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Wendy Lewis
Chemical peel vs. microdermabrasion: Which skin resurfacing technique is best for you?
Fashion & Beauty
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The term resurfacing is used to describe a wide range of skin treatments from superficial chemical peels and microdermabrasion, to ablative laser resurfacing. These procedures can resurface damaged outer layers of the skin to reduce wrinkles, fine lines, sun spots, age spots, freckles, blotchiness, mild scarring, some forms of acne lesions, precancerous lesions, and red veins.


Peels vary according to their active ingredients, strength, length of time on the skin, and the pH. They are all similar in that they involve applying a chemical solution to remove damaged outer layers of skin so that newer layers can replace them. A peel treatment consists of the application of a chemical exfoliating solution to the skin.

Depending on the severity of the skin damage, the solutions are applied in varying concentrations to alter the superficial, medium, or deep layers of the skin. Superficial peels, often referred to as lunchtime peels, are the most commonly used because they require minimal downtime. The deeper a peel penetrates, the more visible results you can achieve, but the longer the recovery may be. Most peels can be performed on the face, neck, chest, hands, arms, and legs. Your doctor may use a combination of chemicals for your procedure to tailor the treatment specifically to your skin type and condition.

Common chemical peels

•    Glycolic Acid
•    Beta Hydroxy Acid
•    Jessner’s Peel
•    Trichloracetic Acid (TCA)

Chemical peel techniques

You must be free of active skin infections, including acne and any type of cold sore, including herpes simplex. You must also not have taken Accutane® for a period of 12 months before a treatment, depending on your doctor’s specifications. You will be asked to limit your sun exposure before the peel. A peel treatment begins with cleansing the skin and removing all traces of grease with rubbing alcohol or acetone. The face is then rinsed with water and dried with a small fan. The doctor or nurse applies the peeling agent so that all areas of the skin to be treated are covered evenly. The peeling solution is left in place for a few minutes and then thoroughly neutralized or removed with water.

  • Superficial Peels
    These peels use mild chemical solutions like glycolic acid, lactic acid, and salicylic acid to lightly peel the skin with almost no recovery involved. They are typically done in a series to maintain results over time. Your face may seem slightly pink followed by temporary flaking, dryness, and scaling until your skin adjusts to the treatments. Superficial peels are usually combined with an at-home skin care regimen for best results. The solution will typically be adjusted for each treatment session based on your skin’s response.
  • Medium Peels
    Jessner’s Solution, Trichloroacetic Acid (TCA), or other solutions are used to correct pigment problems, superficial blemishes, moderate sun damage, fine lines, and acne scars. TCA peels are performed in a doctor’s office or medspa. You may feel a warm or burning sensation, which is followed by some mild stinging. Flaking, redness, and healing will take a few days to a week to resolve.
  • Deep Peels
    Phenol and croton oil peels are usually one-time procedures. They can produce more dramatic, long-term results on wrinkles, brown age spots, mild scarring, and pre-cancerous growths. Because phenol peels can cause permanently lighten skin, they are not recommended for darker skin tones and require that sunscreen be used at all times afterward. Phenol peels are performed in a doctor’s office or surgical center. A full-face, deep chemical peel requires twilight anesthesia.


Microdermabrasion is considered a peel alternative. It entails blasting the face with sterile micro-particles to rub off the very top skin layer, then vacuuming out the particles and the dead skin. Through a wand-like hand piece, tiny aluminum oxide or salt crystals are delivered at high velocity onto the skin’s surface and immediately vacuumed away with the same instrument, taking the top-most layer of dead skin cells with it. The technique exfoliates and gently resurfaces the skin, promoting the formation of new, smoother skin. It is usually performed on the face and neck but can be performed on any part of the body, including the hands, chest, arms, and legs.

Microdermabrasion can improve rough skin texture, some types of mild scarring, uneven pigmentation, and superficial brown spots. It is also good for acne lesions, blackheads, some stretch marks, and fine wrinkles. Microdermabrasion can be safely used for all skin types. The results are similar to a light chemical peel with no need for anesthesia and no downtime. Tiny crystals are sprayed on the skin and suctioned back up into the machine. The pressure can be varied to control the amount of penetration or pass over an area several times to remove the most damaged skin. Each treatment can take about 30-45 minutes. A typical regimen consists of a series of four to eight treatments done at intervals of two to four weeks. Your skin will have a pink glow and feel as smooth as glass after the treatment. Microdermabrasion can be combined with other resurfacing procedures, such as peeling solutions and infusion of cosmeceuticals.

Microdermabrasion basics

Costs: Treatments vary in cost according to the area treated, the individual physician, and the geographic location. Generally, superficial peels or midcrodermabrasion can range from $150 to $350, whereas TCA peels can cost from $500 to $2,000. Typically peels performed in a medical setting are more potent than treatments done in a salon or spa, where only superficial peels are usually offered.

Recovery: Light peels and microdermabrasion treatments require little or no downtime. After the procedure, the skin may be coated with a mild ointment or cooling gel. With all peels it is important to avoid sun exposure for several months to protect the newly formed layers of skin.

Risks and side effects: Possible complications from deeper peel treatments may include infection, scarring, temporary or permanent color change in the skin, and uneven pigment changes. Darker skin types are at a higher risk for hyperpigmentation and skin discoloration.
When you’re ready to discuss skin resurfacing treatments with your dermatologist, bring this list of questions with you.

Questions to ask your dermatologist about skin resurfacing treatment

• Is this the most effective treatment for my skin type and condition?

• Is my skin type appropriate for this type of treatment?

• What are the possible side effects?

• How long lasting are the results?

• How many treatments will I need?

• How often should I have a treatment?

• What will happen if I stop having treatments?

• What is the recovery process?

• When can I wear makeup?

• When can I start using my normal skin care regimen again?

• Is there anything I should be using on my skin before the treatment?

• Are intravenous sedation or local anesthesia necessary?

• Is this treatment best done during the winter or when I will not be outdoors?

• Who will be administering my treatment and what are his/her qualifications?

Have you had chemical peels or microdermabrasion? What was your experience? Please share your tips in the comments section below!

My Veins are Shot
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Giving blood is a great thing to do. Donating your healthy blood to blood banks is terrific. When I was in college I started donating blood. I learned then that my veins are not very cooperative. They look good but they roll away from the needle.

Fast forward a few decades and my veins were tested to their limit with chemotherapy. I chose not to have a port inserted because that part of the whole cancer treatment regime was what freaked me out. Subsequently my chemo had to be administered into my veins in my arm. Because of my breast cancer surgeries only one arm could be used. The chemo drugs are very toxic. The nurses who administer wear heavy gloves, and yet this poison went into my veins. My veins did not like it. They rolled, collapsed, burst and generally made life difficult.

As a result of my treatments, the only place that I can get blood out of my body for a blood test is from my hand. It hurts a bit and the top of my hand is all scarred from my many blood tests as a cancer survivor. My doctor went so far as to recommend I wear a medical alert bracelet!  I just can’t bring myself to wear a bracelet that says, “Veins Suck, Use Right Hand” or “Veins Shot, Administer in Right Hand Only”.

Last week I went for my yearly visit to my oncologist.  Before the visit blood is taken. A good friend of mine had breast cancer a year after my diagnosis. We go to the same oncologist and now we schedule our appointments following each other and then go out to celebrate another year of cancer free living. She has her appointment first because her veins are not shot and her time in the lab is brief.


I don’t think there is note on my chart about my veins but let’s just say I never get the new oncology tech for the blood draw. I still tell them what size needle to use, which hand, which I make certain is warm, and I already drank about a gallon of water before the visit, all to have a timely and successful blood draw.


Anyone else with uncooperative veins?



Charmaine Coimbra
Family & Relationships
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Until sometime in November I don’t think I’ll have much time to craft a fresh blog. Life is presently in the way. (AKA buried in a community fundraiser set for Nov. 2.)  Yesterday I tried cleaning up my e-mail mess on a newer computer (with little success, mind you.) I found this post I wrote on a different blog in 2007. While my thoughts about Hillary Clinton in a possible 2016 presidential run are unformed, the foundation of this piece still rings true.

C. Coimbra photo
C. Coimbra photo

The Bitch

I’ve been thinking about this Hillary Clinton thing. You know, how she is in a horse race with other Democratic candidates, and how “she’s polarizing,” and how freely men and women call her a bitch.

For clarification, Mrs. Clinton is not my candidate of choice. Not because she’s polarizing or because I don’t believe she’s qualified. She hasn’t sold me on her platform. But I’m proud of her because she has tossed herself into the lion’s den of presidential politics. You go, girl.

But back to this bitch business. I wonder how many times I’ve been called a bitch? Was I a bitch because I have strapped “them” on and wrestled the proverbial bulls? Did I wear the title because I stood for my beliefs? Is it bitchy because I’m the boss and confident with decision making? I don’t know. However, I suspect that because I have refused (or been unable) to act subservient or lesser-than, that the bitch word has likely been attached to certain conversations about me.

Have I ever called another woman a bitch? Guilty as charged. I’ve regretted it every time. What makes me think I have the right to assume that another woman’s crankiness isn’t completely justified? And, yes, there are women who I’ve seen misconstrue power and behave badly—just like our buddies of the opposite sex. But only one in these circumstances is nailed with bitch.

Recently, a wealthy man said that what makes a person whole and successful is compassion. I guess he was simply saying that compassion towards others is good karma. I haven’t the foggiest as to whether it was his compassion that made him wealthy, but at least he brought the single most repetitive precept of Jesus Christ to the forefront, compassion.

I don’t know why these simple rules go unnoticed except that a sage woman once told me, “Charmaine, when you look at others you see them through your own soul first. So if there is darkness in your soul, your vision is unclear.” Don’t believe for a moment that I’ve mastered the art of a clear soul. I’ve an Irish temper that is wise to avoid fueling, and barely an ounce of patience flows through my veins. However, when I hear random shouts of “Bitch!” it makes me mindful of how I can better myself and the world in which I dwell.


spider and varicose veins
Healthy Living

what is the best procedure to minimize spider and varicose veins?

VN Editors
Dyspareunia: Is the pain in your head, or your uterus?
Love & Sex
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Dyspareunia, painful sex, is a symptom that can be caused by a wide variety of different conditions. Do you know which one is causing your problem? Is the pain of dyspareunia in your head, or your uterus?

Painful Sex

Sex can become painful for all sorts of reasons, but female dryness may be the most common. Lack of lubrication may be part of a physical problem, like menopause or pregnancy. A change in hormones will quite often affect your personal moisture. Stress and even diet can have an impact on dryness as well. If you’re thinking about pain or stressing about a problem, your body is going to have a hard time creating the moisture it needs to make sex a pleasurable act. Without it, you experience the pain of dyspareunia instead.

Is the pain all in your head because you’re tired, or stressed, or thinking about the Christmas shopping you haven’t done yet? Once you experience female dryness, it’s on your mind. You may be thinking about that problem the next time a chance for intimacy arises, and then the circle repeats.

It’s very common and very natural. But is your dyspareunia really so simple? Sometimes, dyspareunia isn’t caused by what’s going on in your head. Sometimes, the pain is a signal that something may be going on with your uterus.

Physical Ailments

Dyspareunia is almost always a symptom of something else, or a side effect of another condition. Sex isn’t meant to be painful, so you know that something is wrong when it is. Maybe it’s PCS.

Pelvic Congestion Syndrome is difficult to find through traditional testing. This condition relates to large veins in the pelvic region which cause pelvic pain, during sex and at other times. You may also experience urinary tract infections, low back pain and very painful sex if you have this condition. Pay attention to other symptoms you may be having, in addition to dyspareunia, because they may indicate that you have a larger condition that needs to be treated.

Fibroids, non-cancerous tumors in the uterus, can also cause dyspareunia. Many women have fibroids and don’t realize it until they begin experience pain or symptoms (like unusual bleeding). If you’re having pain and can’t pinpoint the cause, an ultrasound can tell you definitely if you have fibroids getting in the way of good sex.

Preventing the Pain

Painful sex isn’t always in the pelvis or even in the mind. Some women suffer from chronic pain due to arthritis, back problems and other conditions. There are many ways to work around pain and still find ways to enjoy sex. If female dryness is causing your dyspareunia, try lubricants or vaginal estrogen cream. If chronic pain is causing the problem, try new positions and different forms of sexual enjoyment.

Don’t decide to live with the pain, or stop enjoying sex because of it. Dyspareunia is a condition that can be defeated. Find out what’s causing it and move on from there.

Marcia R Reich
Surprise! Getting Naked Is Often Easier for midlife women
Love & Sex
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According to a new survey, women say they feel more comfortable undressing in front of men than they do undressing in front of other women. They say that women are too judgmental, where, of course, men are just grateful.” –Robert De Niro

Midlife sex can be complicated—or at least that’s what I thought until I began to do some research. Contrary to what you may think, women feel better at 50 than they do at 40—particularly when it comes to getting naked. At 40, many women feel that they have to look like their 20-year-old sisters (and daughters). Rather than embracing 40, they mourn for 25 and 30 holding an even larger magnifying glass up to what they consider their imperfections. The truth is—the majority of men don’t even know what cellulite is, don’t know where your boobs used to be and absolutely love the feel of soft, touchable flesh.

At 50 women seem to care less what both other women and men think about their bodies and focus on their own pleasure. “I just want to have lots of fun in bed” said a woman I talked to about sex in midlife. “I certainly have lots of flaws and imperfections but what the hell—they don’t stop me from having great sex and great orgasms”.

The consensus among these “older” women is that sex is about experience and feeling and not about looking and seeing. “If a man “sees” something he doesn’t like, he’s welcome to go elsewhere!” says another woman. “I don’t have time to waste on my veins and brown spots!” Amen!


Tom Cruise and Scientology and More About a Man I Like to Dislike
Books & Entertainment, News
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I had heard that Tom Cruise was on the list of Least Influential People of 2012. So I clicked through 30 slides on the GQ website and found Jerry Sandusky’s lawyer, but I didn’t find Tom, one of the people I most like to dislike. (My personal organizer told me never to say hate, that if you do, it goes through all the veins in your body.)

Maybe Tom is too irrelevant to rank among the least influential along with Donald Trump and number one on the list, Mitt Romney.

I consider myself a very tolerant person. I have friends who are Republicans. But Scientology? Given what I know about that and the lives it has ruined, I cannot accept Tom Cruise and Scientology any more than I can accept the Ku Klux Klan. Okay, a dot or more more.

In addition to Tom’s Scientology, I take issue with Eyes Wide Shut, the film he was in with Nicole Kidman, when they were still married. It is one thing to wach a pair of actors having sex on the silver screen and quite another to be put in the role of voyeur when the actors are a real-life couple: exhibitionist and creepy. (I know, I didn’t have to go see it.)

As for his height, let me first say, I have a decided preference for short men—at least romantically—those who are in proportion to my 5 foot 4 in stature. The other night when Cruise was on The Daily Show, he stood for quite a while before sitting down and looked bizarrely out of proportion to John and to his former self, as though he were wearing stilettos.

Recently a puff piece in The New York Times talked about how he does his own stunts. Might insecurity about his height may have something to do with all of his jumping between buildings and onto sofas?

Scientology, silver screen, and stilettos aside, I ought examine why I have a stronger reaction to Tom than I do to, say, Jew-disliker Mel Gibson. Might there be a tie-in to Tom’s looks? His pretty boy face is annoying, but if he were hugely likable, I fear I might find him attractive (feels icky just to write that), which probably makes me like dislike him all the more.

How do you feel about Tom?


Ann Onymaus
Fashion & Beauty
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So i’m blessed with bowed legs and worsening varicose veins. In the summer it’s capris or bermudas. I’ve tried leg makeup for the veins and work out to try to build up my calf muscles. Should I care really?

being Boswell
Retail Therapy
Home & Garden
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Last weekend really took it out of me. You…the stuffing, the nugget, the pudding. It wasn’t seeing mom; feeling her vulnerability and loneliness. It wasn’t feeling my own helplessness and sadness. No, what left my nervous system in a state of code orange was the encounter with my brother.

A lifetime of fear of his physical and verbal aggression lives in my cell tissue. I am undone every time I encounter his hostility toward me. I end up mad at myself for giving him such power. I fantasize my ability to square off with him, face to face, and with no quiver in my voice, tell him, “Shut the fuck up.”

Instead, I have jello legs, my heart beats out of my chest, and I can’t breathe. I hate him and then myself for responding like a wimp…again. My body responds to the danger by shutting down when my head wants me to either take him out or run away fast and quickly. My head and my body are at odds with one another.

After my encounter, Tom and I headed back to our hotel, stopping on Hope Street (how appropriate) to browse in some of the cute shoppes we had driven past for the last two days. Tom went into the men’s shoppe, I found PB&J’s, a woman’s boutique. It seemed a bit high end for me, but touching the soft fabric soothed me, doing something mundane, like shopping, helped me feel normal.

Then I saw it. A coat. Not just any coat. A great coat. Hanging there, against a wall, so beautifully displayed in it’s isolated simplicity. I knew, as I walked toward it, hands outstretched like I was headed toward the Light, I did not need a new coat. But again my body and mind begged to differ. My feet walked toward the coat regardless of my recent decision to reline and revamp my favorite 10 year old alpaca overcoat.

“Oh, what the heIl,” I cajoled myself as I tried it on. In the mirror looking back at me I saw a grown up, not the frightened child quivering inside. In this well done, cheetah faux fur coat, I felt powerful…dangerous even. Now I am not usually not an animal print person. I think it looks sexy on other women, but I feel a bit pretentious when I wear it. But, this coat was different. Wrapped in it I felt sleek, tall and not afraid. My nervous system calmed. The good enough to eat saffron satin lining sealed the deal. I felt carnivorous. “Don’t mess with me, I will eat you!”

I pulled out my Visa and bought the coat. Thanks to an after Christmas sale it was 25% off, even better. Tom, who had wandered into the store to find me, foolishly asked if I thought the coat would be warm? “Warm? Who cares?” I responded. I left the store, with my totem coat casually draped over my arm, feeling like Audrey Hepburn in her understated glamour.

Yesterday, I shared my weekend with a dear group of women friends. I cried with them as I told them about my terror. I admitted adrenaline was still running through my veins making me forgetful, easily startled and exhausted. They listened and loved me as only wonderful woman friends can. They soothed my self loathing by assuring me it was smart to trust my bodies reaction of terror when facing my brother’s disowned malevolence. They said when someone is being terrorized they are supposed to feel terrified.

As I prepared to leave, throwing my coat over my shoulders, they shared my excitement in buying a powerful, sharp clawed cat coat to made me feel safer. Stronger. And run faster.


Donna Highfill
All I Want for Christmas is a Vampire
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My husband asked me recently what I wanted for Christmas. I replied with the obligatory, “I have all that I need” response, and it felt true from a material standpoint. He wanted me to jot down at least one desired item, and before I knew what I was doing, my pen wrote down one word: “Vampire.”

It’s my daughter’s fault. While in high school, she stood over me until I read the entire Twilight series by Stephanie Meyer. As an English Major from Wake Forest University, I feel as if I should have offered a scathing critique. The truth is: I couldn’t put those books down.

I still have a magnet on my refrigerator that my daughter gave me which says, “My husband has my heart, but my neck belongs to Edward.”

It fascinates me that a world obsessed with youth is so intrigued by these ancient beings. Of course, they stop aging at the point they were turned, which is amazingly always around the ages of 25 to 35. So, although they are represented by the young and the beautiful, they’re still really old. In fact, most of the vampires I’ve read about or watched on the television are several HUNDRED years old.

That would make me quite the catch. To a vampire who has seen several centuries, my 52 years would be a drop in the bucket. Please understand that I wouldn’t want to become a vampire. That choice should have been made about 25 years ago. I don’t want to spend eternity as a menopausal bloodsucker. That possibility is too violent to even consider.

The vampire focus in our house died down temporarily during the hiatus between Twilight movies. That is, until my daughter dragged me, not kicking and screaming, into the television world of “The Vampire Diaries.” (By the way, if you want to sound really cool with younger people, refer to it as TVD. I do, and although it doesn’t really make me sound cool, it is easier to remember that way. )

The show is actually fun to watch, and the vampires are sarcastic and witty and strong — a lot like Rosie O’Donnell. They’re also drop-dead gorgeous, which is not so much Rosie-esque as Johnny Depp-esque.

There’s something about vampires that makes me think they might just be perfect for a menopausal woman. Especially those rare specimens who are in the bodies of men age 45 and older. I say that solely so that you won’t think I’m a pervert attracted to 22-year-old men.

But really, the youth shouldn’t matter, because their centuries of experience make vampires respect the wisdom and intelligence of older women. In fact, vampires tend to decapitate little sorority girls with perky boobs and perkier attitudes. I like that about them.

In addition, vampires value a good vein. They can smell the blood flowing and that puts them into throes of ecstasy. I mean, better than sex. I have some veins on the backs of my thighs that would send them into an absolute tizzy. Stefan, Damon and Edward would be following me around like dogs on a leash.

As far as hot flashes go, vampires are notorious for being ice cold. I cannot imagine the absolute delight of taking my burning face and laying it upon the firm, cold chest of my vampire. It would be like having a traveling ice pack with me.

And those nights when insomnia strikes, I would walk out of my bedroom to the site of my gorgeous nocturnal friend, wide awake and ready to talk. He could be waiting for me with a cocktail, and we could sit around and discuss the centuries in which he’s lived and whom he killed and what dances he attended and if he knew Mark Twain. Then a hot flash would hit, and my head would go straight to his chest and all would be well.

And when people invited me to events that I’d rather not attend, he could look them in the eye and compel them. For those of you who don’t know vampire speak, this means the vampire makes a simple suggestion and their eyes compel people to believe whatever they say. My vampire would say, “Donna will not attend the candle party, and you will be fine with that. In fact, you will be so pleased she did not attend that you will send her five free candles.”

I might have to ask Santa for Twilight‘s Edward, because he has the ability to hear thoughts. It would be extremely helpful to have him around when I walk into my bedroom, look around and wonder why I’m there. “You were looking for your book,” he would say, having read my thought before I got there.

Or when we’re talking and I forget a name and it pops in my head for one split second and leaves, Edward could retrieve that name for me: “You were thinking of Walter Cronkite.” Hours of “What’s that man’s name with the white hair who was on the news?” would be replaced with witty banter.

Most of all, a real vampire wouldn’t care if I put on a little weight, or if things drooped or if skin thinned. “The better to get to your veins, my dear,” he would say.

So, I’m going to ask Santa Claus for a vampire, because my vampire would be less interested in my exterior and more interested in what goes on inside of me, even if it is the blood running through my veins.


Barb DePree MD
The Big “O”: For Him
Love & Sex
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We talk a lot here at MiddlesexMD about the female side of sex, how to keep your libido alive and your sexual experience comfortable and pleasurable.

But we often take the male orgasm for granted (or… maybe not, at this stage of the game). For most of us—at least in the beginning, that pump was always primed; the shotgun always loaded. Now, whether our partner is slowing down, in need of a little pharma assistance, or still willing and able at the drop of a pin, we know for certain that his orgasmic experience is different from ours.

For starters, its purpose is different; the plumbing is different; and the “sexual-response cycle” (a term coined by sex researchers Masters and Johnson) has a different timing (say, like a hair-trigger).

On the other hand, male and female orgasms do share basic similarities in that both genders progress through similar stages. And, as with its female counterpart, a lot is still unknown about the male orgasm.

Since a little knowledge is a helpful thing, understanding what happens during a guy’s orgasm might help us appreciate the similarities and differences of our mutual experience. Maybe Mars and Venus can orbit in slightly greater harmony.

The male orgasm is designed to position healthy, active sperm so that it achieves its biological objective—babymaking. The job involves the coordination of brain, nerve, muscle, and blood, and psychological factors, to get those swimmers into our receptive vessel.

Testosterone is the juice that fuels the system in a male. It’s the critical hormone that keeps his libido finely tuned and his sexual apparatus running properly. Testosterone can boost our libido too, but a guy’s daily testosterone output is about 20 times greater than ours.

Testosterone is produced in the testicles, which also makes the sperm and mixes it with a protein-rich fluid bath for nourishment during the arduous trip up the vagina. Sperm and fluid together constitute semen, which is what is ejaculated during orgasm.

Usually (there are some exceptions), a guy has to have an orgasm for the pumping mechanism to work. For us, orgasm is nice to have, but not essential to the job at hand. Our orgasm might help those little sperms along somewhat, and it makes sex feel good, but orgasm or no, we can still get pregnant.

The actual sexual-response cycle unfolds in four stages for both men and women. For a guy, however, orgasm is a more straightforward and less tricky process. Given a normal anatomy and normal testosterone levels, a flash of nicely turned thigh or bosom is enough to trigger the first stage of the male orgasm: arousal.

We experience arousal too, of course, but it generally takes different stimuli and a longer time frame.

During arousal, blood flows into a guy’s penis through enlarged arteries perhaps 50 times faster than normal, and veins that normally drain blood from the penis close off. Muscles tense and the scrotum pulls inward.

Voilà! Erection.

The second stage is the plateau, in which the man’s body prepares for orgasm. Heartrate and blood pressure increase. Muscles tense further. Involuntary pelvic motions begin. A clear pre-ejaculate fluid may change the PH balance in the urethra so the sperm has a better chance of survival.

Orgasm in men occurs in two phases. First, semen collects in the urethral bulb at the top of the penis. This is called “ejaculatory inevitability,” in which the man reaches the point of no return. Then, the rockets fire. Muscles at the base of the anus contract rapidly to pump semen through the urethra, and nerves deliver orgasmically pleasurable messages to the brain. The ejaculation phase is fairly reflexive and is controlled by nerves in the spinal column.

The final stage—resolution— is when our man rolls over and falls asleep and we’re left feeling all warm and fuzzy and yearning for pillow talk—or for more sex. But don’t jump to conclusions—he’s spent, literally. He loses about half his erection immediately; the rest fades shortly.

While we may not be fully satisfied after one orgasm, our man is. It takes a recovery period (called refraction) before he’s ready to go again. When he was 19, refraction may have lasted half an hour. Now, well, it’s a different story. This is when a little sleight of hand or toy action might help you out.

While the male orgasm is less affected by mood and psychological factors than ours, hormonal imbalances, physical issues, medications, and of course, aging can still muck up a man’s ability to become aroused or to have an orgasm.

So, the next time your man starts to snore as soon as the deed is done, you don’t need to take it personally. Blame nature.


Lisa Copeland, The Dating Coach Who Makes Finding Love After 50 Fun and Easy!
Are You Over 50 But Still Dating Like You’re 20?
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So many women ask me why dating is so difficult for them. What’s the answer? Well that’s easy! We are 50 and over but we date as if we were still in our 20’s.

Don’t you feel like you were just in college? After all, we still wear our jeans and we still have long hair, unlike our mothers who used to cut their hair once they were married. With vibrant memories of our college years from the 60’s and 70’s still floating around in our heads, there is just no way we feel or look like we are in our 50’s and 60’s.

And that’s why we still look at members of the opposite sex like we did in our 20’s.  Most of us still want that handsome football captain who is so successful.

So we go online with our 20-year-old mind and who pops up?  50 plus year old men who look like our grandfathers with grey thinning hair, a belly and a boatload of baggage.  No wonder it seems like no one’s out there to date – they all seem too old for us!

But, we have our stuff too.  While men are balding, we are finding strands of hair popping up all over the place. In fact, if you think about it, hair removal could probably be a full time job for us after 50.

And we often have leftover pregnancy weight from 20 years ago, spider veins becoming more visible every day and hormones that wreak havoc with our systems and put the fear of God into anyone within 10 feet of us on a bad day.

A couple of years ago, I remember seeing a picture on Facebook of my handsome high school sweetheart who, by the way, did play football back then. I was shocked!  The young man I remembered had long black hair and wore painter’s pants.

In my mind, I expected an older version of the black haired, painter’s pants wearing man.  Although still handsome, he looked like his father with snow-white hair and a suit.  There was no way I could look that old too!

But I probably do. I just don’t see it. In fact, a wonderful gentleman told me this story that we can all relate to. He was getting ready to post his picture online and his daughter says, “Dad, Why are you posting a 10 year old picture of you online?”  He confided in me that the picture was how he still saw himself and didn’t realize his face had aged since it was taken.

None of us like to think we are getting older, but we are… and so are the men we are looking at to date.  There are some men who are still handsome and have aged well and there are some who haven’t, but as we get to know their personality, they grow on us and we get to know them better.

Decide what is really important to you when it comes to a companion who will age with you into your 60’s and 70’s.  Do you want a lover?  A friend?  A man who will be with you through thick and thin?  Do you want a man who views you through his eyes as hot and will love you even more as you age and will always think you are beautiful?

He’s out there waiting for you as one of those balding men online staring back at you from your computer screen.  If he seems nice…consider giving him a chance to get to know you.

You might find that this man who looks over 50 with his thinning hair may be the wonderful loving man you’ve been looking for.  Let me know how it works out for you.

Much love and joy to you, Lisa


VN Editors
How much should a breast reduction cost – and how can you pay the bill?
Fashion & Beauty
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Once you’ve decided that breast reduction surgery is right for you and you’ve researched and found a qualified plastic surgeon to perform the procedure, you’ll need a plan for paying the bill.

Budgeting for breast reduction surgery

Breast reduction surgery has both direct and indirect costs. Wendy Lewis, Vibrant Nation health and beauty expert and author of Cosmetic Procedures and Plastic Surgery After 50: Expert Advice for Choosing the Best Option for You, advises women to expect to pay anywhere from $5,000 to $10,000 for the procedure, not including hospital and anesthesia. Hospital and anesthesia fees vary considerably regionally, as well; sometimes they are grouped together, but often each is quoted as a separate fee. You can expect your direct costs to break down within these ranges:

  • $1,500 to $2000 for the person administering anesthesia
  • $500 to $2,000 for the hospital or facility
  • $5,000 to $10,000 for the surgeon

In addition to these direct costs, don’t forget to budget your indirect costs, which can be substantial. They include:

  • Any reduced pay for missed days on the job
  • Medications
  • Your new wardrobe
  • Help with household chores and ready-made meals for a couple of weeks
  • Insurance co-pays if applicable
  • Corrective surgery if required

Of course, the total budget will vary by patient, surgeon, and geographical region, but you should probably be prepared to spend at least $10,000 on the overall costs associated with your breast reduction surgery.

Although breast reduction surgery represents a major investment of money and time, women who have had it don’t question those costs. As one woman shared on, the leading online community for women over 50, “It was one of the best decisions of my life. I am sooooo glad I listened to my own counsel about this issue. Almost 3 1/2 pounds was removed, insurance covered it completely and I feel 110% better. I’ve had no neck or shoulder paid since the surgery. I’m a 36C, enjoy exercising again and have lost 18 pounds.”

Will my health insurance pay for breast reduction surgery?

According to Wendy Lewis in Cosmetic Procedures and Plastic Surgery After 50: Expert Advice for Choosing the Best Option for You, insurance coverage for breast reduction surgery may be obtainable depending on the criteria of your individual carrier. Medical insurance sometimes covers part if not all of the cost of breast reduction surgery if overly large breasts are causing health problems, such as headaches, neck aches, or backaches. If you require or request 500ccs of tissue to be removed from each breast, some health insurance carriers will cover the cost of your breast reduction. Check with the carrier to find out the specifics of your policy.

A Vibrant Nation member advises, “Start creating a history with your primary health care provider. Numbness in my hands and arms, shoulder grooves and neck pain, discomfort while traveling for business, knee and foot and ankle swelling, varicose veins; these conditions can all be either lessened or eliminated by breast reduction. Talk to your doctor.”

Also, talk to your insurance company. Ask:

  • How much, if anything, will be covered by my plan?
  • Will my insurance premiums or future coverage be affected if I file a claim?
  • Can you provide me a checklist of everything I’ll need to provide in order for my insurance plan to pay (for example, a completed pre-authorization form)?

Are there other options to pay for breast reduction surgery?

The amount not covered by medical insurance can be financed, usually through your plastic surgeon’s office. If not, your surgeon can probably refer you to a medical finance company, so check with your doctor’s office first.

Then, compare finance plans carefully to get the best deal. When we researched this topic, most plans offered favorable terms like no down payment, no processing fees, no interest for a fixed number of months, flexible payment options, and no prepayment penalty. But interest rates varied from 5.9% to 18.9%, so do your math homework on this one to determine the cheapest financing option.

Depending on what you learn by comparing medical finance plans, it might even be cheaper to pay for your surgery with a credit card or by drawing from your home’s equity. The idea of making payments for smaller breasts might seem odd to some, but many patients who’ve had breast reduction surgery discover that their newfound comfort level and ability to engage in physical exercise again is well worth the investment.

For more information about breast plastic surgery, download our free report: 5 Keys to Successful Breast Reduction Surgery After 50.

Donna Highfill
Nobody Told Me I’d be Too Tired to Pick Up the Remote
Healthy Living
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I turned fifty and got hit with both menopause and the sleepy stick. I was sure I had mono, or the flu or something worse. I had been warned about the menopausal rages, the hot flashes and the drying skin. But nobody mentioned the fact that  getting off the couch would become the equivalent of an Olympic event.

My days looked something like this:

  • My alarm clock would buzz. Unless it could physically pull me out of the bed or contained a talking bird like that Flinstone clock, I wasn’t about to move.
  • My eyes would open 30 minutes later. I’d lie in bed and wonder why, exactly, I was supposed to get out of it. Then I would realize that I had to get out of bed to get my morning bagel.
  • I would drive through McDonalds where a very nice woman would insist on talking to me. As I drove away, I would slam back into my car seat, exhausted from the expansive conversation with the drive-thru woman.
  • I finally would pull up to my office where I stumbled out of my car. I would leave my briefcase because it was just too heavy to carry and I had my bagel and everything.
  • Once in my office, I would use my last bit of morning energy to push the button on my computer and prepare for a day of work.
  • One hour later I would know everything there was to know about the Kardashians. The phone would then ring and I would glare at it wondering why would a client interrupt my Kardashian fact-finding. Why?
  • When the need to go to the bathroom would strike, I’d find any way possible to put it off. Once I even googled the “space diaper” worn by the astronauts as a possible alternative.
  • Work would FINALLY end, and I would stand up to leave. Most of the time I had to steady myself as the blood that had been resting in my veins suddenly woke up and rushed to my head screaming, “She’s on the move! She’s on the move!”
  • I would drive home and exercise my middle finger repeatedly. At least something got exercise.
  • I would get home and stare at the kitchen counter waiting for a meal to appear. Nothing ever happened. So, I’d grab a Diet Coke and some Cheetos and plop down on my leather couch. I’d turn on my 42″ flat screen television.
  • My viewing included Tabitha’s Salon Take Over because Tabitha is bitchy and unapologetic about it. I’d watch several shows in a row. I’d think about moving but decide against it.
  • My husband would come home with dinner, and I’d rock backwards to get enough energy to stand. The dizziness would pass, and I’d take three steps to get the TV tray and 10 steps to get a paper towel, because the napkins are in the far cupboard. I’d sit back down.
  • House Hunters followed, and I’d bask in the comfort of other people making decisions. Eventually, I’d notice that everyone was suddenly on an island or in Poland, which meant my time has bled directly into House Hunters International.
  • The phone would rarely ring, but when it did I would say something ridiculous like, “Of course, just as I relax somebody wants to talk. GAWWD!”
  • Several Say Yes to the Dress‘s later, I’d prepare to run my next marathon which included the dreaded closing ceremony. I’d grumble about how women have to remove make-up when men can just jump in bed without worrying about it. “In my next life, I’m going to be a man,” I’d say with split flying out of my mouth. My husband would smile and try not to make eye contact.
  • I’d get in bed and start to read my newest Martha Beck or Anne Lamott book. I find them both inspiring and brilliant, and I would begin to plan for my newest career in life. I’d write down some ideas for a blog and turn out the light.
  • Approximately one hour later, a hot flash would awaken me, and I’d find all of that energy that I didn’t have during the day. I’d pace around the house for an hour like a caged shrew and eventually take a Benadryl.
  • A few hours later, the morning sun would have the audacity to peek in the blinds, and my marathon would start all over again.

While I’ve moved past most of this stage at the age of 52, I just wish somebody had warned me about it. I knew I’d be hot. I knew I’d have occasional rages. I didn’t know how excessively tired I would be. That information would have saved me thousands on thyroid and mono tests.

So to all of you Dames who have not entered menopause, I hope this stage is not a part of your experience. But, if it is, just know that it’s part of the package deal we get with monthly cramps and teenagers. It’s a gift that keeps on giving.