Monthly Archives: December 2021

sexual dysfunction

Sexual Dysfunction – A Silent Killer of Relationship

We call sexual dysfunctions the set of disorders in which psychological and / or physiological problems make it difficult for the person to enjoy their sexual activity as they would like. It is a disorder in some phase of the sexual response – excitement, plateau, orgasm, resolution.

Sexual dysfunctions are frequent and it is estimated that 40% of men and women can present them at some point in their lives. The most frequent among women is a lack of interest in sex and arousal problems, and premature ejaculation and impotence appear more frequently among men.

In the diagnosis and treatment of each dysfunction, the sexologist in Delhi analyzes whether the symptoms are primary or secondary, absolute or situational, or if the severity is total or partial.

The physical changes that occur in the four stages of sexual response (excitement, plateau, orgasm, and resolution) serve as the basis for analyzing at what stage sexual dysfunction occurs.

Thus, when the person is mentally and physically excited, the following physical changes appear:

In women:                                                                                                                                                  In men:

 

EXCITEMENT

 

EXCITEMENT

  • Vaginal lubrication
  • Penile erection
  • Clitoral erection
  • Scrotal size increases
  • Swollen lips
  • Increases the size of the testicles
 

PLATEAU

 

PLATEAU

  • Lip coloration
  • Cowper gland discharge
  • Vaginal tightening
  • Prostate gland contraction
  • Vaginal tightening
  • Prostate gland contraction
  • Elevation of the uterus and retraction of the clitoris
  • Terminal vesicle contractions
 

ORGASM

 

ORGASM

  • Contractions of the uterus
  • Ejaculation
  • Rhythmic contractions on the orgasmic platform
  • Contractions of the penis, urethra, and sphincter
  • Rectal sphincter contraction
  • Rectal sphincter contraction
 

RESOLUTION

 

RESOLUTION

  • The uterus and vagina return to their initial state
  • The penis and scrotum recover their initial state

We can classify the dysfunctions related to the sexual response cycle:

WOMENMENS
  • Disorders of desire
  • Excess
    Deficit
  • Excess
    Deficit
  • Sexual arousal disorder
  • Lack of general excitement
  • Problem of starting an erection
    Problem of maintaining an erection
  • Orgasm disorder
  • Difficulty reaching orgasm
    Lack of orgasm
    Premature
    orgasm Delayed orgasm
  • Absence of ejaculation
    Premature ejaculation
    Delayed ejaculation
  • Sexual resolution disorder
  • Delayed resolution
  • Others
  • Dyspareunia
    Vaginismus
    Sexual phobias Socio- sexual
    anxiety
  • Dyspareunia
    Sexual phobias Sexual
    partner anxiety

 

Among the psychological causes of dysfunctions we find the following factors:

Predisposing factors:

  • Lack of information and sexual formation or inadequate information received.
  • Moral education devalues ​​sexual activity.
  • Insecurity in the psychosexual role.
  • Traumatic sexual experiences.

Precipitating factors:

  • Relationship problems (poor communication, fights, infidelity).
  • The appearance of a sporadic problem (excessive tiredness, alcohol, stressful work or family situation).
  • Organic special moments (after a heart attack, after childbirth, anxiety disorder or depression, etc.).

Maintenance factors:

  • Non-existent or inadequate sexual formation.
  • Anxiety associated with sexual interactions.
  • Inappropriate personal or partner performance in sexual relations.
  • General problems in the couple relationship.
  • Specific fears or phobias.

Physiological causes of dysfunctions:

Diseases or injuries: of the cardiovascular system, endocrine system, genitourinary tract, nervous system.

Effects of drugs: sedatives, antiandrogens, anticholinergics and antiadrenergics, psychotropic.

(The most frequent physical disorders are: diabetes, hypertension, hypogonadism, spinal disorders, etc .; at the drug level they are antihypertensive, antidepressant, alcohol, barbiturate, etc.).

Female sexual dysfunctions:

Hypoactive sexual desire (“sexual apathy”, “lack of sexual desire”, “lack of interest in sex”).
Lack of interest in sex, absence of fantasy, dreams or thoughts of sexual content, difficulty engaging in autoerotic or partner sexual activity.

Aversion to sex
Intense feelings of disgust, displeasure, repulsion or fear of situations of a sexual nature (concrete or thought). Sexual contact is usually avoided.

Sexual arousal disorder
Loss of arousal levels, physical and emotional disconnection from sexual intercourse. Inability to respond to caresses, sexual physiological responses are not experienced.

Orgasmic disorder
Difficulty reaching orgasm after an adequate level of arousal.
Dyspareunia
Pain during intercourse.

Vaginismus
Involuntary contraction of the outer third of the vagina upon penetration.

Sexual dysfunctions due to medical illnesses
Some illnesses can influence sexual functioning due to the physiological alterations they produce or the medication they require; These include: diabetes, arthritis, multiple sclerosis, spinal cord injury, thyroid, endometriosis, vaginal infections.

Substance-Induced Sexual Dysfunctions
The use of some drugs or drugs can affect sexual response.

Male sexual dysfunctions:

Impotence, erectile dysfunction:
Inability to obtain or maintain an erection sufficient to perform intercourse satisfactorily.

Premature ejaculation:
Inability to exercise voluntary control over the ejaculatory reflex.

Delayed ejaculation:
The man cannot ejaculate due to excessive involuntary control of the ejaculatory reflex.

Anorgasmia
There is no sensation of pleasure, but the semen does come out.

Dyspareunia
Pain during intercourse, which can be during or after sexual intercourse.

Sex Positions

Questions and Answers About Sex Positions

One of the topics of greatest interest to men and women in relation to their sexuality is that of sexual positions. And somehow underlying the belief that one of the most outstanding virtues of a good lover is precisely the mastery of coital skills: exciting postures and movements, time control, and knowledge of almost acrobatic variants.

Beyond the fact that there are also quite a few false beliefs on this question, we think it is interesting to summarize the most frequently asked questions about it and, of course, answer them.

Is it true that there are hundreds of sexual positions, or is it just a myth?

Although the variants are almost innumerable when we use our imagination and vary the angle of the bodies, the location of the hands and legs or use resources such as cushions, chairs or tables, we could summarize the sexual positions – in pairs of men and women – in four groups: the man on top, the woman on top, from the side and the man behind the woman.

Each position has variants, even advantages and disadvantages that we will analyze later, but most of the ways in which we position ourselves in sex are within this classification.

How much does sexual posture influence a woman to reach orgasm?

Despite what many men believe, despite the fact that it can produce a lot of pleasure and excitement, vaginal penetration is not the best mechanism for most women to reach orgasm. As the clitoris – particularly the glans – is the erogenous zone with the greatest sensitivity, its direct stimulation is essential for approximately half of women, and this type of stimulation does not usually occur in coital friction.

That said, although there are some complementary postures, movements, or stimuli for a woman to reach orgasm, it is very important to develop erotic skills related to stimulating the clitoris such as caresses, oral sex, or the incorporation of sex toys. Therefore, if we broaden the concept of what a good lover is, it would be much broader than just mastering various sexual positions, rhythms, and times. Eroticism is an art more than a marathon.

What is assisted orgasm and what posture does this technique facilitate?

The female assisted orgasm consists of the stimulation of the clitoris while having intercourse. This stimulus can be produced with caresses (with your own hands, those of the partner or both) and also with a vibrator, preferably small and easy to use. Considering the characteristics of a woman’s orgasm, especially the predominance of the clitoris as its trigger, it is a technique that is very important to learn and perfect.

The most suitable coital postures for this maneuver are: the woman sitting on top of the man, who can be sitting on a chair, or lying on his back. In this case, the most practical thing is for her to use her own hands. And the lateral postures are also comfortable, which allows manual stimulation of any of the parts in a comfortable and effective way. It is interesting to incorporate a small vibrator as it facilitates and enhances sexual stimulation, achieving faster and more intense orgasms.

What position facilitates the ejaculatory control of the man?

There are always personal preferences or experiences, but in general, it is the female or Andromeda superior. Except in the case in which the couple’s movements are very exciting, in general in this position the man feels less pressure from the vagina on his penis, and his body is also relaxed -something that facilitates the control of ejaculation-.

Another variant is the lateral position, that is to say on the side, which basically raises two options: to be in front of the couple, or with the back behind them (this variant is what we know as a spoon ). Both can be visually exciting, but they do not allow as vigorous movement as other positions which favor control.

Finally, we have the missionary posture known as the classic, with the man on top. In general, it leads to a race to orgasm, but for some men, it allows an almost millimeter control of movements and that can be key when it comes to mastering the timing of sex.

And which position would be the most difficult for control instead?

In general, it is what is called the puppy, a really wild and primitive posture. It is so exciting for the average man – both visually and genitally – that it is usually performed when the moment of climax has arrived. It is even the one we recommend the most for those men with difficulties to ejaculate, particularly with a variant: the couple lies face down, he penetrates her vaginally and she then closes her legs, causing an extremely exciting pressure on the penis.

What posture would you recommend to maintain good penile rigidity?

At this point, we enter a much more subjective zone of sexual preferences, experiences, and techniques. For example, if the man tends to get turned on by the partner’s breasts, having her on top can be an excellent and almost infallible stimulus. While for others that same posture generates an inhibitory effect by producing less genital sensations than others, or because it implies less control of coital movements.

Therefore, sexologist in Delhi recommends that each man ask himself: What sexual stimulus produces the most psychological and visual excitement? What type of movement, rubbing, or position improves my erectile capacity? And then knowing the particular erotic map will be easier to find the indicated position.

Sexual Response

Sexual Response

The sexual response reveals the cycle of desire, arousal, orgasm, and satisfaction, although in different ways in men and women. What happens in our bodies when we feel erotic pleasure?

What is a sexual response?

The sexual response refers to the cycle of human sexuality that includes the process of desire, arousal, and orgasm in men and women. The sexual response consists of several phases that, in general, follow one another in the order that you will find below. For example, it is difficult to reach an intense and pleasant orgasm without having previously gone through a phase of increased arousal.

However, there are two aspects that accompany us throughout the cycle of our sexual response: desire and satisfaction. Without satisfaction in the different phases, we will hardly find the desire that maintains our impulse to initiate or continue an erotic encounter.

Specifically, the phases of sexual response are as follows:

  • Desire phase
  • Excitation phase
  • Orgasmic phase
  • Resolution phase
  • Satisfaction phase

Although men and women share these phases, in each of the sexes there are a series of physiological aspects and reactions, as well as a series of anatomical changes, that differentiate us. Below we will address in more detail what happens in each of these phases and how they vary in them.

The sexual response: desire phase

The desire appears in our lives in general, and specifically in our sexuality, as a physical and mental perception that drives us to the subject or the object of our desire. Sometimes it arises involuntarily, it surprises us, we become aware of it without having foreseen it, for example when you read a scene from a novel and notice a tingling inside you and you say to yourself: well, I would like to try it. Desire is also deliberately elicited by voluntary, exciting, attractive, or suggestive erotic action that can set it in motion.

Desire is felt, perceived, and leads us to seek its satisfaction. When the initial desire grows, we begin to notice the changes that the phenomenon of arousal causes in our body. The desire usually triggers the beginning of our sexual response and accompanies us, full of nuances, throughout this erotic process.

The desire phase in women

It is not uncommon to hear that in women desire is something complex and even incomprehensible; however, the heart of the matter is simply the fact that female desire functions not identically to male desire. Visual stimuli, for example, have less of an effect on women, while emotions, imagination, and sensual caresses play an important role.

In women, desire is usually associated with willingness to initiate a sexual encounter, when in reality this is false. Desire in women can be associated with the desire to have erotic exchanges other than a traditional sexual encounter, and these can range from a kiss or sensual caresses to an exciting and explicit encounter, but without penetration, for example. The diversity in the nuances of what women want when they want is immense.

The desire phase in men

In general, male desire is triggered many times by a visual stimulus, and also by imagined stimuli or sexual fantasies. Of course, as in the case of women, it is also triggered by a series of tactile stimuli that the person perceives as pleasant, exciting, and satisfying.

In general, male desire and arousal are usually associated with penis erection, although, although this association is often true, there are always exceptions and there may be desire without an erection and even excitement without desire.

Of course, many men break the mold and surprise their partners with original wishes and innovative ideas. Ultimately, every man and every woman can have their own desire triggers, and these may be different from other peoples. The search for normality, or socially standardized desire, is often a great enemy of sexual desire.

The sexual response: arousal phase

In the arousal phase, our sexual tension increases, it grows fueled by the erotic stimuli that surround us. This increasing sexual arousal manifests itself in a series of characteristic changes in our anatomy and physiology, and in turn in an increase in our desire. Of course, this phase can be short or long, everything will depend on our body, our feelings and the circumstances.

Throughout this phase –the second within the sexual response–, in both men and women, the heart rate accelerates, our blood pressure rises and our muscles become tenser and tenser.

Arousal in women

The clitoris swells, or what is the same, remains erect, and the labia major and minor also swell and their color becomes more intense, as blood flows into it.

As we progress through this stage, the glans of the clitoris – the visible part of this organ of pleasure – retracts and is covered by the cap. This is important as it may mean that we want a change in how we stimulate ourselves. In addition, the vagina becomes lubricated and enlarged, the uterus rises, and the nipples harden and increase in size.

Excitement in men

The vasocongestion of the male genital area causes the erection of the penis, in addition the scrotum swells and the testicles rise. Some men, as in the case of women, also experience a tightening of the nipples and an increase in their sensitivity.

As we advance in this phase, and the excitement increases, the hardness of the shaft of the penis and the glans intensifies, and its color become more purplish. All this is due to the influx of blood into the corpora cavernosa, which is the erectile tissue of the penis. Cowper’s glands or bulbourethral glands secrete precum to acidify the urethra and prepare it for the passage of semen during the orgasmic phase.

The sexual response: orgasmic phase

When arousal increases and a threshold is exceeded, orgasm arrives. In the orgasmic phase – the third within the sexual response – the muscular tension that we had accumulated during the increasing arousal intensifies even more and is released shortly thereafter. Our breathing continues to increase in rate, as do our heart rate and blood pressure. It is the highest expression of the arousal phase.

Orgasm in women

The orgasmic phase is characterized by a series of contractions that begin in the outer third of the vagina, extending toward the vulva and anus, and into the uterus. These contractions, which are very intense at first and then softer, take place at 0.8-second intervals. The number of contractions ranges from three to fifteen, depending on each woman; her age, her orgasmic frequency, the muscle tone of her puboccyocgeal muscles, the level of arousal, and the quality of the stimuli, for example. These are generally very pleasant contractions.

These spasmodic contractions refer to the organic phenomenon, but a woman is much more than her body and, consequently, the perception of this is a very personal experience, closely related to the degree of abandonment to the sensations of pleasure and her expectations of satisfaction. In this, men and women fully agree.

Orgasm in men

As in the case of women, spasmodic contractions also occur every 0.8 seconds, they are usually very pleasant and are perceived in a subjective and significant way by each man, but, unlike the female orgasmic response, the male has two phases: the emission phase and the ejaculation phase.

In the emission phase, the prostate and seminal vesicles contract, and the semen reaches the base of the urethra. It is the moment when you have the feeling of no return, that ejaculation is inevitable and imminent. Then the ejaculation phase begins, giving rise to contractions in the urethra and penis that cause the semen to escape.

Differences in orgasm between men and women

Female sexual anatomy and physiology work in such a way that they do not require a period of rest between orgasm and orgasm. If stimulation continues after the first orgasm, in women arousal can again reach the threshold that will lead to another orgasm. This is why a woman can be multi-orgasmic.

In the case of men, on the contrary, after ejaculation, there is a refractory period that lengthens the time necessary between one orgasm and another, as we will see below in the resolution phase.

The sexual response: resolution phase

After orgasm or orgasms, when stimulation ceases, the body prepares to return to the equilibrium phase before the cycle of sexual response begins. The heart rate, blood pressure, respiration, muscle tension, and vasocongestion in the genital area gradually disappear to give rise to the usual rhythm and coloration of our body at rest.

In this resolution phase, it is interesting to leave us a space to enjoy these invaluable moments and not run away to resume daily obligations.

Resolution phase in women

The swelling of the clitoris and the labia major and minor disappears, and the glans is visible again; the vagina and uterus regain their usual position, and the nipples their previous texture and hardness.

Resolution phase in men

The erection decreases, and the scrotum and testicles also regain their normal position. After ejaculation, which is not necessarily orgasm, the refractory period begins, which is the time a man needs to be able to start the entire cycle of sexual response again. This period has a variable duration depending on age and health status. In adolescents and young people, it can go from one to several hours, while in adults and in old age it can last even several days. During this time, the man will re-manufacture the pre-seminal and seminal fluids that are necessary for the male sexual response to occur.

The sexual response: satisfaction phase

The satisfaction is a subjective assessment that accompanies us throughout the erotic process and is particularly important at the end of the cycle of sexual response at that moment of pleasure and relaxation preceding the return to our daily lives. How do I feel right now? Did I like the experience? Have my expectations been satisfied?

Although it is a subjective experience, it is not for that reason less important, but on the contrary, it is a very significant experience for the future of our future sexuality, since it is a perception that leaves a clear mark. Therefore, the degree of satisfaction or dissatisfaction can bring us closer to or away from a new desire to initiate an erotic or autoerotic encounter. In short, if there is satisfaction, we will want to repeat since it will be something that we consider pleasant, desirable, and exciting. If there is no satisfaction, for whatever reason, it is most likely that our desire will diminish and the attraction for the sexual, erotic, or sensual experience will lose a part of its value.

In both women and men, the entire process of sexual response is accompanied by emotions and feelings, and a desired and expected excitement will not be experienced the same as excitement that we consider inappropriate. The feeling of adequacy is very important in our sexuality. In the same way, so are realistic expectations about what we can expect from our body, in addition to the knowledge to get the most out of our senses.

It is still a myth that satisfaction comes by itself. Therefore, whether you are a man or a woman, the best proposal is to explore and discover in a playful way the potentialities of each of the phases of your sexual response, suggests sexologist in Delhi.

Balanitis

Know The Main Risk Factors For Balanitis

Balanitis is an inflammation of the mucosa that lines the glans (head of the penis). The problem can even extend to the foreskin, which is the skin over the region. In this case, it is a balanoposthitis. The main symptoms are itching, burning or even pain, in addition to a reddish appearance, which may have secretions.

In this post, we will learn more about the condition. Read on!

When does balanitis occur?

The disease is directly related to the hygiene conditions of the penis. This is because of the lack of an adequate cleaning routine promotes the formation of a secretion, composed of dead cells that accumulate in the place. However, there are some factors that can increase a man’s chances of developing the problem.

Individuals who have not been circumcised, for example, are more susceptible to balanitis. The reason is that the skin that covers the glans ends up making hygiene more difficult. Thus, there is a perfect environment to trigger the inflammatory process, since the area becomes warmer, moist and with residues.

On the other hand, people with type 2 diabetes are also more likely to have the disease. In addition, age is a risk factor, since the incidence is higher in men over 40 years. Obesity and previous diagnoses of sexually transmitted diseases are other points of attention, as well as unprotected active sex life.

The use of substances that irritate the glans or allergies due to various products can also trigger inflammation. Therefore, when the first signs appear, the person should see a doctor. The condition may worsen further due to occasional urinary infections.

What are the diagnosis and treatment indicated?

In the clinic, the best sexologist in Delhi will do the clinical test to diagnose the disease through the appearance of the lesions. It will probably be necessary to perform laboratory tests to identify the causative agent of the infection and to be able to direct treatment.

It is worth remembering that inflammation may or may not be associated with an infection and, therefore, this will define which medication is appropriate for the case. The clinical protocol will be indicated to the patient’s partner in order to avoid recurrence.

As the proper hygiene of the region is the main form of prevention, surgery to remove excess skin may be recommended in cases where the narrowing of the foreskin prevents the exposure and correct cleaning of the glans.

As suggested, the best form of prevention is in how a man cleans his sexual organ. Other even more serious problems, like penile cancer, are related to lack of cleanliness.

For correct hygiene, the individual must retract the skin (foreskin) and wash the glans region, ensuring that no residue or secretion remains.

In addition, it is recommended to dry the penis after urinating and to wash it correctly after the sexual act, as well as to consult the specialist in case of suspected abnormalities. These and other cares help the man to maintain health and to avoid balanitis.

Want to know more? I am available to answer any questions you may have and I will be very happy to answer your comments on this matter. Read other articles and learn more about my work as a sexologist in Delhi!

Five questions about libido

Five questions about libido

At the origin of our sexual desires, libido evolves throughout life, for physical and psychological reasons. What do we really know about her? Sexy quiz, to be completed under the covers for two!

Is libido always at its lowest in winter?

False. Ah, it is easy to pretend that winter damages our libido! But that’s an unfounded excuse because studies have only found one case in which it was proven: seasonal depression, the condition caused by lack of light in the fall and winter.

The symptoms are varied: sadness, lack of energy, difficulty in making decisions, sleep and appetite disturbances … and sometimes sexual problems. Low sex desire treatment in Delhi includes psychotherapy, and sometimes antidepressants. But apart from this case, no excuse to hang out alone under the duvet. Moreover, the desire is in oneself, it does not come only from the other. In the beginning, everything is rosy and as soon as we see each other, we jump on each other. With time, desire becomes less automatic, it then comes from oneself and is worked on. Because sexuality often comes after children, work, shopping, cleaning, friends, keeping time for sexuality is therefore essential!

It’s up to us to spice up our winter sexuality, even if it means turning up the heating thermostat to warm up our libido.

Does libido depend on hormones?

In part. Libido depends on many factors, first and foremost hormones.

In women, it evolves according to the cycle. The female desire is under the yoke of several hormones, of which the testosterone (in much less quantity than the men) and the estrogens, the female sex hormones. These are produced at a peak just before ovulation, an archaic heritage of our animal condition: they boost desire in order to ensure the reproduction of the species! But do not worry if this is not the case, some feel much less this hormonal sexual tension.

When breastfeeding, a hormone, prolactin, inhibits sexual desire. It was long believed that at menopause, libido collapsed. A study put an end to this belief: it is especially the negative received ideas about sexuality after menopause, which are responsible for its collapse. Many women over 50 have fulfilling sexuality.

In man, we often hear that they want it all the time … It’s not that simple. In men, desire is more linear than that of women, because it is conditioned by testosterone, a male sex hormone secreted continuously. But in practice, other factors must be taken into account, such as stress, which can have a negative impact on male libido.

Is the drop in libido necessarily psychological?

False! This misconception is completely wrong. The decrease in desire can be caused by diseases, for example of endocrine origin (hypothyroidism, pituitary gland tumor, etc.), depression, and the consequences of childbirth or breastfeeding.

The andropause, the equivalent of the female menopause, is defined by the drop in testosterone level. Which can alter the desire in some men? Just like some drugs: certain pills, certain antidepressants, antihypertensive (diuretics), anxiolytics, etc. It is sometimes difficult to know if it is the medicine or the condition for which it is taken, that is causing the altered libido, but it is important to talk to your sexologist in Delhi, which may be able to decrease. Doses or change medication. On the other hand, it is forbidden to stop your treatment on your own!

The psychological component of libido is very important. Conditioning oneself positively with regard to sexuality, by granting it space and time, is also important to regain desire. The advice of women’s magazines (alluring underwear, a night at a hotel, and fulfillment of fantasies …) will not revolutionize desire, especially if the origin of the drop in libido is a disease or a treatment, or if there is a marital problem behind the decline in desire. But in some, especially those who are motivated together to relaunch their desire, they help to stimulate a little vis-à-vis sexuality, to give it a real place again, to be more available and attentive for her lover. Which is far from negligible…

Is there a treatment for low libido?

In case of a decrease in libido that lasts, it is recommended to talk to your GP or a sex specialist in Delhi, who will seek to identify the cause. The support then includes the treatment of a medical origin, the adaptation of low sex desire treatment in Delhi if it is involved, psychotherapy or even couple therapy in the event of marital conflict, a frequent explanation of decreased desire!

Do stress and fatigue have an effect on libido?

Often. The stress has variable effects on libido, according to the people. It makes adrenaline secrete, a hormone antinomic of the libido: for some lovers, impossible to make love when they are very stressed. On the contrary, others seek the well-being caused by the endorphins secreted after orgasm: a good remedy against stress!

As for fatigue, it can have a devastating effect on libido: sex requires significant physical effort and emotional investment. When one is exhausted, it may be impossible to find that animal energy necessary for the sexual drive and its gratification. The mental load is often invoked by women to explain their lack of desire, they are so exhausted from dealing with everything.

Work on his desire, on his way of conceiving sexuality, can then be interesting, seeing the sexual relation differently, no longer as the prelude to an obligatory orgasm, but simply as a moment of intimacy and pleasure, of reunion with the loved one. In addition, sexuality is not limited to penetration: masturbation, fellatio, cunnilingus are less expensive in terms of energy and emotions. The erotic massage also provides much valuable sensual interlude.