The most common sexual problems for men are
1) lax erections
- a) getting an erection
- b) maintaining an erection
- c) and completing the sexual act to the desired effect of both partners
2) premature ejaculation. Areas of focus here may be male partner's awareness of anticipatory disappointment, "my wife will be angry" or "it's going to happen again." These thoughts will further maintain the dysfunctional premature ejaculation cycle. Learning the "squeeze technique" may be helpful to this couple as well warm and gentle discussion of each partner's fears and deep desires to please one another. Medical conditions, such as obesity and diabetes, often interfere with a man's ability to achieve an erection. Other psychological disorders, such as depression, will hamper a man's libido due to increased cortisol (stress hormone) and decreased testosterone. The most common sexual problem for women is no or low sexual desire. Three thoughtful questions will be a) does sex feel pleasurable to her once initiated b) is she able to achieve orgasm and c) is there physical discomfort or pain?
Many medications negatively impact libido.
"... Research on the effects of attachment security suggest that a secure partner will be able to communicate more openly, assert needs more easily, be more empathic and responsive to his or her partner, and explore physical and emotional closeness in and out of the bedroom."
It's no surprise that psychological stress, such as anxiety and depression, create less arousal and less satisfaction in physical pleasure. Arousal requires relaxation, the ability to let go and surrender to physical sensation.
Women want positive feelings prior to the sexual act. Men feel more connected to their partner during and after the sexual act, with the positive feelings and connection towards their partner lasting for some time...what a conundrum!
Sexual pleasure in a long-term relationship occurs when each partner is able to attune oneself to the moment, each other, and fully engage. Therapy provides a safe place for reasonable dialogue to occur. Breaking the negative patterns of communication can help ease a couple towards physical closeness and pleasure.
As one may expect, infidelity will create a severe physical rift between partners, as can years of resentment or psychic injury. Yet, there is always room for improvement and a skilled professional can guide a couple through a rough patch of physical disconnected-ness.
Initially, it may feel awkward to discuss these very personal and delicate matters with your partner and a third party. But, over time, the sexual topic becomes "normalized" and begins to feel safer and comfortable. It is a necessary conversation
*Even contented couples may experience a flatness of energy in their sexual relationship, either temporarily or for extended periods of time.
*Some couples have never enjoyed satisfying sex but are happily married.
*One partner may desire a stronger sexual component in the relationship (a natural higher libido than their partner).
*Life circumstance may be interfering in an otherwise healthy relationship - birth of a baby, care giving responsibilities of others, death of a family member, job loss, physical injury or illness.
Most common physical challenges to sexual intimacy: For men, prostate surgery and diabetes. For women, physical pain during intercourse, either due to medical condition (i.e. bladder surgery) or a psychogenic disorder related to past trauma (i.e., rape, incest.)
Aids available! There are helpful aids available to improve intimacy, such as, hormone creams, physical therapy, vaginal aids, and biofeedback. Learning to vocalize (breathing with sound) can also be a breakthrough for women desiring greater physical sensation.
Physical pleasure is worth fighting for.Sex is important to a healthy relationship.
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