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Healthy Sexual Function

This pamphlet is intended to provide a brief introduction to healthy sexual function. Although there are many aspects of sexual function not mentioned, this does not decrease the importance of such topics, but only emphasizes the vast array of issues involving sexuality.

COMMUNICATION

Sometimes, in a relationship, we avoid certain topics because we don’t want to bring up something that could ruin the relationship.  It can be especially hard to talk about sex and sexual issues; however, there are some important topics to discuss with a potential or current sexual partner. 

How do I find the right words to use?

Finding words that you and your partner are comfortable with is often a challenge.  The clinical, “proper” words sound official and distant, but some slang terms sound crude. It is important for you and your partner to use terms that are comfortable for both of you.  It is also important to define ambiguous terms so that you both know the definition when using the word.  For example the word abstinence, for some individuals, means no vaginal-penile intercourse but does include “outercourse” where one engages in everything but penetration.  For others, abstinence means no genital contact.  If one partner was using abstinence in a sentence, such as “I think we should practice abstinence,” the meaning would be unclear unless they discussed the definition of abstinence.

How can I communicate intimate thoughts to my partner?

Discussing what is sensual or erotic to you is also important.  When things are getting hot and heavy, saying what really turns you on or what you don’t like may be difficult.  However, telling your partner what does and does not feel good will make the sexual experience more pleasurable for both of you. 

Talking about what you find pleasurable may be easier during a time when you’re not physically involved because neither of you is distracted.  Sometimes, describing what we like may be difficult, so saying “Why don’t you try this? and “I like it when…” Showing your partner may be the easiest and most comfortable way.  You know your body better than anyone else, so it just makes sense to share your knowledge about your sexual desires.

In today’s age of sexually transmitted infections, it is extremely important to communicate about the sexual history of you and your partner.  Although both of you may be uncomfortable discussing such experiences, being understanding and nonjudgmental can help ease the tension.

Communication is not always the easiest thing, and sometimes it can be downright difficult.  However, communication is an intimate aspect of any relationship, especially a sexual one.

ORGASM

Orgasm, the Big O, climax, whatever the word, it is often thought of as the pinnacle of sex, or the sole purpose of a sexual experience.  This type of thinking can lead to unrealistic expectations that are difficult or even impossible to achieve.  There is more to sexual activity than just orgasm. As a society, we have been conditioned to think of sex as vaginal-penile intercourse with orgasm as the goal.  In reality, there are many enjoyable sexual activities besides intercourse, some of which may result in orgasm, some of which may not.

So what is an orgasm, anyway?

An orgasm involves involuntary muscle contractions that release the built-up tension or pressure within the pelvic area.  Describing how an orgasm feels is difficult because an orgasm is as individual as the way someone talks or the color of one’s eyes.  Even for the same individual, an orgasm may vary with a different partner or a different type of stimulation (penis, finger, vibrator, etc.). Some women say that they feel contractions in their vagina, uterus and rectum, while others experience tightness. A male orgasm is usually simultaneous with ejaculation, and feels like a great release of tension and built-up pressure. 

What else should I know about orgasm?

Many women do not have an orgasm every time they have sexual relations. Additionally, many women achieve orgasm more easily during oral or manual stimulation than vaginal penetration because the clitoris is more easily stimulated in this way.  Some women may have two or more orgasms in a short period of time, something most men cannot do.  Both women and men need to remember that an orgasm, like any sexual experience, is unique and that each individual needs to do what feels best for them.  Being comfortable with yourself and not trying to live up to standards is important.  Worrying about your orgasm can make your body tense and actually prevent you from having one.

A common orgasm myth is that a couple should achieve orgasm simultaneously.  This is often a difficult accomplishment because of the varying needs of partners.  Some individuals require more time to become aroused and therefore more time to achieve orgasm.  Like many other sexual ideas, having an orgasm at the same time has become another “goal” in a sexual experience.  With sexual experiences, it is not the destination, but the trip itself.  Enjoy it.

For any sexual experience, how you feel after its completion is important.  If you feel happy and content, then it was a good experience.  If you feel miserable and regret the encounter, then you need to think about the relationship as a whole, as well as its sexual aspect.

LIBIDO

What is libido?

This is a word we hear often, but what does it mean?  Libido means sexual urge or instinct.  You might also think of it as your sex drive.

What is a normal amount of libido?

Sexual urge, sex drive, or libido is different for everyone.  There is no “right” or recommended amount of libido.  Like many other aspects of your sexuality, your libido should be the amount of sexual urges and sex drive that feels right for you. 

What affects a person’s libido or sex drive?

There are a number of things that can affect someone’s libido.  Visually, we all experience turn-ons and turn-offs.  For example, for some individuals seeing a partner partially naked may do more to impact sex drive than seeing a partner fully nude.  It is also suggested that body chemistry or pheromones (body chemicals) may impact your libido, but we do not know the extent to which they influence sexual attraction or behavior in humans.  The meanings of specific words or phrases along with hearing certain sounds, voices, and songs may result in an increase or decrease in sexual urges.  Touch also plays a big role in libido as it has the most direct effect on sexual arousal and response.  In addition to what we have included here, there may be a number of other situations, objects, scenarios, tastes, smells, etc. that you notice as affecting your libido.  Also, there is a lot of variation within and between individuals in terms of the factors that influence libido.

What can I do about decreased sex drive?

It might be worthwhile to initially consider any life changes that could have led to a decrease in libido.  Decreased libido might simply be the result of a busy time at school or work, added stress, hormonal changes, illness, or relationship troubles.  If after considering these possible factors, you are still concerned, you could talk to a professional counselor, therapist or medical professional.

MASTURBATION

Most of us do not sit around talking about masturbation.  Let’s face it, masturbation is one of those topics that people rarely discuss.  When it is mentioned, the remark often causes nervous laughter. 

Why don’t we talk about masturbation?

One of the most obvious reasons no one discusses masturbation is that many of us have been brought up to believe that it is something dirty and that “nice” people don’t touch themselves that way. Society has ingrained such thoughts in us, and consequently we don’t try it or if we do, we don’t talk about it.  All smirks and snide comments aside, let’s talk briefly about masturbation or self-pleasuring. 

Think of it this way:  it may be easier to tell someone else what feels good to us if we have taken the time to explore our own bodies and sexual potential. 

Self-pleasuring is one way that we can get in touch with our bodies.  It is a way to explore our bodies without having to worry about the needs and demands of a partner.  Masturbation gives us time to discover what feels good to us. 

What is masturbation?

Some people spend time touching their bodies or genitalia with their fingers; others may lie still and contract the muscles around their genitalia.  Still others don’t touch themselves at all and engage in mental stimulation- fantasies about locations, partners, positions.  This is an individual process; what may be pleasuring to one person may not be gratifying to another.  Once you’ve discovered what feels good, you can tell (or show) your partner.  By knowing what turns you on, other sexual experiences can be even more satisfying.  Just like everything else, some people don’t find masturbation enjoyable.  Like other sexual activities, if it doesn’t feel good to you – mentally or physically – trust your feelings and don’t do it.

COMMON SEXUAL CONCERNS AND QUESTIONS

Many people have questions and concerns regarding their sexual health and activity.  They wonder if they and their desires are normal or if their partner’s desires are normal.  They wonder what is considered normal frequency for having sex.  They wonder if their body works right.

We are all born with normal sexual responses and desires.  Sometimes, due to the environment, physical problems or negative sexual experiences, sexual functioning can go wrong and professional help is needed to correct problems.  Generally, all sexual activity is “OK” if between two consenting adults. 

What is consent? Consent is an unmistakable, often verbal, positive response to participate in sexual activity. It is un-coerced and freely given. (A person under the influence of alcohol or drugs is NOT consenting.)  Remember NO person has the right to use or abuse another individual.

Some of the more common concerns we hear at the Health Center include:

1.  I’m not sure if I have had an orgasm (climax, come).  My partner thinks there is something wrong because I don’t come every time we have sex.

An orgasm is the point at which all the tension in your body is suddenly released in a series of involuntary and pleasurable muscle contractions.  Although the definition seems clear, an orgasm is a unique experience for each individual.  It can even feel different for the same individual, if the stimulation, partner or position is different.  It is important that you feel comfortable with yourself and not worry about what your friends have told you or what you think you are supposed to feel.  Sometimes, worrying about whether or not you are going to orgasm makes your body more tense and actually prevents you from having an orgasm.

2.  My partner never comes during (vaginal) intercourse – what’s wrong with her?

There is nothing wrong with your partner.  Fewer than 50 percent of women reach orgasm during vaginal intercourse.  Sometimes, the man reaches orgasm more quickly than his female partner and the couple may end intercourse before the woman has had an opportunity to orgasm.  Another possibility is that a thrusting penis or other object may not be enough stimulation and more direct stimulation of the clitoris may be needed.  Alternate positions and activities, such as manual or oral stimulation, may be pleasurable to the point of orgasm. 

3.  I can orgasm more easily when I masturbate.

Sometimes, it is easier for an individual to have an orgasm while masturbating.  First, you may feel more relaxed when masturbating than when you’re with a partner.  We often feel a lot of pressure to act a certain way or to do a certain thing when we are with someone else.   This pressure can cause the body to become so tense that achieving orgasm would be extremely difficult, perhaps even impossible.  Or perhaps you are concentrating too hard on your partner’s pleasure and are not focusing on your pleasure as much.  Finally, when you masturbate, you may be touching yourself in a way that your partner does not or cannot duplicate. 

4.  Is masturbation harmful?

There is no danger in masturbating.  Masturbation can be an excellent source of sexual relief and does not thwart your ability to engage in other sexual activities.

5.  It sometimes hurts when I have sex.

Almost all individuals experience pain with sex at some point in their life.  For women, some common causes of pain include insufficient lubrication – the vagina is not wet enough to be able to handle the insertion of the penis or finger. Using lubrication can help with this problem.  A local condition, such as a yeast infection, may become irritated by the penis or a finger also causing discomfort.  Treat any yeast infections before engaging in sexual activity. Sometimes spermicides cause irritation.  A tightness around the vaginal opening may be a source of pain as well, and can be caused by tension or lack of arousal. 

During or around ovulation, the area surrounding the ovaries may be sensitive causing painful intercourse.  A pain deep in the pelvis could also be caused by several physical reasons, such as endometriosis, cysts on the ovaries or an infection in the cervix, uterus or fallopian tube.  All of the conditions listed above are treatable.

There is a condition called vaginismus, the involuntary tightening of vaginal muscles near the opening that makes any form of penetration difficult or impossible.  Such a condition is usually a physical response to a fear of penetration and is treatable. 

Men can also experience pain during sex; it usually occurs with ejaculation and sometimes with erection.  If his partner is dry, he could also experience skin irritations.  Any of these difficulties should be discussed with his health care provider.

6.  Are all skin irritations due to Sexually Transmitted Infections? 

No; sometimes an individual can get skin irritations during masturbation or sex with a partner, particularly if the skin is dry.  However, any unexplained bumps, sores, or breaks in the skin should be examined by a medical professional.  An appointment should be made while the area is sore or irritated.

7.  I am a male who wants to extend the length of time from erection to ejaculation.

Here are some suggestions to increase this time:

1. Increase the frequency of ejaculation through masturbation.  Abstinence often causes a man to ejaculate quickly.

2. Sometimes, especially with a younger individual, the male can ejaculate quickly, be restimulated and continue intercourse to second orgasm, usually taking longer to achieve.

3. Using a condom can also increase the time of erection to ejaculation because it decreases the sensitivity of the penis.

There are other, more specific techniques, which can be used.  All require good communication with your partner.  A common one is the start-stop method.  The penis is manually stimulated, but stopped before ejaculation until the feeling subsides.  The stimulation is started again and continued until just before ejaculation and again stopped.  After three times, the penis can be stimulated to the point of ejaculation.   

Resources

There are many excellent books written for people who are interested in learning more about sexuality or improving their sex life; some of the better ones are included below.

  • Because it Feels Good: A Woman's Guide to Sexual Pleasure and Satisfaction. Debby Herbenick, Rodale, 2009
  • Becoming Orgasmic. Julia Heiman, Prentice Hall, 1988
  • Doing it: Real People Having Real Good Sex. Isadora Al-man, Conari Press, 2001
  • For Yourself: the Fulfillment of Female Sexuality. Lonnie Garfield Barbach, Signet Books, 1975
  • The Good in Bed Guide to: Anal Pleasuring. Debby Herbenick, 2011
  • The Good Vibrations Guide to Sex. Cathy Winks and Anne Semans, Cleis Press, 1994
  • Great in Bed. Debby Herbenick & Grant Stoddard, DK Publishing, 2012
  • The Guide to Getting it On. Paul Joannides, The Goofy Foot Press, 1996
  • The New Joy of Gay Sex. Charles Silverstein and Felice Picano, Harper Collins, 1992
  • The New Our Bodies, Ourselves. Boston Women’s Health Collective, Simon & Shuster, 1992
  • Read my Lips: A Complete Guide to the Vagina and Vulva. Debby Herbenick and Vanessa Schick, Rowman & Littlefield Publishers, 2011
  • Sex Made Easy: Your awkward questions answered-for better, smarter, amazing sex. Debby Herbenick, Running Press, 2012
  • Sexual Awareness: Enhancing Sexual Pleasure. Barry and Emily McCarthy, Carol and Grof Publishers, 1993
  • The Whole Lesbian Sex Book. Felice Newman, Cleis Press, 1999

Online Resources