Sex Matters 03/06/03 -- Louanne Cole Weston, PhD -- 03/06/03

By Louanne Cole Weston
WebMD Live Events Transcript

It's everything you've ever wanted to know about sex but were afraid to type. WebMD's Sex Matters® expert, Louanne Cole Weston, PhD, joined us on March 6, 2003 to discuss our members' intimate questions and concerns.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome back to WebMD Live, Louanne. It's been too long. We missed you! Let's get right to the questions

Member: Recently I have been visiting some penis enlargement sites, and found out they all have some exercises in common, one being jelq as they call it, and some mention the PC muscle (even on WebMD). Is it safe to do these PC muscles exercise and is it true what's said about it, that this muscle is the one that gives rock-hard erection, longer orgasm, power to control, etc.?

Weston: This is a difficult question to answer because there are competing theories about it. Some people swear on their most valued possession that things such as jelquing really do work to enlarge a penis. Others say, "Gee, isn't jelquing kind of like masturbating?" If that were the case, anyone who masturbated a great deal would have very large penis, and we don't have data to support that. Some people say that the type of pulling in jelquing is unique and responsible for the changes they claim to have. In my opinion, the jury is still out.

The fact that sites are springing up with techniques about how to enlarge a penis does not surprise me, since it's one of the most sought after changes that men express. Sometimes these sites have something to sell and they use penis enlargement as a way to attract people to the site. Others are simply "devoted believers," who want to believe that they have discovered a way to do something that answers many men's dreams. I'm going to wait for the research being conducted in a controlled, scientific manner before I'll put my final vote in.

It certainly cannot harm you to do Kegel exercises in the meantime; they strengthen the muscles that contract during orgasm and are responsible for much of the pleasurable sensation of orgasm. In order to do it, squeeze the muscles that you would use to stop the flow of urine if you are urinating. I have not heard anyone claim that doing Kegel exercises will enlarge a penis, but I've heard much anecdotal evidence that strengthening the PC muscles with Kegel exercises will intensify orgasm.

Member: Dr. Weston, every time that I have intercourse, I am unable to have an orgasm. I can have an orgasm by oral and manual stimulation, just not intercourse. Is there something I'm not doing? Or something that I can do? Or are there just some women that cannot have orgasm during intercourse. Thank you.

Weston: This is a frequently asked question and one that has concerned women since before the 1950s. Fortunately, Masters and Johnson came along and helped women feel less worried about not reaching orgasm during intercourse. Studies have shown that about 70% of women don't have orgasm from intercourse alone. The highest rate any study has found has been 50%. I am not willing to describe 50% of women as dysfunctional, and most sex researchers aren't.

The penis is comparable to the clitoris in terms of its origin and development in the fetus and most men require stimulation directly to their penis to reach orgasm. Similarly, most women require direct stimulation to the clitoris to reach orgasm. Intercourse gives indirect stimulation to the clitoris, at best. And so that would be similar to rhythmically stimulating a man's scrotum and not touching his penis. That doesn't work for too many men except for when they're 16 and a smile will do. So, you need not feel bad about this situation. There are various approaches you can take to try and expand your sexual repertoire, but I wouldn't make it do or die endeavor.

Weston: I am not a neurologist, but I would strongly encourage you to consult one and be explicit in describing the sexual difficulty that has begun over the last few years. It is possible that your sexual dysfunction is related to your spinal cord injury, but it also could be something entirely separate, related to your circulatory system or hormones or something else. I would recommend getting urological exam in addition to consulting your neurologist.

Member: Seconds after I have an orgasm, I have this thought or feeling that death would be wonderful. I asked a psychiatrist about this and he did not want to talk about it. Have you ever heard of this before? Thank you.

Weston: The French have a saying to describe orgasm -- they call it "la petite mort." This means the little death, which is the French way of describing how some people experience absence of sensation following the intense sensation of orgasm. So it's not entirely strange that you might have thoughts about the attractiveness of death right after orgasm. It isn't the common experience of most people, but it is not highly far-fetched.

It's surprising that your psychiatrist would not be willing to discuss this with you. It sounds like you hit a nerve. Consider addressing the topic with him or her once again, and if it really bothers you, you may want to consider switching to another mental healthcare provider. You have every right as a patient to ask why someone is unwilling to talk about something. And it generally is an obligation of mental health providers to explore, carefully, any comments by patients that even sound slightly like suicidal thinking.

Member: I have recently discovered that my husband is looking at a lot of porn on his computer. Some of it is bondage, S&M type stuff, things we do not do. I feel jealousy and wonder if I should suggest trying new things? Should I ask him about the porn?

Weston: The Internet has allowed many people to explore sexual topics that, before, would have gone unexplored. It may have allowed your husband to learn about something brand new to him, or he may have always had an interest in these themes, but very little access to the images that the Internet provides. I think it would be fine to ask him about these themes and if you are willing to do some exploration with him, this might lead to some very intimate moments between the two of you. Sometimes people use their history trail on the Internet to communicate a desire to their mate. So, I would suggest that you consider bringing the topic up with him and let him know to what extent you would be willing to explore it.

Member: Is there something women can do to "ejaculate" when they orgasm?

Weston: This topic is another one of those "wait and see" issues, but I can tell you the things that we think we know: People who are able to ejaculate fluid during sexual activity often try to aim internal stimulation in the vagina toward the anterior side of the body (toward the tummy). Generally, stimulation for this area (the G-spot) tends to be the stimulation area that leads to the spurting of the fluid. This can be accomplished by inserting a finger in the vagina and wiggling it as if to say come here. Or, you can try having intercourse in positions that tend to stroke the tummy side of the vagina. Those are the best suggestions that I can offer to help you try to find a way to ejaculate.

Member: My boyfriend likes to talk about other people watching us, not only online but in real life. Also, sometimes he gets rough, not violent, but rough and calls me his "little slut and whore." Most of the time it doesn't bother me. But sometimes I just want to have a nice intimate moment. I've communicated to him that sometimes it really bothers me, but he still continues to speak and act this way. It is even more concerning since I am 32 weeks pregnant. What should I do?

Weston: It sounds like your boyfriend is fairly strongly attached to getting aroused by one approach. It sounds also like this approach is dominating your experiences together. I'm hoping that you can say to him, number one, "I want there to some variety in our sexual experiences together that include other ways, beside the rough/little slut style" that your boyfriend apparently really likes. It's possible that he has a fetishistic arousal pattern going and only gets aroused that one way. But you'll need to ask him to vary his approach to see whether there's other ways of doing it.

Number two, it's pretty important that you not have rough sex at this stage in your pregnancy, for the health of the baby and you. So, if he starts to get rough be very determined and say, "We cannot do this," and pull yourself away physically. You might experience some benefits from seeing a sex therapist with him. Help sort out issues with his singular approach, as well as his paying attention to your requests for things to be different.

Member: Sometimes after intercourse, I get this awful pain around where my ovaries are. It kind of feels like its bruised or something and makes me feel a little nauseated. Is this normal and why is this happening? Could it be that he is too big for me? I was recently diagnosed with interstitial cystitis and figured maybe that has something to do with it. Please help!

Weston: It is not normal for you to feel this bruising sensation and other pain. This definitely should be examined by your physician. You might even arrange it so that you have intercourse just prior to your gynecology exam so that the tender spots can be isolated and located easily by your doctor. Only an in-person physical exam can get to the cause of this, so I strongly recommend that you see you gynecologist.

Member: My boyfriend, who is 42 years old, has trouble getting a full erection sometimes. Other times he is able to. Is this normal?

Weston: At 42, it's possible that there maybe something physiological going on that could cause erratic erection dysfunction. For example, the onset of diabetes can cause erections to sometimes work and sometimes not. On the other hand, erratic erections are very often linked to psychological issues, and so after ruling out physiological causes by having a urological exam I would recommend some sex therapy for the two of you as a couple. Erection dysfunction is often caused by anxiety in the sexual situation. So it's possible that your partner is feeling anxious about something when the two of you go to be sexual sometimes.

You also might want to take a look at other things such as the use of drugs, both recreational and prescription, and the possible effects of those on his ability to get and keep an erection. For example, some blood pressure medications can undermine erections. We have a detailed article in the http://my.webmd.com/medical_information/medical_library/ask_a_question/questions?channelId=1687">Sex Matters archives on the various effects of blood pressure meds on erections. Also, the use of recreational drugs can lead to erratic erections. Take a look at his drug use of all kinds and that may give you a clue as to the cause of his difficulties.

Even if he has erection dysfunction caused by physical problems, there are many approaches that you and he can take to bolster his ability to get reliable erections.

Member: Is it normal for women that have been sexually molested to not want to have sex even with their spouse? If so what can I do to help get over this. It has been several years and I still can't get interested in my husband. Could there be a bigger problem with me than my past? I want to have a baby but I can't even become interested in sex. My doctor gave me samples of Viagra for women, but all it did was get me interested, but then I couldn't have an orgasm, which made things even worse for me. Can you help?

Weston: If you wish to become pregnant, it is not necessary for you to have an orgasm. In fact, it's not necessary to even have intercourse. Fertility clinics get people pregnant all the time without actual intercourse occurring. That said, you might still interested in changing how you feel about sexuality in the interest of bettering your relationship. You may be lacking sexual desire because of your negative experience with sexuality in the past (the molestation) and/or you may have low interest being sexual because you have not yet learned how to become reliably orgasmic. It makes sense that you would avoid sex for either of these reasons, and so having both gives you even greater reason.

I'm a believer in participating in sex therapy in situations like this. You can learn about good ways to learn to become orgasmic as well as talk about feeling you have from sexual exploitation. I'm going to recommend two things for you to read; one is called The Survivors Guide to Sex: How to Have an Empowered Sex Life after Child Sexual Abuse, by Staci Hanes, and second, a book called For Yourself, by Lonnie Barbach.

Member: Sometimes I have a lot of anxiety over whether or not my husband masturbates while I am gone. My ex-husband had a real problem and it took the place of what we should share together. I am so paranoid that my current husband will fall into the same pattern. What should I do?

Weston: There really isn't anything that an individual can do to control the masturbation habits of a mate. Often when masturbation takes the place of partner sex, it has to do with the level of intimacy in the relationship increasing to a point that is greater than one or both people can handle. At other times, masturbation is present because there is a discrepancy in the level of sexual desire between the two people. In the case you have just described with your ex-husband, I would lean toward the former explanation based on the little bit of data you provided.

You might take a look at a book called Passionate Marriage, by David Schnarch. He has a great deal of helpful info in that book to deal with the situation you described both in thinking about your past marriage, and doing your best with your current marriage.

Moderator: Thanks to Louanne Cole Weston for being our guest.

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