Categories
Sexual Dysfunction

Male Sexual Dysfunction

In order to be diagnosed as having primary orgasmic dysfunction, a woman must report lack of orgasmic attainment during her entire lifespan. There is no definition of male sexual dysfunction that parallels in this severity of exclusion.

A Male Is Judged Primarily Impotent:
The definition means simply that he has never been able to achieve intromission in either homosexual or heterosexual opportunity. However, he might, and usually does, masturbate with some regularity or enjoy occasions of partner manipulation to ejaculation.

For the primarily non orgasmic woman, however, the definition demands a standard of total inorgasmic responsivity.

The edict of lifetime non orgasmic return in the Foundation’s definition of primary orgasmic dysfunction includes a history of consistent non orgasmic response to all attempts at physical stimulation, such as masturbation, male or female manipulation, oral genital contact, and vaginal or rectal intercourse.

In Short
Every possible physical approach to sexual stimulation initiated by self or received from any partner has been totally unsuccessful in developing an orgasmic experience for the particular woman diagnosed as primarily non orgasmic.

If a woman is orgasmic in dreams or in fantasy alone, she still would be considered primarily non orgasmic.

Foundation personnel have encountered two women who provided a positive history of an occasional dream sequence with orgasmic return and a negative history of physically initiated orgasmic release.

However, no woman has been encountered to date that described the ability to fantasy to orgasm without providing a concomitant history of successful orgasmic return from a variety of physically stimulative measures.

There are salient truths about male and female sexual interaction that place the female in a relatively untenable position from the point of view of equality of sexual response.

Of primary consideration is the fact of woman’s physical necessity for an effectively functioning male sexual partner if she is to achieve coitally experienced orgasmic return.

During coition the non orgasmic human female is immediately more disadvantaged than her sexually inadequate partner in that her fears for performance are dual in character. Her primary fear is, of course, for her own inability to respond as a woman, but she frequently must contend with the secondary fear for inadequacy of male sexual performance.

The outstanding example of such a situation is, of course, that of the woman married to a premature ejaculator. From the point of view of mutual responsibility for sexual performance, the woman has only to make herself physically available in order to provide the male with ejaculatory satisfaction.

The premature ejaculator in turn makes himself available, there usually is little correlation between intromission, rapid ejaculation, and female orgasmic return during the episode.

Married Premature Ejaculator

The biophysically disadvantaged female usually is additionally disadvantaged from a psychosocial point of view. Not only is there insufficient bio-physical opportunity to accomplish orgasmic return, but in short order the wife develops the concept of being sexually used in the marriage.

She feels that her husband has no real interest in her personally nor any concept of responsibility to her as a sexual entity. Many times the wife might be at a peak of sexual excitation with intromission. Without fear for her husband’s sexual performance she could be orgasmically responsive shortly after coital connection, displaying full bio-physical capacity for sexual response.

But as she sees and feels the male thrusting frantically for ejaculatory release, she immediately fears loss of sexual opportunity, is distracted from input of biophysical stimuli by that fear, and rapidly loses sexual interest.

With the negative psychosocial-system influence from the concept of being used more than counterbalancing the high level of biophysically oriented sexual tension she brought to the coital act, orgasmic opportunity is lost.

Brief attempt should be made to highlight the direct association of male and female sexual dysfunction in marriage, for there were 223 couples referred to the Foundation for treatment with bilateral partner complaints of sexual inadequacy. By far the greatest instance of a combined diagnosis was that of a non orgasmic woman married to a premature ejaculator.

Of the total 186 premature ejaculators treated in the 11 year program, 68 were married to women reported as primarily non orgasmic and an additional 39 wives were diagnosed as situationally non orgasmie. Thus, in 107 of the 223 marriages with bilateral partner complaint of sexual dysfunction, the specific male sexual inadequacy was premature ejaculation.

Since the in-depth descriptions of the premature ejaculator presented in earlier topic include full descriptions of the problems of female sexual functioning in this situation, there is no need for a detailed history representative of the 68 women primarily non orgasmic in marriages to prematurely ejaculating men.

Another salient feature in the human female’s disadvantaged role in coital connection is the centuries old concept that it is woman’s duty to satisfy her sexual partner. When the age old demand for accommodation during coital connection dominates any woman’s responsivity, her own opportunities for orgasmic expression are lessened proportionately.

If woman is to express her biophysical drive effectively, she must have the single-standard opportunity to think and feel sexually during coital connection that previous cultures have accorded the man.

The male
must consider the marital bed as not only his privilege but also a shared responsibility if his wife is to respond fully with him in coital expression. The heedless male driving for orgasm can carry along the woman already lost in high levels of sexual demand, but his chances of elevating to orgasm the woman who is trying to accommodate to the rhythm, depth, and power of his demanding pelvic thrusting are indeed poor.

It is extremely difficult to categorize female sexual dysfunction on a relatively secure etiological basis. There is such a multiplicity of influences within the biophysical and psychosocial systems that to isolate and underscore a single, major etiological factor in any particular situation is to invite later confrontation with pitfalls in therapeutic progression.

Categories
Sex & Dyspareunia

Penis Irritations

Many men complain:
Burning, itching, and irritation after coital connection with women contending with chronic or acute vaginal infections.

Not infrequently small blisters appear on the glans penis, particularly around the urethral outlet. If there are any abrasions on either the glans or shaft of the penis, secondary infection can occur in these local sites.

Irritative Penile Reaction

The same type of irritative penile reaction may develop from exposure to a non-infectious vaginal environment as a response to the chemicals in contraceptive creams, jellies, foams, etc.

It may not be the female that responds in a sensitive manner to an intravaginal chemical contraceptive agent but rather her male partner. Sensitivity to intravaginal chemical contraceptives is seen quite frequently in the male and, if symptoms develop, the contraceptive technique should be changed.

The same sort of irritative penile reaction can be elicited by a repetitive pattern of vaginal douching.

There are some douche preparations to which not the female but the male partner becomes sensitive.

Not infrequently, vesicles form on the glans penis. If these blisters rupture, the raw areas on the glans are quite painful, particularly during sexual connection.

Gonorrhea

In the actual process of ejaculation, there are many situations that return painful stimuli to the involved male. If the individual has had gonorrhea there may be strictures (adhesions) throughout the length of the penile urethra, and attempts to urinate and/or ejaculate may cause severe pain spreading throughout the penile urethra and radiating to the bladder and prostate.

Infection in the Bladder, Prostate, or the Seminal Vesicles

There may be the sensation of intense burning during and particularly in the first few minutes after ejaculation. Particularly if the offending agent has been the gonococcus, the pain with ejaculation sometimes is exquisite. Immediate medical attention should be given to any complaint of burning or itching during or immediately after the ejaculatory process.

Prostate and Ejaculation

There is a spastic reaction of the prostate gland seen in older men during the stage of ejaculatory inevitability. In this situation, the prostate contracts spastically rather than in its regularly recurring contractile pattern, and the return can be one of very real pelvic pain and/or aching radiating to the inner aspects of the thighs or into the bladder and occasionally to the rectum.

This pathologic spastic contraction pattern can be treated effectively by providing a minimal amount of testosterone replacement therapy.

Care should be taken to evaluate the possibility of concurrent infection in the prostate. Occasionally, chronic prostatitis has caused significant degrees of pain during an ejaculatory process.

As a point in differential diagnosis, the painful response with prostatic infection is with the second, not the first, stage of the orgasmic experience, while that of prostatic spasm has just the reverse sequence. Careful questioning usually will establish specifically the timing in the onset of the painful response and thus suggest a more definitive diagnosis.

Prostate

Benign hypertrophy of the prostate gland primarily and carcinoma of the prostate rarely may be responsible for the onset of pain with the ejaculatory process. The pain is secondary (acquired) in character and radiates to the bladder and rectum.

Usually confined to older age groups, the onset of this type of dyspareunia should be investigated immediately by the competent authority. This review of the major causes of dyspareunia has been primarily directed toward the female partner, for from her come by far the greater number of complaints of painful coital connection.

However, male dyspareunia no longer should be ignored by the medical and behavioral literature. The review of the etiology of male dyspareunia has not been exhaustive, nor is it within the province of this text to do so.

In concept, the entire chapter has been designed to suggest to co-therapists, faced daily with a myriad of problems focusing upon both male and female sexual dysfunction, that there are physiological as well as psychological causes for sexual inadequacy.

Combined pelvic and rectal examinations for the female and rectal examination for the male partner are a routine part of the total physical examination provided for both members of any marital unit referred to the Foundation for treatment of sexual dysfunction.

To attempt to define and to treat the basic elements of sexual dysfunction for either sex without including the opportunity for thorough physical examination and complete laboratory evaluations as an integral part of the patient’s diagnostic and therapeutic program is to do the individual and the marital unit a clinical disservice.

Categories
Impotence Cure

Sexual Dysfunction in Husband & Wife

Of course, most wives would not consider public discussion of the sexual inadequacy in their marriages. For a variety of reasons, they choose to keep their own counsel.

They may feel that their husband’s dysfunction has origin in, or at least is magnified by, their own lack of physical appeal, or that they forced this inadequacy by their lack of competence of sexual functioning.

Most women identify completely with and suffer for, their husbands in sexual inadequacy. They feel warmth and sympathy and understand the psychosocial trauma created by his obvious failure in the marriage bed.

For a variety of reasons then, most women would not consider discussing their husband’s sexual dysfunction even with their closest friend.

But most women, whether they accuse publicly or support privately, do not comprehend the degree to which they have directly influenced their husband’s sexual inadequacy.

There is no such entity as an uninvolved partner in a marriage contending with any form of sexual inadequacy.

Sexual Dysfunction is A Couple’s Problem

not a husband’s or wife’s problem.

Therefore, husband and wife should be treated simultaneously when symptoms of impotence distress the husband and wife. The Foundation will not treat a husband for impotence or a wife for non-orgasmic return as single entities.

If not accompanied by his wife, the impotent husband is not accepted in therapy. Both marital partners have not only contributed to but are totally immersed in, the clinical distress by the time any unit is seen in therapy.

How best to treat clinical impotence? The first tenet in therapy is to avoid the expected, direct clinical approach to the symptoms of erective inadequacy.

The secret of successful therapy (for this dysfunction):
is not to treat the symptoms of impotence at all, for to do so means attempting to train or educate the male to attain a satisfactory erection, and places the therapist at exactly the same psychological disadvantage as that of the impotent male trying to will an erection.

Therapists cannot supplant or improve on a natural process and achievement and maintenance of penile erection is a natural process.

The major therapeutic contribution involves convincing the emotionally distraught male that he does not have to be taught, to establish an erection. He cannot be taught to achieve an erection any more than he can be taught to breathe.

Erections develop just as involuntarily and with just as little effort as breathing. This is the salient therapeutic fact the disturbed man must learn. No man can will an erection.

Every impotent man has to negate or neutralize a number of psychosocial influences which have helped to create his sexual dysfunction if he is to achieve erective effectiveness.

However, the prevalent roadblock is one of fear. Fear can prevent erections just as fear can increase the respiratory rate or lead to diarrhea or vomiting.

At the onset of therapy, the impotent man’s fears of performance and his resultant spectator’s role are described specifically by the co-therapists and must be accepted in totality by the distressed male if reversal of the sexual dysfunction is to be accomplished.

Every impotent male is only too cognizant of his fears of performance, and, once the point is emphasized, he also is completely aware of the involuntary spectator role he plays during the coital attempt.

The Three Primary Goals in Treating Impotence Are:

  1. remove the man’s fears for sexual performance
  2. to reorient involuntary behavioral patterning so that he becomes an active participant, far removed from his accustomed spectator’s role.
  3. to relieve the wife’s fears for her husband’s sexual performance.

Whenever any individual evaluates his sexual performance or that of his partner during an active sexual encounter, he is removing sex from its natural context. And this, of course, is the all-important factor in both onset of and reversal of sexual inadequacy.

Penis flaccidity
With any form of sexual dysfunction, sex is removed from its natural context. The man watching carefully to see whether he is to achieve erection sweats and strains to will that erection.

The more the male strains the more distracted he becomes and the less input of sensual pleasures he receives from his partner; therefore, the more entrenched the continued state of penile flaccidity.

Sexual Tension

In a natural cycle of sexual response, there is input to any sexually involved individual from two sources.

As an example, presume an interested husband approaching his receptive wife. There are two principal sources of his sexual excitation. The first is developed as the husband approaches his wife sexually, stimulating her to high levels of sexual tension.

Her biophysical response to his stimulative approach (her pleasure factor), usually expressed by means of nonverbal communication, is highly exciting to the male partner. While pleasing his wife and noting the signs of her physical excitation (increased muscle tone, rapid breathing, flushed face, abundance of vaginal lubrication), he usually develops an erection and does so without any direct physical approach from his wife.

In this situation, he is giving himself to his wife and getting a high level of sexual excitation from her in return.

The second source of male stimulation develops as the wife approaches her husband with direct physical contact.

Regardless of the technique employed, his wife’s direct approach to his body generally, and the pelvic area specifically, is sexually exciting and usually productive of an erection.

When stimuli from both sources are combined by mutuality of sexual play, the natural effect is the rapid elevation of sexual tension resulting in a full, demanding erection.

Often men move into a pattern of erective failure because they do not experience sensate input from both sides of the give-to-get cycle. Loss of supportive sexual excitation frequently develops not because wives are unavailable or uninterested but because one or both of the basic modes of input of sexual stimuli is blocked.