Mom, What's Sexy?

A few nights ago, my seven-year old son crawled into my lap near bedtime. (He usually gravitates more toward my husband then.) And, happily, my youngest sought out his dad about the same time.

We're a two-rocking chair family, so I headed for the one in the boys' room and my husband to the one in the family room. We rocked for a few minutes quietly and then my son said, "Mom, what's sexy mean?" I thought, "Oh good, another teachable moment." I inhaled to formulate where I was going to start -- and in doing so, made a common mistake. I forgot to make sure that I really understood what his question was.

So, off I began with, "Well, it's a feeling that you get in your penis (if you're a boy) and in your brain. It's a good feeling to both places. That's what makes your penis get hard sometimes. Does that make sense?" At least I was following my own advice to stop every so often and make sure that your kid is tracking along with what is being said.

My son said, "Well, yeah Mom. But, what's sexy?" I realized at this point that I did not understand his question but, in knowing that, I was no closer to knowing what he was really asking. I said, "Sweetie, I would really like to answer your question, but I think that I'm not really figuring out what it is that you want to know."

He said, "Sexy, Mom. Like pregnant." Phew! Finally a clue I could work with. "Oh, you want to talk about how women get pregnant again? Sure, we can do that."

I described the usual way when a man put his penis in a woman's vagina and rubs it in and out -- and that eventually semen comes out inside the woman. And, since fertility treatments were an essential part of the story of conceiving both this son and his younger brother, I reminded him of the other way. We drifted off into masturbation and whether that could cause a woman to be pregnant. And, yes, it could if the man did it into a special container (and later the semen was put in the woman by a doctor), but that usually he would do it just because it felt good.

"Where would someone do it with his hand?" "Oh," I replied, "in bed, in the shower, into a toilet" -- naming some of the more common locations. "Does everyone have to do it with their hand?" "No, only if you want to." "Why would someone do it?" "Mainly because it feels good and it helps some boys relax."

And, that was it. The questions stopped. We had covered how the egg meets the sperm and masturbation -- not at all where I thought we were headed with my son's opening question.

Kids (even in sexually fluent households) don't always use sexual words in the way that adults typically tend to interpret them. So, I'll be heeding my own advice next time and making sure that I know what a question really means. And, I'll be leaving Robie Harris' book, It's Perfectly Normal, out in the boys' room again in case they want to revisit the topic with its wonderful cartoon-style illustrations.

Related Topics:

• Talking to Your Kids About Sex
• When to Talk to Your Child About Sex

Technorati Tags: sexuality, sex education

With All of My Mice!

In an effort to raise children who see words that deal with sexuality as somewhat the same as any other words, I occasionally run into a dilemma. That happened a few days ago when my brother-in-law was visiting our home.

He was teasing my three-year old son at the dinner table in a way that my son apparently did not appreciate. And so, my son took it upon himself to reply in a way that got his uncle's attention -- and that of all of the rest of us.

He said loudly and earnestly, "I'm going to punch you in the penis! ... And with all of my mice!!"

We were all concerned initially because of the hostility he expressed and because of the particular body part he decided was going to be attacked. The fairly long pause between the first part of his threat and the second gave me any opportunity to step into my parental mode. But once he completed his threat, the vivid picture of many mice clutched in his little hand immediately laid waste to my sage words about expressing our angry feelings in non-aggressive ways.

My husband held a straight face for the longest (about four seconds). I came in second at about two seconds, but my brother-in-law went sideways off of his chair instantly laughing. My seven-year looked around, mystified by the fact that his younger brother had just gotten away with a hostile statement and no one was "discussing" this with him.

Our family has a habit of collecting phrases that were once misspoken even though the meaning got through -- and reusing them at a later date. I'm really looking forward to having an opportunity to let someone know that I'm going to try really hard and do something "with all of my mice!"

Related Topics:

• Why We Laugh
• Actually, Laughter May Be the Best Medicine

Technorati Tags: laughter, funny kids

Part 8: Levels of SHBG

As I discussed in Part 7, testosterone levels can play a major part in a woman's sexual desire. Ways to supplement low levels were covered. But, how does it get low in the first place?

One of the most common ways for low testosterone to develop is when the level of SHBG (sex hormone binding globulin) is high. There are many aspects to the hormones that can impact sexuality, but SHBG is a stand-out. (Frustatingly, many endocrinologists have shied away from looking for remedies for low sexual desire based on hormonal levels.)

SHBG "floats" in the bloodstream and combines with free testosterone. This makes the testosterone "bound" or not free. When it's bound, it cannot affect a woman's libido. It's rendered neutral.

That's why it's important to know the free testosterone level of a woman. But, getting an accurate measurement of free testosterone can be difficult to do because female levels are often quite low and become virtually unmeasureable. Equilibrium dialysis of blood is the optimal measurement of free testosterone.

If that test is unavailable, there is another way to arrive at a reasonable assessment of free testosterone: Have blood tests done for total testosterone and for SHBG. Then plug those numbers into the Free and Bioavailable Testosterone Calculator here.

Optimal levels for sexual functioning should be in the upper two tertiles of the "normal" range. That means that the lowest one-third of "normal" should be considered low. This is due to the fact that when labs derive their values for "normal," women with low sexual desire have been included. Sexual researchers have therefore determined that the upper two-thirds of the "normal" range from labs should be the target since those are women with adequate sexual desire.

While not all sex researchers agree, there is a growing contingent that suspects use of hormonal approaches to birth control as a cause of elevated SHBG levels. If you or your mate is having low sexual desire and is on a hormonal birth control (pill, patch, shot or ring), consider going off of this method in order to restore sexual desire.

Related Topics: Halting Oral Contraceptives: Effects Linger, Less Sexual Desire After the Pill?

Technorati Tags: sexuality, women's health, SHBG

Part 6: Relationship Conflicts

This is the sixth in a series of "Ten Reasons Why Women May Lack Sexual Desire."

Many times in my practice I'll encounter a person who will want to resolve conflicts and dissolve unpleasant feelings with a mate by having a sexual connection with that estranged mate. Some women do turn to sex to work out negative feelings that they may have from disagreements with their mate, but many -- if not most -- don't. This tends to be true most often in long term relationships, though it shows up with some frequency in rather new relationships too.

The women who can turn to sex to, in part, bridge the gap of disconnection tend to be women who are able to "objectify" their partners in a fairly healthy way. Even though they may be angry or frustrated with their partner, their personal enjoyment of their partner's body or way of expressing sexuality can be so great that objections are set aside. In other words, a healthy case of lust wins out over hurt or anger.

When the squabbles are small lust has a better chance of succeeding, but when the problems are sizable the chances are nil for most women. In my experience, the primary exception to this is women who have erotic attachment to anger. They like having sex with an angry edge to it. They may even sometimes provoke a conflict in order to have a sexual session to "make up."

When the sexual relationship between two people has taken a serious hit from their relationship conflicts, it's often a good time to see a sex therapist to sort out the issues and see if the sexual aspects (as well as the others) can get back on track.

Related Topics: Want a Happy Marriage? Be Nice, Don't Nitpick, Newlyweds' 5 Biggest Pitfalls

Technorati Tags: marriage, sexuality, relationships

One More Reason Not to Circumcise

I've been in favor of leaving male penises intact for many years.

I wrote an article about it for the San Francisco Examiner in 1993. My emphasis then was on sexual functioning, pleasure and health. It was also on the psychological health of males.

What must it be like to be just days old and be strapped to a board and have part of one's genitals removed? As a woman, I'll never know. (Female genital mutilation is another topic altogether that I will address at another time.)

The topic of male circumcision stirred up much emotion for many reasons. For example, while preparing for a radio show on which I had been a frequent guest, I was told by the producer not to bring up the topic of circumcision because the host did not want to discuss it. Even though it was the host's pattern to discuss the recent articles I had written in my weekly newspaper column, he wanted no part of that discussion. (Luckily, it was a somewhat frequent topic by another host, a physician, on that same station -- so there was some airing of the issue for that station's listeners.)

Over the years, I've urged parents to seriously consider leaving their male newborns intact. I've asked them to resist the weak argument that "we want him to look just like his dad" and leave what isn't "broken" alone.

Then I came across even one more reason to stop a surgical procedure which most of the rest of the world does not practice. Here's the story.

In 2004, the New York City Department of Health received reports of three newborn, male babies who contracted herpes simplex virus (HSV-1). All of them required weeks of hospital care and intravenous injections of powerful antiviral medication. Tragically, one of them died from the infection. Unlike a mere cold sore or bothersome genital blisters, herpes for a newborn is a matter of life and death. The herpes virus can destroy a newborn's brain rapidly.

The New York City Department of Health figured out that all of these babies contracted herpes shortly after undergoing a ritual circumcision by the same mohel, the religious figure in the Jewish faith charged with conducting the longstanding ceremony called a bris.

Under Jewish law, the mohel is required to draw blood from the circumcision site, to remove what the Old Testament refers to as "impurities." The thought, back then, was that a flow of blood away from the circumcision site would carry these potentially dangerous entities away from the baby.

But the traditional way to do this, a practice called Metzizah bi peh, calls for the mohel to use his mouth and suck out the blood.

Make no mistake, this method of viral spread is rare. But, there have been eleven cases of male babies who contracted herpes following circumcisions that included Metzizah bi peh reported over the past five years in New York, Canada, and Israel. In 2005, there were four infected babies in New York City. They were all circumcised by the same New York-based mohel (who only recently was persuaded to stop).

According to New York City's Commissioner of Health, coincidence does not explain this. There is no doubt that the practice of Metzizah bi peh has infected several infants in New York City with the herpes virus, including one child who has died and another who has evidence of brain damage.

Since more than 70% of all adults 40 years of age or older are infected with the herpes simplex virus; the mouth is the most common site of HSV-1 infection; and most adults with oral herpes typically do not have symptoms, but can still spread the infection to others -- one can begin to understand the potential public health problems associated with such a tradition.

Indeed, this is why the Chief Rabbinate in Israel and the New York-based Rabbinical Council of America, began urging all mohels to avoid the potential spread of infection by using a tiny, sterile glass tube to draw the blood instead of putting their mouths directly on the circumcision wound. The overwhelming majority of mohels working today follows this manner of keeping the custom.

Yet the ultra-Orthodox Hasidic Jewish community insists in maintaining this practice. No one can deny that this practice presents a real and serious health risk. And, equally upsetting is that there have been Jewish parents who, while less Orthodox in their religious practices, hired ultra-Orthodox mohels without knowledge that they practiced the potentially risky Metzizah bi peh procedure.

Taking one giant step back from the specifics of this situation, I'll offer my viewpoint in just a few words: "A foreskin is not a birth defect."

Related Topics: Rare Circumcision Ritual Carries Herpes Risk, American Academy of Pediatrics: Circumcision Policy Statement

Technorati Tags: circumcision, HSV-1, metzitzah