...And a Happy New Year!

“Then sing, young hearts that are full of cheer,
With never a thought of sorrow;
The old goes out, but the glad young year
Comes merrily in tomorrow”
Emily Miller, “New Year Song”

Congratulations everyone! You made it through another year! Some of you breezed through (I got a new job/car/lover). For others, it was a struggle (my rent went up; I lost a toe surfing). But for most of us, it was some of each (my boyfriend left me, but then this totally cute guy moved in down the hall!).

Let’s face it: right about now most of us can use a small jolt of self-analysis. The start of a new year is a great time to reflect on what’s transpired, as well as look forward and think about making any changes. It can be like reading a book about yourself (and you’re the hero!), remembering all the fun you had (that time we kissed in the car and wound up late to dinner) as well as the missteps (my parents were so mad at us because the restaurant wouldn’t hold the table).

New Year’s resolutions get short shrift these days (can anyone tell me if shrift is a metric measurement?). Many claim resolutions aren’t effective because we forget about them right after the holidays. Actually, many people find resolutions helpful in deciding what is/isn’t working, and in organizing our thoughts into a coherent pattern so we can identify those things about ourselves we’d like to change. It’s beneficial to have some sort of framework, and that’s where New Year’s resolutions come in handy.

If making a list of resolutions works for you, great; if not, see you next week in 2007. Some of us are given to self-reflection, while the more action-oriented among us just want to get on with it. Maybe you don’t want to look back: (2006? Ugly, stupid year!), and if that’s the case, just fast-forward to next week’s post about sexual communication.

My best wishes to all of you for a happy and healthy New Year full of love and joy. Play safe.

With Pleasure.

Dr. J

“The future always arrives too fast—and in the wrong order.”
Alvin Toffler

Happy, Giddy, Sexy Holidays

So stick up ivy and the bays,
And then restore the heathen ways,
Green will remind you of the Spring,
Though this great day denies the thing,
And mortifies the earth, and all
But your wild revels, and loose hall.
Henry Vaughan, 17th cent. Poet

I’m in a silly holiday mood. Something about this time of the year brings out my inner child. Girl wants to play, exchange presents by a warm fire, share holiday cheer with friends and family and generously spread love and joy everywhere! (Note to self: GET MORE MISTLETOE!)

This is a seriously stressful time of year (is everyone exhausted yet?), so it’s important to let your inner kid come out and play (oh please, oh please!). Here are a few suggestions (your mileage may vary): make naked snow angels--but only if you have a hot tub for “after,” sing Winter Wonderland too loud (on/off key is totally optional), get a massage, take a luxurious bath, buy something frivolous. In short, be sure to put yourself on your own gift list, too (For me?! It’s just what I wanted! How did you know?).

Don’t forget the coming attractions: Sexual communication, differing sexual needs, and other issues that may emerge in sexual relationships; but that’s all for “after.” In the meantime, my best wishes to one and all for a very joyous holiday season. Remember to play safe.

With Pleasure,

Dr. J

Sexual Concerns Part 2B: Men’s Guide to Getting Your Groove Back

“We never do anything well till we cease to think about the manner of doing it”
William Hazlitt, 18th century author

During the past week, we were favorably reviewed by Janesguide.com ("staff choice") as well as several European sites; and as a result, we've had another huge influx of readers. So in addition to welcoming you newbies, here’s a note about how to get the most out of this blog. As regular readers can attest, you might find it a bit different from others you’ve read because my intention is to be both entertaining and educational. Each new post is based on information presented in the previous one; so to get the maximum benefit, I recommend you begin with the introductory post from August and read forward from there.

***

Calling all men! You have suffered in silence long enough! Most of the popular literature has been focused on female sexuality, while references to male sexuality have been limited to Viagra, penis mechanics, and such. If you listen to the radio or read the newspaper, you’re bombarded by ads from the pharmaceutical/medical industry asking whether you’re performing “up to par” (one can only imagine what below par might be, brrrr!), whether you want better performance, stronger erections (and what exactly is a “weak” erection?), to last longer, etc. The implicit message seems to be that you’re supposed to perform, not complain or question, and be content because you’re “getting some.” Pleasure? What’s that? Not only does this do a huge disservice to men, but it also leaves you vulnerable to exploitation by reinforcing the idea that this is what you should want. And if you don’t, what’s wrong with you?

Performance is the enemy of both pleasure and fun. The #1 cause of male sexual concerns is that many men focus on their performance rather than on their pleasure.

Picture this: You’re an actor, shooting a scene in which you’re eating a succulent gourmet dinner. You’re focused on your lines and technique, but not on the food. How much do you think you’d enjoy the actual meal? Well, sex is the same: if you focus on performance, you’re just working; and with an attitude like that, you miss all the fun.

Oh, sure, sometimes performing can be enjoyable; but eventually it’s just work. Have you bought into this model? If so, you might have discovered that sex is beginning to feel like a chore instead of fun. The first step in letting go of this attitude is educating yourself. Read The New Male Sexuality by Bernie Zilbergeld, a classic and still the best book on the subject. My male students swear by it. It will also help you to open up and share your concerns with a partner. Some men assume their partners want them to perform, but that usually isn’t the case. You might find there’s more room for flexibility than you assumed.


To develop erection reliability: Do you feel you always have to be in charge and it’s up to you to initiate sex? How do you feel about this? Are you comfortable telling your partner what you need? Try exploring any conflicts you have about being sexual as well as any past negative messages regarding some aspect of sex or what being “manly” means to you. I’m sure it won’t surprise you to learn that men sometimes just want to be held, kissed and stroked. Also ask yourself whether you’re angry at a partner or resentful.

If none of the above is true for you, see a urologist for a check-up to rule out any physiological factors getting between you and your experiencing pleasure. Also note that in general, if you’re having erections at other times, e.g., upon awaking (“morning wood”), that's an indication that there’s probably nothing physically amiss. Of course, too much alcohol or other drugs can also affect erection.

To last longer: First, slow down during self-pleasuring and unlearn that old pattern of getting in fast before you blast. Try teasing yourself by stimulating yourself just to the point where you feel you’re about to orgasm, then backing off and relaxing, and then beginning again. “Lather, rinse, repeat.” This will give you a sense of control as well as teach you to recognize your own point of “orgasmic inevitability.”

Once you feel in control of your orgasm, you can also examine whether you have any feelings of discomfort with being sexual—either with yourself or with a partner. These feelings of discomfort can create extreme conflict and cause you to feel the need to get it over with quickly. If you look at sex as something to finish quickly—get it up, get it in, get it off—you’ll need to let go of that old mentality. And naturally, any relationship conflicts can also contribute.

If you’re not having orgasms: OK, lasting longer isn’t quite your concern, but what if you’re just not orgasming, even with prolonged stimulation? Maybe that prolonged stimulation is actually causing you to “numb out.” Likewise, examine the activities you and your partner are engaging in and be honest with yourself about whether they’re still doing the trick for you. And be aware that just as with erections, too much alcohol or other drugs can inhibit orgasm.

Turn on; tune in: Also investigate whether you’re carrying any old messages regarding sex as something evil or dirty. In some cases, baggage like that can come back to haunt and inhibit your orgasms. One of my past clients had no memory of any negative messages until he got married and discovered that he was incapable of thinking of his wife as sexual. Examining this, he shared that he’d grown up in an extremely orthodox environment in which women were portrayed as sinful temptresses, and the boys in his class were warned about the “evils of the flesh.” The connection between his background and his current attitude never occurred to him.

If you lack desire or have low desire: Are you still turned on to your partner, or are you just going through the motions? Maybe you’re bored because sex has become routine. Or maybe you’re feeling like your partner doesn’t want the same things as you. How can you find out? ASK. In some cases, people totally turn off their desire for sex—regardless of whether they’re partnered—because they’re guilty, conflicted, etc. And for some people, sex just isn’t a priority. If this is true for you, be yourself and don’t worry about it. Don’t let anyone try to convince you you’re defective!

As I wrote last week, sexual concerns are often multi-causal; there may be several factors complicating your sexual enjoyment, for instance: anxiety (“What if she thinks I’m too small?!”), performance orientation (“I’ve got to be perfect”), and ignorance (“Women really want it hard and fast”).

Of course, education alone can’t always solve everything. After reading and trying the above, if you’re still having a concern, a clinical sexologist can help you decide on your next steps. If you can’t find one in your area, I’m happy to provide a referral.

The really cool thing is that as you become comfortable with your own unique sexuality, and cease trying to live up to some “ideal,” you’ll develop sexual self esteem. And no one can take it away from you!

Coming Attractions: Sexual communication, differing sexual needs, and other issues that may emerge in sexual relationships.

I would be pleased to answer any questions, and I welcome your comments.

With Pleasure,

Dr. J

Sexual Concerns, Part 2A: Women’s Guide to Getting Your Groove Back

“And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom”
Anais Nin

In the past week, we’ve had a huge increase in readership; so in addition to welcoming you newbies, here’s a note about how to get the most out of this blog. As regular readers can attest, you might find it a bit different from others you’ve read because my intention is to be both entertaining and educational. Each new post is based on information presented in the previous one; so to get the maximum benefit, I recommend you begin with the introductory post from August and read forward from there.

Last week we discussed how many sexual concerns are related to ignorance (“Girls aren’t supposed to know about sex”), misinformation (when he was a child, my partner’s friend told him his mom had a penis!), negative childhood messages (many girls are given two washcloths—one for the rest of their body and one for that dreaded “down there”), emotional difficulties like depression, and relationship issues (and who among us hasn’t been there?).

Happily, several readers have emailed me to say their concerns were alleviated merely by reading last week’s post about those contributing factors. In fact, many sexual concerns can be relieved simply by becoming more educated.

However, often in this era of tabloid TV and self-help books, we want simple answers to complex problems. To offset this, I offer the following suggestions, which are not meant to be an end, but a beginning to helping you with sexual issues:

If you haven’t yet had an orgasm: First, you need to get comfortable with yourself as a sexual being. This means overcoming all those negative messages you’ve internalized about female sexuality, including the idea that women shouldn’t be interested in sex or knowledgeable about it. Would you drive a car down a crowded street if you didn’t first learn how to steer around a safe, empty parking lot? Learning about your own orgasm takes time, especially when everything’s new to you. Talking to other women is helpful, and so is reading about their experiences–-especially those who have struggled with the same issues and overcome them. The surest way to orgasm is through self-pleasuring, so what are you waiting for? Getting over any discomfort is the first step. The second step is determining which of your hands works best.

For Yourself: The Fulfillment of Female Sexuality by Lonnie Barbach, has lots of supportive information, and The Hite Report by Shere Hite details how other women have experienced their sexuality. Both of these are classics in this area and have helped thousands of women. Once you’ve learned how to orgasm, you can decide if you want to share this with a partner; with this knowledge, you’ll be able to communicate your needs.

To develop orgasmic reliability: Practice makes perfect, and lots of self-pleasuring will teach you what works best for you. You can experiment with teasing yourself—going up and coming back down. You’ll get a sense of control, which is very important. If you have a sex partner or partners, let them know what might turn you on as well as what definitely does turn you on, and let them know whether you need them too spend more time stimulating you, or if you need a different kind of stimulation. You can also show them how you like to be touched by placing your hand on theirs and demonstrating–-they’re probably learning too, so be patient with them.

If you’re using alcohol or drugs to relax or zone out during sex, be aware that they may inhibit orgasmic reliability. Examine why you’re relying on them. Perhaps you still have some unresolved anxiety or fear?

If you experience pain or tightening of the vaginal muscle during sex: Make sure you’re turned on! If you’re not, explore why. Perhaps you feel angry, conflicted, guilty, or resentful. Is your partner unconcerned with your pleasure, or just clueless? Many relationship issues can also inhibit arousal, as can guilt and/or discomfort with sex and past sexual trauma. Be honest with yourself; and if none of the above fits for you, see your gynecologist for a “well woman” exam to determine whether there are any contributing physiological factors.

If you lack desire or have low desire: Are you still turned on to your partner, or just going through the motions? Maybe you’re bored because sex has become routine. Or maybe you’re feeling like your partner doesn’t want the same things as you. How can you find out? ASK. In some cases, people totally turn off their desire for sex—regardless of whether they’re partnered—because they’re guilty, conflicted, etc. And for some people, sex is just not a priority. If this is true for you, be yourself and don’t worry about it. Don’t let anyone try to convince you you’re defective!

One final thought: Often, sexual concerns are multi-causal; there may be several factors complicating your sexual enjoyment, for instance: body image (“My breasts are too small to be sexy”), guilt (“Every time I self-pleasure, I can feel my mother’s disapproval”), and ignorance (“Men don’t want women to take the lead in sex”).

Of course, education alone can’t always solve everything. After reading and trying the above, if you’re still having a concern, a clinical sexologist can help you decide on your next steps. If you can’t find one in your area, I’m happy to provide referrals.

The really cool thing is that as you learn about your body, take responsibility for your own pleasure, and become comfortable with yourself as a sexual being, you’ll develop what I refer to as “sexual self esteem.” And no one can take it away from you!

Next Week: Sexual Concerns Part 2B: Men’s Guide to Getting your Groove Back

Let me hear from you; your questions and comments are welcome.

With Pleasure,

Dr. J

Sexual Concerns, Part 1: Learning to Let Go and Enjoy

“When things don’t work well in the bedroom, they don’t work well in the living room, either”
Dr. William H. Masters (Masters & Johnson)

I want to welcome any new readers to this blog. As regular readers can attest, you might find it a bit different from others you’ve read because my intention is to be both entertaining and educational. Each new post is based on information from the previous one; so to get the maximum benefit, I suggest you begin with the introductory post from August and read forward from there.

Can We Talk?

A word about language: I use the term “sexual concern” rather than “sexual dysfunction” because dysfunction means “broken.” If you ever once wanted sex when a partner didn’t, you’ve had a sexual concern, as have most of us at some time in our lives. But that doesn’t mean we’re broken. “Dysfunction” is a term that reinforces the attitude that when something isn’t absolutely perfect sexually, it’s a huge disaster and is in need of some drastic form of “treatment.” Thinking like this both disempowers and sets us up for feeling tremendously inadequate.

Many people have sexual experiences that cause them concern. Some may only happen occasionally and as such, are simply a part of our fluctuating sexual life experiences (“I had six beers at the party and got really turned on; so why couldn’t I get it up?”). However, there are some concerns that can be a long-term source of anxiety and discomfort. This week, we’ll discuss the most common ones along with possible contributing factors; and in next week’s post, I’ll discuss effective strategies for easing them.

Women:

1. Pre-orgasmic (haven’t yet had an orgasm). If you can’t ride a bicycle or swim, it’s generally because you haven’t yet learned how, not because of some inherent condition. Orgasm is similar. Many of us simply haven’t learned how, due to ignorance and/or discomfort regarding our own sexual response, guilt about sex, not getting enough stimulation or effective touch (“a little to the left and higher please”),and anxiety about whether we’re taking “too long,” what our partner thinks of us, etc.

2. Orgasmic reliability. Similar to above, with the addition that some of us aren’t getting the duration of stimulation we need, or we’re self-conscious (sometimes it takes awhile to relax and “go for it”). We may also be shy about communicating needs to a partner, or we’ve been numbed by too much alcohol or drugs.

3. Pain during sex. If we’re not turned on, we don’t lubricate, and if we don’t lubricate—ouch! Like fingernails on a blackboard, isn’t it? Physiological conditions like infection or injury can also contribute to pain.

4. Tight vaginal muscle. If we’ve had some past negative experience, fear may cause us to tighten up. Some of us are anxious about being sexual, and this can also contribute. The usual physiological culprits of infection and injury may also be involved.

Men:

1. Erection reliability. Whenever a man tells me he “lost” his erection, I want to look down at the floor and say, “well it must be around here somewhere.” Seriously, it isn’t lost, it’s just resting. Erections go up and down all the time, but some men are so anxious that their erection won’t return, it becomes a self-fulfilling prophecy. Relax. It’ll come back. Some men don’t get effective stimulation and don’t know how to tell their partner (Surprise! Men have just as much trouble communicating as women). Or they may expect instant erections even when they’re tired, ill, etc. Guilt and anxiety can also kill an erection faster than hearing your mother knocking on your door. And do you really expect to have great sex even when you’re feeling very angry at your partner? Hurt? Conflicted? Forget it. That’s the stuff of movies and romance novels. Too much alcohol or drugs will also do the trick. But the #1 cause of erection concerns is that many men focus on their performance rather than on their pleasure. More about that next week.

2. Coming too soon. During their early self-pleasuring experiments, many men learn a very quick orgasm pattern in order to avoid detection—like in the bathroom (“You’ve been in there for hours! What are you doing?”) Learning to come quickly with a partner can also set up this pattern. Guilt, anxiety and relationship conflict may create a situation where some men just want to get it over with quickly so they won’t have to deal with any of those feelings.

3. Orgasm difficulty. While not having an orgasm can be caused by many of the above factors (fear, anxiety, etc.), it may also be the result of ineffective stimulation, a focus on performance rather than pleasure or prolonged stimulation that results in numbness. And let’s not forget about the numbing effects of too much alcohol/drugs.

Both:

Lack of desire/low desire. This is the most common concern among busy, high-achieving professionals who have the expectation that they can simply turn on a “sexual switch” at the end of a 12-hour day and have everything work just like it did during college! Other factors are discomfort regarding sex, fear, boredom, and our old friend—relationship conflict. Some of us discover we have different sexual needs than our partner. I’m reminded of a scene from a movie in which there’s a split screen, showing each member of a couple, separately, at their therapist, answering a question regarding how often they have sex. He says: “Hardly ever! Three times a week.” She says: “All the time! Three times a week.”

Do you see how some contributing factors keep cropping up? Fear, anxiety, ignorance, etc. can greatly interfere with and undermine our sexual enjoyment. All of the above concerns can be related to socio-cultural constraints, emotional issues such as depression, relationship conflicts and lack of communication. In addition, illness, injury, recreational and/or prescription drugs can also interfere with sexual response.

OK, so now we’ve discussed possible causes. But wait, there's more! Next week, we’ll move on to some effective strategies for overcoming these concerns. See you then!

As always, the doctor is in for your questions and comments.

With Pleasure,

Dr. J