‘performance anxiety’

No Orgasm? Lots of Good Reasons

Just about every week I see a new patient who complains that he has trouble having orgasms.

Of course, I ask lots of questions. Does this happen only with a partner, or with masturbation too? What medication is he taking? How much alcohol is generally involved before and during sex? How does his partner usually respond? How does he usually respond?

And if he’s been bothered about this for a while, why is he coming in now?

I want to eliminate medical issues first, so I always ask if he’s seen a physician. Since many of these guys are referred to me by a doc, let’s skip over the possible health issues (such as diabetes, auto-immune diseases, and possession by the devil) and…

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Sexually, Is Pleasure What Motivates You?

If you ask most people what they want from sex, they’ll say some combination of pleasure and closeness. And yet people’s decisions around sex are clearly about other things. The way men and women select partners; choose to initiate or decline sex; relate to their preferences or fantasies; obsess on how they look, sound, or smell; and remain present or check out during sex—all of these decisions make it clear that for many people, their sexual agendas go way beyond pleasure or closeness. In fact, pleasure and closeness may be quite far from what people are really going after in…

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Naked In Tokyo

Last week I went to Tokyo to speak at World Sexual Health Day. Coordinated by the World Association for Sexology, the Japanese Society for Sex Education, and others, the program featured an impressive array of national and international speakers. Some are now new friends. My talk was the last event of the day, and in a different location from the rest of the program. And so at 6pm my Tokyo host (whom I’d met the previous day) and my sexologist-translator (whom I’d never met) picked me up at my hotel, and after a short taxi ride we arrived at a…

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