If Intercourse is Painful Your Sex Life Does Not Have to Be Over
Our view of sex as having to revolve around penile/vaginal intercourse is perhaps the single most limiting and misleading element of our current sex education. There are many kinds of sex. There’s oral sex, manual sex, anal sex. There is sex using every potential part of your body. If you can’t have sex one way…there are so many other ways!!
Why does someone who can’t have vaginal intercourse feel as though she should be embarrassed to discuss this?
And why does she feel like her sex life is over??? I had a patient who had vaginismus (a condition in which you can’t get a penis into the vagina.) She was married for 3 years when I saw her. (And yes, we I her!) She had one of the best sex lives I’ve seen. She was having sex with her husband about 3 times a week, in various ways. She had an orgasm (or more) most every time they had sex. She was having fun. Now — do I think she’s probably having more fun now that they are having vaginal intercourse? Yes. Probably. (Although she’s quite clear that intercourse is not her favorite sexual activity.) More options is usually better. BUT do I think someone’s sex life should be over because they can’t have vaginal intercourse?! No way. And I think we’d do ourselves, our daughters and our partners a big service if we put vaginal intercourse into perspective.
Would her husband be having a grand old time if he was having sex 2 times a week with a happy, excited, willing partner who was the queen of blow jobs (kind of how she describes herself), who brought him to orgasm with her tongue, her lips, her breasts, her feet, her butt, her anus? Would her husband be having a grand old time if he was having sex 2 times a week with a happy, excited, willing partner who was having orgasms using his hand, a vibrator, his mouth. My guess is yes. Would he miss vaginal intercourse? Probably. Is that a price he would pay to be with a woman he loves? Would it be that be so very different from a guy who is heartbroken because his wife won’t go down on him and he loves oral sex? Perhaps not so very different.
So here’s advice if you (or your friend or your partner) has pain with intercourse:
1- Get help.
2- It’s probably not in your head
3- Try to build a fun, happy sex life anyhow.
You can do it.

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
I struggle with the concept of casual sex
A generation ago the teens were horrifying the adults in their life because they espoused the viability of sex without marriage. Many felt that the adults’ values were antiquated and that sex was a potentially positive force within the context of a loving (albeit young and thus very possibly, superficial) context.
Now that same generation (while we have become parents or even grandparents) seems to bemoan the sexual activity of the current younger women because they have gone one step further and divorced sex from emotional commitment. What might be observed among our children’s peers is that they often take part in sex as merely a physically pleasurable activity or perhaps one with short-term emotional pay-outs.
Maybe it’s time we “older women” (the mothers) challenged ourselves and examined our need for a “meaningful relationship” attached to sex as another version of the “needed marriage." “Maybe the current view of sex is okay. Maybe it’s just another step in the road to demystifying and taking away some of the over-dramatizing of sex.
I can already feel the angry eyes upon me. “What????? You are suggesting that sex be so casual that it is OKAY outside the context of a meaningful relationship”? Well…Maybe. Maybe that’s not what I want. Maybe that’s not what you want. Maybe that’s not what you want for your child. Maybe in the long term most of us are looking for a meaningful relationship and love that includes passion. It is totally fair, even important, to communicate those values to your children.
But maybe, just maybe, for some people sex can also exist in a context outside of a meaningful relationship for its own sake — and maybe that’s not such a terrible thing. It’s just something for us to think about.

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
Reclaiming our fantasy life (part 2)
Part 2
Often women clients will say something to me, like “OMG, I have all these fantasies about women, but I’m not really interested in having sex with a woman. Am I a repressed lesbian?” To which I will always respond: “All it means, when you like fantasizing about women, is… that you like fantasizing about women. Period. And if it turns you on, great. Stop trying to figure out what your fantasies say about you or what they ‘really mean’. You’ll turn yourself into a pretzel for nothing.” And for the record, (not that it should matter), it is extremely common for women who consider themselves heterosexual to enjoy sexual fantasies about women.
Also, very commonly women get upset about their fantasies because they think that they are not politically correct. “Oh my g-d, I fantasized about being overcome by a stranger in the woods.” Or “What is wrong with me, I fantasized about trading sex with a cop to get out of a parking ticket. Am I sick or what?” (And by the way, variations of these are also extremely common fantasies.)
I’m here to assure you that you should never worry about fantasies because the whole fun of fantasies is that they are merely that, fantasies. It does not mean you want the scenario to happen in real life. It just means there is some element of that fantasy that appeals to you.
Let me illustrate this with a popular fantasy. It is very common for women to have “overpowerment” fantasies when, if in real life, they were raped or taken without their consent they would be devastated and traumatized. That fantasy is one of the most common female fantasies. And there could be any number of reasons why it’s so popular.
Here are a few:
- It allows a woman to feel as though she is giving up total control and can then completely submit to the pleasure that sex affords without the concern, guilt or second guessing she might have in real life.
- Women get turned on by being the object of desire. A rape fantasy suggests that they are so desirable that someone is willing to go to crazy lengths to “have them” and being desired that much is a turn on.
- The reality, of course, is that when you’re fantasizing, (even when you’re fantasizing about losing control) you have absolute control over your fantasy. The fantasy is exactly what you want, when you want it and how you want it. And you get to decide when and how that fantasy is going to end.
I’m constantly reminding people to enjoy, not edit, their fantasies. So what if there is a monkey in your fantasy? Two women? 62 people watching you? Whips and chains? It doesn’t mean that you are a lesbian, an exhibitionist, into BDSM or any particular activity — not that there's anything wrong with any of those things. It just means that thinking about those things turn you on.
If you are interested in doing a bit more soul searching, you can think about what appeals to you in the fantasy… it is the absolute power? Is it feeling beautiful? Is it a sense of equality? Is it the romance? Then you can see if there are elements that you might be able to incorporate into your real life sex. But only if you want to. Let’s see… you fantasize about being onstage having sex and people are throwing roses at you… so maybe a little bit of exhibitionism might turn you on. Maybe you and your partner want to leave the shades open sometime, or video yourselves. Or maybe you just want to do a striptease for your partner. Or not. These could be elements of fantasies that you have no interest in exploring outside the confines of your brain, and that is perfectly fine.
Now about sharing those fantasies with your partner, that is, should you tell your partner about your fantasies? My only advice is that the decision to do so should be totally up to you alone. If you think it would be fun to act out a fantasy or even just talk about it, go for it! You can shoot an email or leave a note or an erotic story on your partner’s bed if you can’t quite work up the courage to bring it up face to face. Or, snuggled up in bed when it’s dark and they can’t see your face is always another option. Be prepared though, you might have to follow it up with real sex, because, well, fantasies are a big turn on.
But never let a partner push you into sharing a fantasy that you want to keep private — you never “owe” it to someone to tell them your fantasies. Let’s remember that distinction between fantasy and reality I was talking about. Your fantasies belong to you alone and they are for your pleasure entirely.
It is so important for all of us to learn to enjoy our fantasies and not feel guilty about them. And even better, learn to revel in them. Fantasies can fuel your sex and love life for decades providing a variety and range that would be impossible in real life. So embrace your fantasies, as exactly that, fantasies and as always, make sure you are having fun.

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
Part I
If you’ve heard me say it once, you have probably heard me say it countless times: fantasies are one of the most important components to maintaining a long-term healthy sex life. Fantasies are so important that many women have an “orgasm fantasy,” some scene that is so erotic to them that they use it during stimulation in order to have an orgasm. And for most people, a healthy ability to fantasize also suggests a robust ability to get turned on and desire sex.
Somewhere along the way, however, our society lost the ability to distinguish between imagination and real life, and I know that loss of distinction affects us in many unhealthy ways. And, as a sex therapist, I’ll assure you, that your sex life is at front and center.
So here’s the first question I often get asked as a sex therapist: If I fantasize about something frequently does it mean that I actually want it to happen???? And here are my answers. No way. Nope. No. Not necessarily. Maybe sometimes. But most importantly who cares?”
I’m here to assure you that the only thing I know (or more importantly that you can know) for sure is that when you identify something you like to fantasize about, you know… that you like to fantasize about that activity. Beyond that, there is absolutely no implication that you actually want to “actualize” the fantasies.
There may be fantasies you have that you know you do want to act out. If you have always “fantasized” about having sex with a drummer, and you know you do want to have sex with a drummer, then yes, that fantasy is projecting something real and you may indeed want to date a drummer. But that is fundamentally different from a fantasy of having sex on a spaceship to Mars with a group of 10 Martians, and equally different from a fantasy of having sex in the middle of Broadway with 100 onlookers.
There are different kinds of fantasies, and understanding that there are some you actually might want to try, does not, in any way, suggest that you want to try all of them! You may not want to try out a fantasy because it is too wild and crazy and may result in negative secondary consequences. You may not want to act out a fantasy because it’s just plain unrealistic (take my Martian example) or because, well, you are just not into it in reality, you are only interested in your imagination. And that, my friends, is the joy of fantasizing!
In my experience women, much more than men, are heavy-duty into second-guessing themselves, and, as a result, editing their fantasies. And trust me, that is just not helpful with your sex life.
Stay tuned for Part II where I talk about those “questionable fantasies that make you nervous”

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
I hear this again and again from my clients.
It’s just so hard to initiate and they feel terrible about it. More often than not, it’s the woman, but frankly, it can be the men as well.
First of all, be a little understanding of yourself. It is just so hard to be vulnerable. There is almost nothing as scary as communicating “I want to have sex with you” and having the other person not respond positively. It makes us want to crawl into a hole and disappear in the netherworld.
Here are a bunch of the reasons people have trouble initiating:
- Somehow women think it’s the “guys job” to initiate sex and so we’ve never learned how to do it. And the guys get resentful (understandably.)
- We’ve gotten shot down too many times before. We’ve tried to initiate sex and we’ve gotten rebuffed or turned down time and again and it’s starting to feel pointless.
- We’re afraid if we initiate this time, he’ll expect you to initiate all the time, say 3 times a week, every day, 3 times a day? You rather just ignore the whole thing.
- You’ve gotten turned down in hurtful ways. Being pushed away, ignored, having eyes rolled at you or being belittled with “G-d, all you ever want is sex” really creates a huge sting. It’s much easier to take a no, if it comes with an I love you so much and I do really want to have sex with you, just not now when I’m in the middle of 2 loads of laundry, finishing the work project due tomorrow and fielding carpooling calls. How about we make time Saturday night?
- We’re not at all sure how to do it. We are afraid we might come across as too aggressive or too silly, too transactional or not clearly enough. Initiating really is a dance and you both have to learn the steps.
- We are just plain out of practice. We haven’t done it in so long and that is part of what makes the hurdle higher and higher. Like anything else, say public speaking, we are just not used to doing it and the longer between gigs the scarier it gets.
I promise you. Once you are aware of what’s getting in the way, it makes it much easier to start turning this around. Hey you… turn off the computer and go initiate sex! Now.

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
Well, obviously, I think so.
There's some fascinating research suggesting that marriages with good sex tend to be happier overall. But now comes the big question: which came first, the great relationship or the fantastic sex? As a sex therapist, I can tell you it's not as simple as picking one or the other. It's a bit like pondering the age-old riddle of the chicken and the egg - both have a role to play!
You know, it's kind of funny how our society often forgets that sex can actually create greater intimacy. Instead, we've bought into this idea that intimacy leads to good sex. But let's be real here - it can work both ways.
Imagine this scenario: you and your partner are having some sexual hiccups, and you decide to see a couple's counselor. More often than not, they'll suggest focusing on the rest of the relationship and working on communication, with the promise that the good sex will follow. But guess what? It doesn't always go as planned!
Here's another curious thing I've noticed - there's a subtle bias against using sex to create intimacy. People tend to criticize “but the sex was so good in the relationship” or “one of the things I love about him/her is how they smell.”
As someone in the field, I can vouch for the fact that sex seriously affects relationships - big time! It might sound hard to believe, but I've seen many relationships improve drastically when the sex got better. Good sex brings intimacy, joy, and acceptance into the picture. It makes people feel loved and appreciated. Now, don't get me wrong - I'm all about respecting personal boundaries. Nobody should be pressured into anything they're not comfortable with. But here's a thought: even when you're feeling neutral or a bit down, giving sex a shot might actually be a good thing. Because truth be told, sex in a relationship can be a real game-changer!
Picture this scenario: you come home to find your partner left dishes in the sink, socks on the floor, and a wet towel on the bed. If you've recently had some great sex, you'd probably just laugh it off and take care of the mess. But if it's been a while since you had sex, well, you might be tempted to use those socks as a weapon! Yikes!
But here's the exciting part - sex can be like the magical glue that binds a couple together, turning them from mere roommates into a power couple.It sets the stage for better communication, trust, and openness. Seriously, good sex just makes everything in a marriage better.
So instead of thinking that sex is only for expressing intimacy that's already there, why not view it as a tool to reignite or recreate that intimacy? Sometimes, couples get caught up in complex issues and spend years working them out, when focusing on the sexual aspect could be the key to their happiness.
And hey, here's a friendly reminder - don't quickly dismiss the idea of sex just because you're not in the mood or things have been a bit tense with your partner lately. Sex might just be the missing piece that helps heal and strengthen your intimacy. I've seen it work wonders with countless clients, and it's definitely worth a shot.
(And read more in my book: Satisfaction Guaranteed: How to Have The Sex You’ve Always Wanted.)

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
Vibrators and men? you bet
An article published in the Journal of Sex & Marital Therapy (“Vibrator Use Among Heterosexual Men Varies by Partnership Status: Results From a Nationally Representative Study in the United States”), states that 44% of heterosexual men have used a vibrator at some point in their lives. In most cases they’ve used it with a partner, but in some cases they’ve also used it alone.
So here are some of my thoughts and pointers on vibrators and men — pay special attention if you’re a guy:
- Check and see if your partner is interested in trying a vibrator.
- Encourage your partner to use a vibrator, especially if she is having trouble with orgasm.
- Try both a light and strong vibrator — each of you will have a different “vibration need.” Too strong and you may (or she) may feel “numbed out.” Too weak and you might find yourselves yawning and pulling out the Scrabble set.
- Play with positioning. I had one patient who said her partner loved her to keep the vibrator on under her bottom while they were having intercourse. He could feel the vibrations and it felt great.
- Like with everything else…a sense of humor is crucial, so keep you mind open and your laugh ready.
- And have a great time.

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
It’s FINE that you Orgasm That Way
I read a moving and sad article about lichen planus and vulvodynia. A young woman talks about her vaginal pain and how it has shamed her and ruined her sex life.
Vaginal intercourse became excruciatingly painful and none of her gynecologists could see any problem and so everyone thought it was in her head. Over the years she became more and more avoidant and the lack of sexual contact with her partners ruined a number of relationships.
I have so many thoughts.
I think it was very brave of this woman to describe her situation which has caused her so much shame, self doubt and pain.
I can’t help but wonder how many more women have been told that their pain is “in their heads” because a physician wasn’t able to identify the problem. I wish more MDs would be comfortable saying, “I’m sorry. I just don’t know.” As a practitioner it just makes me so mad. If I had a nickel for every woman we have seen who we have been able to help through physical/medical/behavioral interventions who had spent years in therapy with little to show if it, I’d be rich! I think most women have a gut feeling whether the problem is physical or psychological. We should trust them. And more often than not, pain is PHYSICAL.
If you are having pain, trust yourself and keep looking for someone who can help you!

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
It’s FINE that you Orgasm That Way
I deal with many common misconceptions every day in my practice but here is one that creates so much stress needlessly:
Many, many women have orgasms while lying on their stomachs rather than on their backs, and they feel like there's something strange about it. But let me tell you, it's totally normal and actually pretty common!
I don't have hard statistics, but I'd say around 20% of the women I see prefer the stomach orgasm. And you know what? That's absolutely fine! It all comes down to how our brains get wired and what we learn early on in our experiences. Many women start exploring their bodies and pleasuring themselves when they're young, and for some, the stomach position becomes their go-to method for achieving orgasm. (Think about rubbing against a soft blanket, pillow or toey.) Once that pattern is established, it can be challenging to change.
So, why do these women feel like it's some deep, dark secret? Blame it on popular media! We're bombarded with images of sex that usually involve heterosexual intercourse with the woman lying on her back having mind-blowing orgasms. There's not much room for showing variations, and that's why the stomach orgasm isn't portrayed much. It's a shame, really, because many women feel embarrassed about it and even avoid talking to their partners about it.
But let me clear something up: there's absolutely nothing bad or problematic about having an orgasm on your stomach! An orgasm is an orgasm, and it's equally pleasurable, intense, and valuable, regardless of the position. Sure, it might be a bit more challenging to have your partner stimulate you that way during sex, but it doesn't make the experience any less enjoyable.
Now, the big question is, should you try to change the way you orgasm if the stomach is your preferred posture? Well, it's a personal choice. If you're perfectly happy with the way things are and you and your partner have found what works for you, then keep going! No need to fix something that ain't broke, right?
But if you haven't told your partner about your preference, it's time to come clean. Trust me; living with a deep dark secret about your orgasms is no fun and can lead to resentment. Communication is key in any relationship, especially when it comes to sexual satisfaction.
Sure, you can try learning to orgasm on your back if you want to explore different options. Practice can help you rewire your brain and expand your pleasure possibilities. But listen, if it becomes stressful or makes you feel bad about yourself, it's not worth it! The most important thing is to enjoy your sex life and have fun with your partner.
So, to all you wonderful women who orgasm on your stomachs, embrace your preferences, communicate with your partner, and most importantly, have a blast! Remember, there's no one-size-fits-all approach to pleasure, and what matters most is that you're happy and fulfilled. You go, girl!
(And read more in my book: Satisfaction Guaranteed: How to Have The Sex You’ve Always Wanted.)

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted
Here’s how you can tell if you are sexually compatible with someone
I hear it all the time. How do I “know” if I am sexually compatible with someone? Do I need to have had sex (people usually mean intercourse) in order to “know for sure”?
So, my answer is no. No, you don’t need to have had oral sex, intercourse, or any other kind of sex to know if you are compatible. And honestly, nothing is going to guarantee long-term compatibility anyhow, because we all change. All the time. However, I do think there are some basic indicators that can give you an idea if you will (or are) sexually compatible.
So, here are my top 3 things:
# 1 - You like the way they smell.
The reality is that sexual attraction is not rational. It’s not well understood, but there is something about body chemistry, be it pheromones, or something as yet undiscovered, which let’s you know pretty quickly whether or not there is a basic attraction to this person. Without it, it is hard to weather the ups and downs of a long-term physical relationship. You’ll never be able to talk yourself into attraction, but when it’s there it’s a good sign that this person might well be for you.
# 2 - You like the way they kiss.
You like the way they kiss. I think it’s time we jettisoned the idea that soulmates are determined by communication and non-physical relationship criteria! When did we decide to privilege the verbal over the physical? A good sign that this person is your soulmate, and that the relationship will have staying power may well be that you love the way they kiss. The physical reality and presence of instinctive attraction is at least as good an indicator of soulmate material as loving their sense of humor. Let’s get over our discounting of physical reactions as “unimportant” or “merely temporary.” A strong physical relationship can be a huge determinant of a strong long term prognosis in a relationship.
# 3 - You've both talked about it and you both way the same kind of sex.
Let’s face it, if one person’s idea of a good sex life is having sex once a week primarily in the bedroom, and the other person's idea is having sex twice a day, having regular threesomes or steady visits to sex clubs, then I think compatibility may be a question! So, if you're not having sex with the person yet you may want to have a conversation about what a good sex life looks like to them. Or if you are having sex and your expectations are that as the relationship develops it will look different than it does now, you should probably explore that. Because wanting and expecting a certain kind of sex-life needs to be clarified.

Written By
Dr. Bat Sheva Marcus
Sex Therapist & Relationship Expert | Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted