If you can’t be honest with me, I can’t help you.  I tell all my clients that at the beginning of the very first session.  I strive to create a non-judgmental environment where people will feel comfortable sharing extremely private information.  Likewise, it is your doctor’s responsibility to make sure that you are treated with respect and to take your sexual health concerns seriously.  The doctor-patient relationship is a two-way street though.  You are responsible for being honest about your sexuality so that your doctor can do his/her job and make important decisions about your health care.

The students gathered at the annual conference of the American Medical Student Association want to know what they need to do to make you feel safe and as comfortable as possible talking about your sexual concerns and what mistakes they need to avoid that might jeopardize your willingness to give them all the information they need to help you.  I’ll tell them, if you tell me.

Today’s question:  Have you ever withheld information about your sexual behavior from your doctor?  What kept you from being completely honest?

Medical education relies heavily on the concept of preceptorships where each student shadows a physician observing the day-to-day practice of various medical specialties.  Experienced doctors can serve as models of professional, compassionate care, but they can also pass on bad habits.

When I speak to the “baby” docs at the American Medical Student Association’s 60th Annual Convention, I want to be able to them give examples of what works and what doesn’t work, when it comes to addressing sexual health, from a patient’s perspective.  Your voice has been the missing puzzle piece in training the next generation of doctors, until now.

Today’s question:  Have you had any positive interactions with a doctor around sexuality?  If so, what made it a good experience?  Describe a negative experience and how it could have been improved.

What do all the Viagra and Cialis ads tell you to do?  Talk to your doctor.  Sexuality is increasingly viewed through the lens of medicine.  Unhappy with an aspect of your sexual anatomy or performance?  There’s a pill, injection, or surgery for that.  But what if you don’t feel comfortable talking to your doctor about your sexual health concerns?

This Friday, 3/12, I will be traveling to the Disneyland Hotel to speak to the future of medicine at the annual conference of the American Medical Student Association.  I’ll be joined on the panel entitled, “Everything Doctors Want to Know About Sex, But Never Asked,” by cultural sexologist, Carol Queen, certified sexuality educator, Megan Andelloux, and Kat Wentworth director of Project Prepare.

I want to give you the opportunity to “speak” to these students and tell them what they need to know about providing sexual health care.  Today through Thursday I will pose a different question about sexual health and the role of your doctor in ensuring you have a happy, healthy sex life.  Tell me what you think and I’ll pass it on to the budding doctors who desperately want to learn how to make the doctor’s office a more sex positive environment.

Today’s question:  Do you think the doctor’s office is an appropriate place to seek help for sexual health concerns?

There it stood.  For about a week.  A tree in the panhandle of Golden Gate Park adorned with neon, orange penises.  Those are strange leaves, oh wait, those aren’t leaves, it’s a dildo tree!  The ultimate “woody.”  I’m glad I took this shot when I did because the very next day there was no trace of it.  I have no idea who put it up or what their inspiration was in the first place, nor do I know who took it down and why.

Each “ornament” appeared to be hand stitched, complete with balls.  There were thick ones, thin ones, short ones, and long ones.  Some of them even had a natural curvature.  Together they represented the wonderful variety of normal, healthy, human anatomy.  Fluttering in the breeze, in plain sight, they could be perceived as a symbol of power in a patriarchal society, a sexual provocation, or a whimsical, rogue art installation among many other explanations.

I’ll never know the whole story, but what if it was a magical dildo tree that granted sexual wishes?  What would you wish for?

Make a Wish!

No, not that “c” word, I’m talking about cancer.  Dr. Mark has been bringing sex out of the cancer closet since 2006 and she can be heard on The Stupid Cancer Show on Monday, March 1!

The Stupid Cancer Show is the voice of young adults affected by cancer. Unlike every other age group, this is about a generation of millions (aged 15-39) for whom there has been zero improvement in survival rates since Nixon. This is not OK! Hosted by young adult survivors Lisa Bernhard — acclaimed journalist and former Entertainment Correspondent for the Fox News Channel and Deputy Editor of TV Guide — and i[2]y Founder/CEO Matthew Zachary, we are challenging the status quo and demanding change from the establishment. It’s time. It’s our time. It’s about time. Stupid cancer. Survivors rule.

Jacking, Jilling, whacking, or fingering.  No matter what you call it, masturbation is the most accessible form of sexual expression.  But, thanks to a strict sexual dichotomy it seems that for every pleasure there is often an equal and opposite sense of guilt.

In a recent study reported in the Journal of Sex Research, 20 heterosexual, teenage (16-18) girls from a school in the south of England were asked about what discussions, if any, they have had with their parents about sex and relationships, their relationship histories, attitudes about their own body and masturbation, attitudes about safer sex, feelings of control in sexual situations, and other related issues.  Responses ranged from extremely negative to extremely positive.  Some girls felt that only boys should touch their genitals and even then it wasn’t pleasurable.  Others had unsuccessfully attempted masturbation only to end up feeling dirty, bad, or guilty.

On a positive note, a few of the girls described the discovery of masturbation as being accompanied by feelings of “amazement,” a sense of release, and inner calmness afterward.  Even with a positive attitude a few of these girls had struggled to overcome negative emotions associated with masturbation, however, what all these girls had in common was open communication with their parents.  They reported being able to talk about all topics, not just sex, without embarrassment or discomfort.

Discussions of masturbation tend to be few and far between and this silence only contributes to sexual shame and feelings of disgust.  If we are to move toward sexual health and happiness, it’s about time we began examining our attitudes toward masturbation.

You can start by considering these questions:  What is your masturbation narrative?  Do you find masturbation uncomfortable and uninteresting or rewarding and pleasurable?  If you are a parent, what conversations are you having with your children about masturbation?

Recommended Reading:

“Sex for One:  The Joy of Selfloving” by Betty Dodson

“I Am My Lover:  Women Pleasure Themselves” edited by Joani Blank

“Third Base Ain’t What It Used To Be:  What Your Kids are Learning About Sex Today - And How to Teach Them to be Sexually Healthy Adults” by Logan Levkoff

I am pleased to announce the first STEPS™: Sexual Transformation & Empowerment Program for Survivors workshop of 2010!  For the first time the workshop will welcome male and female survivors of any cancer type.  We may have different body parts, but we’ve all been through cancer of one type or another and we all want to find our way to a happy, healthy post-cancer sex life.

This is what one STEPS™ participant had to say about her experience:

“I have always had issues around my sexuality. The STEPS program seemed like a gift that fell from the sky.  Discussing my sexuality fears, insecurities, desires and attitudes felt incredibly safe - both with Sueann and with my fellow participants.  I recommend this program to anyone who is struggling with their mojo post cancer!”

Space is limited, RSVP to info@drsueannmark.com today!

Get your mojo back after cancer!

Yet another chance to listen to Dr. Mark giving the her own brand of shame-free sex information on The Stupid Cancer Show; Monday, June 8, from 6-7pm Pacific.  The Stupid Cancer Show is the voice of young adults with cancer and Monday’s episode is all about sex!  For more information check out:  http://stupidcancershow.com

Cancer sucks.  Survivors rule!

A 2006 report from the United Nations Office on Drugs and Crime estimates that four percent of the world’s adult population uses marijuana annually.  My guess is that some of those people are also having sex while high and that’s why today, on the unofficial pot smoking holiday, 4/20, we will take a look at the interplay of the two.

Marijuana, just like every other drug legal or not, has different effects in different people based on the individual’s body chemistry.  For some, pot is clearly not sexy especially if it increases their anxiety.  A little anxiety can sometimes enhance a sexual experience - think back to when you were younger, making out or having sex in a parked car with the very real possibility that you might get caught - exciting!  But, too much anxiety - racing thoughts, paranoia, feeling like you might have a heart attack - generally serve to take you out of the mood real quick.

On the other hand, getting high can also positively effect sexuality.  Some people report feeling more physical pleasure and connection to their partner(s).  Due to pot’s effect on time perception sex can seem to last forever under the influence.  Also, we know from research that marijuana works as a vasodilator, opening blood vessels which allows more blood to flow to the genitals thereby increasing sensation.

Unfortunately, due to prohibition, there are very few studies on the effects of cannabis on sex.  With approximately 162 million pot smokers on the planet, perhaps it’s time to fully research and understand the sexual effects of marijuana.  For now, we are limited to anecdotal reports.  Care to share your own experience of sex while high?  I look forward to your comments!

Beyond the hot flashes and sleepless nights, for some women menopause threatens the end of sexual satisfaction.  It is true that once the ovaries stop producing estrogen a woman’s sexual and reproductive anatomy goes through some pretty big changes.  And while menopausal symptoms vary from woman to woman, most will experience some degree of vaginal dryness, decreased desire, difficulty achieving orgasm, dulled orgasmic sensations, and possibly even vaginal atrophy.  Luckily you don’t have to suffer or just give up on sex.  There is no one magic bullet that will “fix” your post-menopausal sex life, however, there are several different ways in which to tackle the problem and an integrated approach may be the most prudent one.  I recommend you consider all of your options and choose the best combination for you.

While traditional hormone replacement therapy has fallen out of vogue, due to an increased risk of breast cancer, there are other hormonal treatments available.  Some women, in consultation with their doctor, use a vaginal ring that releases a small amount of estrogen directly into the vaginal tissues.  Similarly, other women may choose to use a cream that contains either estrogen or testosterone.  These products help with lubrication, sensation, desire and the overall health of the vagina.  There are also various herbs that can be used in consultation with an herbalist or doctor of traditional Chinese medicine.  As with all medications, these treatments may not be safe for all women, especially those with a history of hormone-dependent cancer.  But fear not my survivor sisters, there is research underway to determine the safety of some hormonal treatments for us so this story is to be continued.

Of course, we don’t have to rely soley on drugs and doctors to maintain our sex lives.  Remember sex is a “use it or lose it” type activity.  The more sexual you are on a regular basis, solo or with a partner, the healthier and more repsonsive your body will be.  Try Kegel exercises to encourage blood flow to the genitals and increase sensation.  Regular vibrator use will also help with blood flow to the clitoris.  If you’re feeling dry, use a good lube (avoid oil based lubes if you are using condoms).  I recommend getting a sampler pack from someplace like Good Vibrations so you can try different brands and find the one you like the best.  You can increase your desire for sex by reading erotica or watching porn.

Just remember, you deserve sexual pleasure, so don’t give it up without a fight!