Sex and Relationships

Sexual Dysfunction

Answers to questions about sex therapy and sexuality

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7/23/98 Q: Hi, I'm a seventeen year old gay male. I masturbate an average >of five hours a day. At a time, I masturbate for about two hours at least. I >have tried to stop, but I have only managed to go without for three days in at >least a year. That record was only achieved by avoiding all arousing imagery >like the plague. Even if I want to read or something, I have an overwhelming >urge to masturbate and I do that instead. I have a great amount of restraint >in relationships and I am always the one to slow it down. Still, privately I >have little resistance. > I would like to know if this qualifies as hypersexuality, sexual >addiction, or something else. Please, recommend a way to deal with this, like >anaphrodisiacs. Thank you. > >

A: There is a normal curve of almost everything measureable, such as intelligence, height, etc. I think that you are on the upper end of the testosterone scale and that time and maturity and competing activities will result in a gradual reduction in the number of hours per day you spend pleasuring yourself.

7/23/98 Q: Dear Sexdoc: > >Many thanks for your previous responses. I do have one more question: > >A male friend (and sometime lover) claims he's had prostate-induced orgasms >via anal sex. I understand males sometimes ejaculate when their prostate is >merely touched. Prostate massage has put me into a state close to nirvana, >but I have not been able to proceed to orgasm/resolution, which I suspect >would be incredible. I've used my middle finger as well as a dildo but >can't quite get "there". Is it possible to induce orgasm in this way? I >realize it may be an individual matter, but how long does it take (on >average?) for a male to get himself off in this way? I realize it may not >be possible for all of us, but if there's a chance...please let me know. >Thanks again! Tom >

A: Dear Tom, Because this is an infrequent activity, I know of no surveys or larger than anecdotal samples of how long it takes. My patients (small sample and statistically meaningless) report various times, from 3 minutes for a "quickie" to about an hour to prolong the delicious sensations as long as possible without causing tissue irritation.

I suggest trying a Pavlovian paired-stimulus approach: after you are in plateau from prostate stimulation alone for several minutes, stimulate your penis while continuing to stimulate your prostate (the dildo will make your wrist less tired and less subject to carpal tunnel syndrome (could be difficult explaining to the wrist specialist how your repetitive motion was achieved). Achieve orgasm. Over successive trials see if you can spend less and less time stimulating your penis. Or, if that feels good, why not just stimulate both? Let me know what happens.


7/23/98 Q: Dear Dr Fitz, > I have been with a most loving and respectful man for the past two years. >He is aware that I have a bit of a self esteem problem and is unbelievably >sensitive towards my insecurities. However, I have been vague and >dishonest with him about the exact root of my unhappiness. Prior to last >night, whenever we'd make love, mostly always in the complete dark, I was >unable to thoroughly enjoy the experience because I'd be constantly guiding >(more like steering) his hands away from certain parts of my body. When >he'd ask me what was wrong, I could only bring myself to say, "I'm ugly." >Last night, however, when I began to kiss him, he didn't reciprocate and >instead, took my hand and explained to me how very much he loves me and >that I should feel free to tell him precisely what the matter is. I ended >up breaking into tears and muttered something about being insecure about my >weight and stopped once I felt I had convinced him. Doctor, the problem is >so not my weight, rather it is a body hair problem, which I feel no one I >have ever encountered shares with me. I think it's very important that I >be specific when describing what I have. > > From the top - my face. I keep my hair very long, so I can cover the >sides of my face, which are covered in hair, not as course as a man's but >very noticeable. There is dark hair scattered on my cheeks and in excess >on my upper lip. > > My chest, abdomen and stomach is covered with more hair than my older >brother (who never ceases to torment me with this fact) I will not >complain about the pubic hair covering my vaginal area, but there is hair, >just as dark and course, growing all the way to my anus and ending in >lighter hair at my lower back. > > I have confided this in only one aquaintance, who I rarely see and does >not know my boyfriend. She assured my that he probably doesn't have a >clue. Doctor, that doesn't really matter because I am incredibly aware of >it and it torments me. I wear long sweaters in the summer because I am so >afraid that someone on the bus or at my work will realize what kind of >monster is in their presense. > > When I was in high school, someone did notice and left a razor in my >locker one day. I wanted to take the blade and slice my hairy wrists open. > I know that there are ways to remove the hair but I am horrified to let >anyone see my body in a well-lit room. Doctor, if there is any kind of >drug or female hormone pills that I can take to reduce my superfluous hair, >please let me know. I am letting this take over my life and possibly >destroy the most meaningful relationship I have ever had. I feel as if no >one takes this matter seriously. You never see it being the topic of an >Oprah show and yet I feel as if it is as psychologically damaging as a >weight problem. Please take what I've written into consideration and any >words of advice would be greatly appreciated. >

A: What it sounds like you don't know is that there are men who adore hair on a woman. I suspect that it is hormonally induced, naturally within you, and that it also is related to your sexual response. I suggest that you see an endocrinologist for a hormone assay to assess whether it is symptomatic of something that needs to be addressed medically, but if your body fluids are within normal ranges, you have a psychological matter to deal with.

People come in all shapes and sizes, and you can modify only so much. Current definitions of "beauty" are barbaric (or should I make a pun and say "barbie-ic"), and it was only about 200 years ago that chubby women were considered the paragon of perfection (go to any gallery of art that has paintings from that era to see what I mean). Many European women think that Americans are absolutely wierd for shaving their lega and armpits! I suggest that if you cannot accept your individual differences that you seek help.

Yes, some men will reject you for being hairy. And some will reject women who don't give blow jobs, or whose boobs are too small, etc., but that doesn't mean that there aren't men who will prize your unique combination of attributes. Your task is to find one.

7/23/98 Contributed by a friend:

This happened to a friend of ours, we got this report by email... ouch!

> Subject: Calling in Sick...A Cat Owner's Story >

> Calling in sick to work makes me uncomfortable > because no matter how legitimate my illness, I > always sense my boss thinks I am lying. > On one occasion, I had a valid reason but lied > anyway because the truth was > to humiliating to reveal.

> I simply mentioned that I had sustained a head > injury and I hoped I would feel up to coming in > the next day. By then, I could think up a > doozy to explain the bandage on my crown. > In this case, the truth hurt. I mean it really > hurt in the place men feel the most pain. The > accident occurred mainly because I conceded to > my wife's wishes to adopt a cute little kitty.

> As the daily routine prescribes, I was taking > my shower after breakfast when I heard my wife, > Deb, call out to me from the kitchen. "Ed!" > she hearkened. "The garbage disposal is dead. > Come reset it." > "You know where the button is." I protested > through the shower (pitter-patter). "Reset it > yourself!" > "I am scared!" She pleaded. "What if it > starts going and sucks me in?" Pause. "C'mon, > it'll only take a second."

> No logical assurance about how a disposal can't > start itself will calm the fears of a person > who suffers from "Big-ol-scary-machinephobia," > a condition brought on by watching too many > Stephen King movies. > It is futile to argue or explain, kind of like > Lloyd Bentsen telling Americans they are > over-taxed. And if a poltergeist did, in fact, > possess the disposal, and she was ground into > round, I'd have to live with that the rest of > my life.

> So out I came, dripping wet and buck naked, > hoping to make a statement about > how her cowardly behavior was not without > consequence but it was I who would suffer. > I crouched down and stuck my head under the > sink to find the button. It is the last action > I remember performing. It struck without > warning, without respect to my circumstances. > Nay, it wasn't a hexed disposal,drawing me > into its gnashing metal teeth. it was our new > kitty, clawing playfully at the dangling objects > she spied between my legs.

> She ("Buttons" aka "the Grater) had been poised > around the corner and stalked me as I took the > bait under the sink. At precisely the second I > was most vulnerable, she leapt at the toys I > unwittingly offered and snagged > them with her needle-like claws.

> Now when men feel pain or even sense danger > anywhere close to their masculine region, they > lose all rational thought to control orderly > bodily movements. Instinctively, their nerves > compel the body to contort inwardly, while > rising upwardly at a violent rate of speed. > Not even a well trained monk could calmly stand > with his groin supporting the full weight of a kitten > and rectify the situation in a step-by-step > procedure. Wild animals are sometimes faced > with a "fight or flight" syndrome; men, in this > predicament, choose only the "flight" option. > Fleeing straight up, I knew at that moment how > a cat feels when it is alarmed. It was a > dismal irony. But, whereas cats seek great > heights to escape, I never made it that far. > The sink and cabinet bluntly impeded my ascent; > the impact knocked me out cold.

> When I awoke, my wife and the paramedics stood > over me. Having been fully > briefed by my wife, the paramedics snorted as > they tried to conduct their work while > suppressing their hysterical laughter. My wife > told me I should be flattered.

> At the office, colleagues tried to coax an > explanation out of me. I kept silent, claiming > it was too painful to talk. "What's the > matter, cat got your tongue?" > If they had only known

7/23/98 Q: Hello Doctor! My name is Lisa and I have a problem I hope you could help me with. I'm not sure if there is a charge for this, and if there is, just tell me. You see, I have a problem achieving orgasm during sex with my boyfriend. He is my first partner, and I have never gotten an orgasm with him. I have no problem getting it when I masturbate, or if he gives me a hand job or even oral sex, it's only when I have sex. My boyfriend is endowed just fine, about 6 1/2 inches erect, but he has a curve toward the left. Does this have anything to do with my problem? I would appreciate any advice I can get from you.

Thanks a million!! Lisa

A: Only about 40% of women have an orgasm from penile-vaginal thrusting alone. The clitoris is what needs to be stimulated and there isn't enough drag on labia tissue to pull vigorously enough on the clitoral hood to stimulate the clitoris enough. The solution is to give the clitoris the added stimulation it needs however possible (his or your fingers, etc.). I doubt that the curve of his penis has anything to do with it.

7/16/98 Q: >Dear Doc, > > I am currently in a wonderful relationship. My fiancee would like to >play games like spanking me. I must admit that I find it a bit of a >stimulating idea. Would you please tell me anything you know about the >psychology of it. Why do some men enjoy spanking and why do some women enjoy >being spanked? > >

A: Dear Spanky, (I couldn't resist)

I type slowly and whole books have been written about this! Basically it's added neurological stimulation to the brain. The reptilian brain stem confuses good (pleasureable) nerve stimulation with slightly painful bnerve stimulation -- so you get a multiplicative effect.

I suggest that you savor the experience like a fine wine to be consumed only on special occasions -- done too often and it loses SOME of it's erotic value. Enjoy!


After her comments in reaction, the Sexdoc adds:

A variation on "straight spanking": Have your boyfriend sit on the bed where he can lean back against the wall or headboard. He spreads his legs and puts a pillow on top of each thigh. You lie on your tummy facing the bottom of the bed, with your legs spread and on top of the pillows on his thighs. With one hand he spanks you, and with the other he stumulates your labia, your clitoris, and with 1, 2, or 3 fingers, your G spot.

A pillow under the hips is optional. Tying your wrists to the corners of the bottom of the bed, and/or your ankles to the top corners of the bed are optional as well. Talk about a violent orgasm(s)!

One word of caution: If he gets inspired to stimulate you anally as well, the finger(s) that penetrate you anally MUST NOT then be inserted vaginally until cleansed of bacteria.

She replies: YOU ARE NAUGHTY! giggle > >Spanky > SPANKY:  The last two e-mails I sent to you came back undeliverable. If you have a new e-mail address and want what I tried to send, please let me know where to reach you. sexdoc

7/16/98 Two questions and a response from one writer:

Q: i was wondering if you could tell me what a guy usually thinks when he sees >his girlfriend naked for the first time? >im really worried what my boyfriends going to think, espically because i have >small breasts (34A) >thnx >brittany > >

A: Dear Brittany,

90% of guys are thinking "Holy shit -- am I going to come in my jeans just from SEEING her naked??????

10% are thinking "I have died and gone to heaven".

Any guy who is shallow enough to prefer to be with a woman with big tits for that reason alone deserves a heavy-breasted bimbo. It's what you do with what you got that counts. Many guys are worried that their erect penis isn't big enough or long enough. Relax! You don't have to compensate for a shallow lower-class emphasis on big boobs.

Got the picture?


Q:  >i have (dark) hair on my upper back. theres not like a huge amount but its >noticable. >im in my early teens and am wondering if this is something i will grow out of, >or is a horomanal imbalance or something? >i just want to know what to do because i am rather embarressed by it and am >not quite sure what my boyfriend will think if he sees it >thnx alot >brittany > >p.s. i know this doesnt have alot to do with sex but hey, i didnt know who >else to ask and i really didnt want to call MTV's Loveline. you seemed like a >good person to ask. >

A: No one can diagnose via the internet -- please be leery of anyone who implies otherwise.

Ask an MD the next time you're naked in front of one (or ask him or her to look at your back and render an opinion).

ALSO: Any boyfriend worth anything will be admiring your other bodily charms, and if any guy is "turned off" by hair on your back thank him for letting you know how shallow he is this soon in the relationship (and ditch him immediately).

Sounds to me like you are insecure about your body. Experience with decent guys should address that.

best wishes


thnx much more than you'll probally ever know !! :-)

Aok i DO have another question. >what percentage of females masturbate? >am i 'normal' to do so? >thnx again >brittany > >


Because people tell interviewers what they think the interviewer wants to hear or what they want the interviewer to think of them, they often distort answers to questions about masturbation and other sexual activities.

Reliable surveys indicate that about 80% of women regularly masturbate. It's healthy, keeps your plumbing in good working order, can help some women with attractive fat distribution, and it strengthens the immune system, so you get sick less. At least 2X per week -- at least once every 3 1/2 days -- is a biological minimum (and it will make you a more responsive lover when you start having intercourse). What's not to like about this?

7/16/98 Q: >My boyfriend and I have not had sex in many months due to problems with >impotence. We have been together, on and off, for over a few years. On >many occasions when we have had sex, my boyfriend has not come to orgasm >even though he was able to sustain an erection. My boyfriend and I are >both in our late 30's and have been together only a few years. He has >never been sure of his abilities as a lover and I have spoken to him >many times about my desire for a more satisfying sex life with him. I >have given him suggestions about how he can please me and have suggested >that he find reading materials, videos...etc. to learn sexual techniques >as I have done myself in the past. Although I have never degraded him, >I'm sure my expressions of dissatisfaction have probably contributed to >his insecurity and impotence problems. My previous sexual relationships >with other men were very satisfying for both parties. I do not want to >give up on an otherwise very good relationship, however, my boyfriend >has not attempted to educate himself about sexual techniques and has not >consulted a professional about his impotence problem. I have stopped >short of buying books for him or scheduling an appointment for him for >fear of hurting his feelings further. My boyfriend is aware that this >is an important issue for me that is not only standing in the way of our >relationship but chipping away at it. I am ready to give up on this >relationship because I see no end to this problem because there is no >attempt on his part to deal with it. What else can I do? > >

A: Tell him that because you love him you cannot stand to see him with such an impaired quality of life, and that because this is common, and that there is lots of help for it, that you cannot participate in his misery. Tell him that if he goes for help you'll support him, and that if he doesn't, that he is sending you a clear message that he would rather be miserable and insufficiently concerned about you and your needs, and that you deserve better. Give him a reasonable time -- say a month, then carry through. He MIGHT lose you, then realize the loss and act then.

7/16/98 Q: >I'm a 29 year old male and have had limited sexual experiences for the >following reason. After ejaculation (whether it be a result of intercourse, >oral, or masterbation) I get an extreme feeling of guilt or become depressed >(this is a temporary condition that usually lasts from a couple hours up to >24 hours). However, the guilt/depression is much more prevalent when I >ejaculate as a result of sex with a girlfriend. Why is this? I'm a happy >person and am very satisfied with my job/friends/family, etc. I've thought >these feelings through and I've come up with my own answers that range from >me not loving the person to questioning my own sexuality (I've never had sex >or feelings for another man). I'm more concerned about this now, than ever >before, because I've met a special person that I care about and we are >approaching the point in our relationship where sex is an issue (we'll be >having it soon). This has put a major damper on previous relationships as >my girlfriends realize that I don't want to touch them, talk to them, etc. >immediately after sex. Do you have any insight regarding this emotional >state I fall into after ejaculation? I look forward to your reply. > >Thanks for taking the time. >PS - I truly enjoy foreplay and sex, but it's the aftermath (ejaculation) >that gives me these feelings. > >

A: Some men get such a rush from sex that when they get a massive squirt of endorphins on orgasm, the misinterpret the anesthetic nature of the endorphin effect as depression. So my first question is whether you are indeed not just getting one hell of a lot of morphine-like hormones flooding your biochemistry (feel drowsy?).

My second thought is that while there could be some nefarious emotions coming into play, it might just be idiosyncratic sensitivity. I suggest that you consult with a sex therapist about your sensations. Possibly one session would clear it up (or your re-thinking what you feel based on what I have just written).

Please let me know what happens.


7/16/98 Q: In the eyes of the law, ignorance of her age is no excuse!

>Doctor, > >My Name Is Philip, I am 18 years old and live in salt lake city, utah. >I have been dateing this girl for a little over a year now, our relationship >is quite an odd one. It first started out as one of the best relationships >that i have ever had in my entire 18 years. When i first met her she had to >have been the most attractive that i have dated to this point. At the time >she told me she was 16 years old going on 17 in one month, so I didn't even >think twice about her age. In August of 1997 her and I had sexual >intercorse... One month later I get a phone call from a private >investigater with charges against me for "unlawfull sexual intercorse with a >minor" I immediately called her after the phone conversation and she then >admitted to me that she wasn't as old as she looked (could have fooled me, >well she did) and She also admited several other things that she lied to me >about... > >I had to go to a hearing in the juvenile court systems, and was very honest >and very descriptive to the judge... despite my honesty i got slapped with >6months Probation 1 month of house arrest and i'm pending review.... I was >also required to seek therapy... and Have done so.... I took the MMPI test >and most of the other tests and the results are very me... i'm paranoid and >nieve... My question to you doc, do you think that what i did was bad?? i >mean... I didn't know her age???? and maybe im still a bit confused... > > > > >

A: Dear Philip:

The law sets a limit somewhere. It's not fair in all cases, but it's the law. In the extreme, if a man and a woman make love on their 18th birthdays, they're legal (in most states). If they were to have made love when he was 18 and a day and she was 17 and 364 days, it's statutory rape and he gets what you got.

You have a right to be confused, along with lots of other emotions. Use your therapy to work on that!

7/16/98 Q: Dear SexDoc, > I'm not really sure if my questions are of "sexual therapist" caliber, >but I had to ask someone. I'm a 21 year old virgin, and in the upcoming >week I'll be having intercourse for the first time. I must admit that >like most men I know, I am totally clueless about matters concerning the >vagina. I've had my share of foreplay and what not over the years, but >the opportunity for close vaginal inspection has never really presented >itself. I've heard countless "tips" and "strategies" over the last few >years, especially in high school, about how to bring a woman to orgasm, >but I'm still nervous about my first experience. I am unsure if my >girlfriend is a virgin or not, and I'm fairly sure that she isn't aware >that I am. Regardless, I don't want to come off as completely inept in >the art of love making, so I was wondering if you might be able to >bestow upon me knowledge about the physiology of the vagina and any >techniques that are time-proven and true. I've heard a great deal about >stimulating the clitoris, but have no idea whereabouts it's located. As >I said earlier, I've had some minor experiences with manually >masturbating my partners, but have never had the opportunity to try oral >sex, thus I've never really seen a vagina up-close. I tried seeking help >via the wealth of information available on the Internet, but to no >avail. I beseech you sir, can you help me? > > Concerned and curious, >

A: A picture is worth a thousand words! Get thee to a library and look for anatomy or a college text in Human Sexuality.

There are limites to what the e-mail system can do ....

7/16/98 Q: Dear Sex Doc-- > I would like you to answer a question for a very close friend of mine. >He is going through the hiring process at our local police department, and >he has to take a polygraph examination. He is a normal guy who did >something that he doesn't feel comfortable with, and he would like you to >confirm if it is sexually bizarre or strange. He is 22 years old, and when >he was an adolescent (around age 12 or 13), he was playing around in the >woods behind his house. He then went out to the corn field past the woods, >and in the middle of the corn, took his clothes off. As soon as he did >this, he put his clothing back on, and went home. My friend is afraid that >this was a sick and shameful thing to do, and that he will not get hired at >the police department if he admits it on his polygraph examination. > Another thing that he is intensely worried about is an incident that >occurred about a year ago. He often has to drive to our neighboring state >to go to work, and one day on the way home on the interstate, he >masturbated in his vehicle. No one saw anything, and he was completely >alone. I have asked another therapist about this incident who did not find >it damaging to his career, but I would just like to confirm it further. > I would greatly appreciate a prompt and honest response about these two >situations. He has never been molested or abused in any way, and I >typically think of him as a normal person. It would greatly help him if >you could shed some light on the matter, so he can make the best possible >decision for the polygraph examination. Thank you, and once again I >appreciate it. > > Sincerely, > > Nervous > >


First and foremost, tell him to answer HONESTLY on the polygraph! ANY measured falsehood could terminate his chances.

In reality, stripping naked at 12 or 13 is "child's play" and only the most repressed police examiner would think that there is something wrong with it.

Masturbating in a vehicle when no one can see you is not against the law, and again, it would take a stretch of the imagination to be bent out of shape over it.

So if he's asked "Have you ever done anything sexual that you are ashamed about", the answer is "YES". No police psychologist in his right mind is going to classify those two events as evidence of unfit to serve. Tell your friend to expect the examiner to look quizzical and say "Is that all? Are you SURE?????"

Ah, the anxieties we suffer from such a sexually confused (American) society!

7/6/98 Q: I hope I can write to your specifications, I am a 31 year old female, involved in a relationship now for a year with a 47 year old man, for the first 3 months the sex was plentiful and pleasurable then it started dwindling for reasons unbeknownst to me, when I tried to bring it up in a positive manner he did not want to talk about it. Unfortunately frustration has led to anger and some hurtful things were said regarding sex (ie he told me i dont suck dick very good, and I told him I could do better with my fingers). I have always been very open minded regarding sex and I am confused if he does not find me sexually desirable, or its a fear of getting emotionally involved. His last relationships especially his marriage he was hurt very bad and I think sex has always been an issue with him. My feelings get hurt when he goes and buys pornographic movies as I feel why does he need them when he has me. I have tried on numerious occasions to approach the subject but to no avail what do I do? Please help me, as now it has become somewhat of a self esteem problem for me.

Thank you Helen

A: Dear Helen,

A rose is a rose is a rose, but sex is not always the same. Masturbation while watching pornographic movies is different from penile-vaginal intercourse, which is different from sequential oral sex to orgasm. For men, masturbation during pornographic movies is an escape from reality with sexual release. Women, who are less orgasm-driven, spend many hours reading romance novels, but imagine how silly it would sound if a man complained to his therapist: Why does she have to do that when she has me? It's not instead of you; it's in addition to being sexual with you.

I suggest that you focus on the "real" problem, which sounds like his emotional withdrawal. I apologize if I sound like an "infomercial" but you have contacted me BECAUSE you have not been able to work it out between the two of you; therefore, if you can't, I suggest that you see a therapist.

p.s. The longer you wait, the worse it'll get (up to a point), and the longer it will take to deal with therapeutically, and the lower the probability of success (however defined).


7/6/98 Q: I have a problem where I was a virgin until my 21st birthday because my >girlfriend would not have sex. All my friends now make fun of me and the >girls around town have gotten the word and laugh when they see me. I feel >like my social life has been ruined. I don't even try and date anymore >because I am tired of the humiliation. My last girlfriend constantly amused >herself at my expense and I left her as a result. This really sux. Why >couldn't I have taken some of those earlier opportunities and avoided all of >this. Being a virgin for too long is a shitty experience. My question is why >do parents promote waiting when this is the kind of crap that results? I am >so unhappy. >

I hear you! Control of the masses (behavior) and creating the greatest number of religious followers by maximizing the birth rate have a lot to do with it.

Are you saying that parents want you to delay sex because of religious reasons. My parents weren't religious.

How big is the town you live in -- what geographical opportunities do you have?

Not many, it's a big city but I ran in a huge crowd and I see people I know every night I go out, even when i'm not looking. I can't imagine having to move because I was a virgin till 21. Something just doesn't make sense there.

I'm tight on time right now but wanted to get some reply to you. You have a great point!

The challenge is what you're going to do now to get over this and get on with your life.

Right now I'm just putting my head down and bearing it. It's got me kind of gun shy with girls. I don't know how open I can be about this for fear that I will be tortured mentally by whomever. I used to feel good that I waited for my girlfriend and remained loyal, not hurting her etc. Now I feel like shit about it.

I respectfully suggest that your parents, however religious or not, have been affected by the judeo-christian culture prevalent in America.

You're not the only 21-year old virgin! Find a new woman (your town is big enough) and when things get to the point of the possibility of sex, tell her honestly what the problem is. You might be pleasantly surprised by the number of "Florence Nightingale's" there are out there. Just make sure you don't wake up as the only 25 year old virgin. If you have a problem with this, get an older buddy to help or see a therapist.


7/6/98 Q: Dear Dr. Fitz,

I have been with my fiance' for a year now. I love making love with him, but I'm finding it so hard to orgasm. I know it's not unusual, but what do I need to do to achieve this? We try different positions. We've introduced toys. Vibrators feel nice, but I don't orgasm with them. Could this be a mental problem? Am I thinking about about it too much, or trying to hard? We have sex on an average of 2 times a week. Maybe if I can orgasm, our sexual play will increase. Can you help me?

Thank you, deprived

A: Dear Deprived,

One way to address this is to first be able to bring yourself to orgasm; then during lovemaking with your fiance, stimulate yourself before, during, and/or after intromission (insertion of the penis into the vagina) so you can have an orgasm while he's inside you.

If that doesn't work, please follow the instructions in Lonnie Barbach's book "For Yourself".


Risk of pregnancy from Oral Sex

7/6/98 Q: Hello Dr. Fitz, I am a 17 year old female. I have never engaged in intercourse but my boyfriend and I do perform oral sex on each other. One reason we haven't done intercourse is because I am so afraid of getting pregnant. Is there still a chance that I can get pregnant? Is it possible for his "come" to come inside me without his penis coming inside? If it can get inside, would it be enough to make me pregnant? I looked through your web site for an answer close to this but did not find anything. I would greatly appreciate it if you would answer my questions.

Thank you for your time, A.


Please stop to think of the mechanics. You have an egg inside you. Your reproductive system is isolated from your alimentary canal (from mouth to anus) so getting sperm in one end or the other won't cross into your vaginal opening. Your mission, if you choose to accept it, is to make sure that what comes out of his penis at any time (urine, what's called "pre-cum" which is clear, and ejaculate which is usually whitish) doesn't get into your vagina.

Sperm are heads with whipping tails that make them swim, right? They LOVE to swim upstream. If he comes on your leg, then his fingers or yours scoop up some of the liquid and that finger gets inserted inside your vagina, Bingo, any sperm on that finger start swimming up toward your egg.

The AVERAGE ejaculation contains 200 MILLION to 400 MILLION sperm. It takes only ONE to impregnate the egg (you). Sooooo, if you give your boyfriend oral sex, and he emits ANY liquid from his penis into your mouth, then you and he french kiss (whether you've swallowed or not), then he returns the favor to "go down" on you, and sticks his tongue you-know-where, all he needs is one two hundred millionth of what got into your mouth to get into his mouth to get into your vagina, and you're at risk for pregnancy. You're not 100% safe if you cover his penis with a condom. Of every 100 women who use condoms (male, not female condoms) as their sole form of birth control, 2-10 will become pregnant within one year. Condoms can slip, tear, leak, etc.

Dear "A" and other readers, men and women: Does this make sense?

Think of the mechanics of keeping what comes out of his penis from getting into her vagina, and you'll be OK. All of that having been said, please look forward to the days of being on the birth control pill so you won't have to worry about the mechanics.

I'd enjoy hearing reactions to this (above).


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Q: I have fallen madly in love with a 26 year old woman who warned me that she gets very wet during sex. That was an understatement. During her first orgasm she squirted volumes of liquid, and during the three more, later, she squirted but with less volume. What is this?

A:  The event is known as "female ejaculation" and some consider it a hoax. The sexdoc speaks with great confidence to let you know: it is very real, although a source of embarrassment and somewhat of a nuisance to deal with (wetting the bed and all). The porn star "Fallon" is known as "the little squirt" because of her feats of doing this on screen. I have a videotape with her and Ron Jeremy in which she is on top and when she comes she squirts about 10 feet across the room. Some of my patients thought that they were losing bladder control during orgasm, and while that sometimes happens, it's usually only a tablespoonful or so (Kegel exercises work wonders for women who "tinkle a little" when they sneeze or have an orgasm). If a woman has had the experience of being told to be ashamed of wetting the bed on climaxing, she will tremendously appreciate a lover who accepts this behavior as an external sign of how powerfully she experienced the climax! With bed wetting pads, towels, and a washing machine you have a little more "overhead" hassle, but a devoted and grateful lover!

Q: My boyfriend is 45 and while he gets erections during the night he is having more and more trouble maintaining an erection or having an orgasm. It used to occur only during intercourse, but now it's happening during oral sex, which always got him off before. Any suggestions?

A:  Sexual behavior is a complex series of events that are affected by psychological and physiological conditions. There is no "aging process" in sexual function per se -- sexual behavior is interfered with by other body processes failing, such as diabetes, high blood pressure, coronary heart disease, etc. If the problem is primarily medical, all the psychotherapy in the world won't correct it. In the absence of other compromising psychological factors, such as stress, anger, trust, etc., the physiological component must be assessed. I suggest that your 45-year old boyfriend have a complete check up, including a hormone assay. If that all checks out OK and you're still having the problem, see a competent sex therapist.

NOTE:  Once again, instead of quoting the essence of the question I am including the entire text because I know that many readers will appreciate the context of the question.

Q:  I have always taken longer than most women (so I am told) to achieve orgasm and find it most pleasureable being manipulated by my lover's fingers rather than by oral sex or intercourse (although I love intercourse after having an orgasm and usually have another orgasm during intercourse if I have had one previously).

I am considering getting a genital piercing to make me more responsive and orgasm more quickly. Although I enjoy immensely being stimulated for hours at a time (reaching plateaus of pleasure until finally achieving the big O), my boyfriend does not share in enjoying this activity. The few times he has agreed to do this for me the pleasure has been out of this world (while he suffers from an achy arm and hand for the rest of the week).

I know that vibrators and such are on the market (which I use by myself on occasion) for such problems, but my boyfriend doesn't like using "toys" during sex together. Any suggestions?

A: There are men who would DIE for a lover like you! You're not wishy-washy, you're not inhibited, you don't whine because you can't achieve an orgasm (and make it your lover's responsibility to "get you off"), and you're not unappreciative! I infer that you have told him, as well as me, that the pleasure those few times was out of this world. Show me a man who is not delighted with his lover's ecstacy and I will show you a selfish lover! If you offer an excellent Merlot to someone used to Boone's Farm or Thunderbird, you're going to be told that it's not sweet enough. The "problem" is not the quality of your offering; it is with the taste of the consumer! Loving your lover means doing what he or she finds to be pleasureable, so long as you don't find it to be painful (well, too painful at least), humiliating, degrading, shameful, illegal, ETC. Keeping you stimulated without him ending up with an achy arm and hand for a week is a challenge! I thought that that was precisely why God invented vibrators -- because She didn't anticipate Repetitive Stress Syndrome! He shouldn't get an achy arm -- the two of you need to determine what feels good to you for a prolonged period of time, and that doesn't cause him discomfort. If he's jealous that you can stay sexually excited for a long time, suggest that he read the books on ESO (Extended Sexual Orgasm) by Brauer and Brauer.

You are a woman who has listened to her body and who knows what feels really, really good. You're getting a steady supply of endorphins. It is known that endorphins are released during sexual activity, that endorphins are related to a sense of well being and that they strengthen the immune system. Endorphins are morphine-like in chemical structure, and tend to act as a localized anesthetic to pain points (which is why runners do not feel a bad blister until the race is over). It is women who stop getting a steady supply of endorphins who say "Not tonight, dear, I have a headache".

On the topic of genital piercing: Please err on the side of caution. Some places are not licensed or regulated, and some are run by scum bags who want the cheap thrill of looking and touching genitals. Make absolutely certain that things are sterile, and be positive that if you change your mind, that there will be minimal (acceptable to you) residual effect. Some people who have had genital piercings have reported that they were a thrill for a few months, but that they got used to the sensations after a while.

P.S. I presume that everyone knows what Merlot is (if not ask anyone familiar with fine wine). Just in case I am being obscure or out of date, Boone's Farm and Thunderbird are very cheap, nauseatingly sweet wines consumed by poor college students and winos, respectively.

Q:  I am a 30 year old woman who has never had an orgasm even though I have been sexually active half my life. I have had wonderful, caring men in my life whom I have loved, and although I get wet and intercourse is not a problem, I experience little arousal. I have never felt sexual pleasure and I don't know how to make masturbation enjoyable. I am feeling quite depressed but feel that I cannot afford professional help. Any advice?

A: If this was the realm of physical medicine, the analogy would be "I was born with a deformed elbow, and although I can dress, bathe, and eat OK, I can't play basketball or tennis like other people. I can't afford orthopedic surgery but I sure would like to function better." Dear questioner and dear reader, please note: Some problems need face to face differential diagnosis and probably some form of intervention as treatment. The best self-help is reading Lonnie Barbach's book "For Yourself", doing every exercise no matter how simple it seems, and using a strong vibrator, making sure to vary the location so the touched part doesn't get numb from over-stimulation. If that doesn't work, a work-up by a good, sensitive medical doctor including a hormone assay would be in order. What amazes the sexdoc is that people go through life until the age of 30 (or older) without getting help for problems like this! The quality of life of people who are sexually active (starting when they are emotionally able to handle it) is remarkably superior to those who are asexual. Please don't suffer in silence! There is help out there!

Q:  How can I reassure my boyfriend that the size of his penis is O.K. with me? All his life he has had difficulty with a penis that is less than average. I have told him repeatedly that it doesn't matter and I love hin just the way he is. It has gotten so bad that now he can't perform sexually. I've tried everything and nothing seems to work. What can I do?

A: Show your love for him by demanding that he seek professional help! If you have literally done everything, there is nothing left that you can do -- so somebody else will have to step in and intervene. Make it clear that being sexual with him is very important to you, and that if he denies you that aspect of your relationship that you will have to reconsider the relationship itself. Shake him up with threats to leave because he's frozen in inaction. Make it crystal clear that you don't want to leave him because of his penis size; you want to be sexual with someone you love and if he can't get beyond his penis size for you, you'll have to find someone who can accept reality.

The sad truth is that it might just take your leaving to jolt him out of the pity pot rut he's in.

Q:  I am 35, married for 11 years, three kids, wife has put on a lot of weight, she is uninterested in sex for 5 years now, I'm having an affair with a woman who likes sex the way I do (1-2 hours of foreplay; wide variations in sexual activity), and now I'm starting to have problems attaining or maintaining an erection when I have sex with my wife. No problems (yet) with my lover, but I'm beginning to worry that I might. My questions are: 1) how do I solve the erection problem with my wife, and 2) how do I prevent creating erection problems with my lover?

A:  Every now and then along comes a question that cannot be answered without controversy. I have been around long enough to know that no matter what I say here about what "ought" to be done somebody's nose will be out of joint. And if I highlight the issues and call upon individual judgment calls, someone will accuse me of ducking responsibilities. This is one of those cases where I say "Five into four won't go". Religiosity, American puritanism, and talk show publicity (presidential hypocrisy notwithstanding) all condemn adultery, and at some level of consciousness this gets addressed even if only by rationalization. If there weren't some sense of worng, there wouldn't be a need for justifying it! It's hard to bring them back to the farm after they've seen the lights of the big city! While this could be totally coincidental (I doubt it), I suspect that at least dissatisfaction, and at most, guilt, has kicked in to interfere with erectile functioning. Once your penis and your brain have been spoiled (read "lavished")  by all the extra excitement that comes with a new woman, doing something "naughty", and only when arrangeable (not freely available whenever), it's difficult to get excited doing the same-old-same-old. Your penis is just confirming that fact.

If the strongest hypothesis is "dissatisfaction causes erection problems with wife" and "guilt causes problems (at least worrying that there might be a problem) with lover", than how elegant a solution if you actually began to have erection problems with your lover! If that interrupted the extra-marital sex (lover dissatisfied with you?), you'd be back to investing effort into making your sex life with your wife more fulfilling.

This is also the kind of problem that is best solved "upstream". You ask what you should do when you're in the only life boat, and it has a hole in it. The answer is to make sure that the big boat was more sea worthy, or that you didn't sail too close to the rocks, or that you made sure you had a reliable life boat. In this case, I would ask why your wife put on weight, and why you did not appeal to psychotherapy alone or with your wife to work an a solution within the marriage.

To come full circle, however, and I think that all of the above had to be said first, the "solutions" to your problems are to create ways for sex between you and your wife to be more exciting, and to rid yourself of guilt over sex with your extra-marital lover (if that is possible). Complicated situations like this are the daily fare for competent sex and marital therapists. You can't see your forest for the trees. Seek professional help that can help you with this.

Q: I am a 31 year old female who had a botched attempt at intercourse at 19. I was always afraid of sex and thought of the act as revolting and unappealing. I have not dated until several months ago. Recently I have tried to masturbate but whether by my fingers, a vibrator, or my boyfriend's stimulation the feelings become too intense and I can't tolerate it any more. My boyfriend feels like he is failing me; we would like to share orgasm during love making. What can I do?

A: The human interplay of body and mind is an amazing thing, and it adapts and conforms to achieve a harmonious integration of belief and action where possible. When the sexdoc hears of this circumstance, all kinds of possibilities get triggered. While there are many reasons why people deny their sexuality, the net effect is that they seal off this part of their life. In the same way that riding a bicycle becomes second nature and you don't have to think about each aspect of balance and velocity, your mind attempts to accommodate your body if the behavior is to ignore sexuality. That's exactly why the expression "use it or lose it" is operative in sexual functioning.

At all ages, the best predictor of sexual activity during the next 12 months is the level of sexual activity during the previous 12 months. This is dramatically illustrated by folks 35+ years of age who, for any of a number of reasons, drastically reduce their frequency of orgasm. Several years later, attempts to resume earlier levels of sexual functioning are hampered by various roadblocks. The proof of this is that folks whose primary relationship is no longer available for frequency of orgasm (by termination of the relationship or by illness), who maintain that frequency in alternative ways, whether by self pleasure or with another partner, have remarkably fewer sexual problems when they wish to once again re-engage in sexual activity with a new partner.

So years ago you asked your body to adapt to your mind's conviction that sex was to be feared and that the act was revolting, and your body served you very well, re-interpreting sexual feelings, whether neurological or emotional, as something different -- successfully avoiding fear and revulsion. It would be nice if you had been in a form of sexual "suspended animation", because then you could be a delayed adolescent starting fresh. But alas, you will have to back out of the blind alley, unlearn the connections you have so diligently cemented over the years, and then learn new interpretations for feelings. I suspect that when you feel the feelings become "too intense" that that is a combination of a flood of nerve signals, coupled with emotional confusion.

The self-help approach would be for you to go through Lonnie Barbach's "For Yourself" (paperback book) exercises, followed by you and your boyfriend to go through each step of the ESO books by Brauer and Brauer. That might do it. But if you find that you're not making progress, you would be well advised to get into competent sex therapy, so that what you are rehearsing (if you are stagnant) doesn't also get fixed as a maladaptive behavior pattern. Never lose sight of the idea that you deserve a happy, healthy, satisfying, and pleasureable sex life!

Q:  Can a man have an orgasm from anal sex alone?

A:  As with other questions of this nature I will reply on the page devoted to anal sex.

Q:  My girlfriend and I are both 18; we have been dating steadily for 2 years. We are both virgins. When I'm with her everything is great, but when I'm not, I am attracted to other women and think about having a relationship with them. I feel like I have missed out on being a bachelor. I want my steady girlfriend but I want experiences with other women, too. Is this common?

A:  Aye, there's the rub. What you are feeling is universal -- wanting your steady relationship but wanting to know what it is like being with other women. With the prefacing comment that I am ignoring religious beliefs and speaking only from a perspective of psychodynamics, please consider the following: I expect you to sample a number of women to assess your emotional compatibility with them. Surely you would agree that you need to know the relationship between your intelligence and that of a potential spouse. Brain surgeons and ditch diggers do not make a good marital match. In the same sense, if you and your betrothed marry as virgins, and find that you are seriously mis-matched physically (sports, camping, sex, etc.), that will be a potential problem in your relationship.

While there are always exceptions to the rule, I have found that people who have refined their tastes by experience with a potential spouse in the realms of intellectual, emotional and physical attributes are in the best position to propose marriage with informed sincerity. While you might fall in love with your first car, there are other models out there, and before you buy one, you would be well advised to check under the hood (see how it performs where it counts) than be smitten only with its looks. You can't have "missed out" on being a bachelor -- you're only 18 and dated one woman for 2 years! Both you and your girlfriend would benefit from experience with other people. I'm not saying that double-virgin marriages are doomed to failure! I'm proposing that you will make the best decision when you have more complete information.

Q: Is a pleasureable response to internal prostate stimulation a sign of being homosexual?

A: Please see the answer (and the longer question) on the page devoted to anal sex.

Q: It seems that more and more girls are shaving their genitals totally bald. I was wondering if this is my imagination. How should I go about shaving my girlfriend?

A: VERY CAREFULLY! How would you know if more and more, etc.? Where is this survey published? Yes, it probably is your imagination -- and what a wonderful fantasy. Every woman you see you can not only disrobe mentally, but imagine her shaved genitals as well! Congratulations on a vivid imagination. In regard to shaving your girlfriend, I suggest an electric razor. I have had numerous women describe the ecstasy of a vibrating electric shaver shearing their nether hair, followed by the agony during the following days and weeks of the itch from the hair growing back (to say nothing of the prickly stabs of lovers' body parts during that time). Use of a straight edge or safety razor should be left to the professionals. (An A+ to the first person who e-mails me with the correct definition of a "Merkin Barber")

Q:  I am 24 and female in a serious relationship with a man for 18 months, the last 10 of which we have lived together. Our sexual activity has dwindled from 5-6 times per week during the first 9 months to once every 2 weeks in the last 6 months. I still find him attractive and I get horny but I can't bear the thought of him touching me or looking at my naked body. HELP!

A: Some things cannot be solved by the parties involved, which justifies effective therapy. This is more common than I am comfortable with, but there are therapeutic protocols that are effective in a vast majority of the time to deal with this circumstance. Please keep in mind that the longer this goes on, the more solidified it becomes, and therefore, the longer it will take to respond to intervention. There are many roads to this place and it would be potentially misleading to attempt to catalogue all of them here. I encourage you to search meticulously for anything that might have happened after the nine months. Such "dividing line events" can be therapeutic gold mines!

Dear Reader: Please compare this Q/A with the next one

Q:  I am a 20 year old male college student engaged for 2 years to a 20 year old female college student. I knew she had a problem with intimacy and I thought I could deal with it, but I was wrong. She is a virgin; I have been with 2 other people. She has a thing about touching me even when we are naked showering. On rare occasions she will let me rub her using my finger for masturbation [I never go inside; she says it hurts unless she is lying on her side(?)]. She still has a problem kissing me. She refuses to take the initiative and seek help. She swears she can deal with it on her own. Is there anything I can do?

A:  While infrequent sexual contact and apparent lack of female attraction to her partner are in common between this question and the one above, the essential difference is sexual experience. While both women might have a fear of intimacy, it is complicated here by this 20 year old female's lack of experience. If she internalized messages such as "nice girls don't" and "you've got to be a virgin when you marry", she might experience significant anxiety and confusion over the conflict between what she believes (or has been told to believe) and what she feels. I suspect that she has no idea of sexual limits. If mutual petting to orgasm is OK but "going all the way" is not, you can have sexual pleasure and pleasure someone else, but know where to draw the line. If you believe that the first "transgression" pushes you over the slippery slope to hell, you better not take even the first step -- and God forbid, enjoy it! What can the author of the question do? He can tell his fiance that he loves her so much that he absolutely insists that she seek help. She has an emotional "broken leg". If the two of you were skiing, and she broke her leg, would you passively accept it if she insisted that she didn't need help? What is going on between you right now is potentially fatal to your relationship. If she still refuses to seek help, you will have to decide if you are willing to watch someone in such emotional anguish or emptiness and conflict.

Q:  I am an 18 year old girl living in Canada. My boyfriend lives in France. We met on the internet. We have been together in person twice in a year. For me the sex went too fast. Last week we had cybersex and I got a stomach ache. I know I'm going to hurt him if I tell him I don't want to do sex any more. He says he needs to feel my body and that he was feeling like I did not love that side of him when I told him I didn't want to do it. Sometimes I feel like we do not understand each other too well. How can I tell him about this and not make him feel guilty?

A:  Each person owns his or her body and deserves to exercise the right over behavior. The problem is that most people want to be popular, loved, respected, and affectionate, and people will trade one commodity for another. Sexually, most people regret action more than caution. The sexdoc is hard pressed to believe that sufficient compatibility intellectually, emotionally, and physically could have been achieved over the internet and during meetings in person twice in one year for you to have concluded that this is a man you are willing to be sexual with. This is not prudish -- this is an attempt to encourage you to consider how you think you will feel three months and three years from now. Your question is full of signals that you are not ready for this yet. Slow down! Get some experience with guys who are not GU (geographically unacceptable).

A rule of thumb for assessing manipulation: If someone truly cares about you and wants to be sexually intimate with you, he or she is considerate of your feelings. If your feelings dictate more cautious sexual behavior, your significant other ("SO") is entitled to disappointment and can choose whether to stay in a relationship that has less sex than he or she wants. If your SO persists to ignore your wishes and tries to force sex, either by emotional blackmail, or by physical force, he or she is manipulating you to achieve the behavior he or she wants. Ask yourself how you think you will feel in three weeks and three months if you yield to the manipulation. To state it in the reverse, if someone wants to be sexual with you without being considerate of your feelings, then they are less than loving and they are selfishly putting their desires ahead of yours. You deserve better!

Q: What can I do when his penis is too large for me (or I'm too small) and causes pain and bleeding from intercourse?

A:  Penises come in a very wide range of sizes -- both length and girth (size around). Vaginas, while approximately proportionate to the size of the woman, are quite elastic, as is the opening through which the penis must pass to get into the vagina. BUT:  There are limits. Please consider individual differences. Some people are taller, others are tiny, some have big noses (NO BODY PART OF A MAN IS AN INDICATION OF THE SIZE OF HIS PENIS!) etc. In the same way, there are men and women who are mis-matched sexually in regard to penis/vagina. Pain and bleeding from intercourse can easily happen if there is not enough lubrication and/or if dilation is too rapid. If your labia and his penis are really, really slippery, either from your biological lubrication from the vagina or by a store-bought product, and if the opening to the vagina is slowly expanded (dilated), and if you're positive that you're inserting the penis in the right place, and you still have pain and bleeding, you just don't match up size-wise. Sorry about that.

Q: Is it true that women who are overweight do not enjoy intercourse as much as thinner women?

A: The sexdoc is not afraid to answer any question. The predominant dimensions here are mechanics and self concept. People who are overweight to the extent that it interferes with the depth of penile thrusting sometimes report less satisfaction. People who are not aerobically fit, some of whom are overweight, often report less satisfaction in sexual behavior. If the overweight is associated with emotional compensation, then the emotional factors would likely cause both the food compensation and a sense of personal dissatisfaction with self, of which sexuality is an integral part for many people. That having been said, read on: The sexdoc has known men and women, both personally and professionally, who are well in touch with their hedonic sides (look that up in your Funk & Wagnalls!), and whose passion for life includes music, food, sex, and fine wine. Many are connoisseurs of all, but some extra pounds are more visible than the ambiguous Cheshire-cat grin caused by wild, crazy, wonderful, highly-varied, and frequent sex. The moral of the story is that it is misleading to generalize.

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