‘sex therapy’

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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How Much Sex Do People Need?

Old therapy joke:
Q: What’s the difference between defense mechanisms and sex? A: You can go a whole day without sex.

Actually, we can go without sex for a lot longer than that. But you wouldn’t know it from listening to some of my patients. Or their partners.

It generally sounds like this: “So I just need a lot of sex. I can’t help it, that’s just how I am—I need a lot of sex, preferably every day.”

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When Partners Disagree On How Much Sex To Have

As a sex therapist, I work with couples every week in which one partner wants more sex than the other.

When it’s a small disparity people generally work it out. But when one person wants sex twice a week and other wants it twice a year, many couples simply can’t cope. Ideally, couples would struggle over this together: what are WE going to do about OUR problem?

What’s more common, unfortunately, is that each partner sees themselves as having the primary pain. And each person looks at the other and says what are YOU going to do about MY suffering that YOU’VE created?

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Have Orgasms, Don’t Have Orgasms—Just Don’t COUNT Orgasms

Some of my patients count orgasms. Sometimes they count their own, but more often, they count their partners’. Both men and women do this. “When my wife doesn’t climax, I feel I haven’t done my job,” says Max. “When a boyfriend doesn’t orgasm, I figure it’s because I don’t turn him on enough,” says Maria. “I want to totally satisfy my husband every time, says Claire. “I don’t want LaShonda to think I’m selfish, or that I don’t care,” says Marcus, “so I try to make her cum no matter how long it takes.” Listening to people say such things,…

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