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Sexual Health: Sex Matters

Louanne Cole Weston, PhD, shares information and advice on men's and women's sexual health issues from masturbation to erectile dysfunction.

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Monday, February 25, 2008

Vaginismus Treatments Done Differently
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I'm in San Diego attending a conference of the International Society for the Study of Women's Sexual Health. We start early and finish late. I'm exhausted, but my brain is satisfyingly full.

This year 25 countries have sent researchers and therapists to present lectures about a vast array of issues that pertain to female sexual well being. I am amazed at the dedication of the presenters and thrilled about the progress that this field is making. There are about three hundred people attending and about 50% are medical health providers (medical doctors, nurse practitioners, physical therapists), 20% solely scientific researchers and the remaining 30% are primarily mental health providers. I don't present - just listen. I prefer to translate the research into information that the average person could possibly use. Not all researchers present the fruits of their work in easily understandable terms, so that's what I do.

I've treated clients in my office for vaginismus (painful vaginal spasms) for many years. The work with these clients is often slow paced. I measure progress in my mind with some equivalent of emotions measured in microns. And, I am OK with this.

The treatment works if the woman sticks with it. If she does her work at home by writing her thoughts in some journal form and uses her insertors regularly, she can take the steps that mature her sexuality. And, I usually strongly suggest that she learn to eroticize what can be a very clinical "getting to know you" session with her genitals. It often takes six to nine months to accomplish full insertion with an insertor that resembles her partner's erect penis size.

So, when Moniek M. ter Kuile of The Netherlands presented her research, I was very interested. At the Outpatient Clinic for Psychosomatic Gynecology and Sexology at Leiden University Medical Center she was permitted to treat vaginismus clients in a uniquely effective and time-sparing manner.

It turns out that 60 women with lifelong vaginismus participated with their sexual partner in a therapist-aided treatment of their condition. Nearly all of the women were able to use insertors that began with very small sizes and gradually increased to the size of their partner's penis. The treatment consisted of up to three two-hour sessions in one week's time in which the woman controlled the insertion of these learning devices into her own vagina while her partner held a mirror for her to see her own genitals. The therapist verbally assisted with guidance and helped the woman to follow through with what she came there to do.

I was very struck with the contrast!

As a licensed marriage and family therapist in California, ethically I am not supposed to touch my clients (other than the occasional handshake or to receive a "thank you" hug). As it is, people with little information about what I do as a sex therapist confuse the nature of my job with sexual surrogate therapists. All I do is talk, draw diagrams and use pictures to explain sexual and relationship information.

So, I sat there wondering if the medical setting of this study somehow legitimized this approach for the women. I wondered if this worked and was accepted just because The Netherlands is a more liberal country. And I wondered if there was a way that I could incorporate this into my practice.

The therapist did not touch the clients. She was just present in the room, keeping the couple on course and offering support. People often comment that I seem fairly placid, calm and easy to be around. Perhaps there is a gynecologist who would join in on this type of treatment. I'll be giving that one some thought. If women could accomplish this in a week's time rather than the better part of a year -- wouldn't that be great?

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Posted by: Louanne Cole Weston PhD at 3:32 PM

Tuesday, February 12, 2008

Valentine's Day: Love on Demand
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For as long as I've been writing for readers (other than my college professors), I've been asked to write something about Valentine's Day when the holiday approaches. So, readers of The San Francisco Examiner, onhealth.com, WebMDmagazine and WebMD.com have been subjected to my somewhat contrarian views about the holiday for about fifteen years. Here we go again.

Today I found that I'm not alone when I read Nancy Gibbs' essay, "A Time to Forget," in Time magazine (the 2/18/2008 issue). As she puts it, true romance comes unscheduled, ripens over time, and includes private jokes, sudden kisses and flowers for no particular reason. She wraps it all up with the apt Shakespeare quote: "Love sought is good, but given unsought is better."

So true. I can recall a number of clients for whom Valentine's Day has been a real white- knuckle time. Somehow the burden of orchestrating Valentine's Day has fallen primarily upon men. In heterosexual couples, the men sweat whether they will be viewed as having done enough. Or, maybe they are reminded of it on the radio or get a text message from their significant other "hinting" about it and realize that they've forgotten. They then buy some flowers from those folks on the street corners as they drive home that day. Or, perhaps they forget altogether.

Women are often in two categories: 1) Having high hopes of getting exactly the expression of love they wanted (or something even better and beyond that!) or 2) Wondering if their mate will do anything at all. In same-sex couples, the assigned Valentine's roles get quite blurry and each person in the relationship is free to choose among any of these very uncomfortable positions.

I've found that unhitched couples often do much more when it comes to celebrating Valentine's Day. It's a bit like an audition -- "See how romantic and creative I can be? Now can I actually get the part??" My own dating life had aspects of that.

Once one does "get the part," Valentine's Day can morph in several directions. There's the "newlywed" (legal or via commitment ceremonies for same-sex couples) phase. Special efforts are made to confirm that we're not an old, tired couple. Later, for couples who choose this route, there's the "we've-had-kids" phase when a romantic dinner out requires a sitter and throws off the typical school night routine (unless it happens to fall on a weekend).

Then a strange thing occurs -- children are brought in on the holiday. Kids are writing out a Valentine card to each kid in class and sending them to their parents. For my five-year old, it became an exercise in writing out the names of nineteen kids and signing his name that many times (quite a task!). I had purchased Spiderman cards and he was quite happy with my selection. But, buying his eight-year old brother Spiderman cards was a huge mistake. "Mom, Spiderman is so kindergarten. You should've gotten Harry Potter or Yu-Gi-Oh." Will someone remind me what all this has to do with romance or sexy lingerie? Or love?

Valentine's Day isn't the first holiday to be unnecessarily expanded through clever marketing and never-ending attempts to surprise the public -- even with the absurd (potatoes carved in the shape of a heart available online?). No doubt, there will be electronic Valentine's cards and text abbreviations of "bvf" ("best Valentine forever") soaring through the cables on Thursday.

Valentine's Day has become an event filled with pressure to love on demand -- and that's the very antithesis of romance or good sex. More important than cards, candy and flowers will be hearing, "I love you" on February 15th.

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Posted by: Louanne Cole Weston, PhD at 12:55 PM

Monday, February 04, 2008

The "Tongue Dinger" - A Humdinger!
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A client recently told me about (and showed me) a new sex toy called the Tongue Dinger Night Stroker, a glow-in-the-dark vibrating tongue ring. According to the package, it offered 40 minutes of "powerful vibrating pleasure." And then, when the battery dies, the proud owner can throw it away. Talk about a "consumable!" As I listened to her story, I thought, "Disposable razor blades have nothing over this gadget!"

The "ring" part of this toy is made from some stretchy, rubbery "jelly" type of material and when at rest (unstretched) looks like an overgrown mood ring. The vibration is rather strong for its "Mexican Jumping Bean" size. (Yep, my client hadn't used all of her 40 minutes.)

But, she reported one problem with it. The saliva on her partner's tongue kept causing the ring part to slip off of his tongue. They had tried in vain to "dry" his tongue off, but that didn't work. So, he'd push it on as deep as he could manage, lick away, and then after a minute or two stop when the ring had slipped to the tip of his tongue. She said that she'd just get going with being aroused and then it would be time to stop and reposition that "darned Tongue Dinger."

The vibrations were great, but the interruptions to her pleasure finally got her so rattled that she took the Tongue Dinger from her partner, grasped it between her fingers, and pressed it right where she wanted it while he held her and did other arousing things. At last, all was well for her...

From the packaging, it looked like the developers had had a good time creating this product. There were cute phrases like "Tongue Tired? Let the Tongue Dinger Take Over!" and "Glow Where No Tongue Has Glowed Before!"

But, there was that pesky issue addressed in the fine print: "This product is small enough to be swallowed. Use with extreme caution!" I can only imagine this little hummer accidentally going down the throat of the "wearer." Choking aside (which is a big aside), at least the Tongue Dinger wouldn't be vibrating all the way through the GI tract. If it didn't have that 40-minute time limit, I can only imagine that a bowel movement which brought this device to the outside world again would definitely be a "humdinger!"

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Posted by: Louanne Cole Weston, PhD at 2:13 PM

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