Sexual Function/Problems

Question from a student attending University of Kentucky:
Is it normal for a man, on occasion, not to be able to get an erection while being stimulated?
Female, Sophomore

Dr. Caron's Response: Yes. Physical and emotional factors may interfere. For example, alcohol and other drugs can interfere with a man's ability to get an erection. Also, a man who is overtired or overstressed is not at his best in anything. Be understanding and patient.

A student at the University of Maine wants to know...
My girlfriend and I have been with each other for almost 4 years now. I don't get to see her often but when either of us visits each other we usually have a good amount of sex in a short period of time (over a weekend). In the past 2 months my girlfriend has been saying that every so often it really hurts her to have intercourse... it's to the point where she starts crying. I was just wondering if this is okay or should she have it looked at? And is there anything I can do in the boyfriend role to make her feel better?
Male, Senior

Dr. Caron's Answer:
My first suggestion is STOP. Intercourse should not be painful. If it is, she should seek a medical opinion. The most common reason for pain is lack of lubrication, which can easily be resolved with a lubricant. However, pain with intercourse can be caused by a number of other issues that should be explored with a medical provider who specializes in women's health. Sex should be about pleasure.  When you say she starts crying because it hurts, that is a clear indication that you need to stop. I mean, what is the point of continuing if it is not pleasurable for her? And one has to wonder how it could be pleasurable for you if you know it is hurting her. It would be no surprise to see a person's desire to engage in sex drop very quickly in this situation.  As her boyfriend, your role should be one of showing care and concern for her well-being by accompanying her to her medical appointment. Until her pain is resolved, it means being patient and showing a willingness to find other ways to be sexually intimate with each other besides penis-in-vagina. It also means assuring her that you are there for her and that you will wait until she feels ready to initiate intercourse.  Best wishes.


A student from UM wants to know...
My boyfriend and I have been together for a long time but we haven't been sexually active with each other (or anyone else) for a few years. I can't seem to bring myself to want to do stuff with him. Is there anything I can do or we can do? It is starting to become a big problem.
Female, Junior

Dr. Caron's Answer:
You say it is becoming a problem. I wish I knew what you meant by this. For example, is it that you feel pressured to be doing something sexually because you assume every else is? is it that you don't think this is how "normal" couples should interact? Or is it that your boyfriend is not happy with the way things are? Some couples feel that there may be something wrong with them if they do not have frequent sex. You may be surprised to know that many couples who are in what they consider "long term happy relationships" are not sexually involved with one another. In fact, a national sexuality study published about 10 years ago (Sex in America by Michael et al.) reported that nearly one-third of couples said they rarely, if ever, had sex.  Knowing this may take some of the pressure off you to change what may be a very comfortable, fun-loving relationship for the two of you.

On the other hand, you say it is starting to create problems, which suggests you would like a change. You want to have the sexual part of the relationship, but can't seem to find the desire. Consider those aspects of your life situation and/or your relationship that may be creating roadblocks to desire. For example, it's hard to have desire when you have so many other demands in your life, or if you do not feel that your partner cares about you or if there is unresolved anger. Were there problems within the sexual relationship that led to a lack of desire (e.g., you were never sexually satisfied, he was feeling pressured to perform)? You do not mention any of these, but these could be issues to look at and discuss (either with your partner, a friend, or a counselor).

It seems like a good place to start would be to talk with your partner about his comfort with the relationship as it is. Perhaps there is no need to change. Or maybe he feels the same way.  Perhaps you two have become so comfortable that you forget about those earlier times in the relationship when sex played a key role - it may have been a way to make you feel wanted, satisfied, sexy, loved, and cared for. Like so many things in life, it can be hard to keep the excitement alive over time. Think of it as an analogy to your favorite food - for example, Ben and Jerry's ice-cream... let's say the first time you tried the Phish Food flavor it was amazing. But if you started eating it every week, or even every day, well, it probably got pretty boring pretty quickly. A little taste once in awhile may be just what you need... Begin to rekindle those tastes, those feelings, by finding a way to "date" one another again, adding little surprises to the relationship, and doing those things that used to turn you on that have now fallen by the wayside. Find time to just kiss and hold one another, to snuggle and lay close together and listen to each other's heartbeat. Take it slow, and work on rekindling those pleasurable activities that create sexual feelings for you - work on building upon those little things that make you feel comfortable, loved, and cared for.


A student from Michigan State University wants to know...

Is there a difference between the sex drives in men and women? If yes, what are those differences?
Female

Physically, we know that men and women are equally capable of sexual arousal. However, when we look at the impact of society on our thoughts and behaviors,we see that men and women are often raised with somewhat different messages/ideas about the meaning of sex and this may lead to different expectations. For example, he may have been raised to think that sex is about finding physical satisfaction/orgasm, versus she may have learned it is a way to find emotional pleasure/love. While society may try to portray women as less interested or uninterested in sex, the reality is that people vary. Some women and some men have very high sex drives, while other men and women do not.


A student from the University of Connecticut wants to know...

What does it really take to have a healthy sexual relationship? I think I know a lot about the right moves, but what else should I be thinking of?
Male, Junior

Dr. Caron's Answer:
Most people recognize that technique is only a small part of what it takes to have a healthy sexual relationship. It appears to be more important to be able to communicate and create an openness to intimacy and sharing. Survey after survey reveals that a sexual relationship is rated as more satisfying if it is based on such things responsibility, equality, and honesty. This has been found to be true whether it is in the context of a one-night stand or a long-term relationship. Since no two people are alike, a technique (or "move", as you say) that is a turn-on for one person may be the opposite for another. The only sure way to figure out what pleases your partner is to communicate. By this, I mean not only being able to talk, but also being able to listen to your partner. You'll need to have an atmosphere of openness. A few examples of ways that sex can be unhealthy include when it becomes a performance (thinking you must know everything and be the best) and when sex becomes a competition (thinking you have to out-do your partner's previous lovers). Remember: You want to increase the pleasure by reducing the pressure. Again, great sex isn't so much about the right move, as the right mood! Being open to sharing what feels good for each other is an important part of the equation.


A student from Michigan wants to know...

My girlfriend and i have been together for four months and while I would say our sex life is pretty good, it is limited to intercourse and a bit of touching.....however, oral sex is not even in the picture.... I have tried to convince my girlfriend that it is a normal thing to do, but she isn't willing to even try. Is this normal for her not to even want to try?
Male, Sophomore

Dr. Caron's Answer:
You bring up a good point: No one should ever be forced or coerced into any sexual behavior they are not comfortable with.  In terms of who likes or does not like oral sex: depending on what study you look at, 10%-30% of people surveyed found oral sex unusual, kinky or very unappealing. Older adults report less experience with oral sex than younger people; those with more education are more likely to engage in oral sex than those with fewer years of schooling. There are many reasons why someone may feel uncomfortable with oral sex and wish to avoid it. Can you talk with your partner about what may be going on for her?  One of the most obvious relates to an individual's morals and attitudes about sex. Some believe that oral sex is simply wrong and conflicts with their personal code of acceptable behavior. Other reasons are unrelated to morality and concern the mechanics of the behavior itself. Women are often concerned that the man will ejaculate in her mouth and she will find that unpleasant.  While it is not dangerous to swallow semen (assuming there are no infections), some women would rather not do so (and since many students ask, please know that semen is low in calories with only 5 calories in the average ejaculate). Both men and women worry that the smell or taste of the female genitals will be unpleasant or repulsive. In reality, female genitals that are washed with normal regularity have a natural fragrance that most people find attractive and enjoyable. If these are some of her concerns, perhaps they can be overcome by sensitivity, respect and patience.


A student from the University of Maine wants to know....
How does a women tactfully tell her partner that she is not satisfied, that he needs to slow down and perhaps take time to do a few more things rather than just take care of himself - especially when he is convinced that he is doing everything well?   How do you bring this up?
Female, Senior

Dr. Caron's response:
First of all, I would suggest the conversation take place outside the bedroom.  You could begin by saying, "I think our lovemaking is nice, but I'd like to tell you a few things that would make it even better."  Or, you may want to ask him what pleases him sexually.  Even if he responds that everything is fine, you could let him know that some things he does for you are fine but he must have some preferences also.  By getting him to talk about what he really likes opens up the conversation for you to tell him what you like.  It's important to be specific and let him know what turns you on, where, when.... In bed, you may want to show him how you like to be touched.  Keep in mind that no one likes to be criticized or made to feel stupid, so try to give your partner positive feedback.  By communicating with each other, you will be better able to meet each other's needs.


A student at Boston College wants to know....
My girlfriend and I were talking and wondered if there is a time of the year that people have sex more than other times?
Male, Sophomore

Dr. Caron's Answer:
Interesting question. I have heard it said that June is the most popular month for first sexual experiences. In terms of the time of year more sex occurs, a good indicator may be to look at condom sales. In a year, Americans purchase over 350 million condoms - that works out to about 27 million condoms in a four-week period (monthly).  A national study by ACNeilsen in 2002 found that condom sales increased from mid-May to mid-August, to nearly 28 million condoms sold in four-week period. Based on these findings, one could assume that more people have sex (at least safely) during this time of the year.  This study also found that the lowest sales are from September to November, with only about 26 million condoms sold per four-week period.  As a side note, the study found that more at-home pregnancy tests are sold in March than in any other month...perhaps the result of Valentine's Day activities.   Interesting.


A college student from BU wants to know....
We are new at this and wondering: Can a woman have sex while she is menstruating? Is it really safe?

Male, First-Year

Dr. Caron's answer:
Yes, and many women do.  Some women even prefer intercourse during this time because they fear pregnancy less (assuming they ovulate in the middle of their cycle).  For others, having sex/orgasm often makes a women feel particularly good at this time and can relieve menstrual cramping by relieving pelvic congestion.  While some women feel more sexual during this period, it should be noted that others wouldn't dream of desiring sex at this time.  Although sex during a woman's period is harmless, one's attitude about menstruation can effect how she (or her partner) feels about participating in sex during this time.


A student from Georgia Southern wants to know.....
I have been in a relationship with a girl I have known for almost a year now. Our sex life is healthy but she says that I am not creative. She wants me to think up new ideas but I need help. Suggestions?
Male, First-Year


Dr. Caron's response:
Let me begin by saying that since your sex life involves her, I guess I would ask her to participate in the creativity process.... and not expect you to be the one who initiates or creates the new experience.  And what exactly does she mean by "creative"? If she means she would like to try new positions, well... the Kama Sutra suggests there are 529 possible positions... so this may be a resource for you. My guess would be that your relationship has fallen into a pattern or routine where the newness has worn off... if it is the same old thing time after time, it's going to get boring.  That's true with many things in life... for example, if you get excited about a new flavor of Ben & Jerry's ice-cream and then proceed to eat it every day, the excitement will wear off and it will become boring.  I imagine that whoever said, "variety is the spice of life" may have been referring to our sex life. I think expanding one's definition of sex beyond penis-in-vagina is a good place to start.  What else do you do in terms of touching and caressing one another? Varying the time and place of your sexual interaction can help add to the excitement and sense of newness.  But as I said in the beginning, I think this task of being more creative involves both of you... can you talk to her about ideas she may have to spice things up?  Perhaps asking her what turns her on and where she likes to be touched would help.....maybe when you are in bed together you could ask her to show you. I believe that by communicating with each other, you will be better able to meet each other's needs.  Best wishes.


A student from Simon's Rock College of Bard wants to know....

Question: What positions during intercourse are more comfortable for women. Is it normal for some positions to be painful?
Female, First-year

Dr. Caron's response: Comfortable positions during intercourse really vary from person to person - while some may enjoy the man-on-top position, others may enjoy having the woman on top, being side by side or using rear entry. Some people enjoy experimenting with more than one position. Comfort level really varies widely from couple to couple. However, I will say that some women report that they find the woman-on-top position more comfortable because they have a greater range of motion and can more easily control the angle, rate, and depth of penile penetration. Is it normal for some positions to be painful - yes. For example, pain can be the result of a woman not being lubricated enough. Sex can also be painful if she has an infection (such as a yeast infection), and some contraceptives have been known to irritate the vagina (like certain foams and gels, and even condoms!) which can lead to painful sex. Other pain can result when thrusting is so vigorous that the ligaments that support the uterus are pushed and suddenly stretched - the woman-on-top position comes in handy in this case since she controls the depth of the thrusts. Although all women may experience some pain during some episode of intercourse, there is reason to be concerned if you find that you have this pain most or all the time - in whatever position you find yourself in. A pelvic exam performed by a gynecologist would be recommended. For example, endometriosis (when menstrual tissue ends up outside the uterus and attaches within the pelvis to the ovaries, tubes, and uterus) is associated with pain during penile thrusting and you would want to have this checked and treated. For more information on endometriosis, check out this website: http://www.endometriosisassn.org/. Best wishes.


A student from Connecticut wants to know....
I've suffered from premature ejaculation ever since I began having sex at age 16. I'm 20 now and it only gets worse. Upon insertion, I have no control over what happens. It's hurting my relationship now and I'm afraid it will hurt me for the rest of my life. Is there a cure? Something that can fix it?
Male, Junior

Dr. Caron's answer: Premature ejaculation is also called early ejaculation. When a man ejaculates before intromission, at the point of intromission, within 2-5 thrusts, or within a minute, almost all couples will identify this as premature or early ejaculation. I think it is important for you to know that it is the most common male sexual dysfunction, especially among younger men. Fifty percent of young males report early ejaculation and one-third of adult males report they ejaculate more rapidly then they would like. So I guess what I am saying is that you are not alone.
I hope you have been able to talk openly with your partner about how you are both feeling - rather than trying to "sweep things under the rug" or pretend nothing is upsetting you! Some couples find that while the man may ejaculate too quickly the first time they attempt intercourse, they can then resume lovemaking/touching/playing around, and his second erection lasts much longer. How are you coping with this? I ask because I wonder how you have dealt with this so far. I also hope your partner is not taking this personally - as a disappointment or some kind of rejection. That will be important to discuss as well. The other area to look at is expanding your definition of sexual activity beyond "penis-insertion- into-wherever" -and look to other activities that are mutually pleasing, such as oral sex. If sex ends with your ejaculation, I can see where it would be a major problem.
Early ejaculation is commonly a physical issue that can be corrected with some "re-training" and awareness. I really discourage "do-it-yourself" techniques such as wearing two condoms, using a desensitizing cream, biting his tongue, or thinking negative thoughts (such as how much money you owe). These can be harmful in two ways: 1) These techniques serve to reduce arousal and can cause erection difficulty rather than lead to ejaculatory control; and 2) You end up isolating yourself from your partner, which leads to further emotional alienation and can destroy the couple's bond. THE KEY ELEMENT IN LEARNING EJACULATORY CONTROL ISTO IDENTIFY THE POINT OF EJACULATORY INEVITABILITY.
Most often early ejaculation is due to lack of knowledge, attention, or skill. It is often a result of early sexual experiences (rapid ejaculatory response learned through masturbation/partner sex). If you were to go to a sex therapist for assistance, the treatment would focus on helping you learn to identify the point of "ejaculatory inevitability." In my own sex therapy practice, one procedure that I recommend is the "stop-start" technique, developed in the 1950's by Dr. Semans. This technique asks the male to practice penile stimulation to the point prior to ejaculation, first through masturbation and later with his partner. The male with early ejaculation signals his partner when to stop so that his arousal level can subside. Stimulation is then resumed after a pause, and the process is repeated at least three times before allowing ejaculation to occur. It is important for you to enjoy your own sensations and to learn to identify the various levels of arousal that you experience. You need to learn to accurately identify the point of ejaculatory inevitability. This exercise should be practiced 2-3 times per week. For most men I see, ejaculatory control can be learned in 8 to 20 weeks. I strongly recommend reading The New Male Sexuality by Bernie Zilbergeld - it has excellent suggestions and greater detail on this technique. Best wishes!


A question from a student at University of Toledo:
Is it true that "sex before the big game" weakens you? Male, Senior

Dr. Caron's Answer: Most experts disagree with the athletic tradition of sexual abstinence before a big event. The prevailing advice is not to disturb your regular sex pattern. For instance, if you normally have sex 2 times a week, then continue to do so the week prior to your important event. This may help your athletic performance by keeping you relaxed. According to studies, relaxed athletes.


Question from a student at the University of Minnesota Duluth: When my boyfriend and I were having sex he tried to reach, go in as far as he could. Anyways, he touched something in me that felt like a bone or something solid, I felt it too. I thought it hurt or caused some pressure that was extremely new to me. Do you have any idea on what he was feeling and why I could feel it too. Thanks for your time. (Female, Sophomore)

Dr. Caron's answer: I assume that what you and he touched was your cervix. I often tell students that if you reach up into your vagina you will feel something that feels like the end of your nose.... it is the base of the uterus. You may also notice that it feels like it has a dimple. This is the opening into the uterus (the cervical os) - which is about the size of a pencil lead. It allows menstrual flow to leave the uterus, and allows sperm to enter the uterus on its way to the fallopian tube to meet an egg.

If you feel the cervix at different times over the course of a month, you will notice that it changes from feeling very hard to feeling softer at different times of the month. For example, around ovulation (when a women releases an egg from her ovary - usually occurs about 2 weeks before her period), it will feel softer. In fact, one of the things women do who are using Natural Family Planning, is to record the changes in the cervix (as well as temperature and mucous changes). I hope this relieves some of your anxiety. You may also find it useful to refer to a basic biology book to understand the positioning and structure of all your reproductive/sexual organs. Best wishes


Question from a student at Michigan State University:
I feel that my boyfriend doesn't get into sex, or isn't turned on. What
can I do to make it better? (Female, Sophomore)


Dr. Caron's Answer:
What do you want to do? It sounds to me like you may have a fine
platonic relationship. One where you enjoy being with this person, but
you do not share sexual experiences. How does your boyfriend feel
about this? Is this something he is happy with? I suggest you sit down
together and discuss the relationship openly and see if you are in
agreement.


It might be important to examine if your perception of his lack of
interest has been this way all along, or if this is something that you
see as a more recent change? That may help guide the conversation you
have with him. If he refuses to talk about it, you'll have to think
about your own needs and options. For example, is it worth it to stay
in a relationship that is not meeting your needs?


I am interested to know if you have been together for quite awhile and
this is something that you have observed over time. If so, it is
important to recognize that anything that is routine, which happens
over and over again in the same exact way, becomes boring or stale.
Even sex. If that is your situation, you may want to talk about how you
might spice up the relationship: changing your positions, places, and
times; adding little surprises; doing the things that used to turn you
on which have now fallen to the side. It's important to find ways to
vary your experiences - this means communicating and negotiating with
your partner.


Finally, recognize that loving relationships thrive on mutual respect.
I am not sure that you can make anybody feel turned on and interested
because you're feeling turned on and interested. Generally, "turn-ons"
for men include caring, touch, shared feelings, and the interest in
mutual respect. Best wishes.


Question from a student at the University of Calgary:
I have a question for a friend of mine. He has recently been dating this woman. She states that she has never had an orgasm before. She has not had sex in 2 years. When my friend and her went to have intercourse, he said that it was very painful for her. They tried Vaseline and lubrication from the drugstore, but it didn't seem to alleviate the pain. Any suggestions as to why or how they can prevent future reoccurrences of this painful event. Female, Junior.

Dr. Caron's Answer:
Your question raises several issues. One issue is the pain this woman is experiencing with intercourse. I would like to know if she has always experienced pain, or if it is just now with this new partner. If she has always experienced pain, an appointment with a gynecologist would be recommended to rule out a physical concern. Assuming it is not physical, you say they have tried lubricants but that did not seem to help relieve the pain. The choice to use a lubricant indicates a possible arousal issue. In order for her own body to produce sufficient lubrication, she needs to feel desire, trust, and affection for her partner.

You say this is a new relationship. Perhaps their emotional intimacy needs to be further developed before they proceed with physical intimacy. One suggestion is for them to try to expand their definition of sex - thinking of it as more than just intercourse. Certainly slowing things down, focusing less on intercourse and reaching orgasm, and more on the pleasure of giving will help. It is also important that she have control in the sexual situation so that should penetration take place, she is guiding that process and finding the position that is best for her. [Note: Use of a water-based lubricant is advised (e.g., Astroglide, K-Y jelly); oil-based lubricants such as Vaseline are not recommended.]

The other issue you raise is about her inexperience (you say she has not had sex in several years and she has never had an orgasm). This can certainly relate to her lack of arousal, and any anxiety or stress she may be placing on the sexual aspect of their relationship. It sounds like she (and maybe even he) does not know much about her own sexual functioning. For example, some people do not realize that the clitoris is strategically located outside and above the vaginal opening. For many women, stimulation around this area is essential for reaching orgasm. Such stimulation does not require intercourse or a penis. It's important for a woman to first find out for herself what feels good and then gently show her partner. Many men (and women) have been told that "real sex" means "penis-in-vagina" only; many of us recognize that sex involves much more than this.

Overall, I think there is something to be said about the importance of this couple to talk to one another openly about what they are experiencing. Sexual communication is both an important and necessary aspect of any relationship. Couples that explore each other's need and desires enhance the satisfaction experienced in an intimate relationship. However, many couples choose to overlook the possibilities that open communication implies. Lack of or ineffective communication is a leading cause of sexual dysfunction.
Talking about sex is not always easy, but it is necessary. Communication not only alleviates anxiety, but also heightens sexual pleasure. One might start by asking, "What do you like?" or "What feels good to you?" The bedroom may not be the best place to start this conversation. Although communication is sometimes difficult, it is essential to a healthy and growing relationship.


Question from a student at York College of Pennsylvania:
After having sex, my partner often complains that she is sore in the area around the vagina, but she is constantly telling me that I am gentle with her. What is it that I could be doing wrong, or better, what is it that I could be doing right? Male, Junior

Dr. Caron's Answer
Showing concern for your partner sounds like something you are certainly doing right!! For many women, lack of lubrication can create soreness around the vaginal opening - typically felt after intercourse. I wonder if this is what is happening in your situation. If so, this may indicate you might want to spend more time on what some people call "foreplay" - or outercourse - other things besides just intercourse (oral sex, genital touching, caressing). If she is sufficiently "turned on" but finds that her lubrication is not as much as you both desire, try purchasing a water-based lubricant such as Astroglide or KY jelly. This should help decrease any soreness caused by lack of lubrication. If she still feels sore after intercourse, have her visit a health care provider for a gyn exam. Perhaps there is a slight yeast infection building that is causing some irritation - this will be easily treated.


Question from a student at the University of Maine: My boyfriend only lasts 5 minutes, but he has been having sex with me for one year. We have alot of foreplay before intercourse and I am wondering how he can prolong his longevity so that I can orgasm during intercourse.
Female, Junior

Dr. Caron's Answer: There seems to be two very distinct parts to your question: one has to do with your partner coming too quickly, the other has to do with your ability to orgasm with intercourse.

When you say your boyfriend only lasts 5 minutes, it sounds like you're referring to someone who experiences premature or early ejaculation. It's one of the most common sex problems for men and the easiest to fix. One common method used to help the man gain control (last longer) is to try the stop-start technique (developed by Dr. Semen's in the 1950's - yes, that really was his name). Here, the partner stimulates the man's penis almost to the point of ejaculation, but then pauses until the urge to climax has passed. The process is repeated many times, each successive episode generally prolonging the amount of time needed between pauses to inhibit ejaculation. The man eventually develops the capacity to control his ejaculatory reflex in the presence of intense, prolonged stimulation.

Another suggestion was developed by the famous sex therapists Master's & Johnson in the '70s called the squeeze technique. This involves the man's partner GENTLY squeezing his erect penis at the head or the base. The partner performs the "squeeze" as soon as the man indicates an urge to ejaculate and until the urge has passed (usually just a few seconds). Sex resumes and the process is repeated (usually 3-4 times) until the man learns ejaculatory control.

But even if he lasts longer, that is no guarantee that you will reach orgasm through intercourse, which is the other half of your question. You suggest that, despite a lot of foreplay, stimulation, and arousal, you are not able to reach orgasm with the thrusting of penis-in-vagina. Most women need stimulation of the clitoris. Intercourse is usually not the most effective way to get it because there is often a lack of stimulation of this area (since the clitoris is hiding in the folds of skin outside and above the vaginal opening), Many women are unable to reach orgasm solely through penetration of the vagina. Most couples find it helpful to incorporate techniques for making sure the clitoris is adequately stimulated not only before, but also during or immediately after intercourse. Best wishes.

 


Question from a student at Tennessee State: Me and my boyfriend have been together for 4 months. When we have sex I can't come. I think I can do it but I'm not sure, this upsets my boyfriend as he thinks I don't get pleasure from sex with him but I do. Can you help me??
Female, Sophomore

Dr. Caron's Answer: It is not uncommon for women to have problems reaching orgasm early on in a sexual relationship. It takes time to get to know what is possible when the two of you are together. It sounds like you need to spend some time finding out what is pleasurable for you.

Are you comfortable touching your own body? Once you know what feels good - you will be better able to point your partner in the right direction. It's also important to know that most women need direct stimulation of the clitoris for orgasm to occur.

As far as penis-in-vagina sex: this tends to be an ineffective method for many women to reach orgasm. The clitoris is located too far from the vaginal opening to receive adequate stimulation from thrusting alone. It is not surprising to hear you have not reached orgasm this way. Your boyfriend needs to know this and be educated as well.

I suggest you begin by familiarizing yourself with your own body. One book that has been helpful for many women in your situation is, For Each Other, by Lonnie Barbach (see suggested books on my website). Her book discusses female anatomy, pleasure, and touching, as well as how to communicate your needs and desires to your partner. I think your boyfriend would benefit from reading this with you.

Remember: Every woman is unique. The only way he will know how to please you is if you understand yourself. Best wishes!



Question from a student at Western Kentucky: When I am having sex with my girlfriend, I am unable to hold back my orgasm for longer than a few minutes. Is there something I can do to last longer and better please my girlfriend?

Male, Senior

 

Dr. Caron's Answer: It sounds like what you may be experiencing is premature ejaculation (which is also called early ejaculation). When a man ejaculates before penetration, at the point of insertion, within 2-5 thrusts, or within a minute or so, almost all couples will identify this as premature or early ejaculation.

I think it's important for you to know that it is the most common male sexual problem, especially among younger men. Fifty percent of young males report early ejaculation and one-third of adult males report they ejaculate more rapidly then they would like.

I really discourage "do-it-yourself" techniques such as wearing two condoms, using a desensitizing cream, biting your tongue, or thinking negative thoughts (such as how much money you have borrowed for college). These can be harmful in two ways: 1) These techniques serve to reduce arousal and can cause erection difficulty rather than lead to ejaculatory control; and 2) The man is isolating himself from his partner, which leads to further emotional alienation and can destroy the couple's bond.

THE KEY ELEMENT IN LEARNING EJACULATORY CONTROL IS TO IDENTIFY THE POINT OF EJACULATORY INEVITABILITY. Most often early ejaculation is due to lack of knowledge, attention, or skill. It is often a result of early sexual experiences (rapid ejaculatory response learned through masturbation/partner sex). If you were to go to a sex therapist for assistance, you would l find that the focus would be on helping you learn to identify the point of "ejaculatory inevitability."

In my own sex therapy practice, one procedure I use is the "stop-start" technique, developed in the 1950's by Dr. Semans (that's right, Dr. Semans). This technique asks the male to practice penile stimulation to the point prior to ejaculation, first through masturbation and then with his partner. The male with early ejaculation signals his partner when to stop so that his arousal level can subside. Stimulation is then resumed after a pause, and the process is repeated at least three times before allowing ejaculation to occur. It is important for the male to enjoy his sensations and to learn to identify the various levels of arousal that he experiences.

You need to learn to accurately identify the point of ejaculatory inevitability. This exercise should be practiced 2-3 times per week. For most men I see, ejaculatory control can be learned in 8 to 20 weeks. Another great resource is the book, The New Male Sexuality by Dr. Bernie Zilbergeld (listed under recommended books at my website), who talks about this issue in greater detail.




Question from a student at Miami University:
I am never able to fuly attain an orgasm. Whether with my boyfriend, or while masturbating, I always reach the point where I feel an orgasm coming, and then my body becomes completely numb for a few moments. After, I feel overly sensitive, as though I've just had an orgasm.

What can I do to stop "freezing" and start feeling the orgasm? I've had orgasms in the past, but not in a few years. I've never experienced anything sexually traumatic, and my relationship with my boyfriend is very fulfilling, so what could the problem be?
Female, Senior

Answer: It is not uncommon for women to have problems reaching orgasm. It takes time to get to know your body and how it works - what feels good and what is a turn-on. You say you reach a point where things become numb. One suggestion is to move toward orgasm more slowly. Another is to stimulate the area around the clitoris rather than directly. In fact, some women find that direct stimulation of the clitoris is way too sensitive, and they shut down. So try to begin by gently stimulating the area around the clitoris, and then "back off" every few minutes before returning to stroking your clitoris. Allow yourself to build toward the orgasm. The other suggestion is to purchase a vibrator (sold as body massager in most stores), and use that either alone or with your partner to explore what feels good. One book I would recommend is For Yourself, by Lonnie Barbach. It may offer you some valuable insight.

 

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