Category Archives: Sex Therapy

Fear of Sex, Lasting Longer, Performance Anxiety, Preorgasmic Women, Sensate Focus

Female Sexual Dysfunction Is A Fictional Disorder

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Name: Sharon
Gender: female
Age: 30
Location: PA
I’ve been reading a lot lately about FSD, or female sexual dysfunction. Is there such at thing? It strikes me as a fictitious “ailment” that is being promulgated to sell pharmaceuticals to unsuspecting women. What are your thoughts?

I share your skepticism. I think that, for the most part, female sexual dysfunction, or FSD, is a fictional disorder. I also think pharmaceutical companies are trying to hit on a female version of Viagra to treat this imaginary disorder so they can make a bundle, just like they did with as the male version.

body as art

So much of female sexuality is caught up with the cultural context of a women’s role in society — family obligations, body image and patriarchal views of marriage, etc. For the most part, men aren’t nearly so encumbered. So when one talks about female sexuality, particularly when the notion of a condition or a disorder arises; ya gotta ask yourself, what’s going on here?

I too have been noticing a lot of discussion in the popular culture lately about female sexual dysfunction. My first response is to ask myself, who’s raising the issue and why? Sure some women, like some men, experience difficulties in terms of desire, arousal and orgasm, but what of it? Is it a syndrome? Is it really a dysfunction? I personally don’t think so. The sexual difficulties most people experience can be explained and dealt with in a less dramatic way then with drugs?

And here’s an interesting phenomenon; the repeated appearance of the term female sexual dysfunction in the media lately actually gives the concept legitimacy. I’m certain the pharmaceutical industry is hoping that it will. If they can make the connection in the public mind between what women experience in terms of desire, arousal and orgasm concerns and what men describe as erectile dysfunction, then most of the work is done. In other words, I think the entire effort is a marketing ploy.

female sxualityI think we can safely say that, in order to determine what female sexual dysfunction might be, one has to clearly understand what a “normal” sexual response is for a woman. This is where we traditionally run into problems. Sex science is notoriously lacking in this endeavor. One thing for certain, although both women and men have a discernable sexual response cycle, a woman’s sexual response is not the same as a man’s. Even though we can’t say with certainty what “normal” is, therapists are famous for turning difficulties into disorders. And once you have a disorder it becomes the basis for developing a drug therapy. So you can see how this becomes a self-fulfilling prophecy.

Currently there’s a real buzz among clinicians concerning the efficacy of Addyi, the so-called “female Viagra”. But most sexologists, myself included, are unimpressed. Basically, the drug in question is an antidepressant. When I heard that, red flags began to fly. Antidepressants are notorious for their adverse side effects, especially in terms of sexual arousal in both men and women. The second problem with the study was the whole notion of desire and distress. Lots of women experience diminished sexual arousal but are not distressed by it. But if there’s no distress, clinically speaking, then it can’t be considered a disorder. You see where I’m going with this, right? If there’s not a “disorder” there’s no need for a pharmaceutical intervention.FUCK

According to the research some of the women in the clinical studies leading up to the approval of the drug claimed they were less distressed by their “condition,” Hypoactive Sexual Desire Disorder, than they were at the beginning of the study. According to clinical trials of Addyi held in 2013, only 8% – 13% of the women experienced “much improved” sexual desire and only about 2 more satisfying sexual encounters per month were had. In other words, when behaviors were studied, the actual number of satisfying sexual episodes reported by these less distressed women hardly changed of all. This indicates to me that the antidepressant helped lift the spirits of the distressed women, but did nothing to increase their satisfaction with their sexual outlet.

Twice the FDA rejected Addyi for its severe side effects and marginal ability to produce the effect that it is being marketed for. And despite the fact that the drug is now available, those side effects still exist. Women who take the pill are likely to experience dizziness, nausea, drowsiness, fainting spells, and falling blood pressure. Coupled with alcohol and even hormonal contraceptives the odds of these potential side effects occurring increase. Persons with liver ailments, or taking certain other medicines, such as types of steroids are also at higher risk. On the other hand Viagra has very mild side effects that may include headaches, indigestion, blue-tinted vision and in some cases a stuffy nose.

While a man can pop Viagra an hour or so before he plans to have sex, women who are looking for increased sexual desire need to take Addyi daily for up to a month before they should expect to see any effects.

Good luck

A Poisonous Relationship

Name: Clare
Gender: Female
Age: 40
Location: St Louis
My best friend can’t bring herself to sever her ties with her ex-boyfriend. Even though their last attempted reunion ended in a very violent fight. My friend has this weird nostalgia for the relationship she had with her ex at the beginning. Back then, before he started drinking and drugging, they did have a couple of good years, but that was a long time ago. I’m very concerned for my friend. She’s often depressed and she is pulling away from her friends. I think she is seriously considering getting back with her no-good, two-timing ex. I know that my role as a friend is to love and support her, but her ex is not to be trusted. I fear as much for her safety as for her heart. What’s a friend to do?

So many things are going on here, Clare. It’s hard to know where to begin. Your friend can’t sever her ties with her ex because she doesn’t want to. Even if she wanted to end it once and for all, it’s not an easy thing to do.

Anyone who has been there will tell ya that quitin’ a bad relationship is as difficult as quitin’ booze or dope…maybe even harder. Most folks in poisonous relationships can’t extricate themselves because they are part of the toxicity. Bad relationships, like the good ones, are completely dependent on the participation of both individuals in the couple. Each one feeds off the other and each one’s bad behaviors rewards and facilitates the pathologies of the other.

crying girl

There is no such thing as a good, psychologically healthy person in a bad relationship. There may be one in the couple that is less culpable, or less abusive, or less self-destructive, but there is never one that is without blame.

Like all junkies, your friend is hooked. Her depression and withdrawal are outward signs of the pathology. Nothing is gonna change this for her until she acknowledges that she is caught in a downward spiral. Domestic violence — and we ought to label the nature of your friend’s relationship for what it is — will escalate. It always does. Will your friend get out in time? There’s no guarantee. Is there anything you can do? Well that, Clare, is a more difficult question to answer. If you do too much you are at risk of supporting her habit. Or worse, you could be co-opted into the pathological dynamic of the relationship.

The best you can do is to tell your friend how you feel about her predicament. Speak your mind in no uncertain terms. If you decide to confront your friend with an intervention, I suggest that you have some well-considered resources to hand her while you are doing so. For example, you could do some legwork and find some local domestic violence resources — a hot line, a shelter, counseling referrals and the like. Once you make this intervention and it’s over, drop it. Drop it for good. This is the hardest thing a friend has to do, but constantly badgering someone in your friend’s condition is counterproductive. If you can’t stand to witness the self-destruction, take your leave of the friendship and hope for the best.

However you play this, don’t hold your breath for a happy ending. They happen sometime, of course, but real life is so not like the movies.

Good luck

What Happens To Men Who Stay Abstinent Until Marriage?

by Sarah Diefendorf

Russell Wilson and his girlfriend Ciara

Seattle Seahawks quarterback Russell Wilson and his girlfriend Ciara arrive at a White House State Dinner in April.

Seattle Seahawks quarterback Russell Wilson and his girlfriend, the singer Ciara, recently announced plans to remain sexually abstinent until marriage.

It was a vow that came as a surprise to many. After all, sexual purity is a commitment that is historically expected of, associated with – even demanded of – women. However, sexual abstinence is not something assumed of men, especially men like Russell Wilson.

Wilson, an accomplished, attractive athlete, embodies contemporary ideals of masculinity, which include style, wealth and, yes, sexual prowess.

So how does a man like Russell Wilson navigate a commitment to abstinence while upholding ideals of masculinity? Wilson’s status as an athlete and heartthrob is likely giving him what sociologist CJ Pascoe calls “jock insurance.” In other words, due to his celebrity status, he can make traditionally nonmasculine choices without having his masculinity questioned.

But what does it mean for a man who isn’t in the limelight, who makes a similar type of commitment to abstinence? And what does it mean for the women they date, and might eventually marry?

I’ve been researching men who pledge sexual abstinence since 2008, work that comes out of a larger scholarly interest in masculinities, religion and sex education.

While men make this commitment with the good intentions for a fulfilling marriage and sex life, my research indicates that the beliefs about sexuality and gender that come hand in hand with these pledges of abstinence do not necessarily make for an easy transition to a married sexual life.

Who’s Pledging “Purity?”

Comedian Joy Behar recently joked that abstinence is what you do after you’ve been married for a long time. Here, Behar makes two assumptions. One is that sexual activity declines both with age and the time spent in a relationship. This is true.

The second is that abstinence is not something you do before marriage. For the most part, this is true as well: by age 21, 85% of men and 81% of women in the United States have engaged in sexual intercourse.

purity ringIf we compare these numbers to the average age of first marriage in the United States – 27 for women, and 29 for men – we get the picture: most people are having sex before marriage.

Still, some in the United States are making “virginity pledges,” and commit to abstinence until marriage. Most of the data that exist on this practice show that those who make the pledges will do so in high school, often by either signing a pledge card or donning a purity ring.

Research on this population tells us a few things: that those who pledge are more likely to be young women, and that – regardless of gender – an abstinence pledge delays the onset of sexual activity by only 18 months. Furthermore, taking a virginity pledge will often encourage other types of sexual behavior.

Virgins In Guyland

But little is known about men who pledge and navigate this commitment to abstinence.

I was curious about how men maintain pledges in light of these statistics, and also balance them with expectations about masculinity. So in 2008, I began researching a support group of 15 men at an Evangelical church in the Southwest. All members were white, in their early to mid-20’s, single or casually dating – and supporting each other in their decisions to remain abstinent until marriage.

The group, called The River, met once a week, where, sitting on couches, eating pizza or talking about video games, they’d eventually gravitate toward the topic that brought them all together in the first place: sex.

On the surface, it would seem impossible for these men to participate in what sociologist Michael Kimmel calls “Guyland” – a developmental and social stage driven by a “guy code” that demands, among other things, sexual conquest and detached intimacy.

Rather, the men of The River approach sex as something sacred, a gift from God meant to be enjoyed in the confines of the marriage bed. At the same time, these men struggle with what they describe as the “beastly elements” – or temptations – of sexuality. And it is precisely because of these so-called beastly elements that these men find each other in the same space every week.

The men of The River grappled with pornography use, masturbation, lust and same-sex desire, all of which can potentially derail these men from their pledge.

It raises an interesting dilemma: to these men, sex is both sacred and beastly. Yet the way they navigate this seeming contradiction actually allows them to exert their masculinity in line with the demands of Guyland.

Group members had an elaborate network of accountability partners to help them resist temptations. For example, one had an accountability partner who viewed his weekly online browsing history to make sure he wasn’t looking at pornography. Another accountability partner texted him each night to make sure that he and his girlfriend were “behaving.”

While these behaviors may seem unusual, they work in ways that allow men to actually assert their masculinity. Through what sociologist Amy Wilkins calls “collective performances of temptation,” these men are able to discuss just how difficult it is to refrain from the beastly urges; in this way, they reinforce the norm that they are highly sexual men, even in the absence of sexual activity.

The River, as a support group, works largely in the same way. These men are able to confirm their sexual desires in a homosocial space – similar to Kimmel’s research in Guyland – from which Kimmel notes that the “actual experience of sex pales in comparison to the experience of talking about sex.”

A ‘Sacred Gift’ – With Mixed Returns

The men of The River believed that the time and work required to maintain these pledges would pay off in the form of a happy and healthy marriage.

Ciara, in discussing her commitment to abstinence with Russell Wilson, similarly added that she believes such a promise is important for creating a foundation of love and friendship. She stated that, “if we have that [base] that strong, we can conquer anything with our love.”

So what happened once after the men of The River got married? In 2011, I followed up with them.

All but one had gotten married. But while the transition to married life brought promises of enjoying their “sacred gift from God,” this gift was fraught.

Respondents reported that they still struggled with the beastly elements of sexuality. They also had the added concern of extramarital affairs. Furthermore – and perhaps most importantly – men no longer had the support to work through these temptations.

There were two reasons behind this development.

First, respondents had been told, since they were young, that women were nonsexual. At the same time, these men had also been taught that their wives would be available for their pleasure.

It’s a double standard that’s in line with longstanding cultural ideals of the relationship between femininity and purity. But it’s a contradiction that leaves men unwilling to open up to the very women they’re having sex with.

These married men and women were not talking to each other about sex. Rather than freely discussing sex or temptation with their wives (as they had done with their accountability partners), the men simply tried to suppress temptation by imagining the devastation any sexual deviations might cause their wives.

after marriage

After marriage, the men felt left to their own devices.

Second, these men could no longer reach out to their support networks due to their own ideals of masculinity. They had been promised a sacred gift: a sexually active, happy marriage. Yet many weren’t fully satisfied, as evidenced by the continued tension between the sacred and beastly. However, to open up about these continued struggles would be to admit failure as masculine, Christian man.

In the end, the research indicates that a pledge of sexual abstinence works to uphold an ideal of masculinity that disadvantages both men and women.

After 25 years of being told that sex is something dangerous that needs to be controlled, the transition to married (and sexual) life is difficult, at best, while leaving men without the support they need. Women, meanwhile, are often left out of the conversation entirely.

So when we urge abstinence in place of healthy conversations about sex and sexuality, we may be undermining the relationships that are the driving goal of these commitments in the first place.

Complete Article HERE!

Notching the belt

Hey Doc,

So I’ve asked you a question anonymously before and you were a huge help so here I am again.
My names Mike and I’m 17 years old. For some reason it takes me a ridiculously long time to “finish” with my girlfriend. It’s not her, because this has happened with about 4 or 5 other women before her. It’s an annoying flaw that it takes me about 90 minutes to finish, if I finish at all. My GF and I get tired and eventually just stop because it’s too tiring and just plain tiresome. Is it performance anxiety or something? My first time having sex was anal with a girl, and I have done anal with girls many times before so it was a lot tighter than vaginal intercourse, not sure if that affects anything… I am really tired of lasting so long; I just want to be done when she is, much earlier.

I’ll be glad to answer any questions or anything you might need to know,
Thank you so much in advance, Mike.

finger fuck00445Where to begin, Mike? You’re 17, you’re having performance problems with your GF and you have had with about 4 or 5 other women before her. Holy Cow! you certainly are a sexually precocious lad, aren’t you?

I can’t help but notice a bit of sexual bravado in your message. I don’t know if that’s intended or if it’s more of a subliminal message. Either way, I have a feeling that there is some belt notching goin on here and that may be the root of your problems.

Here’s why I say this. There is nothing in your message that communicates that the sex you’re having is fun, or that it’s play. All I hear is that you’re a young man on a mission. You want to get off in a timely fashion and you’re currently being frustrated in that pursuit. You sound so goal oriented and your sex sounds like a task, rather than a playful adventure.

Us men folk get like this sometimes; and we’re the poorer for it. We’re all about solving a problem instead of enjoying the moment. The curious thing about this is that enjoying the moment is often the best way to solve a sexual performance problem.bryan_tony_box

When I hear men and/or women talking about their sex life like it’s work, I know there will be problems ahead. And you, Mike, sound like your sex is way more work than fun. If you were a sex worker or a porn star, I’d understand your predicament. But I suspect that you are neither a sex worker nor a porn star. You are, however, a young man who has, for one reason or another, scuttled all the joy and wonderment from your sex play. And that, my friend, is a crying shame…and at your tender age too. How do you suppose you’ll behave when you’re an old man of 25?

This path you’re on will continue to lead you into a sexual wilderness. You will become increasingly frustrated in your efforts to cum “on time”…and I use that term in quotes, because you’re all about bangin’ something rather than pleasuring and being pleasured by someone.

The comment you make about the difference between butt sex and pussy sex also tells me a lot about the kind of tightness you need to get off. I’d be willing to guess that you have a death grip on your johnson when you wank; am I right? Obviously your average asshole is a tighter orifice than your average pussy. But, if you were really turned on and enjoying the mutual pleasure available to you and your partner, instead of worrying about busting your nut during the fuck itself, you could jettison all those “shoulds” you have when you’re supposed to be enjoying yourself in the company of your lover.

beltWhy not stop what you are doing and take a look at why and how you are doing it. You may surprise yourself with what you find. And if you are man enough, have a heart-to-heart chat with your GF and get her feedback on what she encounters when she fucks you. Again, I’d be willing to guess she’d have some timely advice to offer you on how to fuck and get fucked.

Good Luck

5 Ways to Make his Cock go from LIMP to LIVELY

Erectile Dysfunction (ED) means your man can’t get it up or keep it up during sex. Many men suffer from this condition — approximately 30 million men to be exact. To explain what causes this, let’s review the basic anatomy of the penis and what happens during an erection.

erection

The penis has four main parts: glans (the head), corpus cavernosum and corpus spongiosum (the shaft), and the urethra (the hole that you urinate or ejaculate from). When a man is aroused from sexual thoughts or direct stimulation, nerves and hormones work to cause the muscles in the penis to relax and the corpus cavernosum and spongiosum will fill with blood causing the shaft to get hard — an erection. Another set of muscles cuts off the blood supply when the penis is erect to maintain its hardness. Once he orgasms, the blood will drain and the penis softens.

So what causes erectile dysfunction? There’s more than one answer. Taking prescribed medications to control blood pressure, allergies, anxiety, depression, peptic ulcer disease and or your appetite can lead to ED as can aging, and being depressed. Chronic illnesses such as diabetes, high blood pressure, or high cholesterol which can lead to poor blood flow to the penis can cause a penis to be limp. Drinking too much alcohol, smoking cigarettes, doing illegal drugs, even being too tired, having relationship problems, being stressed out about work or being anxious can cause this problem.

Any type of damage to the penis, nerves, and arteries that help maintain his erection can also lead to ED. The good news is that ED can be treatable. Just talk to your doc — an urologist. They will do a history and physical and order lab tests. If embarrassment has caused you to turn to the Internet for treatment options, be warned that this can be dangerous. You just don’t know what is in the medications that you get from many online sites. Before you turn to medications or even surgery to fix this problem, let’s discuss some ways to cope with a man who can’t get or maintain an erection NATURALLY.

  1. Make him do more Cardio exercises. He needs only 30 minutes a day. This will boost his testosterone. He may also lose weight, which can help the testosterone to work better. Testosterone is one of those important hormones that work to get an erection. Exercising also reduces stress and increases blood flow — all factors that can help! Read all about sex hormones HERE!
  2. Cook for him. There are nitrates in leafy greens, lycopene in tomatoes, and zinc in oysters. These essential nutrients will help keep his penis erect. Diet is so important. Read all about sex and food HERE!
  3. Have more FOREPLAY with him. Try oral sex. And remember, oral doesn’t just mean the penis. Play with his nipples or the back of his neck. KISS him more. Add sex toys in the bedroom BUT make sure they are smaller than his penis. Read all about foreplay HERE!
  4. Purchase a vacuum penis pump. This fun device will draw blood into the penis to help get it erect. If you have an increased risk of bleeding, have sickle cell anemia, or other blood disorders, this is NOT for you. And be careful — if not used correctly, this can cause bruising. Read all about penis pumps HERE!
  5.   Try using a cock ring. Once you get the penis erect, this sex toy will keep it that way.  Read all about cock rings HERE!

You should also make sure your man gets his diabetes, cholesterol, and/or high blood pressure under control. Quit smoking. Make sure he doesn’t drink alcohol or do hard drugs. Find ways to reduce his stress and anxiety. Make sure he is getting enough sleep. Get help if you are suffering from depression. Ladies (and guys) try not to be discouraging. You both will overcome this.

Good luck

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