MA, LPC, NCC

Sexual Issues

 

For men:

 

The most common male sexual problems are premature ejaculation and erectile dysfunction.

 

Premature Ejaculation (PE)

 

Premature ejaculation is defined as ejaculating in less than 2 minutes of intercourse. Thirty percent of adult males complain of PE and the percentage is even higher in younger men.

 

“Do it yourself” techniques to reduce arousal (biting your lip, focusing on non-sexual thoughts like h ow much money you owe your mother-in-law, using two condoms or a penile desensitizing cream, masturbating before couple sex), do not help you learn ejaculatory control and can cause erectile dysfunction (loss of erection).

 

Erectile Dysfunction (ED)

 

By age 40, 90 percent of males have experienced at least one erectile failure (not being able to attain or maintain an erection sufficient for intercourse). This include loss of erection during intercourse. This is a normal occurrence and not a sign of erectile dysfunction.

 

The majority of erectile problems (especially for men under 50) are caused by psychological or relational factors, not medical or physiological problems. To comprehensively evaluate medical factors, consult your internist and/or a urologist with training in erectile function and dysfunction.

 

ED can be caused by a wide variety of factors. Medical problems include side effects of medication, fatigue, vascular or neurological issues, diabetes, and hormonal deficiency.

 

Psychological problems include anxiety, depression, anger, frustration, not feeling sexual at that time or with that partner. Lack of sexual experience can also play a major role in ED.

 

While oral medications like Viagra and Cialis may help, they need to be integrated into your couple style of intimacy, pleasuring and eroticism in order to be most effective.

 

There are many strategies to help with PE and ED either with or without a partner.

 

 

For women:

 

Inhibited Sexual Desire and Non-Orgasmic Response

 

There is more written about orgasm than any other area of female sexuality. The good news is that awareness of the woman’s “sexual voice” which includes desire/pleasure/eroticism/satisfaction is healthy for the woman, the couple, and the culture. The bad news is that sexual performance demands, specifically viewing orgasm as a “pass-fail” test, increases self-consciousness and reduces sexual desire.

 

You are responsible for your desire/pleasure/eroticism/orgasm. Developing your unique sexual voice is a positive personal challenge. It is not the man’s responsibility to “give her an orgasm.”

 

Arousal involves both subjective components (feeling sexy and turned-on) and objective components (vaginal lubrication and physical receptivity to intercourse).

 

Being aware of what facilitates and what subverts healthy sexuality is extremely important. Take an active role in verbally and non-verbally making requests and guiding your partner. This will help you develop your unique sexual voice.

 

These and other guidelines will help improve and increase your pleasure, eroticism and orgasm.

 

For couples:

 

Couple Sexuality

 

Are the following statements true or false?

 

• Sexual problems are typically caused by individual or relational problems. If therapy resolves these underlying issues, sex will spontaneously improve.

   

• The more intimacy, the better the sex.

   

• You must deal with core problems first—anxiety or depression, bi-polar disorder, alcoholism, history of trauma or family of origin issues. Then address relational and sexual issues.

   

• Sexual dysfunction, especially inhibited sexual desire, is best understood as a symptom.
  The best therapeutic strategy is to deal with sex indirectly.

   

• With advances in the bio-medical field, a stand-alone medical intervention will resolve the great majority of sexual problems.

   

• Once the couple has created a healthy sexual relationship, they can proceed on their own. They should not need further help.

   

  All the above statements are false. With professional help, sexual problems between partners can be happily resolved by dealing with them directly.