Recognition of the problem is a good place to begin. Try not to have hurt feelings over this problem. It's a common couple occurrence. And, it’s not just men who suffer insipid sex. Women actually report boredom in the bedroom more often than men, according to research. Time to really man up guys!

There's something new on the menu for you. Set aside more time than you think you’ll need to satiate your sexual desires. Go in hungry, literally hungry. Be open. Be vulnerable. Own it. . Check your problems at the door. Keep the end game in mind. It’ll be fantastic, you’ll feel fulfilled and fabulous--if you follow my lead!

Chances are you have not satiated your sexual palate lately. Make a commitment together that the two of you will add flavour to your sexual repertoire. To do so, look no further than your own refrigerator--time to bring in the aphrodisiacs! Pour yourself a stiff drink. Then get out the whipping cream, chocolate sauce, honey, maple syrup and more. The ultimate in oral sex.

Now you’re getting it. Maybe it’s time to rekindle the flame somewhere other than your bedroom. Make love in the lav. Dim the lights, add candles. Think shower head. Excellent for experiencing sexual pleasure. Besides, it’ll make things hot and steamy. Place some thick luscious towels on the base of the tub and hop in. Run warm water, bask in your oasis.

Set up a smorgasbord of your favourite sensual flavours soon to be turned into sexual sensation delicacies. The softness of the whipping cream, the silkiness of chocolate, the sweetness of honey making a mess of maple syrup! Invite your lover to pick their favourite flavour gently applying, rubbing, massaging onto their erogenous zones. Touch, lick, taste. Oral love play.

Head for the shower, it’ll add some splash! With a little creativity, imagination, time and a towel, you’ll soon be asking, “what’s on the menu tonight, honey?”

Naturally this conversation took a muff dive as we discussed "to trim or not to trim".......the bush vs. the hedge.

There are a few different ways to smooth things over down there.....shaving, waxing, plucking (Ouch!) laser therapy, trimming and the less popular but also less risky, depilatory (hair removal) creams. Shaving is the most common way to clear the runway, however it may irritate and inflame the hair follicles potentially leaving open wounds, a conduit for infection.

According to a study in the American Journal of Obstetrics and Gynaecology, 60 percent of women had at least one health complication incurred from pubic hair removal, typically epidermal abrasion (invisible cuts to the skin), laceration, rashes and ingrown hairs. It was also shown to cause severe skin irritation and infections. The lesson here? Ladybits need tender loving care.

Waxing one's way back to pre-pubesecent wonder is efficient but hurts like heck! Worse than that, there is evidence that it is dangerous and women are at risk of boils and sexually transmitted infections. Just ask Emily Gibson, director of the health centre at Western Washington University who launched an appeal to put a stop to the trend of pubic hair removal because of these risks.

Laser removal is growing in popularity and is now offered by technicians in medi spas rather than physicians. Know that your ladybits are at risk of being burned, ladies. Lawsuits claimed against non-physician operators increased by 78% over a one year period according to one recent study.

Hair removal creams contain chemicals however do appear to be less irritating if you can bear the scent which has improved over the years. Don't be in a hurry to bare all. Ensure that anyone who goes at it with a wand, wax or any other device is trained in the procedure and also in dealing with your skin type.

To trim or not to trim? That is the question and may be the answer too. Ladies, you can still have that sought after neatness without baring it all. Tidy things up "down there" by trimming instead of a full hair removal as it will ensure your hair follicles remain intact. If you decide to shave, then, take your time and use proper shaving products.

So why would a woman be so happy to remove her hedge when pubic hair is there to “absorb moisture and drain it away from areas that aren’t exposed?” If there’s no hair, the skin is more vulnerable to sexually transmitted infections like herpes and genital warts which can be passed onto one's partner.

So I scratch my head when I hear that a full bush is a deal breaker for many men who prefer that smooth pre-adolescent Barbie doll look. Many women derive a great deal of pleasure from oral sex so they often succumb (submit?) to this particular male grooming request.

An entire generation of women believe there is something gross and downright wrong about a woman with a bush. This belief may have its roots in pornography. Even pubic hair goes grey, another popular reason for "Edward Scissorhanding" the hedge. There are dyes for pubic hair, but that's another blog. Still some women find the clean shaven look empowering, one way to exhibit feminine power. Talk about the feminine mystique.

Fashion trends come and go and the clean shaven look is just that, in for now, out before you know it.

Maureen McGrath is a women’s health expert and hosts the Sunday Night Sex Show on News Talk 980 CKNW. She is creator of the blog 50ShadesofPink.ca and has a clinical practice in North Vancouver, British Columbia. She's thrilled with her hedge trimming.

Vaginal Dryness? Painful Sex? Light Bladder Leakage? Lichen Sclerosis? For information about vaginal rejuvenation, Mona Lisa Touch might be for you. Please visit Mona Lisa Touch

Love your sex radio program the Sunday Night Sex Show on News Talk 980 CKNW that I found on iTunes.

I am a 48 year old sexual woman. Intercourse with my husband has become painful and so my libido has left me. Penetration is particularly painful.  I've been diagnosed with vaginal atrophy but I don't want to use any treatments that contain estrogen due to my history of breast cancer at the young age of 26.

Thanks for any suggestions.

Alexa

Dear Alexa,

What you are experiencing is very common for women during peri-menopause (the years leading up to menopause).  Estrogen is the hormone regulator of the vagina which accounts for a woman's natural lubrication. When the estrogen levels in the vagina decrease, vaginal dryness may set in and it is very uncomfortable! The normally elastic tissues become tight making penetration of a penis very difficult. The tissues may become thin, dry and lose elasticity. The vaginal tissues literally atrophy or "dry up." It can wreak havoc on a woman's sex life and relationship and it knocks you off your game!

If you are uncomfortable with estrogen to treat your vaginal health issues because of a history of breast cancer, not to worry. There are a number of hormone-free personal moisturizers available. The one I would recommend for you is Gynatrof because in addition to the fact that it does not contain hormones, it has been approved for the treatment of vaginal atrophy by Health Canada and is easily absorbed in the vaginal tissues.

In honour of the Super Bowl, having "skin in the game" is helpful. So, I would also advise that you kiss, lick and suckle your husband's penis as pre-game play. Men love oral sex because they view it as the ultimate expression of female love!  Your saliva adds further lubrication when he penetrates you, so lay it on!

To treat the now smaller opening to your vagina, I might incorporate vaginal dilators into your regime. They come in graduated sets of six dilators ranging from a small size to larger sizes. Start with the smallest one and remember to use Gynatrof when you insert it. Better yet, get naked and have your husband insert it and do gentle circular motions with the dilator to expand your vaginal opening. Score!

Remember to have him stimulate your erogenous zones like your clitoris so it is not only therapeutic but pleasurable too. He'll score some big points for this. Use the smallest dilator daily for about one to two weeks in a circular motion stretching the opening to your vagina. Then move on to the next size up. If the next size hurts then go back to the smaller size.

The Gynatrof will take about 2-3 months to optimize which is also the time it will take to "stretch" the opening to your vagina. It is difficult to relax during sex after you have experiencedpain but remember being fully vulnerable during intimate times is key.

This triple play (Oral sex, Gynatrof, and a set of dilators) will help you get your game back on and get you back to the bedroom for some action with your husband in no time!

Maureen McGrath is a Registered Nurse host of the Sunday Night Sex Show on News Talk 980 CKNW, feminist, women's health expert and a 2016 TED speaker on the Sexless Marriage. Her book is available on Amazon.ca : Sex & Health: Why One Can't Come Without The Other. She is recipient of the Vancouver Board of Trade Community Catalyst Award 2016 and a finalist for YWCA Women of Distinction.

She and her husband were hardly intimate and she felt quite badly about this. She loved her husband said they had so much in common but on the rare occasion that they did get back to the bedroom, their sex life was lacklustre to say the least. She said she did not feel anything "down there" and rarely experienced orgasm. The natural thing one would think is that fatigue was a major contributor to Tina's sorry sex life because that is indeed the number one reason for low sexual desire in women. But it was more than that.......

Tina said she never really enjoyed sex and never had that "Sex in the City" kind of sex anyway. "Who has that?" she wondered. Those who report spicy sex lives are women who are educated well in terms of sexuality, can be vulnerable with themselves or a partner, value their sex lives and most important are comfortable getting naked because body image is key.

When I inquired about the kind of sex Tina was having, she said no longer did they have penetrative sex because she has vaginal dryness. She also told me she was not comfortable having oral sex and therefore her husband never "went down" on her. She did not enjoy giving oral sex either basically because she lacked the skill. I hope they both like vanilla was all I was thinking. Regardless, it was clear that Tina was at a time in her relationship and life that she had a desire to strive for a more robust sex life and after four children was in need of a little sex education.

Tina was curious about how she could improve their sex life as she did not want to perceive herself exclusively as a mother and not a sexual woman. In terms of sex education, Tina had learned that sex was not to be enjoyed and that she should get it over with quickly. She was breaking this sexpert's heart. Before I could address Tina's inappropriate education and views on healthy sex, I had to address another health issue of hers. Tina had had four babies in six years and her body went through many hormonal changes, which would impact her vaginal health, the root cause of vaginal dryness and decreased sexual sensation.

The personal moisturizer Repagyn that I recommended for her vaginal dryness contains Vitamin E and Hyaluronic Acid to heal vaginal tissues and keep them youthful.  She reported that treatment with Repagyn, "woke her up down there." She said she started to feel tingling sensations in her clitoris and labia when she thought of making love to her young buck. Her vagina was almost as young again as he was!

Next up (pun intended) was dealing with her fear about sex or great sex. First I was quick to point out the advantages of oral love play. Oral sex when performed on a woman (cunnilingus) is an excellent way of helping her to get sexually aroused and may help to increase her own personal lubrication. If a woman's partner whether male or female is skilled at oral sex, it is a great way of helping her to experience an orgasm.

Oral sex performed on a man or oral stimulation of a man's penis (fellatio) is something most men find exhilarating but sadly for many it is no more than the annual birthday gift. Be sure you look your man straight in the eye when performing oral sex and fondle his testicles, I advised Tina. A little "rimming" in other words using her tongue on her husband's anal rim will add variety for her and increase sensation for him. Rubbing his penile shaft will help and being enthusiastic is critical!

Tina was more comfortable now and felt that oral sex was something she was willing to try on her husband! "Blow out the candles, lucky man, your birthday is coming early! I explained to Tina, that licking her husband's penis like you're licking an ice cream cone (in their case vanilla) is a real turn on for a guy and a nice way to begin. Regular rhythm would get her into the groove and get him worked up, sustaining the arousal.

Tina's husband had occasional erectile dysfunction (yes men in their thirties can get ED) and I explained that oral sex for men with erectile dysfunction may be helpful in that the sucking motion of a person's mouth may induce or improve an erection. Tina felt better learning how sex is related to health and that her intimate life is vital to a happy and healthy relationship. Sex in the City, here she comes! For more information about how sex is related to health, go to my website backtothebedroom.ca where you will find information on how to order my book: Sex & Health: Why One Can't Come Without The Other.

What is HIV?

HIV is the Human Immunodeficiency Virus, the virus that causes AIDS which is Acquired Immunodeficiency Syndrome or the late stage of HIV infection. The immune system weakens and a person may get serious illnesses as a result.  If a person is HIV infected or has HIV disease, it means that they have HIV in their body and can transmit the virus to others.

HIV/AIDS is a global crisis and young people are the most vulnerable group. Girls are at 2-4 times greater risk due to the surface area of the vagina and labia. Also, semen contains a higher concentration of the virus when a person is infected with HIV compared with HIV positive female sexual secretions. The presence of an STI (Sexually Transmitted Infection) increases the risk of HIV transmission.  The highest STI rate is in girls aged 15-19 years old.

It is important that health care professionals, especially family doctors develop a good rapport with their young patients to help them develop the necessary skills to:

1. Make healthy decisions;
2. Know what healthy and unhealthy relationships are; and
3. Help to de-stigmatize HIV and AIDS

Doctors and nurses and members of the health care team are trusted professionals and that is why it is important that they impart sex education on their young patients or they will learn the information from someone else and it may not be accurate. A child’s own parents may not be comfortable talking about sex and fail to speak to their children about it at a young age. Many are surprised when they find their child viewing porn and realize their children are sexual beings. Newsflash: We all are!

Transmission Facts

It is vital that kids know HIV is not transmitted by:

1. Casual contact (hand shaking, touching, hugging)
2. Sneezing
3. Tears, saliva or sweat
4. Sharing drinking glasses (although this is poor hygiene and other diseases may be transmitted)
5. Public washrooms, drinking fountains, swimming pools/hot tubs
6. Pets
7. Sharing razors

HIV is transmitted through vaginal, anal and/or oral sex without the use of a condom with a person who has HIV or a person whose HIV status is unknown. HIV is also spread through sharing needles, syringes or works (spoons, cotton, bottle caps that have been used by a person with HIV to shoot drugs including vitamins, insulin and/or steroids). Sharing needles for tattooing or piercing is also risky.

Teach Teens to Practice Safe Sex

What is most important is that teens know that it’s all sex... vaginal, oral and anal.  Abstinence is a choice and is the only sure fire way to prevent HIV and STIs. Teens need to know to practice safe sex and use a condom. Also, alcohol and drugs fuel poor decision making and increases risk because it is harder to say no, especially as peer pressure increases.

Adolescence may be a challenging time for most kids as they navigate this developmental stage. Armed with accurate information, health care professionals gain confidence in discussing the subject of sex. I refer to the Plissit Model when I discuss sex with my patients and I also suggest a few good openers such as:

1. Many students speak to me about…
2. Hey, I saw this article about HIV and teens...

An important question: teens who have had at-risk sex may ask when they should be tested for HIV. It takes three months for antibodies to develop; you will want to advise them to avoid risky behaviour while waiting to be tested.

It may be helpful to learn a bit of #teenspeak in your efforts to treat your teenage patients. Learn their language and use it with them, but not too much. Be mad (cool).  Make it turnt (fun). Hashtag everything. Ask them if they are killing it (doing amazing things like succeeding in school or sports). Teens hook up these days and have friends with benefits; “friends for cut” is lingo for having sex. TBT? Nope, not Throwback Thursday. It means what a great time we had getting wasted at that party last week.  Mupload that ish (post that selfie)...#Hashtagwhatever, the list goes on...

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