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#ive had it for years as a self archive cause no one follows it and i figure other people might enjoy it
quenepacrossing · 2 months
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i’ve never done this before, but you if you like my acnh vibe and you follow cute ~aes~ blogs on tumblr you might really like mine @freshlinen
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aerialflight · 3 years
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Fic Recs (cause it's always nice to give a shout out and get people into things I'm into rn)
[The Magnus Archives] (I recently finished the podcast and I fell into a hole for a while so here you go)
Sing a Song of Sixpence by Kaiel
Ship: Jon/Martin
In which Jonathan Sims is a Siren, and he fails to notice any new abilities granted to him by the position of Archivist. Or really anything about the Entities at all.
Takes place in season 1 featuring Jonah Magnus’s slow decent into madness
(The new mythology interwoven with tma's worldbuilding is so freaking good and I love how all the characters change and develop because of these changes. Also, f you Elias)
Along Came a Spider by Dribbledscribbles
Ship: implied Jon/Martin
Sasha James is the Archivist, as expected. Martin Blackwood is menaced by Jane Prentiss, as expected. Elias Bouchard weaves his web, as expected.
All goes as it should.
At least until something calling itself Jonathan Sims steps in.
(Web!Jon in this makes me want to weep, it's so freaking good. A pretty long, very excellent oneshot on what could've happened if Jon got taken by the web when he was a kid. And Sasha as the Archivist is ALWAYS so cool, we love her in this house.)
A Break in the Clouds by Ash_Rabbit
“I’m eight.” the kid sniffs as if eight was any different from four, maybe not an unspeakable horror then, just a regular horror. “And I heard that the Magnus Institute deals with-” his little nose scrunches, cute. “-spooky things.”
“Do you have a-” he cracks a grin, and then rethinks it as small hands tighten against their burden.”-spooky thing to deliver?” gods he hopes not, it’s bad enough when adults walk in and lay out all of their baggage, but for a child-
“There’s a spider in this book.” the kid says solemnly, raising his textbook sized parcel. “It ate Evan Pritchard.” a bloody fucking Leitner. Of course an eight year old would find a murder spider book. “This seemed like the best place to bring it.”
(I never thought about what the Original Elias could've been like AND NOW I CAN'T STOP THINKING ABOUT IT BECAUSE OF THIS FIC. I LOVE HIM, HE'S COMPLEX AND HE CARES AND JON CARES AND THEY BOTH CARE ABOUT EACH OTHER. THIS IS THE CONTENT I WANT, OMG. Also, Jon being even smaller than usual is adorable, so cute. No wonder Elias wants to hug him, a LOT.)
See the Line where the Sky meets the Sea by The_Floating_World
Ship: Jon/Martin, Jon/Oliver Banks
When Jon is a child he looks into the infinite abyss of space. The Vast looks back into him.
(One of my all time fave fics in this fandom, no questions asked. I have reread this three times and am open to doing it again, god. Vast!Jon, such a concept. It's written so beautifully and the relationships Jon develops, so good. ugh. My heart. Please please read.)
Sweet As Roses by Prim_the_Amazing
Ship: Jon/Martin
“Come in, Martin,” he says, not looking up from his notes.
“Hi, Jon,” he says, and Jon stops writing at the sound of his voice. “We’re out of the green tea, but we’ve got lemon?”
Jon looks at him. Martin smiles at him in his usual tentative way as he sets the mug of tea down on Jon’s desk. Heat spikes so sharply in his gut that he twitches with it.
“Thank you, Martin,” he says, mouth dry, and he stands up.
“Oh,” he says, sounding almost surprised. He smiles again. “No-- no problem-- um, what are you--”
Jon takes Martin by the shoulders, leans up on the tips of his toes, and kisses him.
(You have no idea how much I howled through this fic, my god. *buries face in hands* The number of times I wanted to cry from sheer hilarity and horror reading this good lord.)
Things Could Always Be Worse by theOestofOCs
Ship: Jon/Martin, Georgie/Melanie
Sometimes, the most horrifying thing of all is what might have been.
Somewhere, Jon could swear he heard a crowd laughing.
Or: in which Jonathan Sims is forced to swap places with his alternate self—a tall, chivalrous hero extraordinaire, who knows neither fear nor nuance—and is sent to the aggressively straight alternate universe the Magnus Archives was never meant to be.
“Whatever place this is,” Jon announced, “I just want to be sure it knows I hate it.”
(I will say this once, THIS IS THE MOST CURSED THING IVE EVER READ EVER. Like holy hell. I can't believe this thing exists. please read it oh please please please)
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[Supernatural]
heard from your mother (she don't recognize you) by Schmuzz
Ship: Dean/Cas, Jessica/Sam
A man named Cas wakes up in 2003 with no memories, but he's able to piece together a few things:
1. Supernatural creatures exist, and most of them will hurt innocent civilians if he doesn't stop them; 2. He has abilities that no human hunter should have, but he knows enough about human hunters to keep that to himself, and finally; 3. He keeps running into another hunter named Dean Winchester, who seems to be about as lonely as he is if he's willing to put up with those former facts long enough to help Cas unravel the mystery of who (or what) he really is.
For his part, Dean's still (not) dealing with Sam's departure to Stanford, and figures distracting himself with a bit of mystery and intrigue is as harmless as it gets, right? Right.
(THE fic I'm most into right now, been following this from the very start and it's AMAZING. Cas has agency and is making friends and S1 Dean is growing out of John's influence and is becoming a Person and the both of them first being friends then more. The slow burn as their relationship develops, SO GOOD. SO SO DAMN GOOD. *screams* Seriously one of the best spn fics I've read in a long, long time.)
anamnesis by cenotaphy
Ships: Castiel/Dean, Sam/Eileen
Chuck is depowered, Jack is the new god, and the world is free. Dean and Sam get into the Impala and chase down the miles on an endless highway, and their story is finally, finally their own to follow. At least, that's what Dean tells himself. But the diners and motels and painted interstate lines are blurring together and the smallest details keep catching at his brain like tiny fishhooks and he can't quite shake the feeling that not everything is exactly as it should be.
* Fix-it/alternate series finale. Canon-compliant through the end of 15.19.
(THIS IS THE FIC THAT GOT ME THROUGH THE FINALE OKAY. WHY COULDN'T THIS HAVE BEEN CANON. It's Disturbing and honestly plot-wise this makes more sense. Why couldn't we have had this. *screams*)
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[Avatar: The Last Airbender]
where the stars do not take sides by WitchofEndor
Ship: Sokka/Zuko
When Azula is nine, she becomes an only child. She hears the Fire Lord call for Zuko's life, and in the morning, her mother and brother are gone. Azula may be young, but she isn't naive. She knows what happened to them.
Which makes it all the more surprising when Azula tracks the Avatar down and fights his group of peasant friends, only to find herself staring into an eerily familiar face.
(The fact one of the tags in this fic is, "Sibling Dynamic: Fucked Up But Wholesome" should give you an idea what this fic is like. Chaotic as HELL and I just love Azula here, she loves Zuko so much in her messed up way and Zuko loves her back in the exact same way lol. It's batshit and I am Here For This.)
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[Naruto]
Eclipse by AislingRoisin (JayBird345) for HybrisAnaideia
Ship: Nara Shikaku/OFC
"In life, it's easier to remain stagnant and wallow in your troubles. But life isn't merely about continued existence, nor is it meant to be gone through alone."
(This is a fic that's slept on and I NEED people to read this. A self-insert fic that I find really interesting in its approach and the worldbuilding for the post-third war shinobi world is fantastic. I feel like there's a certain pattern with self-insert fics, not that is a detriment in any way to how much I enjoy them, so this fic feels fresh to me in a way I haven't read in a while. I am waiting eagerly for this to get updated! Please read!)
On Freedom and Other Formalities by iaso
Ship: Kakashi/Genma/OFC
When push comes to shove, Hiwa Inuzuka doesn't go down easy. Reborn into a new, dangerous world? She puts her past life as a spy to work. Thrown into a war? Hiwa does her duty, for Konoha. And when she's forced into an arranged marriage? All there is to do is beat them to the punch and get married first. Thankfully, Genma Shiranui is willing to lend a hand. Literally. SI/OC
(Listen, LISTEN, it's about the slow burn, the longing, the communication (it both has and hasn't and isn't THAT great??), the messy way you fit three very different people together, it's so freaking good! Also, Kakashi is so Chaotic here this is my fave characterization of him, you can't change my mind. And Genma is a Good Boi who is Doing His Best, along with the Self-insert character who I LOVE SO MUCH, SHE'S FANTASTIC FNEIWOPAF. Sped past this fic in the speed of light, I could not stop reading!)(Honestly, read all of the author's fics, they're all really REALLY good!)
Building a Castle by WhisperingDarkness
Without needing anyone to tell her, Sakura knew that talking to someone no-one else could see or hear would make her weird. It would draw the bad kind of attention to her, something people could make fun of her for.
She didn’t like being weird, but she did like the voice. Her inner voice was helpful and it was a part of her that had always been there. The idea of it not being there would have been so much weirder than anything else.
It was during her first year at the Academy that Sakura realised the voice was not in her head at all, but that it came from a cloudy shape floating next to her.
(Basically a short-ish retelling of Hikaru no Go. Only with more Shogi and Nara and Ninja's)
(Sakura can see ghosts (I'm noticing this is a popular trope for her) and it's really cute haha! Her relationship with Tobirama is sweet and I just enjoyed reading this so much.)
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[The Magicians]
So Long (And Thanks For All The Books) by IncompleteSentanc (Erava)
Ships: Quentin/Eliot, James/Julia, Quentin/Margo/Eliot
When Quentin is told Julia wasn't admitted to Brakebills, he realizes he has a drastic decision in front of him. If he tells Julia about magic, he'll have his mind wiped as well as hers. But he can't just leave her behind, either. He can't lose his best friend, and he can't let her life a life with her magical potential stolen away from her.
So he makes a third choice.
(Really, and I mean REALLY well-done canon divergent fic, this is the Quentin & Julia friendship fic I have been looking for forever. It explores so much of what could've happened and I just love Quentin here, I really really do. Characterization done so right. I also recommend the author's other works too. Been a follower of them for a long time, they're great.)
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[Game of Thrones]
The Road to Victory by writing_as_tracey
Too late in preparing for the Night King and the Long Night, the last stand at Winterfell is close to falling. Bran takes desperate measures to ensure victory, and Jon, Sansa, and Arya pay the price for it in a time unfamiliar to them, on the cusp of another war. [GoT, time-travel fix it]
(I swear, this fic made me laugh so many times, all the Stark are BAMF and fantastic, and Rhaegar gets Wrecked lol. It's crack btw, and the plot goes in directions you'll never guess and it's amazing hahaha!)
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[Haikyuu!!] (I am very very late to the fandom but here I am)
Ballare (To Dance) by MidnightSparks
Ship: Iwaizumi Hajime/Kageyama Tobio/Oikawa Tooru, and platonic Kageyama & Kentarou (really love their friendship)
Kageyama’s first love is volleyball. His second, however, is ballet.
In one world, Kageyama Tobio is left behind by his parents. In this world, the existence of soulbonds keeps Kageyama’s parents in Miyagi and leaves Kageyama in the care of his grandma and grandpa.
(In which soulmates exist and that changes everything and nothing at the same time.)
(*buries face in hands* I have fallen for this ship so hard and I can't get out fudge me. I understand now. Their DYNAMICS FIEWONPAF)
Kings of Tomorrow by bokubroya (liarielle)
Ship: Kageyama Tobio/Oikawa Tooru
On the eve of Tobio’s 16th birthday, he counts down the seconds to midnight, and emerges with Oikawa Tooru’s name on his wrist.
It’s been two years since then, and Tobio thought they had an understanding. A silent, never spoken about understanding that this thing between them is nothing, and they’re going to pretend it doesn’t exist.
Of course, it’s just like Oikawa to change the game and leave Tobio wondering what comes next.
(I am WEAK for soulmate fics between these two, I don't even really like soulmate fics half the times what is WRONG WITH ME-)(Please suffer with me, I'm begging you. Its a good fic, thumbs up.)
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[Crossover]
Honey and Magic by JustARatherVerySillyWriter, White_Squirrel for Super Carlin Brothers
Fandoms: Matilda (yeah you read that right), Harry Potter
Everyone knew Matilda was a rather extraordinary child, but even she didn't know she was a witch. Matilda Honey receives her Hogwarts letter in the year of the Triwizard Tournament, and soon, she will leave her unique mark on the magical world.
(Do I even need to explain how amazing it is to have Matilda in the wizarding world? And Matilda is a HUFFLEPUFF AND I WILL DIE ON THIS HILL THIS FIC IS GREAT PLEASE READ!!!)
An Eye for an Eye by DpsMercy
Fandoms: The Magnus Archives, Welcome to Night Vale
In which Jonathan Sims is not from the UK but instead, if you took his origins and turned them sideways twice then flipped them over, he technically would be from the US, the town of Night Vale specifically. Elias can’t do shit about it and gets a headache and slowly creeping madness instead.
(Look, I know probably everyone has read this because if they haven't, what have you been DOING with your lives??? Jon interning at Night Vale is Incredible, nothing phases this man, it's Delightful. I laughed so many times reading this, I'm not even kidding right now. Read or perish.)
The Favour by R_Cookie
Fandoms: Harry Potter, Fantastic Beasts and Where to Find Them
Ship: Original Percival Graves/Harry Potter
Percival is ten years old when his grandfather tries to tell him that he's ensured the greatness of the Graves legacy for him, that he ought to be eternally grateful - but the explanation is hijacked by a stranger who manages to intimidate Chester Graves with an ease never seen before.
or: Hadrian (Harry) Potter is the Master of Death, who grants Graves a boon. Nobody could have known that the Deathly Hallows didn't turn you so much into the 'Master of Death' as into the anthropomorphic personification of Death. And so, Death becomes Percival's guardian angel, and Percival does not spit out his cereal.
(Look, I don't know how I stumbled back into the FBAWTFT fandom either, it just happened and I'm grateful for that. Otherwise, I wouldn't have found this amazing fic. Their relationship is slow and strange and I just love how Percival is characterized here. Also, one of the tag promises that it deviates from canon so I am really, really excited for that! XD)
baby that's what i do by natanije
Fandoms: Naruto, Katekyou Hitman Reborn!
"Are you telling me," Hidan exclaims, incredulous, "that you collect money all this time to give to orphans?!"
Kakuzu pauses. He blinks a few times.
"Huh. I guess I do."
(Tsuna reincarnates as Kakuzu and it's HILARIOUS. HE'S SUCH A MOM HAHAHA)
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My Sweetest Friend: Which Version of “Hurt” is Better?
(CW: Suicide mention, self-harm mention, drug mention)
Recently, I had been going through the discography of the legendary industrial rock band Nine Inch Nails. After listening to their second record multiple times, I decided to tackle an age-old question that music critics, fans, scholars, and religious philosophers have been debating for centuries. What is the better version of “Hurt”, Nine Inch Nails’ original song or Johnny Cash’s cover?
Nine Inch Nails’ original appears at the end of their seminal sophomore album The Downward Spiral, a dark, masterful concept album, exploring themes of drug abuse, self-hatred, and bleakness with only a faint glimmer of hope at the end of the tunnel, if there even is one. The song takes place after the penultimate title track, in which the character followed all throughout the album attempts suicide. He survives, and then the song slowly transitions into “Hurt”. The opening lines are iconic, “I hurt myself today / To see if I still feel / I focus on the pain / The only thing that’s real”. To be so broken and empty that all you can do is just feel the poke of the needle or the cut of the razor blade that causes some sort of relief.
The context of Cash’s version is much different. Trent Reznor, the mastermind behind Nine Inch Nails, was a 29-year-old man when “Hurt” was released. Johnny Cash was 69 when his rendition of it appeared on his record American IV: The Man Comes Around, released in his American Recordings series, which show Cash performing mostly covers. Cash was a phenomenal covers artist, and it shows on these records, especially American IV. He does an excellent rendition of The Beatles’ “In My Life”, a lovely duet with Fiona Apple covering Simon & Garfunkel’s “Bridge Over Troubled Water”, and even a country rock rendition of a new wave classic, Depeche Mode’s “Personal Jesus”. But the most notable cover is track 2, that of Nine Inch Nails’ “Hurt”. In the context of the album, it’s still great, but it feels strange to go from a powerful, emotional performance of that song to then have the subsequent song on the record be “Give My Love to Rose”, as you’re continuing to process the power and beauty of such a heavy performance of “Hurt”. 
The best way to listen to Cash’s version of the song is with the music video. Directed by frequent Nine Inch Nails collaborator Mark Romanek, the video attempted to show the contrast between Johnny’s beginnings as a bright, vibrant young man, and Johnny’s present as a withered old man, surrounded by his legacy. To this day, I can’t listen to that lyric “Everyone I know goes away in the end” paired with that immediate cut to a picture of his widow, June Carter, and not just get chills. To see the archival footage of him performing on television, delivering his signature smile, coupled with the empty halls of the House of Cash museum, a frame containing a gold record shattered on the floor is a beautiful, heartbreaking contrast. 
The production of Reznor’s song is distorted and fuzzy, reflecting the ugliness of the record. Some parts feel like you’re listening to the track through a radio, with those crackles on his vocals and the guitars sounding like the audio from said radio is just starting to get out of range, echoing the loss that is in Reznor’s vocals. He sings the verses and the first half of the chorus in a bit of a whisper, as if the shame and regret is too much to bear. The production on Cash’s version is much more spare, just a man and his guitar, alongside some piano during the chorus. Because this cover is stripped of any sort of industrial rock, Cash sings it with much more clarity, like he is in a confession booth, telling all of this to anyone who will listen. 
Certain lyrics in each version stand out much more. One of the best lines is “You are someone else / I am still right here”. In Trent’s version, it makes the most sense, as I imagine him singing this about his old friends, maybe former addicts who have gotten clean and seem to have their lives and their health in order, and he is still in the same place as he was. His delivery on that line is just absolutely perfect.
The one line that sticks with me on Cash’s version is “And you can have it all / My empire of dirt”. In the original, Trent sings it with the intention that his life has completely amounted to nothing, as does Cash. What makes this line so haunting and effective is that Johnny Cash is a country legend. Considered to be one of, if not, the greatest performer in the genre. Millions and millions of records sold, and a blossoming late career that showed that he was still the best in the game. A museum dedicated to his legacy and the impact that he had left, nothing more than dirt on the ground in his eyes. Was all the fame and glory worth it if it didn’t kill the demons you had yet to conquer and if it had left people that he had loved hurt? 
But then there’s the ending line; “If I could start again / A million miles away / I would keep myself / I would find a way”. In the Cash cover, he sings those final lines so clearly, even as the strumming of his guitar and the clinks of the piano only get louder. As dark and as tragic as this cover is, there’s something so beautiful about the way the instrumentation stops and Cash sings “a way”. After a song of self-hatred, anger, pain, and sadness, there’s a calmness, an acceptance, even a hope to his voice at the end of “Hurt”. In Trent’s case, however, it's the opposite. The outro starts off hopeful, with the drums giving a sound of someone finally having that sense of turning their own life around, but once Trent sings “I would find a way”, there’s an ugly, sludgy guitar chord, drowning out his voice, followed by the sound of static, as the album ends. The protagonist cannot escape, they only get sucked into a further darkness. A haunting ending to a haunting album. 
But which version of this classic song is the better one?
The answer is, no version of “Hurt” is best. I know that’s a cop-out answer, but both of these versions showcase two men at different points in their life. Trent Reznor was a drug-addicted twentysomething who needed to perform this song as some sort of catharsis. To attempt to triumph over the demons he was facing. Johnny Cash needed to sing this song as he realized that his own life was about to come to an end. He had also struggled with drug addiction throughout most of his life, and could probably relate to the same things Trent was singing about. Compositionally, each note is perfect, and shows that whether performed on synthesizers or acoustic guitars, Trent Reznor wrote a song that perfectly captures the darkest corners of someone’s mind, at their brink, at their bleakest, one that is the perfect closer to one of the greatest albums ever recorded, and Johnny Cash’s cover transformed the song into one of the most iconic country tracks of the 21st century. One version can be preferred over the other, and it’s the correct answer.
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panharmonium · 4 years
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you can be my ride or die: a staggeringly long essay about a deceptively short appearance
(aka, pan’s personal depository of notes about prince william of ealdor.)
now that my fic is long since done and posted, i can finally transfer this monster piece of meta out of my google docs and onto my blog, where it can serve as an unasked-for, absurdly detailed, beginning-to-end analysis of my obscure fave.
(whose line ‘yeah, and i’m prince william, of ealdor’ is still the funniest damn shit i’ve ever heard and also the most shocking burn arthur has ever received; i hope he thinks of it sometimes and remembers that humility is a virtue)
(the BRISTLING DISRESPECT!  the ZERO FUCKS GIVEN!  i love him!  please can someone else talk to arthur like this!  he needs it!)
disclaimer before we begin: i wrote this over a year ago, as a character check for myself during the very early stages of working on my fic.  i kept messily adding bits to it over the course of a couple weeks as i explored what i knew about this character and who i understood him to be, but at the time, i didn’t intend on posting it; it was just prep work for my own story-making.  it’s still essentially just a record of my train of thought as i pieced this character together - i’ve cleaned it up a bit now and added some recent links to make it more coherent, but it was never meant to be a posted essay, just a collection of notes for myself.  
be forewarned, it is more comprehensive than the things i’ve written about this character since, and it goes on for years.  if you are not interested in many, many pages of super heavy in-depth musings about a character who appeared in one episode, now is the time to scroll on by.  i promise i won’t mind in the slightest; i wrote this for my own purposes and don’t really expect people to read it - i’m posting it just to have it archived with the rest of my merlin stuff.
if you are interested in that sort of thing, however - hit the jump, and off we go!
i really love the episode where we meet will, though i’ve started to love it for new reasons since the first time i watched it.
the first time i watched season 1, 'the moment of truth’ was my favorite S1 episode overall, because it was the first time the Fab Four went off on an adventure together, and that was very exciting; and i also loved it because all the character stuff in that episode was so good; and i also loved it because look, all of us are suckers for that classic seven samurai plot, you know - i loved it in TCW, i loved it in the mandalorian, i loved it in merlin.  not gonna get bored of ‘simple farmers defend their homes with pitchforks’ anytime soon.  it is overall just a solid, self-contained plot with clear emotional arcs, and it sticks its landing well.  it’s a simple, strong story.
nowadays, though, i also love it because of will.
i. will whomst?
prince william of ealdor, that’s who!
will straddles a kind of weird place in canon, because he feels like a minor character to the audience but is very much not a minor character for merlin, who has known will much longer than the brief hour we get to spend with him and who has spent his entire life with will as his sole friend.
but, because will only appears once - let’s start with a round-up.  what do we actually know about him?
he’s a peasant farmer from ealdor, like merlin
his father was killed fighting for king cenred (as a foot soldier - these people are not wealthy enough or high-status enough to afford or be accepted into the knighthood)
his mother is either dead or absent
he’s painfully class conscious and doesn’t trust the nobility
he’s a “troublemaker” (the interpretation of which is...well, it’s left to the viewer’s discretion.  fandom seems to jump to ‘fun mischief and pranks,’ though i personally don’t get that vibe from this episode.  “troublemaker” in will’s case seems to mean more “doesn’t know how to keep his head down/can’t go along to get along to save his life.”  it means when he sees something that he thinks is Wrong, he absolutely will not shut up about it even when all his neighbors are sick of him and want him to just let it go.  it means he can’t stop rocking the boat even when rocking the boat makes everybody want to strangle him.)
he supplements his agricultural pursuits with carpentry.  you can see in his house big piles of hewn timber along one wall, as well as a grindstone and a shaving horse, and when he comes out of his house on two separate occasions he’s holding woodworking tools (mallet, chisel, etc)
he knows about merlin’s magic - for how long this has been the case, we’re not told.  it doesn’t feel like a new thing to me, but ultimately that’s guesswork.
he appears to have just one friend
that one friend is merlin
will loves merlin enough to die lying for him
merlin left will behind.
ii. it wasn’t what i wanted
so let’s talk about that.
merlin is asked “why did you leave?” twice in this episode, first by arthur and then by will.  he gives completely contradictory answers to the two of them, and it’s worth remembering, before examining both responses, that one answer is inherently more honest than the other, because merlin is only able to tell the whole truth to one of these people.
so when merlin talks to arthur, it goes like this:
“why did you leave?”
“things just...changed.”
“how?”
*silence*
“come on, stop pretending to be interesting and tell me.”
“i just didn’t fit in anymore.  i wanted to find somewhere I did.”
arthur has to drag this answer out of merlin, and it’s not because merlin doesn’t feel like sharing (i mean, come on, we know merlin; merlin wants to be in everybody’s business and he feeds off human connection like a starving man; he’d be thrilled that arthur was interested in his life) - the problem isn’t that he’s shy; it’s that he’s not exactly telling the truth and he’s trying to figure out how to do it in the least deceptive way possible.
i just didn’t fit in anymore.  i wanted to find somewhere i did.
that’s nice.  
it’s also a lie.  
it’s not a total lie, of course - there’s an element of it that becomes true, after merlin gets to camelot and realizes that working for arthur is “not totally horrible all the time” - that he sort of likes the excitement, and the newness, and being somewhere where nobody knows him and nobody will judge him - but that’s the reason he stays in camelot, not the reason he leaves ealdor.
by contrast, when will asks the question, merlin gives a completely different answer:
“why did you leave?”
“it wasn’t what I wanted.  mother was worried.  when she found out you knew - she was so angry.”
it wasn’t what I wanted.  
can we digest that for a moment?
merlin didn’t want to leave home.  
not that he isn’t enjoying himself in camelot now, of course - which he conveniently doesn’t mention in this conversation, because will is upset with him and merlin feels guilty that he’s been off enjoying his new life while will has been struggling at home alone - but at the point of departure, merlin didn’t want to go.  
his answer to arthur about finding a place where he belonged is certain-point-of-view bunk.  he didn’t just up and decide that he wanted to run off and find a place where he fit in better.  he didn’t leave because he wanted to escape a place he didn’t belong.  he didn’t set off in search of adventure and a new life.  it’s true that he didn’t feel like he fit in in ealdor, but that’s not what sent him packing.  he left because his mother found out that will knew about his magic, and she panicked and sent him away.  
iii. why did you leave
most fannish things i’ve encountered tend to interpret merlin’s departure in a much more generous light than i do, with merlin explaining to will that he’s leaving and will being unhappy about it but eventually understanding and kind of like...giving his blessing before merlin goes.  this is fine, of course, but it did surprise me, when i started dipping my toes into fandom, because i never interpreted events in this episode like that, and i don’t think it’s even a plausible read, not from the conversations we’re actually given.  the antipathy that accompanies merlin’s return doesn’t make sense under those circumstances, and moreover, from the way things actually unfold in this episode, we’re told, in order, the following three things:
1) the fact that will asks “why did you leave” tells us that he and merlin did not discuss it prior to the point of departure.  there’s no other reason for will to ask this question.  everything about will’s tone and body language in this scene indicates that he’s been stewing over this for a long time, that he doesn’t understand, that this is something profoundly difficult for him to address.  and while it might be nicer to think that merlin sat down and discussed things with will before leaving for camelot, that’s not the inference we’re being asked to make here.  
2) there is absolutely no way they wouldn’t have discussed it, if will had known that merlin was going to leave.  like - if your only friend in the world told you they were moving to another country tomorrow, there’s no way “why?” wouldn’t be the first question you asked.  there’s no way you wouldn’t have that discussion, at the most basic level, before separating.  it just wouldn’t happen.
3) so, given that information, the unfortunate, inescapable conclusion is this: will didn’t know merlin was going to leave.  merlin left without telling him.
everyone is free to continue to headcanon this in their own ways, of course.  but this is what we’re actually being told.
iv. we don’t want your kind round here
the fact that merlin vanishes without so much as a word to his best friend goes a long way towards explaining why merlin is so uncomfortable when he first sees will in the street.  
when they first encounter each other, merlin looks so apprehensive and wary, and the writers are playing it like ‘uh-oh, someone saw him use magic and now he’s nervous about it!!!’  but two seconds later, you realize that this can’t possibly be what’s causing merlin’s concern, because it’s made immediately clear that will already knows about merlin’s magic and isn’t going to say anything about it.  
merlin isn’t afraid of being outed, in this scene.  but he might, however, be afraid of the reception he’s going to get, given what we just discussed.
merlin just up and disappeared from home, and not so much as a letter since - we know will’s had a secondhand update, probably from hunith (“how’ve you been?!  i hear you’re skivvying for some prince”) but he very clearly hasn’t had any direct contact with merlin since before merlin left.  
merlin knows this was a big fuck-up.  he feels guilty.
(and to be clear - i think there is a lot to be said about just how merlin’s departure unfolded, and what stopped him from getting in touch.  it’s a complicated enough topic for its own piece, and it’s not quite within the scope of this essay, but suffice it to say for now that i don’t believe it stemmed from deliberate thoughtlessness or callousness on merlin’s part; it’s...deeper and more complicated than that.  honestly, i think merlin looks back on this as like...the first major mistake he ever made in his life, his...original sin, sort of.  and i don’t think he’s ever forgiven himself for it, either, but again, that’s a story for another day.)  the point here is that merlin didn’t necessarily want to cause harm, but he knew that’s what he was doing regardless - he knew that leaving without a word was the wrong thing to do.  and in this moment he feels rightfully guilty about all of it, and he’s afraid that his friend won’t welcome him home.
merlin’s moment of uncertainty is real, when will pretends to greet him with hostility.  merlin is afraid that will is angry with him for leaving him behind.
(and let’s not kid ourselves, will definitely is)
it’s a festering thing that keeps boiling to the surface as we progress through the episode.  it shows in the way will finally asks why did you leave, avoiding merlin’s eyes, the question laden with vulnerability.  it’s in the exchange “are you going to abandon them?”/“what, like you did?”  there’s real pain there, and confusion, lots of hurt feelings.
but.
despite all of that, will doesn’t freeze merlin out, when merlin comes riding back into town.  merlin is rightfully afraid that will might not want to see him, afraid that “we don’t want your kind round here” might be less of a joke than it ought to be.  and while all of the troubles that merlin is worried about are absolutely real and poised to cause friction later, the truth is that at that exact moment, when merlin comes walking up the road - none of it matters.  will has been nursing a collection of hurt feelings for months now, yeah, but in the immediate moment, when it comes down to it - he puts them aside.
they both do.  nerves, guilty thoughts, bruised feelings - they temporarily abandon all of that in favor of a momentary joy.  you can see how excited they are when they reunite.  how they start smiling at the same time.  how they laugh their way into that hug.  they’re so happy to see each other.
people get pretty worked up about ***That Time Arthur Finally Hugged Merlin!!!***, but i don’t know.  i think it matters to remember that merlin had people who knew how to hold him long before arthur was even a flicker of a shadow in merlin’s mind.
v. why are you being like this
so they reunite!
and then they fight. D:
but what really matters is how they fight, because even when they’re having an argument, they never let things escalate quite to the level of interpersonal nastiness, certainly never to the level of cruelty for cruelty’s sake - just a few hard truths and a pile of hurt feelings:
“i trust arthur with my life.”
“is that so?  so he knows your secret, then?”
...
“face it, merlin, you’re living a lie, just like you were here.  you’re arthur’s servant, nothing more.  otherwise you’d tell him the truth.”
the delivery in this scene is essential for understanding how these two interact with each other.  it’s so telling.  merlin and will are having an argument, and will is angry about everything we’ve already discussed, and on top of that, some prince is trying to round up a bunch of will’s neighbors for a fight that’s going to get a lot of people killed, and will sounds so sharp when he’s talking, up to and including the challenging “is that so?”  
but then when he sees that he’s touched a nerve there and merlin knows he’s right, his voice drops those edges and goes gentler, regretful, like - he and merlin aren’t all hunky-dory right now, but he’s not out to rub merlin’s face in it, either.  he’s not trying to “get back” at merlin for leaving him.  he’s not like...happy that merlin’s situation is shitty.  
vi.  if i broke it (would you quit?)
we mostly only see these two in a tense season.  they’re arguing with each other for almost the entire episode, and yet even in this at-odds state, there are little things that remind us of what they’re usually like - that they don’t want to be arguing, that this isn’t a natural at-rest state for them, that this isn’t what they’re used to.  they butt heads, but they keep swinging around back to each other, and trying again, and trying again, and trying again.  they never write each other off.  they keep trying to make it work.  
examples: merlin asking “why are you being like this?,” the implication being that will isn’t usually like this, that this isn’t how they usually act around each other.  the two of them together in the background of arthur’s pitiful training session, coming right off the tail-end of another argument and busying themselves with their own work, but still reflexively hanging in each other’s orbit.  merlin, even in the middle of a strained conversation, helping clean up the mess that the bandits made of will’s house, without asking or being asked, like it’s just the automatic, reflexive, natural thing to do.  merlin using will’s proper name when discussing him with other people, but always the diminutive when they’re talking to each other.  merlin following will every time will walks away; will doing the same when merlin’s the one who’s leaving.  that moment up in the hedgerow, with will’s embittered “you know why,” which sets them to arguing again, except instead of it pushing them apart, it pulls them closer together - will climbs right up into the hedge where merlin is standing so they can sit next to each other and talk.
like.  he’s angry!  but the instinct isn’t to storm away, it’s to get closer.
i love that so much.  i love how they’re starting to have another argument and merlin stands there and says “why are you being like this,” to which will, already upset, responds “you know why,” BUT -
but
will stalks up into that hedge and plops himself down right next to merlin, and merlin, without a moment’s hesitation, sits down beside him.
i love that.  they’re angry with each other, but their first instinct is still to close the distance.
i wonder, sometimes, how much of that is a function of them only having each other.  when you’re on the outs with someone, usually you can lean on your other friends, but what can they do?  it’s different when the person you usually seek out for comfort is the same person who’s pissing you off.  you don’t have anyone else to run to, so you can’t ever really storm off.  you have to learn how to hash things out.  you have to learn how to make it work.  you have to learn not to give up on each other.  
vii. she was so angry
the implied backstory for how merlin actually ended up in camelot is so painfully fascinating and, quite frankly, wrenching to think about, given how this episode eventually ends.
when will asks merlin why he left, merlin tells him, “it wasn’t what i wanted.  my mother was worried.  when she found out you knew - she was so angry.”  this is telling us that merlin’s departure for camelot was directly preceded by his mother discovering that will knew about merlin’s magic.  that is what ultimately prompted her to send merlin off to camelot.  of course there would have been other contributing factors - it’s evident that merlin’s situation in ealdor has always been precarious - but her immediate reason for sending him away was the fact that she found out that will knew about merlin’s magic, and she was angry and afraid to learn that merlin had been lying to her about something that put him at risk.
“i wouldn’t have told anyone.”
“i know you wouldn’t.”
but merlin’s mother didn’t believe that, or she wouldn’t listen to him when he tried to tell her, and she shipped him off to camelot anyway, despite the fact that camelot is arguably more dangerous for merlin than ealdor ever was.
the web of how this played out is such a tangled mess.  is it my fault, thinks will, before the episode even starts, desperately trying to figure out why merlin would abandon him like that.  it’s my fault, thinks merlin, at the end, knowing that if he had used his magic sooner, or come back alone, events would have unfolded differently.  it’s my fault, thinks hunith, realizing that the particular fear upon which she based merlin’s entire departure was utterly unfounded.
merlin doesn’t blame her for it, even though he has reason enough to be angry about it, by the end of this episode.  he understands that she was just trying to protect him.  but the truth of the matter is that she did make a mistake.  she was afraid for him, and she saw danger everywhere, and so she made a misjudgment.  
it’s the miniest of mini-arcs, but it’s there.  at the end of this episode, right after will drops the Big Damn Lie, merlin looks desperately around for the only other person in the room who understands, and the camera rests on hunith’s face for one lingering moment, as she realizes what’s happening.  when she’s exiting the house, there’s a shot where she pauses for a minute on her way out the door, staring back at her son's dying friend, who just offered himself up as a willing sacrifice to keep merlin’s secret safe.  
she and merlin are the only people in the room who understand the real import of that moment, the real meaning of that gesture.  they’re the only ones who know what’s happening, what it really means for will to say “i did it.”
hunith knows she misjudged that kid big-time.
viii. you can be my ride or die
so.  will.
why am i even interested in him?  what is it about this character that makes me want to write about him?
number one: i love him because he’s the only person we ever meet who cares exclusively about merlin.  
everyone else merlin has met up until this point is either a) as beholden to camelot and arthur as merlin is himself, or b) aware of merlin’s “destiny,” which isn’t necessarily a bad thing but does change the way people talk to him and treat him.  
it’s not that merlin doesn’t have people who care about him, but those relationships are not the same as the one he has with will.  merlin is obviously #1 in his mom’s life, of course - but, importantly, even hunith’s immediate reaction to merlin’s uncertainty at the end of 1.10 is to tell him that he has to go back to camelot, that arthur needs him, that he’s “the other side of a coin.”  this despite the fact that hunith has known arthur for all of five minutes and that merlin, in the moment where she talks to him, is in a lot of pain, and maybe it isn’t the most appropriate moment say, ‘hey, you absolutely must devote yourself to that guy i literally just watched lecture you about the evils of magic while attending your (supposedly magical) dead best friend’s funeral.’  
and when it comes to merlin’s camelot network, well - he’s #1 in gaius’s life, too, but gaius also is deeply concerned with the greater good, with the future emergence of albion, with what merlin is meant to become and do.  morgana and arthur - well, they don’t know merlin, first of all (really know him, all of him, the important bits) - they definitely like him well enough, and care about him in their way, but ultimately they’re royalty or pseudo-royalty and they have priorities that go beyond merlin, who, at the end of the day, is still a servant.  gwen comes the closest to being on merlin’s level, but she doesn’t know him-know him either, and as time goes on she gets more involved with the Crown, with arthur, and with the responsibilities all of that brings.  even merlin’s later friends all go on to have other missions - they absolutely all love him, but they all become knights, and they are as concerned about the well-being of the realm and the king as merlin is.  even merlin HIMSELF puts arthur’s life ahead of his own - he defines his worth by how well he can protect his prince.  
but will is the only person we ever meet who just cares about merlin - merlin the regular person, not the servant he pretends to be, or the legend he’s supposed to become.  not the fake, non-magical merlin facade (which is what almost everyone else needs merlin to be before they can condescend to be his friend) and not some destiny-laden figure out of prophecy, either.  will doesn’t know anything about destiny or prophecies.  he’s never needed to know about any of that stuff to care.  he’s always liked merlin.  just merlin.  just as he is.  
that matters.  all merlin ever does in this show is deny himself or be denied of the things every regular human being needs to thrive - love, acceptance, truth, safety.  he constantly puts or is forced to put other priorities ahead of his own interests, to a point where now, by season five, he’s spent years defending a regime that oppresses him, protecting kings who would execute him.  
will, in a display of true-to-character contrariness, upsets that entire narrative, because he does not care one whit about any of the things for which merlin is supposed to sacrifice his life.  will gives less than zero (count them: negative zero) fucks about arthur pendragon, and he doesn’t care about camelot, and he wouldn’t know what “albion” meant if he heard the word.  and it is refreshing - a blessed, beautiful, heartbreaking relief - to see one person in the world who only cares about merlin, for whom arthur pendragon, in comparison with merlin, isn’t the slightest bit important.  arthur isn’t even on the map.  he’s a non-entity.  he doesn’t exist.  
it’s a complete inversion of the way things are supposed to go, in this story.  you know how it goes - arthur is the once and future king, and merlin’s job is to usher in his reign.  "maybe that is its purpose,” gaius says, about merlin’s magic being meant to protect arthur, about merlin being born this way for that particular reason.  it’s merlin’s job to save arthur’s life.  it’s merlin’s job to teach arthur to be a better person, at his own expense.  it’s all for arthur.  i give my life for arthur’s.  his life is worth a hundred of mine.  what is the life of a servant compared with that of a prince?
will delivers the biggest fuck-you to that entire framework, because he doesn’t assess merlin’s worth based on what merlin can do for some random prince on the other side of the border.  merlin’s magic wasn’t purposed for anything, as far as will is concerned.  it doesn’t need to justify itself.  it just is.  it’s just who merlin is.  
and who merlin is has always been just fine.
ix. am i the only one wondering who the hell this is
for will, it’s people like arthur who need to justify themselves.  arthur with all of his power, arthur riding into little villages with his sword drawn, arthur and his bossing around and his “now, merlin!” conversation-interrupting.  will makes no allowances for wealth and couldn’t be less interested in royalty - his frame of reference isn’t you’re the once and future king and merlin exists to prop you up; it’s who the hell are you?  what gives you the right to be here?  what did you do to earn what you have?  
will, like gwaine after him, is acutely aware of the injustice of the reigning social system, and he’s not afraid to throw it in arthur’s face.  he knows that people like himself and merlin and all of their neighbors are unjustly disadvantaged from birth until death, and he knows they’re disadvantaged solely because the people at the top of the social chain are greedy lords who sow no seed but reap all the grain, who do no work but enjoy the greatest rewards, who steal from the people with impunity and call it divine entitlement.  will knows that he and merlin and all of their neighbors are considered no better than plow-beasts or war-fodder, and he knows that there is absolutely nothing they can do to stop the nobility from either taxing them into starvation or sending them off to die in a ditch - which makes him impossibly angry, and, unlike everybody else in his village, he’s not shy about saying so.
will is, at this point, literally the first non-villain to look at arthur and not immediately see some messianic pinnacle of human greatness - which is refreshing, to be honest, and fair enough besides!  he’s evaluating arthur from merlin’s side of things, after all, which nobody - including merlin - ever does, and while i love arthur as much as anybody - for the people’s hero that he could be, and for what he is, sometimes, if not frequently enough - the truth is that he’s not good for all of his people, not yet, and he’s not good for merlin, not the way things stand right now.  
will knows that.  he looks at arthur and sees a guy with a lot of power, who also happens to rule over the the least magic-friendly place in the five kingdoms, to whom merlin needs to lie in order to avoid the executioner’s block, and he sees merlin deluding himself into thinking that this supremely unequal, extremely unsafe situation counts as friendship.  
now, is will’s assessment of the situation a snap judgment based on personal encounters with an unjust social system and very limited knowledge of arthur as a person?  yes, definitely.  are there nuances to merlin and arthur’s relationship that he’s missing?  absolutely.
is he wrong?
not really.  and merlin knows it.
x. friends don’t lord it over one another!
i think about that line every damn episode.
over and over again, it comes back to me.  i hear it every time arthur gets On His Shit and invokes power he pretends not to have, every time i see more evidence of how this supposed “friendship” between him and merlin is inherently imbalanced.  it’s my favorite thing will says in all of 1.10, because it is so true and yet, most of the time, so unacknowledged as a dynamic.
we’re meant to love arthur and merlin together, and we do - i do; i do; when i see those moments that approach true mutual respect and care between them i am as swept up by the potential beauty of this friendship as anyone - but i still think about this line all the time.  it’s not right, the power dynamic between the two of them.  it’s not just about servants vs. royalty, though of course that’s a structural part of how it plays out.  it’s about the fact that, in a real friendship, one person can’t just whip out “you ever say anything like that again, and i swear you’ll join her in exile forever” to shut down a conversation and cow you into silence.  one person can’t just throw you in jail to spend a night “cooling off,” and they definitely can’t arrest you whenever someone levels a random accusation at you.  in a real friendship, it’s not one person who has all the power.  
but when it comes to arthur and merlin, that’s exactly what happens.  arthur gets to decide when he and merlin are and aren’t friends.  arthur gets to call merlin in or send him away.  arthur gets to make all the decisions about when to listen, when to ignore, when to trust, when to believe.  merlin can nudge, encourage, suggest, even defy, but ultimately, when you get right down to it, arthur is the king, and merlin is his servant, a dynamic which is compounded by the deadly particulars of merlin’s situation.  the relationship isn’t unequal solely because of a difference in social class, it’s unequal because arthur literally has the power of life and death over merlin.  arthur could (and would, as far as merlin knows) have merlin executed any day of the week, if he found out who merlin really was.  
that’s why when merlin tries to tell will that arthur is his friend, will snaps, “friends don’t lord it over one another!”  it’s not that you can’t care about someone who has more power than you, and it’s not that you can’t have some kind of relationship with them, but it is not real friendship if you think your “friend” will kill you when they find out who you really are.  it is not a real friendship if you have to pretend to be someone you’re not in order to preserve the relationship.  real friends don’t leverage impossible amounts of power to shut you up when you say something they don’t want to hear.  real friends don’t say things like “you’ll be a friend for life if you do [x thing]” to convince you to lie to their dad while they go out with a girl and thus get you clapped in the stocks three times in a row, and then turn around and show their appreciation by letting people raid and ransack your house multiple times, throwing you in jail at least twice, accusing (and once nearly executing!) your loyal long-serving mentor more than once - among innumerable other issues.  real friends aren’t “you’re my friend when i need you to be, but not when it’s inconvenient.”  they don’t have the kind of power to turn things on and off whenever they want.
i love that will is the only person who ever acknowledges this, across five seasons of this show.  i love that he spits it out immediately, without hesitation, the minute merlin tries to makes things sound better than they are.  i love that he says it unapologetically, to merlin’s face, because he says it for merlin’s sake, after all - the point of saying ‘friends don’t lord it over one another’ is to say ‘that guy doesn’t appreciate you the way you appreciate him/this isn’t reciprocal and he’s taking advantage of you/this isn’t the friendship you want it to be and i don’t like seeing you settle for this.’  will is that friend who watches you interact with someone and then later gets in your business like ‘EXCUSE ME!  I DO NOT LIKE HOW HE TALKS TO YOU!  I DON’T LIKE HOW HE TREATS YOU!'
will knows that merlin deserves better than arthur pendragon, even when merlin himself won’t concede that point.  merlin won’t advocate for himself, so will tries to do it for him.  merlin can try to convince himself that arthur is a real friend all he wants, but will knows what’s up.  he knows.  he knows where this is going, if merlin’s relationship with arthur is allowed to continue on exactly as-is.  will knows, from the very beginning, that this is a recipe for disaster.  
[addendum 2020: speaking from a post season-5 perspective...will understood where merlin and arthur were headed long before even we the audience did.]
xi. friends don’t lord it over one another [reprise]
you know what real friends do do for each other, though?
a) listen - even when they don’t like what the other person is saying
b) care - even when they’re angry
that’s it.  that’s what matters.  
we don’t need more than an hour of watching will and merlin onscreen together to see that this is how they interact with each other.  they’re arguing for most of this episode, and they’re both right, in different ways, but by the time they’ve had it out with one another, they both understand where their own arguments were wrong, too.  they listen to each other despite the fact that they’re angry, and despite the fact that they both have very strong feelings about their respective positions.  they care enough about each other to look past their personal injuries and accept where the other person is coming from.
merlin starts off this episode absolutely dead-set against using his magic to help ealdor, if there’s any chance arthur could find out about it.  but later, before he and will have even officially reconciled onscreen, we can already see that he’s been listening to what will’s been saying, that he’s come around to will’s way of thinking, because he tells his mother “if it comes down to a choice between revealing who i truly am and saving lives - that’s no choice at all,” hearkening back to will’s “are you telling me you’d rather keep your magic a secret for arthur’s sake than use it to protect your friends and family?”  and: “if arthur doesn’t accept me for who i am...well...then he’s not the friend i hoped he was” (you’re arthur’s servant, nothing more.  otherwise you’d tell him the truth.)  
merlin has been listening the whole time, even if he didn’t like what will was saying.
and the same goes for will, too.  he’s (understandably!) bitter about merlin’s situation, about the way merlin left, about the new life merlin built for himself while will was suffering in a confused limbo of abandonment at home - and will also obviously thinks the Farmers’ Resistance is a total disaster, a noble-spun farce that’s going to get good people killed - but even though he doesn’t trust the camelot contingent and couldn’t give fewer shits about prince arthur pendragon specifically, he trusts merlin.  he listens to merlin, even though they’ve been fighting.  he comes back because merlin keeps telling him it’s the right thing to do.
they both listen, even when it seems like they’re just arguing with each other.  and they both acknowledge where the other person was right, even when it means making themselves vulnerable.  will comes back to help his neighbors fight a battle against hopeless odds.  merlin exposes his magic to save people’s lives.  
they teach each other how to do the right thing.  they make each other brave.
xii. you just saved my life
let’s talk about being brave, then.
this kid jumps in front of a crossbow for a guy he doesn’t even like.
can we be clear about that?  will doesn’t even LIKE arthur.  he doesn’t particularly care about him.  he doesn’t accept him as the noble savior of all mankind.  he isn’t interested in defending the nobility, and he certainly hasn’t jumped on the camelot bandwagon.  just because he’s seen that arthur wasn’t planning on sending them all to their deaths without risking his own neck doesn’t mean will is suddenly going to start flying the pendragon crest from atop his house.
but he isn’t going to step back and let a coward shoot another man in the back, either.
arthur’s still a prince, yeah.  arthur’s still sitting at the tip-top of an unjust social system, benefitting from all kinds of privileges he didn’t earn.  arthur’s still a crappy friend to merlin.  heck, two seconds before that crossbow gets fired, arthur’s gone full-on inquisition-mode, interrogating merlin about sorcery, which, given that arthur can just go ahead and have merlin executed with a snap of his fingers, isn’t a great way to earn will’s respect or trust.  
but you know what?  when it comes down to it, will’s automatic, reflexive reaction upon seeing someone in immediate danger is to Get In The Way.  
it doesn’t matter that will doesn’t like arthur.  it doesn’t even matter that he actively dislikes arthur.  will doesn’t even think about it, he just moves.  instinctively.  automatically.  he isn’t going to let anyone standing right in front of him get murdered with their back turned, no matter how much he can’t stand them.  
let’s all take a second to remember and acknowledge something in arthur’s stead, since i’m not sure arthur will do it himself - arthur pendragon would have been dead right there if it weren’t for a dirt-poor peasant farmer from cenred’s kingdom who never had anything nice to say to a prince but still stepped between a pendragon and a crossbow in the name of doing the right thing.  without will, the story would have ended in season 1, episode 10.  albion itself owes its future existence to a young man with no surname who will never be acknowledged or recognized for anything he did, not for teaching the future king a lesson in humility, not for saving the prince’s life, and certainly not for the greatest and most noble move he ever made, because that gesture’s success is predicated upon its remaining a secret.  
this kid saves the entire World That Will Be.  the show would have ended before it ever really began, if not for our man prince william of ealdor.  
merlin knows that, and merlin never forgets it.  but i’m not so sure about everyone else.
xiii. yeah, don’t know what i was thinking
let’s talk about defiance.
this kid is dying, and he’s still full of piss and vinegar.  when arthur says, wide-eyed, “you’re a sorcerer,” will responds, “yeah.  what are you going to do, kill me?”  
what a power move.  what a thing to say.  
that’s not a question.  that is a no-fucks-given, shame-and-blame challenge.  
what are you going to do, kill me?  
merlin uses those exact same words during his confrontation with morgana in 3.02.  when he’s trapped - when he’s cornered and betrayed and angry - he reaches for the kind of defiance he once saw exercised on his own behalf, for a shameless bravery that burned itself into his brain.  for the kind of strength he wants to channel himself.
when it comes to holding your ground in front of the pendragon dynasty, merlin learned from the best.
xiv. and i’m prince william, of ealdor
let’s talk about names.
william: from wil (will or determination) and helm (protection, a helm)
hence the common translation of resolute protector.
which, given the events of 1.10, seems very fitting.
xv. i did it
let’s talk about lies.
because resolute protector rings even more powerfully true when it comes to merlin than it does for arthur.
at the time of this writing, i have four more episodes to watch before i’m done with season 5.  at this point, at the end of the show, merlin’s magic is still a secret.  merlin’s gotten involved in a lot of dangerous situations, risking his life in other ways, but the one danger he’s never had to really confront is the executioner’s block, because none of the pendragons know his secret.
and the reason none of the pendragons know his secret is thanks to our boy prince william of ealdor, who turns his own untimely death into a last-second rescue operation by telling the Biggest Damn Lie of his life and then doubling down on it when merlin tries to tell him no.
will is the one who secures merlin’s next five years of relative safety.  not from all of life’s dangers, of course; no one can do that - but when it comes to merlin’s greatest fear, the worst outcome, the prospect of being dragged out of his home in chains and murdered in front of an ogling crowd for just existing - will buys merlin’s escape from that fate with his life.  merlin remains hidden and unexposed to this very day because will died protecting his secret, because will lied to the prince of magic-hunting and invited upon himself all of the risk and scorn and danger and condemnation that a false confession like that entailed.
i honestly don’t know how to express clearly enough the enormity of that moment.  the momentousness of that gesture.  i called it a bold and tremendous lie in some other post somewhere, and i don’t know how else to capture what it was.  the thought of what it would mean, to be merlin, and to see someone throw themselves on the block for your sake, for your safety and your future and your freedom, when the rest of the world and every message you’ve ever absorbed says you don’t deserve to be safe, you don’t deserve to be free, you don’t deserve to exist.  
it is impossible to overstate how much that matters.  merlin carries that with him for the rest of his life.
xvi: i can’t fight you anymore (it’s you i’m fighting for)
let’s talk about love, okay?
this ep is called the moment of truth, right?  
so here are some truths about will.  in the time that we spend with him, we come to understand that he is the following:
a poor peasant kid with nothing to his name
a kid whose father is dead  
a kid whose mother is either dead or absent
a kid who “people are used to ignoring”
a kid who’s been making his own way through this backbreaking subsistence-farmer’s life with no grown-ups to hold him or help him or listen to him when he comes home at night
a kid who isn’t trusted to protect merlin’s secret, even by merlin’s own mother, whom will has known for his entire life
a kid whose only friend in the world fucked off to the country next door without a hint of warning or any indication that it was something that should matter to either one of them, making will think he misread the only meaningful relationship he’s ever had, because if merlin can just vanish to nowhere and not even bother to send a note, then either merlin wasn’t actually his friend to begin with or merlin was his friend at one time but doesn’t want to be anymore, both of which options are soul-crushing
a closed-off, heavily-armored, hurting kid who’s been unspeakably lonely for the past few months but also angry and ashamed at himself for feeling that way, because how stupid did he have to be, to think that he mattered to someone, that someone would ever want him or love him or need him or miss him, to think that this time would be different, that this time somebody wouldn’t leave him -
and even in this state - even in the midst of all this -
at the moment of truth, he still puts himself on the chopping block.  he still says, “you’ll have to go through me.”
he comes through for merlin.  of course he does.  the irony is bitter and beautiful - hunith sent merlin away precisely because she didn’t trust that merlin would be safe with will knowing about his magic, but in the end it’s will who gives up everything to keep merlin’s secret concealed.
not just to keep it concealed, even - to reverse merlin being outed.  merlin had already been exposed.  the deed was done!  the magic was seen!  it was all over - and then, miraculously, it wasn’t.  what will did was the only way merlin could ever have slipped safely back under the cover of secrecy.
will didn’t have to do that.  he didn’t have to lie about performing magic, and he didn’t have to save arthur, either.  it would have been better for will to let arthur die, in fact, and it would have been better for him to let merlin get caught, too, because ‘maybe then merlin would have to stay here with me’ - but will is so much better than petty revenge.  he’s so much better than anybody ever gives him credit for, merlin excepted.  
the fight will has with merlin doesn’t matter to him, in the end.  it was a complicated situation for both of them; will knows this.  if he weren’t dying now, he and merlin would have talked it out and made up - will knows that, too.  things could have gone a little smoother between them, maybe, and will still thinks going back to camelot is less than what merlin deserves, but it’s what merlin wants, and the mark of truly loving someone is when you want the best for them, even if it means you don’t get what you want for yourself.  so ultimately, when it comes down to it, the truth for will is this: he wants merlin to have a good life.  he wants merlin to be safe.  he wants merlin to be happy.  he wants merlin to be with him, too, but if he can’t have that, it’s no reason to withhold any of the other gifts he can bestow.  if one of those gifts is freedom, if one of those gifts is safety - it’s no choice at all.  
merlin is will’s one good thing.  merlin deserves everything will can give him, as far as will is concerned.
xvii. the only place worth being
this place has been boring without you.
what a thing to tell someone.
what a powerful thing to say to someone whose entire life up to this point has been a litany of ‘there’s something wrong with you,’ ‘you don’t belong here,’ ‘you’re cursed/broken/wrong/unnatural.’  what a dauntlessly loving thing to tell someone whose entire life has been the message ‘people like you deserve to die,’ over and over and over again.
what a singularly beautiful thing it is, for someone like merlin to hear ‘you are what makes this place worth living in.’
xviii: the only one worth seeing
likewise it’s good to see you again.
because it’s not just “it’s good to see you again;” it’s an acknowledgement that merlin is the last person will is ever going to see.  
and will is like, okay.
he’d rather be alive, yeah, but if he had choose - it’s good that it’s you.
xix: the only bed worth sleeping in (is the one right next to you)
the most devastating moment in this sequence, for me, is at the very end, when will confesses fear.
it doesn’t happen until everything else has been taken care of.  arthur’s been fooled, merlin’s been safely shuffled back under the cover of secrecy, everybody’s been taken in by the ruse and sent away, none the wiser  - all the necessary and important business has been dealt with.
only at the very, very end does will’s own predicament rear its ugly head.  only after everything else is done does he even allow himself to feel it.  he’s spent the rest of this sequence making jokes and roasting arthur and keeping it all together, but at the last second, when he falters, he comes undone for the only person he trusts, the only person who understands him, the only person in the world who gives a damn about him.  his defenses come down, in that last moment, for merlin - and it could ONLY be for merlin - when will says, “merlin, i’m scared.”
we don’t need anything else, to understand their relationship.  we’ve seen enough of will by now to recognize that he keeps the world at arm’s length, that even his walls have walls, that this is just not the sort of thing he would ever admit to.  confessions of pain?  acknowledging vulnerability?  never.  he’s not that kind of character.  we know he has a big heart - look at what he’s doing - but we also know he’s had a hard life.  he’s wrapped himself in layers upon layers of protection - snark and anger and deflection and sarcasm and still making jokes at the prince’s expense after being shot in the chest - nobody is allowed to see him open and undefended, never.
except merlin.
will is dying.  he is so young.  he has been so alone, for so much of his life, and he’s so young, and he’s dying.  he clutches for this lifeline like it’s the only thing he has, because it is the only thing he has - merlin is his only friend.  merlin is the person will loves best in the whole world.
merlin, i’m scared.
that is so unbelievably vulnerable.  that is so utterly naked.  that is totally defenseless, exposed, belly-up and barethroated under someone else’s burning gaze.
that is absolute trust.  will would never have said that in front of anyone else.  he would never have allowed anyone else to see him like that.
his confession is, like pretty much everything else he ever does, for merlin alone.
xx. your heart is on my sleeve
merlin, will keeps repeating.  merlin.
how much do you have to love someone, to make their name your last words?  how much do you have to care about someone, for that to be the only thing you can think to say, again and again, in your last terrified moments on this earth?
that’s a rhetorical question.  
i know how much.
xxi: i missed you too
i think, sometimes, about will, when i watch the later seasons of merlin, and about how he would feel if he could see what merlin’s life has turned into.
i sometimes wonder how he would feel, if he could see how merlin allows himself to be passed over, disbelieved, disrespected.  if he could see how merlin has started to define his worth in terms of how well he is able to protect Some Dude who doesn’t even know who merlin is, who keeps people like merlin trapped in the shadows of subjugation, hidden citizens in their own kingdom.  if will could see how merlin has laid his entire life down for other people’s enrichment, if he could see how little hope merlin now holds for his own happiness, if he could see the way merlin in S5 has given up on his own liberation -  
i don’t have to guess what will would say about it.  i know how he would feel.  if will could see merlin in season 5, his raging little heart would break.
i wish he were here to tell merlin exactly what he thought about it.  merlin does all this self-sacrificing for the sake of his “destiny”; whereas will would think that any destiny making merlin this miserable was a steaming pile of trash.  will would tell kilgharrah to get lost, and to take his questionable advice with him.  will would tell arthur to fuck off - he’s done it already, in slightly less explicit terms.  
does that mean i truly think merlin is supposed to abandon his mission and ditch camelot and run off to live his own life?  no.  merlin cares too much about making the world a better place to be truly happy with that kind of existence; he wants to change things for the common good; he wants to help the people he cares about.  but merlin, as he tries to fulfill his mission, is desperately missing will’s kind of support in his life.  merlin needs someone who is only here for him.  he needs someone who is going to get up in his face and remind him, “you matter.”  he needs someone to tell him, “you deserve better than this.”  he needs someone who isn’t afraid to tell destiny to fuck off, when telling destiny to fuck off is in merlin’s best interests.
merlin needs someone who is on his side.  
not camelot’s side.  not albion’s side.  not arthur’s side.  
HIS side.  merlin’s side.
xxii: he still is
the thing about will, then, for me, is this: i can’t minimize him.
i can’t do it.  i can’t diminish that part of merlin’s life.  
i don’t think it’s possible to overestimate his importance, frankly.  merlin, when we meet him, has only ever had two people in his life.  that is such an...unfathomable experience, for many of us.  just two people.  just two people to know you.  just two people to love you.  just two people, for your whole life.
will wasn’t just some friend.  will was half of merlin’s world.
fannish pursuits that i have seen...the things where will appears are already so limited, and of course that’s completely understandable - it’s not like he’s a main character, or even a side character, by any means; i totally get that.  but - so much of what i see is him serving solely as a set-up for merlin/arthur, or otherwise being shoved out of the way as soon as arthur shows up on the scene, or showing up only to be a receptacle for discussion about arthur and merlin’s developing relationship - even will and merlin’s own ship tag is 90% merlin/arthur fics.
and there’s nothing wrong with this, ultimately; everybody should continue to write exactly what they want and enjoy exactly what they want; that’s the fun of fandom.  i mention these things here only because for me, personally, the whole point of will’s character is that merlin’s life is bigger than just arthur.  the most important relationship merlin had for most of his life had zip-zero-nothing to do with arthur pendragon, and it still has zip-zero-nothing to do with arthur pendragon, after will is dead.  
you remember will’s funeral at the end of 1.10?  arthur has an entire conversation (a horrible one, fyi) with merlin, and merlin doesn’t look at him once.  he answers arthur’s questions because he has to, but his eyes never once leave the pyre in front of him - not while he’s listening, not while he’s talking, not once.  not ever.  arthur comes, arthur chastises, and arthur goes, all without being granted so much as a glance, because this isn’t about him.  this is none of his business.
the whole point of will is that it is possible for someone to love merlin and not give a tinker’s cuss about arthur pendragon.  the whole point of will is that having someone love merlin without caring about arthur pendragon is, in fact, a good thing.  merlin needs somebody like that in his life.  he struggles when he doesn’t have someone like this around to advocate for him.  just look at where he is in season 5 - look at what his life has become, when it’s been years since he had an in-the-know friend.
merlin suffers when he loses this kind of support.  it’s easy to say that will is never mentioned again after 1.10, but there are real reasons why merlin wouldn’t be willing to explicitly mention him, and the lack of explicit references doesn’t mean we can’t still see him, if we pay attention.  we see the immediate impact of his death in merlin’s attitude shift in 1.11.  we see him in 2.02, when merlin names his fake tournament knight sir william and spends the rest of the episode roasting arthur to within an inch of his life.  we see him in the season 3 opener, when morgana levels her sword at merlin and the first thing that pops out of merlin’s mouth is “what are you going to do, kill me?”  we see him in gwaine’s intro episode, when merlin immediately cleaves to this class-conscious ‘people get sick of me too quickly’ stranger whose father was killed fighting one of the king’s wars.  and his absence is felt, more generally (as is lancelot’s) in how quickly merlin’s life starts to spiral out of control once the only two honest friends he ever had are gone.  their loss doesn’t have to be explicitly referenced for us to understand that merlin, without that kind of support system, is faltering.  we see it happening with our own eyes.
[edit, post-viewing-of-S5-finale: and we see where it eventually leads, too.]  
so, once again, as i said - i can’t minimize this character.  i can’t overstate the positive impact of merlin having somebody who was here for him and only him, who affirmed merlin’s value independently of arthur pendragon’s fate, who knew and loved merlin without caring about a “destiny” that ultimately, in the end, turned out to be a cruel joke made at merlin’s expense.  
if will had lived, i’m not sure we would have ended up in quite so dark a place.  we might have landed in some other tight spot, sure, but i can tell you one thing for certain - will would not have sat quietly by and allowed merlin to throw his life away, not for camelot, not for arthur, and certainly not for a parade of empty promises.
xxiii: where you are, there i’ll be
the bottom line is this.
merlin spent the first two decades of his life with one friend.
one.  
loved by one friend.  
one.
merlin had his mother, who was there for him from the beginning, whose love was unconditional, who was an “of course.”
and he had will, who chose merlin, who kept choosing merlin even after merlin told him the Terrible, Horrible, No Good, Very Bad Secret.  will’s presence in merlin’s life is the only reason merlin grows up believing himself to be deserving of love from people who aren’t his own mother.  his presence in merlin’s life is the only reason merlin knows how to have and be a friend.  his presence in merlin’s life is the only reason merlin is who he is - a merlin who’d spent his entire life without a single friend would not have been the same confident, optimistic, gregarious person who later walked into camelot and told arthur pendragon, “i’d never have a friend who could be such an ass.”
will mattered.  we don’t talk about him much, because he only appeared in one episode, but it wasn’t “one episode” for merlin; it was closer to twenty years of companionship, of elbows in ribcages and smirks exchanged across the room and someone to natter on at, a person to sit next to and walk beside, in every season and all sorts of weather.
will chose merlin, and he kept right on choosing him, until he breathed his very last breath.  that is enough for me to love him, to feel grateful that he existed.  i don’t care how rough he is around the edges.  i don’t care that he hates arthur pendragon’s guts, that he has a big mouth, that he speaks out of turn, that he has no tact, that he can’t suffer fools, that he has a chip on his shoulder the size of a minor planetoid and wings it at people’s heads when the mood is on him.
he loved merlin.  actual, magical merlin; merlin as he truly is, merlin in all his gifted, unnatural, beautiful imperfection.  
that is a desperately rare thing.  that is worth celebrating.
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grasslandgirl · 5 years
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im distracting myself from the impending doom of a six month hiatus and everything that... happened in MAG160 by thinking about all the Wonderful possibilities for jonmartin dynamics post-159 because I’m a sucker for pining and minor miscommunications and dumb fanfic tropes and I’m dragging all of you along on this ride with me!
1) They’re Both Just Chill: there’s no miscommunications, no misunderstandings. despite what peter said about them not knowing each other super well (and maybe he raised some valid points, despite being an asshole) they DO know each other well enough and had a deep enough connection during the look at me/ i see you, jon scene that they both just (for lack of a better word) Know. they look into each other’s eyes in the middle of the Lonely and they see the love there, and the hurt and the pain and the anger and everything, but they do see the love. and they recognize that, oh, we’ve been so dumb this entire time. and there’s no big Talk, no awkward stumbling around the question, they just move forward from jon and martin to jon-and-martin because they’ve wasted enough time already, haven’t they? they can’t afford to waste any more time at this point, and hey. they kind of have bigger problems going on, right?
2) I Really Loved You, You Know: ok so this one i’ve seen in quite a few fanfics and speculative posts about this one, and jon misconstruing how martin uses the past tense when talking to him in the Lonely, and can i just say....... it’s very good. you have jon, who’s been desperately trying to reconnect with people, especially martin, this entire season, who dives headfirst into the Lonely after him, and maybe he heard martin’s tape with elias from the end of s3, maybe he knows about martin’s feelings for him, maybe he at least suspects, and maybe he doesn’t; but the point of the matter is that he goes into the Lonely after martin because jon’s in love with him and i think we can mostly all agree that at least by MAG159 (and we can argue about WHEN he realizes it, later) jon is aware of his own feelings for martin. but he follows the man he loves, and he finds him, and he’s begging him to follow him out of the lonely, to come with him, and martin tells him that he loved him. really loved him. loved him, as in past tense. which, like, if you think about it? that’s SO heartbreaking. but jon keeps after him ANYWAY, and he breaks martin out of the Lonely’s grasp and they walk out side by side and then you’re left with jon, who is terrified on SO many different levels, and thinks that he failed, again. that he was too late with martin, too late to be his friend, too late to save him from Peter, and too late to love him, and he saved him, he did it, but it’s still heartbreaking, right? and juxtapose that with martin, who’s just been literally pulled out of his own loneliness by the man he’s been in love with for three years, and he told him he LOVED him and jon Didn’t Respond. and like? all the hurt and the pining and the trying to take care of each other despite everything and despite your own hurt that can happen there? SUPER good
3) Clueless Jon Doesn’t Know He Has A Boyfriend: this one kind of crosses over with #2 but it’s a little lighter and a little more fun. essentially you have martin, who says he loves jon and assumes jon heard his tape with elias where he outed martin entirely and sees jon come into the lonely to save him and hugs jon while crying when he comes to his senses and walks out of the lonely hand in hand with jon and thinks, quite reasonably, that ok, they’re dating now. and you have martin “caretaker” blackwood who’s worrying over jon and taking care of him and letting jon take care of him, and making him eat and they do all this vaguely date-y stuff because the world is kind of maybe ending, but hey! martin’s in love and hes going to enjoy it goddamnit. but then one day our beloved archivist, jon “emotionally obtuse” sims, has nearly a breakdown and he starts rambling on about how he’s in love with martin and he’s sorry and he wants there to be something between them and how he doesn’t want to change anything and this is terrible timing and he doesn’t even Know if martin feels the same way but he needed to get this off his chest etc etc etc and martin’s just like “i thought. i thought we were ALREADY dating.” which is.... hysterical if you ask me
4) Jonathan “Fuck The Lonely” Sims: kind of the opposite of the last two, in which jon is LESS of a moron than anyone expected! jon “the archivist” sims actually... thinks! he listens to the tape of elias and martin from MAG118 and reevaluates every interaction he ever had w martin after he wakes up from his coma and realizes that martin’s in love with him, and not only that, but HE’S in love with MARTIN, but has no way of communicating that to him until 154 and that whole conversation is just jon trying (and failing) to say “i love you. i love you and i know you love me and lets just say fuck this place and go. please lets just go the two of us, say you’ll come with me. i love you.” and martin. doesn’t understand. but then 159 happens and jon follows and they have That Moment and jon thinks that Finally they’re on the same page and meanwhile you have martin, who’s PEAK in his pining time, fresh out of a good year of self isolation and pure loneliness and needs a while to pull away from Forsaken and thinks that he’s alone in his pining after jon, because jon never said anything about the tape with elias, or martin saying he loved him in the lonely, and is completely clueless to the fact that jon thinks theyre straight up dating and are just taking it Slow. and then one day jon is like “hey ready for our date later” (they had dinner plans or smth but this is the first time he outrightly calls it a Date) or he kisses martin briefly on the forehead or cheek or smth and martin is like “WHAT IS GOING ON” and jon is just. baffled cause he’s not used to being the oblivious one in the relationship
5) Just Full On Pining Hours: theres some crossover here with both #2 and #4, but specifically this one is where BOTH jon and martin are full on in love and are idiots and think that the other person Doesn’t Love Them Back :( possibly featuring: jon focusing on the past tense of “i really lovED you, you know,” martin comparing jon going into the lonely to save him to jon going into the buried to save daisy/ cutting the bullet out of her leg to save melanie from the slaughter, jon being dumb and thinking all the statements he’s heard about martin’s “feelings” are elaborations/inaccurate/only in the past/etc, martin being so stuck in the lonely he pulls away from jon on instinct, jon caught up on what peter said about them not really knowing each other and MAD second guessing himself and questioning what his feelings for martin are really based on, both martin and jon throwing themselves MAJOR pity parties about falling to the power of the eye/the lonely respectively, jon going into “im a monster and im the worst and ive lost my humanity” mode and thinking he’s not Worthy of being with martin in the first place, martin being haunted by his time with peter and the lonely and keep falling back into the habit of pushing people (jon) away “for their own good,” etc etc etc etc! just a lot of sad pining hours bc these guys have been through a LOT and it’s hard to just drop straight into a healthy relationship (or Any relationship) when there’s so much baggage and history there in between
6) Run Away With Me, by Carly Rae Jepsen: I said what I said. i want them to be happy and so what if they run away and blind themselves and leave the archives and live in some house in another continent and never think about any of the entities again? i get to make the rules, its my fantasy au world and jonny can’t do anything to hurt them here
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seijuurouxryuu · 6 years
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Sew My Bleeding Heart Back
Title: Sew My Bleeding Heart Back Author: Shiro (TeitoxAkashi [AO3]/ seijuurouxryuu [Tumblr]) Rating: T Pairing: Byakuran/ Sawada Tsunayoshi Event: @khrrarepairweek Prompt: Enemies to Friends to Lovers | Secret Relationship AU Tags/Warnings: No Archive Warning Applied, Major Character Death
Day 3: Sun Day
"I'll kill you even if that means I've to go to hell and back."
"You're my- our friend. You're one of us."
"Don't worry. Whatever happens, we will be with you. I will be with you."
AO3
1. To Kill
"Decimo! One of our scouting teams has been attacked!" Tsuna looked up from the his paperwork as one of his subordinates barged into his office, sweating and panicking. Tsuna placed down his pen and stood up from his chair, forgoing his jacket as he rushed out, heading immediately to the medical wing. His subordinate followed as he asked. "Who's injured?"
"M-most of the them have minor injuries, but Gokudera-sama and Yamamoto-sama barely made it out from a bomb attack."
Tsuna scowled, lips tugged down as he gritted his teeth. "Bomb attack?" His subordinate visibly flinched at the rage dripping in his tone of voice. This man must've never saw Tsuna's anger. Or perhaps he had. Well, that wasn't his main worry. Not when they've arrived at the medical wing.
Most of the members of the medical team were patching up the scouting team, who struggled to stand and salute when they saw him. He waved them down and simply made his way into the Private Room. Shamal and Ryohei were nowhere to be seen, so they must be busy attending his Storm and Rain.
He felt another wave of anger when he was right. Gokudera was unconscious on one of the bed, patched up with an IV drip while Ryohei and Shamal was still healing Yamamoto. He could see the burnt on both of the unconscious men, the beeping sound from the monitor and how Ryohei and Shamal looked slowly relief when they were almost done were his only reassurance that they were still alive.
"Who did this?" He said lowly, only audible to the man that had followed him as he didn't want to disturb the two from their concentration. "M-Millefiore, sir."
A dark look flitted across his face. He took one last look at his guardians and turned to leave the room. "Inform Hibari and Mukuro to be on standby." He paused. "Tell Hibari this; Code White."
o o o o o o o o o o
Byakuran could still remember the time Tsuna, the adult one, had died. A shot right into his stomach followed by one straight into the heart. He could still remember the exact words that has been said, the smell of blood, the adrenaline, the promise of death. He could still remember it vividly.
("B-Byakuran, even if you're the last person on earth, I'll never forgive you-" Tsuna coughed, clutching his sides as blood dribbled down from the corner of his lips. His eyes glowed in orange, burning in hatred. "I'll kill you even if that means I've to go to hell and back.")
He smiled wryly as he gazed at the brunette, the younger one, through the flames.
painpainpainithurtssomuch-
His eyes shone with so determination, so much ambition, so much love for his family, and so much will. That wasn't the eyes of a killer, but a savior. A savior of their world, of the Tri-Ni-Sette, of his family. Someone who would save them from Byakuran. Someone who would save Byakuran.
But who would save him from himself?
So much questions, to the teen, to himself, to fate, but Byakuran doesn't has the time.
'It seems like you've held onto your promise, Tsunayoshi-kun.' His grin stretched. "I've lost."
o o o o o o o o o o
2. To Protect
Tsuna looked up to see Byakuran floating a few feet above the ground, he smiled. "You seemed contented." Byakuran laughed at that. "Do I? Hmm, maybe I am~" He sing-sang, swaying slightly. Tsuna chuckled and shook his head, turning back to look down at the town.
The two of them sat on top of the Namimori hill, where they'd have trekked. Byakuran had came to visit and Tsuna decided to take him to sight-seeing, since Irie wasn't around and Reborn was strangely being a saint. They had walked around the town, chatting here and there about anything until they decided to watch the town from the hill.
They sat there in silence, basking in the sound of nature, the smell of earth, the soft touches of the wind.
"It's been two years, huh." Since the future mayhem.
Byakuran nodded. "Unbelievable, honestly." Tsuna laughed, short but genuine. "You can say that again." Byakuran hummed. He rocked back slightly before he floated down until he sat beside the brunette on the ground.
"Say, why did you accept me back then?" Why did you forgive me, when all I did was give you pain?
Tsuna blinked at the sudden question, no doubt hearing the unspoken words. He gave the white haired teen a strange look. "Why shouldn't I?" Byakuran double took at that. "You are you. Sure you've your wrong doings, but that wasn't you. You're different from your alternate self."
Tsuna grinned all too brightly at him, knocking Byakuran's chest lightly. "You're my- our friend. You're one of us." You're family, and we protect family.
Byakuran's heart stuttered at that as he tilted his head down and away from the brunette. A genuine smile lighted on his face. He felt so warmsafepeacefulquiethomehomehome.
"... Grazie."
o o o o o o o o o
3. To Love
Tsuna shifted, slowly stirring. He tried to hide his face from the ray of sunlight from the gap between the curtains, smushing his face against the chest, but it didn't work. An inaudible whine rumbled at the back of his throat as he cracked an eye open. He blinked up, eyelids heavy with sleep. He couldn't, however, stop the smile from stretching on his lips.
Byakuran was still asleep, arms around him. He looked peaceful, face void of the stress and concern he had wore the day before. Although, Tsuna noted remorsefully that he still had a little hint of eyebags. He pursed his lips and buried his face against the crook of the other's neck, breathing in the smell of the ozone and a musk he could never describe it with any words other than Byakuran.
The man was slowly waking up at his movement, if the tightening of his hold indicated anything. Tsuna felt a small hum vibrating from him as he felt a chaste kiss on his forehead, and a deep intake of air. "Good morn'.." Byakuran slurred, clearly half awake. Tsuna chuckled and returned the greeting.
They basked in each others presence in silence as they gathered themselves for the day. It was going to be a long day for the both of them. Tsuna closed his eyes as he remembered the screams the both of them had thrown at each other the night before, the mindless insult, the heated words. They had made up, but it was still fresh in his mind.
He had made a mistake. A mistake that had almost killed him and his guardians. A mistake that had caused a rigged connection between on of the allies.
There will be a meeting later in the day, and Tsuna was worried because if another mistake was made, it would meant war. And that was the last thing he wanted to happen.
Byakuran kissed on top of his head again, a hand burying itself in his hair. "Don't worry. Whatever happens, we will be with you. I will be with you."
Tsuna smiled, grateful as his eyes met Byakuran's bright purple eyes, soft and filled with adoration. He leaned up and pecked him on the lips. "Thank you." Byakuran grinned and swooped in for another kiss. "Love you."
"Hmm~ Love you too!"
They stayed in bed a little longer even though it was time for breakfast, and Gokudera or Reborn might burst in anytime since they were late. They didn't care though. They stayed in each others embrace, loving every second to every heartbeat they heard from each other.
Although, who knew that they would become lovers when they were enemies the first time they've met? Certainly not them.
A/N= I've no explanation for this one.
Note that the first snippet features TYL!Tsuna from the parallel world our Tsuna got dumped into. TYL!Tsuna is a changed Tsuna so not our Tsuna. Our Tsuna is nice and lovely. :3c
Code white means Past Self Operation; On.
[I apologize for any grammar, spelling, etc. etc. mistakes]
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comicteaparty · 6 years
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January 3rd, 2019 CTP Archive
The archive for the Comic Tea Party chat that occurred on January 3rd, 2019, from 5PM - 7PM PST.  The chat focused on Princess Pups by Lindsay Hornsby.
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RebelVampire
COMIC TEA PARTY- THURSDAY BOOK CLUB START!
Good evening, everyone~! This week’s Thursday Book Club is officially beginning! Today we are discussing Princess Pups by Lindsay Hornsby~! (https://tapas.io/series/Princess-Pups)
Remember that Thursday discussions are completely freeform! However, every 30 minutes I will drop in OPTIONAL discussion questions in case you’d like a bit of a prompt. If you miss out on one of these prompts, you can find them pinned for the chat’s duration. Additionally, remember that while constructive criticism is allowed, our focus is fun and respectfully appreciating the comic. All that said, let’s begin!
QUESTION 1. What is your favorite strip in the comic so far and why?
one strip i really enjoyed myself was this one https://tapas.io/episode/295876 where the pups are having a debate. partly just cause of how quickly the debate devolved, and partly cause i loved how cute it was that the judging pups got to have cake and cookies and were basically the ultimate winners.
although my all time favorite is definitely the valentines strip https://tapas.io/episode/284778. this one just hurt my heart with the cuteness and i think sends such a positive message about how maybe the jerks around us also just didnt get their own valentines and are lashing out in jealousy. and i love the princess pups for putting kindness before revenge.
in terms of comedy, to lighten things up from that last one, there's also this strip https://tapas.io/episode/812585 that i enjoyed. partly cause i always love Pug Pups shenanigans of just basically wanting to eat anything and everything. but also because i like the irony that nope the eclipse was just a giant cookie thing in the sky. although maybe theyll figure it out when it takes a while to disappear
L Hornsby
Hiya, I draw Princess Pups and I'm glad you like it @RebelVampire !
RebelVampire
thank you for coming, @L Hornsby ~!
related to pug pup https://tapas.io/episode/499353 i super loved pug pups idea of a horror story is that the fridge is empty. XD but another good strip just cause they once again didnt scorn the ghost. just said come on ghost, join our party. which i mean is a sign theyre great party throwers cause basically anyone is a potential guest.
L Hornsby
They especially love having a party with someone else who enjoys candy
(even if they are a ghost)
RebelVampire
which now made me overthink wondering if the ghost cant actually eat it and it just passes through them. XD although i doubt pug pup would complain about that. can just follow the trail and eat all those candies
L Hornsby
The ghost probably enjoys at least being around candies and cookies I hadn't considered if it could eat it though. Makes me think about Slimer from GhostBusters going after a buffet
RebelVampire
lol. mysteries for another day probably. more important they have a good, fun experience
L Hornsby
Yeah!
RebelVampire
https://tapas.io/episode/266696 another strip i thought was hilarious. the princess pups making all these elaborate plans to get their food back. meanwhile the cats basically self sabotage by beating each other up and having a slap fight. which tbf is very accurate to cats since they dont like food competition XD
L Hornsby
The Commando Cats sometimes work together, but usually don't
RebelVampire
wait theyre called the commando cats? XD thats great
L Hornsby
Yeah Since the Pups don't talk, it doesn't get brought up in the comics unless I'm putting a note under the comic
I wanted something sort of opposite of "Princess Pups" but with cats and I also wanted them to wear hats instead of crowns
RebelVampire
i do enjoy their hats
QUESTION 2. Which of the Princess Pups is your favorite insofar? What about this pup makes you like them? Of the strips so far, what has been your favorite story to have this pup in it? What about their role in the strip made it enjoyable for you? In regards to your favorite pup, which pup do you love to see them interact with and why? What pup(s) do you feel your favorite should interact with more? Lastly, are there any minor recurring characters you enjoy seeing? Who are they and what about them do you like?
despite where my answers may have lead one to believe, my favorite pup is actually Scruffy Pup. I love her overall design and how it suits her messy personality in general, to start with. I especially just love her eyes though. Sometimes about them just makes her have the cutest facial expressions to me. As far as strips with her in it, I really liked Goat World https://tapas.io/episode/516356. partly cause i enjoyed just how plain enthusiastic she was about going to goat world. things go awry, and in the end the goats that she loved betrayed her by trying to eat all her stuff. which i mean is sad, but also hilarious just cause goats just be doin goat things.
as for interactions, im not sure i really have a preference. although i would like to see scruffy pup and pug pup interact more in the future. cause pug pup is my 2nd favorite and i feel the messiest pup + the eatiest pup could result in the best of pup shenanigans
L Hornsby
I drew Goat World due to a visit to a petting zoo where the goats kept trying to take my map, my backpack, and a piece of thread from my shirt
Scruffy Pup and Pug Pup definitely are the messiest and hungriest of the pups for sure though!
RebelVampire
lol omg. that sounds like quite the experience and reminds me why i dont really go to petting zoos
since pug pup is my second favorite, i will also answer these questions for pug pup. i really enjoy pug pup because she basically the most chill. like that whole pizza party story arch. pug pup didnt care what was on the pizza. she just wanted to eat it. and i think that makes her adorable. her immense single minded focus. i dont really have a fave strip in this case cause i generally like all of pug pup's roles in any strips. i think in general she alone provides a ton of the comedy moments for the comic. XD
in terms of minor characters, i love the commando cats. partly out of my biased love for cats, but i also just love both their cute hats and the fact that theyre super cat like in how they react. like theyre the antagonists more by cat nature rather than this over the top manner you usually see in things.
L Hornsby
They're a mix of a few cats I've had growing up / currently. Cats can be really grumpy and fight each other, but can also be cuddle friends, but then go back to smacking each other XD
RebelVampire
yes that is definitely accurate to cats
mathtans
Hello dere. Only had a chance to read the origin so far this week, but wanted to say I'm impressed at how much gets conveyed without dialogue balloons.
L Hornsby
Pug Pup might be one of my most favorite to draw, but also least favorite because sometimes I forget to color her mouth markings, and I feel silly when that happens
mathtans
Also, I love the term "cloud meeples".
L Hornsby
Thanks @mathtans ! The comic I'd been doing previous to Princess Pups involved a very chatty six year old, so I wanted to try to keep this one very pantomime
RebelVampire
speaking of hte origin story, i love teacup pup had to have official princess pup papers that fluff pup scrutinized thoroughly XD
mathtans
Scanning the backlog here. Yep, that seems accurate to cats, though I admit I'm a cat person.
Teacup pup is precious. Vacuum sucks.
I'm reading through more now. I wonder if they make the charts themselves, or use the wands to do it.
RebelVampire
i actually wondered if the vacuum was accurate to dogs. like i know cats consider them their mortal enemies. but ive never owned a dog to know if they too fear the monster vacuum(edited)
L Hornsby
Sometimes they make things by hand (paw), sometimes TeaCup Pup will use Magics
Oh man, my dog can't stand the vacuum. My dog growing up couldn't stand it either.
King Vacuum is based on this awful vacuum my mom had when I was a kid that weighed probably 50 pounds and was super annoying to use. It was called a Kirby Vacuum (not as cool as Kirby from Kirby's Dream Land)
mathtans
Maybe in the sequel they fight a roomba.
L Hornsby
https://i.ebayimg.com/00/s/NDAwWDMwMA==/z/u4IAAOSwxH1UB0PB/$_35.JPG?set_id=2 this is totally that vacuum
mathtans
Reminds me of the vacuum from "littlest toaster" for some reason.
RebelVampire
we still have a kirby vacuum in my house. XD it is very annoying to use and i support it being the ultimate vacuum enemy
mathtans
"Magic" is too funny.
RebelVampire
as in the strip, math?
cause if you mean the strip, i do wonder how long it was before corgi pup noticed the tail XD
mathtans
The strip I got to, yes. Very "bunny".
OMG, all the feels for that Valentine one, you're right Rebel.
RebelVampire
QUESTION 3. The strips offer a lot of variety in terms of set-up. Which of the strips did you feel was most relatable as far as the behavior of dogs go? What about that strip makes it this way to you? Of all the strips, which strip played out in a way that you didn’t expect and potentially made you laugh or aww at it? Why did it catch you off guard, and what made the twist likeable? Many of the strips also have positive messages within them. Which strip left the most impact on you in terms of endearment or positive messages behind it? What about the strip left this impact?
next time the pups face a vacuum they can join forces with the commando cats. and together they can win against the roomba army.
mathtans
I don't know much about dog behaviour. I had a newspaper route for 7 years and got bitten once, so mostly I avoid them.
L Hornsby
That's too bad
mathtans
It would be interesting to see the dogs and cats against a common enemy.
L Hornsby
That's true.
mathtans
I didn't expect the 'piff' into the cloud at the bottom of the slide, that was amusing.
RebelVampire
https://tapas.io/episode/334958 that was probably the strip i found probably reflected dog behavior the most. also qualifies as one where i didnt expect the twist. i legit thought they were gonna make a nice garden.
and then they didnt
although poor scruffy pup
missed out on dirt rolling
mathtans
Dog gonnit.
RebelVampire
oh no the puns have begun XD
L Hornsby
If the Princess Pups did more than just bark and make dog noises, there would be A Lot More Puns
RebelVampire
they can just write a dog pun book
send the commando cats a free copy
mathtans
The "silent movie" aspect is pretty cool though.
RebelVampire
yeah i think it works well cause theyre all very expressive and the scenarios have that right blend of simplicity where the stories are always understandable and relateable
mathtans
Actually, if it counts, some of the author comments at the end give me unexpected laughs too. (How DO they get a pool in the clouds?)
Yeah, expressions are great. Some of the posing in particular is fun to read.
RebelVampire
ya know im not gonna question a pool in the clouds cause tbh the beginning made me wonder if they were in doggie heaven since cloud imagery usually equals heaven XD
so i will always be thankful its not
and they just live in the clouds
L Hornsby
LOL oh no, I hadn't thought of that
mathtans
Pug Pup seems so amusingly clueless. Might be my fave, which is weird, because I'm not a fan of the wrinkly look in real life.
I was wondering if they were angels or something initially too. Like would they be visiting earth and seeing humans or something.
L Hornsby
Nah, they just live in the clouds and occasionally slide down rainbows to visit the ground
mathtans
Now alien meeples. Meeples is the best word.
L Hornsby
It really is!
RebelVampire
im glad im not the only one who thought the dead angel thing. XD cause that would be a morbid start.
mathtans
Constantly amazed at how much gets conveyed without dialogue in these strips. So good.
Like the no cookie stuff in the space sequence.
Or the ghost encounter and telling stories.
RebelVampire
this is another strip i think had a twist in that i overguessed. https://tapas.io/episode/616509 cause when the dinosaur leg went missing i was like "nah it couldnt be this is gonna be some doggie profiling." but then nope, it was my favorite pup being super obvious about it. which also surprised me cause totally thought pug pup would be the bone thief if it was anyone.
mathtans
Or for that matter, Santa and the goat.
Heh, nice parody of the venus oyster shell painting in that one.
RebelVampire
i questioned corgi pup's choice of gift. i wasnt sure if scruffy pup would still even like goats after the goat world incident XD
and then the goat tried to eat scruffy pup, the nightmares relived O_O
mathtans
I like the one just before that, with the fly needing it's own book. Would not have called that.
Goats are tricky. Like elves.
L Hornsby
Corgi Pup assumed that Scruffy Pup's love of goats hadn't wavered after such and experience at Goat World. But Corgi Pup probably should have examined closer to see that it was a Baby Krampus she was buying instead
RebelVampire
i did like the fly needing its own book. also made me aww just cause i love when the pups are being precious like that and putting kindness first. truly model princesses
mathtans
I hate getting a krampus in my legus.
RebelVampire
at least santa saved the day
mathtans
Yis, very precious attitudes.
RebelVampire
another strip i loved that had a twist was https://tapas.io/episode/833602
like i assumed pug pup would defy the odds and catch something
did not expect it to be scruffy pup XD
and those looks of surprise are priceless XD
mathtans
I'm learning about pineapples.
RebelVampire
haha
i thought it was super lucky teacup pup was the one to get the pineapple
so she could cheat and use the wand
cause idk how the other pups wouldve managed XD
QUESTION 4. The Princess Pups have met with two other pup groups: the CowPoke Pups and the Space Pups. Which of these other groups interested you the most and why? Whether your favorite group, which about each story line did you like? What other groups do you think the Princess Pups might meet? In terms of future stories, do you think we will see the CowPoke Pups or Space Pups again? If so, in what manner might we see them? In general, what shenanigans do you think the Princess Pups will get up to in the future?
i liked both groups, but i think im gonna side with the space pups just cause they had fun things like the ability to turn off gravity. and no gravity makes for some fun parties where you can do lots and lots of things.
mathtans
Huh, I don't think I even clued in that she was the only one with a wand.
RebelVampire
yes it was her prize for defeating king vacuum and being the brave one
mathtans
Space Pups also had alien meeples.
Rebel - I thought it was just her official graduation gift or something, like the others had them in reserve without occasion to use them.
L Hornsby
Oh man, I looked up so many images of Pineapples and how they grow for that Pizza Party story
mathtans
I was wondering how much research was necessary. Ever decide, 'heck with it, they're getting broccoli'?
L Hornsby
TeaCup Pup was passed the mantle of holding The Wand by Fluf Pup after the origin story @mathtans
How DOES broccoli grow?
mathtans
I thought it was just heads in the ground like cauliflower but now I'm not sure. O.o
L Hornsby
It grows up and is quite green lol
still has leafy things around it like the Pineapples
mathtans
Still reading during the chat. I like how the unconventional topping of a cupcake helped save the day.
L Hornsby
I did like drawing the Alien Meeples a lot
RebelVampire
broccoli is a weird looking plant ill say. although would probably have been easier than pineapple. but then again idk how many pups would want broccoli on the pizza. not that i think pug pup would complain. i just assume pug pup will eat anything edible. maybe some not edible things
i really liked in the cowpoke pups storyline where they had to catch up to a moving train and jump on. it felt very epically western and made me admire how cool and brave the pups are.
mathtans
Yeah, pug doesn't seem too fussy.
Also, the Space Pups returned to create an eclipse, that was an unexpected guest starring role.
L Hornsby
The Solar Eclipse in 2017 was sooooooo cool! And it totally looked like a giant sandwich cookie to me
RebelVampire
its kind of a shame the space pups didnt invite the princess pups again to eat the sandwich cookie
i kind of hope we see the space pups again as the call the princess pups needing help on a space mission
ultimate space adventure
L Hornsby
They'll probably show up again
mathtans
I kinda remember that eclipse, aye.
Hm, are there also pups that live in the sea? Mer-Pups?
L Hornsby
The Space Pups are based on my dog Hannah and her brother Walter. We adopted Hannah and someone else adopted Walter a few days later
There might be Mer-Pups?
RebelVampire
omg
i totally support mer pups
that would adorable
and cool undersea parties can be had
with colorful coral
L Hornsby
The Pups might end up going back in time first. I'm a sucker for drawing dinosaurs
mathtans
Oooh, time travel is always fun. Hopefully they don't go for the bones of the live dinosaurs.
I've reached the Go West part.
RebelVampire
that also sounds awesome. can just picture them running from the trex. then making friends. all sitting around having cookies together
L Hornsby
Prehistoric cookies
or maybe just dinosaur shaped ones
RebelVampire
thatd also be cute. endear the dinosaurs to them by making cookie self portraits.
i wonder if there are secret agent pups
who go around everywhere wearing sunglasses
L Hornsby
maybe?
mathtans
(Sorry, little one was fussing, had to run off for a moment.)
Just wanted to say before the end, the goat eyes are interestingly unique, makes it easy to tell them apart from the rest of the animals.
RebelVampire
https://tapas.io/episode/1197013 i really love this vulture train dude with the hat btw. i actually hope we see the vultures again cause they had such great expressive and evil faces
mathtans
Those vultures are pretty petty.
L Hornsby
Vultures are both cute and terrifying in real life
And the same with goats. I wanted to use Actual Goat Eyes because they're SO WEIRD
mathtans
Oh hey, caught up just in time. I like the one balloon falling down.
Goats + Pineapples = wha?
RebelVampire
as we draw to a close, i just want to say the comic was really nice and a great way to start off the year i think. there were just so many heartwarming moments and i loved the immense kindness the pups always showed despite adversity
L Hornsby
A Goat Pineapple?!?
mathtans
Pineapple with slanty eyes.
Agreed, Rebel.
L Hornsby
Aw, thanks guys! I don't have a huge following so it was good to hear from some readers!
RebelVampire
COMIC TEA PARTY- THURSDAY BOOK CLUB END!
Sadly, this wraps up this week’s Thursday Book Club chat for now. Thank you so much to everyone for reading and joining us! We want to give a special thank you to Lindsay Hornsby, as well, for making Princess Pups. If you liked the comic, make sure to support Lindsay Hornsby’s efforts however you’re able to~!
Read and Comment: https://tapas.io/series/Princess-Pups
Lindsay Hornsby’s Gumroad Shop: https://gumroad.com/fizzlebit
Lindsay Hornsby’s Twitter: https://twitter.com/Fizzlebit
Comic Tea Party- Thursday Book Club
Next week’s Thursday Book Club will be about Chasing Little Lights by Evelyn Shi. For participants, you have the next week to read as much of the comic as you would like~! We hope to see you on Thursday, January 10th, from 5PM to 7PM PST for the chat in #thursday_bookclub!
Comic’s Main Site: http://www.cllcomic.com/
Comic’s Tapas Mirror: https://tapas.io/series/cll
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pensurfing · 6 years
Text
Caitlin’s Three Things List
Okay, so moments (probably hours by the time I finish this) ago I wrote a goals list that I think is good for self-evaluation. (Keyword: This is what I think. results may vary depending on what you’re looking for.)
I’m going to hop to it and answer some of these that I laid out in hopes of having a better idea of what I want to accomplish. 
The Three Things Lists!
1) Three things that went well this year.
* Audience growth
So once upon a time, I grew a pretty decent following due to creating an Inktober Prompt list. My expectations: Maybe two of my friends would do this, maybe. And then one stranger that has followed me for a while. (There are a few followers I recognize their username because if I post something they always like it and for some reason that keeps me going.)
But because of this prompt, I was exposed to MANY new creators and illustrators that I now enjoy chatting with and following! Instagram had the biggest maintained growth. I’m excited to create for an audience that actually expects me to create and not just for friends who see my things “whenever they aren’t busy”. (Not to bash them or anything, just there are a lot where unless I tell them, they don’t see the posts I make.)
Another surge of growth in my audience was due to tabling at conventions this year. I was terrified to show my work let alone attempt to sell it to someone. Tabling at cons not only boosted my confidence but also quieted one of my ever going demons. “YoU sUcK aT dRaWiNg CaItLiN.” “How do you have a degree? oh right, you just barely passed.” I can’t say this is the case, there is an audience that genuinely enjoys my scribbles. So I am forever thankful to Atlanta Comic Con for giving me that chance. It honestly opened a few doors for me.
**Process
I’ve gotten more comfortable with showing my process. It can be messy, crisp, and illogical. But turns out the people who enjoy my content enjoy my scrambled thoughts. It’s something about not being alone in this sort of sense that calms the nerves.
So I can say with chest poked out that sharing process has gotten MUCH better. I can thank a self-help book I bought this year that was a FANTASTIC BUY. Austin Kleon has [two] (currently? If he has more then I’m buying it like people buy a name brand.) books that helped me see that it is GREAT to share not only the process but advice. “Show Your Work” is the book I’m talking about for now. Great tips, the outline is on the back of the book. So if you’re like me, I need to clearly see what I might be getting into, you might have a ball.
And finally, (not calling myself out on this but other) If you’re going to respond to people when they ask you “how do you___?” do not answer “Google it”. That is the rudest thing I’ve seen some of even my FAVORITE illustrators do; that response can burn in hell. PERIODT. (my one typo allowed.)
*** Art Style Exploration
For those who think college will help you establish an art style that you’ll enjoy or help nourish the one you currently have.... Let me save you over 80K.... No, the fuck it won’t.
That was the biggest thought I had going into art school. If anything, it confused me more and utterly destroyed what little confidence I had in my drawing style. After graduating, I had a huge swing from how I used to draw to how my art currently looks. I stopped trying to please the one professor who stood between me and my degree and started drawing to please my tastes. And guess what? That did something. And that something WORKED. I love what I draw now; I see why I chose this as my career path. I’m genuinely happy with how my pieces turn out versus in college just wanting to turn the damn thing in and hoping it isn’t an F.
2) Three things you could have handled better.
* The loss of a good paying client.
Now hear me out when I say this: A good paying client DOES NOT EQUAL a good client. Say that three times and then exhale.
Back earlier this year, I had the opportunity to work with a writer who gave me hell and back. And even that is an understatement. I dealt with her because in school you were taught “if they pay on time, finish the work and get the exposure.” 
I’m here to tell you my lesson learned: A good paying client DOES NOT EQUAL good exposure, good pay, a good client. 
I was doing the work of three for the price of one and a half. (And was always told I charged too much.) She tried abusing this power with friends of mine, with other illustrators. When things turned out bad, she tried saying it was my fault. She read my contract and then tried telling me I changed the wording, I purposely did this thing, another thing was my fault. I could go on with this story.
The part that I wish I handled better?
How I treated myself afterward. I’m so used to people telling me, “Cait, this is what you do wrong. This is how you fix it.” that I don’t consider my own feelings, and when I bring my feelings into the scenario they no longer matter. Because they tell me they don’t matter. In this case, I wish I had treated me better, because my feelings, my mental health, DOES matter.
**My Patience Getting Into Conventions.
Pretty self-explanatory. I got into one, finished one, and wanted to do eight more in a week. But this sort of thing just takes time and I need to accept that.
***My losses
I had to listen to a Little Mix song to actually learn this one. The context of the song is nowhere near the topic at hand. But a verse from Power feat Stomzy really packs a punch after this year: 
“ You look him in the eye and say, "I know I'm not a guy But see there's power in my losses and there's power in my wins" “
I had to look one of my demons in the face, and state something similar. My loses mean I’m trying. My loses piling shows I’m not willing to give up easily, and that is something that took a while to be content with.
3) Three things artistically you want to improve on.
*Composition
It’s not awful, but it can be better.
**Color
I told this BOLDLY if I might add while critiquing someone else’s portfolio; “Your color palette is boring. All your [things] look as if they are from the same universe, during the same time of day, with the same kind of mood. After three photos it’s bland, boring, and understood you have a preference.” 
Can you say damn Cait? The statement was, in fact, true, but I certainly could not talk. My color palette is mainly bright, pop, and happy. In order to tell a story, I KNOW it is best told with color. And I failed myself this year. But I sure won’t next year.
***My Damn Tag
Okay, alright. Why is it well-established artists have their tag figured out? Even some who’s art style is so recognizable (I’m looking HEAVILY at you Gabriel Piccolo.) we know it’s theirs, seem to have a tag that suits them and works for them. But more importantly, they put it in A VERY DECENT SPOT. SOMEONE SHARE THIS SCIENCE WITH ME? CAUSE APPARENTLY I DON’T GET IT.
4) Three things you want to focus on trying.
*More backgrounds.
As much as it pains me, I need to improve on backgrounds and perspective. When I do make backgrounds, I’m told I make great pieces. That I should look into becoming a background artist. And don’t get me wrong, I like them. But I don’t like them.
I feel as though I need to improve in that region so that way I don’t feel as though it’s a weakness of mine. My backgrounds are nice, but they aren’t nice to my standards.
**More designs
I love character designs, but let’s be real. If you were to scroll down my site or my Instagram page, or even this Tumblr archive, could you tell? 
I draw characters a lot sure, but none are designs. No process, no sheets, no turnarounds, none of that. So that’s a huge goal of mine for 2019.
***Scheduling posting
At one point I was pretty good at this. Live stream in Instagram and Twitter, cool. Videos on Facebook, Twitter, and Instagram. Cool. Everywhere gets a photo, everywhere gets a silly one-liner. Yay. I’m not leaving anything out.
Well by the end of this year that totally crumbled. 
SO I want to try getting better at that thing there. Because having attempted this at the end of the year was cool, but it still wasn’t enough apparently.
5) Three positive things to tell yourself.
* You are an inspiration. That’s all you wanted to be in life, you did it. I’m proud of you.
**You didn’t kill yourself like you tried to; you opened up about it for once and used that pint up anger creatively. That is very hard to do, trust. I’m proud of you.
***You moved on, matured, and let it go. Even when the goddess inside you told you these peasants didn’t deserve your light, your friendship, your greatness. I’m proud of you.
I’m just proud of me for not snapping when I had every right to; not everything deserves a reaction.
6) Three negative things you want to leave for 2018.
*Comparisons 
Oh boy. I am extremely guilty for this: I’ll compare myself to a well-known illustrator my age. I’ll compare myself to friends who are in the field having a blast and getting work; I’ll compare myself to friends who aren’t in the field and they struggle at getting work. I’ll compare myself to the kid I graduated high school with who is traveling the world, is able to eat, come home to his dog and relax because he doesn’t have tuition to pay. I’ll compare myself to these goddamn baby boomers who keep repeating “We didn’t have it hard, you’re just being stupid. Millennials aka our children deserve to starve. We’ll just put our faith in our grandchildren because screw the kids we raised and refuse to pay accordingly. $7 an hour worked in my day, they need to make it work now.” I’ll compare myself to fake people I created in my head and purposely made scenarios and wonder why I’m not like them, said creations I made because I was pretty low for ten minutes...
I just compare myself too much. To any damn body. It’s draining, obnoxious and most of all pointless. My new motto for next year is: “Unless it is helping you grow yourself, your brand, your spirituality, don’t do it.”
I’m not comparing my chapter two to someone’s chapter thirty-five. I’m not even comparing my chapter two to someone else’s chapter two. I need to stop doing that PERIOD! My journey is different, unique, and worth seeing through.
**Listening to negative others.
A couple of years ago, I lost a close friend around the time my aunt passed away. During this time I was hypersensitive to any and everything done or said; I also kept many walls up to hide my mourning. He caught the crossfire of all of that. I kept secrets from him I was too prideful of admitting and lashed out because of the emotional turmoil I kept suppressed. While in the midst of packing his things and leaving my life, he mentioned that I was a failure because I was unemployed and artistically speaking I hadn’t accomplished anything; that I would remain that way because that’s just the person I deserved to be. Now mind you, I graduated college that year; he was a flunk out. I changed my art style dramatically compared to when I started school to pass; he thought just posting crappy pictures of lukewarm sketches were equivalent. I started attempting trends and all he could do was copy. Don’t get me wrong, this isn’t to bash my old friend. If he were to come back into my life and move on like nothing had happened I’d do the same. (With some limitations.)
It’s just while typing out this scenario, of our four-year friendship I can’t think of one nice thing/compliment/gesture he has said to me. That’s my problem.
I can be praised, admired, and look highly upon for years straight. But my problem is I let others negative thinking and comments marinate with me for a long while. Too long of a while.
Another example is my mother’s friend. (My mom has many friends that do this shit, but this one stung more.) 
This friend always roots for me; treats me like a person, and encourages my artistic journey. I consider her family before my actual relatives. 
We went over for some barbeque the family was having and I was ready. Black Hallmark Cookouts, laughing, good food, good music, shit talking others teams. She asked me a harmless question of when was I going to quit my day job. Seemed like nothing at first, until the added gest of what she continued with. “All I’m saying is you can’t do [your day job] forever. That will get old. If the art thing doesn’t work out next year what’s plan b?”
I’m not a calm person (usually). Normal Caitlin would have cursed her out and mentioned how just because she chose a job to settle and be miserable at for most of her life doesn’t mean I have to follow suit. But again, of all the nice encouraging things she has done, said, and showed, for a while, I couldn’t think of it. 
So I pray I let go of this nasty behavior in 2018; it’s going to be hard but it is dire.
***Saying I’m Not Enough
Alright, now put the combination of the two above in a bowl and what do you get? A Caitlin who struggles in interviews and applying for jobs because I let comparisons and negative comments rule my thoughts. This stopped me from applying to jobs I would have been perfect for; internships that could have helped me; posting art online.
We (including me) have to stop thinking that in order to be an illustrator means we have to pass a certain threshold of struggle, success, and a huge number of followers. That isn’t the job description. NO JOB DESCRIPTION has ”must have at least 10K followers on Instagram or Twitter.” nOnE. 
So we (including me) need to stop treating ourselves this way. Period.
7) Three things you’re looking forward to in 2019.
*Going to move conventions.
**Adding pieces to my portfolio to try again at job hunting.
***Becoming content with the fact that my current situation isn’t my permanent situation. Unless I laze around and make it so.
Alright, so this was basically me calling myself out on my noise. Lashing out my demons and putting it in writing what I want to accomplish. I hope this inspires you to write yours, even if you keep it private. I hope it guides you and maintains your vision.
I’ll see you in 2019
A new wave
Caitlin xx
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Breast Metastasis in a Patient with Primary Hepatocellular Carcinoma | Iris Publishers
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Authored by Bouchagier Konstantinos* AbstractHepatocellular carcinoma is the most common primary carcinoma of the liver, that metastasises most commonly to lungs, lymph nodes, bones and adrenal glands. We report a case of a 70 years old female, with a left breast metastasis from hepatocellular carcinoma, along with hepatocellular carcinoma recurrence in the liver, that underwent a left mastectomy. The pathological report confirmed the metastasis. To the best of our knowledge, this is the second study reporting a breast metastasis from primary hepatocellular carcinoma.Keywords: Hepatocellular carcinoma; Breast metastasisIntroductionHepatocellular carcinoma (HCC), is the 4th most common neoplasm in men and 9th most common neoplasm in women, making it one of the leading causes of cancer-related deaths (approximately 600.000 deaths/year worldwide) [1-12]. Its geographical distribution varies according to the prevalence of known aetiologic factors such as HBV, HCV infection, alcohol, cirrhosis [12]. Extrahepatic metastases occur in 14-37% of cases and are associated with poor prognosis (1 year survival<40%) [10,13] The most common extrahepatic HCC metastases sites are the lungs (49%), lymph nodes (41%), bone metastases (16%) and the adrenal glands (15%) Metastases occur via the portal vein system or via mediastinal nodes [2]. Breast Ca is the most commonly diagnosed cancer in the world, among women, and the second leading cause of cancer deaths, after lung cancer [14]. Breast metastases are extremely rare, according to worldwide literature. This is the second report of breast metastasis to a patient with primary hepatocellular carcinoma. Case ReportA 70 years old Caucasian female, with chronic HCV infection, presented on the outpatient clinic, during routine follow-up after right hepatectomy, complaining of mastalgia and a palpable mass on her left breast, discovered during self-palpation. The mass was rigid, tender about 5x4 cm in size. She had a previous surgical history of right hepatectomy 8 months ago, due to hepatocellular carcinoma in segments VI, VII of the liver, after an embolism of the right portal vein and counterbalancing hypertrophy of the left liver lobe. The biopsy had reported hepatocellular carcinoma with neuroendocrine differentiation, grade III-IV Edmondson-Steiner, CK8-, CK18+, CK7+, hepatocyte+, glypican-3+, AFP+, pCEA+, β-catenin+,s-100-, CHR moderately positive, SYN moderately positive, CD56-, Ki 67~80% . During surgical follow- up, the patient underwent CT scan of the abdomen, thorax and brain, which showed a left breast mass with irregular borders 5.9x4.5 cm and a mass 7.9x8.3 cm on the VII liver segment, with enlarged hepatic lymph nodes and splenomegaly (Figure1).
Read More…Full Text For More articles in Archives of Clinical Case Studies please click on: https://irispublishers.com/accs/ For more open access journals in Iris Publishers please click on: https://irispublishers.com/
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Sexual Dysfunctions in Women
Overview
A woman's sexuality is a complex interplay of physical and emotional responses that affects the way she thinks and feels about herself. When a woman has a sexual problem, it can impact many aspects of her life, including her personal relationships and her self-esteem. Many women are hesitant to talk about their sexuality with their health care professionals, and many health professionals are reluctant to begin a discussion about sexuality with their patients. Instead, women may needlessly suffer in silence when their problems could be treated. Sexual activity includes a wide variety of intimate activities, such as fondling, self-stimulation, oral sex, vaginal penetration and intercourse. Every woman differs in her sexual interest, response and expression. A woman's feelings about sexuality can change according to the circumstances and stages of her life. Women also can experience a variety of sexual problems, such as lack of desire, difficulty becoming aroused, difficulty having an orgasm or pain during sex. When a physical or emotional problem associated with sex persists, it's time to contact a health care professional. Characteristics of Sexual Arousal: Scientific Research Early Research: Masters & Johnson Research on the sexual response in the mid-1960s by Masters & Johnson established what is known as the traditional linear sexual-response cycle: desire-arousal-orgasm-resolution. The stages are defined as follows: Excitement/Arousal: The feeling that you want to have sex, followed by physical changes that occur in your body as you become sexually excited. These include moistening of the vagina; relaxation of the muscles of the vagina; and swelling of the labia, (skin folds that are part of the vulva), and the clitoris (a small, sensitive organ above the vagina, where the inner labia, which surround the vagina, meet). The nipples also become erect. Plateau: The above changes in the genitals continue, there is an increase in blood flow to the labia, the vagina grows longer, and glands in the labia produce secretions. There is an overall increase in muscle tension. Orgasm: Known as the peak of the sexual response, the muscles of the vagina anduterus contract leading to a strong, pleasurable feeling. Resolution: You return to your normal state. Contemporary Research: Rosemary Basson, MD More contemporary research suggests that a woman's sexual response is both more complex and varied than this model suggests, particularly when the woman is involved in a long-term relationship. In 2002, the leader in this field, Rosemary Basson, MD, introduced a new cycle for the female sexual response that focuses on women's need for intimacy. These differences are important to understanding your sexual health as well as for accurately diagnosing and treating sexual dysfunction. The differences, in part, include recognizing that women's sexual responses are connected more to relationship and intimacy than to physical needs, and that the orgasm stage can be highly variable for women without actually being "dysfunctional." In addition, it's important to distinguish a woman's sexuality and sexual response from a man's. In men, thinking about sex translates to erection, but in women, arousal often comes about after the actual lovemaking begins. In other words, a woman may start out making love with her partner somewhat uninterested, but as things progress and she focuses on the stimulation and sensations she's feeling, she becomes increasingly more aroused. Sexual Dysfunctions in Women Sexual dysfunctions are disturbances in one or more of the sexual response cycle's phases or pain associated with arousal or intercourse. A study published in the Journal of the American Medical Association (JAMA) involving a national sample of 1,749 women estimated that sexual dysfunctions occur in 43 percent of women in the United States. According to this 1999 study, you may be at greater risk for sexual problems if you are: single, divorced, widowed or separated not a high school graduate experiencing emotional or stress-related problems experiencing a decline in your economic position feeling unhappy, or physically and emotionally unsatisfied a victim of sexual abuse or forced sexual contact Causes of Sexual Dysfunctions There are several types of sexual dysfunctions. They can be lifelong problems that have always been present, acquired problems that develop after a period of normal sexual function or situational problems that develop only under certain circumstances or with certain partners. Causes of sexual dysfunctions can be psychological, physical or related to interpersonal relationships or sociocultural influences. Psychological causes can include: stress from work or family responsibilities concern about sexual performance depression/anxiety unresolved sexual orientation issues previous traumatic sexual or physical experience body image and self-esteem problems Physical causes can include: diabetes heart disease liver disease kidney disease pelvic surgery pelvic injury or trauma neurological disorders medication side effects hormonal changes, including those related to pregnancy and menopause thyroid disease alcohol or drug abuse fatigue Interpersonal relationship causes may include: partner performance and technique lack of a partner relationship quality and conflict lack of privacy Sociocultural influence causes may include: inadequate education conflict with religious, personal, or family values societal taboos Types of Sexual Dysfunctions Lack of sexual desire is the most common sexual problem in women. The Association of Reproductive Health Professionals reports in the National Health and Social Life Survey that 33 percent of women lacked interest in sex for at least a few months in the previous year. The American College of Obstetricians and Gynecologists (ACOG) reports that a woman's sexual response tends to peak in her mid-30s to early 40s. That's not to say, however, that a woman can't have a full physical and emotional response to sex throughout her life. Most women will have a passing sexual problem at some point in their lives, and that is normal. However, sexual dysfunction in its true sense is most common in women aged 45 to 64. Often, sexual desire is affected by a woman's relationship with her sexual partner. The more a woman enjoys the relationship, the greater her desire for sex. The stresses of daily living can affect desire, however, and occasionally feeling uninterested in sex is no cause for concern. Hypoactive Sexual Desire Disorder: When sexual fantasies or thoughts and desire for sexual activity are persistently reduced or absent causing distress or relationship difficulties, the problem is known as hypoactive sexual desire disorder, or inhibited sexual desire disorder. The Merck Manual estimates hypoactive sexual desire disorder occurs in about 20 percent of women. Sexual aversion disorder: Diagnosed when you avoid all or almost all genital sexual contact with a sexual partner to the point that it causes personal distress and relationship difficulties. This condition may affect women who have experienced some type of sexual abuse or who grew up in a rigid atmosphere in which sex was taboo. A study in the journal Archives of Sexual Behavior found that among patients with panic disorder, 75 percent had sexual problems, and that sexual aversion disorder was the most common complaint, affecting 50 percent of women with the disorder. Sexual arousal disorder: The persistent or recurrent inability to reach or sustain the lubrication and swelling reaction in the arousal phase of the sexual response to the point that it causes personal distress. It is the second most common sexual problem among women, affecting an estimated 20 percent of women, and most frequently occurs in postmenopausal women. Low estrogen levels after menopause can make vaginal tissue dry and thin and reduce blood flow to genitals. As a result, the arousal phase of the sexual response may take longer and sensitivity of the vaginal area may decline. However, this can happen at any age. Female orgasmic disorder: The persistent absence or recurrent delay in orgasm after sufficient stimulation and arousal, causing personal distress. According to the Association of Reproductive Health Professionals, 24 to 37 percent of women have problems reaching orgasm. Most women are biologically able to experience orgasm. Never having an orgasm, or not having one in certain situations, are problems that can often be resolved by learning how the female body responds, how to ensure adequate stimulation and/or how to overcome inhibitions or anxieties. Some medications, including but not limited to those used to treat highblood pressure, depression and psychosis, can reduce your sexual desire and sexual arousal and interfere with orgasm. If you are taking such drugs and experiencing sexual side effects, talk with your health care professional about changing your dosage or prescription. Another type of sexual arousal disorder has the opposite effect. Some women may always feel sexually aroused, an experience that can be quite uncomfortable and upsetting. Although most health care professionals recognize hyperactive sexual desire as a problem, it is not an official condition according to the DMS-IV. Women who have a hyperactive sexual drive tend to be very demanding sexually because their desire for sex is constant. Sexual Disorders Involving Pain Dyspareunia: Pain during or after intercourse, called dyspareunia, occurs in nearly two out of three women at some time during their lives, according to ACOG. Like other sexual disorders, it can have physical and/or emotional causes. The most common cause of pain during sex is inadequate vaginal lubrication occurring from a lack of arousal, medications or hormonal changes. Painful sex also can be a sign of illness, infection, cysts or tumors requiring medical treatment or surgery, another reason why you should discuss the problem with your health care professional. Vaginismus: The involuntary spasm of the muscles at the opening of the vagina, making anything entering the vagina painful. Vaginismus can have medical causes, including: scars in the vagina from an injury, childbirth or surgery irritations from douches, spermicides or latex in condoms pelvic infections Vaginismus also can have psychological causes. It can be a response to a fear, such as fear of losing control or fear of pregnancy. It can also stem from pain or trauma such as rape or sexual abuse. Vulvodynia: Defined as any pain in the vulva. It could be outside the vulva on the labia or an itching, burning or sharp pain within. Treating Sexual Dysfunctions If your relationship or sexual problem is new, try having an open, honest talk with your partner to relieve concerns and clear up disagreements or conflicts. Women who learn to tell their partners about their sexual needs and concerns have a better chance at a more satisfying sex life. If the sexual problem persists, discuss your concerns with your health care professional. Most sexual problems can be treated. Diagnosis If you're having sexual problems, your health care professional will try to rule out medical causes first by conducting a thorough medical history and exam, including a pelvic exam and blood tests. If there is no physical or biological cause, you may be referred for psychological counseling. Askfor a referral to a sex therapist. These specialists are trained to provide the type of therapy you need and, with your input, make a diagnosis and recommend treatment. When possible, your partner should be included in this therapy with you. To find a certified, trained sex therapist contact the American Association of Sexuality Educators, Counselors and Therapists at http://www.aasect.org. Be sure to tell your health care professional if you have any of the following conditions that can have a significant impact on sexual functioning, both physically and psychologically: Chronic illness, such as diabetes and heart, kidney or liver diseaseThese conditions can lead to nerve damage and affect blood flow to the pelvic organs, affecting arousal and decreasing vaginal lubrication. Additionally, having a lifelong illness can hurt a woman's self-image and make her feel less sexual, affecting desire. CancerRadiation treatment, as well as certain medications used to treat cancer, may result in lubrication problems, and, in turn, painful sex. Anti-estrogen hormonal medications for breast cancer or drugs used to prevent recurrence of breast cancer, such as tamoxifen (Nolvadex), may also produce low desire, vaginal dryness and difficulties with vaginal penetration. Chemotherapy for cancer can affect many physical functions and responses, including sexual desire and arousal. Additionally, cancer treatment can produce fatigue, decreased self-esteem, fear of death, disfigurement and/or rejection that can affect a woman's sexual feelings. PregnancyWomen differ in their sexual activity patterns during pregnancy. Some curb their activity in the first three months and again near the end of pregnancy when physical discomfort can lead to decreased desire. Some have an increase in activity when the initial discomfort wanes. Generally, however, sexual activity doesn't have to stop because of pregnancy. Sex won't hurt the fetus. However, if you are at risk for a preterm birth, your health care professional may advise against sex during pregnancy.Some pregnant women find sexual interest decreases steadily over the course of the pregnancy. After the baby is born, changing hormone levels, fatigue and/or a healing episiotomy may lead to reduced sexual desire. Additionally, it is common for women who breastfeed to notice a lack of vaginal lubrication. This is caused by high levels of the hormone prolactin, which is stimulated by nursing. Also, as prolactin increases, testosterone, a hormone that contributes to sexual desire, decreases, another reason for declining sexual desire. MenopauseLow estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to the genital area and reduced vaginal sensitivity that may contribute to arousal and, in turn, orgasm problems. Postmenopausal women often find that the arousal phase of the sexual response cycle takes longer or is less intense. Changing hormone levels also can produce mood swings that make some women nearing menopause feel less interested in sex. Substance abuseAlcohol affects the arousal states and inhibits orgasm. Chronic alcohol use reduces desire. Abusing drugs, especially narcotics such as morphine, codeine and heroin, impairs sexual function and reduces desire. If you are having a sexual problem, make sure you tell your health care professional about any medications you're taking. Blood pressure medications, antipsychotics and antidepressants are commonly prescribed drugs that can interfere with the sexual response. Selective serotonin reuptake inhibitors (SSRI) such as paroxetine (Paxil) and fluoxetine (Prozac) frequently produce side effects that inhibit or prevent orgasm. Other antidepressants can affect sexual function as well, including tricyclic antidepressants such as imipramine (Tofranil) and clomipramine (Anafranil), monoamine oxidase inhibitors such as phenelzine (Nardil) and mixed antidepressants such as venlafaxine (Effexor). Anticonvulsants for seizures also can cause sexual problems. A change in dosage or medication may help resolve your sexual problem. If you have pain associated with sexual activity, it's important to accurately describe where the pain is located so your health care professional can determine its cause. The types of pain associated with sex include: Vulvar painThis type of pain is felt on the outside of the vagina and often occurs when some part of the vulva is touched. It can be caused by irritation from soaps, feminine hygiene sprays or douches, scars, cysts or infections. Vaginal painThis type of pain is felt inside the vagina. The most common cause is a lack of lubrication from inadequate arousal, medications, medical conditions, pregnancy, breastfeeding or menopause. Vaginal pain also can be caused by an inflammation of the vagina, known as vaginitis. Additional symptoms of vaginitis are a vaginal discharge, itching and burning of the vagina and vulva. It can be caused by a yeast or bacterial infection or a sexually transmitted disease.Vaginal pain also can be caused by vaginismus. This pain occurs when anything attempts to enter the vagina, including tampons or even during a pelvic examination. It can be caused by irritation from douches, spermicides or latex in condoms, infections, scars from an injury, childbirth, surgery or psychological problems from sexual trauma or abuse. Deep painPain that is felt deep inside the vagina, lower back, pelvic area, uterus or bladder can be a sign of an internal medical problem. It can be caused by: pelvic inflammatory disease endometriosis, a condition in which the tissue that lines the uterus grows outside the uterus pelvic tumor bowel or bladder disease, such as interstitial cystitis scar tissue ovarian cysts If you are experiencing deep pain during sex, your health care professional may recommend a variety of tests including but not limited to blood tests, urine tests and scans to check for possible causes. Treatment Treatment for sexual dysfunction depends on the cause of the problem. If the cause is physical, medical treatment is aimed at correcting the underlying disorder. If the cause is psychological, treatment consists of counseling. Treatment can include a combination of medical and psychological approaches. Sometimes, treatment may be behavioral. For example, with loss of desire, changes in the environment, timing, lovemaking techniques or foreplay can produce desire. With arousal disorder, the use of toys and vibrators can help with vaginal circulation. A warm bath and a massage from your partner can also help. Medical Treatment Lubricating creams, gels or suppositoriesIf you are suffering from vaginal dryness caused by medications, a chronic condition or declining estrogen levels, your health care professional may suggest water-based, over-the counter vaginal lubricants such as Astroglide or K-Y Jelly to make sex more comfortable. Or you might try Replens, a long-acting vaginal moisturizer that releases purified water to produce a moist film over the vaginal tissue. Do not use oil-based products, such as petroleum jelly, baby oil or mineral oil with latex condoms because they can cause a condom to break. Topical estrogenFor menopausal women with vaginal thinning, dryness or insensitivity, your health care professional may prescribe an estrogen cream such as Estrace or Premarin, or a vaginal ring, such as Estring, Phadia (low-dose) or Femring (higher dose), to ease sexual discomfort. And a vaginal tablet (Vagifem) containing estradiol, a type of estrogen, is available by prescription for vaginal dryness. Unlike creams, which usually are used at night, Vagifem can be inserted any time of day. Hormone therapyFor menopausal women, hormone therapy (either a combination of estrogen and progestin or estrogen-only therapy) may improve the sensitivity of the clitoris, ease discomfort caused by vaginal thinning and dryness and improve blood flow to the pelvic area. In addition, hormone therapy (HT) can help relieve other bothersome menopausal symptoms, including hot flashes, which can interfere with intimacy. A woman should not take any form of HT until she has weighed the pros and cons and discussed the risks and benefits with her doctor. Because of the potential risks that go along with HT, the U.S. Food and Drug Administration (FDA) now advises health care professionals to prescribe it at the lowest possible dose and for the shortest possible length of time to achieve treatment goals.Although HT can result in increased sensitivity and decreased discomfort during sex for menopausal women, the therapy may not improve sexual desire. Some health care professionals add testosterone, a hormone produced by the ovaries and adrenal glands that plays a role in sexual desire, to HT to stimulate sexual arousal. Treatment with testosterone is controversial, however. Estratest, an estrogen/testosterone combination, is currently the only testosterone treatment available. However, there is conflicting evidence and opinion in the medical community concerning whether or not the benefits of the drug outweigh the risks, which include increased risk of breast and endometrial cancer, adverse effects on blood cholesterol and liver toxicity. Studies on other androgen products used to treat sexual dysfunction have also had mixed results.Although there is no FDA-approved form of testosterone available to treat women's sexual dysfunction, many doctors prescribe it "off label" in small amounts, particularly for women whose ovaries have been removed. Removing the ovaries drastically reduces testosterone levels, and some research shows that women who have had their ovaries removed are most likely to benefit from androgen therapy.Supplementing with testosterone has potential risks. In too high a dose, testosterone can produce masculinizing effects, such as increased facial hair and enlargement of the clitoris. The oral form can also produce liver damage, acne and a decrease in HDL cholesterol (the "good" cholesterol). The use of testosterone in men and women is highly controversial, so be sure to discuss with your health care professional whether androgen supplementation is right for you. Clitoral therapy device The Eros Clitoral Therapy device is an FDA-approved device designed to treat female sexual arousal disorder. It consists of a small, soft suction cup attached to a palm-sized, battery-operated vacuum pump. The suction cup is placed over the clitoris before sex. The gentle vacuum increases genital blood flow, thus increasing sexual arousal and enhancing orgasm. Studies have shown that the Eros Clitoral Therapy device effectively boosts sensation, orgasms, lubrication and overall sexual satisfaction. The device is available by prescription. Vaginal weights Women with orgasmic disorders may benefit from treatment with vaginal weights. Vaginal weights are used to strengthen the pelvic floor muscles, improving awareness of sexual response and also potentially correcting urine leakage, which can cause problems during sexual activity. Vaginal weights are usually available in sets of five. To use them, you insert the lightest weight and remain upright for 15 minutes, two times a day. When the weight is in place, you should feel the urge to hold it in. After a few days, as the muscles strengthen, this urge will go away, and you will be able to move up to the next weight. When you get to the fifth weight, you will insert it for five to seven consecutive days each month to maintain strength in your pelvic muscles. Sildenafil (Viagra) The drug that treats erectile dysfunction in men is also being studied in clinical trials for female sexual arousal disorder. Some studies have found it may increase blood flow to the female genital area and increase relaxation of clitoral and vaginal muscles. However, several large placebo-controlled studies including about 3,000 women with female sexual arousal disorder had inconclusive results. Therefore, the manufacturer of Viagra has decided not to seek FDA approval to use the drug for female sexual arousal disorder. Other Medical Approaches Better control of chronic diseases, switching prescriptions to reduce side effects and treating vaginal infections by taking antibiotics can eliminate sexual problems related to desire, arousal, orgasm and pain. On very rare occasions, surgery may be needed to remove structural problems, such as cysts, tumors or growths that produce pain during sex. Psychological Treatment Psychological treatment for sexual dysfunction usually involves a series of steps identifying and modifying emotions and behaviors that interfere with sexual response, changing behaviors that act as barriers to sexual responsiveness and learning new physical and emotional behaviors that encourage sexual responsiveness. Sex therapy is talk therapy in which you and your counselor, along with your partner, discuss problems, how and why they occur and ways to solve them. You and your partner receive exercises and techniques to try at home, then report on the results at the following session. Depending on your needs, goals and diagnosis, such counseling typically can involve a one-hour session once a week for about two to six months. Poor communication between partners is often present with sexual dysfunction. Learning to communicate, resolving conflict and dealing with negative emotions are the focus of therapy designed to address this issue. Group therapy or support groups also may be recommended. Behavioral changes may also help. These include: changes in the environment, love making at different times of the day, warm baths, masturbation, massage and the use of sexual toys and vibrators. Sensate focus exercises are often recommended by therapists to treat sexual arousal disorder and orgasm disorder. These exercises help you and your partner relate to each other physically without any pressure to perform sexually. You begin by touching each other, slowly progressing to genital stimulation and possibly eventually proceeding to intercourse. Learning the functions of sexual organs and how the body responds sexually, including clitoral and vaginal stimulation, can help with arousal and orgasm disorders. Kegel exercises can strengthen voluntary control of pelvic muscles, improving the sense of control and quality of orgasms. Treatment for vaginismus (involuntary spasm of the muscles at the vaginal opening) may focus on techniques to relax the vagina. One option is using dilators in graduated sizes that are placed into the vagina and kept in place for 10 minutes. The woman usually places the dilators herself. Performing Kegel exercises while the dilator is in place helps you learn to control your vaginal muscles. The exercises also can be done with your fingers. Sometimes, waiting for the muscle to relax after penetration may help. FSD Research Research is progressing on a couple of drugs aimed at helping women with sexual problems. At a recent meeting of the International Society for the Study of Women's Sexual Health, a study was released on bremelanotide, a drug undergoing trials for treatment of female sexual dysfunction (FSD). In the trials, the drug was well-tolerated and increased arousal, desire and the number of sexually satisfying events in women with hypoactive sexual desire disorder (HSDD) and women with both HSDD and female sexual arousal disorder. The final phase of testing could start near the end of this year. Another drug that is being studied for possible treatment of overall sexual function is tibolone. It is a synthetic steroid currently used in Europe and Australia to treat postmenopausal osteoporosis, but, in one study, it was also shown to enhance sexual function in postmenopausal women. It has not been approved for use in the United States because of concerns over increased risk of breast cancer and stroke. Studies also are looking at the effectiveness of phosphodiesterase inhibitors, the class of drugs that includes sildenafil (Viagra). So far, results show little effectiveness in treating FSD, but these drugs may help women who experience sexual dysfunction as the result of taking certain antidepressants. However, sildenafil should not be taken by anyone using nitroglycerin for angina. Prevention A healthy lifestyle can go a long way toward preventing chronic illnesses and diseases that can contribute to sexual dysfunction. Eating a balanced diet, getting plenty of exercise, stopping smoking, limiting alcohol consumption and controlling stress will help you feel well, build a healthy self-image, boost your energy and help you maintain confidence in your sexuality. Visit your health care professional regularly to avoid medical problems that may affect your sexual responses. Other things you can do to enhance your sexual desire and pleasure include: Communicate with your partnerEmotional intimacy is the essential beginning for sexual intimacy for many women. Talk frankly and honestly about your feelings with your partner to help build your relationship. Silence can result in repressed feelings, anger and alienation that can harm your well-being and even your long-term mental and physical health. Express your desiresTell your partner what you want sexually and what "turns you on," and guide your partner to do those things that please you. Be less predictable and more spontaneous in your sexual experiencesPartners who have been together for years can get into patterns in which sex is always the same. Try new ways to be intimate, and prolong your sexual experience by being more creative with touching, positions, timing and location of sexual activities. Examine your prioritiesDon't let work or family responsibilities take time away from your relationship with your partner. Spending time together is part of building intimacy and helps both partners feel connected to each other. Stay sexually active after menopauseRegular sexual activity, with a partner or through self-stimulation, can improve vaginal lubrication and elasticity as estrogen levels decline. Sexuality is highly personal and varies from woman to woman. A woman's sexual responses can vary from one time to another, and no one pattern is more "normal" than another. Nearly everyone has a problem with sex at some time in their lives, and often the problem can be worked out with patience and talking with your partner. When the problem is life-disrupting, causes trouble in your relationships or involves physical pain, it's time to talk with your health care professional. In many cases, your sexual problem can be treated with medical treatments, psychological therapy or both. Facts to Know Sexual problems occur in 43 percent of women in the United States, according to a study published in 1999 in the Journal of the American Medical Association. A lack of desire is the most common sexual problem in women The Association of Reproductive Health Professionals reports that in the National Health and Social Life Survey, 33 percent of women lacked interest in sex for at least a few months in the previous year. Sexual arousal disorder is the second most common sexual problem among women, affecting an estimated 20 percent of women. Twenty-four to 37 percent of women have problems reaching orgasm, according to the Association of Reproductive Health Professionals. Pain during or after intercourse occurs in nearly two out of three women at some time during their lives, according to the American College of Obstetricians and Gynecologists. Low estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to genital areas and reduced vaginal sensitivity that can contribute to arousal and, in turn, orgasm problems. Low androgen levels may contribute to desire problems. Hormone therapy often can help. The most common cause of pain during sex is inadequate vaginal lubrication, which can occur from a lack of arousal, medications or hormonal changes. It is common for women who breast-feed to notice a lack of vaginal lubrication and sexual interest caused by an elevation of the hormone prolactin, which is stimulated by lactation. Sexual disorders can have medical causes, psychological causes or both. One way women can help prevent sexual dysfunction is to have sex frequently. Sexual activity increases blood flow, which leads to better overall sexual function. Key Q&A What is the sexual response cycle?Masters & Johnson, pioneering sex therapists, defined a classic sexual response cycle in the mid-1960s. The stages of this model are: Excitement/Arousal: The feeling that you want to have sex followed by physical changes that occur in your body as you become sexually excited. These include moistening of the vagina, relaxation of the muscles of the vagina; swelling of the labia, (skin folds that are part of the vulva) and the clitoris (a small, sensitive organ above the vagina, where the inner labia, which surrounds the vagina, meet that acts as a source of sexual excitement). The nipples also become erect. Plateau: The above changes in the genitals continue, there is an increase in blood flow to the labia, the vagina grows longer, and glands in the labia produce secretions. There is an increase in muscle tension. Orgasm: Known as the peak of the sexual response, the muscles of the vagina and uterus contract leading to a strong, pleasurable feeling. Resolution: You return to your normal state. However, it's important to point out that more contemporary research suggests that women's sexual response is more complex and includes more elements than the traditional model outlines. Relationship and intimacy needs appear to play a greater role in women's sexual health. According to sexual health experts, a better understanding of the complexity of women's sexuality will help to more accurately diagnose and treat sexual dysfunction. How do I know if I have sexual dysfunction?Sexual dysfunctions are defined as one or more disturbances in the sexual response cycle, or pain associated with arousal or intercourse. Lack of desire, difficulty becoming aroused, lack or delay in orgasm or pain during or after sex are all examples of sexual problems faced by women. Such problems can be occasional and seem to go away on their own. But when they are persistent or recurrent, disrupting your life or your relationships and causing you emotional upset, they may be dysfunctions that should be discussed with your health care professional. What causes sexual dysfunctions?Causes of sexual dysfunctions can be physical, psychological or related to interpersonal relationships or sociocultural influences. Psychological causes can include: stress or anxiety from work or family responsibilities concern about sexual performance conflicts in the relationship with your partner depression unresolved sexual orientation issues previous traumatic sexual experience body image and self-esteem problems Physical causes can include: diabetes heart disease liver disease kidney disease pelvic surgery pelvic injury or trauma neurological disorders medication side effects hormonal changes, including those related to pregnancy and menopause thyroid disease alcohol or drug abuse How are sexual dysfunctions treated?Treatment depends on the cause. If the cause is physical, the treatment will be aimed at correcting the medical or biological problem. For example, if the cause is hormonal imbalance, hormonal supplements may be prescribed. If the cause is a structural problem, such as a cyst or tumor, surgery may be needed. Sometimes, treatment can involve changes in behavior. Better control of chronic illnesses and disease often solves sexual problems associated with them.Some medications can cause sexual problems, and changing prescriptions to those with fewer side effects can treat the problem. Regardless of the cause, counseling, ideally with a sexual therapist, is recommended and should include both partners together. Treatment can include both treating the physical or medical problem and counseling. I just don't feel like having sex anymore. Is there something wrong with me?Lack of desire is the most common sexual problem in women. It can be caused by problems in a woman's relationship with her partner, stress, fatigue, medications and low levels of the hormones estrogen or androgen. Often, lack of desire is affected by a woman's relationship with her sexual partner. The more a woman enjoys the relationship, the greater the desire for sex.The stresses of daily living can affect desire, and occasionally feeling uninterested in sex is no cause for concern. But, when sexual fantasies or thoughts and desire for sexual activity are persistently or recurrently reduced or absent and cause distress or interpersonal difficulties, the problem is known as hypoactive sexual desire disorder or inhibited sexual desire disorder.If you are approaching menopause (a time frame, typically in a woman's mid- to late 40s, known as perimenopause) or have reached menopause, declining estrogen levels can cause vaginal lubrication problems that make sex uncomfortable, and, as a result, less desirable to you. Changing hormone levels during and after pregnancy can also contribute to decreases in sexual desire. Talk with your health care professional about your problem and what treatment may be best for you. Does menopause mean the end of my sex life?No. Many women find the end of their reproductive years sexually invigorating because they no longer face the risk of pregnancy. Plus, regular sexual activity for postmenopausal women improves vaginal lubrication and elasticity after estrogen declines. However, menopause can bring bodily changes that contribute to arousal problems, and in turn, orgasm problems. Low estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to the genital area and reduced vaginal sensitivity. Postmenopausal women often find the arousal phase of the sexual response cycle takes longer or is less intense.Changing hormone levels also can produce mood swings and emotional upsets that make some women nearing menopause feel less interested in sex. Hormone replacement therapy relieves these symptoms for many perimenopausal women. Using over-the-counter vaginal lubricants may help with dryness problems. Discuss your treatment options with your health care professional, particularly the latest research regarding the safety of HT and ET and how the risks and benefits affect your personal health needs. I have pain during intercourse. Should I see my health care professional about it?Yes, especially if the pain is felt deep inside the vagina, lower back, pelvis, uterus or bladder. Pain associated with sexual activity can be a sign of a medical problem that needs treatment. Deep pain can be a sign of pelvic inflammatory disease, endometriosis, a pelvic tumor, ovarian cysts, bowel or bladder disease or scar tissue.Pain felt in the vagina can be caused by inflammation from an infection or sexually transmitted disease, but it is most commonly caused by lack of vaginal lubrication. Pain felt at the opening of the vagina can be a sign of infection, cysts or scarring. Such vulvar pain also can be caused by irritation from soaps or feminine hygiene products. What kinds of medications can cause sexual problems?Blood pressure, antipsychotic and certain antidepressant medications are commonly prescribed drugs that can interfere with the sexual response. Birth control pills change your hormone levels and can cause a decrease in desire or vaginal dryness. Anti-estrogen hormonal medications for breast cancer or drugs used to prevent recurrence of breast cancer, such as tamoxifen (Nolvadex), also can produce vaginal dryness and difficulties with vaginal penetration. Chemotherapy for cancer can impair many bodily functions and responses, including sexual desire and arousal. Anti-convulsants for seizures also can cause sexual problems. Read the full article
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comicteaparty · 6 years
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September 6th, 2018 CTP Archive
The archive for the Comic Tea Party chat that occurred on September 6th, 2018, from 5PM - 7PM PDT.  The chat focused on MORBIDITY by Charu.
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RebelVampire
COMIC TEA PARTY- THURSDAY BOOK CLUB START!
Good evening, everyone~! This week’s Thursday Book Club is officially beginning! Today we are discussing MORBIDITY by Charu~! (https://tapas.io/series/MORBIDITY)
Remember that Thursday discussions are completely freeform! However, every 30 minutes I will drop in OPTIONAL discussion questions in case you’d like a bit of a prompt. If you miss out on one of these prompts, you can find them pinned for the chat’s duration. Additionally, remember that while constructive criticism is allowed, our focus is fun and respectfully appreciating the comic. All that said, let’s begin!
QUESTION 1. What is your favorite scene in the comic so far and why?
Superjustinbros
Ello!
RebelVampire
good day, SJ
Superjustinbros
Good day to you as well
RebelVampire
lets see, i think not so much a full scene, but one of my favorite moments is when Yuuto asks Keagan why Keagan let him in if Keagan doesn't recognize him. and keagan just has the best expression while saying he wonders himself. it was such a great insert of comedy in that moment that i couldnt help but laugh. i also think it was kind of a great showcase for keagan's personality as well
Superjustinbros
https://tapas.io/episode/1111726 I dunno why but I got a bit of a chuckle out of this scene
With how... sudden the tone changed
RebelVampire
i do enjoy how confused keagan looks in this part. i like the sense of ominous with that broken piece on the plant though. it screams with beautiful foreshadowing i hope at least.
Superjustinbros
Yeah
RebelVampire
ive also been enjoying how the recent chapter has been going. mostly with how its framed in that we never really get to see who i assume is ryo really. its focused on keagan and i like that it makes ryo seem a tad more mysterious
saetje
My favorite scene is definitely near the end of the content where Ryo starts freaking out/getting corrupted. I think it’s at that point we’re getting a sort of taste for a mood shift that’s going to be happening
Superjustinbros
I couldn't think of a good way to mention that little... episode earlier
but it definitely seems strange(edited)
saetje
I also agree I like that ryo is only seen through Keegan’s eyes right now. Solely focusing on Keegan’s perspective leaves ryo on a pedestal currently. I have a feeling we’re going to learn more about ryo later, but it’s smart to start us off through Kaegan’s eyes
RebelVampire
i like how with the whole mood shift that ryo was super accurate in that he was spoiling the mood. i particularly loved when yuuto caught up to ryo cause at that point just the sheer imagery and what was going on made me feel that the situation was truly dangerous
mathtans
I made it. ^^ Rebel, I liked that same scene, where Yuuto then remarks on how it's good he's trustworthy or whatnot.
Superjustinbros
MATH
mathtans
I didn't even notice the planet, whoa.
Hi all!
Superjustinbros
The end of the chapter looks like the start of some kind of crazy creepypasta(edited)
mathtans
Yuuto's attitude in general is pretty fun in my mind (okay if I play games?) but it definitely took a turn with the reactions towards the end. I think he didn't do his research on Keagan.
RebelVampire
haha it does kind of have a creepypasta vibe. i can picture the reddit thread for r/nosleep now. XD
to be fair to yuuto its been like 16 years so ryo would be a poor source of keagan info and maybe keagan is an internet hermit who doesnt even have facebook
saetje
I think it’s an interesting thought that kaegan’s attachment to Ryo is a little selfish. It seems as though it’s literally tethering Ryo’s ghost from moving on and putting his spirit (and others?) in danger, as well as ruining kaegan’s own relationships and life. Kaegan does seem quite overly obsessed(edited)
mathtans
It's possible. I wonder if Ryo was paying more attention to Keagan for a long time (either of his own volition or not) and only recently got his brother involved... then Yuuto didn't realize how bad things were.
seatje: Agreed. I wonder if maybe he was partly responsible for Ryo's death.
saetje
Oh that’s an interesting thought, math!
RebelVampire
yeah tbh i adore how grey it is. cause you could make an argument equally as valid in saying its selfish for ryo to ask keagan to move on. and i love that cause its what makes the conflict complicated and complex. cause there isnt one right answer cause you just cant make ppl feel things you want to feel at the drop of a hat.
saetje
So true
mathtans
I can't think of another good reason why he'd obsess that much. Even if they were lovers (which is kind of implied), I figure there has to be more to it...?
Yup, humans are a complex mess.
RebelVampire
nah they werent lovers cause huge age diff. i think the summary says it was a one-sided crush.
Superjustinbros
Right they are, math
RebelVampire
so theres def something fishy going on here
mathtans
I'm actually kind of reminded of a serial I wrote on a similar topic, which occurred to me as I was reading too. It's a good theme to build on.
saetje
I’m a little confused by the timeline- was kaegan young and just had a crush on an older ryo or did they get to a point of being consenting lovers?
Oh! Rebel answered
mathtans
Rebel: Ahh, good point, missed that. Guess I jumped to conclusions given the circumstances of when we first heard the name.
RebelVampire
“Nine year old Keagan had a onesided crush on eightteen year old Ryo. Then, Ryo died. Nearly sixteen years later Ryo's little brother Yuuto comes into Keagan's life to tell him to "get over Ryo's death".”
just so everyone can be on the same page
Superjustinbros
Thanks, Rebel.
RebelVampire
i take the implication to be that ryo died when keagan was 9
saetje
Okay, there you go! Thank you
RebelVampire
which man, props to keagan for A+ memory. i barely remember anything from when i was 9 XD
mathtans
Could still have been somewhat responsible though, even if young.
I barely remember things from last week sometimes. O.o
Superjustinbros
I remember a lot of things from my childhood
just saying
I practically remember how all the rooms in my house looked when I was that age
saetje
I was just thinking that, ha. Sixteen years is a long time to hold onto something, especially from childhood in such a strong way. But I guess it was also such a traumatic event for him, which tends to stick more too
Superjustinbros
and how my schools looked at the time I attended.
RebelVampire
yeah i guess if were being fair id have remembered a traumatic death. but it implies super closeness i think that goes beyond a one-sided crush. so theres definitely more to see there
QUESTION 2. While it’s clear that Keagan and Ryo had past history, a lot is left to question. How do you believe Keagan and Ryo met, especially considering their age difference? Why do you think Keagan crushed so hard on Ryo despite the age difference between them? Do you think the attachment to Ryo was born purely out of affection, or do you think there’s more to Keagan’s past that explains the attachment? Do you think the way Ryo died has something to do with why Keagan can’t move forward? Or is it something in general perhaps about Keagan’s past history with Ryo? Lastly, why do you think Keagan remembers Ryo so well but seems completely clueless about Yuuto?
gives self A+ for beautiful segway
mathtans
Or segue, even.
saetje
Oh that’s true- how could he not know yuuto?
mathtans
Maybe Yuuto's a half-brother?
saetje
I have a thought that yuuto may be a trans man? So perhaps he transitioned and presented as a girl on the past?
Superjustinbros
I wonder, if Ryo didn't die, would Keagan find it more easy to move forward?
mathtans
Yuuto's also younger, so maybe Ryo left home at 16 or something and didn't talk about his family.
saetje
Just feels as though the artist is fairly good at drawing anatomy of all sexes, not shying away from lgbt content, and yuuto seems intentionally more slender and androgynous. But it’s just a passing thought/hunch , I could be wrong
mathtans
On the topic of how they met... maybe they met online first? Or through some sort of spiritual connection? That could also explain the difficulty in letting go.
saetje
Yeah it’s also possible he never met Yuuto?
Superjustinbros
What was technology like back when Keagan was younger
I wonder
mathtans
Saeje: Could be, I guess based on some of the Q&A stuff I just see him as a guy with his own style.
Superjustinbros
Cause when I was that age the internet was like, brand new
mathtans
That who never met Yuuto, Keagan or Ryo himself?
saetje
Ah, I tend to skim q&a stuff so it’s possible I missed some key character insights
RebelVampire
dont discount the trans theory. never impossible. and i assume theyre following our time line so internet was probably like it was 16 years ago.
i feel like keagan must of met yuuto tho
just cause yuuto showed up thinking keagan would obviously know him somehow
and if they never met there is no reason for yuuto to assume that
and in all honesty it seems most likely that keagan met ryo through yuuto
just cause yuuto and keagan seem closer in age maybe
mathtans
I guess I just assumed that the "would obviously know" part came from the fact that if you're obsessing over a guy for 15+ years, you'd look into his family. Come to think, maybe they met at the funeral and Keegan simply doesn't recall that.
Assuming that there was a funeral, and it's not a case of Ryo's body vanishing after being murdered by an evil demon that Keagan unleashed upon the world.
saetje
just found this on the 'q&a' section, but might not be canon:(edited)
mathtans
(Oh no, new channel, I can't do my trolling face...)
Superjustinbros
Dawwww!!!
saetje
so I'm probably wrong aaand! I guess they did know each other, but it's just likely Kaegan didn't recognize him right away. I mean his style did change quite a lot
mathtans
Right, I saw that, I guess I didn't immediately think it was an actual photo as much as an artist rendering.
RebelVampire
ah yeah i was just gonna point that image out from the Q&A!
mathtans
Yuuto dyes the hair now.
Superjustinbros
well people do change a lot when they age
mathtans
I wonder if he went into the practice in part because of whatever happened to Ryo.
Maybe it used to be Ryo's thing.
Now gotta pick up the slack in the family.
RebelVampire
yeah to be fair if yuuto and keagan lost contact, of course he probably doesnt recognize yuuto after 16 years old.
Superjustinbros
Exactly
saetje
yeah
RebelVampire
and yuuto is silly in retrospect to expect that. but hard to say what the nature of the relationship was
maybe keagan and yuuto were bestest friends, yuuto introduced keagan to ryo, and then keagan was like "who are you im busy crushing on this cool older fellow"
saetje
It's not improbable they (kaegan and yuuto) were friends first, and Kaegan just crushed real bad on the older brother, which would also make sense why it was so one-sided but they would also be hanging out (as he was probably hanging out with/chaperoning his little brother, and consequently his little brother's friends as well)(edited)
mathtans
Maybe it's something a bit more supernatural. Like, Keagan tried some sort of "forget" spell on Ryo but it backfired so much that he forgot Yuuto instead.
RebelVampire
thatd be tragic, tho would be more likely itd be yuuto doing the spell casting.
albeit to this notion of keagan and yuuto being friends, we dont really see yuuto in the flashbacks so far so its also possible something else was going on. like ryo was keagan's tutor or something
im gonna go out on a limb and suspect that keagan did not have a happy home life
and thus the attachment to ryo cause ryo was an adult who was showing him kindness
mathtans
That's a very good thought.
Interesting how in the bit of flashback we've seen, Ryo is trying to get Keagan to skate on his own, metaphor for life?
Superjustinbros
Oh yea
That would traumatize someone, seeing an adult that they once loved died
RebelVampire
oh ya know what, i wasnt even reading that scene metaphorically. good catch, math~!
metaphorically i certainly is very telling of what keagan is feeling
mathtans
Seems like even back then, before Ryo died, Keagan had issues. Tied in with your unhappy home life thing.
Superjustinbros
^
RebelVampire
but im just taking a stab in the dark tbf. i just feel like theres gotta be more than one-sided crush. and that ryo's death is tied up in personal demons
albeit you could be right that keagan somehow caused ryo's death
mathtans
Keagan introduced the cat, not knowing about the deadly cat allergy.
RebelVampire
has it been stated how ryo died?
mathtans
If so, I missed it.
I just offer up my crazy theories.
RebelVampire
i dont recall either so how ryo died could have a lot to do with things even if keagan didnt cause it
QUESTION 3. The entire plot of the comic is essentially based around one question: will Keagan be able to move on from Ryo? What do you think is holding Keagan back exactly? Is it fear of the future without Ryo, true love, or some sort of inner demon? Do you think Keagan is sincere when he says he has tried to move on, or do you suspect self-sabotage? Even if Keagan gets over Ryo, do you think Ryo will successfully be able to move on? How do you even think Keagan might get over Ryo? Also, what do you think Yuuto and/or Suzy’s role if any might be in helping him move forward? Finally, do you have any theories in general for future events of the comic?
mathtans
I feel like it's one of those things where after you move on, you're worried you'll forget details... which is true enough. But Keagan's got himself so tied up in it that he might forget things about himself. I don't know that it's anything external.
RebelVampire
oh ya know what, i never thought of it from that perspective. that he doesnt want to move on cause hes afraid of all the memories vanishing in the breeze
mathtans
Also, I think Keagan might have tried to move on in the past, but after it didn't work a couple times he just goes through the motions now to appease others around him.
Not just memories of Ryo, but memories of how happy he was back then. Maybe the happiest he'd ever been?
Superjustinbros
Perhaps
Then again it can be hard to move on form something
and even if you do, memories of what happened can still haunt you(edited)
RebelVampire
tbf this makes me reconsider that maybe keagan's attachment is not bred from a bad past, but a lackluster present.
Superjustinbros
That could be the case
RebelVampire
in that maybe keagan has continually had life issues that have made him cling to that happiness
like what does keagan do for a living even O_O maybe he missed out on dat dream job
mathtans
Could be a bit of both.
Maybe he's an insurance salesman.
"Please buy this life insurance... I have this whole story about how sad people will be if you die..."
RebelVampire
spirit insurance. if only yuuto had come to him sooner, yuuto couldve gotten ryo's spirit state ensured. yuuto is gonna miss out on that sweat afterlife policy money now
in regards to keagan's sincerity in trying to move on, i actually think it was subconscious self-sabotage. so in that he was doing everything he was told mentally and physically, but there was that small tiny part of his brain continually whispering how nothing would ever be right again without ryo
mathtans
Which reminds me, I wonder where Yuuto had to go to get the stone.
There probably was some self-sabotage, or at least Ryo seemed keen on calling him on that.
Maybe Yuuto was guided to find the stone by Ryo...? Wait, no, because Ryo didn't even think it would work. We're not sure what any of their day jobs are, are we?
RebelVampire
well yuuto said he was a spirit medium. albeit doesnt mean thats a career technically speaking. idk if being a spirit medium can pay these days without people staring and accusing you of being a fraud. or ya know if you get a reality tv show.
cleary the entire comic is just a tv show hoax so yuuto can become the most prolific spirit medium on tv
mathtans
A spirit medium's rare.
He seems to know what he's doing though. I wonder if Ryo sought him out for that reason, or if it's just a freebie for the family.
Superjustinbros
Now that'd be quite a twist
RebelVampire
that or ryo just had nowhere to go. i mean its like theres much to do as a ghost i imagine
cause you cant touch things or anything
or talk to anyone
you just float around and look at stuff
but considering the cover to chapter 1, i will say that its not just keagan holding ryo back. cause ryo is clearly chained to both yuuto and keagan and i dont think yuuto has quite moved on himself.
mathtans
Oh, that's an interesting point with the visual. Does the chaining work both ways, I wonder, or is it a matter of Yuuto's moved on but is still linked to Ryo out of necessity?
Ghost karaoke might be pretty neat.
Superjustinbros
Poor Ryo :<
For real tho ghost karaoke sounds metal as heck(edited)
mathtans
As far as the future of the comic goes, I figure we'll see the results of a spirit being darkened somehow, either directly or in the history books or something.
RebelVampire
oooooh
did not consider that but i hope thats the case
that we actually get to see a vengeful spirit not ryo
cause i feel like keagan is the type who goes by the mantra seeing is believing
in the sense that yuuto will tell him, keagan will be like "suuuure"
and then vengeful spirit will be seen and keagan will be like "RYO NOOOOOO"
mathtans
"You see this building?" "No." "That's because a ghost KNOCKED IT DOWN." "Ahhhh!" ^.^
Do you think Ryo can see other spirits? Like, would have an idea of what's happening to himself? Or is it not obvious internally?
RebelVampire
idk about seeing other spirits but maybe? i do think ryo has some idea about whats happening to him tho. cause i get the impression that its not so much the spirit ceases to be themselves as it is that they become engulfed in their own emotional vengence and can think of nothing else
mathtans
Ryo: "Look, the ghost of Christmas Future."
RebelVampire
but dont quote me on that, cause theres a lot to be learned about spirits
mathtans
Ooh, emotional vengence is an interesting one... do you think Ryo might hurt Keagan? (And that Keagan would just totally take it?)
RebelVampire
QUESTION 4. Events in the comic come about solely because of the actions of the mysterious Yuuto. Do you believe Yuuto’s motivations are purely to protect his brother’s spirit, or do you think he might be up to something else? How do you think Yuuto wound up becoming a spirit medium? Was it family tradition, a career choice for Yuuto to connect with spirits (and his brother by extension), or was it happenstance? Considering it’s been 16 years, why do you think Yuuto waited so long to come to Keagan? Did Ryo’s spirit only come to Yuuto’s attention recently, or did Yuuto feel no need to take action until Ryo was becoming a vengeful spirit? Additionally, why do you think Ryo has been stable as a spirit over all those years and is only now coming undone? What consequences would there be if Ryo became a vengeful spirit at the end?
RebelVampire
if ryo became of vengful spirit then yes
cause the vengful part implies vengence
and clearly the vengence is gonna be aimed at the ppl not letting you move on
Superjustinbros
Well it's part of the name
mathtans
Could just be aimed at humans in general. Or for that matter, at spirit mediums, maybe that's part of the reason Yuuto's motivated. Doesn't want ghosts messing up his profession.
RebelVampire
could be. it actually would also depend how mindful of vengful spirit is. cause if theyre driven by pure emotion than they might not be consciously able to target their hurt and just lash out at anyone
mathtans
Also, maybe Ryo hasn't been stable as a spirit over all those years? Maybe he was more etherial, and it's only in the last year or so that he's been able to manifest himself to Yuuto.
RebelVampire
that could be
Superjustinbros
Seems like that could be the case, @mathtans
He's never been stable cause he's had someone latching onto him for years
even in death
He can never escape affection
RebelVampire
or ya know, we have no idea how long yuuto has been a medium
maybe yuuto has literally been a medium for all of 2 weeks
and just happens to be smug about it XD
mathtans
He graduated from being a small last year.
Maybe he's not even the most powerful medium in town, just the one most connected? Keagan might seek out others for more information.
I wonder if Ryo can possess people, now that he's levelling up.
saetje
That would be scary
I’m interested to know how like a corrupted ghost like ryo could/will harm those around them
mathtans
Oh! Maybe Keagan is just a prognosticator, because Ryo is going to possess Suzy, and that's why he used the name at the start.
"I have foreseen this."
Superjustinbros
Guess this is gonig further into the idea that this story's gonna get a lot more creepier
mathtans
I think it can still be lighthearted though. In fact, that makes some of the other moments (a la Release Me) all the more eye opening.
Superjustinbros
Yea
good point
RebelVampire
possession would certainly be quite dangerous. though idk how that fulfills vengence. unless the plan is to possess keagan, spend all keagan's money, and then roll out
Superjustinbros
Christ
that's cold
mathtans
"I spent it all on potato chips."
Superjustinbros
I would totally do that
RebelVampire
if im going to assume yuuto is actually also chaining ryo to the mortal plane, i actually want to assume ryo has been around for a while and yuuto himself just didnt want to do anything about it. and was like "nah its fine well get you to move on soon bro lets spend time together." and only now when ryo is going crazy is yuuto like "oops"
but this begs a question suddenly
how the heck did they even know its keagan's fault?
like is there magic ghost senses going on here?
are they just visiting everyone who knew ryo and accusing them?
Superjustinbros
All this time I was thinking "who is this ghost boy just chilling around everyone" until I noticed it's Ryo
mathtans
I suppose I just figured that Ryo would know who was tying him down/thinking of him.
Given the need to have the stone, I don't think they'd be walking around semi-randomly.
I'm also not convinced that Yuuto is tying him down. Maybe he's just acting as an anchor, like, to keep you from getting pulled way over there to the dark places, hold onto a piece of me.
Superjustinbros
I can see that
mathtans
Though it could have morphed into something else over all this time.
Maybe even something neither of them see.
What with both of them wearing glasses.
Superjustinbros
Lol
mathtans
Actually, any comments on art style? I'm very bad for really noticing that stuff. Nice shading though?
Superjustinbros
It's got some good shading, I'll say.
Backgrounds aren't super detailed but that's alright since they're not the focus
https://tapas.io/episode/1089748 Though some of the more trippy ones like these are cool
mathtans
Spirit craziness.
Superjustinbros
Playing with spirits is some really trippy stuff
"What kind of drugs are you taking"
mathtans
That androgynous look that sae brought up is a good point too; I can see it, but Yuuto still comes across as male (and in the genderbend art for q&a as female).
RebelVampire
visually i think the comic stands out most when the tone shifts to the creepy. cause thats when the effects really are A+ and just capture that nice unsettling feel
Superjustinbros
Exactly
saetje
I think the art is pretty good! Artist has a good eye for anatomy, I appreciate the character designs.
I agree the art style is neat when it gets creepy
Superjustinbros
Anatomy especially
Plus the creepy stuff is out of place that it can surprise the viewer when comparing it to the comic's normal art
saetje
Yeah, they vary their body types and really understand anatomy! Very solid character construction
Superjustinbros
Indeed
saetje
Ohh yeah good point Superjustinbros
It sort of gives this vibe of duality
Superjustinbros
Indeed
Like you got a normal world
and a creepy spiritual one
like dimensional rifts between two universes that don 't belong
saetje
Yeah!
mathtans
I liked seeing how some of the character designs shifted in the behind the scenes stuff.
As for my usual shipping thoughts.... hmmm... Suzy and Yuuto? He did feel bad for her. ^.-
saetje
He also seemed to check her out walking up the stairs
RebelVampire
i do hope suzy has a role in this because at the very least i hope she gets her underwear back XD
saetje
Ha! Also bras are expensive so, yeah, definitely.
mathtans
Oh, right! That little whistle.
Superjustinbros
Gotta go for that underwear! XD
saetje
She needs those back
Superjustinbros
Definitely
mathtans
It's interesting that Yuuto has an earring which is an inverted cross too, I think.
Superjustinbros
Well this is the last minute, so I'd like to say good luck to charuchii on continuing the comic.
mathtans
I'm all for more Suzy partly to see if she has some girl friends she talks to as well. Normal people.
Superjustinbros
It was fun chatting~
mathtans
It's a very interesting premise!
RebelVampire
COMIC TEA PARTY- THURSDAY BOOK CLUB END!
Sadly, this wraps up this week’s Thursday Book Club chat for now. Thank you so much to everyone for reading and joining us! We want to give a special thank you to Charu, as well, for making MORBIDITY. If you liked the comic, make sure to support Charu’s efforts however you’re able to~!
Read and Comment: https://tapas.io/series/MORBIDITY
Charu’s Twitter: https://twitter.com/charuchii
Comic Tea Party- Thursday Book Club
Next week’s Thursday Book Club will be about Gemini Journey by Tracy MacLauchlan & Yesenia Carrero. For participants, you have the next week to read as much of the comic as you would like~! We hope to see you on Thursday, September 13th, from 5PM to 7PM PDT for the chat in #thursday_bookclub!
Comic’s Main Site: http://geminijourney.com/
Comic’s LINE Webtoon Mirror: https://www.webtoons.com/en/challenge/gemini-journey/list?title_no=111693
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Sexual Dysfunctions in Women
Overview
A woman's sexuality is a complex interplay of physical and emotional responses that affects the way she thinks and feels about herself. When a woman has a sexual problem, it can impact many aspects of her life, including her personal relationships and her self-esteem. Many women are hesitant to talk about their sexuality with their health care professionals, and many health professionals are reluctant to begin a discussion about sexuality with their patients. Instead, women may needlessly suffer in silence when their problems could be treated. Sexual activity includes a wide variety of intimate activities, such as fondling, self-stimulation, oral sex, vaginal penetration and intercourse. Every woman differs in her sexual interest, response and expression. A woman's feelings about sexuality can change according to the circumstances and stages of her life. Women also can experience a variety of sexual problems, such as lack of desire, difficulty becoming aroused, difficulty having an orgasm or pain during sex. When a physical or emotional problem associated with sex persists, it's time to contact a health care professional. Characteristics of Sexual Arousal: Scientific Research Early Research: Masters & Johnson Research on the sexual response in the mid-1960s by Masters & Johnson established what is known as the traditional linear sexual-response cycle: desire-arousal-orgasm-resolution. The stages are defined as follows: Excitement/Arousal: The feeling that you want to have sex, followed by physical changes that occur in your body as you become sexually excited. These include moistening of the vagina; relaxation of the muscles of the vagina; and swelling of the labia, (skin folds that are part of the vulva), and the clitoris (a small, sensitive organ above the vagina, where the inner labia, which surround the vagina, meet). The nipples also become erect. Plateau: The above changes in the genitals continue, there is an increase in blood flow to the labia, the vagina grows longer, and glands in the labia produce secretions. There is an overall increase in muscle tension. Orgasm: Known as the peak of the sexual response, the muscles of the vagina anduterus contract leading to a strong, pleasurable feeling. Resolution: You return to your normal state. Contemporary Research: Rosemary Basson, MD More contemporary research suggests that a woman's sexual response is both more complex and varied than this model suggests, particularly when the woman is involved in a long-term relationship. In 2002, the leader in this field, Rosemary Basson, MD, introduced a new cycle for the female sexual response that focuses on women's need for intimacy. These differences are important to understanding your sexual health as well as for accurately diagnosing and treating sexual dysfunction. The differences, in part, include recognizing that women's sexual responses are connected more to relationship and intimacy than to physical needs, and that the orgasm stage can be highly variable for women without actually being "dysfunctional." In addition, it's important to distinguish a woman's sexuality and sexual response from a man's. In men, thinking about sex translates to erection, but in women, arousal often comes about after the actual lovemaking begins. In other words, a woman may start out making love with her partner somewhat uninterested, but as things progress and she focuses on the stimulation and sensations she's feeling, she becomes increasingly more aroused. Sexual Dysfunctions in Women Sexual dysfunctions are disturbances in one or more of the sexual response cycle's phases or pain associated with arousal or intercourse. A study published in the Journal of the American Medical Association (JAMA) involving a national sample of 1,749 women estimated that sexual dysfunctions occur in 43 percent of women in the United States. According to this 1999 study, you may be at greater risk for sexual problems if you are: single, divorced, widowed or separated not a high school graduate experiencing emotional or stress-related problems experiencing a decline in your economic position feeling unhappy, or physically and emotionally unsatisfied a victim of sexual abuse or forced sexual contact Causes of Sexual Dysfunctions There are several types of sexual dysfunctions. They can be lifelong problems that have always been present, acquired problems that develop after a period of normal sexual function or situational problems that develop only under certain circumstances or with certain partners. Causes of sexual dysfunctions can be psychological, physical or related to interpersonal relationships or sociocultural influences. Psychological causes can include: stress from work or family responsibilities concern about sexual performance depression/anxiety unresolved sexual orientation issues previous traumatic sexual or physical experience body image and self-esteem problems Physical causes can include: diabetes heart disease liver disease kidney disease pelvic surgery pelvic injury or trauma neurological disorders medication side effects hormonal changes, including those related to pregnancy and menopause thyroid disease alcohol or drug abuse fatigue Interpersonal relationship causes may include: partner performance and technique lack of a partner relationship quality and conflict lack of privacy Sociocultural influence causes may include: inadequate education conflict with religious, personal, or family values societal taboos Types of Sexual Dysfunctions Lack of sexual desire is the most common sexual problem in women. The Association of Reproductive Health Professionals reports in the National Health and Social Life Survey that 33 percent of women lacked interest in sex for at least a few months in the previous year. The American College of Obstetricians and Gynecologists (ACOG) reports that a woman's sexual response tends to peak in her mid-30s to early 40s. That's not to say, however, that a woman can't have a full physical and emotional response to sex throughout her life. Most women will have a passing sexual problem at some point in their lives, and that is normal. However, sexual dysfunction in its true sense is most common in women aged 45 to 64. Often, sexual desire is affected by a woman's relationship with her sexual partner. The more a woman enjoys the relationship, the greater her desire for sex. The stresses of daily living can affect desire, however, and occasionally feeling uninterested in sex is no cause for concern. Hypoactive Sexual Desire Disorder: When sexual fantasies or thoughts and desire for sexual activity are persistently reduced or absent causing distress or relationship difficulties, the problem is known as hypoactive sexual desire disorder, or inhibited sexual desire disorder. The Merck Manual estimates hypoactive sexual desire disorder occurs in about 20 percent of women. Sexual aversion disorder: Diagnosed when you avoid all or almost all genital sexual contact with a sexual partner to the point that it causes personal distress and relationship difficulties. This condition may affect women who have experienced some type of sexual abuse or who grew up in a rigid atmosphere in which sex was taboo. A study in the journal Archives of Sexual Behavior found that among patients with panic disorder, 75 percent had sexual problems, and that sexual aversion disorder was the most common complaint, affecting 50 percent of women with the disorder. Sexual arousal disorder: The persistent or recurrent inability to reach or sustain the lubrication and swelling reaction in the arousal phase of the sexual response to the point that it causes personal distress. It is the second most common sexual problem among women, affecting an estimated 20 percent of women, and most frequently occurs in postmenopausal women. Low estrogen levels after menopause can make vaginal tissue dry and thin and reduce blood flow to genitals. As a result, the arousal phase of the sexual response may take longer and sensitivity of the vaginal area may decline. However, this can happen at any age. Female orgasmic disorder: The persistent absence or recurrent delay in orgasm after sufficient stimulation and arousal, causing personal distress. According to the Association of Reproductive Health Professionals, 24 to 37 percent of women have problems reaching orgasm. Most women are biologically able to experience orgasm. Never having an orgasm, or not having one in certain situations, are problems that can often be resolved by learning how the female body responds, how to ensure adequate stimulation and/or how to overcome inhibitions or anxieties. Some medications, including but not limited to those used to treat highblood pressure, depression and psychosis, can reduce your sexual desire and sexual arousal and interfere with orgasm. If you are taking such drugs and experiencing sexual side effects, talk with your health care professional about changing your dosage or prescription. Another type of sexual arousal disorder has the opposite effect. Some women may always feel sexually aroused, an experience that can be quite uncomfortable and upsetting. Although most health care professionals recognize hyperactive sexual desire as a problem, it is not an official condition according to the DMS-IV. Women who have a hyperactive sexual drive tend to be very demanding sexually because their desire for sex is constant. Sexual Disorders Involving Pain Dyspareunia: Pain during or after intercourse, called dyspareunia, occurs in nearly two out of three women at some time during their lives, according to ACOG. Like other sexual disorders, it can have physical and/or emotional causes. The most common cause of pain during sex is inadequate vaginal lubrication occurring from a lack of arousal, medications or hormonal changes. Painful sex also can be a sign of illness, infection, cysts or tumors requiring medical treatment or surgery, another reason why you should discuss the problem with your health care professional. Vaginismus: The involuntary spasm of the muscles at the opening of the vagina, making anything entering the vagina painful. Vaginismus can have medical causes, including: scars in the vagina from an injury, childbirth or surgery irritations from douches, spermicides or latex in condoms pelvic infections Vaginismus also can have psychological causes. It can be a response to a fear, such as fear of losing control or fear of pregnancy. It can also stem from pain or trauma such as rape or sexual abuse. Vulvodynia: Defined as any pain in the vulva. It could be outside the vulva on the labia or an itching, burning or sharp pain within. Treating Sexual Dysfunctions If your relationship or sexual problem is new, try having an open, honest talk with your partner to relieve concerns and clear up disagreements or conflicts. Women who learn to tell their partners about their sexual needs and concerns have a better chance at a more satisfying sex life. If the sexual problem persists, discuss your concerns with your health care professional. Most sexual problems can be treated. Diagnosis If you're having sexual problems, your health care professional will try to rule out medical causes first by conducting a thorough medical history and exam, including a pelvic exam and blood tests. If there is no physical or biological cause, you may be referred for psychological counseling. Askfor a referral to a sex therapist. These specialists are trained to provide the type of therapy you need and, with your input, make a diagnosis and recommend treatment. When possible, your partner should be included in this therapy with you. To find a certified, trained sex therapist contact the American Association of Sexuality Educators, Counselors and Therapists at http://www.aasect.org. Be sure to tell your health care professional if you have any of the following conditions that can have a significant impact on sexual functioning, both physically and psychologically: Chronic illness, such as diabetes and heart, kidney or liver diseaseThese conditions can lead to nerve damage and affect blood flow to the pelvic organs, affecting arousal and decreasing vaginal lubrication. Additionally, having a lifelong illness can hurt a woman's self-image and make her feel less sexual, affecting desire. CancerRadiation treatment, as well as certain medications used to treat cancer, may result in lubrication problems, and, in turn, painful sex. Anti-estrogen hormonal medications for breast cancer or drugs used to prevent recurrence of breast cancer, such as tamoxifen (Nolvadex), may also produce low desire, vaginal dryness and difficulties with vaginal penetration. Chemotherapy for cancer can affect many physical functions and responses, including sexual desire and arousal. Additionally, cancer treatment can produce fatigue, decreased self-esteem, fear of death, disfigurement and/or rejection that can affect a woman's sexual feelings. PregnancyWomen differ in their sexual activity patterns during pregnancy. Some curb their activity in the first three months and again near the end of pregnancy when physical discomfort can lead to decreased desire. Some have an increase in activity when the initial discomfort wanes. Generally, however, sexual activity doesn't have to stop because of pregnancy. Sex won't hurt the fetus. However, if you are at risk for a preterm birth, your health care professional may advise against sex during pregnancy.Some pregnant women find sexual interest decreases steadily over the course of the pregnancy. After the baby is born, changing hormone levels, fatigue and/or a healing episiotomy may lead to reduced sexual desire. Additionally, it is common for women who breastfeed to notice a lack of vaginal lubrication. This is caused by high levels of the hormone prolactin, which is stimulated by nursing. Also, as prolactin increases, testosterone, a hormone that contributes to sexual desire, decreases, another reason for declining sexual desire. MenopauseLow estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to the genital area and reduced vaginal sensitivity that may contribute to arousal and, in turn, orgasm problems. Postmenopausal women often find that the arousal phase of the sexual response cycle takes longer or is less intense. Changing hormone levels also can produce mood swings that make some women nearing menopause feel less interested in sex. Substance abuseAlcohol affects the arousal states and inhibits orgasm. Chronic alcohol use reduces desire. Abusing drugs, especially narcotics such as morphine, codeine and heroin, impairs sexual function and reduces desire. If you are having a sexual problem, make sure you tell your health care professional about any medications you're taking. Blood pressure medications, antipsychotics and antidepressants are commonly prescribed drugs that can interfere with the sexual response. Selective serotonin reuptake inhibitors (SSRI) such as paroxetine (Paxil) and fluoxetine (Prozac) frequently produce side effects that inhibit or prevent orgasm. Other antidepressants can affect sexual function as well, including tricyclic antidepressants such as imipramine (Tofranil) and clomipramine (Anafranil), monoamine oxidase inhibitors such as phenelzine (Nardil) and mixed antidepressants such as venlafaxine (Effexor). Anticonvulsants for seizures also can cause sexual problems. A change in dosage or medication may help resolve your sexual problem. If you have pain associated with sexual activity, it's important to accurately describe where the pain is located so your health care professional can determine its cause. The types of pain associated with sex include: Vulvar painThis type of pain is felt on the outside of the vagina and often occurs when some part of the vulva is touched. It can be caused by irritation from soaps, feminine hygiene sprays or douches, scars, cysts or infections. Vaginal painThis type of pain is felt inside the vagina. The most common cause is a lack of lubrication from inadequate arousal, medications, medical conditions, pregnancy, breastfeeding or menopause. Vaginal pain also can be caused by an inflammation of the vagina, known as vaginitis. Additional symptoms of vaginitis are a vaginal discharge, itching and burning of the vagina and vulva. It can be caused by a yeast or bacterial infection or a sexually transmitted disease.Vaginal pain also can be caused by vaginismus. This pain occurs when anything attempts to enter the vagina, including tampons or even during a pelvic examination. It can be caused by irritation from douches, spermicides or latex in condoms, infections, scars from an injury, childbirth, surgery or psychological problems from sexual trauma or abuse. Deep painPain that is felt deep inside the vagina, lower back, pelvic area, uterus or bladder can be a sign of an internal medical problem. It can be caused by: pelvic inflammatory disease endometriosis, a condition in which the tissue that lines the uterus grows outside the uterus pelvic tumor bowel or bladder disease, such as interstitial cystitis scar tissue ovarian cysts If you are experiencing deep pain during sex, your health care professional may recommend a variety of tests including but not limited to blood tests, urine tests and scans to check for possible causes. Treatment Treatment for sexual dysfunction depends on the cause of the problem. If the cause is physical, medical treatment is aimed at correcting the underlying disorder. If the cause is psychological, treatment consists of counseling. Treatment can include a combination of medical and psychological approaches. Sometimes, treatment may be behavioral. For example, with loss of desire, changes in the environment, timing, lovemaking techniques or foreplay can produce desire. With arousal disorder, the use of toys and vibrators can help with vaginal circulation. A warm bath and a massage from your partner can also help. Medical Treatment Lubricating creams, gels or suppositoriesIf you are suffering from vaginal dryness caused by medications, a chronic condition or declining estrogen levels, your health care professional may suggest water-based, over-the counter vaginal lubricants such as Astroglide or K-Y Jelly to make sex more comfortable. Or you might try Replens, a long-acting vaginal moisturizer that releases purified water to produce a moist film over the vaginal tissue. Do not use oil-based products, such as petroleum jelly, baby oil or mineral oil with latex condoms because they can cause a condom to break. Topical estrogenFor menopausal women with vaginal thinning, dryness or insensitivity, your health care professional may prescribe an estrogen cream such as Estrace or Premarin, or a vaginal ring, such as Estring, Phadia (low-dose) or Femring (higher dose), to ease sexual discomfort. And a vaginal tablet (Vagifem) containing estradiol, a type of estrogen, is available by prescription for vaginal dryness. Unlike creams, which usually are used at night, Vagifem can be inserted any time of day. Hormone therapyFor menopausal women, hormone therapy (either a combination of estrogen and progestin or estrogen-only therapy) may improve the sensitivity of the clitoris, ease discomfort caused by vaginal thinning and dryness and improve blood flow to the pelvic area. In addition, hormone therapy (HT) can help relieve other bothersome menopausal symptoms, including hot flashes, which can interfere with intimacy. A woman should not take any form of HT until she has weighed the pros and cons and discussed the risks and benefits with her doctor. Because of the potential risks that go along with HT, the U.S. Food and Drug Administration (FDA) now advises health care professionals to prescribe it at the lowest possible dose and for the shortest possible length of time to achieve treatment goals.Although HT can result in increased sensitivity and decreased discomfort during sex for menopausal women, the therapy may not improve sexual desire. Some health care professionals add testosterone, a hormone produced by the ovaries and adrenal glands that plays a role in sexual desire, to HT to stimulate sexual arousal. Treatment with testosterone is controversial, however. Estratest, an estrogen/testosterone combination, is currently the only testosterone treatment available. However, there is conflicting evidence and opinion in the medical community concerning whether or not the benefits of the drug outweigh the risks, which include increased risk of breast and endometrial cancer, adverse effects on blood cholesterol and liver toxicity. Studies on other androgen products used to treat sexual dysfunction have also had mixed results.Although there is no FDA-approved form of testosterone available to treat women's sexual dysfunction, many doctors prescribe it "off label" in small amounts, particularly for women whose ovaries have been removed. Removing the ovaries drastically reduces testosterone levels, and some research shows that women who have had their ovaries removed are most likely to benefit from androgen therapy.Supplementing with testosterone has potential risks. In too high a dose, testosterone can produce masculinizing effects, such as increased facial hair and enlargement of the clitoris. The oral form can also produce liver damage, acne and a decrease in HDL cholesterol (the "good" cholesterol). The use of testosterone in men and women is highly controversial, so be sure to discuss with your health care professional whether androgen supplementation is right for you. Clitoral therapy device The Eros Clitoral Therapy device is an FDA-approved device designed to treat female sexual arousal disorder. It consists of a small, soft suction cup attached to a palm-sized, battery-operated vacuum pump. The suction cup is placed over the clitoris before sex. The gentle vacuum increases genital blood flow, thus increasing sexual arousal and enhancing orgasm. Studies have shown that the Eros Clitoral Therapy device effectively boosts sensation, orgasms, lubrication and overall sexual satisfaction. The device is available by prescription. Vaginal weights Women with orgasmic disorders may benefit from treatment with vaginal weights. Vaginal weights are used to strengthen the pelvic floor muscles, improving awareness of sexual response and also potentially correcting urine leakage, which can cause problems during sexual activity. Vaginal weights are usually available in sets of five. To use them, you insert the lightest weight and remain upright for 15 minutes, two times a day. When the weight is in place, you should feel the urge to hold it in. After a few days, as the muscles strengthen, this urge will go away, and you will be able to move up to the next weight. When you get to the fifth weight, you will insert it for five to seven consecutive days each month to maintain strength in your pelvic muscles. Sildenafil (Viagra) The drug that treats erectile dysfunction in men is also being studied in clinical trials for female sexual arousal disorder. Some studies have found it may increase blood flow to the female genital area and increase relaxation of clitoral and vaginal muscles. However, several large placebo-controlled studies including about 3,000 women with female sexual arousal disorder had inconclusive results. Therefore, the manufacturer of Viagra has decided not to seek FDA approval to use the drug for female sexual arousal disorder. Other Medical Approaches Better control of chronic diseases, switching prescriptions to reduce side effects and treating vaginal infections by taking antibiotics can eliminate sexual problems related to desire, arousal, orgasm and pain. On very rare occasions, surgery may be needed to remove structural problems, such as cysts, tumors or growths that produce pain during sex. Psychological Treatment Psychological treatment for sexual dysfunction usually involves a series of steps identifying and modifying emotions and behaviors that interfere with sexual response, changing behaviors that act as barriers to sexual responsiveness and learning new physical and emotional behaviors that encourage sexual responsiveness. Sex therapy is talk therapy in which you and your counselor, along with your partner, discuss problems, how and why they occur and ways to solve them. You and your partner receive exercises and techniques to try at home, then report on the results at the following session. Depending on your needs, goals and diagnosis, such counseling typically can involve a one-hour session once a week for about two to six months. Poor communication between partners is often present with sexual dysfunction. Learning to communicate, resolving conflict and dealing with negative emotions are the focus of therapy designed to address this issue. Group therapy or support groups also may be recommended. Behavioral changes may also help. These include: changes in the environment, love making at different times of the day, warm baths, masturbation, massage and the use of sexual toys and vibrators. Sensate focus exercises are often recommended by therapists to treat sexual arousal disorder and orgasm disorder. These exercises help you and your partner relate to each other physically without any pressure to perform sexually. You begin by touching each other, slowly progressing to genital stimulation and possibly eventually proceeding to intercourse. Learning the functions of sexual organs and how the body responds sexually, including clitoral and vaginal stimulation, can help with arousal and orgasm disorders. Kegel exercises can strengthen voluntary control of pelvic muscles, improving the sense of control and quality of orgasms. Treatment for vaginismus (involuntary spasm of the muscles at the vaginal opening) may focus on techniques to relax the vagina. One option is using dilators in graduated sizes that are placed into the vagina and kept in place for 10 minutes. The woman usually places the dilators herself. Performing Kegel exercises while the dilator is in place helps you learn to control your vaginal muscles. The exercises also can be done with your fingers. Sometimes, waiting for the muscle to relax after penetration may help. FSD Research Research is progressing on a couple of drugs aimed at helping women with sexual problems. At a recent meeting of the International Society for the Study of Women's Sexual Health, a study was released on bremelanotide, a drug undergoing trials for treatment of female sexual dysfunction (FSD). In the trials, the drug was well-tolerated and increased arousal, desire and the number of sexually satisfying events in women with hypoactive sexual desire disorder (HSDD) and women with both HSDD and female sexual arousal disorder. The final phase of testing could start near the end of this year. Another drug that is being studied for possible treatment of overall sexual function is tibolone. It is a synthetic steroid currently used in Europe and Australia to treat postmenopausal osteoporosis, but, in one study, it was also shown to enhance sexual function in postmenopausal women. It has not been approved for use in the United States because of concerns over increased risk of breast cancer and stroke. Studies also are looking at the effectiveness of phosphodiesterase inhibitors, the class of drugs that includes sildenafil (Viagra). So far, results show little effectiveness in treating FSD, but these drugs may help women who experience sexual dysfunction as the result of taking certain antidepressants. However, sildenafil should not be taken by anyone using nitroglycerin for angina. Prevention A healthy lifestyle can go a long way toward preventing chronic illnesses and diseases that can contribute to sexual dysfunction. Eating a balanced diet, getting plenty of exercise, stopping smoking, limiting alcohol consumption and controlling stress will help you feel well, build a healthy self-image, boost your energy and help you maintain confidence in your sexuality. Visit your health care professional regularly to avoid medical problems that may affect your sexual responses. Other things you can do to enhance your sexual desire and pleasure include: Communicate with your partnerEmotional intimacy is the essential beginning for sexual intimacy for many women. Talk frankly and honestly about your feelings with your partner to help build your relationship. Silence can result in repressed feelings, anger and alienation that can harm your well-being and even your long-term mental and physical health. Express your desiresTell your partner what you want sexually and what "turns you on," and guide your partner to do those things that please you. Be less predictable and more spontaneous in your sexual experiencesPartners who have been together for years can get into patterns in which sex is always the same. Try new ways to be intimate, and prolong your sexual experience by being more creative with touching, positions, timing and location of sexual activities. Examine your prioritiesDon't let work or family responsibilities take time away from your relationship with your partner. Spending time together is part of building intimacy and helps both partners feel connected to each other. Stay sexually active after menopauseRegular sexual activity, with a partner or through self-stimulation, can improve vaginal lubrication and elasticity as estrogen levels decline. Sexuality is highly personal and varies from woman to woman. A woman's sexual responses can vary from one time to another, and no one pattern is more "normal" than another. Nearly everyone has a problem with sex at some time in their lives, and often the problem can be worked out with patience and talking with your partner. When the problem is life-disrupting, causes trouble in your relationships or involves physical pain, it's time to talk with your health care professional. In many cases, your sexual problem can be treated with medical treatments, psychological therapy or both. Facts to Know Sexual problems occur in 43 percent of women in the United States, according to a study published in 1999 in the Journal of the American Medical Association. A lack of desire is the most common sexual problem in women The Association of Reproductive Health Professionals reports that in the National Health and Social Life Survey, 33 percent of women lacked interest in sex for at least a few months in the previous year. Sexual arousal disorder is the second most common sexual problem among women, affecting an estimated 20 percent of women. Twenty-four to 37 percent of women have problems reaching orgasm, according to the Association of Reproductive Health Professionals. Pain during or after intercourse occurs in nearly two out of three women at some time during their lives, according to the American College of Obstetricians and Gynecologists. Low estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to genital areas and reduced vaginal sensitivity that can contribute to arousal and, in turn, orgasm problems. Low androgen levels may contribute to desire problems. Hormone therapy often can help. The most common cause of pain during sex is inadequate vaginal lubrication, which can occur from a lack of arousal, medications or hormonal changes. It is common for women who breast-feed to notice a lack of vaginal lubrication and sexual interest caused by an elevation of the hormone prolactin, which is stimulated by lactation. Sexual disorders can have medical causes, psychological causes or both. One way women can help prevent sexual dysfunction is to have sex frequently. Sexual activity increases blood flow, which leads to better overall sexual function. Key Q&A What is the sexual response cycle?Masters & Johnson, pioneering sex therapists, defined a classic sexual response cycle in the mid-1960s. The stages of this model are: Excitement/Arousal: The feeling that you want to have sex followed by physical changes that occur in your body as you become sexually excited. These include moistening of the vagina, relaxation of the muscles of the vagina; swelling of the labia, (skin folds that are part of the vulva) and the clitoris (a small, sensitive organ above the vagina, where the inner labia, which surrounds the vagina, meet that acts as a source of sexual excitement). The nipples also become erect. Plateau: The above changes in the genitals continue, there is an increase in blood flow to the labia, the vagina grows longer, and glands in the labia produce secretions. There is an increase in muscle tension. Orgasm: Known as the peak of the sexual response, the muscles of the vagina and uterus contract leading to a strong, pleasurable feeling. Resolution: You return to your normal state. However, it's important to point out that more contemporary research suggests that women's sexual response is more complex and includes more elements than the traditional model outlines. Relationship and intimacy needs appear to play a greater role in women's sexual health. According to sexual health experts, a better understanding of the complexity of women's sexuality will help to more accurately diagnose and treat sexual dysfunction. How do I know if I have sexual dysfunction?Sexual dysfunctions are defined as one or more disturbances in the sexual response cycle, or pain associated with arousal or intercourse. Lack of desire, difficulty becoming aroused, lack or delay in orgasm or pain during or after sex are all examples of sexual problems faced by women. Such problems can be occasional and seem to go away on their own. But when they are persistent or recurrent, disrupting your life or your relationships and causing you emotional upset, they may be dysfunctions that should be discussed with your health care professional. What causes sexual dysfunctions?Causes of sexual dysfunctions can be physical, psychological or related to interpersonal relationships or sociocultural influences. Psychological causes can include: stress or anxiety from work or family responsibilities concern about sexual performance conflicts in the relationship with your partner depression unresolved sexual orientation issues previous traumatic sexual experience body image and self-esteem problems Physical causes can include: diabetes heart disease liver disease kidney disease pelvic surgery pelvic injury or trauma neurological disorders medication side effects hormonal changes, including those related to pregnancy and menopause thyroid disease alcohol or drug abuse How are sexual dysfunctions treated?Treatment depends on the cause. If the cause is physical, the treatment will be aimed at correcting the medical or biological problem. For example, if the cause is hormonal imbalance, hormonal supplements may be prescribed. If the cause is a structural problem, such as a cyst or tumor, surgery may be needed. Sometimes, treatment can involve changes in behavior. Better control of chronic illnesses and disease often solves sexual problems associated with them.Some medications can cause sexual problems, and changing prescriptions to those with fewer side effects can treat the problem. Regardless of the cause, counseling, ideally with a sexual therapist, is recommended and should include both partners together. Treatment can include both treating the physical or medical problem and counseling. I just don't feel like having sex anymore. Is there something wrong with me?Lack of desire is the most common sexual problem in women. It can be caused by problems in a woman's relationship with her partner, stress, fatigue, medications and low levels of the hormones estrogen or androgen. Often, lack of desire is affected by a woman's relationship with her sexual partner. The more a woman enjoys the relationship, the greater the desire for sex.The stresses of daily living can affect desire, and occasionally feeling uninterested in sex is no cause for concern. But, when sexual fantasies or thoughts and desire for sexual activity are persistently or recurrently reduced or absent and cause distress or interpersonal difficulties, the problem is known as hypoactive sexual desire disorder or inhibited sexual desire disorder.If you are approaching menopause (a time frame, typically in a woman's mid- to late 40s, known as perimenopause) or have reached menopause, declining estrogen levels can cause vaginal lubrication problems that make sex uncomfortable, and, as a result, less desirable to you. Changing hormone levels during and after pregnancy can also contribute to decreases in sexual desire. Talk with your health care professional about your problem and what treatment may be best for you. Does menopause mean the end of my sex life?No. Many women find the end of their reproductive years sexually invigorating because they no longer face the risk of pregnancy. Plus, regular sexual activity for postmenopausal women improves vaginal lubrication and elasticity after estrogen declines. However, menopause can bring bodily changes that contribute to arousal problems, and in turn, orgasm problems. Low estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to the genital area and reduced vaginal sensitivity. Postmenopausal women often find the arousal phase of the sexual response cycle takes longer or is less intense.Changing hormone levels also can produce mood swings and emotional upsets that make some women nearing menopause feel less interested in sex. Hormone replacement therapy relieves these symptoms for many perimenopausal women. Using over-the-counter vaginal lubricants may help with dryness problems. Discuss your treatment options with your health care professional, particularly the latest research regarding the safety of HT and ET and how the risks and benefits affect your personal health needs. I have pain during intercourse. Should I see my health care professional about it?Yes, especially if the pain is felt deep inside the vagina, lower back, pelvis, uterus or bladder. Pain associated with sexual activity can be a sign of a medical problem that needs treatment. Deep pain can be a sign of pelvic inflammatory disease, endometriosis, a pelvic tumor, ovarian cysts, bowel or bladder disease or scar tissue.Pain felt in the vagina can be caused by inflammation from an infection or sexually transmitted disease, but it is most commonly caused by lack of vaginal lubrication. Pain felt at the opening of the vagina can be a sign of infection, cysts or scarring. Such vulvar pain also can be caused by irritation from soaps or feminine hygiene products. What kinds of medications can cause sexual problems?Blood pressure, antipsychotic and certain antidepressant medications are commonly prescribed drugs that can interfere with the sexual response. Birth control pills change your hormone levels and can cause a decrease in desire or vaginal dryness. Anti-estrogen hormonal medications for breast cancer or drugs used to prevent recurrence of breast cancer, such as tamoxifen (Nolvadex), also can produce vaginal dryness and difficulties with vaginal penetration. Chemotherapy for cancer can impair many bodily functions and responses, including sexual desire and arousal. Anti-convulsants for seizures also can cause sexual problems. Read the full article
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Sexual Dysfunctions in Women
Overview
A woman's sexuality is a complex interplay of physical and emotional responses that affects the way she thinks and feels about herself. When a woman has a sexual problem, it can impact many aspects of her life, including her personal relationships and her self-esteem. Many women are hesitant to talk about their sexuality with their health care professionals, and many health professionals are reluctant to begin a discussion about sexuality with their patients. Instead, women may needlessly suffer in silence when their problems could be treated. Sexual activity includes a wide variety of intimate activities, such as fondling, self-stimulation, oral sex, vaginal penetration and intercourse. Every woman differs in her sexual interest, response and expression. A woman's feelings about sexuality can change according to the circumstances and stages of her life. Women also can experience a variety of sexual problems, such as lack of desire, difficulty becoming aroused, difficulty having an orgasm or pain during sex. When a physical or emotional problem associated with sex persists, it's time to contact a health care professional. Characteristics of Sexual Arousal: Scientific Research Early Research: Masters & Johnson Research on the sexual response in the mid-1960s by Masters & Johnson established what is known as the traditional linear sexual-response cycle: desire-arousal-orgasm-resolution. The stages are defined as follows: Excitement/Arousal: The feeling that you want to have sex, followed by physical changes that occur in your body as you become sexually excited. These include moistening of the vagina; relaxation of the muscles of the vagina; and swelling of the labia, (skin folds that are part of the vulva), and the clitoris (a small, sensitive organ above the vagina, where the inner labia, which surround the vagina, meet). The nipples also become erect. Plateau: The above changes in the genitals continue, there is an increase in blood flow to the labia, the vagina grows longer, and glands in the labia produce secretions. There is an overall increase in muscle tension. Orgasm: Known as the peak of the sexual response, the muscles of the vagina anduterus contract leading to a strong, pleasurable feeling. Resolution: You return to your normal state. Contemporary Research: Rosemary Basson, MD More contemporary research suggests that a woman's sexual response is both more complex and varied than this model suggests, particularly when the woman is involved in a long-term relationship. In 2002, the leader in this field, Rosemary Basson, MD, introduced a new cycle for the female sexual response that focuses on women's need for intimacy. These differences are important to understanding your sexual health as well as for accurately diagnosing and treating sexual dysfunction. The differences, in part, include recognizing that women's sexual responses are connected more to relationship and intimacy than to physical needs, and that the orgasm stage can be highly variable for women without actually being "dysfunctional." In addition, it's important to distinguish a woman's sexuality and sexual response from a man's. In men, thinking about sex translates to erection, but in women, arousal often comes about after the actual lovemaking begins. In other words, a woman may start out making love with her partner somewhat uninterested, but as things progress and she focuses on the stimulation and sensations she's feeling, she becomes increasingly more aroused. Sexual Dysfunctions in Women Sexual dysfunctions are disturbances in one or more of the sexual response cycle's phases or pain associated with arousal or intercourse. A study published in the Journal of the American Medical Association (JAMA) involving a national sample of 1,749 women estimated that sexual dysfunctions occur in 43 percent of women in the United States. According to this 1999 study, you may be at greater risk for sexual problems if you are: single, divorced, widowed or separated not a high school graduate experiencing emotional or stress-related problems experiencing a decline in your economic position feeling unhappy, or physically and emotionally unsatisfied a victim of sexual abuse or forced sexual contact Causes of Sexual Dysfunctions There are several types of sexual dysfunctions. They can be lifelong problems that have always been present, acquired problems that develop after a period of normal sexual function or situational problems that develop only under certain circumstances or with certain partners. Causes of sexual dysfunctions can be psychological, physical or related to interpersonal relationships or sociocultural influences. Psychological causes can include: stress from work or family responsibilities concern about sexual performance depression/anxiety unresolved sexual orientation issues previous traumatic sexual or physical experience body image and self-esteem problems Physical causes can include: diabetes heart disease liver disease kidney disease pelvic surgery pelvic injury or trauma neurological disorders medication side effects hormonal changes, including those related to pregnancy and menopause thyroid disease alcohol or drug abuse fatigue Interpersonal relationship causes may include: partner performance and technique lack of a partner relationship quality and conflict lack of privacy Sociocultural influence causes may include: inadequate education conflict with religious, personal, or family values societal taboos Types of Sexual Dysfunctions Lack of sexual desire is the most common sexual problem in women. The Association of Reproductive Health Professionals reports in the National Health and Social Life Survey that 33 percent of women lacked interest in sex for at least a few months in the previous year. The American College of Obstetricians and Gynecologists (ACOG) reports that a woman's sexual response tends to peak in her mid-30s to early 40s. That's not to say, however, that a woman can't have a full physical and emotional response to sex throughout her life. Most women will have a passing sexual problem at some point in their lives, and that is normal. However, sexual dysfunction in its true sense is most common in women aged 45 to 64. Often, sexual desire is affected by a woman's relationship with her sexual partner. The more a woman enjoys the relationship, the greater her desire for sex. The stresses of daily living can affect desire, however, and occasionally feeling uninterested in sex is no cause for concern. Hypoactive Sexual Desire Disorder: When sexual fantasies or thoughts and desire for sexual activity are persistently reduced or absent causing distress or relationship difficulties, the problem is known as hypoactive sexual desire disorder, or inhibited sexual desire disorder. The Merck Manual estimates hypoactive sexual desire disorder occurs in about 20 percent of women. Sexual aversion disorder: Diagnosed when you avoid all or almost all genital sexual contact with a sexual partner to the point that it causes personal distress and relationship difficulties. This condition may affect women who have experienced some type of sexual abuse or who grew up in a rigid atmosphere in which sex was taboo. A study in the journal Archives of Sexual Behavior found that among patients with panic disorder, 75 percent had sexual problems, and that sexual aversion disorder was the most common complaint, affecting 50 percent of women with the disorder. Sexual arousal disorder: The persistent or recurrent inability to reach or sustain the lubrication and swelling reaction in the arousal phase of the sexual response to the point that it causes personal distress. It is the second most common sexual problem among women, affecting an estimated 20 percent of women, and most frequently occurs in postmenopausal women. Low estrogen levels after menopause can make vaginal tissue dry and thin and reduce blood flow to genitals. As a result, the arousal phase of the sexual response may take longer and sensitivity of the vaginal area may decline. However, this can happen at any age. Female orgasmic disorder: The persistent absence or recurrent delay in orgasm after sufficient stimulation and arousal, causing personal distress. According to the Association of Reproductive Health Professionals, 24 to 37 percent of women have problems reaching orgasm. Most women are biologically able to experience orgasm. Never having an orgasm, or not having one in certain situations, are problems that can often be resolved by learning how the female body responds, how to ensure adequate stimulation and/or how to overcome inhibitions or anxieties. Some medications, including but not limited to those used to treat highblood pressure, depression and psychosis, can reduce your sexual desire and sexual arousal and interfere with orgasm. If you are taking such drugs and experiencing sexual side effects, talk with your health care professional about changing your dosage or prescription. Another type of sexual arousal disorder has the opposite effect. Some women may always feel sexually aroused, an experience that can be quite uncomfortable and upsetting. Although most health care professionals recognize hyperactive sexual desire as a problem, it is not an official condition according to the DMS-IV. Women who have a hyperactive sexual drive tend to be very demanding sexually because their desire for sex is constant. Sexual Disorders Involving Pain Dyspareunia: Pain during or after intercourse, called dyspareunia, occurs in nearly two out of three women at some time during their lives, according to ACOG. Like other sexual disorders, it can have physical and/or emotional causes. The most common cause of pain during sex is inadequate vaginal lubrication occurring from a lack of arousal, medications or hormonal changes. Painful sex also can be a sign of illness, infection, cysts or tumors requiring medical treatment or surgery, another reason why you should discuss the problem with your health care professional. Vaginismus: The involuntary spasm of the muscles at the opening of the vagina, making anything entering the vagina painful. Vaginismus can have medical causes, including: scars in the vagina from an injury, childbirth or surgery irritations from douches, spermicides or latex in condoms pelvic infections Vaginismus also can have psychological causes. It can be a response to a fear, such as fear of losing control or fear of pregnancy. It can also stem from pain or trauma such as rape or sexual abuse. Vulvodynia: Defined as any pain in the vulva. It could be outside the vulva on the labia or an itching, burning or sharp pain within. Treating Sexual Dysfunctions If your relationship or sexual problem is new, try having an open, honest talk with your partner to relieve concerns and clear up disagreements or conflicts. Women who learn to tell their partners about their sexual needs and concerns have a better chance at a more satisfying sex life. If the sexual problem persists, discuss your concerns with your health care professional. Most sexual problems can be treated. Diagnosis If you're having sexual problems, your health care professional will try to rule out medical causes first by conducting a thorough medical history and exam, including a pelvic exam and blood tests. If there is no physical or biological cause, you may be referred for psychological counseling. Askfor a referral to a sex therapist. These specialists are trained to provide the type of therapy you need and, with your input, make a diagnosis and recommend treatment. When possible, your partner should be included in this therapy with you. To find a certified, trained sex therapist contact the American Association of Sexuality Educators, Counselors and Therapists at http://www.aasect.org. Be sure to tell your health care professional if you have any of the following conditions that can have a significant impact on sexual functioning, both physically and psychologically: Chronic illness, such as diabetes and heart, kidney or liver diseaseThese conditions can lead to nerve damage and affect blood flow to the pelvic organs, affecting arousal and decreasing vaginal lubrication. Additionally, having a lifelong illness can hurt a woman's self-image and make her feel less sexual, affecting desire. CancerRadiation treatment, as well as certain medications used to treat cancer, may result in lubrication problems, and, in turn, painful sex. Anti-estrogen hormonal medications for breast cancer or drugs used to prevent recurrence of breast cancer, such as tamoxifen (Nolvadex), may also produce low desire, vaginal dryness and difficulties with vaginal penetration. Chemotherapy for cancer can affect many physical functions and responses, including sexual desire and arousal. Additionally, cancer treatment can produce fatigue, decreased self-esteem, fear of death, disfigurement and/or rejection that can affect a woman's sexual feelings. PregnancyWomen differ in their sexual activity patterns during pregnancy. Some curb their activity in the first three months and again near the end of pregnancy when physical discomfort can lead to decreased desire. Some have an increase in activity when the initial discomfort wanes. Generally, however, sexual activity doesn't have to stop because of pregnancy. Sex won't hurt the fetus. However, if you are at risk for a preterm birth, your health care professional may advise against sex during pregnancy.Some pregnant women find sexual interest decreases steadily over the course of the pregnancy. After the baby is born, changing hormone levels, fatigue and/or a healing episiotomy may lead to reduced sexual desire. Additionally, it is common for women who breastfeed to notice a lack of vaginal lubrication. This is caused by high levels of the hormone prolactin, which is stimulated by nursing. Also, as prolactin increases, testosterone, a hormone that contributes to sexual desire, decreases, another reason for declining sexual desire. MenopauseLow estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to the genital area and reduced vaginal sensitivity that may contribute to arousal and, in turn, orgasm problems. Postmenopausal women often find that the arousal phase of the sexual response cycle takes longer or is less intense. Changing hormone levels also can produce mood swings that make some women nearing menopause feel less interested in sex. Substance abuseAlcohol affects the arousal states and inhibits orgasm. Chronic alcohol use reduces desire. Abusing drugs, especially narcotics such as morphine, codeine and heroin, impairs sexual function and reduces desire. If you are having a sexual problem, make sure you tell your health care professional about any medications you're taking. Blood pressure medications, antipsychotics and antidepressants are commonly prescribed drugs that can interfere with the sexual response. Selective serotonin reuptake inhibitors (SSRI) such as paroxetine (Paxil) and fluoxetine (Prozac) frequently produce side effects that inhibit or prevent orgasm. Other antidepressants can affect sexual function as well, including tricyclic antidepressants such as imipramine (Tofranil) and clomipramine (Anafranil), monoamine oxidase inhibitors such as phenelzine (Nardil) and mixed antidepressants such as venlafaxine (Effexor). Anticonvulsants for seizures also can cause sexual problems. A change in dosage or medication may help resolve your sexual problem. If you have pain associated with sexual activity, it's important to accurately describe where the pain is located so your health care professional can determine its cause. The types of pain associated with sex include: Vulvar painThis type of pain is felt on the outside of the vagina and often occurs when some part of the vulva is touched. It can be caused by irritation from soaps, feminine hygiene sprays or douches, scars, cysts or infections. Vaginal painThis type of pain is felt inside the vagina. The most common cause is a lack of lubrication from inadequate arousal, medications, medical conditions, pregnancy, breastfeeding or menopause. Vaginal pain also can be caused by an inflammation of the vagina, known as vaginitis. Additional symptoms of vaginitis are a vaginal discharge, itching and burning of the vagina and vulva. It can be caused by a yeast or bacterial infection or a sexually transmitted disease.Vaginal pain also can be caused by vaginismus. This pain occurs when anything attempts to enter the vagina, including tampons or even during a pelvic examination. It can be caused by irritation from douches, spermicides or latex in condoms, infections, scars from an injury, childbirth, surgery or psychological problems from sexual trauma or abuse. Deep painPain that is felt deep inside the vagina, lower back, pelvic area, uterus or bladder can be a sign of an internal medical problem. It can be caused by: pelvic inflammatory disease endometriosis, a condition in which the tissue that lines the uterus grows outside the uterus pelvic tumor bowel or bladder disease, such as interstitial cystitis scar tissue ovarian cysts If you are experiencing deep pain during sex, your health care professional may recommend a variety of tests including but not limited to blood tests, urine tests and scans to check for possible causes. Treatment Treatment for sexual dysfunction depends on the cause of the problem. If the cause is physical, medical treatment is aimed at correcting the underlying disorder. If the cause is psychological, treatment consists of counseling. Treatment can include a combination of medical and psychological approaches. Sometimes, treatment may be behavioral. For example, with loss of desire, changes in the environment, timing, lovemaking techniques or foreplay can produce desire. With arousal disorder, the use of toys and vibrators can help with vaginal circulation. A warm bath and a massage from your partner can also help. Medical Treatment Lubricating creams, gels or suppositoriesIf you are suffering from vaginal dryness caused by medications, a chronic condition or declining estrogen levels, your health care professional may suggest water-based, over-the counter vaginal lubricants such as Astroglide or K-Y Jelly to make sex more comfortable. Or you might try Replens, a long-acting vaginal moisturizer that releases purified water to produce a moist film over the vaginal tissue. Do not use oil-based products, such as petroleum jelly, baby oil or mineral oil with latex condoms because they can cause a condom to break. Topical estrogenFor menopausal women with vaginal thinning, dryness or insensitivity, your health care professional may prescribe an estrogen cream such as Estrace or Premarin, or a vaginal ring, such as Estring, Phadia (low-dose) or Femring (higher dose), to ease sexual discomfort. And a vaginal tablet (Vagifem) containing estradiol, a type of estrogen, is available by prescription for vaginal dryness. Unlike creams, which usually are used at night, Vagifem can be inserted any time of day. Hormone therapyFor menopausal women, hormone therapy (either a combination of estrogen and progestin or estrogen-only therapy) may improve the sensitivity of the clitoris, ease discomfort caused by vaginal thinning and dryness and improve blood flow to the pelvic area. In addition, hormone therapy (HT) can help relieve other bothersome menopausal symptoms, including hot flashes, which can interfere with intimacy. A woman should not take any form of HT until she has weighed the pros and cons and discussed the risks and benefits with her doctor. Because of the potential risks that go along with HT, the U.S. Food and Drug Administration (FDA) now advises health care professionals to prescribe it at the lowest possible dose and for the shortest possible length of time to achieve treatment goals.Although HT can result in increased sensitivity and decreased discomfort during sex for menopausal women, the therapy may not improve sexual desire. Some health care professionals add testosterone, a hormone produced by the ovaries and adrenal glands that plays a role in sexual desire, to HT to stimulate sexual arousal. Treatment with testosterone is controversial, however. Estratest, an estrogen/testosterone combination, is currently the only testosterone treatment available. However, there is conflicting evidence and opinion in the medical community concerning whether or not the benefits of the drug outweigh the risks, which include increased risk of breast and endometrial cancer, adverse effects on blood cholesterol and liver toxicity. Studies on other androgen products used to treat sexual dysfunction have also had mixed results.Although there is no FDA-approved form of testosterone available to treat women's sexual dysfunction, many doctors prescribe it "off label" in small amounts, particularly for women whose ovaries have been removed. Removing the ovaries drastically reduces testosterone levels, and some research shows that women who have had their ovaries removed are most likely to benefit from androgen therapy.Supplementing with testosterone has potential risks. In too high a dose, testosterone can produce masculinizing effects, such as increased facial hair and enlargement of the clitoris. The oral form can also produce liver damage, acne and a decrease in HDL cholesterol (the "good" cholesterol). The use of testosterone in men and women is highly controversial, so be sure to discuss with your health care professional whether androgen supplementation is right for you. Clitoral therapy device The Eros Clitoral Therapy device is an FDA-approved device designed to treat female sexual arousal disorder. It consists of a small, soft suction cup attached to a palm-sized, battery-operated vacuum pump. The suction cup is placed over the clitoris before sex. The gentle vacuum increases genital blood flow, thus increasing sexual arousal and enhancing orgasm. Studies have shown that the Eros Clitoral Therapy device effectively boosts sensation, orgasms, lubrication and overall sexual satisfaction. The device is available by prescription. Vaginal weights Women with orgasmic disorders may benefit from treatment with vaginal weights. Vaginal weights are used to strengthen the pelvic floor muscles, improving awareness of sexual response and also potentially correcting urine leakage, which can cause problems during sexual activity. Vaginal weights are usually available in sets of five. To use them, you insert the lightest weight and remain upright for 15 minutes, two times a day. When the weight is in place, you should feel the urge to hold it in. After a few days, as the muscles strengthen, this urge will go away, and you will be able to move up to the next weight. When you get to the fifth weight, you will insert it for five to seven consecutive days each month to maintain strength in your pelvic muscles. Sildenafil (Viagra) The drug that treats erectile dysfunction in men is also being studied in clinical trials for female sexual arousal disorder. Some studies have found it may increase blood flow to the female genital area and increase relaxation of clitoral and vaginal muscles. However, several large placebo-controlled studies including about 3,000 women with female sexual arousal disorder had inconclusive results. Therefore, the manufacturer of Viagra has decided not to seek FDA approval to use the drug for female sexual arousal disorder. Other Medical Approaches Better control of chronic diseases, switching prescriptions to reduce side effects and treating vaginal infections by taking antibiotics can eliminate sexual problems related to desire, arousal, orgasm and pain. On very rare occasions, surgery may be needed to remove structural problems, such as cysts, tumors or growths that produce pain during sex. Psychological Treatment Psychological treatment for sexual dysfunction usually involves a series of steps identifying and modifying emotions and behaviors that interfere with sexual response, changing behaviors that act as barriers to sexual responsiveness and learning new physical and emotional behaviors that encourage sexual responsiveness. Sex therapy is talk therapy in which you and your counselor, along with your partner, discuss problems, how and why they occur and ways to solve them. You and your partner receive exercises and techniques to try at home, then report on the results at the following session. Depending on your needs, goals and diagnosis, such counseling typically can involve a one-hour session once a week for about two to six months. Poor communication between partners is often present with sexual dysfunction. Learning to communicate, resolving conflict and dealing with negative emotions are the focus of therapy designed to address this issue. Group therapy or support groups also may be recommended. Behavioral changes may also help. These include: changes in the environment, love making at different times of the day, warm baths, masturbation, massage and the use of sexual toys and vibrators. Sensate focus exercises are often recommended by therapists to treat sexual arousal disorder and orgasm disorder. These exercises help you and your partner relate to each other physically without any pressure to perform sexually. You begin by touching each other, slowly progressing to genital stimulation and possibly eventually proceeding to intercourse. Learning the functions of sexual organs and how the body responds sexually, including clitoral and vaginal stimulation, can help with arousal and orgasm disorders. Kegel exercises can strengthen voluntary control of pelvic muscles, improving the sense of control and quality of orgasms. Treatment for vaginismus (involuntary spasm of the muscles at the vaginal opening) may focus on techniques to relax the vagina. One option is using dilators in graduated sizes that are placed into the vagina and kept in place for 10 minutes. The woman usually places the dilators herself. Performing Kegel exercises while the dilator is in place helps you learn to control your vaginal muscles. The exercises also can be done with your fingers. Sometimes, waiting for the muscle to relax after penetration may help. FSD Research Research is progressing on a couple of drugs aimed at helping women with sexual problems. At a recent meeting of the International Society for the Study of Women's Sexual Health, a study was released on bremelanotide, a drug undergoing trials for treatment of female sexual dysfunction (FSD). In the trials, the drug was well-tolerated and increased arousal, desire and the number of sexually satisfying events in women with hypoactive sexual desire disorder (HSDD) and women with both HSDD and female sexual arousal disorder. The final phase of testing could start near the end of this year. Another drug that is being studied for possible treatment of overall sexual function is tibolone. It is a synthetic steroid currently used in Europe and Australia to treat postmenopausal osteoporosis, but, in one study, it was also shown to enhance sexual function in postmenopausal women. It has not been approved for use in the United States because of concerns over increased risk of breast cancer and stroke. Studies also are looking at the effectiveness of phosphodiesterase inhibitors, the class of drugs that includes sildenafil (Viagra). So far, results show little effectiveness in treating FSD, but these drugs may help women who experience sexual dysfunction as the result of taking certain antidepressants. However, sildenafil should not be taken by anyone using nitroglycerin for angina. Prevention A healthy lifestyle can go a long way toward preventing chronic illnesses and diseases that can contribute to sexual dysfunction. Eating a balanced diet, getting plenty of exercise, stopping smoking, limiting alcohol consumption and controlling stress will help you feel well, build a healthy self-image, boost your energy and help you maintain confidence in your sexuality. Visit your health care professional regularly to avoid medical problems that may affect your sexual responses. Other things you can do to enhance your sexual desire and pleasure include: Communicate with your partnerEmotional intimacy is the essential beginning for sexual intimacy for many women. Talk frankly and honestly about your feelings with your partner to help build your relationship. Silence can result in repressed feelings, anger and alienation that can harm your well-being and even your long-term mental and physical health. Express your desiresTell your partner what you want sexually and what "turns you on," and guide your partner to do those things that please you. Be less predictable and more spontaneous in your sexual experiencesPartners who have been together for years can get into patterns in which sex is always the same. Try new ways to be intimate, and prolong your sexual experience by being more creative with touching, positions, timing and location of sexual activities. Examine your prioritiesDon't let work or family responsibilities take time away from your relationship with your partner. Spending time together is part of building intimacy and helps both partners feel connected to each other. Stay sexually active after menopauseRegular sexual activity, with a partner or through self-stimulation, can improve vaginal lubrication and elasticity as estrogen levels decline. Sexuality is highly personal and varies from woman to woman. A woman's sexual responses can vary from one time to another, and no one pattern is more "normal" than another. Nearly everyone has a problem with sex at some time in their lives, and often the problem can be worked out with patience and talking with your partner. When the problem is life-disrupting, causes trouble in your relationships or involves physical pain, it's time to talk with your health care professional. In many cases, your sexual problem can be treated with medical treatments, psychological therapy or both. Facts to Know Sexual problems occur in 43 percent of women in the United States, according to a study published in 1999 in the Journal of the American Medical Association. A lack of desire is the most common sexual problem in women The Association of Reproductive Health Professionals reports that in the National Health and Social Life Survey, 33 percent of women lacked interest in sex for at least a few months in the previous year. Sexual arousal disorder is the second most common sexual problem among women, affecting an estimated 20 percent of women. Twenty-four to 37 percent of women have problems reaching orgasm, according to the Association of Reproductive Health Professionals. Pain during or after intercourse occurs in nearly two out of three women at some time during their lives, according to the American College of Obstetricians and Gynecologists. Low estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to genital areas and reduced vaginal sensitivity that can contribute to arousal and, in turn, orgasm problems. Low androgen levels may contribute to desire problems. Hormone therapy often can help. The most common cause of pain during sex is inadequate vaginal lubrication, which can occur from a lack of arousal, medications or hormonal changes. It is common for women who breast-feed to notice a lack of vaginal lubrication and sexual interest caused by an elevation of the hormone prolactin, which is stimulated by lactation. Sexual disorders can have medical causes, psychological causes or both. One way women can help prevent sexual dysfunction is to have sex frequently. Sexual activity increases blood flow, which leads to better overall sexual function. Key Q&A What is the sexual response cycle?Masters & Johnson, pioneering sex therapists, defined a classic sexual response cycle in the mid-1960s. The stages of this model are: Excitement/Arousal: The feeling that you want to have sex followed by physical changes that occur in your body as you become sexually excited. These include moistening of the vagina, relaxation of the muscles of the vagina; swelling of the labia, (skin folds that are part of the vulva) and the clitoris (a small, sensitive organ above the vagina, where the inner labia, which surrounds the vagina, meet that acts as a source of sexual excitement). The nipples also become erect. Plateau: The above changes in the genitals continue, there is an increase in blood flow to the labia, the vagina grows longer, and glands in the labia produce secretions. There is an increase in muscle tension. Orgasm: Known as the peak of the sexual response, the muscles of the vagina and uterus contract leading to a strong, pleasurable feeling. Resolution: You return to your normal state. However, it's important to point out that more contemporary research suggests that women's sexual response is more complex and includes more elements than the traditional model outlines. Relationship and intimacy needs appear to play a greater role in women's sexual health. According to sexual health experts, a better understanding of the complexity of women's sexuality will help to more accurately diagnose and treat sexual dysfunction. How do I know if I have sexual dysfunction?Sexual dysfunctions are defined as one or more disturbances in the sexual response cycle, or pain associated with arousal or intercourse. Lack of desire, difficulty becoming aroused, lack or delay in orgasm or pain during or after sex are all examples of sexual problems faced by women. Such problems can be occasional and seem to go away on their own. But when they are persistent or recurrent, disrupting your life or your relationships and causing you emotional upset, they may be dysfunctions that should be discussed with your health care professional. What causes sexual dysfunctions?Causes of sexual dysfunctions can be physical, psychological or related to interpersonal relationships or sociocultural influences. Psychological causes can include: stress or anxiety from work or family responsibilities concern about sexual performance conflicts in the relationship with your partner depression unresolved sexual orientation issues previous traumatic sexual experience body image and self-esteem problems Physical causes can include: diabetes heart disease liver disease kidney disease pelvic surgery pelvic injury or trauma neurological disorders medication side effects hormonal changes, including those related to pregnancy and menopause thyroid disease alcohol or drug abuse How are sexual dysfunctions treated?Treatment depends on the cause. If the cause is physical, the treatment will be aimed at correcting the medical or biological problem. For example, if the cause is hormonal imbalance, hormonal supplements may be prescribed. If the cause is a structural problem, such as a cyst or tumor, surgery may be needed. Sometimes, treatment can involve changes in behavior. Better control of chronic illnesses and disease often solves sexual problems associated with them.Some medications can cause sexual problems, and changing prescriptions to those with fewer side effects can treat the problem. Regardless of the cause, counseling, ideally with a sexual therapist, is recommended and should include both partners together. Treatment can include both treating the physical or medical problem and counseling. I just don't feel like having sex anymore. Is there something wrong with me?Lack of desire is the most common sexual problem in women. It can be caused by problems in a woman's relationship with her partner, stress, fatigue, medications and low levels of the hormones estrogen or androgen. Often, lack of desire is affected by a woman's relationship with her sexual partner. The more a woman enjoys the relationship, the greater the desire for sex.The stresses of daily living can affect desire, and occasionally feeling uninterested in sex is no cause for concern. But, when sexual fantasies or thoughts and desire for sexual activity are persistently or recurrently reduced or absent and cause distress or interpersonal difficulties, the problem is known as hypoactive sexual desire disorder or inhibited sexual desire disorder.If you are approaching menopause (a time frame, typically in a woman's mid- to late 40s, known as perimenopause) or have reached menopause, declining estrogen levels can cause vaginal lubrication problems that make sex uncomfortable, and, as a result, less desirable to you. Changing hormone levels during and after pregnancy can also contribute to decreases in sexual desire. Talk with your health care professional about your problem and what treatment may be best for you. Does menopause mean the end of my sex life?No. Many women find the end of their reproductive years sexually invigorating because they no longer face the risk of pregnancy. Plus, regular sexual activity for postmenopausal women improves vaginal lubrication and elasticity after estrogen declines. However, menopause can bring bodily changes that contribute to arousal problems, and in turn, orgasm problems. Low estrogen levels can cause vaginal dryness, thinning of vaginal tissues, reduced blood flow to the genital area and reduced vaginal sensitivity. Postmenopausal women often find the arousal phase of the sexual response cycle takes longer or is less intense.Changing hormone levels also can produce mood swings and emotional upsets that make some women nearing menopause feel less interested in sex. Hormone replacement therapy relieves these symptoms for many perimenopausal women. Using over-the-counter vaginal lubricants may help with dryness problems. Discuss your treatment options with your health care professional, particularly the latest research regarding the safety of HT and ET and how the risks and benefits affect your personal health needs. I have pain during intercourse. Should I see my health care professional about it?Yes, especially if the pain is felt deep inside the vagina, lower back, pelvis, uterus or bladder. Pain associated with sexual activity can be a sign of a medical problem that needs treatment. Deep pain can be a sign of pelvic inflammatory disease, endometriosis, a pelvic tumor, ovarian cysts, bowel or bladder disease or scar tissue.Pain felt in the vagina can be caused by inflammation from an infection or sexually transmitted disease, but it is most commonly caused by lack of vaginal lubrication. Pain felt at the opening of the vagina can be a sign of infection, cysts or scarring. Such vulvar pain also can be caused by irritation from soaps or feminine hygiene products. What kinds of medications can cause sexual problems?Blood pressure, antipsychotic and certain antidepressant medications are commonly prescribed drugs that can interfere with the sexual response. Birth control pills change your hormone levels and can cause a decrease in desire or vaginal dryness. Anti-estrogen hormonal medications for breast cancer or drugs used to prevent recurrence of breast cancer, such as tamoxifen (Nolvadex), also can produce vaginal dryness and difficulties with vaginal penetration. Chemotherapy for cancer can impair many bodily functions and responses, including sexual desire and arousal. Anti-convulsants for seizures also can cause sexual problems. Read the full article
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