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counselling

How Our Sexual Needs Vary

As humans, we have many different needs. We have the survival instinct to stay nourished, we have the social and emotional capacity to forge relationships, we have an urge toward maintaining healthy hygiene, and, we have the compulsion to keep the species alive and thereby reproduce. Disbarring all of the above, we also have the drive to meet our sexual needs. But, try as we might to provide an umbrella definition to what those needs are, the truth always settles somewhere around each individual has their own set of needs. What I’m trying to say is that we all have different needs which are never static and do evolve over time.

What are sexual needs?

What arouses and dampens sexual desire can come from outside factors as much as it can from within. We are all made biologically different (even though we all kind of have the same parts more or less), and so what attracts one might turn another off and vice versa. Learning to tune into your own body and the sensations you feel, will allow you to better understand what stimulates you. Once you can identify what makes you feel good (and not so good), then you can start to construct your own little body map, let’s call it, of what your needs are, where you like to be touched, the frequency of your needs, the duration that feels right, and so on.

Feeding the need

Your needs fluctuate and change over time. Depending on your age, you might feel more feisty more often or you might feel slightly less interested anywhere from sometimes to never. The frequency of your desire might also be dependent on whether or not you are in a relationship, and of course, the state of that relationship. Men and women (and their respective hormones) also play a role in how our libidos ebb and flow. The key takeaway about knowing your needs is taking a minute to reflect on whether your desires and your wantingness to meet them are aligned.

Communication is key

We have a profoundly sexualized culture. What that means is that sex is all around us, it’s in how we dress, it’s on TV and social media, it’s in our language, it’s everywhere. It’s hard to ignore. But, that doesn’t have to be a bad thing. What this paves the way for is a more open society, people who are more readily interested in discussing topics that were once considered private or taboo. Being able to talk about your needs and desires with your partner has become a lot more common, comfortable, and almost expected. So get to it!

What else?

When it comes to matters of sex, it’s important to explore what you like and what you dislike. It’s also important to learn what works for you, in both the appeal department as well as the anatomical realm. If you have the desire to engage in sexual intimacy with your partner, but your physiology is stopping you from meeting those needs, don’t fret… we are a phone call away. With treatments for erectile dysfunction and premature ejaculation to vaginal dryness and laxity, Elna Sexual Wellness has got your covered. Any questions?

Lori.

Testosterone Replacement Therapy

Many of you are unfamiliar with the truth behind low testosterone. You’ve seen commercials with a senior-age couple walking along the beach with a voiceover basically hinting at how they could be happier, if only the man would take testosterone replacement therapy to help him maintain his erection. But, that is not the whole story. In fact, that is not even half the story. Testosterone is a hormone responsible for much more than sexual function in males.

The lowdown on low testosterone

Aging is a primary cause for low testosterone. Although men see a steady decline by 1% a year beginning in their 30s, testosterone levels can also decrease due to factors such as:

  • Chemotherapy or radiation treatment
  • High cholesterol or high blood pressure
  • Injury or infection to the testicles
  • Chronic illness, such as diabetes or HIV
  • Alcohol/Opioid abuse
  • Obesity

What does testosterone do?

Low testosterone, or male hypogonadism, is a condition in which the body doesn’t produce enough testosterone. Testosterone is a key hormone in masculine development and helps to maintain ongoing male health. In terms of sexual function, the hormone contributes to arousal, erection, and ejaculation. Should low levels of testosterone occur, erectile dysfunction may begin.

What else?

Another major role that testosterone plays in the body is its contribution to red blood cell production (think iron deficiency), muscle mass, and bone strength (think osteoporosis). The hormone affects mood, clarity of thought and concentration. In adult males, hypogonadism may alter certain physical characteristics and impair normal reproductive function. Low testosterone may also cause mental and emotional changes.

What about testosterone replacement therapy?

Testosterone replacement therapy (TRT) is a hormone replacement therapy prescribed to counter the effects of male hypogonadism or low testosterone reproduction. Helping regain sexual function and support overall health, mood, mental function, and energy levels, TRT is a great option prescribed by your doctor to boost testosterone levels.

Taken through direct injection (subcutaneous) or absorbed through the skin (transdermal or topical), TRT has a plethora of benefits. Some include:

  • Increase libido
  • Increase in fat-free mass
  • Improve focus, memory and cognitive skills
  • Prevention of osteoporosis
  • Decline in symptoms of fatigue and depression

It’s important to talk to your doctor if you feel anything shift in your body. Sometimes it’s hard to figure out exactly what’s going on, but you know your body, and you know when something just just doesn’t feel right anymore. That’s when it’s time to check in with your doctor or a sexual wellness specialist about your testosterone levels so you can restore your sexual function, and much more.

Dr. Steinberg

Treatments for Erectile Dysfunction

Before beginning a course of treatment for erectile dysfunction, you’ll first need the condition to be diagnosed. Erectile Dysfunction is when a man is unable to achieve or sustain an erection firm enough for sex. It’s also not a one-off situation. ED is characterized by the inability to achieve or sustain an erection more than half the time. It’s important to understand that ED is more common than you think – it happens to approximately 50% of men between the ages of 40 to 70 years old. Don’t be stressed over it, if anything, that will only add anxiety to the performance and things could get worse from there.

So, you’ve seen your urologist and it’s been established, you have ED. What next?

Oral medications like Cialis or Viagra may be prescribed. They are the most common treatment insofar as PDEs inhibitors are concerned. They increase blood flow to the penis so that an erection may be achieved (and of course, sustained as desired).

There are also injectable medicines that are readily available. Injectable medications stimulate blood flow so as to achieve and sustain an erection as desired.

PRP Therapy is another avenue that may be recommended. Platelet-Rich Plasma Therapy (also known as the P-Shot) takes the patient’s blood, separates the platelet-poor from the platelet-rich plasma, and then re-injects it into the afflicted area. The experimental PRP therapies revitalize muscles and tissues as well as improve circulatory function.

Erectile Dysfunction Shock Wave Therapy is the application of low-intensity shockwaves sent to reopen the veins and re-establish proper blood flow to the penis.

If your doctor determines that the ED is stemming from something more psychological than physiological, then sexual therapy (counselling) will be recommended. Depression, stress, anxiety (even performance anxiety), and relationship issues can all play a role in ED.

If sex in your relationship is important to, why throw in the towel and succumb to your ED? You don’t have to forever miss the intimacy? Erectile Dysfunction is a treatable condition and most men are able to return to healthy sexual function once they’ve been prescribed a proper course of treatment. So, keep your head up, visit your urologist and set a plan in motion so you can get back in the game!

Dr. Steinberg

Erectile Dysfunction from a Woman’s Point of View

For most couples, sexual intimacy can be a vital part of a romantic relationship. So what happens when a man is starting to experience a breakdown on the erection front? Dealing with the plethora of issues that he might be experiencing—from physical to emotional—your man might seek medical attention to help him with the wide range of issues he might be dealing with so that he may restore proper function. But, what about the woman? How does erectile dysfunction affect her?

The distress of not being able to stay in control compounded by the embarrassment he might feel in not being able to perform will definitely take a toll your relationship no matter which way you slice it. The physical and emotional intimacy that sex provides is not to be taken for granted, so if your man is struggling with his erection, lend a hand (metaphorically speaking) and get that conversation going.

What is erectile dysfunction?

Erectile dysfunction is basically the inability to become erect or sustain an erection long enough for sex. This health concern affects the woman involved as her sex life is being shifted off course, and while the dysfunction is happening in someone else’s body, the symptoms are trickling into her life as well.

How can you help your man?

As the woman on the other end of erectile dysfunction, it is important to get your man to talk about it. Having an open discussion about your sex life will establish trust and open the lines of communication. A lot of the time, the man won’t want to broach the topic on his own, so you might have to take the initiative and get that conversation going. If you find you’ve tried, but to no avail, or you don’t feel comfortable bringing it up unmediated, then try seeking the counsel of a sex therapist. A sex therapist will try to hone in on the source of the issue and find active ways, as well as potential treatments, that are fitting for the case at hand.

It’s not just physical

Most of the time, when it comes to erectile dysfunction, there is a combination of both physical and emotional issues blocking the natural flow of things. In most instances, physical and psychological issues work in tandem, because even if the issue is solely physical, it isn’t long before the man starts to anticipate his inability to perform, and then like a self-fulfilling prophecy, the erection is impossible to achieve or maintain. The connection between the mind and body is certainly there, and when it comes to sexual malfunction, a holistic approach is the most effective way to treat the problem.

Perhaps your man would be more likely to meet with a doctor to learn about all of the available treatments out there. If he hasn’t sought medical advice on his own, then take your sex life into your own hands and book that appointment for the two of you. The support of a partner can see positive effects that will trickle into the relationship. Knowing he can lean on you for help, trust you to help him take action, and feel like you are in this together, are all simple advantages to taking your partner’s health concerns seriously and helping him get the medical attention he most likely needs.

Dr. Steinberg

The Pleasure in Sex

For centuries upon centuries, and even to make it a little less abstract, up until less than 30 years ago, sex education in North America was funnelled down to a talk about reproduction, and safety. By and large, the conversation went something like “these are your body parts, this is how to avoid unwanted pregnancy, and this is so and so STD.” Conversation over. That about brings us up to date on sex talks in schools, in the homes, and in conversation amongst friends. But, one very important aspect of sex talk has been left out and it is finally taking its place centre stage: Pleasure.

How can you and your partner have a better sexual experience?

According to Peggy Orenstein, author of many works discussing the discrepancy between a man and woman’s sexuality, being able to articulate your needs to your partner is one of the fundamental ways to have enjoyable sexual experiences. Pleasure-seeking sex is something that has long been shamed or stigmatized, especially for women whose sexual openness would be labelled as something other than normal. But attitudes are changing and with that, so is the conversation.

Speaking up and letting your partner know what you like and need is becoming more and more common in practice and here is one reason why: learning more about your body and all of its parts allows you to better articulate what feels good and where. Another reason is that people are becoming more candid in their conversations and focusing more on mutual trust, connection, and affection, rather than the prior framework of risks and dangers. Of course there is the fundamental mutual responsibility to practice safe sex, and that is still something that should be largely discussed, but once that conversation has been exhausted, there should be one chapter (if not a few) on sexual intimacy, pleasure, desire, arousal, and enjoyment.

“How do you measure your pleasure?” is one thought-provoking question to get the conversation going. What is good sex? What is bad sex? How do you know that you enjoyed (or are enjoying) a sexual experience? In her TED Talks, Orenstein touches on a slew of questions that seem so basic, but are in fact so far removed from the conversation. It’s important, as a sexually active person, to take the time to think about what you enjoy and what the parameters are that make sex fun and pleasurable for you. Communicating that with your partner is the next step to make sure that you can explore your new findings.

Being able to have an intimate talk with your partner about what you like and what you dislike can help your relationship grow and will hopefully create a space for you to enjoy your relationship even more. Sarah McLelland, psychologist, researcher and professor, explains that there is such a thing called “intimate justice” and it’s about who is entitled to engage in enjoyable sex… the short answer? You are.

Want to learn more about sexual wellness or just need someone to talk to about your sexual health? We are a phone call (or email) away and we are always ready to talk.

 

Dr. Steinberg

Adult Circumcision

You’ve lived this long, you’ve come this far, why now? Why get circumcised as an adult?

Some men come into our clinic to discuss circumcision based on the religious or cultural beliefs. Others prefer the cosmetic appeal of a circumcised penis. While both of these are great reasons to go through with the simple procedure, many men ask (in fact, it’s a widely held debate) if there are any health benefits to a circumcision. The long and the short of it is, yes. Simply put, one of the most common reasons for an adult circumcision is Phimosis, a condition in which the foreskin is so tight that if left untreated, it can cause hygiene problems, pain during urination, and can contribute to painful erections. Also, by removing the foreskin that covers the head of the penis, a man’s potential for contracting potential infections or diseases are significantly reduced.

Ultimately, the choice is deeply personal. However, if you are interested in understanding what the potential benefits are to a little snip, here are 5 health-related benefits to circumcision:

 

 

  1. Foreskin can trap bacteria and other infectious agents. By removing the foreskin, your overall genital hygiene will be improved, thus reducing the risk of balanitis (an inflammation of the glans penis) and other infections.
  2. Statistically, uncircumcised men have a higher incidence of prostate cancer.
  3. Studies have shown a significant reduction in the risk of invasive penile cancer.
  4. Adult or infant, circumcision reduces the risk of urinary tract and bladder infections.
  5. The human papillomavirus (HPV) can adhere to foreskin. Although men are usually only carriers, and therefore can transmit HPV to their female partners, it’s important to note that circumcision reduces the risk of cervical cancer in a female partner by 5.6 times. That’s kind of major.

There are a few other major benefits, such as reduced risk of phimosis, and reduced risk of HIV/AIDS (the HIV virus enters through the inner lining of the foreskin which is thin and vulnerable).

At Elna Sexual Wellness we employ both the standard technique as well as the Pollock Technique according to each unique situation. The Pollock Technique takes under 10 minutes and requires only a local anesthetic along with some skin glue (instead of sutures, which significantly improves cosmetic outcomes). We are diligent about follow-ups to ensure that all is healing properly, and are committed to making our patients feel safe and at ease about the procedure.

With only 2-3 days of downtime and about 6 weeks of healing time before engaging in sexual activity, it’ll almost look and feel like nothing ever happened!

If you are curious about circumcision, call or email for an info session. Our experts will answers any of your questions and provide you with the answers you need to make an informed decision.

Dr. Steinberg

Where’s your Mojo

There is no magical equation on how to derive at what is too high a sex drive and what is too low a sex drive. When it comes to understanding your sexual desire, it’s all about the subjective experience. Knowing what feels “normal” for you and feeling out your own personal fluctuations. If you’re in a relationship, you might use your partner’s libido as a barometer to measure the highs and lows you feel, or you might be in touch with your peaks synching up with certain times of the month, for example. Either way, it’s important to keep in mind that both women and men can experience fluctuations in sexual desire; some of that can be attributed to biological factors like hormone shifts, while some of those rises and falls can coincide with emotional or psychological changes in your life.

Let’s think about what a libido is and where it is located.

Historically speaking, the libido used to be exclusively associated with the sex drive. While this is partially true in today’s world, there are now many other factors that come into play when trying to locate the libido. In terms of psychoanalysis, Sigmund Freud defined the libido as the energy created by the survival and sexual instincts. Not located in one particular area (although it is most likely located in the brain, as Freud believed it was part of the unconscious), the libido is the driving force of all sexual behavior. The libido is the source of our wants and urges, as well as the epicentre of all pleasure-seeking impulses.

Departing from our psychoanalytic father, the libido has taken on new meaning as more well-rounded research has been done in the past century. We now understand the sex drive to have more than just conscious and unconscious motivations and desires. One’s interest in sex is a combination of factors from, as mentioned earlier, biological, psychological, physiological, emotional, and social. Not to mention that other factors can play a role: illness, medication, say nutrition, and other lifestyle habits. Everything affects everything and back around again.

 

Symptoms of low sex drive aren’t as straightforward as you may think. No interest in any type of sexual activity is one major symptom, however it is not the only symptom as a low libido extends to sexual fantasies and thoughts as well. Having too high a sex drive can also be an issue for some, especially if it is getting in the way of your work, ability to focus, or daily activity, or, if you are in a relationship and your partner’s sex drive does not match your own.

Think about your libido. Have questions? Want to talk it out? Call or email Elna Sexual Wellness and let’s get the conversation going.

Dr. Steinberg

What is Sex Therapy Anyway?

Sex therapy has been around for decades, helping women, men, and couples learn how to navigate the huge topic of sex and sexual wellness. I’ve come to understand that most people have limited knowledge about sex therapy and most of what they’ve gathered comes from movies or social media. Unlike the quasi-sex therapist from Meet the Fockers (think Barbara Streisand), sex therapy is not about touching, nudity, and tips and tricks to spice up your sex life. Sex therapy is a legitimate form of psychotherapy whereby the patient(s) seek the help of a health professional to overcome sexual problems or improve sexual feelings and resolve any intimacy issues they may have.

There are a number of reasons why one would seek the counselling of a sex therapist, and in my field, more often than not, I recommend counselling (specifically with a sex therapist) to my patients – here’s why:

As humans, we have multiple systems working in tandem at all times. To treat one aspect or one (dys)function in an isolated manner would be to disregard the human as a whole person. Sounds simple, but the interdisciplinary approach to medicine is a wave that hasn’t fully caught on worldwide, although, it is my belief that the wave is coming and it will be tidal.

We are holistic beings and I treat my patients as such. That means that if a man should come in suffering from erectile dysfunction, I might treat with Shockwave Therapy, Testosterone Replacement Therapy or the experimental P-Shot, but I will almost certainly recommend counselling as well. Whether the premature ejaculation stems from a physical issue or has a psychological origin, physical inevitably seeps into the psychological and the other way around. It’s the basic nature of a mind / body connection; it’s how each pone of us functions on a very fundamental level.

Sex therapy is a great treatment option for those suffering from a plethora of sex concerns, such as:

  • Concerns about sexual desire
  • Erectile dysfunction
  • Ejaculating early (premature ejaculation)
  • Difficulty with sexual arousal
  • Body image
  • Anxiety
  • Menopause
  • Trouble reaching orgasm (anorgasmia)
  • Painful intercourse (dyspareunia)
  • Intimacy issues related to a disability or chronic condition
  • Conflicts with partners about sexual needs, desires, frequency or specific sexual activities

Not limited to the list above, sex therapy is also a forum for people to talk openly and confidentially about any concerns or questions they may have about sex, their sexual lifestyle, and overall sexual wellbeing. You might not have an identifiable physical issue, but might still be interested in sex therapy, because here’s another thing – sex is a part of our lives and it is important that we understand what it means to us and why. There is a strong interaction between thoughts, feelings, social/cultural factors, behaviours, and biological components. By unpacking each one of these five points, a sex therapist will help you identify your values, your beliefs, and your ideas of what sex is as opposed to what you might have previously though sex should be. That is the first step toward a healthier sexual wellness.

There are many benefits to sex therapy. A few notable goals include:

  • Achieving a healthy sexual life
  • Reducing anxiety associated with sexual activity
  • Learning new skills and healthier ways of approaching sex
  • Feeling in control of one’s sexuality and regaining confidence
  • Learning concrete strategies for managing uncomfortable thoughts, emotions, and harmful behaviours that are impacting sex
  • Minimizing pain during intercourse

By understanding and dismantling old attitudes and habits that get in the way of enjoyable sex, sex therapy will help you establish new beliefs that reflect your values so that you can increase sexual arousal, feel less anxious and more comfortable about sex, and ultimately help lead a better, healthier, sexual life. If you aren’t sure sex therapy is for you, call or email to learn more. Put it to you this way, the first step is easy, all you have to do is start talking.

Dr. Steinberg