Sex and Relationships

Sexual Dysfunction

Answers to questions about sex therapy and sexuality

Copyright (C) 1998, 1999, 2000 William F. Fitzgerald, Ph.D.

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Answer page #25

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Guy wants sex with every woman he wants (Darwin would be PROUD!)
9/14/00 Q:  Doc,

I'm sure you have heard this story a thousand times over, but I have yet to
hear a strait answer.  I'm currently married to a very beautiful woman who I
have been with for 9 years.  We have only been married for just a year and
ever since we've been together, I've always hungered for sex with other
woman.  I love my wife very much and I don't want to leave her.  I just
enjoy having sex and if it's with my wife, than fine.  If it's not, than
that's fine also.  I do not incorporate sex with love.  I never have!  I
feel you can have sex with someone, without loving them.  It even makes me
want sex with my wife even more.

Question:  Is this common with men???? Or am I just addicted to sex with
other woman?

A:  The male animal is genetically perfected to want to inseminate as many women as possible.  That is part of survival of the fittest and it diversifies the gene pool to minimize recessive genes from one parent and the same recessive genes from the other parent.  So just like a shark is perfectly engineered genetically to be the perfect eating machine, man is similarly optimized for sperm distribution.

Unfortunately, we hunter-gatherers have not been around for very long, and the functionality of monogamy is quite new and actually counter-intuitive.  Research over and over again shows that men in committed relationships have intercourse, on average, many more times per year than their uncommitted single counterparts, and couples in bonded partnership relationships live longer than those not coupled.

So it is perfectly normal for you to lust after all the women you want, but as a negotiated agreement of monogamy, few women with intact self-esteem will tolerate your having casual sex with other women.

So your choices are monogamy, being single and having sex with as many different partners as you wish, and being in a committed relationship and lying, sneaking, and risking infection.  Being your wife's only lover while you have casual sex with other women while she knows about it is not an option -- or won't last long.  It almost never has.

Some European cultures accept marriage with a mistress if the man is wealthy enough, but until you have the mansion with 47 polished marble floors and two other residences in different parts of the world for inclement weather, I suggest weighing the above options very carefully.


Ass play caused a hemorrhoid [probably not] that a doctor won't remove
9/13/00 Q:  Hi,

up to a few years ago I used to practice regular healthy ass-play,
however one day I had a bit of a rough anal-sex session that left me a
little souvenier,  a hemorrhoid.
Although it doesn't hurt at all, and it never bleeds or gets irritated,
it sure looks ugly.
It's like a little raisin always sticking out of my butt. I'm really
self-conscious about it and as a result I don't feel comfortable having
anal-sex. A little while ago I went to a doctor to see about getting it
removed. When I told him that it didn't give me any phisical problems
but that I wanted to get rid of it only for estetic reasons, he
practicly laughed in my face, and told me he had people with "real
problems" to deal with.
I really want to get it removed, but I don't know what doctor to go to,
someone will be open minded enough to take me seriously.

Got any suggestions?

A:  SHAME on that doctor!  I am so sorry you got that reaction.

I respectfully suggest that you probably developed the hemmie quite independently of ass play -- so don't feel "branded" in sin.

I suggest calling around and persisting.  This is NOT a vain cosmetic thing.  It can mushroom and become a problem.  Explain that you want to "nip it in the bud" no matter what the chances are of it becoming worse.


p.s.  I don't know which doctor you asked but if it wasn't your OB-GYN she or he might be more sympathetic.  ANY MD can do this!

Please don't let one uncomfortable person discourage your persistence.

Is the g-spot a myth?
9/12/00 Q:  Is the "G Spot" an actual location or is it a myth made up by women to get there male partners to try hard?  (no pun intended).  I have heard arguments opposing both the fact and fiction aspect of the legend of the "G Spot".  I have also heard that the "G Spot can move around, is that true?  Please help my girlfriend and myself understand this subject more thoroughly.

Thank you for you help in this matter.

A:  Some women have one and some do not.  I have heard it is in the same location always.

Have her lie on her back and draw her knees up, one of you stimulate her clitoris until she is pretty excited.  You insert the middle finger of a hand into her vagina as far as it will comfortable go and press up gently with the pad of your finger (toward her pubic bone).

Rub that upper wall of the vagina about an inch in circles, front to back, side to side while her clitoris continues to get her closer and closer to orgasm, and IF she has a g-spot, you will feel something between half a pea and two fifty cent pieces glued together sticking down from that upper wall.  As soon as she has the start of her orgasm, you use the fingers of one hand on her clitoris (she will soon be uncontrollably spastic) and the other stimulating that spot, and observe her behavior carefully.  If she has a g-spot you can increase or decrease your stimulation of both her g-spot and her clitoris to keep her "dieseling" -- in a constant state of mini-orgasms that may be between 10% and 25% of the muscle intensity of the big O -- until one of you cries "uncle."

A very good friend sex therapist described observing this and being profoundly jealous that she didn't have one.  The demonstration lasted for 30 minutes before the woman, totally drenched in sweat, gasped "Stop.  I can't take it anymore."  The negative side effects are sore abdominal muscles (passive exercise?) and that she might lock you in the attic and never let you touch another woman.  The positive is that she will be forever grateful.

Woman fantasizes about receiving an erotic massage from a masseuse
9/12/00 Q:  Dear Dr. Fitz, I am a 45 year old female, married 24
years with 3 nearly grown children. During recovery
from surgery this summer, when I couldn't have sex for
6 weeks, I began to masturbate myself to orgasm - for
the first time in my life - and continue to enjoy
doing this.  Sex with my husband has waned somewhat
lately and I have a recurring fantasy of having an
erotic massage by a female massage therapist.  Is this
realistic? And is it normal? And how would I go about
fulfilling this fantasy? There are massage ads in the
newspaper with titles such as: "personal/private"
"personal touch", etc. Do you think this is my best
Any advice you can give would be greatly appreciated.


A:  Dear C,

Many people are incredulous when they learn that "private" masseuses are OFTEN asked to provide an erotic massage to female clients of all ages.  This is not covert lesbianism in the vast majority of cases.  Women feel safer with a woman massaging them, with no worry that a man will "take liberties," and often it is sort of a motherly or sisterly thing.  Make sure that you find out if it is OK with the masseuse that the client is a woman, and be prepared to describe in detail exactly what sequence, frequency and pressure you like best.  Similarly, do NOT feel rejected if the first 3 you call say "no way, dyke."  Even private masseuses have issues with sexuality.  Good private masseuses will watch you carefully for feedback, but they are not mind readers, and some people grimace during sexual excitement and an observer can't tell if that's pleasure or pain.

In the interest of money, some women use the personals ("women looking for women") to trade erotic massages, and some of them are lesbians, but what the hey, set your limits and stick to them.

The "thorny" question has to do with fidelity.  If your contract is "no sexual contact with anyone else," you have a problem.  How would you feel if your husband approached you and asked if it was OK if he and a buddy got together once in a while and masturbated each other?  Many homophobic men would never consider that, and insecure men would worry that you and your female friend might find that sexual contact better than with them.  And some guys would say "Sure, just don't get a disease and tell me all about it the next time we make love."

All of this having been said, be braced for the possibility that the fantasy may be better than reality.  I hear that all the time regarding a three-way, sex with a dog, going to a dominatrix, etc.

Please do me and the readers of the web site a favor:  Keep me posted by e-mail regarding what happens -- telling your husband, phone calls, what happens, etc. -- and remind me to post that on page 25 at 9/12/00.

9/18/00 She writes:  Well, today I actually went for a massage at a salon
that had advertised as "personal/private", thinking I
could have a more intimate experience. (By the way, I
had read this ad before and my husband and I had
driven by there together to make sure it wasn't a
sleazy place, which it isn't. He knows what I'm
wanting and is okay with it - except for the expense
of it!) I asked the therapist if I could get a real
full body massage (but couldn't bring myself to say
genital). She answered that she didn't massage the
front/abdominal area but that she does do the
buttocks, which was nice in itself since I don't
believe I've ever had a professional buttock massage
before. Anyway, although I was somewhat disappointed
the massage was a good one. And it did occur to me
that it might be rather awkward to have someone touch
me that way - someone I don't know who is right there,
face to face with me practically. The room would have
to be somewhat dark, I suppose. However, I have
already chosen the next therapist I will call to see
if perhaps I can't find someone who is a little more
thorough. But I'm going to wait a month or two. Like
you said, the fantasy might actually be better. In the
meantime I'll stay busy with work and world peace.

Ain't the anonymity of the internet GRAND!

HIV from anal sex
9/12/00 Q:  My husband and I have been married 11 years. We both have been with only each other. We engage in anal sex. Is there any way to contract HIV. We both are negative.

A:  If neither of you has cooties, you can't pass them to the other person.  HIV is a virus -- a kind of bug, and it invades the body more easily through unprotected anal sex but to "get HIV" one of you has to have it to give it to the other person.

If it's any consolation, I get this question over and over again.


9/11/00  I answer about 40 to 60 e-mails for every one I post on the web page, and every now and then I get a long reply explaining what someone has done with my reply.  I received one today that is certainly self-aggrandizing, but I am including it here partially to respond to questions of why I spend time pro bono (free) doing this.

He writes near the end of his reply:  I suppose I screwed myself somewhat by
sticking with it for so long, the longer it goes the harder it is to accept
the inevitable. Such is life.  Thank you very much for your advice. I've
never seen a therapist before BTW (and I suppose I would need to speak to
someone specializing in relationships and sex as opposed to a "general"
guy?), and never really intended to, to be honest, but your site and your
kind attitude have given me a new perspective on therapy in general. You're
a credit to your profession. Thank you.

To which I reply: "Sir, you are welcome."

Is it possible for a man to have an orgasm and no ejaculation?
9/11/00 Q:  I recently started a relationship with a wonderful man who has diabetes
related ED.  He is not able to achieve an erection at all.  However, he
did tell me that he is able to orgasm and during our lovemaking when I
went down on him, he seemed to experience orgasm and said that he did.
But, there was no ejaculation.  Is it possible for a man to orgasm without
ejaculation?  This is my first experience with this occurrence.  My former
husband also had ED, but was able to get a semi erection and did ejaculate
upon orgasm.   My present partner also advised me that he has tried viagra
and it did not work for him.  We had a most amazing experience together,
all of which was oral.  I just want to be sure I am doing all I can to
please him since he is so generous with regard to my pleasure.   Thank
you.  S.

A:  Dear S.  Yes, much to many people's surprise, men can experience orgasm without an erection, and sometimes there is no fluid emitted.  Orgasm is the same in both genders:  involuntary pelvic contractions about eight-tenths of a second apart, and anywhere from 3 to 30 contractions.

Some men achieve orgasm from prostate stimulation alone.   Have him have a bowel movement, then use a rectal rinse of plain water (see the links to "anal sex" on my home page), then put on a latex examining glove and insert a well lubricated, glove-covered, short-fingernailed finger and press up toward his pubic bone with a "come hither" motion.

If I were he, I would use penile injections of Prostaglandin E1 (see the link to ED from my home page).

In regard to the Viagra not working, I have had many patients volunteer that it works better on an empty stomach and that sometimes in men for whom it has been effective, there is little response on a full stomach.  I will ask Dr. Fisher if there is a medical reason for this or it is superstition.

Dr. Fisher kindly comments:  Viagra does tend to work best on an empty stomach because the food absorption does not affect the uptake of the Viagra into the bloodstream. Basically, the fat content in food diminishes the effects of the drug.  If you want to make the process of Viagra work faster, try crushing the pill up in hot water (about the size of a dixie cup) and drink.  It cuts the activation time from 45 minutes to about 15 or 20 minutes.

Unwanted hair where the sun don't shine
9/7/00 Q:  Is it Normal for a teenage Girl to have hair in the area Surrounding the
anus? Is there any way to get rid of it?
Thank you,

A:  Dr. Chance Fisher replies:  Yes, it is normal for both men and women to have hair around the anus.  Hair doesn't always grow only where it is suppose to.  You can remove it if it is that bothersome for you, but it is not a life or death situation if you don't.  DO NOT use Nair or any other hair removal cream near your anus or vagina!  It will burn and cause severe irritation.  Some people will use hot wax or wax strips to remove the hair.  Most of the time people will
"carefully" shave the hair from the crack.  You can simply pull it out with your fingers if you desire.

Serious sexual desire discrepancy
9/7/00 Q:  I am in a very committed relationship (2.5yrs) we are young and only
started having sex about 6 months ago.  My girlfriend only enjoys sex
"once in a while" (generally once a week) where I crave it at least once a
day if not more.  This is causing problems between us. I am unhappy with
our sex life but extremely happy with all other aspects of the
relationship.  We have sat down and talked about it before and she is
unwilling to have sex more than she is comfortable with.  I have tried on
my own to come up with some solutions to help the problem such as
masturbation, cooking (to take my mind off sex), keeping busy etc... None
of them seem to help.  I was wondering if you could give me some advice on
what to do.

A:    Each of you has a preference for frequency and clearly you two are incompatible.

You already took the important step of talking about it and seeking a compromise.

Your choices are to suffer in silence and feel like she is a gatekeeper, and experience growing resentment which will terminate the relationship, or make a clean break and find someone with whom you are more compatible.

Girlfriend wants him to talk more during sex
9/7/00 Q:  my girlfriend and I were talking about our sex life, which is good when
there but we both work full time.  One thing she brought up is that she wants me to talk more during
sex but all I can think about is her and I and us feeling good.  Words don't
come easy...and I don't really know what she expects.  I have sort of asked
her but that is followed with a "if I have to tell you..."  The worst part
is that I have never had this problem with other girls and my thoughts are
that the other girl I never really cared about and wasn't worried about
offending them or not so words flowed freely
Any help or advice??!?!

A:  "Talk more during sex" can mean anything from romance and compliments to explicit body parts to "dirty" talk.  Because she says "If I have to tell you ..."  your only approach is to try all three out and be sensitive to her feedback (and if she gives none then you'll have to ask).  Examples:

Romance:  "Darling, your eyes are like limpid pools, and the sparkle of love I see in them fills me with great passion for you.  When we are making love I feel boundless energy and a totally intimate connection with you.  I am sooooo glad I am married to you.  Be mine for eternity."

Explicit body parts:  "I just love feeling the shaft of my penis sliding in and out of you.  I can see your labia clinging to it, with constant caresses.  Feeling your nipples get erect when I suck on them makes me feel so powerful."

Dirty talk:  "Your slutty little cunt just loves it when I ram my cock into you, doesn't it.  Be good or I'll flip you over and shove my prick up your asshole.  And I won't make it slippery first."

Good luck and let me know what happens.


Readers:  How about a contribution of what you like to say or hear and I'll include it here.  Please put "Talking 9/7/00" in the subject line of an e-mail.

Sex becoming repetitive after 10 years of marriage
9/7/00 Q:
I found your site very enlightening.  I am hoping you can give me some
advice about a problem I am having.

My wife and I have been married over 10 years.  Our sex life has always been
active (intercourse two to three times a week) but I feel we are in a rut
now.  My wife only enjoys herself when we have intercourse and she is in the
missionary position or "on top" position.  She is capable of having mulitple
orgasms and really enjoys herself. She would rather not have sex than change
from those positions. She also is only comfortable if sex lasts 10-15
minutes or less.  Get to the orgasms quickly and thats the end of it.  I
would like much more duration at least once or twice a week.  She also is
very willing to give me oral sex. She says she enjoys that as well though
she has no creativity and nothing would ever change and would be very
routine if I did not specifically tell her how to please me.  That in itself
bothers me because past lovers have enjoyed giving me oral sex and being
creative as much as I enjoyed receiving it. She is not interested in
receiving oral sex which is a bummer cause I enjoy giving it to a woman.

I have tried to introduce new things to spice things up. All the suggestions
in the "how to spice up your love life books" have been attempted by me.
Recently we decided to try a very lifelike dildo.  She sounded interested
and told me to order one.  When it came she immediately tried it out, said
it felt amazing, then 30 seconds later lost interest and won't touch it
again like it has the plague.

I am at my wits end for a way to change our now boring love life.  I know
some guy off the street would think she was this great lover but would soon
come to realize that it's the same show over and over again.

Is it me? Am I nuts?  Should we go to sex therapy?  Help..... Thank you in
advance for answering my questions.

A:  Thank you for acknowledging sex therapy as a possibility.  American society is full of conflicting messages that account for all kinds of rigid behavior.  "Nice girls don't, and those who do are sluts" has made many a woman frightened by her sexual desires and lust.  The most common theme in romance novels is the "gentle rape" -- the concept of a woman "being taken" without her consent, but gently (and often by a stranger to whom she is indebted in some way).  We impose daunting restrictions on women with initiative, accusing them of being castrating, ball busters, or bitches.  I remember in the middle '60's learning the words "Hoyden" and "Virago" (look THOSE up in your Funk & Wagnall's!) and being apprehensive about meeting one (the wicked witch of the West personified), and thinking that if I met a woman who knew those words that that could be the cruelest thing I could say.

And in the privacy of your marital bedroom, she probably harbors some fear of your rejection if she gets "too" sexually experimental.  You cannot be part of the solution to that because you are part of the problem.  The good news is that in the hands of a skilled sex therapist, techniques such as Sensate Focus -- don't try this at home; it needs weekly debriefing with a skilled sex therapist -- directly deal with disinhibition.  I get a kick out of describing the protocol to a new couple, and to hear one or both insist that there are no inhibitions, only to have them walk in three or four therapy sessions later acknowledging that they found something.  And many couples, married for 8 to 28 years, discover in sensate focus that they BOTH like something they call "kinky," but each was afraid to propose it for fear the other would think they were a pervert.  And then they'd have to live together knowing this.  And this ranges from her sucking his nipples (ho hum) to various kinds of ass play (about which many people have inhibitions) from his finger in her rectum during vaginal intercourse, to hers in his during fellatio, to anal intercourse to her strapping on a harness and having anal intercourse with him using a dildo.  Spanking, light bondage, using ice cubes and clothes pins as well as cross-dressing (she "makes" him wear thong underwear, for example) also sometimes come up.

So yes, I encourage you two to see a sex therapist.  Sexual flexibility and enhancement are a delightful change of pace from men with psychogenic erection dysfunction and couples with sexual desire discrepancy, for any sex therapist.  You two have probably gone as far as you can between the two of you.  Professional intervention will probably be best.

Please let me know what happens (remind me to find this on page 25 at 9/7/00) and what I have your permission to post here.


Wife prefers anal sex but feels dirty afterward
9/6/00 Q:  my wife and I have anal sex all the time but my wife says that if we
don't do it she is disapointed but right after she feels dirty and
ambarressed . She comes every time I go near her ass but she said she
dreds having sex now because it feels so good but after she feels dirty
and crys sometime . So our question is how can we keep doing this and
she feel that it naturl and good

A:  I can't tell whether she needs education (this is extremely common) or reassurance.  A good sex therapist could find out.

Many women have internalized the idea that "nice girls don't and if they like sex, they're sluts (thus dirty)."

If she's worried about fecal matter on your penis, have her rinse her rectum with a rectal syringe or low volume enema before anal sex.

One or two therapy sessions with a sex therapist might do wonders!


Girlfriend has never had an orgasm, finds several things about sex disgusting; boyfriend: neither of those.
9/6/00 Q:
Dear Dr. Fitz,

Your site is a wonderful source of information, and I commend you for the valuable advice you have given to so many people.  I've learned quite a bit by reading through your past Q&As, but my question seems to be unique.

I've been dating a terrific woman for 8 months now, and we're planning to get married soon.  I am 27 and she is 24, and I feel we have an extremely solid relationship built on love and communication.  We acknowledge we are both sexually inexperienced, neither of us had intercourse before.  We talk about anything and everything, and there is very little we don't know about each other at this point (we've been living together for the past several months).  I honestly can't see myself without her in my life, she is my best friend and lover.

We make love once or twice a week, and although we both derive pleasure from it, I am the only one to orgasm.  In fact, she has never had a orgasm in her life... and she isn't terribly interested in ever achieving one.  She doesn't see the need, doesn't see what the big deal is about.  Don't get me wrong, she's not a cold fish.  Our relationship isn't lacking passion, at times we have a hard time keeping our hands/lips off of each other, and I know she isn't making love to me out of obligation.

She has never masturbated, and finds the idea of touching herself disgusting.  She also finds the idea of vibrators/dildos disgusting too, as well as oral sex.  She doesn't have any sexual skeletons in her closet (such as abuse or rape), she wasn't raised in strict religious setting, she isn't on any medication or the pill (we use condoms), she doesn't drink or do drugs, and neither of us lead particularly stressful lives.  Although she feels pleasure from intercourse and easily becomes wet, she isn't turned on when I touch her with my hands on either her breasts or pubic area.  She says she just doesn't feel anything, and being touched there can be "annoying".  Of course she can't assist me, because she doesn't know where or what would feel good.

I am no stranger to masturbation, and would be more than willing to explore each others sexuality's with oral sex and manual stimulation.  She knows this, but doesn't share my interest at the moment.   I think she's hoping that someday she'll just naturally experience an orgasm while we are making love, which I suppose could happen although I know the odds.  I want to be able to give her the same level of pleasure I receive.  After we make love I feel sexually satisfied, but I don't feel completely satisfied because in my mind things aren't "complete".

Oh, another piece of information that my be pertinent is she did a LOT of bareback horse riding while she was growing up.  It's my personal theory that this may have something to do with her lack of sensitivity, although I'm certainly not a doctor!

So FINALLY here's my question Dr. Fitz...  Should I just let things take their own course, or should I push this issue?  I don't want to put any pressure on her to have an orgasm, because that won't help things at all- but on the other hand if I'm unable to EVER give this woman that I love an orgasm I may lose interest in sex all together over time because I'll feel inadequate.  Am I obsessing on this too much?  She specifically asked me to never buy her a vibrator or self help book, and given our financial situation at the moment we certainly can't afford to see a therapist.  Is it unrealistic to hope that she'll someday have her first orgasm through vaginal intercourse?  I don't want this seemingly small issue at the moment turn into a bigger problem later.

Thank you ever so much for your help!

A:  First the easy part.  The "standard answer" to women about this question:

The most effective way to become orgasmic during intercourse is to learn what you have to do to yourself to achieve the orgasm, then teach your lover(s) what to do.  Also, it is surprising to me that a number of women do not know what an orgasm is.  The absolute sign of an orgasm in both genders is involuntary pelvic muscle contractions approximately eight tenths of a second apart.  There may be 3 or 30 and there could be some, then a pause, then more.   Most women can achieve orgasm from clitoral stimulation, by finger, tongue or vibrator.  You can feel these contractions with one or two fingers either in your vagina or in your rectum.  Only about 40% of women achieve orgasm from penile thrusting alone.  Others have an orgasm before penile penetration, after, never, OR they stimulate or their lover stimulates, their clitoris DURING intercourse.

If YOU canít bring yourself to orgasm, donít expect your lover to.

Before you go to the link below, you need to know that you can't come back here by clicking on "back" on your browser.  Either bookmark this page or on the faqtory site, click on my picture.

 If you are a woman who cannot bring herself to orgasm, please go to

there click on the search tab in the upper-right corner, and in the text window type in


Barbach's book, For Yourself, is the best self-help book for women who experience difficulty achieving orgasm.  VERY IMPORTANT: Read it cover to cover, page by page, without skipping ahead, and do each and every exercise no matter how easy you think it is.

If that doesn't result in your having orgasms you need professional help (start with your OB-GYN).

Now on to the hard part.  Sexual discrepancies in frequency and/or type of activity are cited as one of the top 3 reasons for divorce among a vast majority of people.  I have had couples with what you describe struggle for 12 years to sort this out and by that time there is so much damage in the relationship it can't continue.

I hate to tell you but I think that you two need to acknowledge that you are seriously sexually incompatible and that perpetuating your relationship is simply disaster.

So many couples I have helped to reach this conclusion have wailed and moaned and wished they had been more realistic in the beginning.

Beware of pastoral counselors on this matter.  They will likely tell you to pray and that it will all work out.  Doesn't happen.

If you have a hard time biting the bullet I suggest working a second job to afford at least one but possibly three therapy sessions!

Girlfriend refuses to receive oral sex
9/5/00 Q:  Wow, what a web site! Congratulations and keep up the great work, I think
you are making a difference in people's lives.

>From what I've read in prior answers I would seem to be facing a sexual
incompatibility situation. I've seen this term in many Answers, but what
does this mean in detail? At what point do you draw the line and declare
incompatible?  My situation is a bit odd to me.  While I've read many cases
of women not wanting to perform oral sex on men, the number of women who
don't like oral sex performed on *them* seems to be smaller. Of those I
expect many are uncomfortable because they think they smell or taste bad.
Well, I am a certified pussy-eating freak, if you'll pardon my being blunt.
Never had any complaints about it either, believe me. Until now that is.
My new girlfriend does not like having that done to her. I assumed it was
because she was self-conscious, to my surprise she claimed she is afraid of
mouth germs or some such, as if she could get a yeast infection or some
such nonsense. In other words the reverse of the usual issue, instead of
her pussy being "dirty", my mouth is. However I don't buy this excuse. She
takes fingers and penis just fine without worrying about germs. She will
give me a BJ, and even
swallow and think nothing of it, so it just doesn't make sense. She is just
uptight about body orifices and finally admitted as much.  She needs to use
a vibrator to orgasm, although she knows this is from force of habit and
can be trained away. She has let me eat her out before, and even achieved a
non-vibrator orgasm from it, which was a lifetime first.  She knows I love
doing it, and I know that the fact that I like it so much turns her on. So
I thought I was making major progress being the amateur therapist and
getting her used to the idea. ;-) But she still fights me off most of the
time when I want to go there. The worst part of it is...she tastes
incredible! The frustration level for me is insane, I would lick her night
and day.  She'll wear little skimpy outfits and I'll catch a glimpse of her
beautiful ass and pussy and want
to dive in tongue first, and she won't have it! Even after tons of kissing
and foreplay she won't have it. I have to laugh a little bit considering
that I don't think this is a common situation, and most women would
probably be happy to be so appreciated.  At least in my experience. I'd
love to get kinkier with some rimming and "around the world" stuff but you
can imagine how that would go over. I once let my tongue rove a bit close
to her anus and she claimed she would run screaming if I did that. What's
an oral sex freak to do?  This is a fairly new relationship. We haven't
invested *that* much emotionally yet. This is part of the
compatibility-testing phase in my book, and this is a big red flag. I
intend to keep trying as gently as possible to get her to relax
about this, but I know for a *fact* I can't have a serious relationship
with a woman who can't stand being licked.  I'm a 100% believer in finding
out what you want and testing your sexual compitibility long before
marriage enters the discussion. Maybe I like it a bit more than some men,
but I think this is pretty bread-and-butter sex, nothing wild (well OK the
rimming is a pretty
kinky, but we all have our turn-ons), and she is not religious or a prude
in any other way. I think the relationship is too new for me to suggest
therapy, even though I think learning to enjoy receiving oral sex is *very*
worthwhile and would be good for her whether with me or other people
throughout her life, but I'm not sure that I want to declare
incompatibility and split up just yet. So how do you define
"irreconcilable" incompatibility, to what extent is something like this
"curable" or "resolvable", how do you handle something like this in a newer
relationship (5 months) vs. one with more time and emotion invested, etc.
Thanks! Whether you answer or not, you have a great site!

Best regards, P

A:  Dear P,

Matters like this are disinhibited in sex therapy 95% of the time, but there are men and women whose beliefs are so deeply rooted that they just can't get over certain things.  It is interesting that there are men and women who really get off giving oral sex and there are those who get just plain nauseous at the thought.  I know for a fact that there are women who experience orgasm from sucking on a penis (just from the sucking action -- could be on a finger, as well).

Your interest in anilingus (tongue contact with anus) implies a degree of sexual flexibility and lack of inhibition that sounds incompatible with hers.  Your choices are to respect her limits or to find a woman with whom you are more compatible.  There are women out there who cherish a good cunnilinguist and who would kill to have you for a boyfriend.  Neither you nor your girlfriend is "better or worse."  Please focus on incompatibility (and she might adore being with a guy who can't stand giving oral sex to a woman).

And, because the anus is so richly enervated, there are men and women who are absolute devotees of anal pleasures.  If you find a girlfriend who goes into paroxysms of extreme pleasure when so stimulated, be careful that she doesn't lock you in the attic to keep you all to herself.


p.s.  Thanks for your kind comments about the web page and thanks for a great question!

Can you get pregnant from the clear "pre-cum?"
9/1/00 Q:  Dear sexdoc,

When a man gets an errection, a colourless fluid flows out of his penis. I would like to know if this fluid contains any sperm or can it cause pregnancy ? When we are avoiding pregnancy, is it safe to enter the woman's vagina with the initial fluid flowing out and than take the penis out of the vagina after a little while? If a man now puts the condomn on and have the actual act and come inside the condomn can he still make a woman pregnant with that initial fluid that was coming out of the penis during the erection stage?
I will be very greatful if you can help me out.

A:  The clear liquid that comes out of MOST penises when erect is produced by Cowper's gland, and on average contains about 80,000 sperm.  In the pornographic literature it is called "pre-cum" because ejaculate is called "come" or "cum."  Ejaculate contains on average between 200 million and 400 million sperm.  Withdrawing during intercourse before the man ejaculates is technically called "coitus interruptus" and we call people who practice this form of birth control by the not-so-technical term: "parents."  Any questions?  (Come on, now, let's not always see the same hands being raised!)  p.s.  Some men do not have the clear liquid come out.  That is also normal.

Don't achieve orgasm from oral sex reliably.
8/31/00 Q:  i am a 28 year old male.  I am heterosesxual.  I have only acheived orgasm through oral sex a few times.  why is this?  can it be something i can overcome by seeing a sex therapist.  i have given my wife a complex about it even though she does it great and i tell her so.thank you for your time .

A:  This is common and factors include less stimulation orally or manually, to anxiety over doing something "dirty" or fear of ejaculating in her mouth.

The behavior modification approach is to use manual stimulation until you are about to come, then have her take the penis in her mouth.  Every time you repeat it you use less hand time and more mouth time.  If that doesn't work, it just might be the need for more stimulation.

Great roommates; no sex; should I move on?
8/31/00 Q:  My question is very simple, just exactly how does too much marijuana and cocaine affect a man's sex drive and performance.  I have known this man for seven years and he tells me he loves me and he wants us to live together as roommates, i.e., separate bedrooms.  He never hugs or kisses me and we have never had sex, even though I have tried to be affectionate with him and show him in all ways that I want sex with him.  He seems to really care about me, wants me with him all the time, and we are on intimate terms as far as everything else goes, (he has no problems sharing all the details of his personal life with me and he also shares his dreams with me) but we are not physically intimate.  He watches porn quite a lot, but never touches me.  He takes quite a few prescription drugs for bi-polar disorder and he is a very heavy user of marijuana and I suspect that he is using cocaine.  My friends tell me that he is probably impotent and doesn't want to tell me and others say he is just using me as a housekeeper and wants someone to take care of him.  Does he just want a friend or a buddy?  Or do you think something is physically wrong with him?  Am I a fool to care at all.  I am giving serious consideration to moving on, but each time I tell him I feel it's time for me to leave, he gets very upset and seems to try harder to please me in every way except sex.  What gives??  I need some advice.  Please help if you can.  Thank you.

A:  I think this is in the category of "not seeing the forest for the trees."  From my perspective external to your situation, I think the question is not how those things affect his sex drive, but why you are sticking around when you are clearly not getting your needs met!  At a minimum you two are sexually incompatible.  And in the sense of "that's easy for you to say, Dr. Fitzgerald," and "if it doesn't work out it's a learning experience." I respectfully suggest that you catalog all the things you value in this relationship, then find one that has all that you value PLUS what you are not getting:  sexual intimacy.

John Bradshaw, the TV pop psychologist is fond of saying that people stay in relationships that are "fucked but familiar."  Hope is a wonderful human emotion, but there has to be a progressive trend for behavior change to justify it.  If you were having sex once a month then once a week, I'd encourage you to stick in there and see if you can improve on that (if that is what you want).  But from your description, the handwriting is on the wall.  Clarify your needs and values and search for a relationship that has enough of a critical mass in all areas.  If this doesn't inspire you, please, for your sake, talk with a therapist!

Pain experienced by man during intercourse caused by varicose vein in the genitals
8/31/00 Q:  My Question is I've been diagnosed  with vercos vain in my genitals. After complaining of pain during intercourse or after ejaculation to the urologist. So could you tell me some of the side effects or dangers. The doctor told me some but I would like to know more if possible. He said that the only time the do corrective surgery is when the pain is to much or when fertility is a issue. But the pain is some what bearable and I have know no clue about the other. So any info.would be appreciated.

Chance Fisher, M.D. replies:  Varicose veins in the genitals of men is a common condition.  About 30% of
men have this problem, but fail to realize it because most of the time the
varicose veins are not noted upon visual examination.  Varicose veins are
70% heredity.  They result when the vein twists or becomes weak.  This makes
it hard for the blood to circulate properly.

The main symptoms are pain during intercourse or upon ejaculation, swelling
and itching on the skin around the vein.  They usually are not life
threatening.  Blood clots can form, but usually remedy themselves.  The
main danger is in dealing with fertility.  If the varicose veins are in or
near the testicles (often called Varicoceles) they can cause the testis to
malfunction and not drain properly.  The varicose veins are thought to cause
a rise in temperature and in turn causing defects in sperm production,
travel and shape.  If fertility is an issue, it can be checked with a simple
sperm "donation" at the doctor's office.

Surgery is only advised if you are having fertility problems.  Most of the
time, fertility can be saved if detected and measures are taken.  Now days,
microlaproscopic surgery can be used as a surgical technique.  The surgeon
can remove the problem vein  completely or insert a wire into the vein to
"straighten" it because of twisting.  Surgery is often used to relieve pain,
but it has to be severe.

You can help prevent further varicose veins or help the current condition by
exercising and keeping your blood pumping through those veins.

An update from almost 2 years ago.  Recovered memory of rape accounts for current frigidity.
8/31/00 Q:  Hi Sexdoc. It's been almost two years since I wrote and asked you about why I couldn't seem to relax enough to enjoy sex and or do all the moaning and groaning thing. I still have the problem but have found out why. As I wrote a story for my fourth anniversary with my husband, I recovered my memory of being raped by my ex-husband four times in the last two weeks that I was with him. I am trying to deal with all the emotional baggage of rape now. I still have tremendous trouble in bed unless I get drunk. I have tremendous guilt over orgasaming when I was raped (My ex made sure of that.) so that anytime things start feeling too good, I freeze up. My questions are: should I still try to find a sex therapist or do I need to deal with a psychiatrist first? Or can they be both together? Is there anything that I can do to help myself or is professional help the only way to go? I have read many web pages on rape but it seems that nobody talks about how they get through the difficulty with sex or how they can enjoy it now. All I know is that I need some serious help. Thank you for what you said before.

Still Frigid

A:  Psychologists are trained to deal with the emotional-behavior aspects of the person; psychiatrists are medical doctors trained to deal with that segment of the mentally-compromised population that needs medication, such as psychotics and clinically (biochemically) depressed people.  Yes, you need a sex therapist, not a psychotropic medication, for this recovered memory and guilt.  I am literally ignorant of anyone being able to deal with this effectively through self-help.  Time is of the essence.  The longer your unconscious tries to make order out of this chaotic memory, the more deeply it will be etched in your thought process.  Please get competent psychological help as soon as possible.  And thank you very much for the update!

8/31/00  The sexdoc has been on radio talk shows often these days, and one of the talk show hosts asked what I thought of pedophiles.  I explained that the media usually confuse an opportunistic child molester with a pedophile, but that true pedophiles are really quite rare.  Because I have found that people can more easily understand true pedophilia -- really desiring only children as sexual partners -- as though it were a third sexual orientation, I presented that during the show.  Somewhat to my surprise, I received this:

I heard you on KYNG-FM ("The Talk That Rocks") in Dallas yesterday and I was
quite impressed how you handled one particularly touchy subject: Pedophilia.
I've never heard it referenced as a "third orientation", but that's exactly
what it is. The fact that you did not react violently to the subject
impresses me, however one of your Frequently Asked Questions on the search
site doesn't word things quite so kindly.

Those of us cursed with this "third orientation" usually get nothing but
hatred, shock, and discust. Strangely, the other "deviant" orientation --
homosexuality -- is becoming more and more accepted in our society. I never
see this same acceptance happening with pedophiles, even though there are
distinct parallels between the two.

You are also absolutely correct about making comparisons between homosexuals
being unable to be aroused by members of the opposite sex, and pedophiles
being aroused by adults. It's as unnatural to us as trying to get a
hetrosexual to become aroused by a member of the same sex.

I just wanted to write to you and say "thank you" for not being judgmental.
For those of us who are not sexual offenders and have chosen to keep their
sexuality dormant, I truly appreciate that.

I would be remiss if I didn't add that the primary psychological objection to pedophilia is that being hyper-sexual before adequate coping mechanisms are mature enough causes psychological trauma to SOME children -- but not to all!  And with all the people I have talked to about their entire sexual history, I have found no consistent differentiating factor that accounts for trauma in some and not others.    And it also depends heavily on society's attitude.  In Victorian England there were numerous accounts of mature women leading perfectly normal and maybe sexually more uninhibited lives, who described playful sexual encounters involving mutual masturbation and oral sex with older men when they were 6 to 14 years of age.  It was not prohibited as much and it was not prosecuted as vigorously as now in America.

To be or not to be (sexual).  One of the reasons I wrote the book "SEX:  What Every Young Woman Needs to Know."
8/29/00 Q:  Dearest Doctor

I am a 21year old female  - and i am quite conservative - my problem is that i don;t know when is the correct time to have sex with my boyfriend.

I have been going out with my boyfriend for almost 3 months - at first he only started touching me on the clothes but then things started to get more intimate  and he is now touching me even underneath!!

However i still am afraid to have sex - i am still a virgin and until i meet this guy i always was of the idea that i will have sex only after i get married - however he is constantly telling me that he really wants to have sex with me - and i am afraid that i will eventually let him since i am sure it will feel so good!!

Dearest doctor - what am i to do ?? Am i doing right in letting my boyfriend ( who say he loves me ) touch me and eventually have sex with me?? Am i wrong in wanting to have sex after marriage?? - i am so afraid to tell him so - as he might not want to wait for so long!!!

I would appreciate  it much if you would help me !!


A:  And in the final analysis, the answer is that you must decide and be responsible for the consequences.  Determining that you are sufficiently compatible with your husband before you get engaged is the greatest guarantee that you won't divorce or be miserable.  You wouldn't consider marrying someone who is so intelligent that you constantly feel stupid, nor would you want to be with a man who you think is dumber than water.  If he were insensitive to your emotions, you would feel invalidated and a marriage with that would not last.  But so many people still have this naive belief that "love conquers all" and that after they are married it will all "work out."  WRONG!  The most difficult couples I work with are those who were virgins when married and seriously sexually incompatible.  Now that we have birth control and a great deal of knowledge about sexually transmitted diseases ("STDs"), and an acceptance by some religious leaders that recreational (or at least affectionate) sex without the intent of pregnancy is OK (but only if you're married), things have relaxed somewhat.

So my general answer is that if you are mature enough to handle sexual intimacy, and prudent so you minimize the probability of getting pregnant or contracting an STD, IF you wish to assess your sexual compatibility as well as your intellectual and emotional compatibility, toward the goal of preventing fatal discrepancies in a committed dyadic relationship, the only way to determine that is to be sexual with each other.  But I can't make that decision for you.

Many women have e-mailed to say that starting intercourse before 17 or 18 (or 21 in some cases) was, in their opinion, a very serious mistake.  And others have seriously regretted waiting until they were 23 or older.  In American society, I think that the woman of AVERAGE maturity is ready optimally around 18 to 20.  Does this help?  Other reader comments?

How can a swinger (male) tell me he loves me but be sexual with other women?
8/29/00 Q:  I am in a relationship with a man who has been a swinger for over 10
years.  We have discussed the possibility of introducing me to the
lifestyle, but the opportunity just hasn't been available.  However, I was
under the impression, that although he has such desires, he was remaining
monogamous in our relationship.  He is not!  I do not know how often he is
having sex with others, but the most disturbing thing to me is that he has
been keeping it from me.  How can he tell me he loves and is in love with
me, but still continue to be with other women sexually?

A:  For many men, sex is sex and love is different and there is no contradiction!  I can easily understand that he loves you but enjoys an occasional roll in the hay for fun.  It is entirely plausible that he is able to compartmentalize loving sex with you as categorically different from casual sex with a new partner.

The critical question is what your promise to each other is and if that is monogamy, what you are going to do about the breach of contract.  There is a sense in which you could thank him for letting you know this early in your contact with him what his behavioral decisions are.

Swinging always runs the risk of disruption in a dyadic relationship.


Will frequent anal sex cause fecal incontinence?
8/28/00 Q:  My husband and I have recently begun having anal sex.  Although I find it very pleasurable, I continually worry about the long term effects of this.  Specifically, future control of my bowels.  Will this relax the anal sphincter muscles "too" much, if we do it very often?  Our joke at this point is that I will be walking along and poop will just fall out!!  It concerns me more now, that entry is easier, and not painful if the muscles are looser??

A:  Please relax!  You are experiencing the perfectly normal adaptation of the anal sphincters (internal and external circular muscles) to repeated dilation.  You reptilian brain, responsible for riding a bicycle and engaging in sex, is learning how to take something into your rectum in the opposite direction it is expecting.  Unless you are tiny and your husband's penis is monstrous in diameter, you have nothing to worry about.  Fecal incontinence (as you say, the "poop will just fall out") can occur if you stretch the anal sphincters to the point of tearing, but among my patients who are fond of anal fisting (also called "wristing") in which the entire hand is inserted into the rectum up to the wrist, not one has reported any problem whatsoever (somewhat to my surprise, I might add).

If you surf the internet and find still pictures of a gaping hole into the rectum, don't be alarmed!  Fast frame photography can capture the dilated anus as it gradually closes after the removal of a dilating object.  You can verify this by using very slow motion while viewing a pornographic videotape of anal intercourse if there is a close-up just as the penis or object is removed.

Engaged couple experiencing sexual desire discrepancy
8/28/00 Q:  My fiance and I have been together for almost five years.  We have been having sex for almost four years.  We are both 22 years old.  My fiance enjoys sex so much that he asks me to have sex everyday, and when I say no we fight.  I am so upset because I do not know what hinders my ability to enjoy sex.  We try watching movies to help put me in the mood, we try different positions in order to spice it up.  Unfortunately sex is a very important issue to my fiance, and so we always fight about sex.  That is all we fight about.  Sex has never been my number one priority, and I am afraid that eventually it will ruin this wonderful relationship I have with him.  Can you give me advice on what you think may be a problem, or any tips to try to help me improve my sex life?

A:  Sexual incompatibility is almost always one of the top three reasons listed for divorce.  I have had couples who have intercourse (their only sexual activity) once every 6 weeks, and are perfectly happy, and couples who are sexual every morning and every evening (plus weekend afternoons) for over ten years.  In general, before the late 30's (age) men have a higher sex drive than women, and after then it reverses.  Men and women can fine tune their sex drive and modify it a bit (unless they are inhibited or over-controlled by religious messages), but basically you have your preferred frequency of sex and he has his.  I respectfully suggest that you see a marriage counselor (or sex therapist) to assess this and that you both be prepared to accept that you may be sexually incompatible with each other.  Please, please do not lull yourselves into the false hope that this will "all change once we are married."  In the grand scheme of things 'tis better to know now (and maybe each of you find someone with whom you are more compatible) than to get legally entangled (marriage) and possibly have a child.

I have had patients who were inhibited and/or beaten up by religion who responded quite nicely to therapy, but you might just simply have your unique sexual frequency preference.

Woman, sexually abused as a child, hates sex and vibrators, masturbation, massage, don't help.
NOTE:  When asked about the difference between a counselor and a therapist, I emphasize differential diagnosis first, and treatment second.  This truly sad account clearly exemplifies both misdiagnosis and inappropriate treatment, in my opinion, AND based on this information alone.  Some data have been altered to disguise the identity of the author.
8/23/00 Q:  Hi,
I've been following your web site for awhile now looking for answers.  Unfortunately, I don't know that an answer exists for me.  I am a 33 year old wife and mother of one son.  I HATE sex and intimacy!  When we first married 12 years ago I faked interest in sex and orgasm.  My poor husband had no clue how I really felt.  I believed (I guess I still do) that the only way someone could love or care for me was if I let them have sex.  So, for the first few years that is how it went.  He would ask for it, I would give it, then cry myself to sleep.  Then I got pregnant with our daughter and became very depressed.  I started refusing sex based on my high-risk pregnancy while in reality it was such a relief not to have to give in to his lust.  After our daughter was born I would make excuses as long as possible and would make myself sick, have panic attacks, and become very depressed.  Finally I would give in and let him have it just to get it over with for a few more weeks (which would turn into months).  Now, my relationship with my husband is awful, and causing tension in our household that my daughter (age 9) is acting on.  I have been in therapy for over a year, we talk mostly about my hatred for sex and intimacy, but it doesn't seem to help.  I have openly told my husband I HATE it when he touches me, that I believe the only reason he even comes near me is because he wants sex, otherwise I feel as if I don't exist.  Sometimes I realize that isn't true, but most of the time that is how I feel.  On the rare occasions I do give in I have panic and anxiety attacks.  I have tried getting drunk first, taking sleeping pills, anything to make me relax, and nothing works.  I feel I can't go back and pretend to enjoy it, or pretend orgasm, because I have admitted I hate it.  Following the instructions of my therapist I have purchased a vibrator, tried masturbation, tried letting my husband massage me, etc..... And nothing works.  I made an agreement with my husband at one point that I would allow him to "screw" me every Friday if he would agree not to talk about it or pressure me at any other time.  That didn't work because I couldn't follow through, I would do anything to get out of it.  I know this is all brought on by the fact I was abused as a child.  My step father forced me to have sex with him (vaginally, anal, oral on him, oral on me) for years, and my mother blamed me.  She called me a slut and accused me of trying to steal her husband from her.  I was 10 years old!  I was terrified of him.  As a child I believed the only way for anyone to love you was if you let them "fuck" you.  My mother was never an emotional person, and crying was simply not allowed in our home.

I want to have a better relationship with my husband, and would love to know what it is like to have a healthy sexual relationship.  I don't think my marriage will weather this storm much longer, and it's starting to show in the actions of our daughter.  I just don't know what the answer is.

Can you please help?

A:  This is a classic case of the effects of childhood sexual abuse.  As a boundary violation, this needs intensive individual therapy, and group therapy one to three times per week.  The major problem here is that the abuse was assimilated into this woman's psychological reality (" ... the only way for anyone to love you was if you let them "fuck" you."), and she rehearsed the association between sex and abuse to the point that it is crazy-making as an adult because it doesn't make sense and doesn't "fit" any more.  If she had said that she had spent three years in intensive therapy that specialized in childhood sexual abuse, THEN was encouraged to try the vibrator, masturbation, etc., I would be less critical.  But she says: "I have been in therapy for over a year, we talk mostly about my hatred for sex and intimacy, but it doesn't seem to help."  It is of great professional concern to the sexdoc that the health-care consuming public is unable to know whether they are receiving the "correct" psychological treatment.  You must trust your professionals, but you have the right to ask for, and receive, an approximate description of what will signal progress and in what time frame.  Some of psychotherapy, especially the "brief therapy" models, are experiential.  That is, in the interest of helping the patient function better as soon as possible, some high impact short-term treatment might be tried, with a 50-50 chance of working.  If that doesn't work, a longer-term approach with a higher probability of success could then be employed.

Based on what she has said, I think that this woman does not have a sexual problem.  She has a "childhood abuse" problem which is currently manifested sexually and I am positive in other dysfunctional ways, as well.  If this describes you, do a search engine search for "Parents United" or "Giaretto" or look in your phone book white pages for Parents United (the independent organizations that are run by therapists who have been trained by the Giaretto Institute to provide effective treatment for victims of sexual abuse [as well as for the siblings and parents of the victim, and for the perpetrator and spouse of the perp]).

Too often I have people come in and say "You are the fifth therapist we have seen who says he or she can deal with sex problems.  All the others so far, when sex came up changed the subject or insisted that we'll get to the sex part later.  Please let us know now if you are going to avoid the subject of sex so we can all save time."

By the way, when I took re-training for the diagnosis and treatment of childhood sexual abuse in 1988 at the Giaretto Institute, the training required 9 days of 12 hours a day.  It was particularly gut-wrenching for me because my daughters were then 3 and 7 years old.

To answer her question "Can you please help?" my advice is for her to thank her therapist for doing what he or she believed to be in her best interest, to acknowledge to the therapist that what is being tried isn't working, to find the nearest chapter of Parents United, and to start therapy with someone known to be trained in childhood sexual abuse.  To the one in four women who were sexually abused before their eighteenth birthday:  get competent help as soon as possible.  Because today really is the first day of the rest of your life, the sooner you effectively deal with childhood trauma, the more happy functional days you'll have left.

8/24/00 She replies:  Thank you,

I don't know what to think at this point.  I am desperate, and depressed.  The thought of all those years of one counselor, therapist, social worker, after another not doing any good is crushing.  I've often wondered if this is just my lot in life?  Is the damage just not reversible?  Today that is how it seems.  Starting all over again seems so hopeless, but I want more for my family and myself so I continue.

I checked out the Parents United web page and apparently there doesn't exist a chapter in Grand Rapids, MI.  I emailed them to see if they have anyone listed who is a member or if they know of a therapist trained in the Giaretto program in my area.  I called a local mental health institution and asked if they could recommend a "sex therapist".  They gave me a recommendation, but how am I supposed to know if he's qualified?  I have been in and out of therapy since I was 16, and frankly I am tired of repeating my story over and over again and being left feeling like I do.  My husband has had it, and is really putting on the pressure for me to perform sexually.  The tension in my marriage is making us all miserable.

What questions should I ask when looking for a good sex therapist in my area?  Since the Giaretto Institute is on the other side of the country, I doubt I will find someone familiar with it.  Grand Rapids is a fair sized city, I should hope there is someone who is qualified, but how do I find that person?

Thank you for your time and opinion.  I plan to start all over again, hopefully for the last time.

A:  There are three internationally-known centers for training mental health practitioners in the treatment of childhood sexual abuse.  The Giaretto Institute attracts people from all over the world.  In my (re-)training program there were clinicians from London, New York, Chicago, and many small cities in the US.  I would be quite surprised if there wasn't someone in Grand Rapids.

Have you seen the link on my home page to "How to find a sex therapist?"  I suggest calling the local county Psychological Association and the Chair of the Department of Psychology at your nearest universities, and asking the Chair of the Department of OB-GYN at local hospitals.

Ask the sex therapist you are referred to what training he or she has had.  I am prejudiced in favor of traditional conservative education so a Ph.D. in Psychology would top my list and a "degree" in "sexology" would make me wary.

Too many therapists advertise that they treat sexual problems when they have not had advanced training.

Thank you for letting me be a part of helping you.  When you find someone I encourage you to ask them point blank how you will know if the therapy is working.  Demand specific concrete behaviors and an approximate time frame.  Expect stages of behaviors -- i.e., reduction in frequency of revulsion at the thought of sex, able to sustain a hug for 60 seconds without anxiety (I'm guessing here because I don't know your baseline behaviors), mutual genital touching, etc.

I hope this helps.  And yes, we both wish you were local to me so I could accept you as a patient.

8/28/00 She again writes:  Hello again,

Just wanted to let you know I followed your advice and finally was referred to a therapist trained and experienced in childhood sexual abuse and its effects.  I met him this morning, and I think he may be able to help.  I'm not too excited about starting all over, either is my husband, but we are going to do it.  I think the therapist I was seeing in the past is a little upset about the change, but I feel I needed to do something.

Please accept my heartfelt thanks.  I was beginning to think there was no where else for me to turn.  I emailed the Sexdoc web site to a friend, and she told me this morning she was up all night reading all the question pages!  She loves it.

Thanks again,

Lesbian's lover was abused by father and demands to be addressed as male.  The reply by Dr. Hinkle has application for everyone.
8/23/00 Q:  Ok, well i barely know where to begin,but here goes...first of all I am a
17 year old girl and I've been in a relationship with another girl for
three years,(I was best friends with her for a year before she asked me
out, so I've known her for 4 years) I totally love her with all my heart
and i know she loves me...but there's one major, odd problem:during our
first week together, she asked me to call her by a guy's name, as a joke,
then she wanted me to call her by that name (in addition to refering to
her as a guy and treating as a guy--"he","him")until the end of the
summer, I reluctantly agreed, but then the time for school to start came
and went and I was still calling her by a guys name. Then it got even
worse, every time I would accidentaly call her or refer to her by her real
name she would just glare at me or say "what did you just say" was
really scary, the last thing I wanted to do was hurt her, but it was so
hard to basically give up a friend I had as a girl and suddenly have her
replaced by this new person, and I actually wanted to be in a relationship
with HER, the GIRL, not her the "guy"...and now that we've been together
for 3 years, the awkwardness has never gone away, having sex for the first
time is hard for everyone, but in this situation, believe me, it was a
million times stranger:she eventually came up with the idea to use a dildo
during sex so she can make love to me as a guy, and that's the only way
we've ever done it. This basically means that I have to go through sex as
if she really was a guy, which is hard since she ISN'T, and this mind game
is driving me crazy. I even give her "hand jobs" and "blow jobs" like's just torture, I'm not allowed to physically show her how much
I love her, I want to put my hands all over her, but I can't (since she
has breast and a vagina I can't exactly be with her totally naked and
still pretend as if she was a guy) it's like her body is totally off
limits to me, and it is so painful, because I want to share everything
with her but we can't share the one thing every couple should be able to
share:mutual pleasure. and needless to say, this sort of anxiety and
awkwardness makes it really difficult for me to have an orgasm...since I
feel that all the pleasure she seems to be having is all an act (how can
having a dildo touched feel good to you?) just feels so unfair...and
in terms of the future, how can I carry on a relationship like this, I
mean I want to be with her until the day I die, and I would do absolutely
anything for her, but I can't even speak to her about this honestly, how
can we even begin to discuss marriage or having kids(obviously it would be
through a sperm bank or other outside assistence), if we're both
pretending that my girlfriend is really a boyfriend...this just makes it
so hard to have a normal conversation about my life...I can't even figure
out what I am (gay or bisexual). Since she was my first
everything(relationship, kiss, sex, and love),she's the only thing I've
ever experienced, but she's not a guy or a girl, it's like she's both (so
I don't understand where I fit in to everything). It would be one thing if
she was androgynous or if she wanted to be a guy and then actually talked
to me about it, but she doesn't mention's just this HUGE
secret between us and I know if I spoke to her about it something would
happen, I don't know what though- I'm really afraid that she'd stop
speaking to me at all (I think it would hurt her that much) and I can't
risk losing her, she's the only person on earth who knows who I am (I
basically only have 2 real friends-including her)and she's the only person
I care about...I would also be really afraid she'd kill herself or
something:she has thought of suicide before, and a few years ago there
were huge cuts on her wrists, and one of her friends killed himself last
year, and another person at shool we knew shot and killed himself last
year as well, she was also abused by her father as a child(her parents
divorced last year and thankfully he is out of her life now--I also know
this must have had some impact on her self/sexual identity), and she was
also a marijuana smoker for two years until I gave her an ultimatum: me or
pot (I couldn't watch her hurt herself like that and I was really scared
it would make her depression worse or even life threatening--this was 2
years ago)we both have a psychiatrist, but I know her's doesn't help her
that much, and I am truly afraid that if I brought this up she would kill
herself (I think she'd think I was leaving her or betraying her or
something, and that is her one great fear and the one thing I promised her
I'd never do- and the one thing I never would do)...we've been through so
much shit together, I just want nothing but honesty between us, but I'm
afraid that this will tear us apart, and I don't want her to think that I
want to suddenly get rid of this person I've known and loved for 4 years,
I just want her to be her, I'd love her anyway she decided to be (even if
she wanted to get an opperation and actually become a guy), I just want
her to let me love her, and be open...please, please help me, I have no
idea weather to do anything at all, and if so, when would be the right
time (the fact that I'm leaving for college in a year plays a big roll
too)...I hope you can help, thank you.

Dr. Hinkle replies:

Dear M:

    My heart goes out to you.  This is a deeply disturbing issue for you.  I
hope these thoughts of mine, based on 35 years of experience helping people
with relationship problems, can be of use to you.  First, your friend is
seriously psychologically disturbed, having been abused by her father,
suicidal ideas, cutting her wrists, drugs, and a powerful gender identity
problem.  She is in need of long-term psychotherapy with a psychologist
skilled in working with teenagers, childhood abuse, and gender identity
issues.  You said that her psychiatrist is not helpful.  She should
immediately seek an appropriate psychologist.  These psychological problems
are not cured by medical pills; they are psychological.  You can not be
responsible for her mental health.  She would be a challenge to the most
skilled of psychologists.

    Secondly, any intimate relationship in which you can not communicate
fully and honestly is not worth keeping.  Open communication is the very
foundation of any worthwhile friendship.  I would encourage you to show her
an exact copy of what you sent to us.  You were honest and loving.  If she
can not deal with your reality, then exit the relationship as soon as
possible.  Does your friend honestly think that making love to a plastic
dildo could be enjoyable for anyone?  Such self-centered selfishness! Our
first responsibility as human beings is to take loving care of ourselves;
when that is done, then it is easy to be caring toward others.  This is not
selfishness; it is the necessary loving care of ourselves.

    Thirdly, you believe that leaving this relationship will leave you
painfully alone, so something is better than nothing.  Not true; being alone
will only be a temporary state for you. One's first love is unlike all the
others, because we can not imagine its end.  Yet it does for almost
everyone, and that is a good thing.  What you can't realize at 17 is that
you will love many people in your life.  No one should think of making a
life commitment at your age!  You have not experienced the countless
alternatives that are open to you.  Did you know that 95% of all teenage
marriages end in divorce, yet they all believed they had found true love!
You say that you are even unsure of your own sexual orientation and have
only 2 friends.  How can you possibly understand what is possible for you
with such a limited sample? There are literally millions of females and
males available to you.  At your tender age, you owe it to yourself to
explore as many non-exclusive relationships with both sexes as you can.
That way you will discover the many paths to your bliss.  Most relationship
problems can be avoided by careful rational selection.  Imagine that you had
a daughter you loved.  Would you advise her to commit herself at 17 to a
person exactly like your psychologically disturbed friend?  I think not.
Use your head rather than your emotions!  It is important to acknowledge our
feelings, but the psychologically healthy person looks at the bigger picture
and acts with knowledge, rationality, and wisdom.  You will meet many
wonderful people in college, and you will change.  We all do.  Life is
perpetual change.  Welcome it! Embrace it!  Be on with it!  Fear not!

Dennis Hinkle, Ph.D.

Hypersensitive clitoris
8/22/00 Q:  My clitoris is extremely hypersensitive and I can't tolerate any type of
stimulation of my boyfriend or even of myself by a finger or tongue, and I
would never be able to handle a vibrator to it.  It's just too painful.
I've discussed this with my Dr. because I thought that I had some type of
infection or something, but she told me that many women experience this, it
is common, and there's not much I can do about it.  Does this mean I have a
40% chance of ever achieving an orgasm because the only way I can possible
get it is from intercourse? And, is there any way to desensitize my
clitioris?(I'm not talking about cream or medicine, but some type of
activity) Should we keep trying to stimulate it and eventually it won't be
so sensitive----like my body will get used to it? Thank you

A:  Dr. Chance Fisher replies:  Your clitoris is highly vested with nerves.  You may want to try using a peppermint oil or some mint gel (Kama Sutra product) to give it a "numbing"
effect. Ice cubes can also be used as a numbing device.  If you start
stimulating the clitoris and it starts to become too sensitive, stop and then
proceed a little bit later.  This will help you build a tolerance to touch.
For vibrators, try using a vibrator with your underwear on or placing a
small hand towel over the clit area to give it a barrier so it will not be
as powerful.  And remember, just because a vibrator comes with different
speeds doesn't mean you are required to run it on "high."

Vagina really smells
8/22/00 Q:  Hey, my vagina really smells, i've gone to the doctor and they told me to
take baths instead of showers and to use some hygiene products but that didnt
help my main concern is about when i have oral sex, i have been avoiding this
because of my problem. i know for sure that the odor is stronger than normal
and its not a yeast infection or STD. Its only on the inner skin of the
lips, not inside the vagina. Could it be from sweat, heat and moisture or
what? please help me, thanks!

A:  Dr. Fisher replies:  First, the vagina and it's various parts, especially the inner lips, will
secrete an oil that helps lubricate the vagina and surrounding tissues.
This oily substance is usually not detected, but it can cause an odor,
especially when you are excited. That's why the odor is more noted during
sexual activity.

It is true that sweat, moisture and the natural flora of the vagina will
cause a slight odor and this is normal.  What can cause an odor that seems
to be confined to the inner lips is what you call smegma.  Smegma is the
product of the oily secretions of the clitoris.  The glans of the clitoris
produces the oil to allow the hood of the clit to slide off the clit during
sexual stimulation and thus provides an orgasm. This oil dries and becomes a
white, curd-like substance under the hood of the clit.  You can keep this
from happening by sitting in a warm tub of water and gently rubbing the hood
of the clit back and forth several times.

In general, if you rinse all the soap from the vagina and area and keep it
dry, the odor seems to be kept to a minimum.

Woman stops intercourse just before her orgasm
8/22/00 Q:  I have been dating a really great woman for a month or so.  We are starting
to get sexually active and everything sexually is great except one thing.
She always stops actual intercourse right before her orgasm saying that
"stop, you're gonna kill me".  And no I dont have a huge penis but sexually
everything is great except that.  A bit of history.  She is into light BDSM
(calling her bitch and slave, spanking, etc...nothing really heavy duty!) and
I know shes had some problem past relationships but Ive asked and she wont
really tell me what happened.  Its really got me perplexed and I cant find
any info about ANY possibilites that would cause this.  Any ideas?

A:  It could be any of a number of things:  irrational fear of pregnancy, fear of loss of control, fear of embarrassment if she loses bladder or bowel control on orgasm (some men and some women have this happen), internalized messages that nice girls don't and women who enjoy sex are sluts, etc.

I suspect that talking with a sex therapist could yield some insights.


Can a dog impregnate a woman?
8/19/00 Q:  Where there medical studies conducted by the nazi during WWII on dogs impregnating women, can it happen

A:  I know of no such studies and there is absolutely no way a dog can impregnate a woman.

What affects the taste of semen?
8/18/00 Q:  From Hank, a freelance writer:  What  affects the taste of semen?

A:  (by Dr. Chance Fisher):  First,  right off, I'm going to state that there has not been any "Reliable"  research pertaining specifically to diet and semen in humans.  Most of the
information about the subject comes from surveys and a consistency among
certain semen tastes and diet correlations.

For the most part, the taste of semen is reliant on each individual's body
chemistry.  There is not a specific equation that can be followed to produce
a certain taste or texture of semen.  Some macrobiotic nutritionists say
alkaline based foods such as meat and fish produce a bitter taste, while
fruits and quality fermented alcohol produce a sweet taste.  Processed
liquors tend to produce an acidic taste.  The most awful tasting semen is
said to be the result of eating dairy due to high bacterial purification and

The medical basis for these "tastes"?  While there appear to be a couple of
theories as to the culprit behind the odor or taste, a prime suspect seems
to be a breakdown product of amino acids that are in certain foods and ends
up in the semen.  For example, in asparagus, the amino acid methionine is
broken down and methyl mercaptan is produced and ends up in the urine
producing an awful odor.  If you think of semen as a by product of the body,
like urine, than it makes sense.

Some people report a metallic taste to semen, like when you put coins in
your mouth.  Semen contains a large amount of zinc compared to the other
trace components counterparts.  In fact, men that ejaculate a lot lose a
large portion of their body's zinc content.

I have read in medical journals as well as past experience with patients,
that nicotine and certain drugs such as cocaine can be deposited in genital
organs like the epididymid and seminal vesicles and tend to be detected by
the taste buds.  Researchers have found that sperm carry certain receptors
for cocaine.  Cocaine is a common practice in sex because people think it
enhances it, but it doesn't.  It actually as a numbing effect.

As far as medicines go, there hasn't been a lot of reports on this and the
correlation to semen taste.  But I do know that if a man has certain
diseases or conditions it can affect the taste.  Diabetics tend to have a
honey or cantalope juice taste, most likely due to the spilling over of
excess sugars in the body.  While some report that semen of men that have
prostate and cowper gland problems produce a more acidic tasting semen.

On an interesting note, Most people have a particular gene in their DNA that
allows them to sniff or taste a offensive odor, but both senses are dulled
when a person is sexually aroused.

Virgin invited to join, but not participate, in a three-way
8/16/00 Q:  I am in my mid-twenties, and until recently have had no sexual contact with
the opposite sex (or my own for that matter, since I am strictly hetero),
mainly due to my embarrasement about the flaccid(?) length of my penis. When
erect, it is fairly normal(15 cm long, 13 cm around the base), but in the
flaccid state it is very small(3-6 cm depending on various conditions).

Anyway, I got an offer to be in a threesome with a gorgeous 17-year old girl
(16 years is the minimum legal age where I come from), and her ex-boyfriend.
This girl has only ever been with her ex-boyfriend sexually, and was madly
in love with him, so I guess she offered the threesome to be with him one
more time. Anyway, I didn't think I could refuse, since I thought it sounded
very exciting.

My problem in this, is that she kissed him on the mouth, and let him fuck
her, but when I asked if it would be ok to kiss her, she said "I don't
know", which I interpreted as a no (maybe my first mistake?) -so I didn't.
She didn't seem that interested in my presence at all, though she let me
caress/kiss the rest of her body, and masturbate her. When her ex had fucked
her, he urged me to do it too, but again, I thought she seemed reluctant,
and didn't want to pressure her. ( I'm not even sure if she actually said
no). I know she did think I was a bit old for her, and since I didn't know
her this well, and she also only had been with one other guy before, I
didn't dare pressure her...She later apologized, saying she hoped I didn't
feel to ignored (which of course I did, but didn't say straight out).

I guess my first question is, because I am very confused here; should I be
flattered/happy she would at least let me join them, or should I kick myself
in the leg for being so passive?

The second question is related to my penis; As I mentioned, I have a complex
about it, and I don't think it was fully erect once throughout this 3 hour
threesome-session, so I am not sure I could actually have fucked her if I
got the chance. I sort of dismiss this as a problem, thinking that if she
had been more positive, I would feel less self-conscious, and more aroused.
In addition, being my first time in the sack, so to speak, I guess it wasn't
ideal to start right away with a threesome...And it didn't receive much
attention from her or me (meaning, I usually need some form of physical
contact to get erect.) Do you think this experience could be damaging to my
allready low self-esteem in this area?

I truly hope you can help me get a perspective on things, since I promised
the girl not to tell anyone about the threesome to people I know, in case
somebody could put 2+2 together.

Thank you for your time!


A:  She used you as a way to get with her ex one more time.  It was disrespect  from the two of them and you were the hapless pawn.

You should neither be flattered that you were invited (they took advantage of your inexperience) nor kick yourself for being so passive.  You behaved in an appropriately gentlemanly way and did not commit what could have been date rape.

I suggest that you chalk this up to an interesting learning experience and that you connect with an emotionally and physically available companion with whom to launch your sexual experiences.

Ignore the size of your flaccid penis.   It is erect that counts.  And because you can't safely enlarge it, I suggest that you be very friendly with it.


8/17/00 He writes back:

Thank you for your amazingly prompt reply!

Though, I feel sad I was used this way (I can see that now!), I am very
thankful for your insight. I am also glad I did the right thing, not trying
to have intercourse with the girl; it was just that I've heard the phrase
"she might be saying no, but she really means yes" before, and was unsure
whether or not this is something one should consider. I won't consider it
anymore, after receiving your advice, though.

The sexdoc-service is a great service to the people of the world, and I can
not thank you enough for doing this!



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