Wednesday, June 11, 2014

Ask the Sex Doc 18: needles for dicks, restraints for chicks, and jewels for clits

Posted By on Wed, Jun 11, 2014 at 4:06 PM

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Prick for a Prick
A family friend recently told me her husband had been going to acupuncture for some erectile dysfunction problems. Apparently, it's been helping. Is there some science there or is it totally the placebo effect? - Email


Sarah: As the singular non-medical professional in my family, I find myself often defending alternative medicines - not because I necessarily believe they work, but I find that frustration with unresolved, ongoing medical issues can be (in my totally unqualified opinion, never forget) just another stumbling block on the road to getting better. But really, no one really knows if alternative medicines "work" (a term that is still largely defined by a western-medicine idea of what "working" means) because not a lot of large-sample, objective studies done. But I'm all about feeling better, so long as you're not spending your kids' grocery or diaper money on getting pricked for your prick, I don't see a problem with at least trying it. You might also just try to get into better overall cardiovascular health, because boners require a healthy heart and good circulation to get up and stay up. Dicks are like the indicator lights on male bodies, but in reverse. If the light isn't coming on, you need to deal with something else going on in the body, whether it's just pure exhaustion, performance anxiety, blood pressure issues, diabetes, or any of the other health issues that often show up (er, you know, don't show up) when it's boner time. But as far as the desire to approach health problems holistically rather than just popping pills, I think that should only be applauded.


Debby: There is limited scientific evidence about the effectiveness of acupuncture for erectile dysfunction (ED). One of the challenges of ED is that there are so many different "types" of ED. There's what we think of as organic ED (related to physical issues such as diabetes or cardiovascular disease), psychogenic ED (no physical causes identified but may be linked to performance anxiety or stress, for example), mixed cases (organic + psychogenic), and also very specific causes, for example ED as a side effect of taking certain kinds of anti-depressants or other medications. I mention this because different types of ED respond better or worse to certain treatments. Sex therapy can be quite effective for men whose erectile problems are caused by performance anxiety but may be less effective for men whose ED is primarily linked to significant cardiovascular disease or diabetes (even prescription medications for ED are less effective for men with diabetes, particularly poorly controlled diabetes). As for acupuncture, there is only a little bit of research on acupuncture as a treatment for ED. Quite a few of the studies are small or not well controlled, meaning that ultimately they're of limited scientific value and it's difficult to know what the findings mean. One study looked at acupuncture for men with psychogenic ED - they split the men into two groups (one receiving acupuncture aimed at enhancing erectile function and the second receiving acupuncture aimed at improving headaches, which they deemed their "placebo condition"). More men in the ED acupuncture group improved, suggesting that acupuncture specific to erectile function might help men with psychogenic ED. Other studies on acupuncture for ED have been mixed or not shown a positive effect. Prescription medications (e.g., Viagra, Leviatra, Cialis) and sex therapy have more evidence behind them and there's also some evidence that yohimbine and ginseng may help some men with ED, though we need a bit more research on the herbal treatments.

Bejeweling Your Jewel Box

Clit piercings: your thoughts? - Tumblr

Sarah: Honestly, you guys, did I do something to offend the readership? Because I can't imagine any other confluence of factors that would result in my inbox being so regularly flooded with mental images that make me have to get up and take a damn walk. I know this is a normal thing and a lot of people do it and a lot of people like it and says it makes all their sex magical and amazing and orgasmic and yet: a needle must still puncture the most sensitive part of the female body, and I'm just not cool with that at all. It's already pretty tough to keep other orifice piercings clean during the healing process (not to mention no sex and no touching for WEEKS), but that down there is headier kind of sweaty melange of bacterial interlopers, and the skin down there is just not meant to be broken. Also, keep in mind that you'll have to be super cautious about fabric and stuff catching on it and - *dry heave* - ripping it out. And - nope, that's it. I'm done. Don't do it. Ever.

Debby: There's not been much scientific research on genital piercings and what has been done largely looks at complications related to infection, irritation, and so on. Anecdotally, some people have told me that having a clitoral piercing has enhanced their sexual arousal (during sex and often during walking, sitting, other daily activities) whereas others thought it might enhance their arousal but found that not only did it not enhance their arousal but the piercing was irritating or bothersome or made them or a partner feel cautious or condom use. Everyone's a little different.

Rough Play Ain't Rape Play

I'm kind of interested in something kind of weird. I've had this fantasy [where] my boyfriend kind of restrains me or holds me down during sex. Does that count as a "rape fantasy"? Am I really weird for wanting that? How do I bring it up [to my boyfriend]?   - Tumblr



Sarah: Regardless of what your fantasies turn out to be, it's only destructive to judge yourself for them or feel ashamed of them. That said, always remember that the farther left- or right-of-center your fantasy is, the more delicately you may have to discuss it with a partner. The good news is that restraints, light bondage, or just physically restraining someone during sex is actually not that uncommon. And having an established trust and ongoing consent with your partner doesn't mean you're secretly dying to have him (or anyone else) pretend to rape you just because you like to feel a little physically vulnerable during a sex act. Establish clear boundaries before you start in on something like this, and really make a point to think about where your exact sexual boundaries are in this situation. If done right, play like this could bring you and your man closer, but if done incorrectly, you could permanently damage your mutual trust. Follow the good Doctor's advice and take it slow with a boatload of talking.

Debby: I wouldn't call the simple act of being restrained in a safe, consensual way a "rape fantasy", it just sounds like you have an interest in power play with him being the more dominant one and you being in a more submissive role. There is nothing wrong or weird about that. Even though you would be the one restrained or held down (and thus the "sub"), keep in mind that there's still a great deal of power in that role as well. Done well, it means that you two talk beforehand about your fantasy and what is and is not okay with you. You establish boundaries and have every expectation that they will be respected and honored. Many couples establish "safe words" or phrases that they can use to stop things entirely or to be let out of their restraints. Generally, you don't want to choose a word/phrase like "stop" or "that's hurts" because you may say those things as part of acting out the fantasy but not mean it. Instead, couples or sex play partners might choose words/phrases unlikely to otherwise come up during sex - something like "tomato" - so that when you say it, it's clear that you're done and want out. As for how to bring it up, try to start talking about your sex life more generally with your boyfriend. Get into a rhythm where you talk about what you like, what was exciting or meaningful during sex, what feels good to each of you, and so on. With practice, people can become more comfortable saying after sex or over dinner something like "I loved that thing you did with your tongue" or "That was a fun sex position; we haven't done that in months." Over time it becomes easier to suggest or ask about other things. If you're nervous about suggesting something new with sex, say that. It's a cue for him to be kind and gentle with his response. You might say something like, "I've had some sexual fantasies lately that I want to share with you and talk with you about, but I'm nervous. I hope you'll be into them, but it's also okay if you're not, I just want you to be accepting of me either way." Chances are he's a decent human being who will understand that you're saying something difficult for you - it's hard to be completely vulnerable to someone! - but doing so can make you feel closer to one another whether it's something he's into or not. 

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Sarah Murrell

Sarah Murrell

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Sarah Murrell covers all things food, beverages and sometimes gives decent sex and relationship advice. You can stream her consciousness on Twitter, if that's where life has brought you.

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