Question:
I have had this problem most of my adult life, what are the main causes of
retarded ejaculation, and what can i do about it?
Answer:
by Annette Owens, MD, PhD
'Retarded ejaculation' is also called “delayed ejaculation”. Since you have had
DE for your adult life, it is probably not a medication side effect, but I do
want to point out that several medications can make it harder for a man to
ejaculate. Antidepressants called SSRIs (selective serotonin reuptake
inhibitors) such as Prozac, Zoloft, Paxil, Luvox, and Effexor) sometimes have
this side effect. Other drugs are Anafranil, Elavil and antianxiety medications
such as Librium, Ativan, Valium and Xanax. As a matter of fact, all these
medications are sometimes used to treat men with premature ejaculation (PE).
First of all let me emphasize that you are not alone. I have spoken to several
men who have this condition. DE is considered being relatively rare, but I
believe it is simply under reported. Many men do not view it as a problem but
rather as an asset being able to last longer than others. There are no
self-help books available specifically on this topic (as compared to several
good books on overcoming PE) and information is usually hard to find. Some men
with DE—but far from all—have obsessive/compulsive disorder and the more they
worry about not being able to ejaculate the harder it gets. Other men harbor an
unconscious fear of pregnancy, or they are afraid of loosing control or
becoming too vulnerable to their partner if they ejaculate.
As with all parts of sex play, relaxation and pleasure are the keys. Changing
your focus from being performance oriented to embracing pleasure is crucial.
This means not to focus too much on how hard your erection is or on wanting to
orgasm or ejaculate but instead to focus on what feels good and brings you and
your partner(s) pleasure. Take some pressure off yourself. Don’t thrust harder
and longer when you cannot come during intercourse. That will only make you
experience less sensations. Instead, try to recognize and enjoy all the
different types of pleasure in your love play—visual, sensual (including
non-genital touch), emotional and physical pleasure.
Very often a man with DE can ejaculate when he masturbates. (By the way, orgasm
and ejaculation are separate events usually occurring simultaneously. A man can
reach orgasm without ejaculating and without having an erection and he can
ejaculate without experiencing orgasm.) Most men with DE need a high level of
manual stimulation in order to ejaculate during masturbation or they need to be
in a certain position to do so.
It can be difficult to reach that same level of stimulation during intercourse.
Try to change the way you masturbate by increasingly loosening your grip and
changing positions as well as breathing patterns. Get out of the rut that works
and be open to trying new ways. Don’t get too focused on your penis but explore
new touches on your entire body, when you are alone and with a partner. Once
you have practiced on your own you can integrate your expanded masturbation
repertoire into your love play with partners. Switch back and forth between
intercourse and other types of pleasurable stimulation—don’t just keep
thrusting. Use feathers, silk scarves, oils and lubricants or whatever feels
good to you and your partner(s) on your entire body.
I always ask men with DE whether their level of arousal reached during
masturbation matches the intercourse situation. Many men masturbate to
fantasies which reality simply cannot live up to, leaving real life less
arousing. In that case it is important to search for ways to increase arousal
with a partner and also to try to rely less on those particular fantasies when
alone.
Question:
I am 52 yrs old and 4yrs ago had a vaginal hysterectomy (Laser). Ever since
then I have not been able to have intercourse, it is to painful for any
penetration. My doctor and partner have said I am not dry. I also frequently
have itching and slight burning and have been treated for an abnormal amount of
infections. The word from the doctor is there is nothing they can do, I have
been to a few. The thought is that it must be psychological is there any other
explanation you can think of? Desperate.
Answer:
by Annette Owen, MD, PhD
You mentioned that any penetration is painful. Can you insert your finger(s)?
Has your gynecologist been able to insert a speculum into your vagina? If not,
you may be suffering from vaginismus which is treatable (by a sex therapist or
other specialist in sexual health care).
You also mentioned frequent itching and slight burning and that you have been
treated for an abnormal amount of infections. Have you had your blood sugar
checked? Many women with diabetes have the symptoms you are describing.
Sometimes infections become less frequent when the diabetes is being treated
and blood sugar is better controlled.
It sounds to me as if you may be suffering from vulvodynia (maybe combined with
vaginismus). I suggest that you check out the following two web sitesin order
to learn more about vulvodynia, and possibly get some help that way: Dr.
Glazer’s Vulvodynia Web Site (http://www.vulvodynia.com); NationalVulvodynia
Association (http://www.nva.org). Don’t give up. Vaginismus as well as some
causes for vulvodynia are often treatable. Even if your problem is strictly
psychological there is help available. A sexual health specialist may be able
to define your problem more narrowly, and to provide treatment for you. Don’t
hesitate to contact me for further questions. Good luck.
Question:
I am a 29 year old female. I have been married for 6 years and 9 months, and in
the past year and a half or so my sex drive has almost completely vanished. My
husband and I used to have sex 2-3 times per week until about a year and a half
ago then it diminished to once a month. Now it has been two and a half months
since our last sexual encounter. I have never failed to reach orgasm with my
husband and I can still masturbate (though rarely now) to orgasm. But for some
reason I simply do not relish the idea of sex with another human being. My
husband is very attractive, and very sweet and kind. We cuddle and kiss (no
tongues) all the time, but I don't want it to go any further than that. I also
don't want sex with anyone else either. I've gotten to the point where I can
walk by a man who is absolutely gorgeous and not feel anything.
It might be useful for you to know that I have been taking Depo Provera for
about 4 or 5 years now for birth control. I have heard that that can contribute
to low desire, but my problem only started 18 months ago. I also took Paxil for
two months, which I have also heard can contribute to such a problem, but I
have been off of that for two months now. The next logical question would be to
ask what happened 18 months ago, yes? Well, I've thought about it and the
answer is: nothing unusual. I don't have a stressful job, I get plenty of
sleep, o.k. my diet is horrible (typical American fare), but it always was, I
don't have any children to exhaust me or stress me out, and I couldn't ask for
a better husband. So what's wrong with me? I'm stumped. And I want my sex drive
back. I remember how much fun it was and I miss it. What do I do?
Answer:
by Annette Owens, MD, PhD
You mentioned that you started taking Paxil for a while a few months ago. How
are you feeling now? Are you still depressed? Depression can greatly reduce
sexual desire and it is important to address this issue. I recommend having a
thorough medical exam, including having different hormone levels (such as
thyroid hormones and testosterone) tested. Hormone levels often have a direct
effect on sexual desire.
Be sure to address the issue of feeling low with your doctor. You may benefit
from trying out another antidepressant. But these are not magic pills. I
suggest finding a counselor, who can help you get to the bottom of why you are
feeling depressed. This is in my opinion the most important step for you to
take.
Next, after several years of marriage couples sometimes loose the spark in
their sex-life. A good way of re-connecting may be to do "sensate focus
exercises." These exercises are best done in several steps following detailed
instructions from a sex therapist. But you can also try to do them on your own:
Make an agreement with your husband that you will not have any intercourse and
not achieve orgasms for a while. Get some nice massage oils, and try to arrange
a time, where you both are rested and relaxed. Try to arrange a nice setting
for both of you. If you like, take a relaxing bath together first. Then take
turns touching all areas of your body except the genitals and your
breasts/nipples. Start out lying on your back, and then turn over. Try to spend
at least 1/2 hour on each other, and enjoy caressing different areas of your
bodies. The person, who is receiving the touching, should try to let the other
person know what feels good and what doesn’t. Be inventive. Use feathers, silk
scarves, whipped cream or chocolate sauce to be licked off, whatever you like
and whatever you can think of. Have fun. Try something new. It is the idea to
take small steps every time and after a while to also include the genital
areas. The reason that you should not emphasize intercourse and orgasm in the
beginning is that we often forget that there is more to the human body than
just genitals. You may benefit greatly from re-connecting at a completely
different level, and then you can grow from there. Hopefully you both will find
these exercises pleasurable, and you may get a different attitude towards sex,
which not necessarily has to include intercourse, but can involve giving each
other pleasure simply by exploring and caressing each other's bodies. Good luck
with everything!
Question:
Oral sex (mutual) is very important to me, but soon after we were married my
wife unilaterally decided (without even talking with me about it)that we would
no longer engage in oral sex on the grounds that it supposedly is unhealthful.
I am convinced that she is not correct, scientifically. I feel like the butt of
the old joke: "How do you get a woman to stop enjoying oral sex? Marry her."
She knew before we were married what I like, and I THOUGHT I knew what she
liked, so I think she should be willing to meet half way at least. But she
won't budge an inch. Over the years, my resentment over this has built up
substantially, and she still will not even discuss it no matter how tactful or
clever I am in trying to bring up the subject in a non-threatening manner. It
seems to be no big deal to her, as a matter of sexual satisfaction, because she
often becomes completely satisfied before I orgasm. She also often claims to be
too sore to continue after she orgasms, at which point the rest is left to me,
alone -- which, of course, makes it all the more frustrating to me that we do
not avail ourselves of the oral sex alternative that not only would prevent
soreness, but likely would provide us with more mutual satisfaction.
Answer:
by Annette Owen, MD, PhD
Many married couples enjoy mutual oral sex, but on the other hand, orals sex
can also be a very sensitive issue for many, as it is in your case. Before I
talk more about oral sex techniques, let me address one important point. You
mentioned in your additional information that you experience delayed
ejaculation. How long does it usually take you to reach orgasm in various
situations? Could your wife’s resistance be related to the length of time she
spends performing orals sex on you? Many women complain about that it is hard
on their jaws to engage in oral sex for a prolonged period of time.
Other issues typically are: 1) Hygiene: Many men and women prefer oral sex
following or during a mutual bath. 2) If the size of the penis puts a lot of
stress on the partner’s jaw, it may help to only insert the tip of the penis
into the mouth, while holding and stimulating the shaft of the penis manually.
3) Anything that touches the back of your throat will cause a gag reflex.
Instead of inserting the whole penis into the mouth, she can suck the tip
and/or the shaft, kiss, lick it.
I can recommend the video Better Oral Sex Techniques, which is sold by Good
Vibrations at www.GoodVibes.com (#VB-2398, $29.95 excluding shipping and
handling). You can call them at 1-800-289-8423.
Since this seems to be affecting your relationship, you might benefit from
seeing a sex therapist. You can contact The American Association of Sex
Educators, Counselors, and Therapists (AASECT) at www.aasect.org for
information about how to locate a certified sex therapist near you.
Finally, with regard to health issues, HIV and other sexually transmitted
diseases can be contracted through oral sex. It is important to use condoms in
order to prevent transmission of diseases. This may be what your wife may be
referring to when she mentions oral sex not being healthy.
Reviewed by: SexualHealth.com Editorial Team
Question:
My best friend was told she has HVP, an STD which can lead to cancer
(uterine??) What is it and what can you tell us about it?? Thank you.
Answer:
by Annette Owens, MD, PhD
HPV stands for human papillomavirus and it may cause genital warts. There are
many different types of HPV, and a physician can treat warts in several ways.
It is important to treat the warts in order to prevent spreading and infection
of sexual partners. Depending on the location of the warts, condoms may prevent
transmission of the virus.
There is an association between HPV infection of the cervix and cervical
dysplasia and cancer. The cervix is the part of the uterus that is located
closest to the vagina. A uterus looks like a pear and the cervix is the thin
part where the stalk of a pear would be located. Cervical dysplasia means that
some cells of the lining of the cervix have changed and grown in an unusual
way. There are several stages of growth, the most advanced being cancer of the
cervix.
It is important for women to have yearly gynecological exams, including a Pap
smear. During a Pap smear the health professional swipes off cells from the
cervix, and these will then be analyzed in a laboratory. If the Pap smear is
normal, the cervix is healthy. If the results show cervical dysplasia, the
affected area can be treated in various ways (freezing, CO2 laser, and
resection, including conization, where a small cone is cut out of the cervix).
The physician will recommend the correct treatment option in each case. Having
cervical dysplasia is fairly common and, as long as it is caught early,
treatment usually restores full health. I cannot stress enough how important
regular Pap smears are. I hope that I answered your question. Otherwise, do not
hesitate to ask again.
Question:
I am going in for a hysterectomy in 4 weeks for adenomyosis. Will my husband be
able to tell during sex ? Will I be bigger or will it not change much in the
sense of feeling for him? I fear that I will be too big for my husband to injoy
having sex with me. I am only 23 years old. He is ten years older than me and I
know he will not say anything to me for fear he will upset me. We have had all
the children we want. Is there a way to help both of us with the problems we
will face in a few weeks?
Answer:
by Annette Owens, MD, PhD
In your additional information you mentioned that you and your husband have
been together for 7 years and you have 3 children. Your pain started when your
first child was born 6 years ago, and you often have had to postpone
intercourse because of your pain.
I think there is a very good chance that your sex life will improve much after
the hysterectomy. You have seen two physicians, and I assume that they have
carefully examined from where your pain originates. Several recent studies on
one-year follow up of women who underwent hysterectomies show that the vast
majority reported significant improvement and relief of their pain. One study
found that more than 90% of those who underwent hysterectomy for chronic pain
had a successful outcome. In another study 74% reported cure, while 21% said
that the pain had improved, leaving only 5% where surgery had not had a
successful outcome. Usually, women can first tell whether the surgery was
successful after 2 to 4 weeks.
What type of operation are you going to have? If your ovaries also are being
removed, your doctor will most likely prescribe hormones for you, since you no
longer will be able to produce them yourself. Low hormone levels can affect
your sex drive, and it will be important to give your doctor as much
information as possible, so he or she can adjust your medication accordingly.
If your ovaries are not removed, they will continue to produce hormones.
It is likely that your vagina will initially seem somewhat shrunken or
shortened. However, during careful initial intercourse the vaginal tissues will
most likely stretch. I suggest starting out slowly, and allowing each other
much time to become reacquainted sexually. Once you are ready for penetration,
it may be easier for you to sit on top of your husband, facing him. In this
position you will be able to control the level of penetration and the amount of
thrusting. Be sure to have some lubricant (KY jelly, Astroglide, etc.) handy if
you should need it. Your vagina may not feel any different to your husband
after the surgery. If you feel that you are too wide, you can try to strengthen
your pelvic floor muscles by doing Kegel exercises. Good luck with everything!
Question:
I'm a 32 old male, healthy and athletic with probably above normal sexual
desire. But my most intensive orgasm comes not from having sex with an
attractive partner, but from getting into certain positions myself. I am very
flexible and when I slide my legs into a straddle split position, when my
crotch touches the floor, I can ejaculate without physically touching my penis.
Although I have had various sexual partners, that's by far the best sex I can
ever have. Since my best sex isn't with a female, I take it as abnormal. I'm
just wondering if there are other people like me out there. Should I do
something to correct this anomaly? Or should I just keep enjoying myself?
Answer:
by Annette Owens, MD, PhD
Except for the fact that you can do a split, you sound very normal to me!
Normal sexual behavior is not only limited to heterosexual partner sex. I would
definitely encourage you to keep enjoying yourself this way. How wonderful that
you can have such a great sexual experience by yourself!
If you no longer wanted to have sex with your girlfriend because you preferred
getting satisfied this way, I would say that you had a problem. It is important
to balance sex with your partner and sex by yourself, but there is nothing
wrong with satisfying yourself while in a relationship. It's like eating.
Sometimes you want to go out for a nice dinner for two, while at other times
you just want to grab something to eat by yourself, when you feel the hunger
and it is a good and practical time for you. Try to enjoy both situations in
their own way. The reason that the split position is such a sexual enhancer for
you may be related to the physical impact of stretching. Many people find that
they can trigger or enhance their orgasms when they tighten up their buttocks
muscles during intercourse. Whether your position is related to this, I do not
know. But I know for sure that many people have their preferred positions for
masturbation, and there is nothing wrong with that, unless you or someone else
is hurt by this.
Question:
This probably isn't a very common question, it's just that most of the "ask an
expert" websites seem like they're not really experts, this website looks
different. I recently purchased some flavored lubricant at a novelty store.
Before using it, I had two questions. 1) Will using it weaken the condom? It is
a water-based lubricant, but will its use lower the protection of pregnancy? 2)
Because it is flavored and contains sugar, will it be harmful to my girlfriend?
Will the sugar lead to infections? Thank you for your help and advice.
Answer:
by Annette Owens, MD, PhD
You asked some very good questions. To my knowledge only lubricants, which are
not water based, such as any oil or petroleum based products will destroy latex
condoms, gloves or dental dams. So if you are using a truly water based
product, according to common safer sex standards you should be fine using
condoms. Be aware that some lubes are labeled “water-soluble” and may contain
oils.
Unless your girlfriend is prone to yeast infections or has very sensitive
genital tissue that does not tolerate the artificial colors and flavors of the
lubricant you should be fine using the product. It might be a good idea,
however, to wash remnants of the lubricant off after lovemaking since sugar is
a wonderful medium for most germs to grow. Have fun!
Question:
I am 35 and have been dating a man who 10 years older, we recently had sex for
the first time, and he did not ejaculate. He used a condom, but it came off
during intercourse and unfortunately remained inside of me for a day or so. We
stopped intercourse as soon as we realized he was no longer wearing the condom.
After looking at my cycle, I was in the middle, around the time I should be
ovulating. Upon inspection of the condom when found, it was intact and not
"inside-out", hopefully trapping any pre-ejaculate fluid which may contain
sperm. I took the emergency morning after pill about 24 hours later just to be
on the safe side. I have a couple of questions: How likely is it that I could
be pregnant and how soon can a doctor do a test? How common is it for a
somewhat older man to have difficulty ejaculating?
Answer:
by Annette Owens, MD, PhD
Since you did take the emergency morning after pill the chance of pregnancy
should be low. You can take a sensitive home pregnancy test in a few days,
depending on how recently you had intercourse. Some pregnancy tests can detect
pregnancy even before the first missed period. If you want to use your doctor
you should call their office about when to come in for a test.
With respect to how common it is for a somewhat older man not to ejaculate
during intercourse: It is not uncommon for a man not to be able to ejaculate
during intercourse. And this is not necessarily related to age. Often, the
novelty of a relationship can make it difficult for a man to fully relax and
"let go." Or some men may have had periods in their life where masturbation was
their main way of getting sexual release. In these cases it can take a while to
adjust to a partner. Good luck with everything!
Question:
I am involved intimately, but not to the point of intercourse w/ a 62-year-old
man (I'm 62 also) He has never been married, but has had many sexual affairs.
He is healthy; a self-employed small businessman whose job is stressful &
physically taxing as well. We smooch, pet & I stimulate him (quite easily)
to a huge erection -- but he doesn't ejaculate. Is ejaculation needed for his
complete satisfaction? What would be reasons for it not to occur? What should
I/how should I "handle" this situation?
Answer:
by Mitchell Tepper, PhD, MPH
Whether ejaculation is needed for your partner's complete satisfaction is
something that only he can answer for you and you have to take the answer at
his word. That being said, pleasure, orgasm, and complete satisfaction are all
possible without ejaculation and some men even practice toward that goal.
Others who measure their satisfaction my the distance they can shoot are going
to be devastated if they don't ejaculate. Reasons for not ejaculating vary and
can be related to stress, physical fatigue, neurological conditions,
psychological reasons, or just the need for more intense stimulation. It seems
like you will have to "handle" this one with your mouth. Talk to him and find
out what he needs for complete satisfaction!
Question:
When I meet new people, there is the presumption that "people in wheelchairs
don't do sex." How do I communicate my interests without getting busted for
harassment?
Answer:
by Mitchell Tepper:, PhD, MPH
As long as the person you are expressing your desires to is not a child,
employee, student or another person you have power over, your frankness is not
likely to lead to sexual harassment charges. But if you equate rejection with
self-worth, there may be emotional consequences. Stereotypically we are seen as
asexual, childlike and helpless. We may be perceived as either "safe," needing
to be taken care of or as someone who can easily be controlled. None of these
stereotypes places us on an equal footing for a sexual partnership. If your
partner sees you in any of these ways, then you're faced with a choice between
moving on, accepting a relationship based on their faulty perceptions, or
indicating more clearly that you are interested in a relationship that includes
sex. Moving on may be painful but, in the long-run, healthier than spending all
your emotional energy on trying to change someone else. But first, you should
be sure you have openly and honestly communicated your interests.
Question:
Sex has become close to non-existent due to my wife's chronic pain associated
with fibromyalgia. What suggestions do you have for us?
Answer:
by Mitchell Tepper, PhD, MPH
Many people with chronic pain complain of decreased interest in sexual
interactions, since pain takes a toll on sexual desire and can even make one
feel asexual. And if pain is aggravated by sexual activity, it¹s easy to come
to fear and avoid it. Worse, having sex despite pain out of guilt or a sense of
duty to a partner can have a deleterious effect on a relationship.
Maintaining a good sex life in the face of chronic pain requires flexibility
and ingenuity. Dr. Naomi McCormick, author of When Pleasure Causes Pain: Living
with Interstitial Cystitis, makes the following suggestions that have
application for anyone experiencing pain: • Schedule sexual activities when
your symptoms are least problematic • Take pain-controlling or antispasmodic
medications prior to sexual activity; • Experiment with sexual positions and
activities that minimize painful intercourse; • Have your partner stimulate
your genitals orally; tell your partner exactly what feels good and what is
painful; • Spend time engaged in other sexual, erotic and intimate activities
that do not involve intercourse or orgasm.
Hot tubs, saunas, steam rooms and even tanning beds can ease stiff, sore
muscles and loosen up joints. Try one of these options prior to engaging in
sexual activities. If floating in warm water relieves your wife's pain, you can
rent a hot tub and experiment in the privacy of your home. If overheating is a
concern--it often is for people with multiple sclerosis or are subject to
autonomic dysreflexia--consult with your physician first. Alternatively, try
relaxing your wife with a whole body massage using warm oil. Incorporate gentle
manual stimulation to her breasts, nipples, labia and clitoris. Focus on making
her feel good, not bringing her to orgasm. Let your wife be your guide.
At another time, your wife can focus on pleasuring you in a way that doesn't
aggravate her pain. With regard to intercourse, take time to find positions
that are comfortable for both of you and do not put too much pressure on any
one part of her body. If she becomes uncomfortable, switch positions. And talk.
Communication is critical when pain is involved, especially for women who have
been taught to be sexually passive. McCormick urges women to tell their
partners when they want sex, when they don't want it, and how they want it.
Reducing painful sexual activities and increasing pleasurable ones should help
to revitalize your sexual life.
Question:
My fiance is a paraplegic. He has a c-7 spinal cord injury. We both want
children, but we aren't sure if he can have children. I wanted to know if there
is anyway to find out if he is able to conceive?
Answer:
by Mitchell Tepper, PhD, MPH
Thanks for your question. There certainly is a way to find out if you fiancé is
able to father a child. The first step toward exploring his fertility is to
retrieve some sperm. If he is unable to ejaculate through manual stimulation,
there are two widely used and accepted methods: electrical and penile vibratory
stimulation (PVS). Electrical stimulation, otherwise known as
electroejaculation stimulation (EES), is usually performed under anesthesia in
a hospital setting or clinic. An electric probe is inserted into the rectum to
stimulate the nerves responsible for controlling emission and ejaculation.
Vibratory stimulation--applying a vibrator to the penis--is less invasive than
electrical stimulation, does not require anesthesia, can be done at home, and
often feels good whether you ejaculate or not. In addition, studies at the
Miami Project demonstrate better sperm quality in samples obtained by vibratory
stimulation. Although many clinics still use only electrical stimulation
because it is more dependable, the American Urological Association recommends
vibratory stimulation as the first line of treatment for people with spinal
cord injury (SCI).
Once a sample is obtained, sperm quality should be assessed for several
factors: sperm count, motility, morphology, viscosity, volume and ability to
penetrate mucus. An average sperm count is about 100 million per milliliter.
Motility represents the percentage of sperm that are moving, and at least 50
percent “swimmers” is considered normal. Morphology refers to the shape of the
sperm. Typically only 50 percent to 80 percent are normal, but malformations do
not necessarily cause malformations in the fetus. Viscosity is the thickness of
the semen. Volume, as opposed to sperm count, measures the total amount of
ejaculate and may vary from 1 to 5 milliliters, or about a teaspoon. Then a
penetration test is done to determine whether the sperm, once it gets to the
ovum, will be able to bore through the cell lining to deliver its genetic
message.
Men with SCI generally have adequate volume and sperm count. If there¹s a
problem, it¹s usually caused by low motility. But even if your sperm¹s motility
is too low for home intravaginal insemination, it can still be used in
combination with other assisted reproductive technology (ART) to improve
chances of conception. ARTs are ways to deliver sperm to the ovum. For more on
this subject, please see my article, Making Babies: At-Home Vibrostimulation
and Insemination - link to
http://www.sexualhealth.com/article.php?Action=read&article_id=2&channel=3&topic=71
Question:
I am a 52-year-old woman with multiple sclerosis. Before the onset of MS five
years ago, my husband and I made love about once a week and I always had an
orgasm. But the more disabled I get the less I want to have sex with my
husband. I want to, I dream about it, but I can't do it. I've rejected him for
four years now and I am afraid I am going to lose him. How can I go about
rekindling my desire for sex?
Answer:
by Mitchell Tepper, PhD, MPH
Low sexual desire may be caused by a general medical condition like MS,
psychological factors or a combination of both. Fatigue, medications, disturbed
body image and past negative family or sexual experience can all contribute to
sexual dysfunction.
Based on the information you provide, I would speculate that fear of rejection
and self-loathing because of your disability may be two contributing factors.
Opening yourself to your husband raises the possibility that he might reject
you. This outcome would only confirm your unexpressed feelings about your
attractiveness and ability to fulfill your role as a wife. Loss of physical
function or the ability to perform household tasks does not necessarily
translate into loss of attractiveness. Your husband may still love you for the
life you share together and may still be eager to have sex with you. You'll
only find out if you give him a chance. It may be time to take the risk of
sharing your fears with your husband.
If the communication goes well, you can start with sexual activity that might
be less threatening than intercourse. You may want to please him orally, if
that was part of your love making in the past. You may want him to give you a
massage and bring you to orgasm with his fingers. Taking small steps to build
positive sexual experiences is the best way to overcome fear and regain desire.
If the communication doesn't go well or if you cannot bring yourself to broach
the subject, then you should seek professional help. More severe forms of
reduced sexual desire call for a comprehensive treatment approach. The
foundation of that approach includes a detailed psychosexual and medical
history. Treatment may involve education, exercise and psychological
interventions. It is important to find a qualified sex therapist with training
in working with people with low sexual desire. You might also elicit the help
of a physician who is willing to address sexual issues as part of a general
physical.
Question:
Dear Dr. Kat, My husband and I are newly married and he was recently sent to
the Middle East with a deployment by the Armed Forces. How can we keep the
home-fires burning sexually while he's away.
Answer:
by Kathleen VanKirk, DHS
That can be quite a feat, considering all the stresses your daily life without
your lover, as well as not knowing about his welfare. It's great that you are
both committed to keeping a very rewarding component of your relationship
going, during this no-doubt trying time. Many partners find a new sexual bond,
however, when faced with the daunting ask of maintaining their passions for one
another in the face of conflict. It can also be a great stress-reliever for
both of you.
If you're looking for some sexy ideas that go above and beyond merely keeping
the romance alive, then here are some suggestions for getting started. As they
go from just a little spicy to highly racy, attempt at your own risk:
• It may be an obvious solution, but sending love-letters (or, more
appropriately, 'erotic' letters) is a great way of expressing your passion for
someone. You could go a couple of different routes with this. Either e-mail him
some original prose, or cut and paste some steamy erotica from a website you
like. You could also go the old-fashioned route by buying some beautiful
stationary, perfuming it, and then handwriting something sensual. Kissing it
with lipstick never hurts.
• Men love panties! And specifically "your" panties. Buy a sexy pair and wear
them around for an afternoon. Enclose them in an envelope and off they go to
the post office!
• Digital pictures -- although it can be tricky. It will depend upon his access
to a computer and his level of privacy when he finds one. If you can't pull off
digital pictures, then just include a glossy or two with an erotic letter.
Hopefully, you'll have enough trust in him that you won't have to worry about
your nudie pictures entertaining the whole troop, unless you're feeling
incredibly patriotic and want him to -- in that case there's nothing like
serving your country.
• An audio tape of you masturbating? You bet. Get comfortable one night home
alone, light some candles, and break out the satin sheets on the bed. Then give
him a step-by-step account of what you're doing to yourself on his behalf.
There will be nothing like his head hitting the pillow to your moans at night.
• Body pressings. Basically, you hit your local art store and find some acrylic
paint (which won't irritate the skin) and buy some butcher paper. Canvas would
be better, but it would probably be more difficult to send in the mail. Take
your goodies home, strip down, paint yourself and roll around on a few feet of
paper. Once it's dry you can send it with an explanation of what part is what -
he might need the hint but, regardless, it will be a creative way to peak his
interest.
• Toys for men. There are plenty of sex-toys on the market designed for men as
the "next best thing". Libida's Fleshlight is a real winner. You can have it
shipped directly to him. He'll probably be the luckiest guy in the barracks.
• Ye' old phone-sex or, if possible, cyber-sex. Depending on availability, this
is a way you two can still share a bonding orgasmic moment together in real
time. You can tell him exactly what you'd like to do to him while doing it
yourself. If you want to learn to talk a little dirtier, check out
Exhibitionism For the Shy.
• Read a great erotic novel like Lofting or how-to-book and then write some
notes on the edge of the page of what you liked about it and how it made you
feel. Write with a sexy pen-color and point out which stories were fodder for
your own personal fantasies. Then mail the book off to him and let his own
imagination wander.
• Buy some adult videos and watch them on your own. Then, the next time you
talk to him, you can tell him what scenarios got you off the most. If you're
new to porn, check out a female-friendly director title like Candida Royalle's
Christine.
• Write your own erotic journal. Or maybe just include some notes in your
regular journal of what about him turns you on, and so on. Perhaps you could
both do this and then occasionally swap journals to get a peek into one
another's sexual psyche.
Do you have a loved one in the military and have some sexy ideas of your own to
share? Contact Dr. Kat at drkatvk@sexualhealth.com and she may include them in
a future column.
Question:
Dear Dr. Kat, I got married three years ago and since the birth of my first
child I have added 50 lbs to my 125-pound frame. It has affected my sex life by
my not feeling sexy and although my husband won't admit it, I don't think he's
as attracted to me anymore. In the last two months we've only had sex once. I
don't know what to do. I want to lose the weight (I've started an exercise and
diet program) but it could take months and I don't want the lack of sex my
husband and I are experiencing to affect our relationship in the meantime. What
can I do to feel sexier and have more sex?
Answer:
by Kathleen VanKirk, DHS
It sounds as though there are two concerns here: your finding a way to feel
more sexy and your wanting to deal with the issue of lack of sex that you and
your husband are experiencing. There seems to be nothing that makes a person
more vulnerable and insecure than feeling overweight. Whether it's five pounds
or 100, women in particular may feel the same internal negativity regardless of
what number pops up on the scale. We can feel ugly and unworthy, which leads to
not feeling like we're the glorious sexual beings we are. And then we tend to
not only not seek sex out but also overtly discourage sexual encounters. This
leads to a vicious cycle of not taking care of ourselves emotionally or
physically.
The process of losing weight can be a difficult one. Many women feel that they
don't deserve to feel good about themselves and therefore make futile attempts
to lose the weight and be healthy. It may seem ironic but the situations I have
seen with women (and indeed myself) have shown me that the more you want to
lose the weight, the more you need to accept yourself for who you are right
now, sexually and otherwise. This means that you must believe that you are a
worthy, beautiful, and sexual woman at this very moment regardless of your
size.
The more you can believe (and behave) in ways that reinforce everything you
have to offer yourself, partner, and the world, the more you can cultivate the
desire to change and become even more of the person you want to be. For
instance, if you accept yourself for every perfection and imperfection, the
more you can believe that you do deserve a better life; to be healthy and
sexually satisfied, the more you can dedicate yourself to making a diet and
exercise program work. Or the more you get in touch with your true self, the
more you'll be able to set realistic goals for your weight loss and all the
while over the course of months of embarking on this path to giving yourself a
better life, you'll also be able to love yourself and feel sexual and beautiful
at the same time.
You shouldn't have to sacrifice your sexuality until you're at the
"appropriate" weight to enjoy it. Believe in yourself and enjoy it now. Decide
to exercise and embrace your right to be healthy and don't put so much pressure
on reaching a magic number. Get back in touch with yourself by masturbating.
You can reward yourself through experiencing the pleasure you deserve. Now, I
realize that this is only part of the equation. You still have a concern about
the way your husband is relating to you sexually. My suggestion is that you get
everyone's feelings out on the table to sort through. I have found that couples
spend way too much time guessing. The preference would be that you could both
get honest with one another in a constructive way. Let him in on what you think
has been going on with your sex lives and that you're now on a path to loving
and taking care of yourself more fully. Get his feedback on what he's been
experiencing.
Granted, his feedback may be hard to hear, to the tune of "Yes, I haven't been
feeling as attracted to you because of the weight." But this does not mean that
he doesn't love you or that he can't still feel sexual towards you. Many times
(without a word) partners sense how badly you're feeling about yourself and the
negativity about your body and sexuality. They often will begin to adopt the
same view without even realizing..."Why should I even attempt to be sexual with
her when I know she'll just shut me down." It could be that many partners are
shutting themselves off sexually as well because they know they're only going
to get rejected.
So, I do believe that by feeling better about yourself your partner will sense
this too. Perhaps once you've talked through where you're at, his part can be
giving you support in and out of the bedroom: helping you to be both physically
and sexually healthy. And your part can be embracing what your body is still
capable of, seeing beauty in every curve and translating that into ways to
really taking care of yourself. You can even show him that you're still
interested in sex by seducing him for a change and both of you can work on
making time to be sexual regardless of what circumstances are going on in your
life. I've seen couples who've been able to do this not only grow sexually, but
also strengthen their emotional bonds with one another. Weight may come and go
in any long-term relationship but embracing yourself sexually and emotionally
can be a constant regardless.
Question:
I met this guy online in October and in about a week we decided to see each
other in person. When I saw him in person I was shocked, he did not look what I
expected him to look like. He sent me some pictures, before I met him in
person; the first picture he sent was a picture of him when he was younger. I
kind of liked that one but the other two we did not like. He then told me he
looks much better in person so I went to see him.
When I first saw him in person I decided I did not want to see him again
because he wasn't my type, yet I did not stop. I am pushing myself so hard,
because I am 36 years old and want to have a baby. I just had surgery to remove
a fibroid from my uterus and that even makes it harder for me. The thing is
Doctor, I love this guy when I talk to him over the phone, we talk almost three
hours every other day, but when I see him in person, it's always a problem. I
get overcome with the fact that he is not handsome. I've read other people's
comments online and I know I should just convince myself that looks are not as
important as personality.
I need advice -- I don't know what to think or do anymore. We have not kissed
or done anything yet and it has been three months since I have known him. I
miss him when he does not call, and I love to talk with him over the phone; we
have a lot in common but when it comes to in person -- oh boy, I don't want
anything to do with him. What should I do?
Answer:
by Kathleen VanKirk, DHS
Sometimes it can be difficult to get really real with ourselves and truly
examine our motivations for how we behave. Your underlying desire to have a
child seems to be fueling your interest in this person. Granted you do seem to
enjoy his company (when he's not in person). You genuinely seem to want this to
work this out and in a perfect world looks wouldn't matter but attraction is a
funny thing; when people try and tell themselves it doesn't matter -- most
people usually end up in relationships that they wish they hadn't. Attraction
is powerful and while it is not the whole equation, the lack of attraction can
severely hinder an individual's satisfaction with their relationship. The fact
that you have also been reluctant to be physical with him over several months
leads me to believe that this may not be situation in which you can "learn" to
be attracted to him. Just because you enjoy talking with someone and you miss
them when you don't, doesn't mean that you are in love with them and from
everything that you've said you don't suggest to me that you are in love with
him.
I am also wondering where his feelings are in all of this? You seem very
focused on your own issues (how you feel about him, wanting to have a baby
etc); you've not indicated how you think he feels. After this many months of no
physical contact with him, he must be wondering what's going on as well. I'm
assuming neither of you have actually broached the subject of your true
feelings for one another. You might want to clarify that above and beyond
anything else. And if he is experiencing very strong feelings for you, you are
now getting into the dangerous territory of leading him on.
Most people have a gut instinct about a person within moments of first meeting
them. It sounds like you had yours and you've chosen to ignore it. If you can't
even imagine kissing him, how could you even be considering having sex with
him? Even if the purpose was only to have a child? This situation wouldn't be
fair to him either. He is an individual who deserves to find someone who is
attracted to him and who wants to build a life with him. I understand your
concern with being 36 and feeling like you're lacking the relationship it would
take to become pregnant and raise a child, but wouldn't your rather enter onto
the path of motherhood providing yourself and your child the best possible case
scenario -- a loving parental relationship; rather than settling on a
relationship that may fall apart within a matter of years?
I would suggest sitting him down and explaining to him (as gently as you can)
that you're concerned that there is a lack of sexual chemistry and/or
attraction on your part. It may be hard for him to hear it but he deserves the
opportunity to also tell you how he feels and to at least respond to your
concerns. If you want to pursue it from there at least you will both be on the
same page. And if you do want to continue dating (I suppose just for the
benefit of the doubt), I would suggest that you do see if there is any sexual
chemistry. At this point it doesn't sound like you have any real idea about how
that might be either. I'm sure you have a lot to offer someone but making
decisions based upon anything other than your true feelings towards someone
will end up being unfair to the them and ultimately yourself - and maybe even
your future child. Face up to your feelings and put your issues out on the
table.
Question:
I'm a healthy, well-adjusted 40-year-old woman who loves sex. I have no
interest in getting married or of even getting in a long-term relationship. I
like that I can have sex when and with whom I want.
The problem is that most of my friends and family don't understand this.
They're afraid that I'm becoming an "old maid" by engaging in my "slutty" ways.
They don't understand how I can seduce men and just have sex without being
emotionally tied to the person. I'd be happy to welcome a regular sexual
relationship, but I like that I have the option to fuck someone else. Until
recently I was pretty secure in how I felt, but now I'm questioning if maybe
there is something wrong with me. Why can't I be like everyone else?
Answer:
by Kathleen VanKirk, DHS
Unless there are some other factors that you're not mentioning here, it does
indeed seem as though you are well adjusted and healthy. Unfortunately, our
culture does not yet positively reinforce strongly sexual women. You seem to be
experiencing the brunt of the myth through the comments of your friends and
family, regarding their fears of you becoming an "old maid". But since many
people often feel threatened by a woman with strong sexual prowess, they don't
yet have vocabulary that reaches beyond the term of "slut".
As long as you are taking care of yourself (sexually, and otherwise) and are
not acting out in a detrimental manner (e.g. not using condoms, or having sex
under the influence of drugs or alcohol), and as long as you are having
consensual sex with another adult...enjoy! You seem to have the ability to
separate love from sex, and can benefit by enjoying sex just for the simple
blissful act it can be.
As with anyone, I would suggest that you examine your motivations for choosing
the sexual lifestyle you've chosen to live, however. Ask yourself, "Am I just
avoiding developing emotional intimacy with someone? Am I possibly,
commitment-phobic?" If the answer is that you are completely emotionally
fulfilled on your own and don't feel the need to be defined by another person,
then you may feel reassured in your sexual practices. For, there are many women
out there nowadays who are so secure in their sexuality, that they can feel
free to proactively pursue a variety of sexual relationships with men (and
other women, of course). As long as you are being honest with yourself about
your inner needs, I see no issue with your choice of remaining sexually
assertive and unattached.
You may find that this pattern of sexual behavior lasts for the rest of your
life or that perhaps after a period of time you may look to develop a more
permanent emotional relationship. Sexuality can be much more fluid than one
realizes. Either way, the beauty of you choosing to live your life in a
sexually bold manner is to be applauded. If you're doing what feels good in the
context that works for you, have at it.
Question:
Dear Dr. Kat, I want to use lube but my husband doesn't believe in it. Getting
wet never used to be a problem but now in my early forties I don't seem to
lubricate as much. I've tried to bring it up but my husband thinks I should be
able to get wet on my own. I want to have sex but it's so painful now. Help!
Answer:
by Kathleen VanKirk, DHS
Hormone levels change with age and there can be much fluctuation in them for
most women throughout their lives. You are definitely not alone in noticing a
decrease in vaginal lubrication. You are absolutely right to want to add lube
to your sexual repertoire. Lube has been a godsend to many a sexual
relationship. Dry vaginal play just isn't fun and usually it isn't as much fun
for your partner either. How enjoyable can it be to try and penetrate someone
as they are grimacing and whimpering?
Your husband is missing the boat. He could be having a much fuller sexual
experience with you, which as a by-product would probably make you keener to
have more sex, for longer. Not a bad deal for either one of you.
There is a common misconception among some men that they are responsible for
turning you on and if you can't get wet that something must be wrong with them.
It's funny how tied into a man's sense of virility lubrication can be. On the
flip side nothing is "wrong" with you either for needing a little help. Changes
in lubrication can be considered a natural part of aging and hormone changes.
Although not all women experience it, some do even in their twenties. We're
just all wired a little different.
I've known some women who have gone to the extreme of actually applying a
little lube ahead of time so their husbands won't know it. But I'd like to
think you wouldn't need to take that route. One husband figured out when he
went to perform oral sex on her and could taste the lubricant.
Nothing beats a conversation. So, I say sit him down and explain to him that
you both could be having more sex if you actually enjoyed the sensation of it.
I would also mention to him what we've discussed about women's bodies changing
over time and that you have no control over the amount you actually lubricate.
If need be, you could even visit a gynecologist together have the doctor
explain it to the both of you. Or actually the use of lube in adult movies has
become more prevalent in the last few years too. Maybe watching a few DVDS
together will help you discuss the topic and reinforce the idea that extra
lubrication is a good thing.
Question:
My wife and I have been involved in the "swinger" scene for some time now. It's
been a wonderful way to express our sexuality as a couple over the years.
However, I've sensed she has had more than a fleeting attraction to one of the
other husbands we've been playing with in the last month. She talks about him
all the time and when we show up to parties she seems to focus on him. I'm
somewhat surprised because we've always been so open with one another but I
don't know how to even bring this up. How can I address this with her without
her feeling like I don't trust her? I don't want us to have to change our
lifestyle.
Answer:
by Kathleen VanKir, DHS
Attraction can happen anywhere, whether you're in a married monogamous
relationship of 20 years or dating a variety of people at any given time. For
many people who swing it's about sharing the physical act of sex with others,
completely separate of their primary emotional relationship. Love and sex are
neatly separated out and that's that (in a best case scenario).
This is quite different for those who follow a polyamorous lifestyle. These
individuals actually believe in maintaining primary sexual and emotional
relationships with more than one person on an on-going basis. However, any time
one is sharing an intimate space with another can breed emotional feelings for
that person.
Now, I can just hear the average layperson now, "Well, what do you expect with
putting yourselves in a situation like that. Sooner or later someone is going
to fall in love with someone else." Or the myth that if you swing there is no
such thing as cheating. In actuality, cheating has to do with deceit which true
swinging has nothing to do with. It's quite different to negotiate with your
partner about having sex with someone else (as a couple or otherwise), versus
one or the other sneaking around. There's usually alot of negotiation that
occurs in a swinging relationship. I've meet many couples that maintain
superior communication as a result of needing to establish boundaries while
swinging. What behaviors are and aren't ok, who they choose to play with, as
well as when and where. And over the years these boundaries may change with the
needs of each person in the couple.
The act of swinging thrives on attraction and sharing your sexuality with other
couples. You've probably both dealt with a situation in which you've acted on
those attractions within the context of your swinging. I can only assume that
you must now somehow feel this situation might be different from the previous
standard of behavior your wife has set. So, if you get the sense that there is
more going on here than you may both be talking about -- there probably is. You
both don't appear to be new to the game of swinging and so that tells me you
probably aren't over reacting to the situation like some one who was still
feeling the scene out.
Feelings for other people inevitably come up. The trick is to bring these
feelings into the overt. Ignoring the situation won't make it better. You need
to call your wife on this, granted it should be in a constructive way. And
negotiate this issue just like you have every other one.
Questions should be asked and both of you need to be prepared to hear the
answers. I don't believe that this situation has arisen because you don't trust
your wife. But relationships ebb and flow over the years and everything needs
to be renegotiated at some point. Obviously there are other people involved in
this equation, namely the other husband and his wife. Perhaps once it's been
discussed between yourselves (if you have a trusting relationship with the
other couple) you could discuss it with them as well. What needs to be
clarified here is: Are there feelings on your wife's and or the side of the
other husband that may interfere with both of your primary relationships, and
if so what do you need to do about it? Don't leave the decision up to your wife
to bring this up. By time that happens it may already be too late and what
she'll be saying is that she's moving on.
Question:
I've been with my boyfriend a couple of years and he just told me that his
first sexual experiences were with other boys when he was young teenager. What
I find so disturbing is that it wasn't just like they masturbated each other
but actually gave each other oral sex. Apparently, this lasted several months
and he has said that he hasn't been with a guy since then - nor does he say he
wants to. But he seems way too unapologetic for me. Is my boyfriend really gay
or am I just overreacting?
Answer:
by Kathleen VanKirk, DHS
The short answer is that yes you are overreacting. Many people have their first
sexual experiences with someone of the opposite sex yet they don't identify
themselves as gay or even bi-sexual for that matter. Often growing up it seems
safer to experiment with someone of one's own gender. What matters now is that
he now obviously identifies as a heterosexual man. And your boyfriend obviously
felt safe enough with you to give you this information. Many go through their
whole lives without sharing the "secrets" of how they first experienced sex. I
would consider it an honor that he felt secure enough in your relationship to
tell you something so intimate.
The fact that the experimentation involved oral sex versus just a hand job is
neither here nor there. You seem to be placing the value that oral sex is "more
gay" than mutual masturbation. I would say the same thing even if anal sex were
to have been involved. It doesn't necessarily matter what and how many times he
experimented. What matters is how he identifies himself now. As long as he is
(pardon the pun) being "straight" with you now I don't believe you have
anything to worry about.
Opposed to popular belief, sexuality can be far more fluid than fixed over the
lifetime. Early sexual experiences definitely fall under that. Although, there
may be a range of sexual behavior that people engage in, it is still a range.
The labels of sexual orientation are just what we as a culture assign to
categorize people. If you'd like more information on how people develop their
orientations you might want to check out Dr. Jack Morin's book The Erotic Mind.
Now if for some reason you feel like he's hiding more information from you, ask
him. But if the only evidence you have of him being potentially gay is this, I
wouldn't read too much into it. And good for him that he's unapologetic. He
should not feel compelled to be ashamed of his sexual history. If you feel he
needs to be more shameful perhaps you should look at your own hang ups about
sex.
Question:
hi im a 31 year old male who has been stupid and had unprotected sex since i
have had afew red spots on my penis also the skin seems to b rubbing offu know
when u got a spot and touch it it stings a little well this is how mine is also
on one side of my penis is swelled a little can u please let me know wot u
think it is?
Answer:
by Kelly Ace
I think it is something that should be evaluated by a medical professional as
soon as possible. If you don’t want to go to your primary healthcare provider,
check your local phone listings or the Internet for clinics that specialize in
sexually-transmitted infection (STI) testing and/or family planning.
You can’t undo the fact that you had unprotected sex. But, you can find out
what’s causing your symptoms and what you can do about them. Please don’t let
embarrassment or anger at yourself get in the way of you becoming informed and
taking care of yourself.
There are a lot of reasons why really smart people end up having unprotected
sex. Beating themselves up about won’t help anyone. Figuring out how you ended
up in that situation – and how you can better protect yourself and your partner
in the future – can!
Question:
Do partners, where one partner has completely lost their sex drive, ever agree
on some sort of outsourcing for the driven partner? My girlfriend and i have
been together for 6 years and have a wonderful relationship in all aspects
except one, that is tearing me apart. For the first 18 months we both had very
high sex drives whereby we would have sex between 1 and 3 times per day. At
this point my girlfriend developed a severe case of Chronic Fatigue Syndrome
(after some undetermined virus) and her sex drive and desire deteriorated to
absolute zero after six months and has never returned (incidentally, neither
have her periods). We are still battling her chronic fatigue and four years on
her drive is still zero. The problem is that i am going completely insane as my
drive has remained the same and it appears that masterbation just is not doing
the trick any more. Unfortunately our social upbringing of fidelity does not
consider unusual situations such as this. Sometimes unusual situations need
unusual solutions. I feel that this has been a ridiculous question to ask but
she really has no desire at all any more and i just want to know if people have
managed to keep their relationships alive by changing the rules of this one
aspect. Many people won't understand this thinking, but i live in a country
where prostitution is legal and i have seriously considered using that as an
outlet with her consent. Have you ever heard of this working?? Any other
suggestions would of course be most welcome!
Answer:
by Kelly Ace
Some couples do find that they can negotiate this. Others try and find out that
it takes a major toll on the relationship, even though they didn’t initially
think that it would. Whether you and your girlfriend can do this is hard to
say.
It seems like you are respectful of her changed level of interest, even though
you are not happy about it. It’s less clear whether the two of you have been
able to really talk about how this is affecting both of you, let alone explored
possible ways of improving the sexual aspect of your relationship.
I strongly recommend that the two of you seek couples counseling with an
seasoned therapist who is knowledgeable about sexual issues and willing to help
you explore the pro’s and con’s of non-traditional relationships prior to you
taking any steps that contradict your and your girlfriend’s ideas about
fidelity. (Once done, this can’t be undone, so it’s best to first be really
sure that the potential benefits outweigh the potential risks.) I’m afraid I
don’t know much about sex therapists in Australia. Your primary healthcare
provider or a local family planning clinic may be able to suggest some
professionals with the necessary expertise. (Someone in from the Australian
Society of Sex Educators, Researchers, and Therapists or the human sexuality
departments at the University of Sydney or the Curtain University of Technology
may also be able to help.)
I can’t help but think that it would also be helpful for your girlfriend to be
evaluated by a gynecologist or endocrinologist. While there may be a connection
between abnormal hormone levels and chronic fatigue, I wouldn’t assume that her
current diagnosis explains why she hasn’t had a period in 4 years. Something
else may be going on medically. Depression – which has both physical and
emotional components -- may also be playing a role. Of course, there’s no
guarantee that your girlfriend will be open to looking at these issues.
Broaching the subject is likely to be easier if you emphasize that you are not
only concerned about your sex life, but also want to support her in figuring
out how to feel her best and enjoy her life to the fullest.
If you do end up deciding to become sexually involved with another person,
please remember the importance practicing safer sex.
Best wishes for both you and your girlfriend,
Kelly Ace
Question:
My boyfriend and I have been sexual active for about 4 months, at first the sex
was great and it didn't hurt, but after awhile for some reason if I didn't
position myself right when he penetrated me it felt like his penis was rubbing
up against some kind of bone and it hurts and I feel uncomfortable! Please help
me!
Answer:
by Kelly Ace
Finding some positions uncomfortable for intercourse doesn’t necessarily mean
that there’s a problem. Many women experience discomfort if the penis bumps
against the cervix (the bottom of the uterus) at a certain angle. Keep
experimenting with different positions to find the ones that work best for both
you and your partner. If you find a position uncomfortable, don’t be afraid to
speak up. Saying something like, “Let’s switch to something a little more
comfortable,” rather than “Hey – you’re hurting me!” can help reduce the chance
that your partner will feel like you’re criticizing his technique.
That being said, I definitely recommend that you be evaluated by a healthcare
provider. Pain during intercourse may also be a symptom of infection or other
problems. If you do have an infection, it should be treated as soon as
possible, since some untreated infections can cause serious complications, such
as pelvic inflammatory disease (PID) or infertility.
Best wishes,
Kelly Ace
Question:
I can not reach an orgasm due to a big fight with my husband about a month ago
never happened to me in the last 20 years do I need therapy?
Answer:
by Kelly Ace
Most people find it difficult, if not impossible, to have an orgasm when they
feel unsafe, angry, hurt, or confused. You mentioned elsewhere that your
husband was very drunk at the time of the fight and that he abused you
physically, emotionally, and sexually. It’s hard to feel safe, relaxed,
trusting, and open to pleasure when involved in an activity as intimate as sex
with someone who’s hurt you like that. It’s harder still if the fight stirred
up memories of earlier trauma or bad experiences. So, while your lack of
orgasms since then may seem disappointing or unusual, it is probably also quite
normal under the circumstances.
Whether this is the first time your husband hurt you or the 100th, it’s very
important that you talk with someone who can both help you both explore your
feelings and develop a safety plan. You can call the National Domestic Violence
Hotline toll-free from anywhere in the USA by dialing 1-800-799-SAFE (7233).
[If you use a TTY, dial 1-800-787-322.] You can also check out the resource
section in the phone book (these pages are usually blue) and look under
“Domestic Violence,” “Abuse,” “Mental Health,” or “Counseling.” You can also
get information by going to www.ndvh.org – but only if you are sure that your
husband cannot monitor which websites you visit.
Now, if you ask women who’ve been in similar situations why they are hesitant
to get help, they often say things like this:
He’s sorry and I believe him when he says he’ll never do it again…
I’m too embarrassed…
I’m afraid he’ll find out and try to stop me…
What happened was really my fault…
Talking with a therapist just proves I’m crazy…
It won’t do any good…
I don’t want him to be arrested/lose his job/be humiliated…
I’m afraid he’ll leave me …
You may have similar worries and concerns. But, please don’t let that stop you.
Your husband has a problem managing his emotions and his drinking, at least
sometimes. (Plenty of people get drunk, but most don’t do what your husband
did.) This type of problem tends to get worse, not better, on its own. So,
there’s a good chance that another fight like that could happen – even if he’s
sincerely apologized. You need to protect yourself. If you have any children,
you need to protect them, too.
Talking with an experienced professional is one of the best ways to both help
you heal and stay safe. When those things are underway, you may find that your
orgasm concern resolves on its own.
Best wishes, Kelly Ace
Question:
I was raped and i found out that i have herpes and i need to know if i can have
normal sex with my boyfriend without infecting him and are there any
limitations on things we can do to each other sexually? Is there some kind of
vaccine he can get so that he doesnt contract this virus?
Answer:
by Kelly Ace
Unfortunately, there is no vaccine or other method of guaranteeing that herpes
won’t be passed on to a partner during sexual contact. You can best reduce the
risk by always using condoms (or dental dams for oral sex) and avoiding sexual
contact during the times you have an active outbreak or feel like you are about
to have an outbreak. (Some people describe this as an itching, aching, or
tingling sensation in their genitals a day or so before sores actually appear.)
This link will take to you more articles about herpes, safer sex practices, and
other resources:
http://www.sexualhealth.com/channel/view_sub/sexually-tranmitted-infections/genital-herpes/
.
Often, the trickiest part about having herpes isn’t dealing with the outbreaks
or remembering to have condoms handy, but rather, learning how to talk about it
with a partner. This can be especially true if your outbreaks bring up feelings
and memories related to the assault.
The good news is that talking about herpes tends to get easier with practice.
Also, you don’t have to talk like you’re giving an anatomy lecture whenever you
have an outbreak. You might want to explain to your boyfriend that something
like, “Honey, let’s wait a couple days and then have an especially hot sex
night” is really your way of saying “I have an outbreak, so we need to hold off
on genital sex until the sores heal..” Saying it the first way emphasizes the
fun stuff ahead.
If you find it’s difficult to talk about the issue, you may want to seek help
from your healthcare provider or counselor. They can help you (and your
boyfriend) feel more educated, comfortable, and in control.