What are the causes and treatments for vaginal dryness?

There are a variety of causes for vaginal dryness. Some of the causes could include differing estrogen levels after menopause, cancer treatments, child birth, certain medications and even a lack of foreplay. If you are experiencing vaginal dryness, here are a few tips for how to treat this problem.

1)      Use a lubricant daily to soften the vaginal walls. This can be inserted with your fingers or with the help of a baster. Rub the lubricants around the first 2 to 3 inches of the vaginal entrance (avoiding the urethra). Lubricants that can be used include olive oil, cold pressed coconut oil, or a water based lubricant such as Astroglide or ID.

2)      During sex, use a water based lubricant to make sure the penis is easily inserted. Rub the lubricant around your partner’s penis and around the opening to the vagina. 

3)      If you use these lubricants, and you are still experiencing problems, you can ask your doctor for a prescription. The most common prescriptions prescribed include: Vaginal Estrogen Ring (Estring), Vaginal Estrogen Tablet (Vagifem), and Vaginal Estrogen Cream (Estrace, Premarin).

4)      A helpful resource for learning more about pain during sex is the book “When Sex Hurts,” by Goldstein and Pukol.

5)  Finally, getting a combination of treatment from a Pelvic Floor Physical Therapist, a Sex Therapist, and a Urologist/Gynecologist is the most effective course of treatment for pain during sex.

To make an appointment, call Angela Skurtu, M.Ed., LMFT at 314-973-7997 or www.therapistinstlouis.com.

Can you overuse a vibrator?

Vibrators alone cannot become addictive. However, if used consistently in place of a romantic relationship, one could be accused of vibrator overuse. In these cases, a partner is usually asking for more physical intimacy to be shared rather than relying on solo-sex with a vibrator.

Vibrators can be an excellent enhancement to your love making. For many women, the vibrator can allow orgasm to happen when it previously was not occurring. It is important to find ways to incorporate your partner in the use of a vibrator. 

If you would like to introduce vibrators, talk to your partner about what he/she would be interested in. Next, stop by a sex store or visit a website and research some of the possible tools available. For people who are confused by the whole process, host a pure romance party to learn about different vibrators and how they are used.

Finally, make a plan to introduce the vibrator into your next sexual experience. Be clear with your partner about what feels good and what does not. Try it out on yourself and on your partner as well. After the experience, communicate about what you would like to see happen again and things that felt uncomfortable.  Adjust your use the next time based on what you discussed.

The important thing is to use a vibrator as a piece of your sex life rather than the primary tool you rely on to use. It is important to find a variety of ways to use your bodies and your fantasies as a means for achieving pleasure and possible orgasm.

For more information or to make an appointment, please contact Angela Skurtu at 314-973-7997 or visit www.TherapistinStLouis.com.

Sometimes I don’t get orgasms with my partner, is this normal?

Yes, it is normal. It is not necessary to have an orgasm in order to have good sex. It is necessary to have the ability to accept differences in you and your partner’s sexual response. Both males and females experience sex in different ways. You can enjoy sex by being present and enjoying the moment whether or not either of you has an orgasm.

It is important to have a dialogue about what is going on when you are not having an orgasm. Many individuals find it helpful to say directly, “Let’s make tonight about you,” when they know they aren't going to have an orgasm. Other things to say can include, “I want to enjoy the sex for what it is and it’s okay if I don’t get to orgasm this time.” In the first scenario, the person is not interested in being the focus of attention and may just not be in the mood to do all the work to get an orgasm. In the second scenario, someone may be enjoying the act of sex but not able to get to the next level during this sexual experience.  Both options are fine as long as both partners are happy with what they are doing. Talking about it ahead of time can also be helpful. In a less stressful time couples can discuss sex more directly.

If you never feel like you are getting orgasms with your partner, this is likely going to be a problem long term. In order to get better orgasms: experiment with yourself. Learn what it takes to make you have an orgasm. Try this with your hand first instead of a vibrator because it is difficult to mimic the movements of a vibrator with a hand or tongue.

Then invite your partner in. Show your partner how you like to be touched by having them watch first. Then, have him/her put their hand over your hand as you explore yourself. This gives them an idea of how to practice touching you. Remember to be direct with them and tell them exactly what feels good. After some practice, your partner should be able to give you some orgasms.

Some helpful books to reference about getting orgasms include Becoming Orgasmic by Julia Heiman, For Yourself by Lonnie Barbach, and The Guide to Getting it On by Paul Joannides.

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

Is it strange to have a higher sex drive than your guy?

In any relationship, each partner will have different desire levels. Some people desire sex once a month, once a week, or three times a week, while others desire it once a year. Clearly, there is a large variety of sex drives.

When in a relationship with someone whose drive is lower than yours, it is important to come up with options to make sure each person feels satisfied. Couples need to discuss this openly and directly to come up with the best options for themselves.

One idea may be to cuddle and kiss your partner while the other person self-pleasures. Another idea could be that one partner is willing to provide oral or manual stimulation to help their partner feel sexual. This not only satisfies the high desire partner but can also give you a sense of fulfillment by being able to provide pleasure to your partner. Another option is for couples to come up with trade-offs. For example, one night, you ask your partner to give you a full body massage in exchange for a blow job.

It is very important to feel as though there is a good balance between sexual and non-sexual intimacy. If you feel pressured by the higher desire partner, find a positive way to explain that you need some nights to be focused on non-sexual touch such as kissing, cuddling on the couch or in bed, or just holding hands. When a high desire partner is willing to engage in “no-pressure for sex” nights, it is an important way for them to show respect and love.

Another important tip is to schedule specific times for sex. Some couples don’t like this idea because they believe it takes the spontaneity out of sex. However, in our busy worlds of kids, jobs, and everything else, if you don’t schedule it, it may not happen. Try to schedule a least one date night every other week where you know sex will be involved. That day before the sex date, get thinking about sexy thoughts and flirting with each other to set the mood. This can also be a great way to introduce a new sexy idea, because in the planning you can talk about things you would like to try with each other. Planning can still be sexy!

Finally, seek help if you are struggling. This is a common problem and a Sex Therapist can help couples to find that balance so that both partners feel happy, healthy, and loved.

For more information or to make an appointment, please contact Angela Skurtu at 314-973-7997 or to purchase tickets to one of her seminars visit her website at St. Louis Marriage Therapy, LLC.

Sometimes sex hurts because my boyfriend's penis is too big. What positions or strategies can work with this?

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How do you get your man to be more romantic?

When it comes to romance, it is clear that women tend to complain they don't get enough in their relationships. I hear time and again from the women I speak with that their guys either aren't interested in being romantic or just don't know how to do it. Here are a few tips for how to get more romance from your partner.

1) Praise him when he takes any small steps towards being romantic. Most women I know take more of a critical approach to getting their needs and wants met. They will tell their partner what he is doing wrong rather than encourage what he is doing right. This leaves guys (and gals) feeling like they can't win even when they are trying. So when you see him make an effort towards being romantic, acknowledge it by being thankful. Control your urge to say "I wish you would do this more often," which is a complaint. Instead say, "I love that you arranged this romantic dinner." When you encourage small efforts, you will get more over time.

2) Recognize that guys show romance differently than girls. I have had couples in my office who both reported they were trying to be romantic. However, since they did it differently, they did not recognize their partner's efforts. Each of you can make a list of things you find romantic and compare them. Then pick things from each list to do for each other. The key to this exercise is it do things on your partner's list to show romance and vice versus. You be responsible for trying things on your partner's list, and have your partner be responsible for trying things on your list.

3) Take initiative to create the romance you desire. Too many women get caught up in the idea that it is the man's job to romance the woman. Romance is a two way street. If you want want more romance, you can put the effort in as well. Light candles when you have dinner together. Put on some music and ask to dance in the kitchen. Set up a date night where you both get to dress up and have a night on the town. When he participates in the romance, thank him for spending the time with you.

4) Make it a priority. In the end, romance is a habit like any other habit. You can make a schedule for date nights, come up with daily rituals or even pick out a book that you try new things from weekly. It doesn't matter how you do it as long as you each feel taken care of.

To make an appointment, contact Angela Skurtu at 314-973-7997 or visit www.TherapistinStLouis.com. To purchase tickets to an event, Angela is hosting Sex, Wine and Chocolate on June 28, 2013.

Marriage Therapist to Host Interactive Event “Sex, Wine, and Chocolate: Every Taboo in One Night!”

Marriage Therapist Angela Skurtu invites St. Louis singles and couples to the event “Sex, Wine, and Chocolate: Every Taboo in One Night!” Learn tips and tricks to keep the spark alive in your romantic relationships.

ST. LOUIS, MO, (May 1, 2013)—Ever wonder how to bring up new ideas in the bedroom?  St. Louis Marriage Therapy, LLC announces “Sex, Wine, and Chocolate,” on June 28, 2013, a fun, interactive event that delves into conversation about getting the sex you want! Tickets can be purchased at http://sexwineandchocolate.eventbrite.com/.

“Sex may only be 10% of your relationship,” says Angela Skurtu, Licensed Marriage and Family Therapist and owner of St. Louis Marriage Therapy, “but if it’s not good, it can become 90% of the problems in a relationship.” Skurtu’s current research focuses on sexless marriages, which are defined as ones in which a couple has sex less than 10 times a year. To understand the complexity of a sexless marriage, it is important to first address what makes for a healthy sex life in a long-term relationship. A whole array of life circumstances, including children, moving, grief, illness, weight gain, and medication can all impact desire or performance.

“Good sex long term involves a variety of factors: playfulness, eroticism, excitement, adventure, closeness, love, and respect,” says Skurtu. But difficulties in sexual desire or performance can lead to tiptoeing around delicate subjects, leaving one or both partners feeling shame, frustration, and eventually withdrawing. We know that being fully engaged with the occasional mind blowing orgasm creates a good sexual experience for either party. So where do couples go wrong?

“One of the factors I have seen in my practice is a breakdown in communication-either lack of a sexual language entirely or a sexual language that is critical rather than encouraging. When communication difficulties are connected with shame, I see relationships that lead toward sexless marriages,” says Skurtu.

Sometimes shame enters the relationship because people have been given very shameful messages about sex from an early age. This leads to difficulty creating a positive relationship with sex later in life. Another factor that contributes to a lack of communication and shame is when one of the partners struggles with a personal problem that is linked to sex. These problems may include erection problems, pain during sex, problems achieving orgasm, a disability that affects sexual function, or a life event.

“For a couple struggling with one of these events,” says Skurtu, “Not only will they avoid sex, they will avoid talking about the issue or feel extreme shame when their partner finds out about the problem.” This leads into an avoidance pattern where each partner keeps information to themselves, rather than bringing up a topic that is completely embarrassing. When sex becomes a problem in a relationship, it is often a complex problem for couples to resolve on their own.

Skurtu created the event Sex, Wine, and Chocolate http://sexwineandchocolate.eventbrite.com/ for a date night or a girls’ night out. Individuals who attend will learn valuable tips for how to keep the romance in their relationship long term. The highlight of the night is the anonymous question and answer section. Individuals are given index cards where they can write anonymous questions for Skurtu to answer as a part of her presentation. No subject is too taboo!

“I am always surprised at how detailed the questions get. It is a great opportunity to get answers about sex without worrying about what other people will think of you,” says Skurtu.  “If you want a better sex life, don’t just wait: do something about it. Everyone deserves a happy, healthy sex life.”  And what better way to rekindle your romance than with a little wine and chocolate?

For more information about this event or to purchase tickets, contact Angela Skurtu at 314-973-7997 or visit St. Louis Marriage Therapy at www.TherapistinStLouis.com.