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I recently finished writing and filming a 6-day course for Flo (a women’s health app: @flotracker) on Mastering Your Orgasm!

It was a ton of fun diving into the latest orgasm research and putting the information into bite- sized videos. The best part of this course is that it teaches women from around the world to have better orgasms! It was also a natural fit for me, given that one of my more recent published articles is all about the benefits of genital vibration (one of which is, no surprise, orgasm!).

In this course, you’ll learn some great tips and tricks to have an orgasm (like how your brain is your most powerful orgasm organ). And you’ll learn how to have better orgasms with yourself and with a partner.

If you’re wanting to have mastery of your orgasm, check out the course on Flo (here’s a teaser)!

*Full disclosure: I was paid to do this course for Flo, so I’m biased in my review. . . and I do think this is a really great course!

During the time of COVID-19, video visits (also known as telehealth or teletherapy) are a safe way to engage in therapy while maintaining social distancing. I’ve been providing teletherapy for the past 5 years on a regular basis and it is a great alternative to in-person visits. Check out this video on how they work, or read more below:

Video visits are actually a lot easier than you think. You only need 3 things:

  1. A device with video/audio capabilities (this can be a computer, tablet, or smart phone)
  2. This device must be able to connect to the internet
  3. Privacy

How do video visits work?

The video platform I use is called SimplePractice and it’s about the easiest software I’ve ever used.

  1. On the day of your therapy appointment you will receive an email with a link to your video visit.
  2. Just click the link and a video screen appears. This screen is simply a preview screen that allows you to test your audio (by simply clicking a button) and preview how you look on the video.
  3. When you’re ready, click “Join Video Call.” Once you join the video call, you’ll wait in a virtual waiting room until I login.

Unsure about video visits? Here are the most common worries clients have about video visits:

  • How secure are video visits? The SimplePractice video software I use is integrated with my electronic medical record, so it follows the highest security standards. Video visits are live (never recorded) and HIPAA compliant, meaning they are private, secure and confidential.
  • Where should I be during the video visit? Anywhere you will have privacy for the duration of the visit. Typically, the clients I see are in their home offices or bedrooms.
  • Where is my therapist during the video visit? During this time of COVID-19, I will be conducting video visits from my private home office. You’ll receive the same level of privacy as if you were in my in-person office.
  • Will video visits feel as personal and connected as in-person visits? When I do a video visit, I sometimes feel the disconnect of the video screen for the first minute, but then quickly the screen seems to disappear and the connection between my client and I returns.
  • Are video visits as effective as in-person visits? I have had many clients tell me they don’t want to do video visits because they don’t think video visits will be as effective as in-person visits. Research shows that telehealth is effective and can be as effective as in-person therapy. Personally, I know I can provide the same high quality treatment via video that I can provide in-person.
  • Does insurance reimburse for video visits? Insurance companies typically don’t pay for video visits. The only insurance I accept, University of Utah UNIBHN, is currently making an exception due to COVID-19 and covering video visits.

When will you start to do therapy in-person again?

The short answer to this question is, likely when the Utah COVID-19 risk phase reduces to Low Risk. Salt Lake City is currently in the Moderate Risk Phase, and during this phase telework is recommended, unless not possible. Telehealth is as effective as in-person visits for many mental health concerns, and the vast majority of my clients are finding that (despite the occasional technical difficulty), it’s as beneficial as an in-person session. Given this, I am happy to do my part for reducing risk and continue telework for the time being.  In the meantime, I appreciate all my clients who have transitioned to telehealth and all my clients who are waiting patiently to be seen in-person. We will get through this and I can’t wait to see your faces in-person again!

You’re probably thinking, there’s no way cancer sets the stage for amazing sex. And, of course you’re thinking this. Cancer has caused loss after loss after loss. Loss of your breasts, breast sensation, vaginal health, sexual desire, confidence in your body image… I want to propose a shift in your focus. Focusing not on the losses in your sexual health, not on how you feel stuck with these sexual changes you didn’t ask for, but instead on the potential gains. I am not telling you to just think positive. I hate that. I’m a realist. I am telling you that there are more gains than you may realize. I want to share with you how cancer can set the stage for these gains. How cancer can set the stage for amazing sex. The easiest way to describe this is to tell you a little about skiing.

I live in Utah and I love to ski. Skiing is a lot like amazing sex:

  • It’s about the journey, not the goal. It’s about the experience of riding down the run, not simply trying to get to the bottom. Just like sex. It’s about the journey of experiencing pleasure, not just trying to get it over with.
  • There’s an expansive menu, lots of different terrain. Not just the bunny hill again and again. Like amazing sex, the experience is about the whole body, not just a few parts.
  • It’s about being connected. With skiing, it’s being connected to nature. With sex, it’s connection to yourself and your body or yourself and a partner.

Now, there have been a lot of avalanches in Utah lately. And just a few weeks ago the main road to my favorite ski resort was closed because of an avalanche. No going up and no going down. What do you do when the main road to get to your destination is closed?

Pause for a moment and I want you to think of cancer as the avalanche. Cancer, this horrible diagnosis, may have closed your main road. The main road is how you experienced sex before (e.g., how your body responds, breast sensitivity, how you felt about your body image). For some of you, cancer has forced you off of the main road that you knew, and the way you experienced sex before may not ever be the same again.

If your main road is closed, you’ve got 3 options:

  • You can patiently wait for the main road to re-open. You can wait for your sexual response to return to what it was before cancer. However, sexual side effects caused by cancer typically do not get better over time without treatment or action. Patiently waiting is a gamble that is likely not to pay off.
  • You could give up. The main road is closed, why even try. OK, that’s certainly an option. But, do you really want to give up on your sexuality?
  • You could get creative and find a different path or a different destination. Sexual creativity! This is your best option if you want to maintain or create a healthy sexuality.

How do you get sexually creative?

Focus on the journey and not a goal: Just like skiing, enjoy riding down the slopes instead of focusing on getting to the bottom. Whatever your sexual destination was before, for many it’s orgasm, consider shifting the focus to the journey and not a specific destination. How do you do this? Mindfulness. Mindfulness is being fully present in the moment, without judgment. Being fully present enjoying the experience without demand or pressure, and not striving to reach a goal. Mindfulness Has been shown to improve women’s sexual desire, arousal, orgasm, and reduce sexual pain – and this research has been done with cancer survivors! You can do mindfulness solo or with a partner. Check out: Better Sex Through Mindfulness  by Lori Brotto, PhD to start this journey. Also, with a partner, engage in mindfulness based Sensate Focus exercises.

Expanding your sexual menu: Sex can sometimes be focused on just the erogenous zones, like breasts and genitals. If your breasts do not feel the same sensitivity or they aren’t a source of pleasure like they may have used to be – it’s incredibly important to expand your sexual menu. One easy way to expand your sexual menu is to start with sensate focus. Then get a little more advanced with this sexual menu. Want to get even more advanced? Check out Mojo Upgrade.

Tap into receptive desire: There are actually two different types of desire – although we really only hear about one, spontaneous desire. Spontaneous desire is the type of desire where you think “I want to have sex right now!” This is in many ways driven by hormones. If you’ve had any treatment or surgery, such as AIs or an oophorectomy, that has impacted your hormones, then likely your spontaneous desire has also been impacted. Treatments that suppress hormones may also suppress spontaneous desire, so you need to get creative and tap into the other desire, receptive desire. Receptive desire is a type of desire where you are sexually neutral at first, sex is not on your mind, but the ingredients are in place that allow you to be receptive. Perhaps those ingredients are that you have energy, you’re not in pain, you feel relaxed. Then, your partner initiates and you think, “hmm. . . sex wasn’t on my mind, but I’ll be receptive.” Or, if you don’t have a partner, maybe you pull out an erotic novel, or put something sexy on TV– and you think, “hmm. . . I wasn’t thinking about sex, but all the right ingredients are in place, so yes, I’m receptive to have solo sex.” Bottom line, if your hormones have been impacted by cancer treatment, then receptive desire will likely be your more prevalent desire. They key is to identify what ingredients need to be in place in order to be receptive, and then set aside time to get those ingredients in place. Think about these ingredients and share them with your partner, so they know when you’re more likely to be receptive. Or, if you don’t have a partner, set aside time to cultivate these ingredients for solo sex.

Accessorizing: For those of you on AIs or who have had an oophorectomy and are now in surgery-induced menopause, the loss of hormones may impact vaginal health. We have lots of estrogen receptors in our vulva and vagina, and when we no longer have that estrogen, those receptors essentially starve because they aren’t being fed with estrogen. As a result, the vulvar and vaginal tissues may become dry, rough like sandpaper, the vaginal opening loses its elasticity so with penetration it can rip and tear and be painful, and you lose vaginal lubrication. Estrogen also facilitates blood flow to the genitals. Without that estrogen, there’s much less blood flowing to the genitals. And blood flow is needed for sexual arousal and orgasm. Blood flow is also needed for genital sensation – which means less blood flow equals less genital sensation. If you’re experiencing these sexual side effects, you’re going to need to accessorize. You absolutely need to be using a lubricant. Water based lubricant is a great option. Put it on yourself and on your partner, you really can’t use too much. I recommend lubricants by Sliquid or Ah!Yes. You will also need a vaginal moisturizer. Now a moisturizer is different than a lubricant. A lubricant is as needed for friction reduction in the moment of sex, whereas a moisturizer is something you use daily or every other day to maintain moisture in the vulva/vagina. Think of it as face cream for your vagina. Just like how you may wake up and put on your face cream every day, this is maintenance for your vulva/vagina. I recommend Hyalo Gyn. If these don’t alleviate the vulvar/vaginal dryness or sexual discomfort, then you may want to talk to your oncologist about vaginal estrogen. It comes in a cream, a ring or a tablet, and can be applied directly to the vulva and vagina to feed those starving estrogen receptors. It’s the most effective treatment to reverse the sexual side effects caused by lack of estrogen. Finally, consider a vibrator. If your sensation is less due to less blood flow, a vibrator is a great way to experience increased stimulation. There are vibrators made specifically for external, clitoral use only or for penetrative use, or both. Most women have used a vibrator at some point in their life and nearly half of men have used one as well. My recommended brand is Lelo or you’ll find great products at Smitten Kitten.

Now remember that image of cancer as the avalanche that has closed your main road. The main road was sex the way you knew it before cancer. If cancer has closed the main road you knew, then use this as an opportunity to let cancer set the stage for amazing sex. Don’t patiently wait for your sexual experience to return to what it was before. Don’t give up, you are still a sexual being. Instead, get sexually creative!