Sex and Relationships

Sexual Dysfunction

Answers to questions about sex therapy and sexuality

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8/27/98 Q: Dr. Fitz, >I'm 24 my husband is 26. We've been together for three years. The sex has >always been great, when we have it that is. He is very reserved and >unavailable. I'm a very open person and love to talk. I have tried to draw >him out. In the evenings we watch TV or he works on the computer. I have >complained numerous times about feeling lonely and not interesting. I offer >all kinds of ideas as far as interacting together. He either doesn't feel >like it or is too tired. When it comes to the sex it isn't much different. I >had to deal with getting turned down very early on in the relationship, ( a >new experience.) Any ways I've accepted that. We do it on average twice a >month. When we talk about it he says it's because he's a morning person and >I'm not. The PROBLEM is that for the last year and a half I've been aware >that he secretly masturbates almost every morning. This is where him being a >morning person and me not comes in. So a couple times I've approached him >in the morning. He gets up before me and this is when he does it. When I >initiated it he turned me down only to wait until he thought I was asleep >and then took care of it himself. I've tried to let him know how this makes >me feel. I've never berated him. I don't know what to do. I'm a sexual >person and he's getting his while I get rejected. I know it's not the >timing. He says it's not me. HELP PLEASE! > > > > > >

A: Dear K:

It may be that a rose is a rose is a rose, but sex is not sex is not sex.

Sexual behavior is complicated. In addition to the physical sensations of pleasure and tension release, there are powerful emotional and symbolic overlays related to power, dominance, submission, exposure, intimacy, tenderness, and often, clashes with unattainable fantasy roles of masculinity and femininity.

It sounds to me like this is not an essentially sexual matter -- I think this is an intimacy, or control, or vulnerability matter of your husband's.

You individually are neither the cause of the problem nor capable of providing the solution without help. I say "individually" because if the problem is unconscious anger or control issues with women, you are part of the problem insofar as you are a woman, but you may not be the cause of the problem as far as your attitudes and behavior go. I hope that makes sense -- it's a very important distinction!

And this absolutely, definitely needs to be addressed by psychotherapy. Keep in mind that the sooner you begin to deal with this therapeutically, the shorter the therapy period. If this continues, it gets rehearsed and becomes what we call "entrenched".

I would really appreciate it if you'd let me know what happens.


8/26/98 Q: Dear Dr Fitz... > I am a 22 year old male and have had six sexual partners. With one of my >partners we had sex for a year unprotected, but she never became pregnant. Is >it possible to ejaculate too much and make your sperm not able to fertilize an >egg from a woman? I really want children in the future, so I am worried >dearly about this. Can I have sex too much or masterbate too often that it >will effect the longivity of my sperm? > >Thanks... >Confused One > >

A: While women have a fixed number of eggs at birth, men produce an essentially limitless supply of sperm. The average ejaculate has between 40 and 80 million sperm.

Ejaculating every day from early adolescence on will not hinder your chances of getting pregnant later. In fact, regular ejaculation is good for your prostate gland (it keeps it producing fluid).

I term your year-long experience "lucky". Of 100 women whose only contraceptive is latex condoms, at the end of a year between 2 and 10 will be pregnant!


8/26/98 Q: ok, ive got another question. >seems like i have alot these days, but here goes- >is it 'normal' to have pubic hair growth past the vagina? >i am wondering because i just read a book that said it grows in an upside-down >triangle shape and mine grows just a little on the inner thighs and past the >vaginal opening. if this is NOT normal, what do i tell my mom to get her to >take me to a doc? >i dont like the idea of 'mom, can i go to the doctor? ive got an overgrowth of >pubic hair' >

>also, what is the "average' clitoris size? for my age, at least. >i am wondering cuz there was a drawing in the book (the same one i was talkin >about before) and mine doesnt seem to look anything like that. >IM WORRIED ! >thnx again >brittany > >

A: Dear Brittany,

Thank you for confiding in me. I do enjoy understanding what people of all ages don't know.

We easily accept individual differences in height, hair color, and shape of ears, etc., but everyone wants to be "normal" when it comes to sex.

Body hair grows in funny ways and is a little different from person to person. I encourage you to accept your body hair pattern as uniquely yours; don't worry about it not being the "perfect" triangle.

Also, clits come in all shapes and sizes (well, within some limits). Usually they're about half the size of a pencil eraser, nestled under a hood. Most get stiff when stimulated, just like a penis (they're made from similar tissue). Some are long and thin, as big as two inches, and some are very small.

The "clitoris" is actually shaped like a wishbone, with only the tip showing. The "arms" on either side >descend down around the vagina at about a 35 degree angle, getting bigger as they go down, sort of like tear drops. That way, sideways thrusting of an object in the vagina stimulates the interior parts of the clitoris causing intra-vaginal pleasure.

Thanks again for the questions. You and I know that there are lots of other females your age out there who have the same questions.


8/26/98 Q: Dear Dr.: > >I am a 30 year old woman, with a partner who is 31. We love each other >and have very good communication, and I have reason to believe that he >is the man I'm going to marry. > >Some time ago he began having problems maintaining enough of an erection >for us to have intercourse. He can orgasm with masturbation but has >difficulty doing it during sex. Since this new problem has started he >has complained of 'not being stimulated' and he seems to suddenly lack >sensation in his penis. > >We have had a very healthy and active sex life up to this point, and I >can see how frustrated and anxious he is becoming about this. I know he >has been under some stress at his job and that he is also afraid that I >will leave him if he can't please me. He is physically healthy, not on >any medications. He has revealed some fetishistic/exhibitionist >interests to me, which I have no problem with, but I think he has a hard >time believing he's not a pervert. While I am certainly missing our >frolicking, there's no question for me of leaving the relationship, and >since we 'play' in other ways, I'm not all that frustrated yet. > >Fundamentally, what it looks like to me from the outside is that he is >psychologically driving himself nuts over all of this, and I don't know >how to help him or what the appropriate attitude is for me to take in >all of this. I have suggested some stress management, which he is >interested in. > >Please help if you have any suggestions. I searched your question >archive pretty carefully and didn't see anything that was quite along >the lines of what I am asking. I love this man, and want to do whatever >is right for both of us. > >Thanks, >E.D. >

A: Dear E.D.,

Thanks for searching the prior questions so diligently.

The best course of action would be abstaining from any attempt whatsoever at penile-vaginal intercourse, and getting into sex therapy as soon as possible. The frustration in the "performance failure" is part of the stress, but dealing with the stress alone will not counteract the fear of erection loss when presented with the opportunity of intromission again.

Any other form of sex play is encouraged, except that which "demands" the use of an erect penis. i.e., oral sex is OK if it is OK with both parties if the penis loses its erection.

My best advice.


p.s. The sooner you get into sex therapy the less time it will take to fix the problem. The longer you take to initiate the process, the more time he has to rehearse the fear of failure.

8/28/98 She writes back:

Dear Dr.: > >Thank you for your precise answer. I was not surprised by it, nor by >the fact that my partner met the initial suggestion of therapy with some >resentment and surprise. However, the seed has been planted, and I >think he is aware that if things continue or worsen we need to explore >this option. I had already told him that I felt we should abstain from >intercourse for a while, so this was right in line with your advice. > >I am going ahead investigating finding a therapist. Is sex therapy a >subset of general psychological practice and not its own profession? I >am somewhat confused about this. I have also seen 'sex therapy' used as >a self-help term in referral to 'sensate focus' exercises. I want to be >clear as to whether you were suggesting going to an outside party >immediately or looking ourselves at books and other sources of >information first. Naturally, the latter would be easier. > >Also, (last question)--I am not clear about whether or not this is >something always done as a couple or if it is sometimes an individual >thing. I am Buddhist and my partner is from a rigid Catholic >background, hence he has many 'sin, guilt and evil' issues around his >sexual practices and desires that I find difficult or even impossible to >understand since my spiritual path does not foster those beliefs. We >both have a strong commitment to leading a spiritual life and I think it >is important to have a therapist who can understand and respect our >paths; however, I don't know how to find this kind of thing out--the >receptionist in the doctor's office, or even another doctor, often >doesn't know much about a particular therapist's philosophy or beliefs. >Short of setting up an actual appointment with someone who may or may >not be the right choice, how can I find out more without being >obnoxious? > >Many thanks for your kindness and help, > >E.D. > >

The Sexdoc replies:

Dear E.D.

Thanks for your comments and follow-up. Often I answer a question and it goes into a black hole -- I never hear whether the comments were well received or not.

Sensate Focus is articulated fairly well in Helen Singer Kaplan's book "The Illustrated Manual of Sex Therapy". The problem is that I have had several dozen people ask me to not use sensate focus because they tried it and it didn't work; and I have never had a couple come in for anything who said that they had had a sex problem which they solved on their own by using sensate focus out of a book.

As I use sensate focus, there are links to the chain, all of which must be in place for it to work (believe me, I have searched valiantly for short-cuts, and they backfire):

I wish that there was something you could do to solve the problem on your own, but alas, if I had found that technique I'd be on the national book circuit right now.

Note that it is the objective, trained, third-party redirection by the therapist that separates sensate focus on your own from sensate focus with a therapist's involvement.

In California there are licensed social workers, marriage and family counselors, and psychologists. There are also "sexologists" who are not regulated by the State, and who are permitted by law to deal with people's sexual problems, but not other psychological problems.

I have known sexologists who were great, and licensed folks who I thought were not effective; the difference is that the mental health folks who specialize in sex therapy have also been trained to recognize and diagnose other maladies. For example, sometimes (not always) lack of sexual desire is secondary to (a symptom or consequence of) depression. If someone didn't spot that, all the sex therapy in the world isn't going to "cure" the problem. The depression must be treated, and often (but again not always) sexual desire returns all by itself.

Please note that this is one incidental illustration -- I don't have time to write a lot more right now, but I am confident that you get the picture.

Because it is the COUPLE who wants to be sexual together, the couple working together can achieve a satisfactory solution more effectively than the individual.

Obnoxious? You have a right, as a consumer of health care services, to know the qualifications and treatment approach of a psychotherapist. Any practitioner who won't give you five minutes on the phone to address your question about different religions should, in my opinion, be avoided.

Most people feel such tension-reduction from spilling their (sexual) guts to the first sex therapist they have an appointment with, that the idea of interviewing several to assess "fit" seems like torture! For better or for worse, the best way to do this in my opinion as a 30+ year sex therapist is to have an initial appointment -- for which you will be expected to pay -- with 3 identified sex therapists, one of who must be the opposite gender of the other two. You will complete therapy faster with someone with whom you have a "fit" because you will feel more confidence, you will divulge deep dark dirty secrets and shameful events sooner, and you will have more horsepower in doing what your therapist recommends.

It is cost-effective. If an identical problem were treated by therapist A in 20 sessions, therapist B in 30 sesions, and therapist C in 40 sessions, it would have been smart to see A, B, abd C once, then to have chosen. If you picked "A" you would have paid for 22 sessions -- 20 with A and one each with B and C.

Your feedback on this information will be similarly appreciated.


8/24/98 Q: any tips on how to find her g-spot? > > >

A: Yeah: On my web page.

Between one and 3 inches in, on the upper wall of the vagina, in the center. Stimulate her clitoris while rubbing your (inside) finger tip alternately in circles and left to right and in and out. If she has one (not all women do) you will feel a bump the size of a half of a green pea. Varying the stimulation on her g-spot and her clitoris you can keep her involuntarily pelvically contracting until she cries for you to stop. You have to watch intently and modulate it -- too little stimulation and she'll "cool off". Too much and she'll have a more violent orgasm and demand that you stop NOW!


8/24/98 Q: Hi!

Thanks for a great site (I just found it via an AltaVista search). I will be putting a link to your site on one of my sites (I'll drop you a note when I get the link up so you will know where it is and what I say about your site).

Ok, on to my question:

- ------

I'm a 52 year old male, married for 26 years but now divorced. Ten years ago my genitals were surgically removed, and while this did require some period of adjustment, my wife and I were just fine with it. Even though I can obviously not perform penetrative sexual intercourse, cunnilingus and lots of 'play' meet my needs (and also met those of my wife).

Now that I am single again my concern is how and when to bring up this rather important point to a lady that I am interested in (she's also interested in me). In any non-intimate situation there is no way for her to know and I don't want to just suddenly spring it on her if/when an intimate situation does arise.

I can think of no way to bring up the subject prior to 'the moment of truth,' nor can I seem to frame what sort of things to say.

Suggestions would be appreciated!

Thanks, T.

A: Note: I have interspersed his reactions to my comments, below. Dear T: You have, in my opinion, a choice of a lesser of evils. Surely if you and she are getting undressed and she is getting hotter and hotter imagining your erect penis inside her, and you then tell her, she could be doubly disappointed -- A) with the state of affairs, and B) with the timing.

Absolutely! This is why I'm trying to figure out a way to discuss it well beforehand.

Consequently, I suggest that you minimize potential disappointment by finding a time before she thinks you're going to take her clothes off, and to tell her then.

This is what I felt, also, but, maybe I'm old fashioned, there just doesn't seem to be an appropriate time for such a thing. Uh, discussion of how one is 'hung' (or not) prior to an actual intimate scenario just isn't something that is done in polite society, at least when and where I was brought up. I think what I need is to somehow steer things so that she starts the conversation. I'm trying to think of an appropriate setting.

There are women who strongly prefer all alternatives to penile-vaginal intercourse, and who would welcome a lover well versed in the art of stimulation in non-intercourse ways.

I have met such, Dr. Fitzgerald, so I know they exist. I've even met a very few who were fascinated. Odd quirk, that. :o) (Is there a name for that sort of paraphillia?)

((( The Sexdoc replies to this: There are men and women whose fetish is medical/genetic/other anomalies. There are various names for them, but it boils down to fascination with the rare circumstance. It's sort of a "special" thing. They feel special being sexual with someone special, if that makes sense. )))

There are women who like to have something inside them for their vaginal muscles to squeeze against -- and some of those are prefectly happy selecting a dildo of the girth and length they can count on every time.

Hmmmmmm... For my own reasons I prefer not to use a 'strap on' prosthesis - psychologically that's a killer for me. :o( However, if she wishes to use something by herself, or even with my loving assistance, that's OK - so long as I'm not simulating intercourse. (Did that make any sense?)

So I know that there are women out there who can accept your being genital-less. Your task is to find one and to present it gracefully so she can diplomatically bow out if she insists on doing things the "usual" way.

Yes, certainly there are, and I have a few friends who easily fit into that category. However, that has not been a primary 'search criteria' for me in happening to get closely involved with another. Maybe it somehow should have been.

As to trying to present it gracefully, that's a must for me, and allowing her to 'bow out' is much of my reasoning for trying to figure out how to present it before we become so involved that she feels she's been more or less lied to or cheated.

Omitting your name, of course, may I have your permission to put this Q/A up on the web page?

Certainly, sir, and if you need to edit for clarity or to make it more generally applicable, that's OK, too.

For my edification, I would appreciate it if you would let me know the circumstance that resulted in the surgical removal of your genitals. And, to be precise, this means both testicles-and-scrotum and penis, right?

Yes, total removal - penectomy, scrotomectomy, orchidectomy and perenial urethrostomy. (I have a web page showing drawings of the procedures if that would help.)

A long story, but to make it very short: I was born slightly intersexed and the surgery done to me as an infant and child left me with painful, non-orgasmic genitals. After putting up with that for way too many years, I finally had _elective_ surgery with the blessing of my regular M.D. and two psychologists. Physically and mentally I'm MUCH happier now, and with minimal HRT to stave off osteoporosis and such my health is excellent. My 'body image' is much improved with this change, also. No regrets.

The only problem, and it's minor compared, is new relationships, and how to inform someone while they can still cut and run if they need to.

Thanks for the offer of a link from one of your sites. I will appreciate the publicity.

No problem.

I look forward to hearing from you regarding my suggestions and the other material, above. sexdoc

Well, you just heard from me, sorry my response was so long winded (I get somewhat wordy and pedantic).

Thank you for your time,


8/24/98 Q: Howdy, My girlfriend and I have been dating for five months now and have been sexually active for about three. I am 18 and she is 17. Our problem is she is having a real hard time achieving an orgasm. She has climaxed with me in the past but it is rare for her to. Also, she can cum using a vibrator. I can last a long time so it's not like I climax too quick. And I always perform oral sex on her before I penetrate her. I'm wondering if she is concentrating too hard on achieving an orgasm? Some info would be greatly appreciated.

A: Only about 40% of women achieve orgasm during penile-vaginal thrusting. She might be one of the 60%.

8/24/98 Q: How far does a man have ot go in before he breaks a Womans hyman? Is it >possible ot ahve sex w/o breaking a wms hyman? If you never had SEX >before what do you recommend to prepare yourself for it ? please >respond quickly! > > >

A: Not all women have an intact hymen (one that needs to be torn to permit penetration). How far in varies, but it's usually between 1/2 inch and 2 inches in.

You can have all kinds of sex without breaking a woman's hymen: oral sex, anal sex, manual sex, etc., so long as nothing penis-like penetrates the vagina.

If you have never had penile-vaginal intercourse before, your goal is easy penetration. Stick two well-washed and well-lubricated fingers into your vagina. Do they go in up to the knuckle? Can you spread the fingers and rotate your wrist in a complete circle without your fingers being forced together? If you can, you probably have nothing to worry about (as far as penetration is concerned; you might have a LOT to worry about in terms of getting pregnant or getting caught). The hymen can be gradually stretched -- by using a tampon, for example. For many females it just recedes all by itself. If you are having your periods but you can't get even your little finger in, consult a Gynecologist and ask for a medical opinion about your options.


8/24/98 Q: Dear Hopeful but Bothered in Dreamland,

Because you have organized your comments so well, I am taking the opportunity to respond to them paragraph by paragraph, interspersed with yours.

Dear Dr. Fitz, > > I wrote you a little while ago asking whether or not men looking at >pornography tends to interfere with their appreciation of their >partners. You replied that pornography is only a small part of the >visual stimulus available to men in our culture, and that most >women/wives/partners can't compete with these readily available images. >You said that women need to rely on the theory that a bird in the hand >is worth two in the bush (no pun intended). This implies that although >youth and beauty tend to be very important to men, most men are going to >resign themselves to not being able to get it, so they will settle for >their not so young or beautiful partners.

SEXDOC: Youth and beauty are important to many men, but that doesn't mean that they would trade what they have in a companion for "just" youth and beauty. Men don't need to resign themselves not to being able to get it -- Men of wisdom and maturity will know that they can't and don't want to "keep up" with "youth and beauty". Most 50+ men really don't want to have sex three times a day and dance until dawn every weekend! Realistic men will acknowledge that there are age-appropriate behaviors for their age and for the age of a young and firm-fleshed woman, and that if she has self-respect and integrity, that she will be frustrated in wanting to do her age-appropriate behavior if she is not joined by her man. I have and have had many female patients in their late twenties to late thirties who ride centuries (100 mile or 100 kilometer bicycly rides), want kids, and want to party, dissatisfied with older lovers who can't keep up with them.

> > I find this scenario very disconcerting. I don't want my partner to be >"settling" for me while coveting whatever young and firm piece of flesh >that walks by. Although my partner is no Greek god, I look for all the >things about him that are attractive to me, and I don't compare him to >male models in magazines. Because if I did, I would start to feel >dissatisfied. My partner is very focussed on youth and beauty and >definitely finds me wanting in that department, as I have mentioned >before.

SEXDOC: I think that part of this is semantics. How about "I am glad that my partner has the wisdom and maturity to appreciate the fine qualities that I have while still fantasizing what it would be like to have a sexual escapade with a young woman -- both of these prove that he is still alive!"

SEXDOC: Of course you don't compare him to male models. Most women are not eroticized by visual stimuli, and most men are. If your partner is very focussed on youth and beauty (and definitely finds you wanting in this department) then he can choose to abandon all of your fine qualities to be with another, younger, woman, and trade off looks for history. It's his choice. But tell me, didn't he have you when you were younger and looked closer to society's definition of beauty? If he wanted youth and beauty then, and he is willing to trade the history of your relationship [having been there for each other through thick and thin (etc.)] for another go at youth and beauty now, he's being selfish -- he wants it all (and I hypothesize that he'll soon realize the illusory nature of what he got, to say nothing of his paranoia about losing his young beauty to a more fit stallion).

> > In other replies to people you seem to indicate that this is the >natural scenario, and that partners should have the right to receive >sexual stimulation outside of the relationship as long as it is agreed >upon. That there is no law that says a spouse must be the most sexually >attractive person to their partner. That masturbation to other stimulus >should be acceptable etc.

SEXDOC: To be more precise: It is a matter of contract -- of promise -- of mutual agreement. If you have a contract that neither of you will be sexual with anyone but yourself and each other, then extra-contractual sex is abreach of contract, a ground for appropriate outrage. If you both agree that either or both may be sexual outside of your dyad, and one or both of you does that, then there is no breach of contract. What usually happens, in practice, though, is that what seems "reasonable" from the proverbial armchair is not what either party expected.

SEXDOC: Yes, I agree: "There is no law that says a spouse must be the most sexually attractive person to their partner" in the sense of "attractive" as superficial beauty (in the literal sense of superficial, not a sarcastic sense). But there is an understanding, which I elevate to the level of "contract" that says that "A spouse must be reasonably sexually available and responsive to the needs of his or her spouse if he or she expects his or her spouse to ratify the contract to be sexual only within the relationship." In other words (to anticipate what I suspect many readers are thinking) "If you are not sexually available to engage in SOME reasonable activity with your spouse to fulfill your spouse's sexual NEEDS, then you may not object to your spouse getting his or her sexual needs fulfilled elsewhere -- starting with masturbation and progressing to a discussion (modification of the contract) regarding other partners."

> > My question is, in your thirty years of practise, have you found that >this is always the case with men? In other words, have you had >experience with men who do not wish to be promiscuous deep in their >hearts? Am I living in a dream world when I think that this tendency >toward promiscuity and the obsession with youth and beauty are signs of >emotional immaturity? Am I dreaming to think that there are men who look >for the beauty in their partners rather than comparing them to swimsuit >models?

SEXDOC: Get back to the basics of Darwinian Evolution: Survival of the species. Men are genetically compelled to sow their seed as wide and as far as possible (and often, with total disregard for the "youth" or "beauty" of the sexual partner). Thus, they lust after everything with a bearded clam between her legs. Men are genetically predisposed to value fecundity -- being able to bear children -- and the visual sign of this is permanently swollen mammary glands, a distinction help exclusively by female homo sapiens sapiens; therefore the bigger the better. Women are genetically predisposed to survey the array of men and to select the biggest, strongest, most capable of providing food, shelter, and protection for her and the little ones from marauding sabre-toothed tigers. And once she "captures" her man, to do what she has to to keep him hers. Thus sex for recreation, not only for procreation.

SEXDOC: So, yes, most men wish to be promiscuous from a "reptilian brain" perspective, but society has provided something called "socialization" and with that things like "honor" and "trust" and "respect" as well as guilt, shame, and humiliation. So therein lies the conflict. Men want to fuck everything, but are usually constrained by societal restrictions.

SEXDOC: Thus, the tendency toward promiscuity is genetic. An obsession with youth and beauty is symptomatic of other problems, which need differential diagnosis by a trained mental health care worker.

> > These issues are important to me. If I want a partner who can truly see >my physical beauty without comparing me to an ideal, am I going to have >to be in a relationship with a woman? Do I have to become a lesbian? Am >I the only woman who is bothered by this element of aging relationships? >Do you deal with this issue in your practise and do you always have to >tell older women that they must just accept that this is the way it is, >that their partners will always look for youth and beauty?

SEXDOC: I have news for you: The gay and lesbian community has its own standards for what is attractive, and the AVERAGE length of relationship is short compared to heterosexuals. You deserve a partner who can value all of your qualities while acknowledging that his, and your, body have aged. A comparison to an ideal is shallow and unrealistic.

SEXDOC: The majority of honest men will acknowledge that they are attracted to young, firm, big-breasted women. A majority of them will joke that they "know what to do with that". Most would experience erection failure if dropped into a motel room with the object of their attraction (and would be reluctant to disrobe for fear of repulsing the hard body with their flab and beer belly).

SEXDOC: It is not just older women who must accept that men are attracted to other women -- it is all women who must accept this. You say " ... look for " youth and beauty. I say " ... look at or be attracted to ... youth and beauty".

> > If there are other women bothered by this issue, or who have found some >way to deal with it or a different way to think about it, I would love >to know. Or if there are MEN who see this differently, I would love to >hear about it. > > Thankyou! > >Hopeful in Dreamland > > >Bothered > >

8/24/98 Q: Dear Doc, I've been impressed with your web site, and your answer to >a question I submitted a couple of weeks ago. Anyway, I trying to decide >if I need to go to therapy and would really like some advice before I >go to all the trouble and expense. I'm interested in your telephone >service and costs involved. >Thanks >jack > >


Dear Jack,

Often, what people think is a simple question is something that opens Pandora's box and further branches need to be explored before it is possible to propose an effective course of action. Please entertain the idea that people who call me with a "quick question" often present such a scenario, and I am in conflict trying to answer a "quick question" between patients and devoting the time the question deserves.

My solution is the telephone consultation, which is not therapy, as I emphasize on my web page, but advice on whether to seek therapy or not.

My telephone appointments are 45 minues, for a fee of $135, pre-paid. I used to be able to accept Visa and MasterCard, but I have decided that I want people to really compose their thoughts, not "just" call with plastic, then later realize that they had other questions they wanted answered.

A question I have for you is whether you would be better served by seeking a face to face consultation locally, for about the same expense? If the recommendation is that you proceed with therapy, you will at least have assessed somewhat whether you can be comfortable with the therapist you met in person.

If you question whether most therapists are going to encourage you to come back for several more sessions, that's valid, but something only you can handle.

I don't recall your question; do you think it can be articulated sufficiently by e-mail so I can help you decide whether to go to therapy or not?

If you want to talk, send a check payable to "Allied Psychological Services" or "APS" if you prefer, and mail it to the address below. After I receive it, I'll contact you to set up a time for you to call me.

I look forward to hearing from you.


8/24/98 Q: Dear Dr.F: >I am 25 years old female and my boyfriend is 23 and we are both healthy and >get tested regularly for STD's. We have been dating almost 3 months and >have been having intercourse and oral sex since then. However, last >weekend was the first time he has ejaculated in my mouth. It tasted so >awful I had to run to the bathroom and spit it out. I have performed oral >sex on previous boyfriends, and none of them tasted as bitter and acidic as >he did. He said none of his ex-girlfriends had complained of any "unusual" >taste. We had had vaginal intercourse twice in 4 hours prior to that, >which makes me wonder if that had something to do with it. I have tasted >his pre-ejaculation before, and never noticed anything strange about it. I >have not performed fellatio on him since then (I'm nervous to try again and >get the same result - which could spoil sex from now on), but we are both >concerned as to whether this is possibly a one time occurence under the >circumstances, or a normal thing for some men and he would always taste >that way. He doesn't eat any particularly spicy, salty or sweet foods, >either. >I would appreciate your help, and ask that if you post this to please only >sign me "Nikki" >Thank you > >


Dear Nikki,

Over the years I have heard many similar stories and while sometimes there seems to be a correlation with diet, often neither partner can find a pattern (even when they keep a food intake log). It could have been a coincidentally unpleasant combination of factors (the body being an extremely complex chemical factory), never to be repeated, or it could be consistent. Only additional experience can tell.

If your second event is unpleasant, try masking the taste with honey or mint (mouthwash). If that won't do it, ask your boyfriend if he would prefer last minute withdrawal from the mouth with the palm of your hand holding the tip of his penis as he ejaculates, or nothing. I'll bet he'll be smart to choose the former.

Please let me know what happens.


P.S. A significant number of women have told me that green vegetables are important -- some make the ejaculate bitter, others make it taste "fresh" (their words, not mine).

8/22/98 Q: Dear Dr. F. > For the past eight years, I've been involved in a Dom/sub relationship >(I'm the Mistress/Mommie) with a 45 year old professional (he's in the medical >field) who >LOVES to dress up like a 10 year old girl. (Complete with wigs, lots of pink >bows, pink tights, pink dress -- the entire works). I know that he's afraid >of his mother (to this day) as I have approached the topic with him as to why >he enjoys dressing up like a little girl and being verbally humiliated. I've >never hurt him emotionally or physically, as that's not my style.. That's >probably also the reason why we've been together for so long. I know that >he's seen quite a number of Mistresses/Dominatrixes over the years, but he >feels safe with me. (To me, safety is #1, his pleasures are #2 -- smile). > I'm curious however as to what pushed him to this psychological point. Why >does >dressing up as a 10 year old girl give him such sexual pleasure, and he can't >seem >to have sex outside of a B&D relationship.. I know he's been seeing Mistresses >for >over 20 years. > >Please sign me >Curious Mistress (smile) > >(thank you for leaving my name off of your response if you use it publically) > >

A: Dear Curious Mistress,

Books have been written on this topic and what I have to say here can only be a glossy generality -- there are MANY exceptions to the general rule.

Mostly it's a matter of anxiety and permission. At some point asserting his masculinity was powerfully contradicted. The fetishistic aspect of the get-up gives him "permission" to be sexual without anxiety. When made up he feels OK to be sexual. If he cannot accept the normal sexual urges, being verbally abused makes it OK for him to feel sexual. If sex is dirty, and he is told that he is dirty, he can agree and get dirty by having an orgasm (soiling something, no doubt).

It seems to "work" for him. It usually becomes a formula that can be repeated over and over -- it works every time. Branching out to other scenarios is dangerous because it might not work.

It sounds also like there may be a component of pleasing mother -- maybe trying to please mother with immature coping skills. If mother wanted a girl instead of a boy, she might have communicated the message "If you are a boy I will ignore you. If you are Mommy's little girl I will love you to bits".

Every normal kid desparately wants Mommy's love and approval, and people will do amazing and bizarre things to get it. If you're playing the game with a kid's immature and small bag of tricks, against an adult with all the power and great means to be manipulative, the kid has no chance but to cooperate.

This is a basic explanation, and it is terribly over-simplified. Mothers of the World: Please do not flood me with e-mail saying that it's always Mommy's fault! It's just that Moms are more nurturant and cuddling with little kids than Dads are, and kids will do strange things to get more cuddling.

8/22/98 Q: read through your lists of things you do not respond to and had to laugh. >anyway, what I like to ask is: I want too much sex. I know it is trouble because, I have picked up girls off the street, got locked >up one time for solicitation. If I could not find I would masterbate! I am scared. I have even done it some times 3 times a day. >I have done it even after having sex. Then to add to it I have a girlfriend that I Love. Thanks goodness she doesn't know. I would >like to know what I can to. I want to enjoy my life. And I want to enjoy my life with her. And I know I won't be able to with this burden. This problem overpowers me.

A: Some things can be addressed by e-mail and some need face to face therapy. This one needs therapy to better understand why you are doing this. I urge you to get therapy now at your discretion than to get in trouble with the law and be required to be in therapy as a condition of probation.


8/21/98 Q: Sexdoc, I was watching hardcopy tonight and they were talking about a new sex pill for women, but they never mentioned a name . They did however say it was not Viagra. Do you know anything about it?? This was the first I've heard about it so I guess it may not be on the market yet. > >Thanks, Nichole

A: Dear Nichole,

What I have heard is that several are in the works but none has been approved by the FDA yet. Several reputable sources have said that "Female Sexuality has been largely ignored, and that now, pharmaceutical companies are aggressively positioning for future marketshare." To which I say "IT'S ABOUT TIME!!!!"

Please, please keep me in mind and e-mail me if you hear more.


8/21/98 Q: i'll try to be discreet. >if someone is deep-throating, and he ejaculates, would the semen go into the >lungs, thereby=choking, or would it be=to swallowing. this is a closed, >23-yr., safe relationship. > >

A: The epiglottis (the flap that flip-flops so air goes into the lungs and everything else goes into the stomach) is farther down inside the body than 99.999% of penises can reach. If the recipient of the penis hiccupped or gagged in just the right (wrong) way at just the right (wrong) time, yes, some semen could get into the lungs. But don't let this deter you.

8/21/98 Q: dear doc, >i have been married for 6 years and my husband and i have a very satisfying >sex life. we are both around 30 years old. my husband has asked me several >times to let him cum in my mouth when we are heavily into forplay. but the >one experience with doing that made me sick. but i would like to try it >again to give him pleasure. what could i do to prevent it from making me >sick? thank you, curious > > >

A: Part of the answer depends on what made you sick -- the gagging, the slimy texture, the taste, the odor, etc. If it was mechanical, see if taking less of his penis into your mouth helps (one or two hands wrapped around the shaft can be a position marker). If it was the attempt to swallow, don't -- just let it slither out and have a towel handy. If the taste, try honey in your mouth just before you start, and if odor, a strong minty mouthwash can mask most smells. All of this assumes that he is squeaky clean and that you are both in good spirits and willing at the time.

By the way: some recipients really love to swallow and suck; others are OK with semen in the mouth, but don't like to swallow. Others are OK with the dry penis but withdraw their oral ministrations when liquid is present (sort of how it might get onto a blue party dress, I guess ....). In the sexdoc's opinion, it is the recipient who calls the shots about that. Insisting that the recipient swallow is a power play that is dominating and disrespectful (and, if he says "If you loved me enough, you'd swallow", it's ignorant and manipulative). Any comments?


8/22/98 she writes back: it is the slimy texture and the taste that made me sick. my husband has told me that if i didn't want to do it then it is ok with him. but i know that he wants me to, but he would NEVER force me and he has never put any conditions on it. i want to do it because i would give him pleasure and i want to give that to him. we have a great sex life it is just i would like to try it again but i don't want to get the sick feeling in my stomach thank you.

8/20/98 Q: Hi Dr.Fitz, >My husband and me have been married for 2 years now.In the beginning we >had a great sex life and then slowly it became less frequent.I don`t >know what it is but we have`nt made love in 6 months!God knows i want to >but everytime i go near him he makes an excuse and will refuse to talk >about it.The last time we made love he became limp inside me.Maybe he >thinks that it will happen again.But we love each other very much and >i`m sure its not another woman and i can`t figure out the prblem.I am >only 24 years old and consider myself reasonably good looking and if it >is this bad now i don`t want to think how it will be 10 years down the >line.He refuses to discuss it and i`m sure he will not go to a >therapist.He also has had a problem ejaculating inside me.In fact i >think he has never ejaculated inside me he always has to masturbate >outside to ejaculate.I am really scared about this because if i have to >conceive we will have a big problem.Anyway i need to get my sex life in >order before i think of having a baby so Please Help. >Desperate and worried. >

A: The analogy that comes to mind is that he has a broken arm and refuses medical treatment. If you've never set a broken arm and you don't have all the medical equipment to do it, it can't be done.

There is no "home remedy" for what you describe. The problem needs face to face therapy. The longer this goes on, the longer it will require to respond to therapy.

You both are young and therefore more resilient than older folks. For your sake, fix this problem now before it gets more established!


8/20/98 Q: Hello and how are you doing today. My wife and I have a little problem >with our marriage. We have no sex life any more. We been married for 4 >years and she does not like to have sex any more. We have two kids and >they are three and two. I just found out that she hase not been liking >sex for almost three years. I love her dearly and I want for us to get >help. She used to love sex. I think one problem is that I cum in a few >minutes. I am not big I am only about >5 3/4 inches but she tells me she likes the size of it and it does not >matter that I come fast. She is depresed allot and she does not like >they way she looks. She picked up a little weight since our two kids >are so close in age but I think she is beautiful. I really do. She does >not have any confidence in her self and she is always putting herself >down. I tell her she is beautiful and sexy, and I always compliment her >put she does not believe me. I really do love her and I want our sex >life back please tell me how i can get help. Thank You. >Lonely >

A: Sometimes sex problems are caused by sexual things, and sometimes they are symptomatic of other things that are going on.

I am struck by your reference that she is depressed alot and does not like the way she looks. I'd start with encouraging her to get a prescription from some MD (her OB-GYN or GP) for an anti-depressant. If that's the problem, the interest in sex might likely return spontaneously.

What you describe requires differential diagnosis and medical treatment first if it is a medical problem, before any sex therapy should be attempted.

Please let me know what happens!


8/11/98 Q: ok. I will try to be as specific as possible. I have read over all of the info on your site (did I miss it?) and didn't find what I was looking for. I perused the "clit board" at the welcomed consensus and still couldn't come up with anything. I am a 29 year old female. I have two children, 12 and 8. I was married for 7 years and am getting remarried shortly. (Am, I nuts? No, that wasn't the question, LOL) I also have herpes (genital) and I had cervical cancer and they removed 3/4ths of my cervix, although I do not think that is my problem either. Just trying to be specific. I can not orgasm through vaginal penetration. I can orgasm with anal sex, in ONE position, that is with me on my back, my knees up in the air, and bearing down at the same time as though I am pushing him out. Any other position is just positively painful. I can orgasm with the handheld shower and with a vibrator with clitoral stimulation..

Every man I have ever been with has told me my vaginal opening is down low, lower than they have ever seen, and my doc confirmed that it is low but she says it is nothing to be concerned about. Manual stimulation during vaginal penetration is annoying to me, oral sex is just too intense.

My fiance is angry with me because I have always faked it and just now have decided to tell him. I have tried to explain to him that sex without orgasm can be just as satisfying (it is too me anyway) but he doesn't get it. My sex drive is huge, more than almost anyone I have ever been with.

Over the past 10 years I have read almost everything I can get my hands on, have tried almost everything, but there must be something I am doing wrong or somehow maybe I am wired wrong? Any help will be greatly appreciated. Sincerely R. PS...I do get very close during vaginal sex, I just can't get over that edge.

THE SEXDOC RESPONDS: Please respond with some clarification on several points: > > > 1) Did you find on my page or elsewhere, the information that only about > 40% of women achieve orgasm from penile thrusting alone during > penile-vaginal intercourse?

> Yes

> 2) What is it about manual stimulation -- I presume you mean on your > clitoris, right? -- during intercourse that is annoying? Is it physical, > so that gentler, slower, etc., changes might make it less annoying (tissue > irritating?), or is it more psychological -- a sense of being a failure or > different because you "have to" have additional stimulation? Is the > clitoral stimulation during intercourse equally annoying if you do it or > your lover does it?

**it is annoying because it feels so good but I never come, then it gets annoying because I get over sensitive in that spot. yes, it is equally annoying, when either of us does it. there is a hand in the way, and I feel like an idiot for not being able to come the normal way. > >

3) Do you know that the clitoris is actually a rather large organ that > extends on either side of the vagina in a bulb shape?

**No I didn't know that., i thought it was just that little hooded piece that shows.> >

4) Do you know if you have a G-spot?

*I think I do, there is an area just under my pubic bone that is very sensitive, and that is wehre the sensation of being close to coming is coming from, it is not clitoral in any way. > >

5) What is it about oral sex that is too intense? Please help me > understand how the intensity of the shower head and the vibrator is not too > intense but oral sex is. Again, I have the question about possible > changes, gentler, slower, etc.

**Same as above. I also do not like that feeling that my body is "bucking" uncontrollably when he hits on the right spots. > >

6) I am entertaining the idea that because your introitus (opening to the > vagina) is "low" that vaginal intercourse is insufficiently stimulating > because of the angle of the penis and where the tip of the penis rubs you > internally. Couple that with your finding that anal intercourse in that > position with that pelvic muscle pressure does result in orgasm, and I > wonder where the tip of the penis is in contact internally then.

**It rubs me right under my pubic bone, right in that spot I said above, but only if I bear down. it also hits on my bladder., When I come, I lose control of my bladder. > >

What I want you to research is whether there is some intra-vaginal area > that, when stimulated, produces orgasm. Please be a research scientist on > this one and make notes about different things you try. I suggest using a > dildo for precision of movement. > > The areas that I think are prime are A) the upper wall of the vagina > between a half inch and about three inches in;

**this spot was good

and B) on either side of the > vagina in about the 10 and 2 O'clock positions, approximately between 2 and > 4 inches in.

**this spot caused discomfort. > >

I suggest that you wash the dildo with anti-bacterial soap (Lever 2000 or > Safeguard are good because of the absence of scents; the chemicals that > create smelly soap sometimes are irritating intra-vaginally), dry it, and > use lots of lubricant. KY is fine -- if it starts to get "tacky", don't > add more KY -- just sprinkle a little water on it. > > Lying on your back, raise your knees, breathe deeply, and slowly introduce > the dildo vaginally. Angle it so it rubs internally on the top and move it > in and out. You will probably find it helpful to also stimulate your > clitoris -- the vibrator is fine if you don't want to use your hand. > Strive to become very sexually excited but to stay in plateau -- before > orgasm. When in plateau, reduce (but do not eliminate) the clitoral > stimulation and see if in and out movements with the tip of the dildo > rubbing the top of your vagina (just under the pubic bone) produces > intensely pleasurable sensations that could lead to orgasm. Make the tip > of the dildo go in a small circle. Map the movements that feel better than > others. When you've had "enough", be sure to do whatever works to have an > orgasm (I do NOT want you to be sexually excited for any prolonged period > without culminating it in orgasm -- not good for the plumbing).

**the dildo is too plasticy. I ended up sitting and using my hand > >

On another day repeat the experiment but this time concentrate rubbing the > tip of the dildo on the 10 and 2 O'clock positions; vary the pressure to > see if mildly firm pressure is better than just light pressure. Remember > to keep notes! >

**OK >

Also try the area (top and 10/2) experiments while "bearing down as though > you're pushing [the dildo] out". > > It would also be interesting and informative if you could insert the dildo > anally and bear down and map where the tip is touching to produce an > orgasm. BE SURE that you don't contaminate your vagina with any fecal > bacteria! Either use a different dildo and never confuse the two, or cover > it with a condom before you insert it vaginally. > > A few more questions: > > 7) How is it possible for you to "get close during vaginal sex but not get > over the edge" when "every other position (except anal penetration) is just > positively painful"?

**I wasn't clear on this. Every other position during ANAL sex is painful, not during vaginal sex. The only time vaginal sex hurts is when he hits an ovary accidently.

> > 8) Also: It seems contradictory to me to say that sex without orgasm is > satisfying, but that your sex drive is huge. Please tell me what "huge" > means -- if you could have exactly what you wanted, sexually, describe what > would happen. >

**I like to initiate sex, it makes me feel powerful, sexxy, and I guess in some ways, like I am better thanother submissive women. I want toplease my lover. I want the closenss, the bonding, the sharing of our bodies, and i crave the intense feelings that it brings. However, when the intense feeling doen't culminate in orgasm, instead it slips away, I am NOT left feeling an immediate need to gratify myself. I am not left wanting more, or feeling somehow jilted. > >

9) What is the "clit board at the welcomed concensus"? >

it is a place women discuss thesethings with female sex therapists (I think the purpose is to sell videos) url address is

> Please let me know what you think about conducting these experiments and > answering the questions.

**I picked up the book "For Yourself" and am finding the information fascinating adn VERY enlightening. Thank you for suggesting it. I will continue the experiments in the book as well as your suggestions, and would lke to keep a running dialogue about it. thanks for your patience, for getting back to me so soon, and for helping me with this. I only have one more question, "Why is my fiancee finding that there is suddenly a lack of trust about everything in our lives now that I have confided in him? He is calling everything off, and is getting a truck to move all of my stuff out. Is it really that damaging to his ego? It has been less than 24 hours, should I give him time to cool off, or should I just let it go and get on with my life? OK, not easy questions, but insight into male thinkking patterns would be helpful.

Thanks again!! > > I would like to disguise the information and put this up on a web page, > with copies of our correspondance. Would that be OK with you? I am > thinking that periodic progress reports from you with my comments would be > very interesting to readers of my web page. Please let me know. > >

***OK, change my name though :) > >

> 8/14/98 We talked it over (my fiancee and me) and we worked a little bit of >the ego issue out. I quoted from the book by Lonnie Barbach, and he >was able to understand that it wasn't him, or the size of his penis >(which by the way is bigger than any I have ever seen, and I have had >a lot of experience) There was alot of anger for both of us that we >were able to express, and for me there is a great sense of relief now >about the whole thing. I hope he feels the same way, he says he does, >but still feels as though there is a trust issue now. We are going to >go away for the weekend, leaving Saturday. I think it will be nice to >be away from all that is going on lately. In two weeks is the >anniversary (if you can call it that) of an abortion I had last year >and it is a very painful time for me right now. I guess I have decided >to tackle everything at once, huh? LOL > >I finished reading the book, and am now going to go back and do each >exercise the way she suggested. I am looking forward to it, and glad >that over the next few weeks, I will have the luxury of not having to >worry about finding the time. I will be in transition from moving and >will have all the time in the world to explore before starting my new >job. >

(((( This will be continued ))))

8/20/98 She writes:


Well, we had sex this weekend, maybe we should have held off but the atmosphere was too divine. Seclusion on a private lake with 68,000 acres to ourselves......I couldnt pass it up. And we began with no intention of orgasm, gave no thought to trying to get me to come, just enjoyed ourselves, and "WALLA" there it was. Very tiny, totally different that clitoral stimulation, but it was there just the same. A wave of heat covered my entire body, and ended with this wonderful relaxing satisfied feeling. Well, of course he didnt believe that I had, LOL, poor guy, and it didnt happen again the whole time we were there, but I think this is a good step.

Have been doing the exercises in the book since we got back, haven't been able to come that way, but it is giving me a good sense of what feels good and what doesn't. AMazing I never thought of these feelings in this way before, they have always been goal oriented. I have found all of the wonderful little nooks and crevices that feel fantastic, found that I really enjoy feather light touch instead of the harder touch I always asked for, and the mirror exercise, what a mind opener. I really like my body, in those positions, it really did look sexy. I had always thought of myself as a little overweight in my thighs, but spread apart on my knees and such, I look pretty damn good! I even played around with dancing in front of the mirror....hmmmm.....this could be fun!

I move down to be with him this sunday. part two of the experience will begin then.......I am looking forward to it.

Thank you so much for the info on the book, I have been passing it along on the clit board, and they have been appreciative.

He is going to read the book too, but I wonder if there is one that is designed just for men, from a male perspective?

Thanks so much Doc, it is great that you are there and volunteer your time on the net. I visit Sacramento once every year, are you close to there? Would love to meet you and thank you in person!


8/11/98: dear dr.fitz, >i've been sexually active now for almost six months and i'm still not >quite sure what an orgasm is supposed to feel like. i enjoy sex a lot >but i don't feel anything exceptionally great during intercourse. >however, during foreplay, when my boyfriend touches me, i feel >incredible. is that an orgasm? please tell me what most women >experience when they reach orgasm. > >maria

A: Dear Maria,

The essence of experience of orgasm for both men and women is involuntary contractions of pelvic muscles at approximately 8/10 of a second apart. People will experience 3-30 such contractions.

That's what squeezes out the semen in men and produces a very pleasurable experience pelvically for women.

Does this answer your question?


p.s. Only 40% of women experience orgasm during intercourse -- 85% of women experience orgasm from clitoral stimulation, which migh describe what is happening with your boyfriend.

Does it?

8/14/98 Q: Dear Doc, > >I kept reading all the letters hoping to find someone with >a similar question so I would not have to ask. So maybe I >will help someone else and myself by asking you this >difficult question. > >I am 34, I met a really wonderful man about two years ago >and did not have any contact for a year. I ran into him >again and began to talk without giving him any clue of any >agenda. Well, actually I did not have one, because I was >leaving the country. I talked to him about two to three >days a week for six months and then we decided to date. In >a very short time we were sexually active. I had been >waiting a year and a half with no sex, just because I was >preparing to leave for a year for academic reasons. We >dated 3 months and I left the country. > >Everything seemed ideal, until during sex I notice he >always held my hands above my head, like bondage or some- >thing, then he told me he would like to just fuck me and >walk away without saying anything. I told him I am not >sure I like the way that sounded, but that is what he did >one day. This has been escalating and now he wants to >spank me. > >I have been away for 11 1/2 months we write everyday, phone, >and send cards. I really don't know how I feel about this. >I want to enjoy him. Some of the things we have done together >have been beyond my wildest dreams and great. If he enjoys, >spanking and the feeling of control I would like to give that >to him, but I am afraid as to what this will lead up to. >Is he really just preparing to abuse me? > >As a kid, I was sexually molested and very badly abused (I >have physical scars). I have worked so hard in therapy to >put all of that behind me. I am doing a lot better than >most people. People look at me and think I was raised in >a very well to do family. I share information on a need >to know basis and most people do not need to know. What >potentially can a relationship of this sort do to me? > >I have told him how I feel and how I am unsure as to what >I want to do. But I am going back now and I will see him, >before I see my therapist again and I am really nervous. >Admittedly too, I would really like to begin having fantastic >sex with him. I really just don't know. > >I don't have a lot of experience asking for what I want. I >am much more comfortable in a library with my school books. >In theory all my Catholic teaching works perfectly well >until I have to do anything. > >I think what I really want to know is, is there any other >way of meeting his need. I really don't mind him being in >charge. He is quite competent. I would like to be a lawyer, >but (I laugh as I say this) I don't find any conflict there. > >Incidently, he is a perfect gentleman otherwise. He is a >sharp dresser, well respected. I have a really great time >with him. He opens doors, buys me flowers, has presented >me to his entire family, he has disclosed many things about >gowing up and the boy scouts etc. He said he has never >did this before, and that he doesn't know where it is coming >from, nor why he has this need. He wanted to tattoo my butt >with his name once and I laughed and told him to grow up >and if he wanted me he should just marry me that's what men >do. > >Incidently, I think if I just said no, he would respect that. >He has with other things, but I would wonder if he really >needed more. Is there anything wrong with doing it anyway. >Will it harm me in any way? > >Please respond soon. I am due to return in a >week. > >You have my name, but can you just call me Spanish Eyes. > >Thank you in advance. You really do have a great web page, >and I will put the address up at the student Health Center on >campus. > >


Dear Spanish Eyes:

The safest thing you can do is to tell him you want less "controlling" sex until you have a chance to talk this over with your therapist.

The psychodynamics of control in sex are potentially complicated. Because of your childhood you run the risk that he might do something that reminds you, consciously or unconsciously, in reality or symbolically, of something that happened in your childhood -- and you could have a frightening reaction to that.

Almost anything that is done OCCASIONALLY is OK -- light bondage, spanking, sex where you might get caught, oral sex instead of vaginal intercourse, using sex toys on each other, etc. When there is a repetition and a progression to escalating, and less or no flexibility to do other things that can become a problem.

I suggest that you read "The Story of O" by Pauline Reage for a psychologically accurate account of bondage and discipline progressing to sadomasochism. And read "When I Say No I Feel Guilty" by Manuel Smith, Ph.D. for assertive communication skills.

Thank you for volunteering to put an announcement of my web site up in the student Health Center.

I'd really appreciate it if you would let me know how this progresses.


10/14/98 Q: Dear Dr. Fitz, > > I have been reading some of your responses to people on the subject of >pornography. You seem to support it as a harmless outlet for the >wandering eyes of men. You stated that there is no harm in it. One >concern that I have about it is that, after spending an hour or so >looking at stereotypical beautiful (read: young &firm) bodies, I don't >think my partner finds my body very appealing. Likewise, if I spent a >long time admiring young studly bodybuilders, my partner would look >pretty lame as well. Fortunately for him, I have no interest in doing >that. Unfortunately for me, he has a lot of interest in that activity. >My question is, does pornography not influence how the observer sees and >interacts with his lover/wife/girlfriend? > >Curious > >


Dear Susan:

Part of my point is that men don't need pornography to get jaded by hard bods; they are surrounded by everything from Baywatch to Macy's lingerie ads. Just going to the beach or walking down the street in suburbia, or even justy the local grocery store reveals so much flesh, and the rest is fantasized nude anyway.

Women must, and most do, capitalize on the adage that the "bird in the hand is worth two in the bush". Guys who rudely approach strange (read "unknown", not "wierd") women and propose sex are rebuffed. Better to stick with a proven bedmate than lament that she doesn't have the body of a model. And the guys who do that lead very empty lives.

There is nothing foolproof, but pornography, so easy to target, will not solve social problems if eliminated.

What do you think?


8/15/98 Q: I am 14, and the thing that stood out most was that you were 'sure' that >at this age I'd regret it. I am wondering- are you really sure? do you know >this from expierence? if you don't, you might wanna consider other peoples >opinions. that is in no disrespect to you and your occupation, but I'm not so >sure that you should speak for everybody like that. > >

A: Children who are neglected severely sometimes trade sexual intercourse for human emotional warmth and affection and it "gets them through" the rough period. But the VAST MAJORITY of women who start having sex at 12-16 do so for a variety of reasons that I think are inappropriate -- pressure from the guy, fear of being unpopular, peer pressure, curiosity, boredom, etc. That's why I encourage anyone to ask 20 women in their 20's (age 20 to 29) how old they were when they first had vaginal intercourse, and what their evaluation of that age was.

You will find that most women who started having vaginal intercourse below 17 or 18 will say, if they are honest, that they regretted it.

Many 17+ year-olds will say that it was about the "right" time to find out....

Many women OVER 22 will say "Is this all there is? You mean I waited all this time for this?!"

I am not a woman who was first sexual pre-17 -- I'm a guy. But I have talked to hundreds of women in therapy and have amassed their comments.

As a therapist I "mop up" alot of spilled milk after the fact -- childhood sexual abuse, sexual trauma, sexual dysfunction. I prefer to prevent problems wherever possible. And this is one of those "preventive medicine" things. Have you had the Salk Polio vaccine? You're innoculated against polio so you won't get it. I'd rather challenge people to think before they make a mistake than help them deal with the troubling emotions later.

Don't take my word for it: ASK Women in their 20's (or older)!

And please tell me what you find out.


8/15/98 Q: Hi Doc: I read in a book that a womans vagina was about 4" long and a >couple of pages further on it said that most vaginas could take a 7 to 7 >1/2 penis. Is this true and if so how can they do it. > J > >

A: Dear John,

The vagina is, in the words of Masters and Johnson, a potential rather than an actual space. It is folds of tissue that pull back and up to create space for the penis. Kind of like a collapsed balloon. When a woman gets sexually excited the first thing that happens vaginally is lubrication. The second stage, which signals readiness to accept an erect penis, is called "tenting" and connective tissues attached to the outside of the vagina pull it open.

So it may be 3" to 8" collapsed (between the introitus and the cervix) and "simply" accommodates the penis.


8/17/98 Q: I am a 38 year old divorced mother of two. I was married for 17 years >and divorced 3 years ago. I have been with my fiance now for 2 years. >We live together in his house. We've are very compatible and I believe >most of the time the love I feel for him is returned. Until it comes to >sex. He is obsessed with finding other people to join us. I am guilty >of encouragaing him at times. I seem to feed on his excitement so much >that I say things I don't mean just to make him feel good. He wants to >find another couple or another single for a foursome or threesome. At >times I have finally said, no I don't want to do that. If you love me >you wouldn't want me to. I've even told him that if it ever happened I >know I wouldn't be able to stay with him. I do love him but I don't >want to be with other people. Then he will back off for a bit. The >next thing I know, he is talking about it again. He will say that it's >just talk and fantasizing. Then it gets to the point where he is trying >to convince me that I really want this. I feel his excitement and I >start agreeing. After sex I feel so humilitated and degraded. I love >this man with every breath. We are supposed to be married on May 8, >1999. Can I marry him? He can't have sex with me without talking about >this stuff and I can't take much more. I know I'm confusing him as much >as I'm confused when I start going along with it only to pull the rug >out from under him again. What can I do? How can I fight this one and >win him? Melanie > > >


Dear Melanie:

Yes, you are confusing him because yes, you are confused and conflicted.

The fantasy is great, but the reality sucks -- figuratively and sometimes literally. This is one of those things that needs face to face therapy.

If you marry him without sorting this out I predict intense conflict and anguish. Don't you think you'd be better offdealing with this before getting it more complicated by marriage?

Please let me know what happens.


She writes back: Thank you. I agree with you wholeheartedly and I have decided to address this >issue right away with him. I think he needs to decide if he can be with me >without that lifestyle. If he shows me that he can't then I have to reconsider >if he's the right person for me to be marrying. So I think it's in his lap what >to do. Thanks for confirming what I believed. > >Melanie

Dear Melanie:

The danger I see in confronting him is that if he wants you enough, he will be motivated to promise you anything, believing it to be true, then after you are married, revert to pressuring you again.

Pre-marital counseling in which you bring this up would be an excellent investment.

I take no enjoyment from being told that advice I rendered a year ago that was not heeded, should have been. This is good for you and for him. Just like taking the polio vaccine, get some "preventive" mental health.

Please let me know what happens.


8/19/98: Dear Dr. Fitzgerald, > >I did talk to him. I told him exactly how I felt. I don't want to do it, I >don't want to hear about it and I don't even want to fantasize together about it >anymore. Here is his response and then mine to it. I'm kind of lost now on >what to do. I plan on suggesting therapy but I seriously doubt he will be >receptive to it. Obviously he's not ready to quit discussing it anyway. I >don't want any part of it in my life anymore. His emailing abilities leave a >lot to be desired. I hope you can decipher what he's saying. > >Thank you so much for your time. > >Melanie > >

I have chosen to NOT include their e-mails here, but I did reply:

Dear Melanie,

Proceeding without objective intervention is potentially a problem (and I think it will be).

If he won't pursue therapy, you would benefit from it yourself! You can't see your own forest for the trees! For your sake, get help sorting this out.


8/18/98 Q: Dear Sex Doc, >I'm 17 and my boyfriend is 22. I've been sexually active before but not with >him. I don't know why but I wanted to wait, and now I'm afraid I waited too >long. It seems I pushed him away without knowing it. I starting to fall in >love with him, and I'm afraid he's on the edge of leaving me. I need some help >figuring out what to do. Help please. :o(

A: Talk to him! Tell him what you e-mailed to me and ask if he is cooling off, and discuss the possibility of being sexual together.

If he respects you and will negotiate gently with you, you have the possibility of a good relationship together. If he leaves because he didn't have sex soon enough, let him find someone who will be sexual sooner.

I encourage you to be conservative and have sex a little later than a little too soon. You'll have fewer regrets that way.

And if or when you part company, don't over-compensate with the next boyfriend by having sex too soon!

best wishes


8/18/98 Q: I have a question to ask you regarding giving a blow job. I am learning how to >give a blow job right now with my partner, fortunately for me he is patient. I >am able to "deep throat" him but I often feel like I am going to gag on it (he >is very large-both length and width). How so I avoid this or is this just a >common reflex? Could it be the position I am in when I am giving him head? >Signed "Deep Throat" > >

A: Gagging is a common reflex -- it keeps you alive if you get something too big interfering with breathing!

I suggest not deep throating but concentrate more on stimulating what you can get into your mouth.

If you gag and throw up it will rather dampen the romance of the moment.


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