Dr J's Sex Facts

Fun sex facts and accurate information from a clinical sexologist for a hotter and more fulfilling sex life.

Friday, December 01, 2006

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.


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.


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.


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


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