Five very common sex issues

By Ian Kerner, Ph.D., LMFT

As a sex counselor and author, I end up talking to a lot of people about their sex lives. And not just in the office. Sometimes I can't walk down the street without someone stopping me with a question, my upstairs neighbor, the deli guy who makes my sandwich, random people who may have caught me on TV. In my previous apartment, even the UPS guy would often arrive without a package. He just wanted to talk! While everyone's story is unique, the questions are often the same. So without further ado, the top five questions I generally receive:

From the Guys

How do I slow things down during intercourse?

Premature ejaculation (PE) is the most common sexual complaint reported by men, regularly affecting roughly one in three men. When a man ejaculates too quickly during sex with a partner, he may feel like a bad lover. His partner may consider him a selfish lover. A host of other self-defeating emotions are often thrown into the mix such as shame, resentment, and inadequacy that only compound the problem.

While PE can be troubling to men and to their partners, a big part of the problem with PE is the way we approach it. In our sexual mythology, we applaud women who can reach orgasm quickly (and, often, do it again) and yet glorify men who can last like the Energizer Bunny in bed. We've somehow made "fast" a good thing for women and something close to the end of the world for men. 

What if we thought of PE as part of the same fabulous sexual responsiveness and body-sensitivity that we applaud women for? It would certainly take a lot of the pressure off the guy, and his penis, which, ultimately, is half the battle in managing PE. The truth is, a variety of techniques can help a man gain more control over when he ejaculates. And there are plenty of ways to enjoy satisfying, responsive sex when a guy does reach orgasm early. Attitude, as the old saying goes, is far more important than aptitude, and it's certainly true when handling PE.

From Women

Why can't I have an orgasm during intercourse?

The female orgasm inspires more discussion than perhaps any other subject when talking about sex. From "mercy fakes" to multiple orgasms and everything in between, the subject of female orgasm gets a lot of attention, considering it lasts about five seconds.

Orgasm is often the measure of success for sex. Many men (and women) consider orgasm to be the stamp of approval that a woman enjoyed herself. Perhaps because of this pressure-cooker environment, many women have trouble with orgasm ability at one time or another in their lives. While the majority of women reach orgasm easily through masturbation, many women find themselves distracted or unable to do so during partner sex, or simply can't reach orgasm at all as a result of a health-related issue or other issues at different times in their lives.

Ultimately, the how, what, why, where and when of the female orgasm starts and ends with the woman herself. For many women, the connection and intimacy of sex may be just as enjoyable, if not more enjoyable, than the act of orgasm itself. For other women, sex just isn't sex if it doesn't end with an orgasm. Orgasm ability is affected by everything under the sun: physical health, psychological health, the state of your relationship or lack thereof, how things are going that day, what's happening in bed, and many more factors. A woman's orgasm is a precious thing and it's important to respect that, as well as enjoy sex for the many other wonderful things it has to offer.

How can I make sex less painful?

According to results from the recent National Survey of Sexual Health, nearly one in three women experience pain during sex. While some of these women may have vulvodynia, a condition marked by chronic vulvar pain, it's more likely that most women's pain is caused by everyday issues like vaginal dryness or certain sexual positions. Thankfully, a little lubricant can make many sexual experiences more enjoyable. There are more lubricants available today than ever before and they are more widely available as well.

Also, another way to decrease pain is to increase the time spent during foreplay. Not only can foreplay increase vaginal lubrication, but it can also help pull the uterus upward, making more room in the vaginal canal and decreasing the chances a guy will hit the uterus during deep thrusting.

From Couples

Is it possible to cheat without having sex?

Absolutely. Emotional infidelity is the new threat to loving relationships. An emotional affair starts as friendship, often with colleagues or seemingly harmless online relationships, and slowly progresses to something more. A gradual blurring of the lines between friendship and deeper intimacy draws even happily partnered people into relationships they never saw coming. Many of us have a vision of infidelity in which one partner starts a torrid sexual affair and selfishly lives a double life until it all comes crumbling down.

Emotional infidelity couldn't be more different, which leaves many couples vulnerable to its damaging effects. A couple's best defense against emotional infidelity is to learn about it, then fortify their relationship against it. Attraction is one ingredient of an emotional affair. In order for attraction to launch into an emotional affair, a person has to also develop intimacy and, eventually, a feeling of connection with that person that supersedes their current relationship. In other words, attraction + effort + intimacy = emotional infidelity

What can my partner and I do to break out of a sex rut?

According to reports, more than 40 million Americans are stuck in a sex rut, and more than 52 percent of us are dissatisfied with our sex lives. It's easy to get stuck in a rut when you're in a long-term relationship. After all, for most of us, the most exciting part of a relationship is at the beginning when we're falling in love. It's a time filled with newness and possibility, hot and heavy flirtation, and even hotter and heavier sex. But after being with someone for a while things can understandably get boring.

In my book 52 Weeks of Amazing Sex, I advise couples to try to have sex at least once a week. But it's not just quantity that matters, it's also quality. Sex is like exercise: you have to work all of your muscle groups to get a good workout. Similarly, there are different types of sex: There's sex that's loving and tender and which enhances emotional intimacy, and then there's sex for the sake of sex: you have it because it feels good and relieves stress. There's also sex that taps the power of fantasy and proves that the mind is our biggest sex organ, and there's sex that plays to all of our various senses: sight, sound, smell, touch and taste. So give yourself a sex workout at least once a week.

Those are just the top five, but the questions from people go on and on. In the end everyone wants to know if they're normal, but when it comes to sex the only thing that's really clear is that everyone is different, even if they do experience similar issues.

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