All About Sex

Extended Cycling: A Ride to Erection Problems?

Michael Castleman — Sat, 14 Nov 2009 23:30:17 +0000

Exercise is good for sex. Regular exercisers report fewer sex problems and more erotic enjoyment. But extended cycling--more than three hours a week on a standard bike seat--can cause erection impairment (and presumably loss of genital sensation in women). Fortunately, cyclists can still enjoy riding without sex problems--if they watch how they sit on their bikes.

As early as the fourth century B.C., Hippocrates speculated that long-duration horseback riding might harm erections. His observation was largely forgotten--until case reports popped up of erection problems in healthy young men who had no risk factors--except a devotion to bicycling.

Subsequent studies suggested an unusually high risk of erection problems in devoted cyclists. Danish researchers surveyed 800 bicycle racers. More than 300 (38 percent) reported difficulty raising erections for a few days after races.

Researchers involved in the Massachusetts Male Aging Study investigated bicycling and erection dysfunction among the study's 1,709 participants. As time spent cycling increased, so did erection problems.

When you sit, you bear your weight on the bones of you buttocks (the ischial tuberosities or "sit bones"). But many bicycle saddles are too narrow to support the sit bones. As a result, cyclists on banana-shaped seats bear their weight on the soft tissue between the scrotum and anus (perineum), which compresses the nerves and arteries that supply blood to the penis. Nerve compression may produce numbness of the penis. Arterial compression may limit blood flow into the organ, compromising erection. Recent studies show that banana bike saddles reduce blood and oxygen flow to the penis by about 70 percent within a few minutes.

Worse, over time, compression of the arteries that run through the perineum can actually injure them, causing the development of deposits (plaques) that narrow them, limiting blood flow. Elite bicyclists have few plaques in their other arteries, but often have significant plaque formation in the arteries that run through the perineum.

The first sign of trouble is numbness or tingling after riding. These sensations indicate that blood flow and nerve conduction to the penis have been compromised.

In the Massachusetts study, cycling fewer than three hours a week had no effect on erections. In fact, occasional or short-duration riding significantly reduced risk of sex problems. However, bicycling more than three hours a week raised risk 72 percent above what would be expected for the cyclist's age.

"There are only two kinds of long-distance male cyclists," says Boston urologist Irwin Goldstein, who has researched the link between cycling and sex problems, "those who have erection problems, and those who will have them."

Since this problem came to light, the cycling industry has changed seat design. But new seats are effective only if they take weight off the perineum. Cyclists must sit on their sit bones.

In addition, tilt your seat down and your handlebars up. That way you sit in an upright position instead of leaning forward, which compresses the perineal nerves and arteries. It also helps to ride standing from time to time.

So far, all the research on this issue has focused on men. However, the female perineum contains the same arteries and nerves, and narrow bike saddles can be presumed to have the same effects: numbness, reduced blood flow and nerve conduction to the clitoris, and problems with sexual function.

Has anyone experienced cycling-related sex problems? And relief from using a wide seat?

Men’s Breast Obsession—And Women’s

Michael Castleman — Mon, 02 Nov 2009 19:17:24 +0000

In our culture, men are assumed to be obsessed with women's breasts. Men's obsession is reflected in the huge vocabulary men use when discussing them: tits, boobs, jugs, hooters, melons, globes, knobs, headlights, mammaries, ta-ta's, chest toys, fun bags, the girls, etc. In addition, ask any waitress: Low-cut tops with visible cleavage means better tips. Many women complain that in conversations with men, the guys look at their breasts, not at their faces. And then there's the old joke about a group of women who apply for a job. Some are highly qualified, others, less qualified. Who gets hired? The one with the biggest breasts.

To feel attracted to a woman, some men need a certain breast size--large, medium, or small (just as some women need a certain height or body type in men). But most men like any breasts, especially those attached to the women they're involved with. That's what researchers at UCLA and Cal State Los Angeles found in a survey of 52,227 heterosexual adults, ages 18 to 65, who responded to an online survey. A majority of the men (56 percent) said they were "satisfied with their partners' breasts."

But among the women, only 30 percent felt satisfied with their own. The researchers observed: "Younger and thinner women worried that their breasts were too small. Older and heavier women were concerned about droopiness."

So 70 percent of women--almost three-quarters--say they're dissatisfied with their breasts. Many of them don't just fret. They take action. Countless millions of women wear padded bras, and choose fashions that focus attention on or away from their breasts, depending on the occasion and how they feel about their chests.

In addition, breast surgery is the number one cosmetic procedure in the U.S. The American Society of Plastic Surgery estimates that every year American women undergo some 300,000 breast augmentations and 100,000 breast reductions. Women who get augmented typically want a one- or two-cup-size increase, most typically from A or B to C. Women who want reductions typically go one or two cup sizes down.

Men's breast obsession is clearly sexual. Women's breasts are among men's favorite sex toys. But it's hard to know exactly where women's breast obsession comes from. Men certainly play a role. According to the study, if 56 percent of men feel satisfied with their partners' breasts, then 44 per cent of men--a large proportion--feel unsatisfied. Many women who get augmented say their husbands or boyfriends encouraged or pressured them into it.

Fashion also plays a role in women's breast obsession. From Jane Mansfield's torpedoes in the 1950s to the small, adolescent chests of today's top models, breast fashions evolve. But fashion is not destiny. While today's designers generally favor a petite chest, augmentation is three times as popular as reduction.

Finally, mental health appears to play a role in women's breast obsession. Women who are sufficiently dissatisfied to have breast surgery also tend to feel dissatisfied with other aspect of their lives, feelings that may include serious depression. Several studies agree that compared with women who live with the breasts they were born with, those who choose surgery are twice as likely to commit suicide.

Men and women are both breast-obsessed, but differently. Attention women: Chances are the man in your life likes your breasts better than you do. Attention men: Chances are the woman in your life is critical of her breasts, and might appreciate any reassurance you can provide.

Marital Infidelity: How Common Is It?

Michael Castleman — Thu, 15 Oct 2009 18:07:54 +0000

Marital infidelity is difficult to research because most people are reluctant to admit it. One survey made headlines showing that only a tiny percentage of spouses cheat. But the researchers interviewed respondents with their spouses present. Duh!

Even without spouses, results depend on how questions are asked. University of Colorado researchers surveyed 4,800 married women using face-to-face interviews and an anonymous questionnaire. In the interviews, only 1 percent said they'd cheated during the past year. But the anonymous questionnaire showed 6 percent.

Meanwhile, controversy clouds the definition of "infidelity." Most say it's sex with anyone who isn't your spouse. But what about spouses who are separated but not divorced? What about open marriages? And don't-ask-don't-tell marriages? Is infidelity any sex outside of marriage? Or secret sex? What about people in heterosexual marriages who have homosexual flings? Finally, does cheating require intercourse? What if you have only oral sex? Or handjobs? Or passionate kissing?

Arguably the best research on this subject is the General Social Survey (GSS) conducted annually since 1972 by University of Chicago researchers. For 37 years, they have asked a representative national sample about infidelity. The results have been consistent. Every year, 10 percent of spouses admit cheating--12 percent of men, 7 percent of women.

But in our culture, men with multiple partners are often envied as studs, while similar women are dismissed as sluts. As a result, we would expect men to admit infidelity more freely. In many non-Western cultures, anthropologists have found no gender differences in infidelity rates. Perhaps the same is true for us, but cultural assumptions color admissions.

Recently, the GSS has shown two notable changes--more cheating by spouses over 60 and under 35. These changes have been modest, so it's hard to know if they are real. But many social scientists contend they are, and have proposed explanations.

Among older folks, the reason most often cited is health. Sex tracks health. Today 60 is the new 40, which might explain the rise in cheating among older spouses. However, while many of today's 60-somethings are healthier than their counterparts a generation ago, today we have much more diabetes, a condition that often causes sexual impairment, and substantially more obesity, which may make people feel unattractive, and raises risk of arthritis, heart disease, and cancer, all of which reduce libido and sexual function. In addition, older adults take considerably more medications than they did a generation ago. Many drugs cause sex problems, notably, antidepressants and blood pressure medications. So, does better health in those over 60 explain the increases in infidelity? Maybe, maybe not.

Another oft-cited reason for horny elders is erection medication, which some say has encouraged older men to cheat. But two recent studies show that only 10 percent of men over 50 have even tried these drugs, let alone become regular users. With erection medications used by so few older men, how much of a difference could they make?

Maybe rising infidelity has to do with more working women, particularly women traveling on business, which provides opportunities to dally discreetly. But homemakers of yore had plenty of opportunities for extra-marital sex: the postman, milkman, repairmen, and delivery men of all stripes. Meanwhile, cheating is up only in women over 60 and under 35. If travel explains the increase, why hasn't it risen in women 35 to 59? Most of them work outside the home, and many travel on business.

The fact is, no one knows the true prevalence of marital infidelity and every explanation for supposedly rising rates is open to serious question. What do you think?

Fantasies During Sex: Welcome Them

Michael Castleman — Thu, 01 Oct 2009 01:07:27 +0000

Not long ago, a survey reported in the New York Times magazine asked married couples: "As long as you're sexually faithful to your spouse, do you think it's okay to fantasize having sex with someone else?" More respondents said no than yes--48% no, 46% yes, with 6% declining to answer.

Meanwhile, other surveys have shown that during partner sex, the Number One fantasy is doing it with someone else. Many people express guilt about such fantasies, believing them the moral equivalent of unfaithfulness, and harmful to their relationships.

Great sex is a combination of friction and fantasy. Most lovers enjoy the friction. But many feel uncomfortable with their fantasies. What a shame to feel guilty about something as normal--and healthy--as sexual fantasies during lovemaking.

If you feel "mentally unfaithful" when fantisizing of other lovers during sex, you might be able to forgive yourself if you view lovemaking as a special, interpersonal form of spirituality, a mutual meditation, if you will.

In meditation, people reserve time to take an uninterrupted break from their usual activities. They sit quietly, breathe deeply, empty their minds of conscious thoughts, and repeat a simple word or phrase (mantra) over and over. A while later, they emerge feeling refreshed and relaxed.

But emptying the mind is not easy. Random thoughts dart in and out of conscioussness. Meditation teachers advise accepting these thoughts without judging them, no matter what their content. Teachers say: Your thoughts during meditation are no reflection on you. Thoughts are simply there, like dreams. You're not responsible for them. Observe them, then let go of them as you gently return to your mantra.

Lovemaking is surprisingly similar. Lovers mututally reserve time to take an uninterrputed break from the rest of their busy lives. They breath deeply, relax, and transcend their individual bodies to feel deeply connected with each other, afterward emerging refreshed and relaxed. Lovers don't sit quietly (at least I hope not). Instead, they substitute sensual explorations for the mantra. But in most respects, sex is similar to meditation.

Duuring sex it might be nice to empty your mind of all thoughts other than those of your lover. But that's usually impossible. Other thoughts almost inevitably intrude--including fantasies of other lovers: movie stars, old flames, new acquaintances, anyone. You might also have fantasies of fringe activities: group sex, sex in public, or sexually dominating or submitting to a lover. Just as in meditation, accept your sexual fantasies without judging them. They are no reflection on your morality, faithfulness, or mental health. In sexual fantasy, as in meditation, everything is permitted and nothing is wrong.

The only time sexual fantasies might signal a problem is if you consistently fantasize about making love with one specific other person--and take steps to make that happen. That's a clear sign of a relationship problem. But I'm not talking about falling in love with someone else. I'm concerned with true fantasies, the strange, marvelous, weird, impossible fleeting notions that occupy the mind for a moment then go their merry way.

Accepting one's sexual fantasies allows greater relaxation during lovemaking. Relaxation is key to sexual fulfillment. Feeling guilty about sexual fantasies causes anxiety and emotional stress, which interfere with erotic pleasure. No wonder that in a survey by a University of Vermont researcher, respondents who said they felt guilty about their fantasies of others lovers reported low sexual satisfaction.

The late comedian, Rodney Dangerfield, told a story of making love with his girlfriend. They're going at it, but something is wrong. Neither feels all that aroused. Finally, Dangerfield asks her: "What's the matter? Can't you think of anyone either?"

First Survey of Clients—By a Sex Worker

Michael Castleman — Tue, 15 Sep 2009 17:30:54 +0000

J.M., of Seattle, has been a sex worker for 15 years. Now around 40, charming and articulate, she sees 10 men a week and gives them what they pay for. Her clients like it--62 percent are repeaters.

But after seeing the 2004 movie, "Kinsey" about controversial sex researcher Alfred Kinsey, she decided to give her clients something else, a survey. She presented results based on 225 clients at a meeting of the American Association of Sex Educators, Counselors, and Therapists that I attended. There's no shortage of surveys of sex workers and their patrons. But to my knowledge this is the first survey conducted by a sex worker herself. It presents an intriguing spin.

J.M.'s sample was self-selected, men who visited her, and were willing to participate in her survey, so it can't be viewed as representative of all men who pay women for sex. But it's certainly food for thought.

Half of J.M.'s clients were single, half married. They were overwhelmingly white (93 percent). They ranged in age from 26 to 70, but the largest group was in their 50s.

The stereotype is that single men who visit sex workers are losers who can't get dates. But J.M. characterized her single clients as attractive and charming. None struck her as losers. Most dated and had sex without paying for it (directly). So why visit her? They felt sexually insecure: "I have sex, but I'm anxious. My dating relationships haven't progressed to the kind of comfortable sexual give and take I'd like." "The more sex you have, the better you get at it. I want to learn more about women and how to give them pleasure." "I get nervous on dates. The stakes are higher when you want an emotional connection. Here I can relax."

The stereotype is that married men who visit sex workers don't get any at home, or enough, or what they want. J.M.'s clients bore this out. Most had sex at home but not enough to suit them, and complained that their wives were not interested in either sex or nonsexual affection. "At home I don't get much kissing and touching. I asked my wife to go into therapy. She said, ‘We don't need it.' So this is my therapy." "My wife and I are good friends but there's not enough affection or sex. So after much thought, I decided to make up for what I don't get at home while not hurting anybody." Many married clients told her, "I come here to save my marriage." Few married clients expressed any guilt about visiting J.M., just 8 percent.

Compared with single men, J.M.'s married clients were more interested in her sexual responsiveness, wanting her to have an orgasm with them. "I want to know I can make a woman come." Unlike many sex workers, J.M. is willing to have orgasms with clients who request it--26 percent did.

J.M.'s clients' top two sexual requests were fellatio (91 percent) and vaginal intercourse (71 percent). No surprise there. But many men, both single and married, also wanted more variety than they experienced during noncommercial sex. "Here I get diversity," one said. Requests included receptive anal fingering (55 percent), non-genital massage (53 percent), nipple play (22 percent), receptive anal intercourse with a strap-on dildo (18 percent), and analingus and female domination/male submissiveness (less than 5 percent).

I've seen many surveys of sex workers and their patrons. But this is the first survey of clients by a sex worker. While not earth-shattering, it breaks some new ground. More than half of J.M.'s customers want non-genital massage, and even more want receptive anal. That's news to me. How about you?

Friends with Benefits: How Friendly? How Sexual?

Michael Castleman — Sat, 29 Aug 2009 21:31:02 +0000

Friends with benefits (FWB) describes couples who are more than friends but less than committed lovers. They're friends who, now and then, also have sex. They're not deeply involved and remain free to date others. But they value the friendship, feel mutual affection, and sometimes make love.

FWB relationships are not new. I imagine they've been around in some form forever. But the term "FWB" is fairly recent. I began hearing it about 10 years ago. (If anyone knows more about the history of this term, please comment.)

FWB is most common among young adults. As they grow older, will this this new relationship wrinkle extend into mature adulthood? Time will tell.

In the meantime, FWB relationships raise some questions: How friendly are FWB? How much sex do they have? And what becomes of these liaisons? Researchers at Wayne State University in Detroit and Michigan State in East Lansing surveyed 125 undergraduates (65 women, 60 men). [Bisson, MA and TR Levine, "Negotiating a Friends with Benefits Relationship," Archives of Sexual Behavior (2009) 38:66.]

Sixty percent (40 men, 35 women) said they'd been involved in an FWB relationship, and about one-third were in one when surveyed.

Of the total sample, almost two-thirds (62 percent) said men and women can remain "just friends" while being FWB. The rest said it was impossible, that FWB must soon decide to be friends without sex, or become official lovers. FWB veterans felt more optimistic: 81 percent (34 men, 26 women) said it was quite possible to be happily FWB.

Before they became sexual, FWB couples were friends for an average of 14 months. Some remained long-term FWB (28 percent). But most FWB relationships changed after about six months. Many remained friends but stopped having sex (36 percent). Relatively few became romantically coupled (10 percent). And for some, both the friendship and the sex ended (26 percent).

FWB couples reported various sexual frequencies: only once (19 percent), occasionally (52 percent), and frequently (29 percent).

FWB veterans cited these advantages: sex without commitment (74 percent), having an available sex partner (69 percent), having sex with someone you know, like, and trust as opposed to a one-night hook-up (26 percent), and having some semblance of a relationship while remaining officially single (13 percent).

Disadvantages included: developing romantic feelings (81 percent), risking the friendship (35 percent), lack of commitment (16 percent), and feeling badly about the sex (12 percent).

FWB relationships occupy ambiguous ground between "just friends" and "involved." But they allow participants to experiment. I think that's why they're most common among young adults, folks who are still new to the world of relationships, and looking to find their way.

FWB couples are more likely to remain friends without sex than to become committed lovers. In the long run, that may be FWB's greatest advantage. Couples can explore a sex with someone they like and trust, then stop, ideally without recriminations and heartbreak. I think that's why these relationships are called friends with benefits, and not casual sex. What do you think?

Sexual Predators: NOT an Internet Threat to Kids

Michael Castleman — Sun, 16 Aug 2009 21:48:06 +0000

Take one newly pervasive communications medium that makes some people apprehensive. Add concern about sexual exploitation of children that makes everyone apprehensive. Stir in a few highly publicized cases of pedophiles luring innocent young kids to horrible fates via email or Facebook. Season with echoes of Hansel and Gretel. And what comes out of the oven? Full-blown hysteria that every child with an Internet connection faces substantial risk from sexual predators.

The hysteria may be real. But the actual threat is negligible.

Last year, the attorneys general of 49 states created the Internet Safety Technical Task Force to investigate sexual solicitation of children by molesters who troll for targets using sites popular with kids, among them, MySpace and Facebook. The 278-page report concluded that there's no real problem.

The task force, led by Harvard researchers, looked at reams of scientific data dealing with online sexual predation and found that children and teens were rarely propositioned for sex by adults who made contact via the Internet. In the handful of cases that have been documented-and highly publicized-the researchers found that the victims, almost always older teenagers, were usually willing participants already at risk for exploitation because of family problems, substance abuse, or mental health issues.

The report concluded that MySpace and Facebook "do not appear to have increased minors' overall risk of sexual solicitation." The report said the biggest risk to kids using social networks was bullying by other kids.

"This study shows that online social networks are not bad neighborhoods on the Internet," said John Cardillo, whose company tracks sex offenders. "Social networks are very much like real-world communities that are inhabited mostly by good people who are there for the right reasons."

Not all the participating attorneys general agreed with the report's conclusions. Connecticut Attorney General Richard Blumenthal charged that "thousands" of convicted sex offenders are members of social networking sites.

That may well be true, but most "convicted sex offenders" are not predators who molest children. In most states. "sex crimes" include exhibitionism, voyeurism, public urination, transvestism, even ownership of a vibrator. In addition, in some states 18-year-old men have been convicted of statutory rape, a sex crime, for having sex with their fully consenting 17-year-old girlfriends.

Meanwhile, in the small number of cases where child molesters have connected with children online, most of the encounters have followed a predictable pattern: online contact, leading to telephone contact, ultimately leading to face-to-face meetings. But notice that those who are up in arms about the supposed hazards of social networking sites seem unconcerned about the key role that the telephone plays in the sexual exploitation of children. Why is that?

I think it's because the telephone is an old technology fully integrated into our culture. The Internet is still new, and kids use it more than adults, which makes many adults nervous that something nefarious must be going on. But according to the attorneys general report, next to nothing is.

Can't Afford Sex Therapy? Self-Help Can Probably Help.

Michael Castleman — Sat, 01 Aug 2009 03:53:17 +0000

Hard economic times produce stress, and stress contributes to sex and relationship problems. It also reduces the number of people who can afford professional sex therapy. The good news is that if you have sexual issues but feel financially pinched, there's a decent chance that a self-help book might resolve things.

When people suffer persistent sex problems, some--women more often than men--talk to trusted friends (informal help). If knowledgeable friends are unavailable or their suggestions don't help, people try the Internet, books, or videos (self-help). And if that doesn't work, they consult professional therapists.

Many sex therapists are very supportive of self-help approaches. Many recommend books ("bibliotherapy") and other resources. But some sex therapists express skepticism about self-help. This is understandable. When self-help works, people don't consult therapists, so professionals don't see self-help's successes. And studies show that 88 percent of people with sex problems try some form of self-help before consulting a therapist, which means that almost nine out of ten new clients tell therapists, "I tried self-help and it didn't work."

Meanwhile, dozens of sexual self-help books and videos have been produced. Do they really help? Before answering that question, I must disclose that I am the author of a sexual self-help book, Great Sex: A Man's Guide to the Secrets of Total-Body Lovemaking. Now, do self-help resources work? According to several studies, yes, but professional therapy works somewhat better.

Most of the research comparing sexual self-help with professional sex therapy has been conducted in the Netherlands by Jacques J. van Lankveld, a professor of psychology at Maastricht University. In one study, he and his colleagues worked with 117 women suffering vaginismus, vaginal muscle spasms that cause pain on intercourse or prevent intercourse altogether. The women were randomized to a waiting list, a self-help book (with six brief phone consults with a therapist), or professional group therapy (10 two-hour sessions). After one year, none of the wait-list group reported improvement. In the self-help group, 15 percent said they could have intercourse comfortably. And among those in group therapy, 21 percent. So self-help with minimal professional support produced almost the same benefit as 20 hours of group therapy.

In another study, van Lankveld's team assigned 50 men with erectile dysfunction (ED) and 40 with premature ejaculation (PE) to either a wait list or a Web site that outlined standard sex therapy for these problems. After six months, the men in the wait list reported scant improvement. But among those who used the Web site, half reported significant benefit.

Van Lankveld also offered 12 weeks of Web-based sex therapy with email support to 39 men with ED or PE. Half couldn't deal with it and dropped out. But among those who stayed, two-thirds reported improvement.

Finally, at Concordia University in Illinois, researchers analyzed 70 studies of self-help approaches to various psychological problems. Among the most effective was self-help for sex problems.

It's no surprise that professional therapy works better than self-help. Therapy can be tailored to individual needs, and many studies show that a face-to-face rapport with a therapist is, in itself, beneficial. But if you have a sex problem and your 2009 budget doesn't allow for professional therapy, self-help can probably help.

Desire In Women: Does It Lead To Sex? Or Result From It?

Michael Castleman — Wed, 15 Jul 2009 18:07:15 +0000

The conventional wisdom is that desire precedes sexual arousal. This works for most men. Men are often coiled springs of desire and easily aroused. Men often describe their libido as a drive similar to hunger or thirst. Twentieth-century sexologists assumed that women's libido was, if not identical, then similar--and that if women didn't feel desire, then something was wrong.

Using this reasoning, something would be wrong with one-third of women. That's what University of Chicago researchers found in a landmark 1999 survey. Only 15 percent of male respondents said they felt little or no desire--and alcohol, stress, diabetes, heart disease, and disabilities were clear predictors. But 30 percent of women respondents said they lacked libido, usually for no apparent reason. The Chicago researchers concluded that low libido--or "hypoactive desire disorder"--was disturbingly prevalent among women.

The drug companies agree. They are busily trying to develop pills to boost women's desire.

But what if desire does not precede arousal?

That's what University of British Columbia psychiatrist Rosemary Basson, M.D., discovered in interviews with hundreds of women. Contrary to the conventional model, for many women, desire is not the cause of lovemaking, but rather, its result. "Women," Basson explains, "often begin sexual experiences feeling sexually neutral." But as things heat up, so do they, and they eventually experience desire.

If a substantial proportion of women don't experience desire before becoming sexual, then drugs and supplements that try to pique it before the fact put the cart before the horse and may be a waste of money.

This new concept of women's desire explains why Viagra doesn't work for most women, and why sex-boosting herb blends help only some. These products do not affect desire. They increase blood flow into the genitals. Men are always aware of increased genital blood flow. It's hard to miss an erection, and it's only a short step from erection to desire. But a good deal of research shows that women are often unaware of genital blood engorgement. "Many women have little awareness of it," Basson notes. Even when women are aware it, they often deny feeling aroused.

If so many women don't experience male-style desire before sex, then why do they make love? According to Basson, for reasons that affirm their relationships but are not inherently sexual, wanting to please their lover, feel intimate, prevent strife, or make up after it. Basson's model supports an old saying about the difference between men and women: Men become intimate to have sex. Women have sex to become intimate.

If many women experience desire as the result of lovemaking, then the critical question becomes not how to ignite their desire before sex, but rather: What kind of lovemaking arouses women sufficiently to enable them to experience desire?

According to leading sexologists, the type of sex that fuels desire is leisurely, playful, sensual lovemaking based on whole-body massage that includes the genitals but is not limited to them. This is the lovestyle that many surveys show women prefer, but often don't get. One of women's main sexual complaints is that men are non-sensual--too rushed, and too focused on the breasts, genitals, and a quick plunge into intercourse. Given Basson's view of women's desire, this complaint makes perfect sense. Rushed lovemaking doesn't give women the time many need to become aroused enough to experience desire.

Ironically, the sexual style that allows women to experience desire is the same one sex therapists recommend for men who want to cure premature ejaculation and erectile dysfunction. In other words, a sensual, massage-based approach to lovemaking is a win-win. Men's penises act the way men want. And women are much more likely to experience desire, and become the enthusiastic lovers that both they and their lovers would like them to be.

Does Sex Increase Risk of Prostate Cancer?

Michael Castleman — Tue, 30 Jun 2009 17:23:36 +0000

Prostate cancer strikes 232,000 American men annually and kills 30,000, numbers similar to the toll of breast cancer on women. Could sex boost men's risk? That disturbing possibility has been raised by several recent studies:

* Italian researchers found that compared with men who never married, those who did--and presumably had more sex--had significantly greater risk of prostate cancer. For men married more than twice, risk was three times that of never-married men.

* University of Illinois researchers correlated prostate cancer risk with men's age at first intercourse and estimated lifetime number of women sex partners. The younger the men became sexually active, the greater their risk. And the more sex partners they reported, once again, the greater their risk.

* And University of Iowa researchers found that as number of women sex partners increased, so did risk of prostate cancer, with men who reported sex more than three times a week showing the greatest risk.

On the other hand, the largest study shows just the opposite--that frequent sex protects against prostate cancer. Researchers at the National Cancer Institute asked 29,000 men, aged 46 to 81, to estimate their number of weekly ejaculations during their twenties, forties, and during the past year. Compared with men who reported seven or fewer ejaculations per month, men who experienced 21 or more were significantly less likely to develop prostate cancer.

What's going on?

The smart money says is protective. In medical research, the larger the study, the more valid the results are likely to be. The studies showing that sex increases prostate cancer risk involved a few hundred men. The study showing that sex reduces risk involved 29,000.

But if sex reduces risk of prostate cancer, it's only protective if men avoid sexually transmitted infections (STIs). Many studies show that a history of STIs, especially gonorrhea and syphilis, approximately doubles prostate cancer risk. It's not entirely clear how STIs spur development of prostate cancer, but these infections cause inflammation, which apparently triggers or accelerates cancerous cell changes.

Many studies have linked frequency of sex and an increasing number of sex partners to increased risk of STIs. It now seems likely that it's the STIs, not sex per se, that increases prostate cancer risk in the studies showing that finding. It seems increasingly likely, that like cervical cancer, prostate cancer is sexually transmitted.

"Hey, babe, wanna help me prevent prostate cancer tonight?" Women might be hearing more of that line if subsequent studies confirm that sex is protective. Or maybe not. The large study tracked ejaculations, but did not distinguish between those that occurred during partner sex and masturbation. If a woman is not in the mood to help her man prevent prostate cancer, men can do it themselves.