Is it normal to be anxious about sex?

2019-01-30

I’ll let you into a secret: you’re not the only one whose sex life isn’t perfect all the time. “Sexual problems are way more common than people think and even the numbers we do have are likely to be much lower than in reality, because cases are under-reported due to embarrassment,” says Kate Moyle, a sexual and relationship psychotherapist.

However, it’s key we don’t let shame hold us back from seeking help, adds Ms Moyle. “The longer sexual problems go on for, the more prominent they can become because of a cycle of anxiety: the more anxious we get, the more prevalent the problem,” she points out.

The best thing to do is go and see a pharmacist or GP, and the good news is there will be zero embarrassment involved. “Medical professionals are just that – professionals,” says Ms Moyle. “To them, it’s just another health problem, just another body part.”

So here’s how to start addressing those common sex anxieties…

Anxiety 1: ‘I have erection problems’

Struggling to get – or keep – an erection? You’re not alone: 4.3 million men in the UK are affected^[1]. There’s a whole raft of potential causes, from the physical (such as high blood pressure or the effects of medication) to psychological (such as stress, anxiety or depression). If it’s a recurrent problem, see your pharmacist or GP – the latter can rule out health conditions and discuss potential treatments, from medication to therapy.

“Men can feel under immense performance pressure,” explains Ms Moyle. “There’s a sense the responsibility for sex is on them, because once you have an erection you can have penetrative sex. So as a couple it can help to take the emphasis away from penetrative sex – literally ‘banning’ it for now – and instead focus on foreplay and intimacy. This allows you to enjoy the sensations and you might find you become naturally aroused.”

Anxiety 2: ‘I’m never in the mood’

According to Ms Moyle, there is no “normal” level of sexual desire or amount of sex to have. But if your normal has shifted, potential causes include anxiety, depression, relationship problems, hormonal changes (such as during menopause), and side effects of medication. Her advice to is have a chat with your GP if it’s worrying you.

“It can help to remember sexual desire is usually responsive,” she continues. “You might not be in the mood for sex but if you were to read or watch something that aroused you, or your partner started kissing you, you might respond.

“There’s a lot of miseducation that we should be spontaneously aroused and that’s not really how it works. So try making more opportunities for arousal to happen. And remove other distractions. Often people are struggling with an inability to switch off – so turn everything off around you to get turned on.”

Anxiety 3: ‘Sex is painful for me’

For men, common causes of painful sex include infection, inflammation and a tight foreskin. For women, infection, vaginal dryness, lack of arousal and vaginismus (a condition where muscles in or around the vagina shut tightly) are some typical causes. Again, the advice from Ms Moyle is to get it checked out by a GP.

“If you experience pain during sex, the positives like anticipation and excitement are replaced with fear, anxiety or tension,” she says. “So you might start to avoid sex or, for women, it can become a vicious circle where you tense up and that causes sex to be painful.

“While you’re working out what’s wrong, don’t force it or you’ll reinforce sex as something negative,” adds Ms Moyle. “You need a ‘partner pact’ where it’s OK for you to say when you’re uncomfortable having sex.”

Anxiety 4: ‘I come too soon’

There’s no “correct” amount of time for sex to last. So the speed at which you orgasm is only a problem if it’s a problem to you. However, premature ejaculation in men can be caused by a whole host of things, including prostate problems, thyroid problems and depression, so if you’ve noticed a change, see your GP.

“Men can feel under pressure because there’s this idea that when they climax the sex is over,” says Ms Moyle. “But sex doesn’t have to be linear where the end goal is intercourse. Non-penetrative sex isn’t just a route to penetrative sex, it’s sex in itself. So even if a man has ejaculated he can still engage in that with his partner.”

The same goes if the woman comes first in a hetrosexual couple – she might not feel comfortable carrying on with penetrative sex. But, as Ms Moyle notes, “The focus should be on mutual pleasure.”

Anxiety 5: ‘I’m not confident in the bedroom’

Worried about a lack of experience? Know this: it counts for nothing. “There’s no objective measure of being ‘good at sex’,” says Ms Moyle. “Because you had good sex with someone doesn’t mean the next time you have great sex with someone it will be the same kind of sex.”

But what if it’s body insecurities that are getting you down? “When it comes to body confidence, it doesn’t really matter what your partner thinks about you – it’s about what you think about yourself,” she says. “As much of a buzz-phrase as self-care is, looking after yourself is important so you learn to value yourself.”

For you as an individual, that might mean exercise, a warm bath, therapy or simply spending more alone time.

Anxiety 6: ‘I can’t orgasm’

“Exploring what you like with your partner or through masturbation can make a real difference,” suggests Ms Moyle. However, there can be other issues that play into an inability to orgasm for men (including stress, depression, diabetes and effects of certain medication, and for women (depression, relationship problems and previous traumatic sexual experience are among the potential causes), so seek advice from your GP if you’re concerned.

Removing reaching orgasm as a goal can really help, too. “Having a goal means pressure to succeed,” says Ms Moyle. “If we’re preoccupied with that we’re in our heads, and then we can’t really be in our bodies.

“But it’s the bodily sensations we experience that are going to lead to orgasm. So it’s about trying to be mindful – bringing your focus back to your senses and experiences every time your mind wanders.”

Finding a way forward

This series of Telegraph articles, brought to you by VIAGRA Connect, addresses the myths and misconceptions around erectile problems and helps men find the right treatment

VIAGRA Connect is the first medicine available in the UK without a prescription to help men with erectile dysfunction. It is available from pharmacies and registered online pharmacies.

To find out more about erectile dysfunction, how VIAGRA Connect can help and how it can be bought, go to viagraconnect.co.uk

VIAGRA Connect: 50mg film coated tablets. Contains sildenafil. For erectile dysfunction in adult men. Always read the leaflet. PP-VCO-GBR-0200

Footnotes:

^[1] Prevalence based on men reporting occasional and frequent difficulty getting or maintaining an erection [ref. Kantar TNS Omnibus Survey Dec 2010 – in a survey of 1,033 men]

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Confidentiality concerns may deter teens from sexual, reproductive health care services

2017-04-06

According to a national survey, 12.7% of sexually-active teenagers and young adults who were on their parent’s insurance plan would not use sexual and reproductive health services due to concerns that their parents would learn about it.

“Changes in the U.S. health care system have permitted dependent children to remain on a parent’s health insurance plan until the child’s 26th birthday and required coverage of certain preventive services,” Jami S. Leichliter, PhD, from the Division of Sexually Transmitted Disease Prevention, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, and colleagues wrote. “Although these provisions likely facilitate access to the health care system, adolescents and young adults might not seek care or might delay seeking care for certain services because of concerns about confidentiality, including fears that their parents might find out.”

To ascertain the prevalence of confidentiality concerns among teenagers and young adults, the researchers examined data from sexually-experienced individuals aged between 15 and 25 years (n = 10,205) included in the 2013-2015 National Survey of Family Growth. In addition to information on marriage, divorce, family life, having and raising children and medical care, the National Survey of Family Growth also measures reproductive health status and examines the efficacy or need of health education programs.

The survey included questions concerning confidentiality that addressed whether those aged 15 to 17 would “ever not go for sexual or reproductive health care because their parents might find out,” whether they had “time alone with a provider in the past 12 months without a parent, relative or guardian in the room” and the status of their current health insurance.

Respondents who received STD services were defined as those who had a sexual risk assessment or other clinical services in the past year. A risk assessment included a doctor or health care provider questioning about sexual orientation or the sex of their partners, number of partners, condom use and type of sex (vaginal, oral or anal). Other services include chlamydia testing for girls in the last 12 months or receiving treatment for an STD in the past year for both boys and girls.

Among sexually-experienced youth aged 15 to 17 years, 22.6% responded that they would not seek services with concerns that their parents would know. Girls who were concerned about confidentiality were less likely to report receipt of chlamydia testing (17.1%) compared with girls who did not have concerns about confidentiality (38.7%).

When both male and female youth received more time alone with their health care providers, researchers noted that

they were more likely to report receipt of risk assessment (71.1%); however, when parents were present, reporting dropped to 36.6%. Girls who spent more time alone with their health care provider reported a  higher rate of chlamydia testing (34.0%) than those who had a parent present (14.9%).

“Several medical organizations have emphasized the need for confidentiality for youths seeking care such as STD services,” Leichliter and colleagues wrote. “Previous research has found that females might have more general and sexual and reproductive health-specific confidentiality concerns than do males.” – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.

Hyperfocus: The other side of adult ADHD

2016-07-18

By Jenara Nerenberg, Science of Us

http://edition.cnn.com/2016/07/15/health/adult-adhd-hyperfocus/index.html

In other words, ADHD shows up in different ways depending on the person; the goal is to help people regulate their attention and harness the kind of attention necessary for the task at hand. (And recent research from Brazil and King’s College London, by the way, has suggested that despite its reputation as a childhood problem, it’s more common than you might think for the condition to show up for the first time in adulthood, even among people who never showed signs of it in childhood.) Generally speaking, ADHD is classified into two broad categories: inattentive type, and hyperactive/impulsive type. Hyperfocus is seen among both of these types — and yet it’s been largely neglected in academic research.

How scientists explain the link between workaholism and ADHD

That’s surprising, especially considering the significant impact — both positive and negative — hyperfocus can have at work and at home. Hyperfocus is great for engaging in longer tasks which require intense concentration — but it’s not so great if that means that the more mundane tasks, chores, and assignments fall by the wayside. When composing a song or coding a new program, the tendency to lose sight of all else proves beneficial; when failing to get laundry or dishes done for days on end, the tendency becomes a potential problem.

One of the few pieces of research on the hyperfocus piece of ADHD is from South Africa, and was the subject of a University of Johannesburg master’s thesis by researcher and writer Rony Sklar — indeed, much of her work has raised the question of why hyperfocus isn’t being looked at in the literature, since her own work was limited by sample size. “The field is wide open and people really need to start researching it,” Sklar told Science of Us. “It’s not about having an attention deficit, it’s more a maldistribution of attention. It’s not about not being able to concentrate; it’s about being able to concentrate in different forms and different intensity.” Put another way, there is a spectrum along which attention gets channeled for human beings; those diagnosed with ADHD don’t have less attention than normal — it’s more accurate to say that their attention can be splintered or hyperfocused, or it can swing between the two. Their challenge is to learn ways to distribute their attention more evenly, by regulating it or even manipulating it to serve their purposes according to the task at hand, often through the use of practical tools like timers, calendars, reminders, alarms, and breaking tasks into concrete steps.

What it’s like to have ADHD as a grown woman

In Sklar’s limited research, she’s found that people with ADHD tend to use less mental effort to play a computer game than people without ADHD, “which could mean that they entered the flow state more readily than the non-ADHD group,” says Sklar. Additionally, the ADHD group had higher activation in the parietal lobe, which is notable because most studies have found that ADHD individuals have lower parietal lobe activation. This makes sense if you think about it — under normal day-to-day circumstances where shifting attention is required, the ADHD individual may struggle; the usual lower activation in the parietal lobe of those with ADHD is thought to be linked to impaired attention. But in Sklar’s sample, where people were intensely focused — or in a state of “hyperfocus” — those with ADHD had higher parietal lobe activation than the non-ADHD group, which “could support the idea of people with ADHD being able to sustain attention depending on the specific context,” says Sklar. So this could suggest something rather exciting: that ADHD individuals have, at least in some contexts, a leg up over non-ADHD folks, in that ADHD in fact helps people sustain attention for longer periods than normal in some situations. Under the right conditions, hyperfocus is ADHD’s secret superpower.

No increase in heart attack, stroke risk seen with ADHD meds

For a child or adult with ADHD, the determining variable is interest — if the person loves to play music, they can do it for hours. If they hate doing dishes, they will clean one dish, lose focus, and jump to another activity. One metaphor that captivated Sklar’s attention paints an interesting picture — first put forth by author Thom Hartmann, the theory suggests that those with ADHD have more of a “hunter” orientation, evolutionarily speaking, and those without ADHD are the “farmers.” One group is more nomadic and needs to constantly scan the environment, with attention darting here and there for prey; the other group possesses the patience, calm, and nurturing ability to tend to repeated farming tasks with long-term consistency. The hunter mindset in some ways explains hyperfocus — once the prey is identified, the hunter intensely focuses on her pursuit.

Why more girls — and women — than ever are being diagnosed with ADHD

But Arthur Caye, the lead researcher in Brazil’s recent study, asserts that hyperfocus may be a result of overcompensating: that is, people who have ADHD may tend to zero in on one particular pursuit as a way to make up for the distractedness in other areas. So it may not be that hyperfocus is a clinical symptom of ADHD — and, indeed, hyperfocus is not listed in the DSM-5 — but it could be a response to having the condition, according to Caye, and it can be channeled into productive or unproductive pursuits. Hyperfocus is not a common topic of conversation among researchers, including Caye and his counterparts at King’s College London, but it is among those with ADHD and their therapists and coaches.

This narrative sounds familiar to Maria Yagoda, a writer and Yale graduate who has ADHD. “I will definitely get sucked into something and have to devote all my time and energy into that,” Yagoda told Science of Us. She has written previously for The Atlantic about how the condition affects her and how people are often surprised that someone like her — a successful Ivy League graduate — could have ADHD. “Sometimes on days that are the craziest — different news stories breaking, too many meetings, family drama — I’m able to focus more intensely than I could on a normal day. I feel like I kick into this special productivity gear.”