Contents
- Requirements & Feature Photo
- Work Done - Link up Front - Featuring Ruth – Content Warning
- Waited Years & Graduations
- Sitting on your partners back intimately – Between Lovemaking
- Dedication and Memorial
- Charting 20180519-SA – Updated 20261020-TU:
- Objective - Ravinder P Singh, MD
- Photo Selection - Ruth Ligero Tera (RLT)
- 20180519-SA - Interpreting the Error Rates: Updated 20261020-TU:
- Boundary Assignment
- 20180519-SA - Sign Off (Avey, 2018) – Updated: 20261020-TU:
- Signature – Evolution
- Get Rolling on the Assignment (Avey, 2018) – Last Update: 20261020-TU:
- Pharmacological Agents Causing Sexual Dysfunction
- Psychotropic Inventory – Problematic Medications – Context of Sex Cycles
- 20180519-SA on Discontinued Brands – Drugs in Development
- Steps in Pre-planning - Team Tera (RLT)
- Steps in Face-to-face Encounter with ST – A HRE
- Session Follow up Activities (ST)
- Rate Your (Sex) Therapist - Vitals Standard Elements - For Year = 2004
- Rate your Therapist - Compare In-formal and Formal Therapists (QGM)
- 20180518-F Table – Zoloft - Less serious side effects may include
- Walk Down Memory Lane & Does Zoloft cause impotency?
- Pro-Factors for Hands-on Sex Therapy (ST)
- Worries and Issues 7 Item (Qualitative) – Stressors
- Donovan’s Promises about Sex (10 Item) (Qualitative)
- Content - A Healthy Sex Life
- 20180519-SA-Testosterone Slavery
- FYI – Stigma - Around Self Sex
- Transactions of Intimacy 12 Items
- Jordan Gray – 7 Item Wants in a Relationship Screener
- 20180518-F: Other Wants for MSOE (12-Item)
- Does Sex Therapy Work?
- Boundaries and Sex Therapy
- FYI - Anticholinergic Activity Drugs (Medications)
- Double Sex Dysfunction Stress and Medication
- Zoloft (and to a greater extent Paxil)
- Feature - Profile Zoloft (Sertraline HCL) (2004)
- Donovan Promises of Sex Benefits
- Erectile Dysfunction Sex Therapy: How It Works, Insurance, and More
- Satisfaction with your history around Sex
- Satisfied & And in the End - Does Sex Therapy Work? [YES]
Saturday, May 19, 2018 – R-Rated due to suggestiveness
Ravinder P Singh MD – Assignment – Retroactive 2012 – Boundaries – By Keith E Torkelson
https://healthman2059.blogspot.com/2018/05/ravinder-p-singh-md-assignment.html
Feature – Photo - Not Our Therapist
Promotion - Brittany Steffen
Certified Sex Therapist
https://www.steffencounselingservices.com/brittany-steffen/
My name is Brittany Steffen, and
I am the owner and founder of Steffen Counseling Services. I graduated from
Seattle Pacific University’s marriage and family therapy graduate program in
2012, and have worked as a therapist in the Seattle area for the past 10 plus
years. In 2018 I began the process to become an AASECT Certified Sex Therapist, to meet the expanding demand for sex therapy.
Waited Years
I use my annual Christmas Gift from my sister (CDB) for deep tissue
massages. Unfortunately she passed away
in 2025. As of 2023 I hadn’t seen my
Most Significant Other Ever (MSOE), Joan, since the summer of 2016. Since 2018 for me she has been missing in
action (MIA). Joan had a habit of
“Ghosting” me immediately after we spent the weekend together. When we were apart for a month or more we
call these off periods our Windows of Separation (WOS). For us during the WOS the momentum in our
relationship would cease. Combine her
Ghosting with medication that causes impotence we often found it difficult to perform. During circa 2004 we had several changes in medication
many causing impotence. At one point
working with a referral from our friend Charles A. we linked with “Ruth” a sex
therapist. In two sessions she helped us
get our confidence back. We call Ruth Doctor Ruth even though she did not hold a
PhD or an MD. Overall our association was a success. Ruth practiced in Baja California or BC. Our Sex Therapy Value Quick Score for Ruth is
5.0 star equivalents (SEs) of 5.0 stars maximum. With
SEs higher scores are favorable. Ruth
worked on a sliding scale. We find that as of 2026 we have ED and much less
interest in Sex. We still would prefer
some intimacy like “Making Out”. It is
hard for a female to get close to us because of our “Force Field” which in the
past before 1995 made/makes us untouchable.
Note—Publication 20180519-SAT = 2 years after in person with Joan
Associated with > In House > Metadata > PHR_Xeno_4.0.1_Medication_History_17121101_Develop
V2018
Graduations
We will not replace Joan. If we
do fall for another gal it would be New Love.
For me Joan and I had True Love.
Joan would say we were together twenty (20) years. I take into consideration the time lost
during our WOS and deduct the time from our twenty (20) years. A social worker, Samantha Santos told us that
we would never have an intimate relationship with another female.
Sitting on your partners back intimately – Between Lovemaking
In practice we called it Joan’s Experimental Method or JEM. We would
each sit on each other’s backs. We
usually did it in a park (outdoors) under a tree.
Sitting on a partner's back
intimately can mean a few different physical and emotional dynamics, ranging
from relaxing counter-pressure stretches to close physical connection.
Physical and Emotional Aspects
The-Supporter or Relief Dynamic:
One partner lies face down on a
bed or floor while the other sits or perches gently on their lower or mid-back,
often to provide counter-pressure, stretch out tension, or practice
partner-assisted decompression.
Playful or Grounded Closeness:
Sitting closely on someone who is
lying down or resting creates a sense of weight, safety, and physical presence.
It strips away distance and puts physical trust into the contact.
Vulnerability and Trust:
Being on top of or draped across
a partner's back requires balance and quiet communication. It relies on mutual
comfort so neither person strains a muscle or feels restricted.
Pirated Photo
Dedication and
Memorial
We Dedicate this Paper
We dedicate this paper to Joan MZ and Alexis Payne.
In Memory Of
Dorothy Stratten (Dorothy Ruth Hoogstraten (February 28, 1960 – August 14, 1980)
20180519-SA – Updated
20261020-TU:
This report is submitted for partial credit about an assignment Dr.
Ravinder P Singh offered up to us back in 2012.
The subject for this report is Keith Torkelson a patient of Dr. Singh’s on at least two occasions
starting 2006. As of 2022 Dr. Singh is a
2.5 Star (Objective) or average doctor. We think of her as a 4.0 or
better doctor. This report chronicles
Keith Torkelson managing (coping with) medication associated impotence. We chart his experiences with Ruth
Ligero Tera (RLT) a sex
therapist. Keith gives RTL a score of
5.0 Stars for her help with recovering his confidence and libido. The model medication we address here is the psychotropic Zoloft. Keith’s Most Significant Other Ever (MSOE) is
Joan MZ. Joan had a higher frequency sex
cycle than did Keith. We include a
section on Rate Your Therapist (RYT). The
encounters with RLT have had a lasting effect on Keith’s confidence in the face
of aging. Keith is now as of 2026 67 years old.
For us the investment of time and money with RLT was worth it.
Associated with >
08_Rate_Your_RPS_Singh_Vitals_19061301_Working V2026
Link
https://healthman2059.blogspot.com/2026/09/just-say-no-with-focus-on-dr-rpss.html
Corrected: 20261021-W:
Doctor Singh’s Ratings do not change much – Last Reviewed: 20180518-F:
20180519-SAT Interpreting the Error Rates: Updated 20261020-TU:
It is very likely that GOD is near perfect. For Dr. Singh (RPS): What professional
behaviors lead to poor ratings such as those 21 clients awarded her? One element that goes into poor ratings is
mistakes. Some medical mistakes are
minor whereas others are major and even life threatening. Back in 2012 (Episode 2012), we suffered
catastrophic losses. It is likely that
Dr. Singh contributed. We had thought
her to be one of our best Behavioral Health Doctors until we began profiling
her. By omission we gather RPS would say:
I perfect! You just felt her
perfection when she was with you each day for five minutes. You just know she is and has appropriately
served at least half of her clients.
Remember she is the one that started us on the best medication ever,
CloZAPine. Dr. Bum Soo Lee MD a
colleague finds RPS as unremarkable. She
has much work to do to get her objective ratings (2.5) up to let us say 4.0 or
greater of 5.0 Stars. As of 2026 we
think RPS has retired therefore it is unlikely for her to reach the 4.0
benchmark. If we could find anything
Online in her favor we would be the first to share it with our inner-world
circle via our Blogs. Her 51% success
rate implies a 49% error rate, at least from the client perspective. This is just a notion due to the fact that
the majority of her clients did not go online and rate her. In addition, the same clients might rate her across
multiple platforms.
15_MDOC_Profile_16040501_Singh V2018
Query data = “ravinder p singh…”
Boundary Assignment
Associated With > In House > Metadata > 04_SCR_Singh_Assignment_17092701_Boundry_Evidence
Actual Scan of Medical Records
Dated: 20120425 – Doctor Singh in Charge
20180519-SAT Sign Off (Avey, 2018) – Updated: 20261020-TU:
Doctor Singh (RPS) was a bit miffed when we went into the hospital in 2012 because she had the impression that last fix (2006-2007) was lifelong. Sample to compare the writing (Future paper will address the relationship between writing and health). Note: Dr. Singh’s support-staff fill out as much of forms as permissible. We have to assume that at least the signature is authentic. We here at MSG do not retain any writing analysts. So I, Avey IC, have to try my best. Can you see how hurried that signature looks for signing off. That signature is part of her job. It reflects Dr. Singh’s character as well as motor function. It gets her the big bucks ($200,000 plus per year). Would you RPS her perform surgery on say your eyeball? How is it a signature? One’s signature reflects that inner workings of one’s mind. Buster AKA Keith has had to re-make his signature several times. One culprit was taking Lithium, which induced Lithium Tremors. Enough said OK: Would you let her drill your teeth? (Avey, 2018). Incidentally, we were taken off Lithium this year (2026) and our writing has improved because our tremors are waning.
Signature - Evolution
20180519-SA
Get Rolling on the Assignment (Avey, 2018) – Last Update: 20261020-TU:
What it takes to get focused on the matter at
hand. We have the impression that we
will help improve our boundaries up by discussing Sex Therapy (ST). Our Most Significant Other Ever (MSOE) is
Joan (1998-2018). In any given year Joan
and Keith were apart for up to half the year.
Due to Joan’s problems with dementia we have been apart the longest time
ever or 10 years! Joan had a different
Sexual Response Cycle (SRC) than Buster.
If you have not already gathered this paper is about Keith “Buster”
Torkelson, MS, BS. Joan desired (needed)
sex more frequently than Buster. We have
a written testimony that Joan
wrote about sex and sexuality. We still
are too proper to share it. Joan was
insatiable or hard to satisfy over the course of a week. Combine SRC issues & separations with
Drug (medication) Induced Impotence (DII) and in enters the need to retain a
Sex Therapist. Oh! Who are we – we “B”
MSG or Mentalation Solutions’ Group.
Pharmacological Agents Causing Sexual Dysfunction - Taylor & Francis Online (1977)
[Link broken and thus removed]
By RT Segraves
“Reports of pharmacological
agents affecting the human sexual
response cycle are critically reviewed. Because of the paucity of
adequately designed studies, few definitive statements can be made about
pharmacological effects on human sexual functioning. Tentative evidence
suggests that drugs with side effects of adrenergic
blockade are associated with ejaculatory disturbances. Impotence
appears to be associated with drugs possessing significant anticholinergic
activity. Drug induced impotence and retarded ejaculation could both also be
related to central dopamine blockade.”
Defining the Problem - Anticholinergic Activity Drugs
Anticholinergic and Antispasmodic Drugs
https://www.medicinenet.com/anticholinergics-antispasmodics-oral/article.htm
20180519-SA on Discontinued Brands – Drugs
in Development
Updated:
20261020-TU:
We do not have the resources to flesh about the discontinued brands. Just let it be known one of them Navane is on our list of the five (5) worst medications of all time. See if Pfizer the manufacturer had discontinued Navane earlier we would have been spared the suffering associated with Navane. The generic is still available in the US. Think about this: Why are we developing new drugs. If the current medications (psychotropics) in the arsenal were effective and work well: Why fix them? OK! Let it be said that some of the medications above we personally associate with Drug Induced Impotence (DII). Back circa 2004, Dr. Dobos (Kaiser) said that it was unusual for a male our age to lose his “Sex Drive” or Libido. Later we will address Zoloft a bit. Let’s us get on with how Buster coped with this presenting problem. Enter Ruth Ligero Tera (RLT - Sex Therapist in private practice.
Failure Session – Success Session
Ruth Ligero Tera (RLT - Private Sex Therapist)
Steps in Pre-planning - Team Tera – Last Reviewed: 20180518-F:
Updated: 20261020-TU:
Details Not Important
It is easy to fill in the blanks.
We were so debilitated (moribund) that our first session resulted in a sub-standard
performance. This was corrected and
overcome with the follow up.
Steps in Face-to-face Encounter with ST – A HRE
A Health Related Engagement (HRE): Generate: 20180519-SAT:
Last Updated: 20261020-TU:
HRE = Health Related Engagement
Generated: 20180518-F:
CloZAPine
We have never had to
retain a sex therapist since Dr. Singh put us on CloZAPine back in 2006.
Vitals Method - Date Scored 20180515-TU:
Indications of Satisfaction: Actual Data from 2 Encounters Date of Service
Buster rates association with RTL: Last Reviewed: 20261020-TU:
Dates of Service (2004)
The dates of service may be adjusted when and if we fish the records out of our archives.
Subject Profile (Brief)
This report discusses the Lived Experiences of Keith Torkelson (AKA Buster). The presenting problems were impotence most likely caused by a combination of stress and ingestion of psychotropic medications. We call this chemical impotence and stress impotence.
Quick Grade Method (QGM) – Date Scored: 20180518-F
GPA = Grade Point Average | QGM = Quick Grade Method
Cohort GPA
Drill Down on a Medication – Zoloft
For our purposes we are skipping serious side effects for which you are advised to call your doctor. What follows is a representative list of less serious side effects. It is intriguing that sex problems are not considered serious. We feel that sex problems are core concerns after: Sleep, Peace and Harmony.
20180518-F Table – Zoloft - Less serious side effects may include
FYI – “This is not a complete
list of side effects and others may occur. Call your doctor for medical advice
about side effects. You may report side effects to FDA at 1-800-FDA-1088.
FYI - Reference
https://www.rxlist.com/zoloft-drug/patient-images-side-effects.htm
Walk Down Memory Lane
Every time we address a side effect list our thinking remembers how many psychotropic experiments we have agreed to and paid for. The Zoloft experiment was one of the less costly trials. We provided proof it was interfering with work, school, intimacy, etc. very quickly. As a result we were taken off Zoloft. Note Paxil also cause impotence. We were on Paxil for a term.
Aside - Paxil
Yes, Paxil (paroxetine) can cause
impotence or erectile dysfunction, along with a reduced sex drive and delayed ejaculation or trouble
reaching orgasm. Among selective serotonin reuptake inhibitors (SSRIs), Paxil
is frequently cited as having one of the highest rates of sexual side effects,
affecting roughly 30% to 70% of people who take it.
Does Zoloft cause impotency?
Yes, Zoloft (sertraline) can
cause erectile dysfunction (ED) and other sexual side effects.
How Zoloft Affects Sexual
Function
Brain chemistry shift:
Zoloft is a
selective serotonin reuptake inhibitor (SSRI). Raising serotonin levels can
lower dopamine and norepinephrine,
which are key chemicals for sexual desire and physical arousal.
Common sexual side
effects:
Besides ED,
Zoloft can cause a lower sex drive
(libido), delayed or absent ejaculation, and difficulty reaching
orgasm.
Risk comparison:
While sexual
side effects are common across all SSRIs, Zoloft generally carries a lower risk
of ED than stronger SSRIs like paroxetine (Paxil), according to the Mayo Clinic.
What You Should Do
Talk to your doctor:
Never stop taking Zoloft
abruptly. Stopping suddenly can cause "SSRI discontinuation
syndrome," which brings symptoms like dizziness, nausea, and severe mood rebounds.
Explore solutions:
A healthcare
provider can help you manage the side effects by:
Adjusting your
dosage
Prescribing an
ED medication like sildenafil (Viagra) or tadalafil (Cialis) alongside Zoloft. Switching you
to a different antidepressant with a lower risk of sexual side effects, such as
bupropion (Wellbutrin).
Date Scored: 20180518-F:
Updated: 20261021-W:
Tangent – To Kill a Couple of
Birds
Worries and Issues 7 Item (Qualitative) - Stressors
The Complications with Hands’ On Sex Therapy
ST=Sex Therapy | ED=Erectile Dysfunction
Updated: 20261021-W:
Donovan’s Promises about Sex (10 Item) (Qualitative)
By and For Buster and Joan
AMSOE=About Most Significant Other Ever | DHEA= Dehydroepiandrosterone | RT = Real Time
FAQs
Have we had a healthy sex life?
Are we having a healthy sex life?
Content - A Healthy Sex Life
A healthy sex life is defined
primarily by mutual satisfaction, emotional intimacy, and open communication between partners, rather than by
a specific number or frequency.
Key Characteristics of a
Healthy Sex Life
No Pressure on Frequency:
According to
the International Society for Sexual Medicine,
"normal" frequency is simply whatever works and satisfies both partners. While many couples average about
once a week, rates vary widely based on age, life stages, and stress levels.
Open Communication:
Partners feel safe discussing their desires,
boundaries, and turn-ons without fear of judgment.
Absence of Pain:
Healthy sex
should not cause physical pain or distress.
Mutual Pleasure:
It is never
one-sided; both partners feel cared for and considered, though not every single encounter has to end in
an orgasm.
Connection beyond the
Bedroom:
Intimacy
includes non-sexual touch like cuddling,
kissing, holding hands, and emotional support.
Flexibility:
Partners adapt
to changes over time—such as aging, busy
schedules, or lower libidos—by
communicating or intentionally scheduling time for each other.
Common Health Benefits
A fulfilling sex life contributes
to overall wellness by:
Lowering blood
pressure and protecting heart health
Reducing
stress, anxiety, and depression
Improving
sleep quality and immune function
When to Seek Help
If sexual dissatisfaction, a mismatch in sex drive, pain, or low libido creates persistent distress in your relationship, consider consulting a healthcare provider, OB-GYN, or a certified sex therapist.
20180519-SA-Testosterone Slavery
Back in 1989 we worked as a lab associate for Hospital Pathologist Central Laboratory. It was routine procedure for the staff to run tests on themselves in the due course of a week. Our associates predicted that we would have elevated testosterone based on our pattern balding. They ran it and they were correct. For us testosterone is not only cyclical it is highly detectable at elevated levels. Elevated testosterone can be uncomfortable. We think it can even impair your judgment. We haven’t detected this uncomfortable feeling since we turned 53 in 2012. It looks like we traded performance for comfort.
In House > Metadata >
Rachel Grumman Bender - Sat, May 21, 2022, 4:07 AM
https://www.yahoo.com/lifestyle/fascinating-facts-about-female-masturbation-110722717.html
FYI – Stigma - Around
Self Sex
The stigma surrounding self-sex,
often colloquially referred to as "choking the chicken" (male) or
"spanking the monkey," is a deeply rooted cultural taboo. Despite
being a common, natural, and often
healthy sexual behavior, masturbation is frequently associated with
shame, guilt, and secrecy. This stigma is maintained by a combination of
historical, religious, and societal factors, even though modern sexology
generally considers it beneficial.
WFIHS=With Females in Hospital Setting | WMSOE=With Most Significant Other Ever
Date Scored: 20180518-F: Last Reviewed: 20180518-F:
FYI - Reference
Sexual satisfaction, quality of life and the transaction of
intimacy in hospital patients’ accounts of their (hetero) sexual relationships
Gavin Daker-White and Jenny Donovan (2002 - 25 Pages)
[Link Broken]
Sociology of Health & Illness Vol. 24 No. 1 2002 ISSN
0141–9889, pp. 89–113
Aside - 20180519-SAT Hospital Patients - Sex
We have been in the Behavioral Health Ward (BHW) on more than one
occasion. When we talk with females
about sex on the ward many report they had sex while in lock down. For example some of the females report at
least one intimate experience in Norwalk (Metropolitan) State Hospital. Our male colleagues are either keeping
secrets or never had sex while locked down.
You know how there are reports of professionals such as teachers
having sex with those they help. We feel
there may be a chance for Staff Involvement in lockdown. There was this (pseudo-fictional) TV show
called Women in Prison. It was an: “American
television sitcom created by Katherine Green which aired on Fox from October
11, 1987 to February 20, 1988”. One of
the imprisoned females hooked up regularly with the male maintenance worker. They usually did it in a crawlspace in the
ceiling that was only accessible with a ladder.
The other women in “the block” kept their secret.
FYI - 7 Things Men Want In A Relationship - The Good Men
Project (Jordan Gray, Sep 2, 2014)
https://goodmenproject.com/featured-content/7-things-men-want-in-a-relationship-jgc/
Jordan Gray – 7 Item
Wants in a Relationship Screener
MSOE = Most Significant Other Ever (1998-2018)
Last Reviewed: 20161021-W:
The Best Medicine (***)
Keith (Buster) had physical touch issues with our older brother (Born
1949). On a routine basis our older
brother physically hurt our sister (Born 1955) and us. Keith’s traumatic response to his behavior
most likely contributed to Keith’s gradually becoming an Untouchable. In 1995 Jodi Rombotis successfully addressed
our un-touchable nature. She said
kiss me! And kiss did we ever!
FAQs
Why not just have more of good thing?
Do men need to have sex with their intimate partners?
20261020-TU: Updated
FYI – Sex Therapy for Erectile
Dysfunction: How It Works, Insurance, and More
https://www.webmd.com/erectile-dysfunction/guide/sex-therapy-erectile-dysfunction
Does Sex Therapy Work?
“Sex therapy is most effective when a man's sexual partner is willing
to be part of the treatment. Studies have shown that for men with
stress-related ED, having the partner involved in the therapy resolves the
problem 50%-70% of the time. When the man must go through counseling alone, the
results are somewhat lower.”
Boundaries and Sex
Therapy
Sexual boundaries define personal limits for physical
touch, comfort, and intimacy, while sex therapy provides a structured, non-judgmental environment to
navigate these limits, improve communication, and resolve relationship ruts.
Types of Sexual Boundaries
Physical Touch and
Anatomy:
Limits
regarding specific body parts, kissing styles, or types of contact.
Clothing and Visibility:
Preferences around remaining
dressed, lighting, or partial undress during intimacy.
Activities and Intensity:
Comfort levels
with varying practices, novel experiences, or specialized dynamics (such as BDSM).
Health and Safety:
Agreements regarding sexual
health, STI testing, and contraception.
Privacy:
Rules about sharing intimate details or experiences
outside the relationship.
Tools Used in Sex Therapy to
Explore Boundaries
The Traffic Light System:
Partners
independently rate sexual activities as Green (definitely try), Yellow
(might try / curious), or Red (definitely
not try) before comparing lists
without judgment.
The "Three T's"
Framework:
Discussions
are guided by Trust (believing in
each other's self-knowledge), Turf
(choosing safe, calm, private settings), and Tone (maintaining curiosity instead of criticism).
Structured Check-ins:
Couples
practice active consent, learning how to pause,
pivot, or withdraw consent at any stage of an encounter.
Professional Boundaries in Sex
Therapy
No Physical Touch:
Certified sex and relationship therapists maintain a strict
no-touch policy during clinical work.
Clinical Purpose Only:
Sessions focus
strictly on education, psychological processing, and relational or behavioral
homework; therapists do not request or view explicit imagery or engage in personal/social contact outside
the office.
Explicit Frames:
Therapists
establish clear professional boundaries from the very first session so clients
feel safe discussing vulnerable
topics
FYI - Anticholinergic Activity Drugs
(Medications)
Anticholinergic and Antispasmodic
Drugs
Anticholinergic Drugs and Impotence
Anticholinergic drugs can
contribute to or worsen impotence (erectile dysfunction).
How Anticholinergics Cause
Impotence
Blocking Acetylcholine:
Acetylcholine is a chemical
messenger in the nervous system that helps trigger the parasympathetic
responses necessary for an erection. Anticholinergic drugs block these
receptors, disrupting the nerve signals and smooth muscle relaxation required
to achieve and maintain an erection.
Reduced Secretions &
Blood Flow:
These
medications frequently cause generalized drying effects (such as dry mouth or
decreased lubricating fluids), which can impair local autonomic responses and reduce proper blood flow to the
erectile tissue.
High-Risk Classification:
Epidemiological
data suggest that anticholinergic medications carry a significantly elevated statistical risk for erectile
dysfunction compared to many other drug classes.
Double Sex Dysfunction Stress and Medication
Sexual dysfunction linked to
stress and medication is a common issue affecting libido, arousal, and orgasm.
How Stress Affects Sexual
Function
Hormonal Response:
High stress
raises cortisol and adrenaline levels, which suppresses testosterone and interferes with the body's
natural arousal response.
Psychological
Interruption: Anxiety, fatigue, and racing thoughts
make it difficult to focus on
or enjoy physical intimacy.
Medications Commonly Linked to
Sexual Dysfunction
Antidepressants:
SSRIs (such as
fluoxetine, sertraline, and paroxetine) and SNRIs are major contributors,
affecting 30% to 70% of users by elevating serotonin
and lowering dopamine.
Lower-risk alternatives include bupropion or mirtazapine.
Blood Pressure and Heart
Medications:
Older
beta-blockers (like metoprolol and propranolol)
and diuretics can reduce blood flow and lower desire.
Other Agents:
Antipsychotics, benzodiazepines, and opioids can
also impair sexual performance.
Management and Next Steps
Do Not Stop Meds
Abruptly:
Stopping
psychiatric or blood pressure medications suddenly can trigger severe
withdrawal or rebound symptoms. Always consult your prescribing doctor or
pharmacist first.
Discuss Alternatives:
A healthcare
provider may adjust your dosage, time
your medication around sexual activity, switch you to a medication with
a lower risk profile (such as bupropion or ARBs like losartan), or add a
targeted treatment like a PDE5
inhibitor (sildenafil or tadalafil).
Lifestyle and Therapy:
Reducing
stress through exercise, deep breathing, or counseling can help address the
psychological and physical overlap
Av Constitución, Zona Nte., 22000 Tijuana, B.C., Mexico
List – Book or Magazines on Sexuality
Why Dorothy Stratten [SPELLED]?
She just seemed so perfect and attractive – Ended in a story that made me cry.
Homework - Movies on Sexuality
For the hands off sex therapist they might recommend for homework
watching movies on sexuality. We thought that Surrender in Paradise (content
warning) was nice. We detected fantasies
up the yin-yang in that movie.
FYI – 20261020-TU—The 25 Best Movies About Sexuality of All
Time - IMDb
https://www.imdb.com/list/ls020220974/
The 25 Best Movies About Sexuality of All Time. By Malthe
Tuxen | Updated – 3 years ago
Zoloft (and to a greater extent Paxil)
Minded_Med_Zoloft
Suggested fill in = Zoloft
Zoloft (Sertraline HCL) Patient
Information: Side Effects and Drug
https://www.rxlist.com/zoloft-drug/patient-images-side-effects.htm
FYI - What are the possible side
effects of sertraline (Zoloft)?
Get emergency medical help if you have any of these signs of an
allergic reaction: skin rash or hives; difficulty breathing; swelling of your
face, lips, tongue, or throat.
Zoloft - Involve Your Doctor
Report any new or worsening
symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel
impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed,
or have thoughts about suicide or hurting yourself.
Feature - Profile
Zoloft (Sertraline HCL) (2004)
https://www.rxlist.com/zoloft-drug/patient-images-side-effects.htm
Call your doctor at once if you have a serious side effect such as:
One’s we didn’t experience
- Breathing that stops
- Confusion
- Diarrhea
- Fainting
- Fast or uneven heartbeats (Unknown)
- Fever
- Headache
- High fever
- Loss of appetite
- Memory problems
- Nausea
- Overactive reflexes
- Seizure
- Shallow breathing
- Sweating
- Trouble concentrating
- Vomiting
One’s we did experience
- Agitation
- Feeling like you might pass out
- Feeling unsteady
- Hallucinations
- Impotence
- Loss of coordination
- Loss of Libido
- Tremors
- Very stiff (rigid) muscles
- Weakness
Donovan Promises of Sex Benefits
20261020-Link Check Fails
http://blog-ilmukita.blogspot.com/2008/12/healthy-sex-life-10-reasons-to-make.html
A healthy sex life: 10 reasons to make love by Deb Donovan…estrogen level, protect her heart and keep her vaginal tissues more supple," states Donahey. Live discussions on the Women's Health Questions message board.
Evidence points to the many
health benefits of an active sex life.
Sex Made Easy, an article published in Men's Health Magazine, gives 10 healthy
reasons to hop into bed -- a reminder that making
love is good for both body
and soul.
Exercise
"Sexual activity is a form
of physical exercise," according to Dr. Michael Cirigliano of the
University of Pennsylvania School of Medicine. Making love three times a week burns around 7,500 calories in a year—the
equivalent of jogging 75 miles.
Heavy Breathing
A night of love can raise the
amount of oxygen in cells, helping to keep organs and tissues functioning at
their peak.
Strong Bones and Muscles
"Any kind of physical exercise is going to
increase testosterone," states Dr. Karen Donahey, director of the Sex and
Marital Therapy Program at Chicago's Northwestern University Medical Center.
Testosterone is believed to help keep men's bones and muscles strong.
Lowered Cholesterol
Making love regularly can lower
levels of the body's total cholesterol slightly, while positively changing the
ratio of good-to-bad cholesterol.
Pain Relief
Sex can lower levels of
"arthritic pain, whiplash pain
and headache pain," according to Dr. Beverly Whipple, president-elect of
the American Association of Sex Educators, Counselors and Therapists. Hormones
that are released during sexual excitement and orgasm can elevate pain
thresholds.
DHEA
Without Supplements. DHEA
(dehydroepiandrosterone), a popular supplemental hormone, is released naturally during
lovemaking. "Just before orgasm and ejaculation," Crenshaw says,
"DHEA spikes to levels three to five times higher than usual."
Prostate Protection
Researchers say prostate trouble
may arise or be worsened by fluid
buildup within the gland. Regular ejaculation will help wash out those
fluids. Be cautious when suddenly
changing frequency -- sudden changes may also trigger prostate
problems.
Stress Relief
"Sex can be a very effective
way of reducing stress levels," Donahey told Men's Health.
Love Will Keep Us Together
Crenshaw says affectionate touch
will increase levels of oxytocin—the "bonding hormone."
Oxytocin is a desire-enhancing
chemical secreted by the pituitary. Regular oxytocin release may help encourage
frequent lovemaking.
Hormones
Naturally, "Regular
lovemaking can increase a woman's estrogen level, protect her heart and keep
her vaginal tissues more supple," states Donahey.
Article Created: December, 1998
Last Reviewed: January 30, 2001
Erectile Dysfunction Sex Therapy: How It Works, Insurance, and More
https://www.webmd.com/erectile-dysfunction/guide/sex-therapy-erectile-dysfunction
Sex Therapy for Erectile
Dysfunction: Sex therapy is a short-term form of counseling, generally
involving five to 20 sessions
with a sex therapist. A typical session may be one hour every week or every other week.
Assignment List
During the session, the counselor
will give the patient "assignments" to do at home, such as:
- Make up with significant other
- Take ED helper med PRN
- Return within the month
- Reading books about sexuality
- Touching exercises that are designed to take away the pressure to perform during sex
- Practicing better sexual communication skills
- Write a paper on sexuality
- Publish a paper on sexuality
Best Treatment Option
Sex therapy may be useful for treating erectile dysfunction if a man is able to have a normal erection during sleep, the results of his physical exam and blood tests are normal, and he is generally in good health. Sex therapy may also be helpful when erectile dysfunction is caused by stress resulting from work worries, financial worries, relationship conflicts, and poor sexual communication. In these cases, sex therapy may be the best treatment option.
Satisfaction with your history around Sex
Satisfaction with sexual history
depends on personal values, emotional safety, and how partners communicate about the past.
While moderate experience can signal social desirability or skill, excessive
focus on numbers often triggers insecurity, judgment, or detachment rather than
true intimacy.
Key Factors in Sexual History
The "Number"
Trap:
Statistical
queries or counts rarely reveal emotional compatibility
or relationship health.
Experience vs. Intimacy:
Technical skill gained from past
partners can enhance pleasure, but overly polished routines may feel mechanical
or impersonal.
Safety and Curiosity:
Healthy
discussions focus on mutual respect, emotional safety, and understanding each
other's present needs instead
of keeping score.
Constructive Communication
Ask Open Questions:
Explore favorite moments,
initial attractions, and shared feelings rather than interrogating past acts.
Focus on the Present: Emphasize who your partner is today and how you build trust
together, as detailed by the The Overwhelmed Brain.
Avoid Judgment:
Recognize that
attaching harsh meanings to a partner's background often reflects personal
insecurities rather than objective reality.
This video explores the
psychological and social perspectives behind how people view and evaluate a
partner's sexual history:
Why MEN CARE about a WOMAN'S
SEXUAL HISTORY (Video of 3:27 Minutes)
https://www.youtube.com/watch?v=3McH9u9s7u8
Satisfied
The window of our most activity began in 1972 when a neighbor female
took our “V”. We consider 2016 the end
of our sex life. To sum it up we are
satisfied with our face-to-face sex life.
And in the End - Does Sex Therapy Work?
Sex therapy is most effective when a man's sexual partner is willing to be part of the treatment. Studies have shown that for men with stress-related ED, having the partner involved in the therapy resolves the problem 50%-70% of the time. When the man must go through counseling alone, the results are somewhat lower.
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