sexual dysfunction

I love that.

And I also want to talk a bit about painful sex, because I think, I mean, as you mentioned, pleasure is something different for everybody or sometimes we think it's quote unquote normal that this hurts or it's normal that this and that happens and we won't speak up or we don't change anything about it because it's always been that way for the person.

So how do you address that with your patients, with your clients? Is that difficult to talk about sometimes?

It's definitely difficult to talk about, but I love it when these women reach out to me.

Hello and welcome to the Help Us Here podcast brought to you by the Beyonds Compulsion Academy.

Just a quick one today about dealing with sexual dysfunction.

So this is something which a lot of clients do get in touch about, maybe not right away, but it can be something that maybe after a few months someone feels comfortable opening up about.

They might share how they've had like erectile dysfunction, premature ejaculation, or a different kind of sexual dysfunction of some sort.

And oftentimes These problems are caused by excessive porn and masturbation use.

You know, it changes and sort of rewires their brain to associate sexual pleasure as such with a screen and pornography in particular.

And that would like really, really occupy my mind was like having erectile dysfunction, which I had a few times in the past.

Whereas now I'm like, okay, well, the problem that people have is the inability to deal with their own compulsive desires.

All right.

Now, with regards to painful sex, there might be more to this than just hormone changes and bad technique.

So we are going to talk about the pain, the potential increase in pain when you're having sex during pregnancy.

Okay.

So if you feel pain during sex, I would suggest having an appointment with a healthcare provider.

First stop could be a women's health physiotherapist because they can assess your pelvic floor for issues of tension or muscular imbalance to start with, but also educated in other issues of why sex might hurt.

The other person that you might need to see is your maternity care provider or a gynecologist, and this is specifically if there's some kind of infection or condition that could be contributing to painful sex.

There is a condition called vaginismus, and many of you may not have heard of it.

You do not need them to follow along today, but you will want them.

Today, we are going into painful sex after menopause.

Not in a whispered, uncomfortable, let's get through it kind of way, but in a real clinical, this is what is happening in your body and here is what you can do about it way.

We are also getting into the part of the conversation that I think matters just as much as the clinical piece.

Mm-hmm.

one of the things that I see happen around sexual dysfunction is that the couple's fusion really shows up.

Yes.

So you'll have like, you know, one partner's body's not doing what they want.

This is such a great dynamic topic.

You cite rates of sexual dysfunction at over 80%, that's, that's high, in both men and women on SSRIs, yet you describe it as a topic patients are often reluctant to bring up, again, 'cause it feels uncomfortable or inappropriate or un- unacceptable somehow.

Why do you think there's still m- so much silence about this side effect despite all the education and...

Sure.

So, you know, we can work on that.

pelvic pain is pretty common as well even if it's breast cancer related posture changes and with posture changes that can impact all the way down to the pelvic floor as well so in terms of the most common it's i would say bladder bowel sexual dysfunction pelvic pain but it's really going to depend on the diagnosis and the treatment that they had gotcha

So what do you do when the patient starts to talk about sexual dysfunctions? It's another thing as well, right? Sometimes you just go to see the physician or the gynecologist and they don't really get that many answers.

Right.

So what is your advice and what do you do with this patient?

So I recommend even if you are not a pelvic therapist to still screen for that and that it's not just a checkbox because it is common when we look at the data, depending on the population, upwards of 90 plus percent of cancer survivors deal with some type of sexual dysfunction.

And that's not just pain with intercourse, which is what a lot of people kind of think of.

It could be erectile dysfunction, decreased libido, decreased arousal, vaginal dryness, difficulty with orgasm, leakage with orgasm, which is pretty common.

except for they still have sexual arousal dysfunction, which I completed a study with over 200 brain maps showing that porn-induced ED is a real thing, which there's many other studies that corroborate that.

Just to double click on that one, pun intended, to go deeper into that piece, what actually causes that? What's the neurological reason that watching pornography for too long or too much or whatever it is, how does that then induce sexual dysfunction and erectile dysfunction?

Yeah, it's very logical if you just think about it logically, is that I already told you how pornography is a prime example, a top tier example of algorithm amping, and it amps what are called supernormal stimuli.

So hypersexualized content is highly dopamine producing.