Archive for January, 2013

In my last post, I talked about the importance of touch and foreplay, and encouraged you and your partner to talk about where you like to be touched—and how. Here are some top erogenous zones, according to several sources I’ve run across. Use this as a starter kit, and let us know if you discover something new.

Starting from the top:

Head and scalp. Who doesn’t like a scalp massage? Our scalp is loaded with nerve endings and experts say massaging it releases endorphins. This may be more feel-good than erotic, but who cares? Use fingertips, then fingernails to mix things up.

Some lists mention kissing the forehead, which reminds me more of mommy, but that could be sweetly intimate as well. One woman mentioned an erotic link between her forehead and her lower back, which begins “aching to be touched” when her forehead is kissed. Hmmm. Worth a try.

And of course, there are the ears. Blow gently. Make small, firm circles with your fingers along the outer rim. Massage the earlobe. Does that feel good?

Neck. Exquisitely sensitive, even ticklish to some, the neck is worth exploring. Try tongue, fingers, light touch and other textures. “The moment between feeling breath then feeling lips, tongue, teeth is incredible. It’s the combination of anticipation and pleasure foreshadowing what’s to come,” says one woman in this Huffington Post article.

Armpit. I wouldn’t have thought of this one, but apparently, it’s a hottie. Try licking and a somewhat firm touch so as not to tickle.

Breasts and nipples. This body part is too obvious, but the thing about breasts and nipples is that the right touch is orgasmic and the wrong touch is downright painful, so you’ll have to teach your partner how you like it. This goes in spades for women who’ve had a mastectomy. Your partner needs to know if and how you like to be kissed or touched in this area.

Lower abdomen. This part can be highly erogenous for men and women. Use a feather or light touch in circles from the navel. Head south. Men especially like the anticipation of light touch on their lower abs. For men “…the area of the abdomen between the navel and pelvis is a fun area to tantalize, and as blood flows to the pelvis and sexual tension gathers, it’s a good area to simulate,” says Dr. Ian Kerner, a sex expert in New York City in this Woman’s Day article.

Mons. A little farther south on women, Dr. Michael Krychman, a medical advisor to MiddlesexMD, recommends attention to that little mound above our genitals. The mons “… can also be interesting when incorporated into the sexual repertoire. Caressing the hair area or gentle touch to this area can be exciting and pleasurable.”

Inner thigh. “The gift wrapping to his package,” says this source. I say that we women like erotic touch on our inner thighs, too. Breathe, kiss, stroke lightly. It all feels good. Pay special attention to what’s called the “cut lines” in men—those creases where thigh meets torso. Try licking or kissing his abdomen while stroking the cut lines. Kind of like rubbing your tummy and patting your head, but maybe worth the effort for him.

Back of knees. This is an oft-mentioned sensitive spot for both men and women, the back of the knees can be ticklish, and may be more sensitive in men because it’s less hairy. “Some women find this area especially exciting and pleasurable when showered with gentle touch or caresses,” says Dr. Krychman. Try using massage oil on the legs and thighs.

Feet. Ever the focus of fetishists, the feet have their own beauty and sensitivity. What feels better than a foot rub? (Okay. Maybe a scalp massage.) Some people have a direct sexy link from the arch of their foot or their heel. Others just like the yumminess of it all. Why not spend a night on feet?

Or, work up from the feet. Or start at the top and work down. Or… ?

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You already know (you do know, don’t you) that the skin is your largest sex organ. We’ve talked about that, also about how important foreplay is now that we need a little more stimulation to get in the mood.

So let’s get specific about this whole skin thing.

Not all our parts are created equal: Some are ticklish; some are sensitive; and some are very willing to play along with our pre-sex games. We call these our erogenous zones. Since we have many of them, why not spend some time exploring this secret garden with our partner? I’m betting you’ll discover new ways to tantalize your mate as well as to become aroused yourself.

We are each unique. What turns you on may not excite your partner. A ho-hum move for you may electrify him. Men and women each have special turn-on zones that are unique to the gender. Cut lines for men; nipples for women, for example. Gentle touch may be more pleasurable in one place while another may require a firm hand or even a smack. Variations in touch and texture can also be exciting, so don’t overlook fur and feathers or heat and cold.

Women often wish their partner just knew what they like without having to be told (or shown), but let’s get over it. That may work for Christian in 50 Shades, but our real-world guys need a hint. Heck, you may not even know all your own sexy spots.

You and your partner could map out places on your bodies you’d like to touch and explore. Tell each other where you fantasize being touched just so. Make cards with the names of various erogenous zones and draw one or two randomly. Focus on those in your next love fest. Finally, and most importantly, let each other know when a particular touch feels good—or when it misses the mark.

In my next post I’ll list some top erogenous zones, according to several sources I’ve run across.

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Both before and after menopause, the indication for treating an ovarian mass is based on its symptoms: Is it causing pain with daily life? Is it causing pain with intercourse? How big is it?

Cysts, which are fluid-filled, are not usually worrisome, and usually resolve themselves without intervention—either before or after menopause. We are concerned if they continue to grow (anything less than 5 cm in size is not a worry).

Any solid mass requires investigation, because it is more likely to be a tumor or cancer. Again, the size and growth rate help us to determine a treatment route.

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I’d like to solicit your opinion.

As you know, (or… maybe you don’t) MiddlesexMD has an online store in which we sell all kinds of products geared toward the sexual needs and pleasures of older women—“for midlife women who want to enjoy sexuality for life,” as we say. And some products just for fun.

As I’ve explained before, I created this store for a generation of women who need more sexual stimulation, lubrication, and support, but who probably aren’t going to check out their local sex shop (assuming there is one) and who probably aren’t savvy or experienced shoppers when it comes to choosing items like vibrators or warming oils.

So my team and I did the shopping (when was the last time you went to an “adult” trade show?), testing, and selecting of products we thought would be helpful and safe for midlife women.

It wasn’t easy, let me tell you, but I’m proud of our selection, and I’m confident about the quality of their design and construction and the safety of their materials. Full disclosure: MiddlesexMD is a business, so there is some profit involved.

So what’s the problem?

Because I have this dual role—as a practicing physician and as MiddlesexMD, other health care providers ask my advice about product sales. I know that the doctor-patient relationship is a tender thing, and it’s based on trust. My patients trust me to use my skills on their behalf. They don’t want my commitment to their health and well-being diluted or divided by self-interest. Nor do I.

When doctors sell products, conflict of interest is always lurking. Can doctors be objective when they stand to make money by recommending this vitamin or that weight-loss aid? And wouldn’t patients feel some pressure to buy the product to please the doctor? Does the presence of the product in a doctor’s office imply that the doctor endorses it?

The fact that some doctors derive a significant portion of their income from selling these products in their offices reinforces that appearance of ethical shadow-boxing. A few “celebrity” doctors have become virtual mouthpieces for certain product lines, which often lack research as to their efficacy or even safety.

As you can imagine, the issue has engendered passionate discussion both pro and con within medical circles, and professional medical organization have yet to issue any guidance regarding the practice.

I can honestly say that my primary motivation for selling products that I’ve tested and sometimes use myself is to provide a tasteful, private, safe opportunity for women to buy intimate items that will help keep them sexually active and comfortable and that they’d have a hard time finding otherwise. I set prices comparable to other retail options.

I practiced medicine for years before bringing products into my office. My relationships with patients were well-established. And I’ve seen first-hand that women are more likely to follow through when I can show them what lubricants feel like or how a vibrator functions. When my patients can walk out with products they’re ready to use, rather than with one more research project for their to-do lists—well, I think that’s useful and convenient. I’m not sure I would still have an electric toothbrush if my dentist didn’t offer them for sale.

So I’d like to think I’m offering a valuable service to my patients, but can I truly be objective when I have something, however modest, to gain? Do my patients feel subtly obligated? Do I compromise my professional credibility?

What do you think? Service or self-serving? I’d really like to know.

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So glad you’ve been successful with the dilators you ordered from MiddlesexMD! Vaginal dilators can help to restore capacity and comfort for intercourse. Our website has instructions for how to use them to restore the vaginal opening.

Once you’ve been successful with that therapy, if you’re not having regular intercourse, I recommend that you use dilators at least once a week to maintain the progress you’ve made. Stimulation is important to retaining vaginal health—which is what we mean when we say “use it or lose it.” If you find that you’re having more discomfort, increase the frequency of dilator use.

Post-menopausal women find that using a vaginal moisturizer (like Yes or Emerita) really helps to maintain elasticity.

Congratulations on following through with the dilators—and stay with it! You’ll find it easier to maintain than to regain your comfort.

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As we grow older or experience physical changes, our sexual abilities may change. Oral sex is one alternative, as is anal sex, although that has some drawbacks.

There are also variations called “outercourse.” The woman holds her thighs together, and the man inserts his penis between, either face to face or from behind. Cupped-together breasts are another “outercourse” option.

And remember that orgasm is an important part of intimacy, but it’s not the only part. Cuddling, massage, and even erotic talk are also important alternatives to intercourse.

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In my last post, I talked about how we construct our body image from childhood experience, media messages, and social definitions of beauty. Body image is the result of our own internal dialog, not how others actually see us. For the new year, I hope we can all remember that beauty is in the eye of the beholder, and that our bodies are amazing.

If you’re working on health, start small. First, use this calculator on the CDC website to assess your body mass index (BMI). This gives you a more realistic picture of where you fall on the scale of avoirdupois. Then, change one thing at a time: walk to the store. Join a yoga class. Go to the gym.

“I don’t look like Jane Fonda,” said a participant in the Psychology Today survey. “I look like a normal 46-year-old woman who has had three children. But my body is beautiful because of all it does for me. I have two eyes that can see, a large nose for smelling, a large mouth for eating and smiling, two hands that can hold and hug, two breasts that have nursed three sons, an abdomen that was home to three babies, two legs that can walk everywhere I want to go, and two feet to take me there.”

Amen to that, Sister.

Focus outward. If you’re shy or socially awkward, you may also be overly sensitive about your looks. (I can relate.) If you focus on yourself rather than on the world around you, you become more critical of yourself. Try to make others feel at ease. “Once I worked on my people skills, I found that I worried less about my appearance,” said one 60-year-old woman in the survey.

Confidence is catching. People who are happy and radiate confidence are attractive, and it doesn’t matter how they look or how old they are.

Here’s a tip: If you don’t feel confident, fake it. Stand tall. “Walk like a queen,” my friend said to me. Think of yourself as attractive and interesting. Make eye contact and talk to others. Practice this until you can do it effortlessly.

P.S. Self-confidence is also sexy!

Be true to yourself. Why worry about conforming to expectations? Who has time for that? Wear what you like. Purple if necessary. Say what you believe. It’s time to let the world get to know that wise, experienced woman you are.

Body image, like our bodies, isn’t static. How you felt about yourself as a teenager or a young woman is obviously different from your body image today. The good news is that older women tend to be more comfortable with their bodies as they age. But the work of improving body image is never done. Perhaps being comfortable when we’re naked with our partner is the truest, most difficult, and most important, test of a rock-solid body image.

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