Categories
Treat Orgasm

Female on Top Position

When the marital partners extend their psychosensory interchange to coition in the female-superior position, the wife once mounted is instructed to hold herself quite still and simply to absorb the awareness of penile containment.

Interspersed with moments of sensate pleasure created by her proprioceptive awareness of vaginal dilatation should be the opportunity to feel and think sexually. The vaginal distention should be interpreted in relation to the sensual desire for further increment in sexual pleasure.

This increasing demand for sexual stimulation can be further implemented by the female partner if she will institute a brief period of controlled, slowly exploring, pelvic thrusting. The husband’s specific responsibility at this moment is to provide the needed erect penis without any concept of a demanding thrusting pattern on his part.

In anticipation of her need, the cotherapists must encourage the wife to think of the encompassed penis as hers to play with, to feel, and to enjoy, until the urge for more severe pelvic thrusting involuntarily emerges into her levels of conscious demand. It may take several episodes of female-superior coital positioning, as the woman plays pelvically with the contained penis, before full sensate focus develops vaginally.

Once vaginal sensation develops a pleasant or even a fully demanding vein, the next phase is to add to the sensate picture the male-initiated, non demanding, slow pelvic thrusting.

The non demanding thrusting by the husband should be kept at a pace communicated by his wife. This constrained form of male pelvic thrusting is suggested to create obvious opportunity for extension of the female’s sensory potential and to provide sufficient stimulative activity to maintain an effective erection.

Ejaculatory Control

At this time the question frequently asked by the male member of marital units whose concept of sexual interaction has been based primarily on the stock formula of perform, produce, and achieve is, “What if I feel like ejaculating?” It requires continuing effort by the cotherapists to convey the concept not only that acquiring ejaculatory control is possible but also that such facility usually is enhancing for the male as well as his female partner.

The couple must be educated to understand that ejaculatory control enlarges the range of sensual pleasure in the sexual relationship for both marital partners. However, it is appropriate for cotherapists to emphasize the fact that ejaculation or spontaneously occurring orgasm is not cause for alarm, nor is this involuntary breakthrough considered a breach of direction.

The husband and wife must be reassured that if such a breakthrough from the original direction occurs, the experience should be enjoyed for itself. Within a reasonable length of time, the unit is encouraged to provide another opportunity in which to follow the originally described interactive concepts.

When the husband has developed security of erective maintenance, the episodes of vaginal containment with exploratory pelvic thrusting should continue for as long as both partners demonstrate pleasurable reactions. At appropriate intervals during the total coital episode, the partners should separate two or three times and lie together in each other’s arms.

Once rested, they should return to whatever manner of manual sensate pleasuring they previously enjoyed and continue without any concept of time demand. They should remount, again using the female-superior position, repeating earlier opportunity for the wife’s stimulative proprioceptive awareness of vaginal containment of the penis to be emphasized by alternate periods of exploratory thrusting and lying quietly together in coital connection.

The timing and duration of sexually stimulative activity should follow the directive formula as outlined in Therapy topic. Generally interpreted, any period of time is acceptable that emerges from mutual interest and continues to be enjoyable for both marital partners without incidence of either emotional or physical fatigue.

Once both partners have been successfully educated to employ experimental pelvic movement during their episodes of coital connection rather than following the usual prior pattern of demanding pelvic thrusting, a major step has been accomplished.

Women have little opportunity to feel and think sexually while pursuing or receiving a pattern of forceful pelvic thrusting before their own encompassing levels of excitation are established.

If a woman initiates the demanding thrusting, she usually is attempting to force or to will an orgasmic response. The wife repeatedly must be assured that this forceful approach will not contribute to facility of response.

If the husband initiates the driving, thrusting coital pattern, the wife must devote conscious effort to accommodate to the rhythm of his thrusting, and her opportunity for quiet sensate pleasure in coital connection is lost.

Frequently, it is of help to assure the wife that once the marital unit is sexually joined, the penis belongs to her just as the vagina belongs to her husband. When vaginal penetration occurs, both partners have literally given of themselves as physical beings in order to derive pleasure, each from the other.

Categories
Sexual Dysfunction

Impotent and Female Orgasm

Although emphasis has been placed upon the role of premature ejaculation in the etiology of primary orgasmic dysfunction, primary or secondary impotence also contributes. Again the basic theme of man and woman coital interaction must be emphasized.

If there is not a sexually effective male partner, the female partner has the dual handicap of fear for her husband’s sexual performance as well as for her own.

If there is no penile erection there will be no effective coital connection.

Frequently women married to impotent men cannot accept the idea of developing masturbatory facility or being manipulated to orgasm as a substitute for tension release.

However, if there has been a masturbatory pattern established before coital inadequacy assumes dominance, most women can return to this sexual outlet. In this situation there is sufficient dominance of the previously conditioned biophysical structure to overcome negative input from a psychosocial system distressed by sexual performance fears.

But if there have been no previous substitute measures established, many women cannot turn to this mode of relief once impotence halts effective coital connection. In this situation the psychosocial structure, unopposed by prior biophysical conditioning, assumes the dominant influence in the woman’s sexual response pattern.

Mr. and Mrs. D
were referred to treatment of orgasmic inadequacy after four years of marriage. When seen in therapy she was 27 and her husband 43 years old. He had been married twice previously. There were children of both marriages and none in the current marriage.

The husband also was sexually dysfunctional in that he was secondarily impotent.

His second marriage had been terminated due to his inability to continue effective coital connection. Although, when the unit was seen in consultation the marriage had been consummated, coitus occurred only once or twice a year.

Mrs. D’s background reflected somewhat limited financial means. Her father had died when the three siblings were young, and the family had been raised by their mother, who worked while the grandmother took care of the children.

Clothes were hand-me-downs, food the bare essentials. Her education had of necessity terminated with high school, and she worked as a receptionist in several different offices before her marriage. She continued to live at home while working and contributed what salary she made to help with the family’s limited income.

Mrs. D met her future husband when he visited the office where she worked. He invited the young woman to lunch. She accepted and married him four months later without knowledge of his sexual inadequacy, although she had been somewhat puzzled by his lack of forceful sexual approach during the brief courtship.

Mrs. D’s own sexual history had been one of a few unsuccessful attempts at masturbation, numerous petting episodes with boys in and out of high school, but no attempted coital connection. She had never been orgasmic.

Her husband had inherited a large estate and his financial situation certainly was the determining factor in his wife’s marital commitment. Since the girl had been distressed by a family background of genteel poverty, she felt the offer of marriage to be her real opportunity both to escape her environment and to help her two younger siblings.

The wedding trip was an unfortunate experience for Mrs. D when she realized for the first time that her husband had major functional difficulties. She knew little of male sexual response beyond the petting experiences but did try to help him achieve an erection by a multiplicity of stimulative approaches at his direction. There was no success in erective attainment.

The marriage was not consummated until six months after the ceremony. In the middle of the night Mr. D awoke with an erection, moved to his wife, and inserted the penis. She experienced mild pain but reacted with pleasure, feeling that progress had been made.

However, following the usual pattern of .a secondarily impotent male, progress was fleeting. As stated, there were only a few other coital episodes in the course of the four-year marriage. In these instances she always was awakened from sleep by her husband when he awoke to find himself with an erection.

Quick Ejaculation
Then there was rapid intromission and quick ejaculation. There was no history of a successful sexual approach by her husband under her conscious direction, insistence, or stimulation. Mr. D tried repetitively during long-continued manipulative and oral-genital sessions to bring his wife to orgasm, without result.

When they were referred for treatment, neither husband nor wife described sexual activity outside the marriage.

There have been 193 women treated for primary orgasmic dysfunction during the past 11years. Basically, in this method of therapy the sexually dysfunctional woman is approached through her sexual value system.

If its requirements are non serving limited, unrealistic, or inadequate to the marital relationship-by suggestion she is given an opportunity, with her husband’s help, to manipulate her biophysical and psychosocial structures of influence until an effective sexual value system is formed.

Categories
Knowing Woman Sexuality

Phantom Orgasm

Sadly in life, horrendous things do happen. Women can become paralyzed in their pelvic region from road accidents, disease, and so on. They can lose all sensation in their pelvic area. Yet many paralyzed women continue to be orgasmic. However, our culture tends to perceive people with such disabilities as non-sexual. Indeed, medical textbooks refer to these orgasms as “phantom orgasms.” This is a phantom of medical folklore.

Be that as it may, it is critical to understand:

A woman can have an orgasm without penetration.
A woman can have an orgasm without a penis.
A man can have an orgasm without an erection.
A man can have an orgasm without a penis.

In fact, some women (and men) have orgasms merely by willing them. They do not require foreplay, nor thrusting, to raise sexual tension first. This is rare, but it can and does happen. Keep in mind that people are individuals, and have very different levels of sexual drive.

The human spirit is a wonderful phenomenon. It can withstand the most appalling vicissitudes and still respond with courage and resourcefulness. Women are said to be more stoical than men. They are able to endure more pain, both mental and physical.

Loss of sensation is a savage assault on female primacy. A woman’s first response can be equally savage and destructive. If she responds with a seemingly quiet and depressive state, this is as damaging emotionally as a raging and bitter response. Keep in mind that the healing process can be speeded up by orgasm if so desired. Use a vibrator, erotica, anything which works.

In a loving relationship, the partner can take control. Seduce her out of her angry or passive state. Shock her out of grief and pain by relighting her sexual fires. Turn her emotional energies away from her broken body and back to where happiness awaits.

Avoid over-concern with her feelings. She is a woman still, a real woman, and will find your particular brand of “medication” irresistible. Tell her that she is desirable. Continue to enchant her until she has an orgasm. Then tell her she is so desirable that she must be prepared for another love-making session soon.

Categories
Knowing Woman Sexuality

Pain at Orgasm

Pain at orgasm can occur if the contractions of the uterus become very powerful. In a few cases, they can be as wracking as the cramps of a period. Why put up with unnecessary pain? Visit the physician promptly. The condition may be due to a hormone imbalance which can be sorted out. More often though, these powerful contractions are not experienced as pain, but as a short time of discomfort. Rest after orgasm. The pains will subside as the uterus slowly subsides and returns to its normal size.

Dyspareunia is lovemaking that is painful or difficult. The pain is experienced at some point in the vagina. In rare cases, there can be problems of clitoral adhesions or birth defects. There may be an allergy to some substance in the semen or sperm. More often, pain on thrusting is due to an undiagnosed yeast infection which produces no other symptoms. This pain is sorer and does not begin until thrusting has continued for some time.

However, in the majority of cases, the problem is a lack of sufficient lubrication. This can be avoided by the use of external lubricants. Avoid oils and creams which contain alcohol; they irritate.

Categories
Fertility Problems

Male/Female Tubal Obstruction

Adhesions are scars which form on the outside of the oviducts. They tie down the tube; it cannot move at ovulation to scoop up the free-floating egg. Adhesions can be due to previous pelvic infections, or surgery. If the scarring is widespread, the open ends of the fimbria may be completely blocked. When liquid is passed through the tubes, it cannot flow out. This is known as hydrosalpinx.

Corrective surgery to free the tubes from external adhesions has a success rate of 60 to 70 percent. However, this high rate only applies if the mucus linings inside the tubes have not been damaged by the scarring. Yet, when the fimbria are blocked, this internal lining is almost always severely damaged. The pregnancy rate then drops to between 5 and 20 percent. Keep in mind that there is always the risk that an operation to unblock the tubes can produce even more scar tissue. In these cases, one choice is in vitro fertilization.

Male Tubal Obstruction

The epididymes can be felt by gently rolling the testicles between the fingers and thumb. They are small comma-shaped lumps on top of the testicles; “epididymes” is Greek for “upon the twins.” They are, in fact, tightly coiled tubes which, if stretched out, would measure 20 feet. After baby sperm leave the testicles, they mature in the epididymes, and develop swimming skills. If the epididymes tubes are blocked, the result is tubal obstruction. In rare cases, blocked tubes are the result of a birth defect. The vas tubes which carry the mature sperm to the penis can also be blocked.

Blocked tubes are a common problem in male infertility. They occur for the same reasons as in women; scars from previous infections or surgery. Surgery to repair defective tubes can be successful if the blockage is mild. However, if the degree of scarring is great, the outcome for unblocked tubes is low. One option in these cases is in vitro fertilization.

Categories
Fertility Problems

Fertility Problems

Problem Areas

Some women get pregnant very easily. Others believe it is a miracle when they finally conceive. Fertility problems are now regarded as “couple problems,” yet the breakdown between the genders is interesting.

Infertility can result from:

  • Male problems: 25 percent of couples
  • Female problems: 35 percent of couples
  • Female and male: 24 percent of couples
  • No known cause:16 percent of couples

Factors to be investigated include:

  • Man: Is the quality of sperm poor or good? (testicles)
  • Woman: Is a viable egg produced at midcycle? (ovaries)
  • Man: Are the sperm tubes unblocked? (epididymis & vas)
  • Woman: Are the egg tubes unblocked? (oviducts)
  • Woman: Is the uterus lining well-prepared? (endometrium)
  • Both: Are the sex hormones produced in proper balance?

However, many fertility problems are not really problems and can be resolved by the couples themselves. The first factors to consider do not involve medical intervention.

Categories
Fertility Problems

Body Weight

Fat cells absorb and release the female hormone estrogen. In women who are overweight, estrogen is not only produced by the ovaries, but also from the extra fat cells in other parts of the body. This release of extra estrogen from extra fat cells upsets the fine balance of the feedback system between the pituitary hormones and estrogen. If the problem can be detected on the bathroom scales, reduce weight to within the normal range for age.

Overweight in men. Heat damages sperm production. In men who are overweight, an excess of flesh at the buttocks, inner thighs, and lower abdomen not only keeps the groin hot, it raises the temperature in the testicles. This reduces their ability to produce vigorous sperm. The testicles should be a few degrees below body heat; hence their cooler position outside the body. Wear loose cotton shorts, and reduce weight to within the normal range for age.

Underweight in women. Being underweight can also upset the feedback system between the hormones. A certain level of fat cells is necessary for hormone production. If body weight drops too low, ovulation can be suppressed. Some women athletes and long-distance runners have scanty or absent periods. Avoid crash diets. Avoid any slimming or exercise program which promises a sudden weight loss or one which drops the body weight below the minimum normal range. Increase carbohydrate consumption. Aim for an even body weight within the normal range for age.

Categories
Aging Male Sex

Aging Male & Female

Arbitrarily, statistics reflecting the failure rates of treatment procedures for sexual dysfunction in the aging population will be considered in this section rather than dividing the material between the discussions of sexual inadequacy in the aging male and female.

A brief single presentation seems in order since only marital units are available for consideration in this age group. The male and female statistics are essentially inseparable from a therapeutic point of view, and the overall sample is entirely too small for definitive individual interpretation.

Statistics

In 51 of the total of 56 aging marital units treated for sexual dysfunction, the husband was the instigating agent in bringing the marital unit to therapy. Among the remaining 5 couples, the referral apparently was by the mutual accord in 3 and only at the demand of the wife in 2 couples.

There also was a higher incidence of referred male sexual dysfunction than of female sexual inadequacy in the aging population. Therefore the discussion will focus on the male partner’s age as a point of departure.

Since the husband was the partner most often involved in dysfunctional pathology and was the member of the unit that usually took the necessary steps to accomplish referral to the Foundation, the aging male will be statistically highlighted.

The 56 marital couples referred for treatment divide into 33 units with bilateral complaints of sexual dysfunction and 23 units with unilateral complaints of sexual inadequacy. Thus, there were 89 individual cases of sexual dysfunction treated from the 56 units with husbands’ age 5o years or over as a common baseline.

This 33:23 ratio is a reversal of the overall statistics for dual-partner involvement of marital units as opposed to singly involved units. The fact that there was a dominance of bilateral sexual deficiency among the older marital units is in accord with previously expressed concepts of cultural influences.

Certainly, the older the marital unit the better chance for the Victorian double standard of sexual functioning. With these pressures of performance, one could almost expect more male than female sexual pathology to be in identified unit partners over 50 years of age referred to the Foundation.

The clinical complaints registered by the aging population (male and female) in the 56 marital units referred for treatment. There was a 30.3 percent failure rate to reverse sexual dysfunction, regardless of whether both partners or a single partner is involved, in any marriage with the husband over 50years of age. With gender separation, for the aging male (50 to 79) there was a 25 percent failure rate to reverse his basic complaint of sexual inadequacy as compared to a 40.7 percent failure rate for the aging female (50 to 79).

These statistics simply support the well-established clinical concept that the longer the specific sexual inadequacy exists, the higher the failure rate for any form of therapeutic endeavor.

On the other hand, there was a significantly less than 50 percent failure rate in treatment for any form of sexual dysfunction, regardless of the age of the individuals involved. In short, even if the sexual distress has existed for 25 years or more, there is every reason to attempt a clinical reversal of the symptomatology.

There is so little to lose and so much to gain. Presuming generally good health for the sexual partners, and mutual interests in reversing their established sexual dysfunction, every marital unit, regardless of the ages of the partners involved, should consider the possibility of clinical therapy for sexual dysfunction in a positive vein. The old concept “I’m too old to change” does not apply to the symptoms of sexual dysfunction.