What can you do about premature ejaculation?

1) Masturbation using the Stop/Start Method can be a helpful tool to practice going longer. Initially, a man can practice by masturbating and noticing when he hits the point of no return. As he becomes more aware of this point, he can stop masturbating right before this point and relax for a while before continuing. If a man can practice this several times, he will get better at going longer. This method works best when a partner is eventually brought in to practice the method on the man. That way, he can also get used to her touch not setting him off.

2) A cock ring can be used to help a man maintain an erection for a longer period of time. A cock ring helps by keeping the blood in the penis for a longer period of time. However, it is important not to use a cock ring for more than 30 minutes at a time-constricting the blood flow of any body part long term can cause harm.

3) For some men, using a condom can help because is causes some desensitization.

4) When a man is willing to put more effort into foreplay such as massage, kisses, oral sex, and toys, his partner can still feel satisfied with the sexual experience. The important piece is to make sure each partner is satisfied with the sexual encounter. The variety of means for accomplishing this are endless.

For more information or to make an appointment, contact Angela Skurtu at 314-973-7997 or visit St. Louis Marriage Therapy, LLC.

What resources are available for treating pain during sex?

1)      Seek the opinion of your gynecologist. Some pain conditions can easily be treated with medicine or a lubrication that can be prescribed.

2)      When medication is still not helping, you may need to seek help with a Physical Therapist who specializes in pelvic floor work. A pelvic floor PT can help by giving muscle strengthening exercises, reducing the pain response, and giving you relaxation techniques. http://www.oprah.com/health/Womens-Health-Physical-Therapy-Pelvic-Floor-Rehab/1

3)      Some pain responses also have a psychological component. For example, a woman may receive both physical therapy and medication, but still have anxiety about pain during intercourse. Some couples experience relationship problems as a result of the condition. In these cases, it can be helpful to seek a Sex Therapist or Couples Therapist with a focus in Sex Therapy. http://www.therapistinstlouis.com/

4)      In more severe cases of pain during sex, it is often helpful to work with a combination of your gynecologist, physical therapist, and a Sex Therapist. Using combined treatment offers the most promising results.

If you have more questions or you would like to make an appointment, please visit www.TherapistinStLouis.com or call 314-973-7997.

New Sexy Things to Try

1)      Use positive directions during sex-“I like that.” “It feels really good when you touch me here.” “I like it softer/harder.” “It feels even more intense when you move- left/right/up/down/faster/slower.”

2)      Talk dirty-suggest unique ideas while you are having sex-“Would you like to do a 69?” “I want to be on top!”

3)      Initiate sex-Take charge of your sexuality!

4)      Play sex games-“Truth or Dare.” Dice Game.

5)      Try out sex toys-vibrators, cock rings, anal toys, nipple clamps, etc.

6)      Role Playing-Nurse and Doctor, One Night Stand, Police Officer and Convict.

7)      Take a massage class together.

8)      No sex allowed-Do everything but sex and see how creative you can get.

9)      Anal Sex-Start with small vibrators or butt plugs and always lubricate since the anus does not have natural lubrication.

10)  Take a Tantra Workshop or go on an intimate couples retreat.

Tips for Bringing up Sexy Ideas with Your Partner

1)      Read a sexy book together out loud. Good books-Guide to Getting it On, by Paul Joannides, The Better Sex Guide, by Nitya Lacroix, Over 100 Truly Astonishing Sex Tips, by Lisa Sussman, Just Fuck Me, by Eve Kingsley.

2)      Watch sexy videos together-Sinclair Institute, Pirates, HBO-Real Sex.

3)      Ask open ended questions-“Would you be interested in . . .?” “Have you ever . . . ?” “What’s your favorite position?” “What really turns you on?”

4)      Ask more directly for what you want-“Can we try oral sex tonight?” “I really love it when you …, can we do it again tonight?”

5)      Go to a sex store together or host a Pure Romance party. 

Keeping the Romance in your Relationship

1)      Make it a priority-schedule weekend date nights and alone time during the week.

2)      Create couples rituals that you practice daily.

3)      Touch each other every day-kissing, hugs, cuddling, holding hands, massaging, high fives, wrestling, whatever you enjoy.

4)      Flirt-leave sweet notes for each other, joke around, make suggestive comments, and learn to be playful.

5)      Show appreciation and encouragement-“Thank you so much for. .” “I love it when . . .” "It really turns me on how you . . ."

6)      Take time away together.

Erection Problems

What are some common causes for Erectile Dysfunction?
1) Certain medications can lead to problems either getting or maintaining an erection. http://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysfunction
2) Medical illnesses or physical injuries can lead to temporary or permanent problems. Some of these may include kidney disease, cardiovascular disease, and multiple sclerosis. http://www.mckinley.illinois.edu/handouts/erectile_dysfunction.html
3) Stress and lifestyle can contribute to erection problems. If a man is over-worked, exhausted, and constantly under stress, there may be lifestyle changes that can help.
4) Smoking, drugs, and alcohol can also lead to problems with erections.
5) Relationship problems-when couples are constantly struggling to get along, it can be difficult for a man to perform sexually. The book “Coping with Erectile Dysfunction,” by Michael Metz and Barry McCarthy is a helpful tool.http://www.amazon.com/Coping-Erectile-Dysfunction-Regain-Confidence/dp/1572243864

If you are struggling with this problem and would like to make an appointment, please visit www.TherapistinStLouis.com.

Pain during Sex

Why do some women experience pain during sex?

1) After menopause, some women experience pain due to thinning of the vaginal walls, less lubrication, and less elasticity. http://www.premarinvaginalcream.com/vaginal-atrophy-symptoms.aspx?source=google&HBX_PK=s_sex++pain+during&o=75824775|251525866|0&skwid=43700003140864608

2) After receiving an episiotomy while giving birth, some women get scar tissue that leaves the vaginal walls tight and painful. http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/episiotomy.aspx

3) Some women experience a condition called vaginismus or dyspareunia which is painful condition that can prevent couples from consummating their marriage. http://www.vaginismus.com/?gclid=CPS6j_X6_rUCFcZFMgoddjIA3g

http://www.aafp.org/afp/2001/0415/p1535.html

4) A urinary tract infection, kidney infection, or yeast infection can temporarily make sex uncomfortable if left untreated.

5) Vulvodynia, a chronic pain condition, can cause pain during sex. http://www.nva.org/

For more information or the schedule an appointment, visit Angela Skurtu, M.Ed., LMFT at www.TherapistinStLouis.com