Copyright (C) 1998, William F. Fitzgerald, Ph.D.

Three questions from LISA:

10/29/98 Q: I am an 18 year old female and whenever I have sex with my boyfriend, it is painful and uncomfortable. It feels like his penis is hitting my bladder wall giving me the urge to urinate. We have even tried some different positions but it's the same result. Is it possible to urinate during sex? And no, I do not have a urinary tract infection because I do not feel any pain at all after the intercourse. Please explain what is wrong because it is ruining my sex life. Lisa

A: Dear Lisa (and all other readers),

The Internet is a powerful educational tool, but questions about MOST physical things need to be addressed in person by a medical doctor who can listen to the problem then correlate that with physical symptoms, and often, an examination. I urge you all to be very wary of any "diagnosis" by e-mail.

By contrast, questions like "Do women ejaculate?" (some do) and "How do you know when you're having an orgasm?" (involuntary pelvic contractions eight tenths of a second apart) are general and universal.

sexdoc

Second question: I just wanted to ask a brief question about the contraceptive pill. I have only just started taking it and have only consumed 8 pills before I had sexual intercourse. Afterwards I read on the packet that it is advisable not to have sex until 14 pills have been consumed. Is there now a great chance of me being pregnant? Although, one thought is a comfort and that is, the rhythm method. We had sex the day after my menstruation finished and isn't there a theory about having less risks of getting pregnant when you have sex 5 days after your period?

A: We in the sex business are fond of saying: "You know what they call people who use the rythm method of contraception? PARENTS."

If 100 women use a latex condom as their exclusive means of birth control, and have penile-vaginal intercourse on the average of two times per week, after one year, how many will be pregnant? (((The Answer is at the bottom of this series of three questions)))

Those who get pregnant are 100% pregnant. Those who aren't, aren't. Your question about the chances (" ... is there a great chance ... ") is partly beside the point. Either you are or you aren't. Knowing the probability affects only your anxiety, not the outcome. AND, anxiety can delay your next period, causing more anxiety wondering whether you're pregnant or not! If your next period doesn't arrive on time, you're not necessarily pregnant. You're either irregular, anxious, or pregnant.

Most systems start counting your menstrual cycle as day one when you start your menstrual flow. Day 14 in the most usual cycle is when the egg is available for fertilization. Sperm have been known to swim upstream even during the menstrual flow, and women can and do ovulate early. That's why people who practice the rythm method are called parents! Any questions?

Third question: I recently had an abortion and it stated in the instructions that you were not allowed to have sex until two weeks later but I had sex with my boyfriend 8 days after the abortion. Will anything happen?

A:

The vagina is self-cleaning -- that is, it has a healthy discharge almost all the time. Both the vagina and the penis have organisms in/on them. The vagina has its own balance of flora and fauna (plants and animals) and nutrients and irrigation. A yeast infection is one of the things that can occur, for example, when that gets out of balance.

When you have an abortion, things get raw and susceptible to infection intravaginally. Once you are all healed, the vagina can "handle" the bacteria, etc., that the penis brings in. Before it's healed, you are at greater risk for vaginal infection. If it is really nasty, it can cause infertility.

Please make yourself aware of medical instructions and follow them. There are consequences to failing to do that.

AND THE ANSWER TO: of 100 women who use condoms exclusively, between 2 and 10 will be pregnant after a year. Condoms sometimes break, they can slip off during thrusting and need to be "fished out" of the vagina; and they can leak around the base of the penis.

The more important moral of the story: If sperm can get through and into the vagina, so can the HIV virus (and the herpes virus)! Condoms are "safER sex" not 100% protection from infection!

10/29/98 Q: Dear Doc I am a 54 year old male who had impotence problems a few years ago. With injections and now a permanent younger partner, the difficulty getting and sustaining an erection has gone. However, I only come to orgasm approximately 1 in three times. My partner nevertheless gets a lot of satisfaction every time we have interecourse as I do and in a way not having an orgasm every time enables us to have more sex. When orgasm is finally achieved it has a heightened amount of pleasure for both of us.

My question is, is this unusual and should my 'retarded ejaculation' be seen as a dysfunction or a blessing?

Yours sincerely, G

A: Dear G: Dysfunction or blessing is your judgment call. Physiologically, however, it is not good to get all geared up for an orgasm and not have one. The chronic pelvic vasocongestion can cause men and women to store fat more in their abdomen, butt, and thighs than elsewhere. Both genders should achieve an orgasm once highly sexually physiologically charged up!

On the occasions when you do not achieve an orgasm from penile-vaginal thrusting, and when you're both satisfied with that activity, I strongly urge you to withdraw and find a way to have the orgasm.

sexdoc

10/28/98 Q:   I AM A 28 YEAR OLD WOMAN MY HUSBAND IS 35 AND WE HAVE BEEN MARRIED FOR 16 MONTHS. WE JUST HAD A BABY GIRL 3 MONTHS AGO AND I GAINED 55 POUNDS WITH MY PREGNANCY. I'VE KNOWN MY HUSBAND FOR 13 YEARS I WAS ALWAYS IN LOVE WITH HIM AND IT WAS ALWAYS UNDERSTOOD HE FELT FOR ME AS WELL HOWEVER BECAUSE OF THE AGE DIFFERENCE AT THE TIME WE WENT OUR SEPERATE WAYS. HE HAS 2 KIDS FROM 2 DIFFERENT WOMAN AND I WAS ALSO PREVIOUSLY MARRIED BUT HAD NO CHILDREN IN THAT MARRIAGE. I ALWAYS THOUGHT I KNEW MY HUSBAND VERY WELL AND THAT WE HAD THE PERFECT RELATIONSHIP. THAT'S WHAT EVERYONE AROUND US THINKS AS WELL. IT WAS THIS PAST SATURDAY THAT MY HOUSEKEEPER WOKE ME UP KNOCKING ON MY BEDROOM DOOR TO TELL ME THAT SHE WAS LEAVING BECAUSE MY HUSBAND HAD BEEN FLASHING HIS PENIS AT HER WEEK AFTER WEEK. SHE SAID THIS HAS BEEN GOING ON SINCE I HAD THE BABY. THAT HE NEVER APPROACHED HER ROMANTICALLY OR IN ANY AWAY TRIED TO SEDUCE HER BUT THAT SHE CAUGHT HIM MASTURBATING ONE DAY AND THEN SHOWING HER HIS PENIS. SHE SAID SHE NEVER SAID ANYTHING TO HIM AND JUST IGNORED HIM HOPING HE WOULD STOP, BUT THAT THIS WEEK SHE WAS DETERMINED TO PUT AN END TO THIS AND WHEN IT HAPPENED AGAIN SHE TOLD HIM SHE WOULD TELL ME. HE TOLD HER HE DIDN'T KNOW WHY HE WAS DOING IT BUT THAT IT WOULDN'T HAPPEN AGAIN. SHE STILL TOLD ME AND I OFCOURSE HAVE BEEN LOOSING MY MIND SINCE THEN. I CALLED HIM AS SOON AS SHE LEFT THE HOUSE AND HE TRIED TO DENY IT BUT WHEN HE REALIZED THERE WAS NO WAY OUT HE TOLD ME HE WOULD COME HOME SO WE COULD TALK. I TOLD HIM HE WAS SICK AND THAT I FELT VERY SORRY FOR HIM AND THAT IT WAS OVER BETWEEN US. HE CAME HOME, I WAS NOT THERE ANYLONGER I HAD TAKEN OFF WITH MY BABY AND DIDN'T EVEN KNOW WHERE TO GO OR WHAT TO DO. WHEN I CAME HOME AND WE FINALLY TALKED HE SAID HE HAD NO IDEA WHY HE DID IT. I FEEL IT HAS TO DO WITH ME AND THE FACT THAT I AM SO FAT. I WAS ALWAYS VERY SLIM AND ATTRACTIVE AND IT MUST BE SHOCKING FOR HIM TO SEE ME THIS WAY. HE SAYS IT HAS NOTHING TO DO WITH ME OR MY WEIGHT. I DON'T UNDERSTAND WHY HE DID THIS BECAUSE HE WAS NOT DEPRIVED OF SEX WITH ME EITHER. WE STILL HAD SEX. NOT LIKE BEFORE BECAUSE OF THE BABY BEING IN THE ROOM AND DEMANDING SO MUCH TIME BUT WE DID. I DON'T WANT TO BLAME MYSELF, BUT THIS HAPPENED AFTER THE BABY. SO WHAT ELSE CAN I THINK. I ASKED IF THIS HAS EVER HAPPENED BEFORE AND HE SAID NO. BUT HOW CAN I EVER TRUST HIM AGAIN. I HAVE ALWAYS PUT ON A LOT OF PRESSURE THAT IF HE EVER CHEATED ON ME I WOULD NOT FORGIVE HIM AND I THINK MAYBE THAT COULD BE THE REASON HE DID THIS. BUT WHY NOT BE WITH ME IF HE NEEDED MORE. HE SAYS THAT THINGS WEREN'T THE SAME WITH US LATELY BECAUSE I WAS ASHAMED OF THE WAY I LOOKED AND DIDN'T WANT TO BE IN BED THAT I ONLY WANTED TO DO IT IN THE SHOWER. IT'S TRUE THAT I SUGGESTED THE SHOWER A LOT BUT I THINK IT WAS BECAUSE OF THE BABY BEING IN THE ROOM. I AM FEELING BAD ABOUT MYSELF LATELY BECAUSE OF THE WAY I LOOK. BUT I HAVE LOST 33 OF THE 55 POUNDS ALREADY AND I AM WORKING ON IT SO I NEVER THOUGHT THERE WAS ANYTHING WRONG. I FEEL LIKE I'M LIVING WITH ONE OF THESE PERVERTS YOU SEE ON THE NEWS AND I'M EVEN SCARED FOR MY DAUGHTER. WHAT IF HE EVER TRIED SOMETHING WEIRD WITH HER. I WOULD HAVE NEVER THOUGHT HE WOULD BE CAPABLE OF SUCH A THING, BUT I DON'T KNOW ANYMORE. WE ARE GOING TO A LOCAL THERAPIST THIS FRIDAY BUT IT'S MORE OF A MARRIAGE COUNSELOR. I DON'T KNOW IF THEY CAN HELP. BY THE WAY THIS HOUSEKEEPER IS NOT ATRACTIVE IN THE LEAST BIT AND THAT FREAKS ME OUT ALL IN THE SAME. MY HUSBAND IS VERY ATTRACTIVE AND IF HE WANTED TO GET SOMETHING ELSE HE COULD EASILY. HE SAYS HE DID NOT FIND HER ATTRACTIVE AT ALL AND HE NEVER HAD ANY INTENTIONS OF DOING ANYTHING WITH HER. THEN WHY DID HE DO IT????????? I ASKED HIM TO LEAVE THE HOUSE UNTIL HE GOT HELP BUT HE DOESN'T WANT TO GO. OFCOURSE BECAUSE HE IS EMBARRESSED THAT PEOPLE WILL FIND OUT,BUT WHY SHOULD I COVER UP FOR HIM. HE HAD NO CONSIDERATION FOR ME AND DSRESPECTED ME IN MY OWN HOUSE. HE SAYS HE LOVES ME AND HIS DAUGHTER AND DOESN'T WANT TO LOOSE US. I LOVE HIM TOO. BUT I DON'T WANT TO MAKE A MISTAKE KEEPING HIM AND REGRETING IT LATER. I CAN'T STAND TO HAVE HIM TOUCH ME BECAUSE I FEEL BETRAYED. I AGREED TO LET HIM STAY BUT HE IS SLEEPING IN ONE END OF OUR KING SIZE BED AND ME AT THE OTHER. I KNOW HE IS ASHAMED FOR ME WHAT HE DID AND THAT HE IS SUFFERING BECAUSE OF THE WAY I'M TREATING HIM BUT WHAT IF HE IS JUST TRYING TO GET ME TO GIVE IN AND THEN HE FRAKS OUT ON MY AGAIN ONE DAY. PLEASE HELP. I'M SORRY IF THIS WAS SO LONG BUT I WANTED TO GIVE YOU AS MUCH INFO AS I COULD. PLEASE RESPOND BEFORE FRIDAY IF POSSIBLE. SINCERELY A.

A: Dear A:

I am sorry to inform you that yes, this is a serious problem. I strongly urge you to cancel your appointment with the marriage counselor -- it will be a waste of time -- and to immediately identify a therapist specialty trained in sexual acting out behavior.

While it is unethical to diagnose without examining someone, I suggest that you identify what is happening as "compulsive exhibitionism" when you speak to any professionals.

If there is no intervention, your husband will likely engage in some sexual acting out behavior again. If that happens and it comes to the attention of the law, he could be jailed, have a high bail set, and you will have to assess whether he would lose his job or his income while incarcerated.

Instead of spending thousands of dollars on bail, a criminal defense attorney, court costs, and lost wages, I suggest that you spend money now to prevent further criminal activity (your now former housekeeper can still call this to the attention of the police....).

To find a specialty-trained person, consider the following referral sources:

The President of your local County Psychological Association

The Chairperson of the Department of Psychology and/or Psychiatry at the closest college or university

Look in the Yellow Pages for a criminal law attorney who lists "sexual crimes" and call him or her to ask if they can refer you to a psychotherapist who treats sexual crime offenders.

Have somebody annonymously call the "Officer of the Day" in your local Probation Department to ask if there is a list of "approved" psychotherapists who are known to effectively treat sexual acting out behavior such as exhibitionism, voyeurism, and child molestation.

That's your first stop. That therapist will become the "case manager" and decide if your husband needs to be evaluated by a psychiatrist in consideration of psychotropic medication (compulsive behavior often responds best -- or sometimes only -- to a combination of medication and simultaneous psychotherapy).

While this is embarrassing to your husband now, it can become overwhelmingly humiliating if it becomes public. Now is the time for immediate intervention by a specialist. Do not waste time with anyone who says anything tentative like "Well, I'll have to talk with him to see if I can take the case. Not Acceptable! You need someone who says "Unfortunately, I have seen lots of cases like this in recent years and I know how to handle it".

There is help. This is a problem. It is unfortunately more common than the public is aware. There are treatment "protocols" that have a good chance of (what we call) "containing" the behavior. Without intervention you have an 80% to 100% chance of repetition. With effective intervention (by professionals who know what they're doing) the probability of repetition is less than 15%.

It is almost universal that the wife is sure that there is something wrong with her that caused or triggered it. YOU ARE INNOCENT. Don't focus any attention on you for the cause. Be prepared, however, that this is traumatic for you and that you need psychotherapeutic help, also.

Thank you for having the guts to e-mail the question. Score one more for the anonymity of the internet.

While I can answer a few more follow-on questions you might have before your appointment with the specialist, please understand that once you establish that relationship it would be inappropriate for me to comment from a long distance; you need to then direct all your questions to that professional.

Because there is no identifying information as to name, city, etc., I am posting this on my "Answers page #12" for your information.

I KNOW that you are experiencing high anxiety about this, BUT: I would appreciate it if you e-mail back a progress report to let me know which way worked for you and what's going on with your husband.

sexdoc

10/28/98 Q: Hi Dr,Fitzgerald, I appreciate your help I have one more question that I would appreciate so much if you could help. Its about oral sex I probably will go out with her this weekend we will go to her house, sit down watch a scary movie, then I probably will kiss her ,thats another question I have for you at the end. then probably go up then I will probably caress her up her back unstrap her bra then I will unbutton her pants everything will be off, I need your help from here please what should I do first should I insert a finger, or lick around her thigh and vagina. Please take you time and tell me exactly what to do, I appreciate this so much. My question about kissing is whenever I french kiss a girls you just start with a locked kiss then open mouth kissing, I just want to no if I do it right should I put my tounge in and move it around her mouth or let hers go in mine and just feel eachothers tounge. I just always wanted to know if I did it right. Please help me. Your the best,thanks for your time. If its not to much can you tell me from detail to detail when you have time. thankyou, J.

A: Dear J.

To you and to all young lovers, please take heed: I validate your nervousness, eagerness to "do it right", and wish for guidance and instruction, BUT: Please don't fall into the trap of doing things by "formula".

Yes, there are general guidelines about not forcing anyone to be sexual with you, and about making sure that the woman is highly sexually charged by foreplay before penetration is attempted (to make sure that she is well lubricated and that her vagina has "tented" so it can receive an erect penis comfortably), and knowing about sperm and eggs and how to avoid becoming pregnant, but when it comes to technique, my best advice is "in process" not in specific behaviors.

In process means to tune into each other and to dynamically spend more or less time doing what feels good as long as it feels good. It is about stimulating nerves, so it matters less whether her tongue is outlining your lips, or your tongue hers, or your tongues are touching, than that it feels good!

You want to know what to do when you are both naked. Assuming that you are both willing to go "all the way" I suggest that you plan to make penetration a multiple-evening event. One time get naked and rub against each other, bringing each to orgasm. Show her how you stroke your penis and have her do it -- give direct feedback so you role-model for her that you want her to do the same: verbalize very specific behaviors because you want to please her. While sucking on her nipples (how hard or soft varies TREMENDOUSLY from woman to woman and during a woman's menstrual cycle) gently rub her clitoris, varying the touch (side to side, then up and down, then back to side to side).

If she is lubricating, you are welcome to get your middle finger slippery and to moisten her labia and gently and slowly push a finger in. In Process means that if she says no or tells you to push harder or softer, DO IT!

If you rush, you will regret it. If you make it a "performance", it could cause problems (like the male ejaculating too soon). If you take it too seriously, it will be less fun. Make it fun. Do what feels good. Accept whatever happens without demanding a goal (full and complete penile penetration, or simultaneous orgasm, for example). Keep telling yourself that there will be another time when you can repeat all that you have done and then go further.

If it continues to feel good to both of you and you are safe from pregnancy (and are not afraid of being "caught"), then you are "doing it right".

Check in with each other frequently: "Are you OK with this? Is there something different I could do that would make it feel better for you?" etc.

Have Fun!

sexdoc

10/25/98 Q: MY BOYFRIEND AND I HAVE EXTREMELY HIGH SEX DRIVES OVER 15X A WEEK SOMETIMES. IS THIS NORMAL? IM WORRYED THAT IF GIVEN THE CHANCE HE WOULD SLEEP WITH ANOTHER WOMAN IF GIVEN THE CHANCE. WE LOVE EACH OTHER VERY MUCH, AND I HAVE A HARD TIME TRUSTING HIM BECAUSE HE LOVES SEX SOOO MUCH. I LOVE SEX TOO AND WE NEVER SAY NO TO EACH OTHER. WHAT DO YOU THINK? I FEEL HE WOULD CHEAT ON ME, EVEN THOUTH I GIVE HIM ALL THE SEX HE NEEDS. THANK YOU FOR LISTENING TO ME. AND I HOPE YOU CHOOSE TO ANSWER MY LETTER, BUT EVEN IF YOU DONT I WILL STILL READ YOUR WEB SITE....

A: Dear R:

15 times per week is "OK" unless you are sacrificing other obligations.

My concern is not frequency, but loyalty. If you are concerned that he might be sexual elsewhere, examine your mutual commitment (a therapist would be able to help).

sexdoc

10/25/98 Q:   I only have experience with one woman yet have read about the clitoris and descriptions of it many times. i know where it is but in my reading it seems that the erect clitoris should stick out or be more visible. I have seen the swelling under the skin but have never (outside of a porn flick) seen an erect clitoris which is visibly erect to the point it is discretely sticking up/out . Am I being naive or unreasonable? Is the literature misinformed me? I may be foolish but perhaps you could deal with this issue. thanks for the time

A: You're thinking of the female analogy of en erect penis.

The clitoris enlarges and gets rigid like a penis BUT the clitoral hood also enlarges, and more than the increase in size of the clit. So when watched, it appears that the clit goes away. Not true -- it is justy being overrun by the greater expansion of its shroud.

Make sense?

sexdoc

10/25/98 Q: Dear Dr. Fitz,

First of all, please accept my thanks for reading this letter. I'm a 29 year old woman engaged to a 34 year old man. Our wedding day is just 9 weeks away. I know I should be feeling excited but instead I'm worried. My fiancè is a wonderful man. He's gentle and sensitive and he loves me wholeheartedly. But there is a problem. He is not satisfying me sexually. He's very gentle in bed. But I like hard rough sex, not love making if you understand what I'm saying. I know at times he'd try to pretend to be a rough guy and be more aggressive but he can't control his ejaculation after afew hard thrusts. In the beginning I'd feel frustrated, but now I'm having trouble getting aroused by him. I seem to have lost all my sex drive in the recent months.

I wonder if love has anything to do with it? I love my fiancè(Hal) but I don't feel I'm in love with him. I've been in love before....with my ex- husband (Ralph). I just couldn't feel the same level of intensity I had with Ralph on Hal. I had exceptionally great sex with Ralph. With Hal, I'm always horny. I used to dream having wild sex with Ralph and feel my pelvis contract uncontrollably with wetness while in my sleep. I'd wake up with wetness in my panty and it really felt like I climaxed in my sleep, but it is possible? But with Hal, I can go on weeks without feeling horny. Even though sex was wonderful with Ralph, we couldn't get along. And we eventually were divorced after 10 months of marriage.

I knew Hal before I was married. At the time, Ralph and I have broken up - we were always breaking up and then patching things up again (very turbulent relationship). And I was feeling lonely, and that's why I slept with Hal. Loneliness was the reason, I know I wasn't attracted to him physically or sexually. And on the first night, Hal's perfomance was not good at all. He came quickly and I thought he was smaller. But Ralph and I eventually patched things up and we got married thinking marriage will solve our problems. So....a divorce soon followed. I was shattered....afterall, Ralph is the man I love with my heart and soul. And Hal entered my life. He was supportive, both emotionally and financially. I've never had a man treat me so well in my life. He never fails to provide to whatever I want as long as I ask for it. He always gives in to my tantrums and never for once argued with me. He has so much love and patience for me, that sometimes I'd feel so guilty. He is a really good man, and that's why I said yes when he proposed. But I don't feel sexually attracted to him at all. What should I do? What can I do to get my sex drive back? Could I have hormonal imbalance even if I'm on the pill? I've been using the same pill since I was with Ralph. I'm due to walk down the aisle with him in nine weeks. Please advise. Thank you very much for your precious time, Dr. Fitz. Really hope to hear from you soon.

Sincerely grateful, Kay.

P.S. Do you know any good relationship and sex therapists in the Minneapolis area?

A: Dear Kay.

Red Flags! Alarm Bells! I urge you in the STRONGEST TERMS to get this examined by a competent relationship therapist AS SOON AS POSSIBLE!

I am alarmed because it sounds like you and Hal are sexually incompatible -- how long can your marriage be satisfying to you if this doesn't improve?

If there is ANY WAY you can delay the marriage, do it!

sexdoc

10/25/98 Q: I have been with my boyfriend for 13 months and we have had intercourse abour five times. He has told me that he doesn't enjoy intercourse and thinks it is "over rated." I know that he loves me and is attracted to me so I am hurt and feeling rejected.

When I probed further he gave me a lot of info about his backround. I know that at least one of his sexual partners was verbally abusive to him. She once told him that she didn't like the way he did something and when he told her had never done it before she yelled, "get the hell out of here I don't want to hear that." He also told me that he thought they were having a committed relationship until one day after having intercourse they were laying on the bed naked and she answered the phone. He only heard her side of the conversation which was "No I'm not seeing anyone." He was hurt and embarrassed. Another experience he shared with me happened when he was around 13 and he went to a male doctor for a check up. The doctor told him he was well filled out and fondled my boyfriend's penis. Being a 13 year old going through puberty he started to get an erection. The doctor said to him, "You're getting a hard on, does that bother you?" At the time my boyfriend didn't fully understand what had happened. In fact, I think he blocked it out until a few years later young men came forward saying this doctor had molested them. He was dismissed from his job.

My boyfriend loves to take baths with me, cuddle with me, and stimulate my clit with his fingers. He also likes me to give him blow jobs, and he comes every time. However, in order for him to come he has to masterbate and then at the last minute before he comes I replace his hand with my mouth. He has told me that the problem with that is that he's been single for so long that he's gotten very used to masterbating. He just doesn't like intercourse. He has told me that I am the first person who he has loved whom he has had intercourse with. He said that he is used to sex being a dirty thing and in the past he and his partners would "fuck the shit out of each other." He says that he loves me and feels that doing that with me would be dirty and unfeeling. He says he has to get used to the idea of "clean sex." I have told him that sometimes I like to do dirty things and there is no reason why people in love can't do dirty things sometimes.

the last time we discussed this he said that he "Just doesn't feel very sexy right now." He is overweight by about 40 pounds. I am still attracted to him and think he is sexy, he's the one who disagrees. I am a very sexual person and the idea of having intercourse with the man I love and want to marry is very exciting to me. I can't marry someone who doesn't want to have intercourse except to make babies. (We both want children.) I told him that for him, and for the success of our relationship he has to get professional help. I need him to try to work on this. He said that he would and I decided I want to go talk to someone as well, seperately from him.

I think there may also be some trust issues because of his past. Such as he wants to satisfy me and is afraid he won't and that I will leave him. I love this man more than anything and I want this to work out. Is there hope? Through professional help can this be worked out? I know this was a long saga, but you said that you liked detailed questions with plenty of backround information. thank you in advance for any advice you can give. Please e-mail me back if you can.

A: Dear D,

It is not only women who can get traumatized by bad sexual experiences. I believe the estimates that by the age of 18, one in 4 women and one in 7 men will have had a sexually traumatizing experience.

Therefore, unfortunately what you describe about your fiance is common. The good news is that there are well-established treatment protocols for this kind of problem.

Time is of the essence. The longer he avoids confronting this problem, the more deeply entrenched it gets. You both need professional help as soon as possible; I am pleased to read that you both are committed to doing that.

Yes, there is help and the distinct possibility of dealing effectively with this so he is again comfortable engaging in intercourse. And, the sooner you start, the sooner you'll be through it. Too many people in your circumstance eventually say "Why didn't I do this sooner?!"

sexdoc

10/25/98 Q: My husband and I have been together for five years - married for 1 and a half. He is 40, I am 35. He has openly shared his fantasies with me and I have participated in threesomes, couples, single guy, etc. I do this for my husband. Although they are not my fantasies, I do get turned on occasionally by watching my husband do someone else. The problem is this: this is not my lifestyle, I don't always want to participate in this sort of thing - and my husband ends up frustrated and angry. He says it's not me. It's dealing with the frustration and let-down when it doesn't happen. It's destroying our relationship. I love this man with my heart & soul. I don't want to lose him. When he gets angry, he gets angry at himself. He says things like "I'm sick, I'm perverted." I want to help him thru this. He has so many outstanding qualities but his fantasies get confused with reality (in my opinion). Is this normal? If he wants to rid himself of "abnormal" fantasies, can he? And how can I, as his wife, satisfy him without hurting myself?

If you need more information, I would love to talk. I'm desperate for answers. This is destroying both of us. Thanks for listening.

Hurt and Confused

A: Things like this are very complicated and justify why there are sex therapists available to help.

What you describe is way beyond what can be accomplished by e-mail.

It would be beneficial for you and your husband to talk with a sex therapist face to face. The prognosis depends on his willingness to become aware of, and to deal with in therapy, what drives these things.

sexdoc

10/25/98 Q: Please Help!

I am a 36 year old woman. I have been happily married for almost 17 years to the same man. My problem is that I have NEVER had a Vaginal Orgasm. I have had an orgasm by doing external stimulation only but never internally. What is wrong with me and what can be done about it?

(A second, similar question): dear sex doc, I've very recently lost my virginity to my fiance. We've had sex 54 times and a haven't achieved an orgasm yet. I have when he fingers me and through grinding during foreplay but penetration does not work. Premarital sex is against my religion and I do feel guilty so is that hte reason. My fiance is wonderful in bed but I think I might be the one with the problem. WE have great foreplay and the intercourse feels great but I haven't had an orgasm .What's the problem?

sincerely, the new lover

A: Dear Pre-Orgasmers,

1) Please read answers to this on my web pages

2) Only about 40% of women have orgasms from penile-vaginal intercourse alone.

3) Try clitoral stimulation DURING intercourse (you will be restricted in positions)

4) Get and read cover to cover "For Yourself" by Lonnie Barbach, Ph.D. Do Each and Every exercise no matter how easy you think it is for you to do. Keep a journal.

Let me know what happens.

sexdoc

10/16/98 Q: Dear Dr. Fitz,

I just found out my boyfriend is a devotee (sexually fantasizes about pretty women with one leg amputated above the knee). I have researched this extensively. It's amazing the amount of information on the Internet. Do you think it is defintely linked to childhood emotional trauma and do you think he can be truly fulfilled by an able-bodied woman? He says yes to both quetions. I am not disgusted (on the contrary) - I'm intrigued, almost excited by the idea! Do you think I need therapy or am I just open-minded.

A little insecure, L.

A:   Dear L.:

I never cease to be amazed by the diverse things that erotically charge people! The old joke is "What turns ME on is erotica; what turns YOU on is pornography".

Interestingly enough, many times what turns people on in fantasy is disappointing in reality. I have had male patients get totally horny from fantasies of being dominated painfully by a dominitrix, or being anally penetrated by a big dog, who have the real life experience and find that it is grossly less "fun" than they thought!

Being "truly fulfilled by an able-bodied woman" is largely unrelated to his fantasies UNLESS he concludes that his life will never be complete until he has sex with an amputee.

Many women fantasize about "being taken forcefully", but they do NOT wish to be raped; they wish to be absolved of the responsibility of the decision to be sexual.

For more information about fantasies about amputees ("Acromotomophilia") have a look at the "Encyclopedia of Unusual Sex Practices" by Brenda Love, and for general topics, at books by Nancy Friday on sexual fantasies: "Women on Top" and "Men in Love".

Some clinicians speculate that as a child the devotee may have seen someone who was without one of the limbs and felt an intense compassion. I tend to not spend time on the etiology but focus on current behavior "what you do with it".

Thanks for an unusual question.

sexdoc

10/15/98 Q: I am 16 years old. I am especially attracted to older women. When I play basketball in my neighborhood, there is an older women (about 15 years older) who is walking her dog. I am starting to believe that she knows and enjoys me staring at her. The other day she was wearing a tank top with no bra. Should I pursue this or are my fantasies trying to take over reality. Please respond to this so I don't make the wrong decision.

A: Dear Attracted:

There are several matters to be considered: why you're attracted, what might happen if you let your interest be known, and how you might feel if you and she were sexual.

Many adolescent men are attracted to older women because they see them as more knowledgable, nurturant, socially skilled, and serious than women their age. It's OK to be attracted, but going further can have major emotional consequences. If you approach her and she laughs in your face, how do you think you'd feel? If she says she's flattered, but then says "how old are you, anyway?" how would you feel? How about if she says you're the man of her dreams and how about going back to her place to get naked and do the horizontal mamba?

If you were to have sex with her, I speculate that you would be smitten and want to be with her constantly. If she "wakes up" after some time (one or more sexual trysts) and asks herself what she's doing (statutory rape in most states) and realizes that you two cannot go out in public as lovers without a LOT of criticism, or decided that she wants to get married and have kids and that means that her prospective husband must be already into a career, that leaves you out.

You could be carried to the heights of ecstacy beyond your wildest imagination, then dropped unmercifully onto the sharp rocks below (most likely). You need to be an informed consumer on this one. Considering your options, if you're willing to pay a price that you really cannot imagine, you'll take the next step. My "fatherly" advice, however, is for you to take it slow, interact with females your own age, and learn, learn, learn. If you want to approach her and let her know that you think she is very attractive (and that's why you can't take your eyes off her), fine. Even a patronizing kiss on the forehead from her would be OK. But more than that sets you up for emotional pain beyond your wildest imagination.

If you appreciate my advice, please tell me your reaction and tell me what happens.

sexdoc

10/15/98 Q:   Having had a recent bout of not being able to get an erection, or losing a erection during intercourse (with a very sexy lady, i dont know what the problem is!) I have considered the possible use of a rubber band around the base of my penis to maintain a good erection. I have tried it once after masterbating to become fully erect, and found that i was able to maintain a erection for a long time.

My question is, Is this safe? if so , is there a time limit as to how long you can wear the rubber band before injuring myself permanantly???

Hope you can help, im 30 years old and frustrated with my recent problem, please advise me

Thanks in advance

A: Dear Frustrated,

Any kind of cock ring that traps blood in the penis prevents the continuous flow of blood which occurs in the biologically erect penis. Blood flow brings oxygen, warmth, and nutrients to penile tissue. The tourniquet keeps the penis erect but very soon all the oxygen and warmth is gone.

Women whose lovers have done that tell me that it is like getting fucked by a cadaver -- the penis is larger than usual, but cold.

The technical answers to your question are 1) 30 minutes before you start doing tissue damage, 2) never ever use a fixed-diameter metal band. You can't deflate the penis enough to get it off (arteries that bring blood into the penis are in the interior; veins that carry blood away are near the exterior and it is the veins that get closed), and many a man has been traumatized by seeing a big needle stuck in his penis to withdraw enough blood fast enough to get the band off, and 3) it sounds like psychogenic erection dysfunction -- if you can't overcome the anxiety, see a sex therapist (before you rehearse it so many times that it gets "stuck").

Does this answer your question?

sexdoc

10/14/98 Q: Doc, Wife and I are both 35, married for 7 years. Prior to getting married she had a very active sex drive as do I. About 4 months before we were married her drive practially stopped, and she no longer became lubricated. I asked he why at the time and she said she didn't know . I wrote it off to pre marital stress. Prior to marriage we did not have intercourse, but were very active and creative in all others means of sexual contact. After becoming married I thought and she told me sex would be often and great. That didn't happen. For the first couple of years when we made love she often cried. I would ask why and she would say she didn't know that she just would get emotional. I asked her if she was in pain or if something was bothering and she would say no.

Since then sex has become less and is no non existent. Maybe 4 times las year and once this year. I have taken her out on dates, taken her on extensive vacations to beautiful spots, provider her with all things she has ever wanted. In all I have tried showing her and providing love. Everything that I can think of, none of it has helped.

She has said maybe her problem is hormonal and has been on and off the pill. She still says she doesn't know what her problem is. I have offered to take her anywhere to seek therapy but she feels like she can work it out I enjoy sex very much and miss it. If things don't change I am worried that our marriage is over. Any ideas or suggestions are most welcomed.

Thanks

A: I am a psychotherapist, not a medical doctor, but in coordinating cases with OB-GYNs and Urologists, I feel confident that I can comment as follows:

Before I got to your last paragraph I embraced the "hormone imbalance" idea.

If it is hormonal, there's no way she can work it out! Get her to a good OB-GYN, or endocrinologist or maybe internal medicine doc IMMEDIATELY for a hormone assay. Be prepared to go 4 times during her menstrual cycle.

This could be as simple as supplemental estrogen. Why would she not want to check that out?

I would appreciate it if you would extend the professional courtesy of letting me know what happens.

sexdoc

10/15/98 he replies: Thank you very much for your reply. I will encourage the advice that you have given me. I certainly will do as you asked and keep you informed. Thanks for being so kind and generous with your time, I don't need to tell you about the number of people who need help and aren't sure where to go. It is a wonderful service that you are providing.

Thanks again

10/14/98 Q: Dear Doc

I'm a little worried about initiating penile-vaginal intercourse with my girlfriend. We are both 19 years of age, and have been going out now for about 4 months. This was basically my first relationship where it started towards the sexual nature. By that I mean that of the two previous relationships the most I ever had done was kissing and a little bit of on clothes petting, so to say the least, im very inexperienced in the sexual nature. After a month or so we started to get very comfortable with each other, and we started to bring each other to orgasm by means of her giving me a hand job while I rub her clit. This is fine but still doesnt resolve my fears. My girlfriend is very small, 5'1" tall, and very small boned. Now, my problem is that I'm afraid im going to hurt her when we try to have penile-vaginal intercourse because of the size of my penis, which is approximately 6.5" long and 5.25" in circumference. With her being so small im just afraid that my penise is going to be too long/wide for her vagina. My girlfriend said she had one previous encounter where she had penile-vaginal intercourse. This was with her previous boyfriend, when she was 18 and he was 16. I don't know the size of his penis or any of the details of that encounter. I think that her Hymen (sp?) is broken because a few times while rubbing her clit i have moved farther down and penetrated her vagina with my finger, of which i have gone to about two or a little more inches inside. During one time I tried to use two fingers but she jumped and had later said that I hurt her a bit, which is why im so conserned. If two fingers hurts her what is my penis going to do? We have a fairly loving and open relationship, and have talked a few times about what we would like to do sexually. I would feel a little uncomfortable to talk to her about this problem. Am I crazy? or are my fears validated? and if they are what can I (we) do about it? Your input would be extremely helpful, as I would like to put these worries out of my head. Thank you very much Doc.

Sincerely, L.C.

A: Dear L.C.

The size of a man's penis is not predicted by (correlated with) any other body part. The size that a woman's vaginal introitus can stretch to is almost the size of a baby's head (more than the size of your penis). Her vagina is like a balloon -- it expands to accommodate some pretty big things!

I speculate that she might have said "ouch" with your 2 fingers because she was dilated too quickly or that she wasn't relaxed enough.

Get over your discomfort and talk with her about your fears. Although it is less romantic, tell her that for the sake of both of your anxiety levels that you want to see if you can dilate her slowly and gradually to get three fingers in almost to the knuckle -- done very slowly, in and out, going slightly deeper each time, and with tons of lubrication, either from her or with KY or Astroglide. When you two decide you want to have intercourse, it may be necessary to dilate her with one, two, then three fingers, first, then to withdraw the fingers and replace them with your erect penis. It may sound less romantic, but it's better than trying to get your erect penis in too fast, and to have her experience pain and unconsciously clench her introitus (preventing penetration)!

Any questions?

Please tell me what you think, and if you take my suggestion, let me know what happens.

sexdoc

10/14/98 Q: i met a girl in a nightclub last weekend, we got on well together and went back to her place, when we started having sex i couldn't get an erection and feel i disappointed her and am worried the same thing will happen the next time, i didn't even feel that turned on! i am a very shy 21 year old and that was the first time i had sex. i do masturbate quite a lot and am wondering if that has anything to do with my "impotence", i don't get that many erections anyway, only really when i'm on my own with pictures.

please help.

anonymous.

p.s. what difference does alcohol make to getting an erection?

A: One event of erection dysfunction does not constitute "impotence".

You had performance anxiety and maybe were worried about pregnancy.

Go slower. Rub, pet, and play for a while. Then ask for intercourse verbally or non-verbally.

alcohol in small doses (amount is extremely idiosyncratic) reduces inhibitions and slightly reduces premature ejaculation. Above the unique threshhold for that individual, however, and you either can't get an erection or you can't have an orgasm.

I suggest that you get a book on human sexuality and read more.

best wishes

sexdoc

10/10/98 Q: My problem is very troublesome. My fiance' and I have been together for over 2 years. The problem is she is a dud in the sack, I do not want that to sound that all I care about is myself. I treat her very well and always try to pleasure her everyway I can when we do make love. She just has no drive, I give hints and suggestions but nothing. She will just go to bed at 9:30pm and pay no attention to me. I don't wnat to sound like I am looking for action everynight of the week but 1 or 2 times a month is not cutting it. When I say something about this, she thinks it is amussing. I am about ready to look elsewhere. Don't get me wrong I love her very much, she means everything to me, but this is very distrubing. Furthermore we are both very young,mid twenties. The sex, or lack of it, has been this way for well over a year. Doc will it ever get better? Talking to her doesn't help, and I have tried everything I know at this point, Please help.

Sincerely,

T.

A: Dear T.

RED FLAGS! ALARM BELLS! At a minimum you two are sexually incompatible. I strongly suggest that you two get pre-marital counseling and that you get with a therapist who is not going to patronize the current discrepancy. It is far better to address this problem head on now, than to deny that it exists, hope that it will get better after you are married, and if not, then go through the emotional, financial, and social distress of divorce.

A word to the wise ...

sexdoc

10/10/98 Q: Hi there,

I don't know if you can help me with this one or not, but here goes....

I'm quite a large lady, not gross or anything, but I do have quiet a large over hanging tummy, left over from pregnancy.

The problem is, the man in my life (new man) has quiet a small penis, and were finding intercourse a little difficult.

Can you suggest a position that would make penetration just that bit easier?

Thank you so much for your time. J.

A: Dear J.,

I infer that it took some courage for you to e-mail that. I'm glad you did.

Many heavy patients report that rear entry (so-called "doggy style") provides deeper penetration, but if your buttocks are corpulent, try lying on your back with your knees drawn up, and have him lie on his side with one leg under, and the other leg over, one of your legs. You'll look like a "plus" sign (+). His penis will be in you at an angle, but that will provide deeper penetration.

For those who have trouble visualizing this, imagine that you have just put on a pair of gloves. You want the to fit all the way down your finger, so you spread the index and middle finger of each hand and bring the two "V's" together so the skin between the two adjacent fingers on one hand is as close as possible to the skin between the fingers of the other. Get it?

Aside from that, I suggest that you experiment, and that you break away from the myth that the only "real sex" is penile-vaginal intercourse. You can have a hell of a lot of fun doing wild and crazy things to each other, simultaneously or sequentially!

sexdoc

10/10/98 Q: Dear Doc, I have been married almost 6 years to the world's greatest husband. I love him deeply and while the sex has had its ups and downs, I would say I am happy. There have been some very frustrating sexual episodes for me, probably a result of difficulty in acheiving orgasm. We are working on that though.

About 6 weeks ago, I became "involved" with someone on the internet. That is to say, we talk often (on the internet) and began to have cyber-sex (a first for me). He turns me on completely and now this has turned into a phone sex affair. We converse and talk like friends would, then end up talking erotically to each other while masturbating. I could never go through with a physical affair, as I feel it is a violation of my marriage vows. (He only lives an hour away) However, he turns me on in ways I have never been before. I feel more open and less inhibited with my husband and he (my husband) has noticed the difference!

Should I feel like I am being unfaithful? Is this crazy relationship inevitably going to turn into an affair? Should I tell my husband? Some days I feel like I am doing nothing wrong, other days I feel low. Would this even be happening if I could get off with my husband at will? I feel like I should stop communicating with this person on the phone, but just don't want to. He is single and is not seriously involved with anyone right now. Please help with any advice you can offer.

A:

This is a tough judgment call. Novelty is eroticizing in and of itself, so it's no big surprise that the thrill of doing something "naughty" adds to the excitement of the sexy talk. The best course would be to figure out what it is about what this man says that turns you on so much, and to encourage your husband to talk with you like that.

I define as "adulterous" anything sexual you cannot do in person, with another person, while your spouse is watching (assuming you're not into three-ways and voyeur-exhibitionistic games). Everybody lusts after other people. Everybody has fantasies. But acting on those ideas is usually a breach of your contract with your spouse.

There has, so far, been no physical contact, no penetration, no opportunity for disease transmission. You are no more being unfaithful than if you were reading a sexy romance novel and had your fingers busy between your legs!

Is this going to turn into an affair? My crystal ball is cloudy today ...

Should you tell your husband? I respectfully suggest that you have an affirmative obligation to protect him from knowing what you are doing on the phone, and what you are thinking. It is intellectual property and not a threat to terminate your relationship.

You are now more open and less inhibited. Springboard from that to help your husband know more of what turns you on and see if you can become more easily orgasmic. A good sex therapist can help, too.

And finally, please keep in mind that the fantasy is ALWAYS better than the reality. Your mind fills in the blanks with "perfection". Yes, the first time or two or five sexual events with a new partner are thrilling, but sooner or later, "new" becomes "been there, done that".

Consider using the "drug decision" model. You're either going to do it (try the drug or have sex in person with this guy) or you're not. If you don't, you haven't complicated your life and you might always wonder. If you do, you'll either like it or you won't. If you like it, and want to do more, but shouldn't (drugs or adultery), you'll be in conflict, with complications like feeling bad from drug withdrawal or feeling guilty if you committed adultery. If you didn't like it, you'll regret having done it, and you can't go back (as President Clinton knows all too well now).

I suggest either putting more energy into your relationship with your husband, or sorting this out in therapy.

Does this help?

What do other readers think about this?

sexdoc

10/10/98 Q: I am a 38 year old woman. I lived as a lesbian for the last 9 years and now rediscovered that I am attracted to both sexes, even though I don't know whether I could fall in love with a man (I did fall in love with women in the past).

But my main question is the following: When I am with women I fantasize about heterosexual sex (where I can be active or passive, but at the time of coming I always fantasize I am a man penetrating a woman). And when I am with men I fantazise that I am with a woman (and I penetrate her).

Do these fantasies have any relationship with sexual orientation or gender identity? I feel very happy being female in all other domains. Do many women come fantasizing they are men penetrating other women? Could you give me feed back about this?

Thanks,

R.

A: Dear R.

Our society is uncomfortable with ambiguities, and people are dropped into black and white categories all the time. When it comes to sex, however, there are two dimensions that I think are operative: what percentage of homo/hetero a person is (100/0, 50/50, 10/90, etc.) and how sexual they are, from being asexual, totally uninterested in any sex, to being rampantly sexual all the time. Consider the discomfort many many people have with "half breeds" -- half black, half white, or "apples" -- American indian on the outside but white on the inside (and yes, I know that that has also been a term of derision for purebred indians who vote with white majorities).

So on top of the intense discomfort most people have with gays, they are even more confused by bisexuals.

In regard to your fantasies: Our society associates masculinity with power. It is the one with the penis who does the penetrating (actively powerful) while the woman is penetrated (passive and less powerful). I speculate that the sense of power is a degree of aphrodisiac for you -- it turbo-charges the orgasm. That you fantasize that you are doing the penetrating in both cases encourages me to infer that power is the common denominator.

It is not known if many women fantasize that they are men penetrating other women. People are embarrassed about their fantasies and distort them all the time. I think the operative point here is not whether many women have that fantasy, but whether such fantasies are "inappropriate" or disruptive. I take the position that you are entitled to fantasize about anything you want, so long as your behavior is not illegal, immoral, or fattening.

If you are not aware of them, check out Nancy Friday's books "Women on Top" and "Men in Love". They are compilations of fantasies with a narrative.

Does that answer your questions?

sexdoc

10/6/98 Q: Dear Dr. Fitz,

I am a concerned father. I have a son who is 22 years of age, heterosexual, handsome, well built, intelligent and currently enrolled in college. However, he is a shy person and has never had sexual intercourse and up to a few months ago has never dated. He has just started dating but seems not interested in establishing a sexual relationship. My sense is to give him more time and just encourage him to pursue greater intimacy in a safe and natural manner. I have wondered if suggesting that he visit a sex therapist I might stigmatize him to think he is not normal or even worse, further exacerbate his shyness. He gets a bit defensive when I ask simple questions about his relationships, so I've backed off up to now. I often wonder if there would be any benefit in hiring a very carefully selected and medically tested prostitute (preferably in Germany where we visit from time to time and it is legal) to seduce him in a natural way and thus introduce him to the joys of sexual pleasure. Any advice about this option?

Thanks,

Concerned Dad

A: Dear Concerned,

I hear your concern, and we all have a hard time seeing the forest for the trees when it comes to our own kids, but I encourage you in the following way:

Rather than your focus on "the solution", whether a sex therapist or a carefully chosen prostitute, I suggest significant clarification of "the problem". Based on what you have said, I would find a private time when you won't be interrupted, and tell him essentially:

There are early bloomers and late bloomers

Most men in American society have had some sexual experience by their early 20's

It is an intensely private matter which he is free to keep to himself if he wishes not to discuss it with you

Some men need help developing the social skills necessary to engage in dating someone

You wish to do what you can to help equip him with all the life skills he will need to maximize his quality of life

If he is dissatisfied with his current social circumstance and is willing to accept your help, you would be willing to support the expense of therapy

And by doing that, you will have led the horse to water and invited him to drink. Through this process you need to be prepared that he might inform you that he is asexual -- has essentially no sexual feelings. Or that he is homosexual and that what you perceive as "shyness" is his protecting you from knowing that he is gay (He gets a bit defensive when I ask simple questions about his relationships, so I've backed off up to now).

My opinion is that arranging for a carefully chosen prostitute is your imposition of your values on him, no matter how well-intentioned. It is one thing to impose the importance of honesty, punctuality, and scholastic accomplishment to a developing young man. It is another to urge a 22-year old to have sexual intercourse before he is ready.

Gently encourage him to let you know what's going on with him; emphasize that you accept him under almost any circumstances (becoming a serial killer is not an option). Offer help if he is willing to accept it. And if he declines, accept his developmental pace with dignity and grace.

Please, please let me know what happens.

sexdoc

p.s. Make the judgment call of whether sharing this e-mail (both ways) with him might help be an "ice-breaker" on the topic.

Concerned Dad replies: Dear Dr. Fitzgerald,

Thank you for your answer to my question. What you said is reasonable and sensitive; moreover, it is in character with my relationship with my son. I have always counseled other parents, above all, to protect and nurture their relationship, for without it parents can have only a minimal or negative influence on their child. Since, I wrote you, I have learned that he has entered into a romantic relationship with a female coworker. Thus, your advice about him possibly being a "late bloomer" may have been prophetic. Also, the points about his needing help with his social skills struck a resonant chord. I remember how he acted with an attractive female he liked a few years ago, and his only method of communicating with her was to belittle her - which she didn't appreciate. As a result he alienated her, much to his frustration.

I think I'll take a "wait and see" attitude and keep offering advice in the most gentle manner possible. I thank you for your concern and the time you spent with my question.

Gratefully, CD

10/6/98 Q: Doctor:

My husband and I have been married 3 1/2 years and had our first child 6 months ago. We are a great couple in every respect - we communicate, enjoy spending time with each other, and have a lot in common - except we don't make love enough. We both recognize this as a problem but we are at a loss as to what to do about it. We probably average about once every 3-4 weeks. And, when we do have sex, its not that great. Invariably, my husband tries to stimulate my clitoris to make me cum, but I don't cum and don't get lubricated and then, I just want him to enter to get it over with. He enters and comes within a few minutes. I end up feeling unsatisfied and frustrated. He feels bad about it too. I am worried that we are not sexually attracted to each other. It seems we find other things to do when we're alone - reading, talking, even sleeping - to avoid having sex. I'm worried that it will only get worse with age and more kids. Help!

Thanks, too tired

A: Dear Tired,

I am taking this opportunity to share on the web page this reply because I so rarely put a question/answer like this up on the page.

To you, Too Tired, and to all of you readers who have a similar circumstance: I would LOVE to have an answer to this, but this strikes me as a circumstance in which infrequent sexual behavior is a SYMPTOM of other dynamics -- stuff happening between the two of you -- in the marriage. This kind of circumstance needs to be assessed in person, face to face, with an experienced therapist. If you're between Marin County and Monterey (California), call me. Elsewhere in the country, find a therapist! For your sakes, find a therapist.

sexdoc

10/6/98 Q: My friend and I used to date and have wild passionate sex several times a night...not every night, but quite often. We split up due to distance and not wanting to tie the other person down. Well, he is coming to town soon and I have been faithful and he claims to have been also. I am expecting my period that weekend and if I know him well enough, that won't stop him...Can it hurt me in the pain sense as well as in a physiological sense to have intercourse while menstruating? Any information you have would be greatly appreciated.

P.S don't worry, we will use protection. Impatiently awaiting :)

A: The menstrual discharge can diminish the lubrication, so use extra external lubricant (KY, etc.) so you don't cause vaginal and labial tissue irritation.

The orgasm caused pelvic vasodilation -- the opening of blood vessels in the pelvic (and other body parts) area, which many women say helps relieve cramps.

Intercourse during your period can be messy and smelly, but not hurt you.

have fun (and be prepared for the mess, etc.) And yes, do use condoms -- you can get pregnant if a sperm gets up you and survives until you ovulate next.

Oh yes, with the added fluid, the chance of the condom COMING OFF is greater. Check it!

FLASH (again) The producers of the LEEZA show have invited me to appear again (I was on the show that aired on 9/23/98). Taping is scheduled for Tuesday 10/6/98. Know that "anything can happen". The taping can be cancelled or delayed, and once taped, the show might not air. As I am told, "that's show biz". I will post the scheduled "air date" when I am informed of it.

ANOTHER FLASH! What I wrote above was serendipitously prophetic. The taping got re-scheduled for Wednesday, then at 1 p.m. Monday 10/5/98 I was informed that the show has been postponed indefinitely. I was told "that's show biz".

10/2/98 Q: I am considering on purchasing sex toys for my husband and I to try. I have never been in an adult store, nor do I know what most of the toys are used for. He and I are going to go to one tomorrow and I am going to feel very strange. He says he wants me to pick out what I think will enhance our sex life, but I don't know what most of the items are, let alone how to use them.

Could you suggest a toy for a first timer?

Thanks, B

A: Dear B:  Wow! That's difficult.

If "most purchased" is any criterion, the single greatest sold sex toy is a penis-shaped (or at least a cylinder rounded to a blunt tpoint on one end) battery-operated vibrator. It is used externally (mostly on the clitoris and rubbed up and down the labia), as well as internally, although different women have remarkable different comments about the alleged value of the vibrations internally.

Men secure in their masculinity prefer what are called butt plugs -- that are available in different sizes (both diameter at the widest point and length). insertion rectally by a lover, guided by oral feedback from the recipient, can massage the prostate gland causing great pleasure. Read what I have written on "anal sex" on my web page regarding hygiene, etc.

There are TONS of "sex toy" sites on the web. I suggest surfing those for pictures, etc.

Also, on my site in "other links" I have links to Good Vibrations and Adam & Eve.

I suggest strongly that you ration the toy purchases -- one every two months, taking turns deciding what to buy.

Remember: sex is for FUN

sexdoc

9/29/98 Q: Dear Dr. Fitz,

I am 29 years old, heterosexual, single for now, female and have never had an orgasm through oral, vaginal or anal intercourse. I am extremely upset to learn that most women don't have orgasms through intercourse, does that mean if I haven't I won't? I have tried with every man I have ever slept with ( probably 10) but after ten minutes or so of intercourse, 3-5 minutes of oral sex, usually faked it thinking they must be thinking something is wrong with me and I didn't want to disappoint. I am sure many women also feel this frustration upon reading your column. How can that stat be possible when most everything we read and listen to as women show women having orgasms very easily through intercourse (books, video, movies, word of mouth). And if thats true why do all men expect women to have orgasms through intercourse as well? And why don't our mothers say something? I can't believe there isn't an answer to this problem.

I have always felt that sexual relations with a partner were essential to a healthy mental state, and my guilt about faking it for years comes from thinking that other women WERE having orgasms that way. I have always told myself that eventually I would invest some time into weaning myself off the vibrator and having my first "real" orgasm. I am so disappointed. How could my thinking have been so wrong? I had my first sexual intercourse experience at 14 and while it was very erotic and I loved it, I didn't cum and haven't since through intercourse. Since I was 15, I have been using a vibrator to cum usually within 3-5 minutes. I thoroughly enjoy being touched all over my body and would consider myself sensual and open. I enjoy anal sex, and have tried it a little with one man, but find it embarrassing to ask in general of men, since they usually react poorly.

I'd like to know if it's possible to become addicted to the vibrator and could that be the reason it is difficult for me to cum through intercourse? I mean is the vibrator making my clit become desensitized to the intercourse reactions? or is there no hope for me to experience that. After reading your column I am happy I can at least cum very easily through using a vibrator but I want more. I truly want to share the experience of cumming with a man inside me, it just seems so much more intimate and sensual. I didn't mean to seem like a whiner but I know there must thousands of other women right now reading your column getting angry at the thought that there really is no answer, we are just SOL, as they say. If you are available for sex therapy please let me know. I truly want to experience a deeper sexual relationship and now have the time and money to devote to solving this dilemna. I only wish I had come across your site so much earlier in my life.

Sincerely, Katherine

A: One of the reasons I post correspondence on the web is because people like you can say it so much from the heart and so eloquently. We both know that the vast majority of women reading your e-mail will identify with it!

I think it would be helpful to get together in person at least once -- on-going therapy may be unnecessary depending on what comes up.

The essence of the matter is that penile thrusting alone fails to distend the labia enough to create sufficient movement of the clitoral hood to provide enough sheer raw nerve stimulation in the clitoris.

The "solution" is to provide the clitoris with more stimulation at some point. Some women prefer to use a vibrator (hand, tongue, etc.) until they are close to orgasm, then attaining penile penetration with vigorous thrusting immediately, to get over the edge. Other women prefer to sense when their lover is close to orgasm, and to then use their own fingers on their clitoris to "time" their orgasm with their lover's (or come close; a little play on words, there, I suppose).

It is a myth that "the only REAL sex is penile-vaginal orgasm", and it is a crippling myth that "you should always strive to have simultaneous orgasms". If each party embraces the tenet that each is responsible for her or his own orgasm, you can play sexually for a prolonged period of time, enjoying all kinds of acts and anticipation, and decode when you want relief from the tension! Unless you are trying to make a baby, you can be intimate in a whole hell of a lot of ways! Why limit yourself to penile-vaginal intercourse and as close together in time as possible? Maybe one of you wants to be sexual longer!

That's the "technical" part. There is an emotional part in everybody that therapy can facilitate very efficiently. Just "knowing" doesn't legislate the emotional restructuring.

Link to Answers #11

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