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Sexual Problems

Premature ejaculation is very common

Premature ejaculation or ‘coming too quickly’ is very common among young men in heterosexual relations, just as ‘not coming’ or ‘coming too slowly’ is very frequent among young women. So for most people it is a relative thing. Males are more eager, more excited, more infatuated, more in love, females have more inhibitions, fears, other expectations besides sexual pleasure, and thus tend to be more passive. So it is in fact very normal for boys to come before the girl. As experience, mutual trust and enjoyment increase, the male can learn to time his orgasm, stimulate his partner effectively and come simultaneously with her. This is the traditional ideal, promoted by the early twentieth century sexologists (see sexuology).


A popular approach today is to reject the idea of simultaneous orgasm through intercourse, to emphasize the quality of intimacy and pleasure, and to advise non-penetrative sex first. If couples go into therapy, the first thing they are told is not to have intercourse, but to practise touching, feeling, awareness and arousal without climaxing. Men usually have to learn to be passive, women to be active.


An important question asked of men who come too quickly for their own liking and that of their partner especially, is whether they experience the same problem while masturbating. If not, the problem really is one of lovemaking, not of medication. Now you can take the Premature ejaculation treatment in chennai itself. We also deals with the following problems like impotance, infertility, sexual problems for men, erectile dysfunction.

Premature ejaculation is very common

Primary premature ejaculation


However, a small group of men, perhaps 5%, cannot be helped in this way. Their premature ejaculation is not caused by the normal discrepancy between male and female arousal (see the sexual response). They climax within thirty seconds of entering the vagina, or even before that. No psychological or love skills therapy can help them.


Research has demonstrated that these ‘primary premature ejaculators’ seem to have low concentrations of the neurotransmitter serotonine in the brain. The transfer of signals from the brain to the genital response is adversely affected, and perhaps this explains the uncontrolled orgasm. Now anti-depressants have proved to have a slowing effect on sexual arousal and orgasm, probably because they raise the level of serotonine in the brain.

The drug therapy for the true premature ejaculators is now established among some medical sexologists.

The question remains, however, why these people can masturbate without suffering at all from premature ejaculation.


Learning to enjoy sex

From your letter it is not clear whether you belong to the first or second category. If it is the first, all you need is perhaps a little enlightenment about lovemaking: it is best, for a while, not to have intercourse. There are many effective ways to enjoy sex (see great sex without intercourse). The problem often lies with the female partner as well. If she insists on intercourse, if she places all responsibility on the male’s performance, he will feel obliged to be successful, which causes the anxiety and stress which cause his failure.


So it is a matter for both partners to improve and elaborate their repertoire of sexual pleasure skills to escape from what might be called ‘the coitus imperative’. For those who need a detailed plan of action, the so-called squeeze technique may be of some use.


Pain during sex

Pain during sex is much more frequent than is thought. It is not only a female complaint. Sexology uses the word ‘dyspareunia’, which literally means ‘unsuitable partnership’. Pain nearly always has an adverse effect on the experience of pleasure, and can lead to avoidance of sexual contact.

Pain can be acute or chronic, occur in different locations of the genital area, and at different times during the sexual response cycle: at the onset, and during or after intercourse.


Pain during sex

Pain during sex: the female


Vaginal pain may be due to an infection of the vaginal wall, the urethra or the bladder.

If the pain occurs deep inside the vagina, it may be caused by an infection or other problem in the pelvic muscles, the uterus, or the rectum.

If -as is most often the case- the pain occurs at the opening of the vagina, several causes may be distinguished, the first of which is tenseness of the muscle around the opening. This complaint is fairly common among beginners, and those who are (un)consciously afraid of being penetrated. See undervaginismus.

Other causes of pain in the vaginal mouth are an intact hymen, irritation of the skin by insufficient or exaggerated hygiene (do not use soap), candida infection, an sti (sexually transmittable infection) such as trichomonas or herpes, or an allergic response to rubber (latex) condoms.


Painful entry of the vagina may also be caused by the female’s pubic bone having such a shape and size that it slightly overhangs the vaginal entrance. An inexperienced male may hit his penis against it, thinking it is the entrance of the vagina (which is, in fact, lower down) and cause pain, even after entering the vagina properly but causing friction between the sensitive skin and the front part of the pubic bone called ‘symphysis’. One solution to this problem is for the female to raise her legs all the way up and even backwards (see illustration).

During menopause, the vaginal wall tends to become thinner, dryer and more sensitive, which may be an explanation of pain in women of a certain age. Adequate stimulation and enjoyment as well as the use of a good lubricant can help avoid complaints.


Pain during sex: The male

Men have fewer complaints about pain than women, but pains do occur and can be just as crippling as in women. Causes are various:


Pain during sex the male

Lack of hygiene. Young men who have not learned to clean the head of their penis regularly, may find their first intercourse impossible or unbearably painful, because they are unable to withdraw their foreskin. The cause is adhesion of the foreskin, which has become stuck to the glans by a layer of ‘smegma’ (discarded skin cells of glans and foreskin). They have to practise moving the foreskin back little by little, while cleaning it with warm water every day. It may take some time, even months, before the foreskin can move freely over the head of the penis.


Circumcised men do not have this problem, of course.

Another well-known cause of pain in young men is a short ‘frenulum’, the tiny muscle attaching the foreskin to the shaft of the penis. Pulling the foreskin back all the way, especially if it is done with force, e.g. entering the vagina or being masturbated by an inexperienced partner,cause a great deal of pain, and even bleeding. After it is cured, there may still occasionally be the feeling of pain. Young men can also be preventively helped by a small operation.

Pain during sex the males

Another cause of pain is ‘phimosis’ or a foreskin that is too narrow or rigid. A small operation is necessary to put this right.

Pain can also occur during ejaculation. It may be caused by pressure built up in the prostate gland due to sustained suppression or holding up ejaculation.

Older men can feel pain during orgasm as a result of low testosteron content in the blood.


Also pain can be caused by tension in the pelvic muscles that are involved in the sexual response cycle. Exercising and learning to relax these muscles may bring some relief.

Finally, a pain may occur after ejaculation into the vagina, if the vaginal content is highly acid. The penis cannot bear to stay inside and its gland looks red and the foreskin is swollen. The solution is to bring down the acid content of the vagina, or use a condom.


Erectile dysfunction (impotence)


Erectile dysfunction (impotence)

Erectile dysfunction, also called impotence (lack of power), is considered to be a typically male problem, because it is generally expected that the penis should become sufficiently hard to enter the vagina and remain there long enough to provide pleasure, orgasm, and ejaculation. If occasionally this does not happen, most people do not worry: they blame drink or stress at work, and they do fine the next time. There are also older men who have no erections anymore and accept that. They can still be good sexual partners and enjoy orgasm and ejaculation without an erection.


Erectile dysfunction (impotence): causes


In most other cases, however, erectile dysfunction or impotence is problematic. Situations differ, as do causes. Some are simple, others more complex.

In general, a distinction is made between ‘physical’ and ‘mental’ causes of erectile dysfunction. An example of the former: after an accident at work, a man’s spine or pelvis is injured, and this injury has damaged the nerve which stimulates the small penile artery that fills the penis with blood during arousal. If the nerve is damaged, it does not pass the signal to the artery, so that no erection occurs even though the man is aroused, with or without a partner.


In most other cases of erectile dysfunction the cause is (partly) mental, i.e. the man is quite capable of having erections when he is alone or in his sleep. But when he is with his partner, he cannot have a an erection that is strong enough or lasts long enough. This may also be called ‘situational’, because the man may have no problem when he is with another partner.


Erectile dysfunction (impotence) : old age


Old age is generally associated with erection problems. The general deterioration of physical and mental functions can be blamed, but only to some extent. There is, of course, a gradual decrease in the production of testosterone (the male hormone), an increase in prostate size, higher blood pressure and sugar levels. Life style probably also plays a part, such as excessive drinking and smoking, obesity, depression, or the use of drugs against depression, obesity or blood pressure). Men who live healthy and balanced lives (which may very well include a little drinking and smoking), who are successful and have attractive love partners, can retain good erectile function until death.


Erectile dysfunction (impotence) : young


Erectile dysfunction

When young men are impotent with a partner, even though they have morning erections and no problem when masturbating, the situation is to blame. He feels inadequate. This may be due to an earlier experience: he dreads a repeat, is so concerned with himself and the possibility of failure that he is estranged from his feeling, becomes an observer of himself. This condition adversely influences his sexual competence, and so he ‘fails’ again. Now you can get the treatment for erectile dysfunction treatment in chennai, sinus treatment in chennai, kidney stone treatment in chennai also. The behaviour of the partner plays an important part in the whole process. Although most are quite ready to say that ‘it doesn’t matter’, they often lack sufficient skill and self-confidence to convince him and themselves, so that it repeats itself the next time and causes a kind of despair mixed with irritation. If this happens, it is best to consult a sexologist, who will generally prohibit sexual intercourse (see great sex without intercourse) for some time to come, and in the meantime will set tasks and targets for the couple to help them improve their sexual communication.


Sex therapy


Sex therapy

Someone who suffers from a tooth ache goes to a dentist. Someone with a sexual problem does not as easily go to a sexologist. In the first place, there are not so many sexologists, secondly it is not so normal to talk about sexual problems as it is to talk about a tooth ache. At the same time, sexual difficulties are so normal, one might say, everybody has them.


Sex therapy and sexual problems


What we call ‘sex therapy’ is the treatment of a number of complaints that couples experience, usually after having lived together for some years: erectile dysfunction (impotence),premature ejaculation, orgasmic dysfunction, vaginismus, lack of desire or pain.


These are the most frequent sexual problems that can be dealt with by sex therapists or counsellors. Sex therapy is usually short (between 5 and 10 sessions) during which the couple (or individual) talks about the problem, gets information, is given tasks to do at home and reports about their effect. Sex therapy is successful if at the end the problem has disappeared, or if the couple know how to deal with it if it recurs. Sometimes the clients must be referred to a medical doctor, if the complaints suggest that a medical examination is required, or if drugs are to be prescribed as part of the counselling. Sexologists often work in teams, in which psychology as well as medicine are represented.


The procedure followed in sex therapy


The procedure followed in sex therapy

decision as to what the problem is and how often it occurs  explanation, with the help of illustrations, of the structure and functions of the sexual organs  explanation of the counselling philosophy and procedure  assignment of tasks, beginning usually with learning to relax, lose sense of urgency or obligation, abstain with pleasure from coitus sensate focus practice, specific tasks, such as exploring vagina or penis, manual stimulation, introducing objects graded in thickness into the vagina, stopping before orgasm, applying squeeze technique, practice with pelvic muscles  learning to associate pleasurable lust with relaxation, letting go, communication, gradual increase of time penis remains in the vagina without ejaculation or losing erectile strength. In both these latter cases, medication can be used effectively as part of the therapy.

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