MTV Wants a Sex Therapist

Last week a male colleague forwarded me an email that was looking to generate candidates to fill a media position. He thought I fit the description and knew of my experience on camera and on radio. Here are excerpts of what it said:

I'm a casting producer working on an honest and eye-opening new television project about sex and relationships for MTV Networks. MTV is now on a nationwide search for a recognized specialist to moderate a new series that gives parents and children the confidence to talk about relationships, sex and contraception together. The program hopes to create an open dialogue for topics that are never easy to discuss for millions of Americans. This series is designed to foster communication within families by tackling the hardest topic of all with the help of the expert.

In each episode, the expert and one family will work through their issues through group assignments and open, frank discussion. The hope is that the more families talk openly about sex, the more supportive and honest they can be in other areas of their lives. We are specifically looking for a "Dr. Ruth" type.

We're looking to speak with women (in their 50s and up) who are recognized experts in the field of sexuality issues. Candidates can be either practicing therapists, educators, doctors, authors, etc. or retired. We'd like to find women considered to be thought leaders in the field.

We're searching for an expert that is able to facilitate, in a frank, direct, no-nonsense way, discussions about sex, as well as, help design family activities and homework that will promote further conversations.

I immediately replied to my colleague and thanked him for thinking of me, but that I could not throw my hat in the ring right now. As I did this, I commented out loud to my husband in our home office that I'd just received an interesting email. He said, "Forward it to me at my desk."

A few minutes later, he read it and said, "Do you think that you might be interested in that?" I said, "No." He said, "But for the Dr. Ruth part, that's a description of you." (Even when Dr. Ruth is having a "tall day," I've got thirteen inches on her - and no accent.) I said, "Yeah, I know, but I could never be away from the kids that much - and I don't think that we'd like it much either. It's likely to shoot in New York or LA." He said, "Yeah, you're right." And that was that.

Yesterday I happened to read a letter to an editor in a national magazine from a woman who commented that she was surprised that a new host on The View was going to take the job even though that meant that she would be away from her young child to do so. I thought to myself, "I'm with you on that. What is she thinking?"

I realized that not everyone derives the same pleasure and meaning from parenting in a day-to-day manner. I also realized that not everyone derives the same pleasure and meaning from being on TV and somewhat famous. I also realized that I was so clearly in one camp and not the other that I didn't even need to consult my husband before rejecting the idea of a job that separated me from my family. I don't want to be designing "family activities" for any family except my own.

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Technorati Tags: MTV, sex therapy, parenting

How Bicycle Seats Affect Sexuality

Photo: Uli Harder

Everyone knows that exercise is good for sexual well being, but it turns out that some forms of exercise come with a downside when it comes to sex. I would really like to be reporting on scientific research for both women and men in what follows here, but so far, the evidence-based conclusions have only been completed for men. We can extrapolate a bit for women and I do have some practical tips that might prove useful for dedicated female "roadies."

As early as the 1890s, numbness in the genital area was associated with sitting on a bicycle saddle. Scientific findings during the last 20 years have described the problems in the perineum (the area between the anus and the clitoris or penis, commonly called the "crotch") that can occur due to compression by bicycle saddles. Despite the research, in-person and online testimonials exist touting men who do miles and miles of cycling yet maintain their firm erections. Sometimes even physicians perpetuate the idea that all this cycling won't do any harm. The point is, not every cyclist will have erection dysfunction (ED) from cycling, just as not every smoker will get lung cancer. That doesn't mean there's no risk involved in either activity.

The problems that stem from typical bicycle seats are two-fold for men. There is adequate research that blood flow to the penis is blocked by the pressure of the body weight on the perineum when cycling. Look at "Bicycle Riding and Erectile Dysfunction: An Increase in Interest (and Concern)" in the Journal of Sexual Medicine 2005; 2:596-604 by Vincent Huang, Ricardo Munarriz and Irwin Goldstein. In addition, numbness due to entrapment (pressure that surrounds) of the pudendal nerve is being reported.

So, what's a cyclist to do? Well, the researchers have been busy designing seats that decrease the pressure and decrease the likelihood of cycling-related ED. What they have begun to develop are ergonomically designed saddles that account for urogenital physiologic principles -- in other words, "crotch friendly."

Some early designs were offered. The most notable one had a circular cutout into which the penis fit and which provided some perceived relief to the male cyclist. It turns out, however, that the pressure on the perineum is inversely related to the surface area covered. This means that if there's less of a seat holding up the entire "butt area" there's more pressure to be distributed to the parts that actually have contact with the bike saddle. That means more pressure where you don't want it and the possibility of more ED.

It also turns out that some researchers in Venice, Italy (see "Development of a New Geometric Bicycle Saddle for the Maintenance of Genital-Perineal Vascular Perfusion" by G. Breda, N. Piazza, V. Bernardi, E. Lunardon, and A. Caruso in the Journal of Sexual Medicine 2005; 2: 605-611) have tested a seat that distributes the weight over the buttocks area while including a center open section that does not compress the perineum. In addition, it has a "nose" that tips down (like the beak of an eagle) rather than sticking out even with the main plane of the saddle. This reduces the pressure on the penis and scrotum. The coccyx (tail bone) does not touch the seat either so makes going over rough terrain better and less stressful to that area. The only name I have for this bicycle saddle is the SMP given to it by the Italian researchers.

Perineal pressure on female genitals might very well affect blood supply and nerves. It's reasonable to wonder if it could affect sexual response for women as well. Measurements of erections are often easier to get than measurements of lubrication (the comparable sexual experience of females). So, it may take some time for researchers to develop appropriate devices that allow this to occur for a female cyclist.

Meanwhile, women can help maintain genital health by lubricating the genital folds before cycling. Some suggest Aquaphor, Balmex, Astroglide, or Probe. This helps the labia glide with leg movements and helps prevent irritation, bleeding or chafing from long distance biking. Women with long labia should arrange them after putting on lubricant and make sure to wear bike shorts with padding. Padded underwear can be worn under bike shorts for really long or frequent rides.

So, don't forgo your exercise if cycling is your thing. Just be sure to get up off that seat during spinning classes if it's a narrow seat with a nose. Take this article to your health club and ask them to evaluate their current seats. Look for seats that either have a sloping down ("eagle's beak") nose or no nose at all. If you can't find the SMP seat, get one that distributes the body weight over a greater area and offers pliability.

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Technorati Tags: ED, erectile dysfunction, cycling, bycycle seats, sexual health

End of Year Reflections: Part 3 -- Hospice Options

The kids were up at 7:30 and the presents were all opened by 8:15! Their playing began and I slipped out to see my mom. We ate lunch together and she opened the presents that I had wondered if she would even get to see. She was happy to be back home among her things and somewhat familiar faces. (I have often said that the one good thing about Alzheimer's is that you're always meeting new people!)

One of the staff, knowing what I do for work, stopped in and said, "May I ask you a question?" I said, "Anyone who works on Christmas Day helping take care of my mother can definitely ask me a question." We then discussed why she was unable to have an orgasm with her new husband and how she could keep up with his level of desire for sex.

Our extended family spent time together again. The kids played with their new Wii, we ate, then we all played Charades, and we eventually called it a night.

The next day, a case manager nurse from the hospital called and said that she had reviewed my mother's discharge. She had brought her case to the medical director's attention and they both felt that my mom should qualify for hospice. So, was this good news or bad news? I wasn't sure how to hold this in my mind.

I said, "We were already turned down for hospice. Why are we being considered again?" Well, it turned out that there are "for profit" hospice organizations and "not for profit" hospice organizations. The first one had been "for profit" and apparently did not want to risk betting that my mother would be dead in six months. Since this was my first contact with a hospice type circumstance, I had no idea that there were different types of organizations within the industry. Now I know.

As it turns out, it's probably a pretty good thing that I have begun my hospice education (which, by the way, seems like a wonderful service for those "in need"). My mother-in-law entered the hospital last night with new problems. Her cancer apparently has metastasized. All the out-of-town siblings are on jets or are already home. That means my husband and I are now on double duty as medical advocates for our moms. What does that mean for sex? That means -- not much.

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Technorati Tags: family, aging, Alzheimers, hospice

End of Year Reflections: Part Two -- Where's The Midwest?

By Christmas Eve Day, my mother took a very unexpected turn for the better. Still with her 25% cardiac ejection fraction, the hospitalist physician discharged her from the hospital. So, I took her back to her Assisted Living Unit, got her all settled in, and relied heavily on the great staff there to shepherd her through the evening. Ordinarily, she would have been a part of all the events that followed. But, she was really tired and ready to sleep.

Back at home, my in-laws joined our family for our traditional dinner. By then, I had learned the true meaning of multi-tasking and had really lucked out by working ahead the night before. After dinner, we flipped on the computer to track "Santa's path" by satellite. When we first checked, he was in eastern Canada.

My five-year old then took his bath and, before putting on his jammies, peeked at Santa's location on the computer. The adults had retired to the family room when my son came running into the room stark naked shouting, "He's in the United States! He's in the United States! Santa's in the United States in the Midwest!! Who lives in the Midwest??! Do we know anyone in the Midwest? Does anyone live in the Midwest??!" With that, he fell down on the floor in paroxysms of joy. Then someone said, "That means he's close! You better get into your jammies right away and get into bed before he gets here." And, in the wink of an instant, he was dressed and in the bed.

Our side ached from laughing -- and we now had a story that our family lore will never let die.

I checked on my mom and she was sleeping. I wrapped Santa's presents that had been hidden. Ate the cookies, ate the milk and the carrots -- and staggered to bed.

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Technorati Tags: family, tradition, holiday, health