male-pattern hair loss.)

When your sex drive plummets, it can be difficult to pinpoint why. Could it be low testosterone? Fluctuating hormones due to pregnancy or menopause? Fatigue or stress from a new job? Anxiety or depression? All of these factors can contribute to low libido. So can certain medical conditions like diabetes and cancer.

What comes to mind when you think of pornography?

Greg was losing his interest in sex and he couldn’t figure out why.

Maria looked in the mirror and was troubled by what she saw.