Sex is a subject that provokes considerable curiosity and interest. Unfortunately, it is also surrounded by many myths and misconceptions that often lead to needless anxiety.
The best approach to solving most sexual problems is an understanding, by both partners, how male and female reproductive systems work, and a willingness to talk openly and honestly.
It's as simple as that!
Authors and broadcasters have made themselves rich by producing an exhaustive supply of media on sex-related subjects.
Much of this is preoccupied with the importance of achieving orgasm and places too much emphasis on the purely physical aspect of sex.
Openness about sex encourages people to discuss problems, which previously have been kept secret. Although mainly beneficial, it can be harmful if the person's fears are exaggerated by unrealistic expectations from sex.
It's estimated that 50% of couples suffer some form of sexual problem some time in their relationship.
Nearly everybody has occasional worries about sexual performance. Usually it's psychological and due to a simple lack of communication or misunderstanding.
Many problems occur simply because the partners cannot openly communicate their feelings or desires.
It's such a provocative subject (especially for the male ego), partners often find it very difficult to discuss sexual matters in the bedroom.
'Good lovers' aren't born, it takes time and practice. Unless you're fortunate enough to be psychic, the only way to find out what your partner likes and dislikes, is by asking them.
Vague experimentation can be a turn-off, or even painful to your partner, so ask the vital question: "what do you want me to do, what do you like?"
Striving to perform better sexually will not help. Striving to have a better relationship and talk more openly will.
A better relationship comes from better understanding of each other and one anothers' sexual needs.
You can start by trying to reduce anxiety and embarrassment of bedroom encounters by openly talking, even crack a joke to 'break the ice'.
Sex is an intimate sharing, physically and emotionally, but there is no reason why it cannot be relaxed and fun!
Your partner is probably just as anxious, and breaking the ice will work wonders. Sex with someone new for the first time is always clumsy, everyone is different and you'll have to adjust to their likes and dislikes.
A frank discussion is therefore essential. It may not be appropriate on the first occasion, but soon afterwards.
COUNSELLING
Sex counselling may take different forms. Many family doctors are experienced in dealing with common forms of sexual difficulty, so see them first. You may then be referred to a specialist sex counsellor.
All forms of sexual difficulty have an improved success rate if both partners attend counselling. Often sex counselling is the first time couples talk frankly about their sexual feelings and this simple process often solves the problems by overcoming misunderstandings and reducing anxiety.
SEX IN LATER LIFE
Men peak sexually in late teens and early 20's. During intercourse, they reach orgasm rapidly, ejaculate powerfully and are able to have another erection quickly.
As a man gets older, more stimulation may be necessary to achieve erection (which may not be as stiff as in the past), and ejaculation may be delayed. A second erection may take longer.
However, there is absolutely no reason why both sexes shouldn't enjoy a healthy sex life well into old age. In fact, many people find sexual activity becomes more enjoyable with increased experience and confidence.
If you have problems, discuss your feelings with your partner and experiment with different forms of sexual contact (e.g. mutual stimulation, oral sex).
WHAT IS AN ORGASM?
Male Orgasm
Muscular contraction in penis causes ejaculation of semen, accompanied by intense pleasurable sensation.
Female Orgasm
Walls of outer vagina contract rhythmically and strongly several times and intense sensual feeling spreads from clitoris through body.
On average, an orgasm lasts 3-10 seconds, but may last up to 1min in some women (which may be followed immediately by another).
Generally, women take longer to reach orgasm (about 13mins), compared with less than 3mins for a man.
The female orgasm may be attained by stimulation (massaging) the vagina and/or clitoris. Generally, a clitoral orgasm is easier to achieve.
SEXUAL AROUSAL
Sexual arousal generally progresses in 3 stages and these stages are remarkably similar for men and women.
Arousal is heightened by the imagination, bodily contact and deliberate physical stimulation of sex organs.
Stage 1 normally coincides with commencement of foreplay, and stage 3 with reaching orgasm:
Stage 1
Large increase in flow of blood into sex organs.
° Men - Penis enlarges, lifts and hardens into erection.
° Women - Vagina swells, clitoris (penis equivalent) becomes erect and very sensitive. Vagina walls enlarge and release clear lubricating fluid inside and at opening.
Stage 2
Heartbeat and breathing quicken, pupils dilate.
° Men - Penis enters vagina, thrusting in and out begins, penis reaches maximum size, testicles lift.
° Women - Muscular contractions of vagina help grip penis. Uterus rises, clitoris pulls back beneath hood of skin. Breasts may become sensitive and enlarged.
Stage 3
° Men - Muscular contraction in penis causes ejaculation of semen, accompanied by extremely erotic pleasurable sensations.
° Women - Walls of outer vagina contract rhythmically and strongly several times, and intense erotic pleasurable sensations spread from clitoris through body.
RECOVERY PERIOD
° Men - Penis returns to half erect and testicles descend. The length of time before a second erection varies from minutes to hours (generally dependent on age).
° Women - Clitoris subsides and gradually vagina relaxes and uterus falls. Women often remain fully aroused and may be capable of a series of orgasms.
SEXUAL AIDS
A multitude of unproven sex aids are available to assist erection and stimulate the vagina.
Some drugs and extracts of herbs are sold as aphrodisiacs, but have no credible influence.
Useful drugs, which may improve sex-drive, must be prescribed by your doctor.
MASTURBATION
Usually achieved by hand massaging the male penis or female clitoris. Masturbation is now generally accepted as perfectly normal, at least by the medical fraternity.
It's estimated over 90% of men and 65% of women masturbate at some time. There is no medical evidence to suggest masturbation has any harmful effect on health.
Despite this, myths abound regarding the consequences of masturbating (causes blindness, insanity, etc.).
You may never wish to indulge in masturbation or believe it's wrong, but for many people, it helps their enjoyment of sex.
For many people, masturbation provides a means of learning which sexual stimulus is best suited to them.
With this knowledge, they can work with their partner and build a rewarding sexual relationship. For others, masturbation is simply a harmless relief from sexual tension.
In adolescence, it enhances understanding of bodily responses, improving satisfaction and success rate of, what is important to everyone, the initial sexual experience.
SEXUAL ANXIETY
The major area of ignorance that causes sexual anxiety in many men is the belief that the quality of sexuality should be measured in terms of size or hardness of a man's penis.
Naturally, there are fundamental physical requirements, but beyond these, it is the relationship between the couples which matters.
Additional male anxiety may be due to fear of: Premature ejaculation, making partner pregnant, catching sexually transmitted disease. Usually however, this is only temporary.
The ability to communicate with your partner is essential. Some common male anxieties may be completely unfounded - e.g. assumption your partner requires delayed ejaculation, or a long-lasting erection.
She may prefer other forms of stimulation, such as oral sex. Once you understand what your partner prefers (and you'll only do this by asking), fulfilling sex, without anxiety, is much easier.
If you're experiencing difficulties with your partner, you might try the following exercise which was pioneered by the American doctors, Master and Johnson:
° The 'sensate focus theory' involves a couple exploring each others' bodies by caressing and then preceding, in stages, to the sex organs.
° The process concentrates on rediscovering erotic feelings through touch (heightening sexual responsiveness).
° By initially prohibiting full sexual activity, the therapy removes anxiety about performance and helps overcome inhibitions and tensions.
Sensate Focus Technique
° Each partner agrees to abstain from intercourse for 3 weeks
° Set aside 3 evenings/week (or any convenient time), when you can be alone together without interruption for at least 2hrs
° Each partner should take it in turns to massage the other (best done if both partners are naked)
° Massage should involve gentle exploration of partner's body, avoiding genital areas and breasts
Concentrate on pleasure from being touched/touching. Having overcome any awkwardness and when finding enjoyment from the experience (this may take several days) move onto the next stage.
Continue massaging, but include genital regions and breasts so sexual stimulation is felt in context with other body sensations.
Soon after this stage, you should be ready to resume full intercourse. You should find the process more relaxed and begin to enjoy the full range of physical and emotional sexual feelings.
DELAYED EJACULATION
Some men can only achieve ejaculation by masturbation or during foreplay. Common causes include:
° Habitual effect of practising withdrawal technique as a method of contraception
° Medications (particularly anti-depressants and anti-anxiety drugs)
° Inability to 'let go' emotionally
° Anxiety about sex and ability to satisfy
° Natural causes (if aged 50+)
° Lack of sexual desire
° Stress
As with all sexual problems, a frank discussion is essential.
The 'Sensate Focus Technique' may be used successfully (see 'Sexual Anxiety' section). It's important to ensure the female partner doesn't feel rejection.
If you can masturbate successfully, ask your partner to stimulate you by hand, before entering the vagina.
IMPOTENCE
An inability to achieve or maintain erection. Sexual arousal normally leads to erection in the man (see 'Sex, The Facts, Arousal' section).
Failure to achieve an erection, or inability to maintain it, is a common sexual problem, and affects most men at some time in their lives.
It can happen after a few sexual failures and cause increasing anxiety, which makes the problem worse. The female partner may feel rejection.
As with all sexual problems, a frank discussion is essential. The 'Sensate Focus Technique' may be used successfully (see 'Sexual Anxiety' section).
WOMEN - LUBRICATION
Lack of lubrication can be a sign of failure to be sexually aroused, or losing arousal. Non-lubrication of the vagina is sometimes a cause of painful intercourse. If in doubt, seek medical advise.
Vaginismus is a condition where the vaginal muscles contract, preventing penetration by the penis. It is usually caused by a fear of being hurt, or a form of sex-guilt.
As with all sexual problems, a frank discussion is essential. The 'Sensate Focus Technique' may be used successfully (see 'Sexual Anxiety' section).
PREMATURE EJACULATION
By far, the commonest form of sexual problem. Ejaculation occurs almost immediately upon entering the vagina, or even before.
For most men, it is not a lasting problem and occurs in times of stress, the excitement and anxiety of a new partner, and with sexually inexperienced men.
Habitual 'quick' sex can also cause premature ejaculation.
It's not uncommon to experience premature ejaculation occasionally, but becomes a problem if it persists and your partner becomes frustrated by curtailment of sexual intercourse.
Anxiety tends to make the problem worse. However, premature ejaculation can usually be overcome. All young men have difficulty controlling orgasm during initial sexual experiences.
It normally becomes more controllable with time and experience. A second orgasm is much delayed, so try intercourse again 15-30mins after your first orgasm.
Alternatively, shortly before intercourse, you may wish to masturbate to orgasm. Not only will this delay your next orgasm, but also reduce sexual anxiety.
Using a condom, may dull the sensitivity of the penis and so delay ejaculation (it also provides excellent contraception and good protection against sexually transmitted diseases and AIDS).
Discuss the problem with your partner and experiment with the 'Squeeze Technique:'
The Squeeze Technique
A commonly used method to help a man control orgasm. It teaches both partners to recognise the sensations immediately preceding ejaculation:
° Both adopt a comfortable position
° The woman caresses the penis until full erection
° Continues caressing until the man is close to orgasm
° Just prior to ejaculation, man signals the woman, who then stops stimulating and grips the glans of the penis until erection subsides
° After about 1-2mins, your partner can start again
° Repeat process 2-3 times, before allowing ejaculation
With practice, the woman will soon sense when the man is close to orgasm. After a few sessions, when both have gained confidence about controlling ejaculation, it is possible to move onto the next stage:
° Man lies on his back, partner astride and erect penis in vagina
° Hold position, without moving, as long as possible
° If the man is ready to ejaculate, the woman lifts herself away and applies the squeeze grip as before
° Repeat this 2-3 times
After a few sessions, when control has improved, normal full intercourse can be attempted, with both partners reaching orgasm.
You may find that sexual positions with the female partner on top, are easier. If at any time the man feels ready to ejaculate, before his partner is ready, she can use the 'squeeze technique.'
LOW SEX DRIVE
The desire for sex, or libido, varies greatly between individual men and women. Libido, can be influenced by physical, social and psychological factors.
It may be excited by the availability of the desired person, or by an opportunity for sex. Soft lights and music really does stimulate sex-drive! Good sex and sex-drive feed on themselves; conversely, disappointment reduces desire.
Probably the most common cause of loss of libido is when excitement and novelty of a long term relationship wains.
In this case, talk to your partner and make sure there is no misunderstanding. If you've recently started a family, you might be neglecting each other in favour of the children.
Any offspring should provide focus of your lives together, but not at the expense of your own relationship.
Your child's happiness will be largely affected by the success of your relationship. If your relationship is basically sound in every other way, inject new life and variety.
Try going away together for a weekend, or buy some sex manuals and experiment with new positions and approaches to sex. Common causes of loss of sex-drive include:
° Regular consumption of large amounts of alcohol (possibly leading to impotence)
° Certain drugs, particularly diuretics, anti-depressants, and anti-anxiety drugs (temporary effect)
° Discontentment with current partner
° Existing sexual problems
Whatever the cause, it's important to talk it over with your partner so they don't feel rejected. You'll probably both agree there is little point of intercourse attempted out of duty.
A sexual problem may subconsciously make you feel you do not desire sex. When the underlying problem is solved, sex-drive usually returns to normal.
Libido may be affected by levels of sex hormone. If very low, one is unlikely to be interested in sex and find sexual arousal difficult.
Other symptoms include loss of hair and underdeveloped genitalia. This is a medical condition and should be treated by a doctor.
WOMEN - REACHING ORGASM
Many women never experience an orgasm, yet enjoy sexual experiences. Common causes of difficulties include:
° Bad relationship (uncertain about partner)
° Not receiving enough stimulation (selfish partner, or insensitive love-making technique)
° Not allowing enough stimulation from partner
° Fear of pregnancy
° Painful intercourse (usually lack of lubrication)
° Guilt feelings about own body or sexual pleasure
° Fear of losing control during orgasm (because of lack of sexual experience and inability to relax)
It is estimated 30-50% of women experience difficulty with orgasm some time in their life (10-15% are simply unable to achieve orgasm).
As with all sexual problems, a frank discussion is essential. The 'Sensate Focus Technique' may be used successfully (see 'Sexual Anxiety' section).
Here are two simple tips which may overcome lack of orgasm:
° Concentrate stimulation and massaging on the clitoris, rather than vagina
° Tone up and tighten the vaginal muscles (this can be done by interrupting the stream of urine with your muscles 4/5 times every time you urinate)
WOMEN - PAINFUL INTERCOURSE
Pain in the vagina when the penis penetrates, or during or after sexual intercourse is not uncommon and may be due to emotional or physical reasons.
Whatever the cause, see your doctor since painful sex may affect sexual desire permanently.
Common causes include:
° Soreness from childbirth (may last up to 6 weeks)
° Vaginal infection (see 'General Problems - Women' section)
° Lack of lubrication (see 'Women - Lubrication' section)
° Anxiety (see 'Sexual Anxiety' section)
° Menopause (see 'General Problems - Women' section)
° Bruising and general soreness (over-enthusiastic sex)
Most treatments for these causes are covered in other sections. Some other common reasons for pain may include deep penetration (try another position) and very frequent sex (stop for a few days).
Whatever your problem, seek medical advice to eliminate the possibility of any underlying serious condition.
