Take this test:

1. Where exactly is your lover’s clitoris?

2. What is its purpose or function?

3. How far behind a man’s arousal is the average woman?

4. What usually indicates a woman is aroused and ready for penetrations?

5. How do you tell if a woman is having a real orgasm?

Answers:

1. Above the urethra.

2. Pleasure-stimulation.

3. About 20 minutes.

4. Vaginal lubrication.

5. Sex flush on the chest & body hair erects.

Well, even knowing all or most of this unfortunately won’t guarantee that you are a great lover, but at least you show an interest in matters sexual, and that is a good base.

The truth is that we guys can be a great lover with one woman, and less so with another, or even on occasion with the same one who usually makes us feel great. Yet we want to be perceived as a good, even great, lover. It makes us feel warm all over if we know our partner respects our lovemaking and generally is open to, and eager for, us.

To be or become a good or great lover takes dedication, and an acceptance that while our sexual drive is inborn or innate, how we express that drive is a learned skill. To learn well requires an open mind, and in matters of love, an open heart.

Unfortunately, ingrained in the male psyche is the notion that men need to prove themselves sexually. That is a sad truth. Sad, because it creates pressure on men to perform.

I say to all my patients: sex is not a performance; it is adult play, and a (potentially) profound form of communication.

I say to men: if you feel the need to prove yourself sexually, you are then either with the wrong partner, or with the right partner at the wrong time. The ideal would be for a man (or woman) to go to bed with a partner and not to know whether their loveplay will lead to intercourse. They will flow with the moment and enjoy whatever unfolds.

In my view, the essence of being a great lover is the same as what makes a person a find, mature human being.

Among the important ingredients are: authenticity, congruence, empathy, communication ability, creativity, spontaneity, playfulness, and self-confidence.

These are not qualities we are necessarily born with. Nor do we really reach an endpoint where we say O.K., now we have arrived, “we’re great.” It’s a process rather of becoming, evolving toward these objectives. And, by the way, the same qualities apply whether you are a man or a woman.

Let’s briefly look at these ‘greatness’ ingredients…

Authenticity implies the ability to be real. This is hard to define, but people in contact with you have little difficulty sensing it. An authentic person seems solid, well-grounded, secure. It is the opposite of the poseur, the image conscious cool man, or woman, pre-occupied with how they come across. The authentic person rejects the popular saying ‘image is everything.’

Congruence is a cousin of authenticity. It means that you talk the talk, and you walk the walk. Your mouth and your body say the same thing. You act in accord with your feelings, and you are in touch with those feelings you are expressing.

Empathy is a crucial attribute of mature functioning. Your ability to feel what another person is experiencing, or has gone through, enables you to be a moral person. This helps one to make right choices. Without empathy, morality and thus civilization could not exist.

The ability to communicate is fundamental to nurturing relationships. This applies especially to feelings, and unfortunately is again not a ‘natural’ ability of every man or woman. Yet, we have feelings all the time, but the ability to identify, label and express them can take a lifetime to develop. Certainly, those lucky enough to have had parents or teachers who listened and validated feelings through their growing-up years are very fortunate.

Creativity is a welcome attribute in many human endeavors, and sex is no exception. Unfortunately, many of us growing up don’t get enough support or encouragement to be creative. Indeed, school and life often teach that conformity is the safest way to get by, if not ahead. Further, it does not help that the most readily or easily available models for sexual activity come from porn. These materials, produced factory-like by actors paid to perform on cue, are regrettable and at times harmful sources of ‘sex education.’ Yet, I see many men (and some women) whose sole access to sexually explicit information came from porn videos and magazines. There are better quality, yet still explicit, materials emerging that validate male-female intimacy, and downplay the ‘sex is a performance’ notion, but they are still rather hard to find. A helpful resource on the Internet is drsommers.com.

Spontaneity and playfulness can be considered together. They are the salt and pepper of a good intimate/sexual relationship. With this attitude, lovers can go beyond set times and places for playful erotic interactions, thus creating an atmosphere of surprise and the thrill of the unexpected.

Joanne, an attractive, 35-year-old executive, came to see me with a common problem — she wanted to be able to orgasm with a man. Her last relationship — a 5-year marriage, ended when her husband left her with the complaint: I can never satisfy you. But, she says she actually liked having sex and never complained — yet her husband remained unhappy. He needed to know that he made her come, and thus feel he was a good lover. This attitude is regrettable. Joanne was, and is, an intelligent, sensuous woman who can turn many a man’s head. Of course, the more pressure she felt to come, to perform to expectation, the harder time she had to surrender to her feelings and experience orgasmic release.

So guys, let’s lighten up. We’re not, nor should we expect our partners to be, trained seals, or sex machines with a variety of buttons to be pushed. In truth, no one can make anyone else ‘come.’ Each person allows ‘it’ to happen. If not, this too can be learned.

Now, Joanne, after some treatment, has developed the ability and confidence to have one or more orgasms. She recently met a man she finds very sexy. After a number of dates, she felt comfortable to invite him to stay the night. He was, she says, hungry, a bit “like a bull in a china shop.” With her newly acquired knowledge and confidence, she gently started to guide his hands and convey to him clearly how and where she found his touch most pleasurable. Since she found him open to her feedback, even (wisely) thankful for her guidance, she found the whole initial lovemaking attempt satisfying, though she did not orgasm. No matter. She learned not to become a prisoner of expectations, hers or her lover’s. She now knows that good, gentle guidance, and open communication is the way to establish a mutually satisfying intimate relationship.

The situation with men is no different. Stan, 26, was a stud and proud of it. Tall, slim, athletic, he wore a winning smile and had the gift of the gab. Women were drawn to him and his major problem was whom to choose as his bed companion after an evening out with his buddies at a well-known neighbourhood singles bar.

When I saw him, he was strikingly handsome, but not smiling. In fact, he was downcast, almost crying, as he complained about his failure to perform one night with a ‘hot number.’ He felt devastated and desperate. “Why did this happen to me?” he asked, and “will it ever come back?”

Based on experience, I was able to reassure him that if he goes through treatment and conscientiously does my assignments, he’ll regain his ability to function. But I made it clear that our aim was not to make him able to perform as a stud. Eventually, he came to realize that his previous behaviour was rooted in basic insecurity, which constantly needed reassurance.

Going through the treatment program, Stan learned to realize his potential as an intelligent adult lover able to give up the compulsive need to prove himself, and to live up to some perceived ideal. He became more selective, and was surprised to find sex much more enjoyable.

So, after 30 years of treating couples and single men and women with sexual difficulties, it is clear that sexual health is a complex interaction of physical and psychological factors. Neither can, nor should, be neglected. For example, no matter how considerate a partner you are, how well you communicate, if your personal hygiene habits leave something to be desired — forget it.

What makes sex so fascinating is that it is the ultimate mind-body experience. Sometime, experiment and explore. Touch your lover’s face as you look into their eyes and try to breathe in tune with them. Another time, make complimentary remarks in a low, murmuring voice, such as “I love the way you smell (move, etc.).” Try to make a point of sharing your feelings with your partner, and encourage them to do the same. Above all, remember that developing an exciting sexual relationship can, and usually does, take time. And once you achieve it, it takes tending to, nurturing.

Those without a partner now need to use this valuable time as preparation to become a great lover. Develop those attributes in yourself that will make you a mature adult, and thus a desirable love partner. By doing this, you will send out signals that will attract more suitable, complementary partners. Then together, you will embark on one of life’s most joyous, rewarding activities. You will be dancing among the stars.

One final point to ponder. There is only one organ or body part in females (and none in males) whose sole purpose or function is pleasure. It is called the clitoris. Great lovers never forget this.

- Dr. Frank Sommers

He has been having difficulty getting and keeping erections for the past year or two, with the problem getting gradually worse. He and his girlfriend of 3 years called it quits recently. He felt sad, angry, and hurt, especially when she said in frustration, “you can’t even get it up.”

His past history was also not unusual. Around 18, shortly after starting intercourse, he noticed a creeping ‘fear of performing.’ A need to prove himself as a capable, skillful lover pushed into his awareness more strongly with each new relationship. Especially, if the girl was attractive.

He has been to doctors. Some told him “it’s just anxiety, you’ll get over it.” One prescribed Yohimbine (he was 19), and it helped a bit, but only for a short time.

A highly advertised ‘sex clinic’ taught him how to inject his penis, and then switched him to Viagra. These gave him erections, along with headaches and altered vision, plus cost a bundle. (I jokingly call it ‘sex tax.’)

He keenly wanted to be free of medication, but had difficulty recalling when he last had intercourse without medication.

Significantly, he awoke with firm erections often, and had no difficulty masturbating to ejaculation.

He liked sex, and women, and exercised 3 to 4 times a week. He also did weights. He had a secure job, which he liked. He hoped to someday marry and have a family.

Well, several weeks into our treatment program, using no medication, John is well on his way to being a changed man. Some of my patients say a miracle has happened. I don’t argue with them, but only wish more people would realize that help for sexual problems exists, without the need for drugs. But you have to take the initiative to find a reputable specialist who knows what they are doing.

I hope to offer some help (or at least motivation) to readers like John within the limits a column like this offers. But, I recognize many single men (and women and couples) have all kinds of issues they are dealing with which don’t require a therapist. How to please a woman, how to communicate effectively, how to get a couple’s desire in sync are just a few of the many issues we can explore.

Everyone has to get to know some basic facts about sexuality. Education is a major key to a happy sex life. Most people don’t realize that our basic sexual attitudes are formed at a very early age. If we are lucky, we have parents who feel comfortable with their own sexuality and teach children from the ground up, in age-appropriate ways not only accurate information, but also attitudes. For example, being comfortable about nudity within the family will help children feel a sense of comfort about their own changing bodies as they grow.

Raising children with “penis pride” and “clitoral consciousness,” as my eminent colleague Dr. Yates puts it in her classic book, “Sex Without Shame,” would help to nurture a sexually healthy society, I believe.

If Mary and Steve, an attractive couple in their early thirties, had come from this kind of positive background, their five-year marriage would not have been close to ending when they came to see me. Mary was turned off sex, and Steve was climbing the walls. Along with her sex-negative upbringing (“be careful with boys, they’re only after one thing,” her mother used to say), Mary dreamed that “saving” herself for marriage will fulfill all her sexual longings. Unfortunately, Steve’s sex education came mostly from watching porn videos, and he was puzzled at Mary’s turn-off at his “expert” technique.

My treatment of this couple went back to fundamentals and, after about ten sessions, both felt re-born, re-committed, and in love. I treasure the picture of their baby they sent me about a year later.

Certainly, over 25 years of practice, I have seen how relieved people can be when they realize their problem is not unique, and are happy to find there usually is a solution. I feel gratified to be working in a field where I can offer help to people in such a sensitive area as their sexuality and love life.

I invite you to send in sexuality and relationship questions, make comments, share your interests and concerns. Chances are you will discover that you, too, are not alone.

- Dr. Frank Sommers

Sandy and Doug are not unusual and there must be thousands and thousands of couples like them. When they met, they both were quite emotionally, not to mention sexually, needy. Their happiness was complete in finding somebody they could really “talk to.” The good sexual interaction, everything but intercourse, since they were good Catholics, was a bonus.

By the time their second child was born, the couple was already heading for trouble. Doug was working late hours trying to establish himself and the business, and Sandy was attempting to be the perfect wife and mother. Since neither of them had any real sex education to speak of, it was really a situation of the blind leading the blind, so to speak, when it came to their intimate life together.

Doug had, and has, a rather strong sexual appetite, and one of the things that he found appealing in Sandy was her willingness to be flirtatious and sexually available. However, eventually they found themselves more and more in disagreements, especially over Doug’s frustration about his unmet sexual needs. Eventually, the more Doug pushed for sex, the more Sandy resisted. This then became a vicious circle and when I got to start treatment with them, they reported that they had not had sexual intercourse for more than a year.

This marriage was in crisis.

While treating a couple like this, I am particularly mindful of the reality of the two children they are raising. Should they break up, no matter how smoothly the breakup goes — and it never really is a hundred percent smooth — those developing kids will be at the receiving end of some very unpleasant life lessons. So we’re all trying to make an extra effort to try to remedy the situation, but how?

In this couple’s case, we started by understanding first of all what influences or controls their sexual life on a physical level, and then proceeded to explore emotional complements which enable physiological mechanisms to either work well or perhaps not at all. For example, how men become erect and women wet.

In this regard, a couple’s ability to communicate in an emotional, meaningfully heart to heart, eye to eye manner is critical. What often unfortunately tends to happen is that unless everyday irritation, frustration, annoyance or anger components of daily life are dealt with maturely by the couple, there is a real danger that resentment will develop. Once resentment sets in, desire flies out the window! You don’t really want to be intimate and close with someone you resent. But many couples find themselves in a bind, and in this state they have no idea how to get out of it. It’s like “you’re in a swamp,” I tell my patients.

Fortunately, there is good news. With careful guidance and attention to some very specific communication skill training, we were able to drain the swamp which this couple’s inability to communicate has created, and got them to dry land. Thus they could begin anew. This time, armed with knowledge, which truly is power, they are able to deal with the inevitable ups and downs that are present in everyone’s life, especially if they are working and trying to fulfill conscientiously the roles of parent and loving spouse.

This couple has made great strides in being able to discuss Doug’s strong sexual needs and his belief that he can obtain great relief by having an orgasm at the end of his tension-filled day. (Anyone else feel this way?) However, Sandy’s job is also quite demanding and makes her eager on getting home, not for sex, but for some time just to herself.

With goodwill a number of options can be explored, and this couple is now starting to discuss their need for private time at the end of the workday, and ways to meet each other’s sexual desires. They’re becoming aware that not all sex necessarily leads or proceeds to intercourse, and not all intercourse needs to become a drawn-out prolonged ‘banquet-like’ affair.

Adjusting to their daily routine, they are now finding productive alternatives to fighting and anger. Doug and Sandy are a couple headed for success in resolving a rather difficult, and potentially dangerous, toxic marital situation. It is important for all couples to recognize that the sooner they resolve these problems on their own, or seek assistance from qualified professionals, the sooner they will get on the road to a much happier and fulfilling life.

- Dr. Frank Sommers

As soon as he used the word “perform,” I kind of jumped on him and told him in clear terms that that word was not allowed to be used in my office. I said “sex is not a performance.” “Sex is a form of adult play and a potentially profound form of communication.” As he continued to tell me his story, it became clear that Alex’s whole social life became significantly constricted as a result of his fear of failure in bed.

Like many men I see with such problems, Alex was handsome, well-toned, intelligent, and had a good steady job and source of income. Also, he felt really keen to have a relationship and relieve some of what he felt were the burdens of single life, like loneliness, at times. Similar to many people who experienced a good marriage, even in part, or a good relationship, they crave and want to recreate that aspect of the previous experience.

Also, as with many patients, Alex’s main problem was not that he could not attract women who might be interested in going out with him. He was quite acceptably handsome and clearly would appeal to some members of the opposite sex. Unfortunately, the fear of having to go to the bedroom at some point in the relationship, and potentially suffering a “failure experience,” so inhibited Alex from even attempting to meet women that his whole social life became very severely restricted.

Eventually, Alex attempted to get help by going to a highly advertised clinic where his penis was injected and a firm erection thereby produced. However, he was reluctant to follow their advice and precede every act of potential intercourse with putting a needle into his penis. In exploring alternatives, he also tried Viagra and this too worked with some effect in him but not consistently, and he reported that he had some headaches as well, and he found timing a problem, having to take the pill about an hour before intended sexual contact.

Alex was very relieved when we discussed our approach to treating his sexual problem without any medications whatsoever. Rather, relying on a cognitive/behavioural treatment, which entailed reprogramming the autonomic part of his central nervous system, would then enable his blood vessels to be relaxed and open wide, thus allowing blood to flow to the penis freely and produce an erection whenever he would want.

Indeed, following this 8 to 10 session program, supplemented with readings and homeplay assignments, and looking at carefully selected sex education films and videos, Alex made marvelous progress, like most of my patients.

In one of our last sessions, he related how recently he met on a street near his home a lovely tall blond “with legs up to here,” whom he asked for a coffee after a brief chat. That led to dinner in a nice restaurant and some very exploratory discussion about what each of them had in mind for the future. It turned out that she had also been married once before, and was ready and keen on a serious long-term relationship with children, as was Alex. They both agreed to go slow and to explore each other’s values, goals, and ability to communicate in a meaningful soul-to-soul level. There is every indication now that this relationship will meet Alex’s expectations and even exceed them, and that his long period of solitary life and fear of sexual failure will come to a happy end.

It is stories like Alex’s, repeated many times, in my practice that makes my work so meaningful and rewarding. It is most important that men in a similar position as Alex recognize that these days there are a variety of approaches to help with all kinds of sexual problems, dealing with erections as well as with ejaculation control problems and desire issues as well. It’s most important that people take responsibility when they do have a problem, and seek out appropriate help with a well-qualified doctor or therapist with whom they feel comfortable. If something seems not be working out, do not hesitate to explore alternatives. Do it sooner rather than later, as this makes the treatment program easier. Among resources available to you besides, of course, the Yellow Pages would be preferably referrals from your family doctor and/or a phone call to your local hospital and/or medical society.

- Dr. Frank Sommers

Yet, being sexy was very much part of Mary’s makeup. She had learned how to project an image of being a sexually highly desirable woman and, indeed, her sexual history revealed that she has had numerous boyfriends. Men on the street turned their heads with Mary approaching and she had no difficulty having the pick of the ‘crop’, so to speak.

Many relationships for Mary in the past ended in frustration when the excitement of the new started to fade. Moreover, Mary found that most men she attracted were very much turned on to her physically and imagined her to be a highly responsive, sexually keen partner.

Initially in each relationship, Mary would play the role that she thought was expected of her. She developed a technique to indicate to her partners high excitement which she really did not feel inside. Consequently, much of her intimate lovemaking was a sham. What prompted Mary to come to see me was the total frustration she had come to feel in her life with her current boyfriend, John. She wanted to avoid falling into the same pattern with this relationship, and she resolved to try to remedy her problem. This was a major step for her since John indicated that he was willing to stand by her no matter what.

It’s worth noting that Mary learned to convey or project an extra sense of sensual aliveness and sexual interest, perhaps as a compensation for her deeply felt inadequacy in delivering the goods, so to speak. In subsequent therapy, Mary confided that most men she found not to be too aware of the fact that she was “faking” her sexual interest and response. Her experience of sex was that most guys were primarily motivated to get it on and have intercourse as quickly as possible with the goal of orgasm in mind. Mary’s needs were much more in the realm of affectionate holding, kissing, touching and the feeling of being desired for her own person. Not for the ‘sexy babe’ persona she projected.

There appears to be many Marys out there in the large world who are caught in a bind. They feel they need to project a certain sexy image in order to attract men. At the same time they know they are playing a risky game, because not infrequently, the men they have attracted will be responding to ‘false advertising’. In this game, unfortunately, there are no winners. Sooner or later Mary and the boyfriend will come to a point of frustration, a plateau, where the relationship gets stuck. They are at an impasse. More often than not, the couple will then break up and, sadder but no wiser, will repeat the same cycle in the next relationship.

The good news is that situations like this need not go on and on. Women like Mary and their boyfriends need to learn that this is not such an uncommon problem. Indeed, I think many, many women have great difficulties in coming to climax from intercourse. The answer, which is encouraging, is that most of these problems can be solved rather promptly, through qualified professional assistance. It can be very helpful if women like Mary seek treatment either while single, or with a partner who cares and promises to be supportive.

During treatment, these couples learn that women’s main sexual organ, even more than men, is the brain. It appears that there is a period of heightened sensitivity for the induction of the orgasmic reflex. If this ‘window of opportunity’ is missed, then it may be a harbinger of difficulties to come in developing the ability to orgasm. It’s possible that young, post-pubertal women’s brains and nervous systems need to be exercised with this ‘orgasm reflex’ in order for those connections to be made and to be able to peak more easily. This is only part of the story. We know from experience that women’s arousal is considerably slower than that of men, and unfortunately, because most men’s sexual interest is highly goal-oriented towards the attainment of orgasmic release, many women often find themselves in the frustrating situation of being behind their male partner in arousal intensity.

In my work with such clients, I try to remedy this problem first of all by having the couple become aware, and acquire a different knowledge base about how men and women truly function sexually. Then through a series of graduated exercises, guided readings and videos, I help these patients to reprogram their nervous system, as it were, in order to enable them to function in a more fulfilling way, first of all in solo sexual activity, and then in partner sex. Now there are many happy Marys out there, but guys, let’s learn.

- Dr. Frank Sommers

She had been married for three years when I saw her with her husband, Steve, in my clinic. The problem was, they were not having much sex anymore, since Jill lost all interest. This was a great disappointment to Steve since he remembers on meeting each other how attracted he was, not only to her, but to her wholehearted, enthusiastic participation in physical lovemaking. Those days are long gone now, and their marriage seems to be in serious danger.

At age 29, Jill had a responsible, middle-management job which she thoroughly enjoyed. She felt valued at her workplace and it provided her with challenges she appreciated. The whole situation about their sex life was puzzling for her, and quite frustrating for both of them.

This kind of ‘desire discrepancy’ problem is one that I and my colleagues see now quite frequently. Its resolution or treatment is a great challenge.

The loss of sexual desire is a serious problem, and in particular it is hard to bear for those who one time were very enthusiastic about sex. Their partners are bewildered and often feel cheated. The worry in many of these situations often isn’t that they fear their partner no longer finds them attractive, or that they have found somebody else, but rather that their appetite for close physical intimacy diminishes or evaporates. This puzzling phenomenon occurs with great frequency and I have seen many a man, who was madly in love with his most attractive girlfriend, climbing the walls a few years after marriage when the still sexy partner keeps turning away their mate’s desire for sexual contact. In some of these situations, the problems get worse as the couple, instead of turning to therapy for clues to their predicament, engage in extra-marital experimentation in the hope of “getting it back.”

In reality, when one looks deep within the stories of these individuals one often finds that there is a pattern. Women report that in previous relationships too, they have frequently experienced very intense desire on meeting a new man, quickly jumped into bed, and had a terrific time. This reinforces the rapid bonding of the couple and before long they feel that they may have found their life mate. Unfortunately, after a number of weeks or months of this intense physical sexual activity, a certain degree of cooling sets in, without any apparent external cause. There is also a distancing feeling that starts to occur and as frustration mounts, both start to feel more bewildered, frustrated, angry, and wistful for the high degree of passion which they had earlier. Not infrequently, then, the relationship fades out and then dissolves. Often no wiser, they go their separate ways, saddened by their experience. Although afraid to be hurt, they may find themselves repeating this pattern over and over again. What is wrong? And is there any way to fix it?

The answer is not easy to come by and can vary with the person or couple involved. Jill, for example, related that since she was an attractive teenager, she felt boys hitting on her. While she enjoyed a certain amount of attention, and liked being popular, she formed the idea that the way she looked generated most of the interest. She constantly felt a need to be on guard, since boys would “want and take whatever they could get.”

After much dating, she embarked on married life with Steve, a nice-looking, decent man, and a fine lover. However, as they settled into the long haul of married life, the excitement, spontaneity, and newness diminished, when the demands of daily life at work and home, if anything, increased.

Before too long, Jill started to miss the attention and constant male interest, and the boost to her self esteem this provided. Indeed, some men at work persisted in showering attention on her, despite her married status. This she found strangely exhilarating.

As I worked with this couple, both of them came to realize the inner dynamics of what was happening to them. It was an eye opening experience for them to reflect on the mistaken expectations and real trade-offs involved in maintaining an ongoing couple bond, also called ‘marriage,’ in contrast to a boyfriend-girlfriend dating situation.

In addition, Jill started to see that relying on self-esteem ‘feeds’ from inappropriate male attention exacted a price.

In our therapy, we also intensively focussed on a series of physical, sensual and sexual exercises to help them reconnect. They learned that maintaining the passion in a relationship required some dedicated time and effort. Unlike when they were single or in a new relationship, desire needed to be kindled, and they discovered how their brain, imagination, communication and actions played a very significant role in all this.

To their joy, they found the program empowering and very helpful. Their relationship became reinforced and they began to embark on a more intensely, and personally fulfulling, way of living their life.

- Dr. Frank G. Sommers

Dear Dr. Sommers:

Nine months after my wife died, I invited a lady out for dinner. She was someone I had worked with for seven years and a friend of my wife, although younger than both of us. (She was 39.) I respect and like her very much, but found it difficult to get into the routine of asking someone out. However, having taken the initial step it was a very enjoyable evening. We talked until three in the morning. I took her out several times. I don’t recall exactly how many; but anyway, after a time we went to bed. I must admit I was rather surprised in that I did not expect that she would find me interesting in that our age were fairly wide apart.

Things were going great in bed until we reached the point where she took hold of my penis for insertion and I ejaculated. My reaction and feeling at the time? Complete and utter devastation. I guess even humiliation; certainly failure. Here was someone I cared a great deal about, stimulated to a high pitch and disappointed. Since that time I have not on subsequent tries been able to get a full erection and have ejaculated. In this respect I guess it has gotten worrse. How do I feel about the problem? It is the most debilitating thing I have ever tried to cope with. It has badly affected my self-confidence. It has made it difficult for me to communicate verbally with her. It is on my mind most of the time and affecting my concentration at work and my emotional stability – which I think has always been considerably high. Sometimes when by myself I simply break down and cry.

Over 50 and over the hill

Dr. Sommers responds:

Dear Over:

Reaching out after mourning for a loved spouse who died is an act of re-affirmation of the power of love. To function sexually in a new relationship is not easy. You feel vulnerable and have a certain need to prove yourself to your new lover (and perhaps to yourself as well). No such pressures operated in your previous relationship, a long term, good marriage.

It is not surprising that you would feel great desire, and yet experience disappointing ‘performance.’ In fact, after a period of abstinence, premature or early ejaculation could well be the norm, therefore the expected. The more you can learn to relax with your new partner, and engage in sex play, such as kissing, hugging, and cuddling, and sharing of feelings without any regard to having to ‘perform’ with your penis, the more likely you will feel satisfied. The chances are your lover is with you because she cares for you, all of you, not just your penis. Take time to feel good with each other, enjoying each moment in the ‘here and now.’ Don’t judge your manliness by the behaviour of six or so inches of flesh. You have been through a very traumatic time in your life, so give yourself a chance to feel whole again. Be patient, and allow your mind and body to get accustomed to your new life situation and new intimate partner. Healing takes time.

Notice and Disclaimer:

Answers to questions are provided by a qualified psychiatrist/sex therapist on the understanding that these answers provide education and/or instruction, and do not constitute therapy or counselling. Any person seeking counselling or therapy should consult a local qualified professional.

My wife can only have orgasms with vibrators. I feel very inadequate here. It is causing a very big emotional problem for me and our marriage. She is happy with the situation, and is not willing to do anything to change this. What can I do to feel better about the situation?

Dr. Sommers responds:

Your question is, unfortunately, not surprising. Many women turn to vibrators after experiencing repeated frustration with trying to reach orgasmic release with ‘human power’ only. I have some concerns about this seemingly easy way to resolve the difficulty and try to warn or educate my patients. My main concern is that the nervous system may get used to (habituate) a level of powerful stimulation, and thus change the orgasmic threshold. A number of magazine articles and even therapists don’t seem to be concerned about this.

In my view, the fact you say this is a “big emotional problem for you and your marriage,” and that you “feel very inadequate,” suggests this should be an issue you need to tackle as a couple, and if you can’t arrive at a satisfactory solution, then seeing a local experienced professional may be indicated.

You may need to explore your seeming need to be the one who ‘gives’ your partner an orgasm. She may need to develop increased empathy toward your feelings here, and reflect on a compromise, e.g., if she wishes to keep using the vibrator she might save it for solo sessions only. Or you may agree that you become the person who holds/controls the vibrator in lovemaking. In this regard, did you know you can find a vibrator that attaches to your hand and it’s your fingers then that vibrate in contact with the clitoris?

The above are but some suggestions to explore.

With every good wish for a happy love life,
Frank Sommers, M.D.

Notice and Disclaimer:

Answers to questions are provided by a qualified psychiatrist/sex therapist on the understanding that these answers provide education and/or instruction, and do not constitute therapy or counselling. Any person seeking counselling or therapy should consult a local qualified professional.

Hello, Dr. Sommers,

I am a healthy 26-year-old in a 1-1/2 year relationship. We have sex 1-2x per week. For the last 8 months or so, I haven’t been able to get an erection unless my girlfriend performs oral sex on me. When we roll around in bed it just doesn’t do it for me. Now I think about getting hard when we are together and of course it doesn’t happen…unless she goes down on me. It is creating a problem in our relationship that is otherwise flawless. I’ve looked into the sensate focus approach but it just seems silly because we see each other naked all the time. She is very good looking and I’m still attracted to her but just not sure why I can’t get aroused kissing her and rolling around naked. Viagra worked for a while but now has little effect helping me gain an erection. I can masturbate with no problem. Do you have any ideas that could help me?

Dr. Sommers responds:

Hi, C.,

You are quite right, as soon as you start thinking (worrying) about any aspect of sexual functioning you are sabotaging your ability to immerse yourself in the experience. Sensate focus can work very well, but in my experience you need a context, which a good therapist can provide. Further, if you have allowed any resentment to build up in the relationship this will interfere as well. My guess, in the absence of a proper thorough consultation, is that your nervous system has become conditioned to respond to oral stimulation. This habituation needs to be stopped. One way may be to start decreasing fellatio (or quit it totally for a while) and use manual stimulation (her hand or yours or both) to become erect, and then achieve intromission, or perhaps still supplying manual stimulation to part of the shaft, or clasping the base of the penis to obstruct venous return, this supporting erection.

Best of luck trying this. If you need a qualified sex therapy referral in your area, let us know.

Frank Sommers, M.D., FRCPC

Notice and Disclaimer:

Answers to questions are provided by a qualified psychiatrist/sex therapist on the understanding that these answers provide education and/or instruction, and do not constitute therapy or counselling. Any person seeking counselling or therapy should consult a local qualified professional.

I am 51 years old and have suffered from retarded ejaculation since I was in my 20′s. I have been married for 15 years and until last spring the marriage was sexless because of my problem. Last year I began to see a psychiatrist and a sex therapist. The sex therapist managed to get my wife and I to be intimate again but I still could not ejaculate and we have all but given up trying, and so has my sex therapist. All of this has made me very depressed and has been very difficult on my marriage. I am desperate to get some help with this. Are you in practice now and are you taking on any new patients? If not, can you recommend a therapist who has experience with retarded ejaculation? Most I have talked to either have never treated it or have had little success when they have tried. Thank you.

Dr. Sommers responds:

Dear D.M.,

Unfortunately you are dealing with one of the more complex problems. However, it’s not hopeless, and with the right approach and perseverance it has been overcome by many. If you wish to be seen as a patient, you should get your current therapist’s agreement, and if possible, a referral here. This assessment session would be needed to more accurately advise you as to treatment and prognosis.

With every good wish,
Frank Sommers, M.D.

Notice and Disclaimer:

Answers to questions are provided by a qualified psychiatrist/sex therapist on the understanding that these answers provide education and/or instruction, and do not constitute therapy or counselling. Any person seeking counselling or therapy should consult a local qualified professional.