Sexual Wellness Resource Center
For Adults over 50.

X's and O's News

Anal stimulation

Categorized In General

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"I am a 60 yrs old man. It seems the only way that I can get an erection is with anel stimulation. Should I be concerned or is this normal for a Man of My age? I do drink, smoke and take blood pressure medication. I do wake with an erection upon occasion. I have not been wirh a woman for about 3 yrs. Any insight?"

Hello and thank you for the question. At 60 you are not alone in needing extra stimulation to get an erection. Over the decades spontaneous erections are fewer, the good news is that tactile or touch stimulation can result in firm erections. With aging it is normal to need more touch, whether it be manual, oral or by using sex toys. The nerve endings in the skin between the scrotum and the anus and in and surrounding the anus itself are as sensitive, responsive, and pleasurable as those of the penis. If stimulation of those areas is necessary for erection, not to worry, whatever works is healthy. Anal stimulation is not just reserved for homosexual activity, many heterosexual couples use anal and prostate stimulation to enhance erection quality and orgasm intensity.http://www.xsandos.net/blog/sex-techniques/perineum-anus-erogenous-zones.html

There are sex toys for solo sex which are fun to try and actually work. Check out our store for masturbation sleeves, penis pumps, rectal plugs and prostate massagers. http://store.xsandos.net/mens/

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Couple use of Sex Toys and Menopause

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"My wife and I enjoy sex toys, after the menopause her vaginal wall is very thin. most vibrators are harsh on penetration and rubbing the vagina is discomforting. We use lube obviously, is there any kinder sex toys we could play with."

If your wife is not already using topical vaginal estrogen cream, and has no contraindications to its use, she should get a prescription from her doctor. I usually recommended 1 applicator vaginally daily for two weeks followed by one applicator twice weekly indefinitely. This rejuvenates the lining, making it thicker and more moist. For most patients, this entirely eliminates the symptom of vaginal discomfort. It is a very low dose of estrogen and is quite safe.

Now, if vaginal estrogen is not an option I recommend putting aside the vaginal vibrator, reserving vaginal stimulation by tongue, gentle finger, or erect penis. For penetration the female on top position is better for her to control the rhythm and depth of penetration if there is discomfort. "Kinder" toys can be used for external pleasure, for instance the we-vibe vibrator that you can use together during penetration or a penis ring with a vibrating option.

Thanks for the question, I liked your phrase "kinder sex toys," you are a considerate partner.

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Osphena

Categorized In General

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What do you think about Osphena? Should post menopausal women take it even if they are not sexually active? Gracias

I have to admit that I was not aware of this drug. It was approved by the FDA in 2013 for the treatment of pain with intercourse in menopausal women. What is Osphena? It is an estrogen agonist/antigonist, meaning on some tissues it acts like an estrogen and other tissues it acts like an anti estrogen. It is similar to the drug tamoxifene which is used as additional treatment in some breast cancer patients after surgical or radiation treatment because of its anti estrogen effects on the breast, a good thing for breast cancer survivors.

Osphena acts like estrogen on the vagina and the uterus. It makes the vaginal tissue thicker and less fragile resulting in less pain with intercourse, a good thing. It causes the endometrium, the lining of the uterus, to grow which eventually could cause bleeding, precancer changes or cancer of the endometrium, bad things. To prevent the bad things, it must be taken with progesterone, the balancing hormone of estrogen. That means another pill every day. It can also cause or increase the frequency and intensity of hot flashes, a bad thing for menopausal women who may already be suffering from hot flashes.

Finally, is it safe? Besides the bleeding and cancer risks discussed above, there is a very slight risk increased risk of strokes and blood clots in the legs. However, these risks also exist for women on estrogen alone hormone replacement therapy.

What do I think about Osphena? This is a medication with a lot of drawbacks and potential problems. Vaginal estrogen cream is the standard of care for the treatment of painful sex during the menopause. It is not absorbed into the bold stream, so it does not affect the lining of the uterus, nor increase the risk of stroke or blood clots. It does not require a second medication to prevent uterine cancer. It does not cause or increase hot flashes. For the majority of women vaginal estrogen cream will be the safest option with the fewest side effects.

Logo

Categorized In General

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 I find your articles to be well researched and to the point. As a regular reader, I can't help but be curious as to the symbolism (meaning) behind the website name. Hugs & kisses?? Can you elaborate? xoxo

We are three partners, Cindi, Carolina, and myself.  After deciding to develop a website in sexual health for aging men and women, we spent several weeks trying to come up with a logo.  Something we could use as a brand, something catchy, something that would be universally understood and appeal to both sexes.

Cindi came up with the idea of xoxoxo, the traditional sign of hugs and kisses.  This symbol is often used at the end of a message or letter to some who is important to the sender, like a spouse or a girlfriend or a boyfriend.  I pointed out that the x's and o's are also used in game strategy diagrams, like soccer, football, and basketball.

The result?  A logo with a positive feminine recognition that is also recognized as something familiar and interesting by males.  The design of the logo was done by our website design company.

How did we do?

Silicone

Categorized In General

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What's the difference between medical grade silicone and FDA body approved silicone?

I understand the confusion. Medical grade silicone and FDA body approved silicone are the same thing, so the terms can be used interchangeably. The Food and Drug Administration (FDA) approves all materials that are used for medical purposes. Medical grade silicone, which is phthalate free, is usually grouped into three categories: non implantable (like sexual aids), short-term implantable, and long-term implantable.

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Lubrication

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"After menopause, I've used vasoline or even Neosporin for lubrication for intercourse. I've heard, over time it can cause a build-up. Can you explain so I can understand it a little better?"

This is such a good question that I am going to dedicate an article to the subject. The short answer is any lubricant you use will not build up or accumulate in the vagina, your vagina will absorb what it can and the rest will flow out. Vasoline can damage condoms and can damage sperm. The sperm part is not so important for a menopausal women, however, condom damage can limit the comdom's ability to protect you from STDs. I wouldn't recommend Neosporin, that is a topical antibiotic cream that can change the normal bacteria in the vagina and cause vaginitis, with symptoms of itching, burning and discharge. I usually recommend silicone-based lubricants like Replens or Astroglide. The most important thing for the menopausal patient is vaginal estrogen, watch for the article.

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Viagra for women

Categorized In General

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"If Viagra for men causes increased blood flow to the penis, can it help a woman in the same way to her clitoris? Aren't they the same type of skin and nerve endings to make it more "pleasure sensing"?"

Good question that gets some media attention. Yes, the type of skin and the nerve endings are similar in men and women. There are a few studies about this question, but nothing new for the past 3-4 years. Of the few studies I found, one noted that there was increased blood flow to the clitoris and clitoral enlargement with Viagra, but no comment about whether it increased sexual pleasure. Another found some benefit of viagra for women already taking SSRI antidepressants, the same family of medications to which Addyi belongs, the new drug approved for female low sexual desire. Another found no benefit in postmenopausal on hormone replacement therapy.

If there was good scientific data that Viagra is effective for women, I think pharmaceutical companies would be very interested and doing lots of studies. Since that is not the case, the science probably isn't there to justify further investigation and development. The "pleasure sensing" that you ask about probably is not effected by viagra, even if there is clitoral enlargement.

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Cholesterol

Categorized In General

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"About six months ago, my husband, 56, started taking medication to control his cholesterol.Can this have an effect on his sexual performance? He asked his doctor, but his only response was 'sometimes'. This is the only medication my husband is taking, and it seems to have decreased his interest in sex. Thank you."

Cholesterol medication is a rare cause of decreased sex drive. You should explore other possible causes, including erectile dysfunction, with a doctor who has more to say than "sometimes".

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Penile implant

Categorized In General

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"Dr. Bates, I read the article about your personal experience of impotence... What does a penile implant entail? Will my partner know I have one? How much does it cost? Is it covered by insurance?"

 It is a same-day surgical procedure that requires a small incision in the scrotum. One should plan to be off work and resting for a week. The only difference you or a partner would notice is that a small pump, about the size of a testicle, is placed in the scrotum. It is not obvious and if the male wanted to conceal it from a partner, it would be possible to do so. They are not expensive compared to many other costs in medicine and most insurances cover at least part of the cost.

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Q&A on Addyi

Categorized In Women's Health

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"Dr. Bates, I enjoy reading your articles. At my age, I need all the help can get! I'm curious about the supposed new Viagra for Women (Addyi). I read your article & many of the recent news reports since its FDA approval. They say it works like many serotonin anti-depressants... In my circle, it's widely known the side effects of most anti-depressants are a decrease in libido. What's your take? Would you prescribe a 60+ patient with this new drug? Thank you

Great question!  Your circle is right, this family of medications, SSRIs, is known for the side effect of decreased libido in some patients.  Therefore, it doesn't seem logical to  use this type of drug for low sexual desire, espacially in someone has experienced the side effect.  The key is individual patient selection.  If a patient truly has the diagnosis of hypoactive sexual desire not due to medical or mental disorders or the medications to treat these disorders, she still might be a candidate for a trial of Addyi.

The drug is recommended for premenopausal patients, not for those 60+.  However, I would consider it if the patient was on adequate doses of hormone replacement treatment and she had the diagnosis of hypoactive sexual disorder.

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New Sexual Wellness Resource Center Site Launched

Categorized In General

X's and O's Sexual Wellness Resource Center and online store officially launched on June, 23, 2015. This new web site xsandos.net is designed to promote healthy sex and educate adults 50 and older about issues concerning dating, relationships, health and sex.

Sexual wellness and issues surrounding sex for older adults is becoming a more widely discussed topic as the Baby Boomer generation ages. xsandos.net was created to raise awareness and lift the negative stigma off these discussions. 

The site was created by retired OB/GYN Dr. Michael Bates and his wife Carolina, a professor of linguistics and masters of psychology. News articles and blogs will be posted to the site regularly by Michael and Carolina and their expert partners. Content on the site will appeal to mean an women 50 and older, with topics ranging from online dating and safe sex, to sex techniques and adult sex toys.

The site has an online store where educational material and sex toys can be purchased without pornography or graphic ads. The online store can be visited directly at: store.xsandos.net

Dr Bates practiced as an OB/GYN for 34 years in Wichita, Kansas. He will manage the site with Carolina from their home in Barcelona, Spain. The site was developed by 360ideas in Wichita, KS.