Did the sexual revolution of the 1970’s result in sexual satisfaction and comfort for
women?
No. Instead of experiencing sexual
liberation, many women found a paradoxical gap between unlimited sexual
choices and equally limitless sexual dilemmas. (Introduction)
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At what age is
masturbation normal?
Any age is
"normal" for masturbation. Very young children find and explore
their genitals. At times, small girls will masturbate to orgasm. Some girls
masturbate at puberty, and some when they are adults. Fewer girls
masturbate than boys. It is normal for a woman to masturbate even when she
is in a satisfying sexual relationship. A third or more of all women and
men over the age of 70 masturbate. (Chapter 1 and 12)
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Is there such a
thing as too much sex education?
Ideally, sex
education is an on-going process with questions and answers coming when
children are ready for the information. Sex education does not lead to
premature sexual experimentation, as we can see from European countries
where sex education is more extensive and teen pregnancy, abortion, and
STD’s are lower than in the United States. Also, although it may not
seem so, children do listen to their parents’ values about
sexuality. (Introduction)
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Is there a
G
spot, and if so, how do I find mine?
The G spot is a small area of
tissue (possibly erectile tissue similar to nipples or the clitoris)
located on the front/upper wall of the vagina between the opening and
the cervix. It appears to enlarge and become highly sensitive in
response to direct sexual stimulation. (Chapter 3 and 4) back to top
Why does it seem
easy to orgasm from clitoral stimulation but so hard from intercourse
alone?
Even though sexual intercourse can be
very arousing and satisfying in itself, many or even most women do not
orgasm from the stimulation of intercourse alone. This is because neither
the clitoris nor the G spot typically receives stimulation that is
sustained and intense enough for orgasm. (Chapter 4)
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Are all women
capable of having multiple orgasms?
No, nor
should this be considered the premiere standard of sexual responsiveness.
Some women are so physically sensitive after an orgasm that further
stimulation can be uncomfortable rather than pleasurable. Some women are
very satisfied with one orgasm, and some women are very satisfied without
orgasm during sexual activity. (Chapter 4)
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Is it safe to
have intercourse during menstruation?
Yes.
Having sexual intercourse, including ejaculation, is safe and quite normal
during menstruation. You can also use a vibrator or have oral sex if you
choose. It is entirely a personal choice between you and your partner. (Chapter 5)
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Can having
sexual
intercourse during pregnancy hurt the baby?
No.
A developing fetus is well-protected against physical sensations from the
outside, and the cervix has a mucus plug that blocks any direct passage of
foreign material into the uterus. You should follow your healthcare
provider’s instructions, however, for what is healthy and safe during
your pregnancy. (Chapter 5)
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Can having
sexual
intercourse start labor during pregnancy?
Orgasm causes uterine
contractions, but it is important to note that uterine contractions are
present throughout pregnancy. Labor is not going to start because of the
uterine contractions of orgasm unless the body is ready to go into labor
anyway. If you are full term and "ripe" for delivery, however, semen
coming in contact with the cervix can "cue" the body to begin labor.
Semen contains a large amount of prostaglandin, a hormone associated
with the onset of labor. Your healthcare provider should have the last
word when it comes to sexual intercourse and pregnancy, especially
during the final stage of pregnancy. (Chapter 5) back
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Can infertility
treatment have an impact on sexual functioning?
Yes. It is common for a woman
- and often her partner - to complain of
temporary sexual difficulties during infertility treatment. Having sex on
demand can be daunting. Some treatment procedures are invasive and can
temporarily create sexual avoidance. It’s also difficult to maintain a
positive sense of self and body in the midst of infinitesimal medical
assessments of what is going wrong. (Chapter 5)
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Does "use it
or lose it" apply more to men or women?
Women.
After menopause, vaginal and vulvar tissue thin because of the loss of
estrogen and diminished blood flow to these tissues. Regular sexual
activity stimulates lubrication and blood flow to these vulnerable areas,
and regular penetration with a penis, fingers, vibrators, or dildos can
help keep the vagina from narrowing. (Chapters 2, 3, 4, and 5)
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Does
anorexia or
bulimia affect sexual functioning?
Yes. Eating
disorders are devastating to sexuality. The closer a woman comes to paring
off all of her body fat, the lower her sex hormones. Not only can her
reproductive system shut down (for example, menses cease), but also sexual
desire decreases or becomes non-existent. These disorders are often
associated with body hatred or self-consciousness, which can further
dampen sexual interest. (Chapter 6)
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Why is it that
when my weight is down I feel sexy and interested, but
the more I weigh,
the less I desire?
This is a complex problem.
Genitals, brains, hormones, and nerve endings don’t shut down with
additional weight. A woman’s sexual desire often emanates from how
desirable she sees herself rather than from what she finds
desirable. In our culture, it’s a challenge for a woman to feel
desirable when her weight goes up. The media reinforces in our minds the
connection between perfect bodies and good sex. Encouraging body
dissatisfaction sells beauty and fashion products. Keeping women
dissatisfied with their bodies is good for business but bad for sex. (Chapter 6)
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Does exercise
have any sexual benefits?
Yes.
Exercise serves
as an "on switch" for hormones. It increases energy and
self-esteem. Improved pelvic muscle tone enhances orgasms and sexual
response. (Chapter 6)
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I exercise and I’m
not really overweight, but
I hate my body. What can I do about that?
First,
ask yourself what you your life would be like if you had the body you
yearn for. If you ponder this question long and far enough, you may become
aware that physical appearance is not the road to personal fulfillment. It’s
important to stop negative thinking about our bodies, but it takes
practice. You have to identify the self-defeating thoughts, catch yourself
when you slip into using them, and substitute encouraging thoughts for the
negative ones. (Chapter 6)
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I have cancer—how
do I get good information about my sex life in this circumstance?
Don’t
give up; it’s essential that you get educated about your illness and how
it and your treatment impact sexuality. Ask your nurse or social worker
where you get your medical treatment about resources and recommendations.
Join an Internet chat group that can connect you with other women who have
been through similar circumstances. (Chapter 7)
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I have a chronic
illness, and my treatment has affected my sexual arousal; I don’t
lubricate. Is there any hope?
Yes. Ask your
doctor to discuss all aspects of your treatment and how they impact
genital blood flow. Illness, medications, and treatment can contribute to
the situation. Pay attention to whether there are symptoms of depression,
which can also dampen arousal and contribute to fatigue. A number of
herbal supplements, medications, and devices are being studied for their
effectiveness in increasing sexual arousal. Viagra, for example, may help
pelvic blood flow in cases like yours, although studies are continuing and
at this point Viagra is not FDA approved for women. (Chapters 7 and 13)
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I am in a
wheelchair. I am pretty, witty—and I’ve never been on a date. Why am I
seen as asexual? You know you are sexual
despite challenges. Unfortunately, our culture overidealizes perfect
bodies. You may be marginalized from the sexual mainstream because your
situation may threaten others with the disturbing awareness of their own
vulnerability. You don’t have to settle for this: get educated and
connected through support groups, the Internet, and other resources in
your community. (Chapter 7)
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I have a spinal
cord injury. Is it possible for me to have an orgasm?
Very
possible. About 50% of women with spinal cord injury, even with complete
injury, continue to be orgasmic. Drs. Whipple and Komisaruk have
researched this phenomenon extensively and propose that the vagus nerve
may provide a sensory pathway from the cervix and vagina to the brain that
bypasses the spinal cord. (Chapter 7)
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How do I deal
with my developmentally disabled daughter’s emerging sexuality? Sexuality
and developmental disability are equated with vulnerability. As a result,
parents are often over-protective, which can create even more vulnerability.
A young woman with cognitive limitations needs more, not less
sexual education. She won’t be a perpetual child, no matter how much you
would wish it. Help her to make non-sexual decisions in her life as early
as possible, so she will be prepared for more discriminating decisions as
her life progresses. (Chapter 7)
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I have
severe
pain with intercourse. Is there anything I can do except give up sex
altogether?
Yes. First get medical help ASAP;
pain during sex requires a comprehensive evaluation. If a healthcare
provider minimizes your problem (a common response may be "I can’t
find anything wrong—just try relaxing"), keep looking for a medical
professional who will take you seriously. Medication, physical therapy,
medical treatment, and specialized counseling can be enormously effective. (Chapter 8 and Resources)
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I have a
condition called
Vaginismus. I’m told it is in my head, but talking to
my therapist about it hasn’t helped. Any suggestions?
Vaginismus
(the involuntary tightening or spasming of the pelvic floor muscles near
the opening of the vagina) is happening in your body, even if the
cause was psychological in the first place. This symptom is stubborn but
highly treatable. It requires a specialized approach combining medical
evaluation, sex therapy, and, ideally, physical therapy. (Chapter 8 and Resources)
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Why does the
United States have one of the highest rates of
sexually transmitted
diseases (STDs) in the industrialized world?
It’s ironic that in an
age of supposed sexual enlightenment, STDs are rampant even though
transmission in most cases is preventable. Sex education is failing: in a
1995 Gallup study, 26% of adults and 42% of teen respondents could not
name an STD other than HIV/AIDS. Legislators avoid dealing aggressively
with STDs because it isn’t politically correct to do so, and television - one
of the greatest educators of modern times - virtually ignores STDS. (Chapter 9)
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I’ve heard
women are more susceptible to STDs than men. Is this true?
Yes.
STDs are spread through physical contact. These organisms enter the body
through mucous membranes, areas of skin that are moist, warm, and
hospitable to bacteria and viruses. Because a woman’s genitals contain
more mucous membranes and can retain body fluids from another person for a
longer time, a woman is more at risk than a man for contracting a sexually
transmitted disease. (Chapter 9)
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Can trauma other
than sexual abuse cause sexual problems later?
My mother used to have
explosive rages when she was drinking, and now I find I can’t relax with
my partner sexually, even though I want to. Yes,
non-sexual trauma can cause sexual problems. When you are exposed to
trauma (in some cases even witnessing trauma), your body and brain go into
a self-protective state of emergency. Unfortunately, long after the
original event, certain triggers can prompt your brain to revert to this
emergency state. This state of hypervigilance can make relaxation during
sex very challenging. (Chapter 10)
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Is there sex
after kids?
Yes - if sex is a priority. In order
to sustain a satisfying sex life after kids, couples need to apply the
same creativity and ingenuity that they use to manage their family’s
hectic schedule. They realize that the belief Spontaneity is necessary
for great sex is a myth. They find time for sex by pre-planning,
because if they waited for it to occur spontaneously, sex could become
non-existent. (Chapter 12)
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Isn’t fantasizing a form of cheating?
No.
Sexual
fantasies - the thoughts, ideas, and images that you find exciting - are
perfectly normal and part of the sexual experience of people everywhere.
It’s important to remember that fantasies are not necessarily wishes. As
a matter of fact, research has shown that people often fantasize about
things that they would never act on in real life, even if the
opportunity presented itself. Sexual fantasies provide a valuable way to
keep attention focused during a sexual experience. Using fantasy to
intensify your own excitement doesn’t detract from the basic
significance of your lovemaking—that you are freely choosing to share
with your partner one of the most personal and intimate ways of
experiencing pleasure. (Chapter 12)
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Shouldn’t
people who have a satisfying sexual relationship give up
masturbation? No,
not if they don’t want to. Masturbation has been seen as a social taboo,
which is unfortunate. Self-pleasuring is a positive thing to be enjoyed
and valued. Depending on the study, between forty and seventy percent of
married women and men masturbate even though they have sexual partners.
And many of these people report having wonderful, satisfying sexual
relationships with their partners. Emotionally, masturbation may not
compete with the joy of making love to your partner, but that doesn’t
mean that masturbation can’t be enjoyed in its own right. (Chapter 12)
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What if one
partner wants sex a lot more than the other?
First,
it’s important to acknowledge that two people can have normal sex drives
that differ dramatically. There are many reasons why two people may differ
in how frequently they want to have sex. The discrepancy may be just one
more example of the normal differences that can exist between people. It
may be due to fluctuations that occur in time and circumstances. It may be
due to problems in the relationship. It may be the result of one partner
having a greater need for reassurance or for distance. Having sex with
your partner out of a sense of obligation is not the answer—resentment
will surely be the long-term result. Likewise, shaming and trying to make
the partner with the less-intense sex drive feel guilty will inevitably
create tension in the relationship. Solutions vary according to the cause,
but for starters it is important to remember that any disagreement,
whether it involves sex, money, in-laws, or parenting, can be better
handled when the communication is marked by honesty, sensitivity, and
mutual respect. (Chapter 12)
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When my doctor
gives me only a few minutes to ask questions, how can I bring up
embarrassing sexual problems? When you go for
your appointment, have your questions about the sexual problem written
down. Mention to the medical assistant who puts you in the exam room that
you have several important questions for the healthcare provider and would
like to ask them while you’re still dressed in street clothes. Remaining
dressed until you’ve discussed your questions offers a number of
advantages. It will help you feel more comfortable while discussing your
sexual concerns. It will let the healthcare provider know right from the
start that you have concerns you wish to discuss. And it will prevent you
and the healthcare provider from dashing over the questions because they
were left to the final moments of the appointment. Be prepared to answer
the following: what is the problem, including when you first experienced
the problem and under what circumstances; what is your understanding of
the problem; and what have you done about it? If you have had relevant
tests in the past, be sure to bring those results to the present
appointment. (Chapter 13)
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In this age of
advanced technology and media availability, how can I tell if the
information I’m getting about sex is sound and accurate? Every day
dozens of television talk shows do features on sexual issues. But
remember, their prime objective is to entertain, not to educate, so the
information is not always reliable or helpful.. Internet websites and
self-help books can be important resources, but readers and surfers
should look for the credentials of the authors or the authenticity of
the website source. Things to look for in so-called sexperts are
advanced degrees in relevant fields like medicine, nursing, psychology,
social work, etc.; professional certification as sex educators or
therapists; and/or affiliation with a reputable university. (Chapter 13)
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Isn’t it true
that sexual problems are primarily in one’s head?
Looking
at it another way, the solution, not the problem, may be in one’s head.
After a comprehensive look at the medical aspects of the problem, it is
important that a person reviews his or her own sexual beliefs and values.
Negative attitudes and misinformation can create or contribute to sexual
problems, but those negatives can be replaced with positives, and
misinformation can be corrected. Knowledge and a healthy acceptance of
your sexuality can eliminate many problems and reduce the severity of
those problems that have a medical cause. (Chapter 13)
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How do I know if
I have low sexual desire? My partner wants to have sex much more often
than I do, and suggests it is my problem. Although
low sexual desire is a common sexual problem, it is difficult to measure.
Ask yourself if you ever have sexual thoughts or interest in being
sexually aroused. If you thoughtfully answer yes, rather than you having
low sexual desire, you and your partner may have a sexual discrepancy
issue in your relationship. (Chapter 14)
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Since I’ve been
taking medication for depression, my sexual desire has hit the basement!
Do I have to choose between my mental and sexual health?
No.
Some antidepressant medications may decrease sexual desire, while a
substitute medication may leave sexual desire intact. Or your physician
may decrease your dosage or prescribe an additional medication that
offsets the medication side effects. Be persistent to find a solution. (Chapter 14)
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Is there a Viagra
for women?
Studies are being done right now on
drugs that may help increase blood engorgement of vulvar tissues, genital
sensitivity, and lubrication. Viagra is a vasodilator (a medication that
dilates blood vessels) that may be helpful for some women who have arousal
problems due to illness or menopause, but at this time the FDA has not
approved Viagra for women. Testosterone and herbal remedies such as ginkgo
biloba, ginseng, DHEA, dong quai, and L-Arginine also have been reported
to help with problems of low sexual arousal. (Chapter 15)
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I have noticed a
recent difference in my ability to lubricate. What should I consider in
evaluating this problem?
First, have a medical
examination to see if there are any medical factors interfering with
lubrication. Review whether in recent months you have felt sexual desire.
Monitor what happens in your body if you are sexually stimulated. Consider
whether you can maintain a focus on sexual activity and relax enough to
let go. These insights will help you determine whether the problem is
primarily physical or emotional/relational. (Chapter 15)
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I don’t have
orgasms with sexual intercourse. Is this a sexual problem?
No,
not unless you think it is a problem. If you’re enjoying sex, no orgasm
is no problem. If you decide orgasms are something you want, there are
resources to help you achieve this goal. It may be important to know that
many, if not most, women do not have orgasms from sexual intercourse
alone. (Chapter 16)
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I often feel very
close to an orgasm that never happens, and this is frustrating for me and
my partner. Do other women experience this?
Yes.
You (or your partner) are probably watching obsessively for signs of a
pending orgasm. We call this "orgasm watching." Arousal gets
replaced with being a spectator in your own sexual experience, so that you
are not sufficiently focused on the eroticism of the moment. This
distraction can prevent full arousal and orgasm. (Chapter 16)
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I can have an
orgasm with a vibrator, but my partner worries that the vibrator is
replacing him. He tells me that if I rely on a vibrator it will be the
only way I’ll respond sexually. True?
False.
There is no scientific foundation for the concern that you could become
dependent on or addicted to your vibrator. A vibrator can enhance sexual
pleasure and help women with low arousal, but most women will state that a
vibrator will never replace the closeness and sensation they feel with
their partner. (Chapter 16)
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How do I
determine if I am a lesbian?
For some women,
sexual orientation can take some time to unfold. The very fact that you
have asked this question implies that you will need time, experience, and
reflection to determine the answer for yourself. In this process of
discovery, consider these questions: 1) Were you attracted to heterosexual
images as you were maturing? 2) Did you date guys? If yes, was it to prove
your attraction to males? 3) Are you comfortable with your sexuality? 4)
Are you primarily attracted to women, but fear rejection by others? 5) Are
women, men, or both the subject of your sexual fantasies? (Appendix)
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What is
sex
therapy?
Sex therapy, like most forms of
therapy, is designed to be both a healing and a growth process. What makes
it distinct from other forms of psychotherapy is that what brings the
person through the office door is a sexual problem, as opposed to anxiety,
depression, or stress. Even so, sex therapy doesn’t focus solely on sex.
Our sexuality is woven into our lives, making it impossible to isolate the
focus of therapy on sex alone. Through the process of sex therapy the
client or the couple is encouraged to find pleasure in their sexuality and
to become more comfortable giving and receiving pleasure. Treatment will
include identifying and examining feelings, gaining insight into reasons
for maladaptive behavior, improving communication, learning new ways to
approach old problems, and building on the client’s or couple’s
inherent strengths. (Chapter 17)
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How do I find a
sex therapist?
The American Association of Sex
Educators, Counselors and therapists (AASECT) is a national organization
that certifies sex therapists. They maintain a current roster of certified
sex therapists and will provide you with a list of sex therapists in your
area. Phone 804-644-3288 or log on to
www.aasect.org.
(Chapter 17)
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