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Archive for December, 2015

One of the very first blog posts I published, even before MiddlesexMD was launched, was about receiving a bouquet from a patient. She and I had talked about her options for managing changes in her sexual response, and I’d recommended a device that turned out to make the difference for her.

The flowers were an affirmation from her that she’d gotten her groove back, and I was delighted.

What I’d recommended was a device for “vacuum therapy.” It doesn’t sound very sexy, but it works for two reasons:

First, it works on the brain. Signaling to yourself that you intend to have sex becomes increasingly important as you have less of the hormone stew that supported spontaneous sex in years past. All that talk about “mindfulness” and “marking your calendar”? It’s because intention is a critical part of sexuality for midlife women.

And second, it works on the body. Less circulation results from less estrogen. More circulation is part of our sexual arousal and response. Gentle suction increases circulation to the clitoris. Stimulating blood flow and encouraging vaginal lubrication both prepare us for intimacy and make the experience more enjoyable.

I was thrilled to see, at a medical conference last summer, a new tool for women who want to keep the intimacy alive in their relationships. While previous options have looked a lot like medical equipment, theFiera Arouser is designed to be an intimate aid. It’s discreet and sleek. It combines gentle suction and vibration patterns. And it’s been tested in clinical trials, which documented the “engorgement” that triggers arousal.

How’s it used? The designers of the product call it “before-play,” and it’s where the effects on the brain come in. It’s used in advance of a sexual encounter to increase both your arousal and your responsiveness—which means a more pleasurable experience for you (which means a more pleasurable experience for your partner!). You tuck the Fiera into place, over the clitoris and under the labia, and your hands are free for… other things. Five to fifteen minutes is recommended.

Although it vibrates, the Fiera is not a vibrator. You may still want one of those, too, for increased sensation to experience orgasm. If you’re finding you don’t get to that point as often as you’d like these days, you might find the Fiera Arouser—and the intention to put it to use—to be helpful.

When I saw this product at that medical conference, it wasn’t yet in production. I asked my team to nag—I mean, follow up—with the manufacturer so we could add it to our shop just as soon as it was available. We’re delighted that it’s now in stock, and that we’re partnering with the manufacturer to make it available for women to experience!

Use the coupon code 8AMORE to receive a $49.99 discount on the Fiera Arouser on our site. And let us know how it works for you!

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Our friends at The National Association for Continence recently reported that fully 40 percent of women are doing Kegel exercises incorrectly.

Oh dear.

We want to do our part to correct that, because for one thing, it’s not really that hard to do them right. But most especially because, you really can’t do a single solitary thing to help you maintain pelvic health throughout your life that is more beneficial than Kegels. To avoid incontinence, pelvic organ prolapse, uncomfortable sex, urinary tract infections, a host of difficulties as we age.

Not. One. Thing.

And that goes for your mom. And your daughter.

And guess what? For any man in your life, too.

Yeah! Everybody!

Everybody! Do the Kegels!

But, well, we have a focus here at MiddlesexMD, so our links and discussion might be a bit more female-anatomy-ish. But here’s a very specific link for the men, just so you know I’m quite bullish about Kegels for men, too.

Okay. Let’s get our Kegels on.

First, if you need a refresher, on your the pelvic floor muscles, I wrote all about that here. I encourage you to review that post so you can envision the lovely figure-eight sling of muscles that hold all of your important organs in their proper places, happily chugging along as you move through your busy day.

Once you have a clear sense of that pelvic sling of yours, find a place to sit quietly, feet on the floor, straight out from your hips, hands just folded quietly in your lap, eyes closed, breathing softly, with the space and time to give this practice a little focus.

Are you there? Good. Now, as if you were stopping the flow of urine mid-stream, tighten the muscles around your vagina. That’s all, just as if you were stopping the flow.

And there they are! Those are the primary muscles we will be working!  Well done, you!

Let’s take it another step. Working just a little harder, imagine that you are sucking a heavy, marble ball into your vagina. But, let’s make it a warm one, and well lubricated!

As you develop your sense of your inner landscape, try tightening your inner pelvic muscles to draw your pubic bones and tailbone together or imagine trying to draw your “sit bones” toward one another.

But! And here is where things can go wrong, and where people tend to run off the tracks. When you are doing your Kegels, you should not be tightening your buttocks. Let those stay relaxed. Don’t tighten your inner thigh muscles, either. Let those stay soft.

Definitely don’t hold your breath. Breathe softly. Do not suck in your gut. All is soft except that sling under your organs. Focus. And breathe. This thing that takes some concentration at first will become so natural with practice you will be able to do it while waiting in line at the grocery store.

Here are further ways you can help yourself really refine your practice, and I love these recommendations, and very much encourage you to actually do them!

First, get up close and personal. Use a hand mirror and a good light to watch what happens when you contract these muscles. That’s right—look in the mirror at your pelvic floor in action. It’s pretty cool to see what you can do when you are working those muscles!

Second. Remember they are muscles, and like all muscles, they have a full range of motion that should be worked. Most of us do our Kegels just contracting them. But it’s good practice also to stretch, or elongate them. And one of the best ways to think about that is the Elevator visualization. It goes like this:

Think of your relaxed pelvic muscles as the first floor. Contracting your Kegels as we did for the urine-stop visualization is like taking them to the second or third floor. The marble sucking exercise is maybe the fourth floor. And if you use actual Kegel weights or barbells you can go to the higher floors still. But elongating, or stretching the muscles, is taking your pelvic floor to the basement. Something that’s very good for them. Elongation tends to happen naturally when you yawn. But it’s a nice thing to do for them at the beginning and end of your Kegel sessions. Stretching is a kind of pushing action, a little bit of a bearing down, to stretch the connecting ligaments a little bit, get the blood flowing.

So, I hope that clears thing up. Don’t be among the 40 percent. And don’t let anyone you love be, either. Good pelvic health is everyone’s right. We ought to be the generation that ensures this for everyone.

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