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About Sexology
Sexology is the scientific study of human sexuality. Human sexuality has been studied for centuries in the Eastern and Western world alike with a single focus on pro-creation and the outcomes of sex, rather than on re-creation and the experience of sexuality and pleasure.
Only more recently, modern studies have included human relationships into the study of sex; e.g. the study of love, sexual behaviours, sexual emotions and sexual responses, sexual function and dysfunction, sexual pleasure, sex and aging, and the understanding of sexual orientations and gender. Sexual sciences have also included the study of criminal sexual behaviour.
Forensic Sexology
Forensic Sexology represents an aspect of criminology involving sex and sex crime, including;
- sex offenders and offenses.
- assessments, profiling, treatment, processing.
- survivors of sexual assault and treatment.
- sexual law and sexual law reform.
- forensics, forensic medicine, collection of evidence, materials, specimen.
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Premature Ejaculation
Premature or rapid ejaculation describes the condition where a man ejaculates (cums) too quickly. In its severe and rare form the man comes before any direct stimulation to the penis occurs, just thinking about sexually stimulating situations triggers his ejaculation.
It is more common for the man to ejaculate either during or very soon after penetration. Studies suggest the normal average time for the man to ejaculate is 3-5 minutes after penetration. Obviously some men regularly last much longer than this just as there are men who regularly ejaculate much quicker.
The most important criteria of rapid ejaculation are:
- That ejaculation occurs sooner than the man and his partner wishes
- And this is causing distress in their sexual relationship.
It is important to take the partner's wishes into account because what may seem rapid to the man may be already too long for the partner. Rapid ejaculation is a very common sexual problem affecting men. Most men experience rapid ejaculation on occasions. There is nothing to be worried about.
It becomes a problem only when it occurs during most sexual interactions. Studies show that about 40% of men are troubled by this problem on more then an occasional basis. The effects of rapid ejaculation can be detrimental on relationships. Usually rapid ejaculation has psychological reasons. Physical origins are rare.
Through specialized sex counselling and therapy men can develop a better understanding of how their body works, reduce performance anxiety, and develop a satisfying level of sexual confidence.
Medication for rapid ejaculation is mostly unnecessary and a last resort only.
The successful treatment of rapid ejaculation is usually achieved by seeking consultation with a professional sex therapist. Affirmotive's sex therapist provides face to face therapy sessions, telephone counselling, or skype live online voice/video real time consultations.
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Vaginismus
Vaginismus is a painful condition of vaginal tightnes as a result of a conditioned reflex of the pubococcygeus or PC muscle. This reflex is not under the woman's control but occurs suddenly on the actual or perceived approach of the penis, finger, or object, including objects used in medical examinations such as Pap tests. Vaginismus can vary in severity.
Vaginismus may be a response to an earlier traumatic sexual or psychosexual experience with a viscious cycle of expectations developing that sex will be always painful, sinful or dirty. In the absense of any professional intervention repeated attempts to engage in painful penetration may contribute to worsen the condition.
Primary Vaginismus
This form of vaginismus occurs when a woman has NEVER been able to achieve penetrative sex due to involuntary painful muscle spasm.
Some of the things that may cause primary vaginismus are;
- sexual abuse
- having been taught that sex is immoral or vulgar
- the fear of pain associated with penetration, particularly that of breaking the hymen upon the first attempt at sexual penetration
Secondary Vaginismus
Development of vaginismus despite achieving full pentration previously.
Some of the things that may cause secondary vaginismus include;
- physical causes such as a yeast infection
- trauma during childbirth
- sexual threat, violence, rape, pain
- psychological causes
Treatment by Affirmotive
Affirmotive chooses counselling and therapy approaches from a range of modalities, such as Sexual Education, Sensate Focusing Techniques, Cognitive Behaviour Therapy, Solution Focused and Person Centered Counselling, Post Traumatic Stress Treatment, Voice/Body Dialogue Facilitation, and Professional Counselling.
Physical intervention such as Pelvic Floor Workouts, the use of Medical Dilators, Crossvaginal Massages by a Spezialist Physiotherapist, or medical treatment with Botox may also be considered.
Please also contact your gynecologist or GP to rule out any underlying medical conditions that may prevent painfree pentration.
Masturbation
Masturbation and self-discovery of her own body can help a woman to make friends with her sexuality. Orgasm does not need be the goal of her masturbation. Masturbation can simply be used to increase her comfort with her genital area and helping her to develop awareness of pleasurable sensations and her unique sexual responses.
A range of emotions may surface during genital exploration and need to be addressed. The vaginistic woman may have previously formed negative associations with her genitals, e.g. fears that her genitals are inferior or abnormal, dirty, smelly, or ugly. These distorted beliefs can lead to intense feelings of shame, guilt and inadequacy.
Vaginismus is a treatable disorder. Recovery chances increase with professional sex therapy.
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When partners are different in experiencing Sexual Desire and Libido.
It is a common but misguiding belief that lovers should be sexually in tune at any time they attempt to having sex. This is far from the truth about human sexual reality.
Being sexual, and enjoying fulfilling sexual intercourse and pleasure requires a fair amount of energy, sexual fantasy, sexual stimulation and arousal, privacy, relationship harmony, good health, and relaxation.
Couples may experience sexual desire and sexual arousal at different times. This is a normal experience, but often causing considerable difficulties in long-term and short-term relationships.
It would be an unrealistic expectation to assume that both partners are always equally sexually interested at the same time.
Desire and arousal are not the same. Sexual desire arises from some form of attraction to someone or something. Sexual arousal is a physical response to sexual readiness, the penis erection in a man, and vaginal lubrication and engorgement in a woman.
The primary sex organ is our human brain who’s job it is to send signals of sexual arousal via the spinal cord nervous system to the genitals and directing sufficient blood flow into the erectile tissue of the penis or clitoris, and surges the breasts with blood, causing increased sensation and the breast nipples to harden and stand up.
It is easy to understand that, when our brain is not focused on sexual attraction or sexual fantasy, signals of arousal will fail.
Physical and mental energy is required to convert sexual arousal into sexual action. Poor health, specific pharmaceutical medication or recreational drugs, excess alcohol, hormonal imbalance, sexual incompetence, low self esteem, stress, worry, unresolved relationship upheaval, grief, depression, tiredness - all may distract from arousal and/or desire.
Sexual desire discrepancy, low libido, and the lack of sexual arousal cause many disruptions to a fulfilling sex life.
The sexually more 'switched on' partner may believe they are unable to please their lover, or might feel anger and rejection when their needs are not being met.
The sexually less responsive partner might feel increasingly under pressure, which rather leads to sexual incompetence, performance anxiety, frustration, and avoidance.
Changing positions and other 'bed room acrobatics' as the only form of remedy usually does not help.
I suggest ‘problem solving for smart couples’.
- Being more flexible, less uptight.
- Accepting sexual desire and arousal differences as a normal and recurring part of relationship.
- Partner communication and negotiation.
Couples can learn assertive communication skills and open up to each other about their unique feelings, share their opinions, and talk without fear about what holds them back from feeling sexually turned on.
Major inhibitors to good sex include;
- Wrong sexual expectations may lead to disappointments, performance pressure, anxiety, anger, avoidance.
- Having to juggle too many personal, family, and professional responsibilities.
- Wrong beliefs that sex and intercourse should lead to orgasm and ejaculation all the time.
- Self esteem issues.
- Unresolved relationship upheaval.
- Negative or conflicting beliefs about sex.
- Lack of sexual fantasy.
- Lack of sexual competence.
- Sexual dysfunction.
- Poor body image.
- Fear of painful sex.
- Fear of unwanted pregnancy.
- In doubt about sex during pregnancy or as new parents.
- Fear of contamination.
- STI's.
The price to pay is typically a significant loss of attraction between the partners. Affirmotive recommends professional sex and relationship counselling.
What is Lust
Lust is the memory of extreme pleasure and arousal. Lust is a biologically driven experience, caused by our sex hormones and/or by arousal of sensual memories stored in the brain. The brain is our primary sex organ.
Our unique sexual habits and preferences arise from the impact of our sex hormones and our memories, fantasies, wants and practice of sensual pleasure.
Sexuality is inborn and genital pleasures are discovered by children in their early years of life. Masturbation may begin well before puberty and continues well into old age.
What is Love
The falling in love and lust experience, are both temporary and extreme states or memories of joy and pleasure.
Loving intimacy does not depend on extreme states but requires a shared trusting bond and physical connection. It requires 'growing together'. Intimacy between a loving couple are states of physical, emotional, mental and spiritual pleasures.
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Depression
Many people suffer a major depressive episode in their life.
A major depressive episode is consistent with at least a two week period of severe sadness. The affected person is easily upset and often teary, with symptoms of depressed mood and may lose almost all interest and pleasure in their daily life activities.
This (depressive) state of mood represents a change from the person's normal state of mood. Important functioning is negatively impaired by that change in mood, in nearly all aspects of their daily life; e.g. social, sexual, relational, occupational or educational.
Note - a depressed mood caused by any abuse of substances such as drugs, alcohol, medication or a general medical condition is not considered a major depressive episode. But substance abuse may occur in response to a depressive mood, or may create or deepen a depressive episode.
A major depressive episode includes the following symptoms;
- depressed mood most of the day
- markedly diminished interest or pleasure in all, or almost all, activities
- significant weight loss or weight gain when not dieting
- decrease or increase in appetite nearly every day
- insomnia or hypersomnia
- fatigue or loss of energy
- feelings of worthlessness and hopelessness
- excessive or inappropriate guilt
- diminished ability to think or concentrate
- indecisiveness, irritability, lethargy
- recurrent thoughts of death, suicide, a suicide attempt or a specific plan for committing suicide
If you have recurrent suicidal thoughts it is important to immediately contact your doctor, counsellor or local hospital. Depression is a treatable disorder.
Dysthymia
Dysthymia in adults is characterized by a moderate chronic state of depression, with depressed mood for most days for at least a two year period.
The symptoms in this two year period with no more than a month of symptomatic absence include;
- poor appetite or overeating
- insomnia or hypersomnia
- low energy or fatigue
- low self-esteem
- poor concentration
- difficulty making decisions
- sadness and feelings of hopelessness
The symptoms of dysthymia and depression may cause significant distress or impairment in important areas of a person's daily life, including; social, sexual, relational, occupational and educational functioning.
Depression is a treatable disorder. Professional counselling and psychotherapy are powerful methods and have been successfully used in both, the prevention and treatment of depression. Early intervention by a qualified professional counsellor is recommended.
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Sex Addiction
Sex addiction is a distorted form of normal human life-enhancing sexuality. The difference between 'normal' and 'distorted' lies in a learnt destructive motivation to sex, rather than the behaviour itself.
'Sex addicts' confuse intense sexual desire and arousal with their need for love, attention, attractiveness, closeness and intimacy and may fail to control sexual thoughts, urges, and actions.
Research suggests a number of contributing factors playing a key-role in the the development of addiction; including genetic, biological, neurological, and social influences.
Typically, sexual addiction is characterized by compulsive and obsessive sexual thoughts, fantasies, and acts, with a progression in severity over time, and a tendency of spiraling out of control.
Sexual addiction can be seen as a form of faulty self-regulation, using sex to 'self-medicate' a range of urges, anxieties, moods, and stressors.
The presence of untreated sexual addiction is likely to have severely harming effects on the quality of life of the addicted person themselves, on his/her ability to form or sustain sexually and emotionally sound relationships, on his/her spouse and family by inflicting emotional hurt, on his/her work performance, finances, self-development, and self-esteem.
It is important to realize that sex addiction is NOT a moral failure, but can be defined as a stress-induced defect acting on a genetic vulnerability in the reward-learning (dopamine) system of the midbrain and the memory-choice (glutamate) system in the prefrontal cortex, leading to loss of control and persistent cravings despite an awareness of negative consequences.
Persons suffering from a sexual addiction need specialized professional intervention to stop. A return to normal healthy sexuality can be achieved.
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Eating Disorders and Body Image
Eating disorders can affect anyone, male and female, across various age groups, cultures, and socio-economic backgrounds. The development of eating disorders may be influenced by a variety of factors including; genetic, biological, or social influences.
Persons with eating disorders commonly display self-loathing views of their body shape, attractiveness, or body weight. Those symptoms may become a singular focus and affecting every day life.
Untreated eating disorders can become habitually entrenched and very difficult to overcome. The health toll can be devastating to emotional and physical wellness, and sometimes lead to death.
Affirmotive provides professional counselling and therapy for the following types of eating disorders
Anorexia Nervosa
Individuals with anorexia nervosa may experience extreme fear of any form of weight gain. Even very thin persons with anorexia nervosa may perceive themselves as 'fat', and may do anything to loose more weight.
Extreme dieting or compulsive and excessive physical exercise are typically employed. In order to stay thin, a strict control over certain foods considered 'safe to eat' may be executed. Weight gain may also be prevented by self-purging.
Some individuals with anorexia nervosa accept that they are thin, but cannot escape the compulsion of loosing more weight.
Anorexia nervosa is not primarily about food and body weight control. The anorexics extraordinary ability to control, restrict, or avoid food leads to achieving a euphoric high, and a false but powerful sense of superiority and control over negative moods, low self-esteem, and severe feelings of worthlessness and inadequacy.
Individuals with anorexia nervosa practise food restriction in the unconscious attempt to win a relentless everyday battle of coping with the extreme pressures and interference of their inner world.
Associated physical symptoms of anorexia nervosa include;
- loss of menstrual periods
- intolerance to cold temperatures
- lowered heart rate and blood pressure
- weakening of bones, poor hair, poor nail conditions
Psychological symptoms of anorexia nervosa include;
- depressed mood
- obsessional thoughts
- perfectionism
- negative self image, feelings of guilt and unworthiness
- inability to concentrate on anything but on food, dieting and disorder-rerlated issues.
Bulimia Nervosa
Bulimia Nervosa typically involves a cycle of binge eating, followed by behaviours used to avoid weight gain. The weight gain avoiding behaviours can include rigid dieting which may lead to inadequate nutrition, hunger, fatigue, then followed by strong urges to binge.
Intense fears of weight gain and losing control may cause individuals with bulimia nervosa to purge themselves, using self-induced vomiting, abusing laxatives, fasting, and excessive exercise.
The fear their illness could be detected threatens the bulimics intense emotional need of being in control. Sufferers of bulemia nervosa may become masters of disguise with hiding their illness from friends and loved-ones, and sometimes professionals, for many years.
Psychological and behavioural symptoms of bulimia nervosa include;
- intense feelings of being 'out of control before or during a binge
- extreme concern with body image
- in excess exercising, exercise binge
- lowered mood
- unstable emotions
- feelings of hopelessness, shame and guilt
- social withdrawal
Physical symptoms of bulimia nervosa include;
- gastrointestinal problems - reflux or constipation
- rapid tooth decay
- glandular swelling
- fatigue
- dizziness
- increased risk of cardio-vascular problems
- cardiac arrest
Binge Eating Disorder
Binge eating disorder is characterized by compulsive overeating without compensatory behaviours such as purging, fasting or compulsive exercising. During binge eating episodes, the amounts of food eaten can be very large, and eating is more rapid than usual. Eating may even occur when the individual is not physically hungry.
Typical behaviours include;
- several failed attempts to weight loss
- buying and preparing more food than needed
- eating while preparing food
- eating between meals, and eating when not hungry
- avoiding eating away from home
Psychological symptoms associated with binge eat disorder include;
- low self-esteem
- difficulty to asserting or communicating needs
- social withdrawal or isolation
- self-disgust
- depression
- anxiety
- obsessional thoughts about weight and food
A referral to a medical professional may be necessary in severe cases of eating disorders.
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Erectile Dysfunction and Impotence
Impotence is the inability to achieve or maintain penile erections sufficient to complete satisfactory intercourse. In an estimated 10% of complete impotence erections may not be achieved at all. Ejaculation and pleasure feelings are typically not affected.
Impotence can be classified as primary or secondary.
- Primary Impotence: a man has never had successful intercourse with a partner but may achieve normal erections in other situations.
- Secondary Impotence: despite current impotence problems, there is some history of success with completing intercourse in the past.
Many men will experience occasional or prolonged episodes of impotence, usually resulting from stress, tiredness, lack of energy, relationship upheaval, anxiety, depression, medication for the treatment of depression, too much worrying about their sexual performance and resulting performance anxiety, or excessive drug and alcohol consumption.
Physical causes of impotence may be created by cardiovascular problems, angina, longstanding untreated high blood pressure, high cholesterol, obesity, diabetes, smoking, accident or injury to the spinal cord, and a number of medications for the treatment of hypertension and elevated cholesterol levels.
Resulting poor blood circulation, damaged blood vessels, or disruption of sexual arousal signals traveling from the brain to the pelvic area via the spinal cord may disallow for sufficient blood inflow/outflow to and from the penis.
Impotence can also result from benign prostate enlargement or prostate cancer, with the enlarged prostate gland causing undue pressure on penile nerves. Life saving prostate surgery and treatments may also contribute to erectile dysfunction.
Research indicates a range of impotence in Australian men between 3% in the 40-49 years old age group, 42% in the 60-69 years old age group, and an increase to 64% in the 70-79 years old age group.
Early treatment is recommended to preserve sexual functioning and emotional wellbeing. Affirmotive's professional sex therapist will recomend counselling therapy. A referral to a medical practitioner may be advisable if the condition is physical in origin.
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Delayed Ejaculation
Delayed ejaculation is a relatively rare conditon and should not be confused with impotence. Delayed ejaculation is a condition of involuntary over-control of the ejacultory reflex. Two main factors play a significant role;
Physical Factors
Phase one - seminal fluid gathers inside the the base of the penis with usually no greater sensation then a 'warning' of the approaching orgasm.
Phase two - (shooting phase) requires the contraction of both, the striated and bulbar muscles of the perineum and is responsible for orgasm. The perineal musculature is the area between the anus and the scrotum.
Phase two can be interrupted by a man's conscious or unconscious thought process, including a fear of not being able to cum or perform, and/or an increased tightness of the perineum. Specialist sex counselling and sexual education in relaxation techniques for this group of muscles may be helpful in the treatment of delayed ejaculation.
Physical factors may also include a history of diabetes, nerve damage, urethal scaring, and prostatic disease.
An undesirable side effect of prescription drugs including beta-blockers and some anti-depressants may also contribute to the condition.
Psychological Factors
Younger men who are starting out in sex and are 'paralysed' with sex negative feelings, such as anxiety, sexual inadequacy, sexual fears, sexual shame, or sexual guilt are prone to be affected.
Older men who have experienced an emotional stressful childhood or adulthood development, may have grown mistustful of release and letting go, and may subsequently experience major difficulties with sexual release.
Men who have developed difficulties with being sensual, or with focusing on their pleasure feelings may also need a greater level of emotional or physical stimulation.
Delayed ejaculation is a treatable condition. Affirmotive's specialist sex counsellor can provide effective therapy. Referral to a medical practitioner is advisable if the condition is physical in origin.
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Retrograde Ejaculation
Retrograde ejaculation is a condition of ejaculating inwardly into the bladder. Retrograde ejaculation occurs when the internal sphincter or bladder neck does not close properly and the ejaculate is subsequently not forced out of the urethra but may flow back into the bladder. This condition is harmless and the ejaculate will be evacuated with the next urination. Retrograde ejaculation may be a side effect caused by some psyichiatric drugs.
Urine testing using first urine sample after retrograde ejaculation can clarify the condition.
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Menopause
The word menopause literally means the end of the (female) monthly cycle. The Greek word ‘pausis’ means 'cessation', and the word ‘men’ from ‘mensis’ means 'month'. Menopause occurs commonly in midlife, in western culture typically between the age 40 to 60, with a means of 51 years of a woman’s age.
Menopause is the permanent cessation of ovarian function and indicates the termination of a woman’s childbearing age.
Menopause transition is a natural and healthy life change. The transition itself can be challenging for many women, others experience little discomfort.
Surgical menopause is induced by the removal of both ovaries prior to natural menopause.
On average, women who smoke cigarets experience menopause significantly earlier than non-smokers.
Women in the western world live long enough to spend half their adult life in menopause, a time known as the third age. A woman may choose to view menopause as a problem associated with the end of her childbearing ability, a loss of sexual attraction, and the end of womanhood as she knew it.
Alternatively, and equipped with good menopause knowledge and sex education women may embrace menopause as a new freedom from periods and downtimes, contraceptives, unplanned pregnancies, abortions, and child rearing. Women in menopause can express themselves sexually freely and fully.
Menopausal women may greatly benefit from obtaining dietary advise accommodating their circumstances, regular exercise, regular pelvic floor workouts, regular masturbation, continuation with intercourse, generous use of lubricants, medical dilators, the use of topical vaginal prescription or herbal creams to prevent vaginal dryness or encouraging increased bloodflow into the female erctile tissue (clitoris and clitoris shafts), and a use of safe sex toys.
In doing so women may keep sexual function, libido, and self-esteem in top shape.
Perimenopause
Peri menopause are the years of transition. The ovarian production of estrogens and progesterone becomes more irregular during peri menopause.
Fertility diminishes but does not totally cease. Periods become increasingly irregular and may fluctuate from spotting to light to abnormally heavy flows. Cycles can be as short as two weeks or stop for several month.
Signs of peri menopause may begin as early as 35 years of age, although most women become aware of changes in their mid-to-late 40s, or early 50s.
The most common symptoms of peri menopause are hot flushes. Hot flushes are caused by a sudden increase in body temperature, soaring up multiple degrees. This temperature differential may leave the woman weak and breaking out in heavy sweating as the body attemptes to cool down. Despite this stark discomfort, hot flushes are not considered a disease but the body’s natural regulation of sudden temperature differentials caused by a significant fluctuation of homones.
Pharmaceutical HRT and natural hormone replacement therapies my ease the discomforts. Some women may also develop depression and may benefit from SSRI medications or herbal remedies. In any case, a GP must be consulted when considering treatments.
Common Symptoms of Perimenopause include;
Vascular Instability
- Hot flashes, Cold flashes
- Rapid heartbeat
- Migraine
- Increased risk of atherosclerosis
Urogenital Atrophy/Vaginal Atrophy
- Thinning of the membranes of the vulva, the vagina, the cervix, outer urinary tract
- Considerable shrinking and loss of elasticity of all outer and inner genital areas
- Itching
- Dryness
- Bleeding
- Watery discharge
- Urinary frequency, urgency, possible urinary incontinence
- Increased susceptibility to infection, inflammation, vaginal candidiasis, and urinary tract infections
Skeletal
- Back pain
- Muscle pain
- Joint pain
- Osteopenia, and increased risk to developing osteoporosis
Skin, Soft Tissue
- Breast atrophy, Breast tenderness +/- swelling
- Decreased elasticity of the skin
- Increased dryness and thinning of the skin
- Formication - itching, tingeling, burning, pins and needles, and sensations of ants crawling under skin
Psychological
- Increased anxiety/depression
- Fatigue, loss of energy
- Problems with concentration and temporary memory loss
- Mood disturbance, irritability
- Sleep disturbances, insomnia
Sexual
- Painful intercourse, dyspareunia
- Vaginal dryness, vaginal atrophy
- Decreased libido
- Problems reaching orgasm
Postmenopause
Post menopause is all of the time after the ovaries have become inactive.
A woman who still has her uterus is postmenopausal after a full 12 month after her last menstrual flow, including spotting. A woman’s reproductive hormone levels continue to drop and fluctuate for some time into post menopause.
Any period-like flow or spotting occurring in post menopause must be reported to a medical doctor and the possibility of endometrial cancer must be checked and eliminated.
Menopause may cause much physical strain, emotional distress, and relationship upheaval.
Affirmotive's sex therapist can help with menopause education and personal/relationship counselling.
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Vaginal Atrophy
Vaginal Atrophy (also Atrophic Vaginitis) is the thinning and sometimes inflammation of the vaginal walls, caused by a decline in estrogen.
Vaginal atrophy most commonly occurs after menopause, but can also develop during breast-feeding, or at any other time when the production of estrogen falls low.
Many women, who have developed vaginal atrophy are likely to experiencing painful intercourse and a subsequent lowering of sexual interest. More over, healthy genital function is closely interwined with healthy urinary system function.
Low levels of estrogen may be medically treated, see your doctor for assessment.
Vaginal atrophy is likely to create pain itself, a fear of pain, difficulties with sexual intimacy, and relationship discord.
Affirmotive's sex therapist can help you with returning to healthy sexual functioning and relationships.
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