Yet again, I spoke to a woman who has vaginal pain that her physician couldn’t “see” or identify and the doctor told her to see a therapist because it was likely “in her head.” As a sexual health practitioner it just makes me so mad.
I see it every day, women who have been told that their pain is “in their head” because the doctor wasn’t able to identify the problem. I wish more health care providers would be comfortable saying, “I’m sorry. I just don’t know.”. If I had a nickel for every woman who spent years in therapy talking about her vaginal pain, with little results to show for it, I’d be rich. And time after time, I have seen those women successfully treated through physical/medical/behavioral interventions. 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 a physical problem.
And let’s talk about the “meantime”, while you are trying to work out your sex life. 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. 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 way. She had an orgasm (or more) most every time they had sex. She was having fun.
Now — after we worked together, and she got the help she truly needed, do I think she’s having more fun? 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 from his hand, a vibrator or 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.
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- Get help. Real help.
- Face the reality that it’s probably not in your head
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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
You think that hot woman over there is having great sex? We all have a few crazy ideas about sex:
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- That most people are having better sex than we are.
- That for everyone else sex comes easily and naturally.
- That if someone looks confident, then they must be sexually confident.
- That if someone looks sexy, they must be great lovers, be into sex and have all their shit together.
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Well have I got news for you:
Some of the patients I see having the best sex are nothing like the sexy people we idealize.
That some of my “sexiest” looking patients are having no sex or disappointing sex. And you know what? The fact that everyone assumes that they have a great sex life makes the burden harder to carry. They feel “disappointed” in themselves, or that they are fooling the world.
Most people can have good sex if they work at it.
Most people have periods where the sex is “meh” or not so great.
Most people have periods where there is little to no sex, or the sex is strained.
Almost everyone can have more of the times where the sex is good, and fun and even great sometimes, if they pay attention and work at it. And that is what feels like my life’s mission. I wrote the book Sex Points to help give women access to the answers they need to have great sex. And all of my work with clients is helping them reclaim their sex lives.
So, if you can, stop making assumptions about all the great sex everyone else is having, because it’s a fallacy. And just commit today to doing something that will help your sex life!
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
Women feel as though giving feedback in the bedroom can be a particular landmine with their husbands. And that is often so true. All of us, including our partners, carry around so much shame and insecurity around sexuality. And in the end, that is what defensiveness is all about.
So here are my suggestions to make things easier:
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- Don’t give feedback while you are in the act, or immediately afterwards. That will often be taken (legitimately) as a referendum on the sex you just had.
- Try to frame things more in the positive than the negative. “I like it better when you toss me on the bed, then when you ask my permission to …” “I orgasm better when I use the vibrator with you, so could we?…”
- Have a conversation while not actually looking at the person. (This is the same advice I give parents talking to their kids about sex). Driving and cooking are two good opportunities.
- Sometimes the cover of darkness can be super-helpful. So in bed at night, cuddled up. (But not immediately after sex.)
- Vote early and often. It’s unlikely talking once (no matter how hard for you) will have a long lasting impact. Although it might. Don’t be surprised if you need to bring the topic up more than once for it to be registered.
- Start out and end with “I love you.” Or an “I feel so lucky about our sex life…”
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Try to remember that your husband probably really wants to please you in bed, for so many reasons. He also probably feels insecure and unsure of himself. So if you tell him what you want in a loving, supportive way, hopefully he will be able to hear you without taking it as criticism.
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
All my life (both personal and professional), I have heard that statistic bandied about… men think about sex every 7 seconds.
To be honest, it always rang a bit hollow to me. Really? Every 7 seconds? How on earth do they get anything else done? I must say I am really not all that crazy about the idea of, let’s say, my cardiac surgeon thinking erotic thoughts 1542 times during a 3-hour surgery — are you??
Also, I always wondered what “men” they were talking about. 15-year-old HS students? 35-year-old investment bankers? 75-year-old retirees? Really? All of them? They are all thinking about sex 8228 times a day (that’s based on a day with a generous 8-hour sleep budget)? Even for someone like me who works in the sex field and thus thinks about sex a lot, that strains the limits of credibility.
But way back in 2011, researchers at Ohio State to give 283 men and women on campus hand clickers and have them click off every time they
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- thought about food,
- thought about sleep, and
- thought about sex.
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How clever were they??
So, how often did men actually think about sex in one day? Well, anywhere from 1-388 times. And women? 1-140 times a day. Obviously, with ranges like this, it’s awfully hard to come up with the average. The median, however, was 19 for the guys and 10 for the women. Now those are numbers I can live with.
Let’s take away a few lessons from this study:
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- Men (even college co-eds) aren’t thinking about sex all day long.
- Women think about sex too — perhaps more than we initially thought. And the most important lesson of all…
- People are individuals, each with their own appetites, need for sleep and sex drives. Let’s focus more on the individual and a little less on the aggregate and we’ll have a happier, sexier society!
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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
A few years ago I was heading off to Chicago to speak at a sex therapy and research conference. Yes, Virginia, there is such a thing as sex therapy and research conferences (for the record, many of them are not nearly as much fun as they sound, or as they could be, so don’t go Googling and booking your tickets just yet).
As my carry-on suitcase went through the scanner, I heard the security guard call for a manual inspection. It figures. Okay…here we go. I dutifully followed my suitcase with the woman inspector to the side, where she proceeded to zip open the suitcase.
“Just to let you know” I said, “I’m a sex therapist and there are six vibrators in that suitcase. Would you like me to show you which ones have batteries?” She looked momentarily taken aback but then smiled and said, “No, that’s okay”. However, she then asked me about where these are available, where one can buy them, and seemed so tempted to ask more questions but just didn’t have enough time. I really needed to make my flight. I smiled and offered her my card which she happily took.
Just another day in my line of work.
On the way home I decided to try a pre-emptive strike instead. “Hi”, I said, all friendly-like to the security guard as my suitcase started its glide through the scanner…“Just wanted you to know…I’m a sex therapist and there are a bunch of vibrators in there, some with batteries”. Again, a small flicker of surprise, a ghost of a smile and then a “no problem.” And there was none.
So, I say…if you’re traveling with a vibrator, go for the pre-emptive strikes. And you have my permission to become a sex therapist for the day if that makes you more comfortable!
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
This is what I tell parents to make it easier.
Yes, I know. You’d rather go to the dentist. Okay, maybe it’s not quite so bad, but most parents are just not comfortable talking to their kids about sex. And the sad truth is that many of us don’t even admit that to ourselves.
As a sex therapist, when I am speaking to groups of parents about this topic the discrepancy between their perceptions of their comfort levels in talking to their kids about sex, and the reality of their doing it is astounding. Invariably this is what happens. I say: “So who here feels that they are comfortable talking to their kids about sex?” Out of a room of 100, 90 or so parents will raise their hand. (G-d bless those self-aware 10%.) Then I’ll say: “Okay, so who here has talked to their kids about sex in the past 4 weeks?” Blank stares. Maybe 2 hands will slowly creep up. People seem confused. You mean, Bat Sheva, that there can be an actual correlation between parents who are “comfortable” discussing sex with their children and actually having those conversations on an ongoing basis? Well yes. Actually, that’s exactly right.
The problem is that deep down we may be more uncomfortable than we are willing to admit. And what we end up saying to ourselves is “Well, he never asked.” Or “She’s only 12. I really don’t feel that she is ready.” Or “there’s always tomorrow.”
Well, the truth is, there isn’t always tomorrow. Your kids grow up, they get all kind of information (some of it accurate and much of it inaccurate) from a whole host of sources. They develop attitudes and impressions about sex and sexuality almost from the day they are born. Study after study suggests that the more we talk to our kids about sex, the more correct information they have, the more responsible they are and the later they become sexually active.
Let me try to reframe this for you. If you want to be a parent who talks to your child about sex and sexuality, sadly, it’s just not a one-time proposition. So “the talk” when she gets her period or when he starts dating doesn’t really cut it. It needs to be ongoing.
Also, it’s definitely not a “reactive” subject. You cannot wait for children to ask you questions. Sex in our society, despite being ubiquitous, is enough of a fraught subject that they are awash in mixed messages. Unless you have actively opened channels of communication, your kids most likely won’t be the ones to do it.
Think of it more like talking to your kids about nutrition.
Most parents wouldn’t sit down with their child at the age of 12 and review macronutrients, micronutrients and glycemic indexes and feel like their job was complete. I mean, that conversation would be great. But it should follow years of conversations in different settings, with different discussion and with modeling behavior. You no doubt discuss food and choices as you are shopping and preparing dinner. You are, on the regular, commenting on the foods you are eating, looking at, considering eating, what you like and dislike. Hopefully they see you balancing your thoughts, emotions, information and preferences as you make decisions about food. And they pick up your values and possibly some of your habits.
That is how you should think about talking to your kids about sex! As an ongoing ever-emerging conversation that combines information, values and opinions.
So like it or not, it really is our job. It’s our job to make sure that:
- Your kids are not the last on the block to have correct information. (Trust me, that’s embarrassing. I know. I was the last kid!)
- They have accurate information. And you would not believe how much inaccurate information they will pick up from other sources. I know. I hear about it on my TikTok account.
- That they have heard from you, explicitly, your values and beliefs when it comes to sex. While you ultimately can’t control the choices they make, this is truly the gift of being able to articulate your thoughts to them.
- Most importantly, that they know there is someone they can come talk to about these issues when the time arises, and they need to. Because most of us, at some time, really do need to talk to someone we trust about things that are going on with us sexually.
So here is some practical takeaway advice:
It may be that your child will never ask you anything about sex. This could be because they don’t have any questions (unlikely), have somehow picked up that you’re not too comfortable talking about it (more likely) or just don’t have the vocabulary to ask what they want to know (most likely). So you probably have to open the conversation.
Giving them a book to read or reading to them if they are younger is a great way to start talking. Asking about things at school, works well too. “Do your friends ever talk about sex?” But by far the best is to look for openings. When your fourth grader says: “Joanne called Mary a slut today, isn’t that funny?” it gives you an opportunity to respond without judgment and without shame. “Really? hmm… why’d she call her that? Do you know what a slut means? What do you think of that?” These conversations may not feel natural, but it’s so much better than not talking at all. And if you are skeptical that there will be openings, trust me, as soon as you start looking for them, they are everywhere. I dare you to get through 2 weeks of television watching without thinking of something relevant to your child.
Finally, for those of you who are concerned that your children aren’t ready, or are too young to talk to about sex, it may be time to rethink that. Obviously finding age-appropriate information is crucial, but most kids are more ready than we give them credit for. We really like to believe that our children are innocent and can’t handle information on sex.
In case you still have any doubts here’s a fun statistic quoted in my favorite parenting/sex book Everything you Never Wanted Your Kids To Know about Sex but Were Afraid They’d Ask. The average age in America when a child can correctly articulate how a child is conceived and born is 11 years old. The average age in Britain is 9. And the average age in the Netherlands is 7! So, unless you think that the kids in the Netherlands are somehow inherently smarter than ours, you’ll have to admit it’s cultural. And strikingly, incidents of unwanted pregnancy, STIs, encounters without consent and early sexual activity are all lower there than here.
So maybe cancel your dentist appointment and start talking to your kids about sex!
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
They are good for you, help to bring blood flow into the vaginal area, keep your vagina moist and supple and they are relaxing.
Most (somewhere hovering around 95%) of women can have orgasms. Not so surprising for anyone who has had one, there is a direct correlation between the ability to experience orgasm and sexual satisfaction. The corollary, that the inability to experience an orgasm, lowers a woman’s level of sexual satisfaction, is also true.
There have been so many articles and books that try to describe what women (and men) feel during orgasm. Strikingly, although the descriptions vary widely, there is so much overlap between the descriptions given by men and women. This leads me to my general principal that no two orgasms may be alike but that they are not necessarily so different between genders.
The truth is, that to most of us, whether we experience them or not, an orgasm seems, well, kind of mysterious. So what actually is happening when a woman experiences orgasm? During the excitement phase, when a woman becomes “turned on” typically her breasts swell up, her nipples become erect and her uterus tips downward. (Note: I said “typically”. Many women don’t actually experience any or all of these responses and still have fabulous orgasms.) At this point added stimulation to her clitoris, vulva, and vagina will bring on general body tension and will increase blood flow to the vulvar/vaginal area. As the blood keeps building in the vulvar/vaginal area, a woman will experience her genitals as tense and tight. For most women, this feeling, which comes with tingling, swelling and wetness is pleasurable.
During this time a woman is also getting a lot of neurological stimulation. The nerve endings in her clitoris, vagina and vulva are being stimulated and experience greater and greater stimulation. At the point where the stimulation reaches a crescendo, the nerves “shoot off” to release tension. A series of involuntary contractions occur in response. The contractions, which may happen in the uterus and vagina, (each woman is different) carry the blood away from the genitals and back to the rest of the body (unless she tries to have another orgasm). Most women experience this resolution time, as one where tension fades away and there is relaxed feeling in the genitals and often in the rest of her body as well. That’s why so many people want to have an orgasm to reduce stress.
There is such a wide range of the way women describe their orgasms. Some feel them intensely like there is an internal “explosion” when it happens. Unfortunately, those are the only orgasms depicted by books, TV and movies, so women kind of expect that to be the reality. But so many women talk about something subtler or more low-key but also extremely satisfying. And some women know that they have had an orgasm because they are aware when sex feels like it’s “over” and they feel good and relaxed even though they never felt the orgasm itself. And that is all fine!
It is important that I “bust” two crazy myths here:
The first is that it is commonplace for women to orgasm from penile penetration. Most women do not orgasm from a penis in a vagina alone. The statistic can be found all over the place, but let me repeat it, in case you missed it. Only 30% of women (that’s about 3/10 women) will have an orgasm from a penis in a vagina. Most women, (that’s around 70%,) need clitoral stimulation of some sort to actually have an orgasm. Now please don’t confuse that with “most women don’t orgasm while a penis is in the vagina,” because that is not the same thing. Many more women might have orgasms with a penis in their vagina, because they are simultaneously using a hand or a vibrator on their clitoris. But for most women it is just not realistic to have an orgasm from stimulation in your vagina alone. And so many women think that is “normal” because that is what we see on TV and movies. So relax, and stop using that as a gold standard.
The second? That there are clitoral orgasms and vaginal orgasms and that they are fundamentally different. There is no such thing as a “clitoral” or a “vaginal” orgasm. There are orgasms. Period. Some women enjoy stimulation more in one part of their genitals more than other parts. It is the combined stimulation of the nerve endings that ultimately lead to orgasm and for most women it’s some type of mixed stimulation. That’s why orgasms just feel different when different parts of your anatomy are being stimulated. Some women have more nerve endings in one part of their genitals than other parts.
No orgasm is “better” than another and there is no evidence that one type of orgasm is universally more intense than another! Different women experience stimulation from different parts of their anatomy differently.
However, wherever and with whomever you choose to have an orgasm, enjoy yourself. The really important thing to remember is that they are good for you, they help to bring blood flow into the vaginal area, keep your vagina moist and supple and they are relaxing. Best of all, they usually feel great!
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
All of us feel insecure about something. Many, many of us feel insecure about sex.
Here’s the thing: Insecurities tend to be the result of very deep, very old “wounds” that we may have experienced as children. If something made us feel ashamed and unlovable, (even when it was not meant to) then those feelings will often last our whole lives. And they have the tendency to come out when we are least interested in experiencing them.
So if, for example, you overheard a parent say something about your body that embarrassed you, even if they didn’t mean it badly, the deep mortification that you felt and couldn’t share might bury itself in you and come out later in all kinds of ways. Or if your first sexual experiences were awkward and uncomfortable and left you feeling mortified, that can just move with you throughout your life. The more you carry them around and don’t share them, the deeper into your soul then can burrow and wreak havoc.
In my experience, and I deal a lot with sexual shame, by far the best way to combat shame and the insecurity it causes, is to talk about it in a safe space. I know it sounds incredibly simple. But the truth is, it’s not. It can be horrifically scary and horrible to take that first step and talk to someone.
You can start by talking to a family member or friend whom you truly trust. You can start by letting them know that you need to share something that makes you feel incredibly vulnerable. You can start by talking to a professional. That is what we are here for.
And I can promise you something. Even though it may feel like you have the most shameful secret in the world, it is so likely that it’s incredibly common and not as shameful as you think.
But I want you to know this. The more you take things out of the “shadows,” where the shame lives, and the more you can hold it up to the light of day, the less power it has over you. Slowly over time, in talking and sharing you can truly minimize insecurity.
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 it all the time. How do I know if I am sexually compatible with someone? Do I need to have had sex (intercourse) with them in order to know for sure?
My answer is no. No, you don’t need to have oral sex, intercourse or any other kind of sex to know if you are compatible. Since people are constantly changing, there is nothing that really can guarantee long-term compatibility. However, there are some basic indicators that you can look for as “guide posts”.
Top 3 Tips:
- You find their scent appealing: Since there is no logic behind sexual attraction, it is not well understood. But there is something about body chemistry, be it pheromones or something still undiscovered, that lets you know pretty quickly if there is basic attraction to this person. Without this basic attraction, 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 if their smell is appealing, that is a good sign this person might be good for you.
- You like the way they kiss. It’s time we realize that a soulmate isn’t solely determined by communication or non-physical relationship criteria. When was it decided that being verbal in a relationship is more important than being physical? Finding pleasure in your partner's kiss, is a good sign this person is a good contender for long term compatibility.
- You agree on your sex life as a couple. You’ve made clear to each other, what you want in your sex life. (At least for now). Let’s face it, if you don’t agree on the basics, you’re relationship will not last. If one person’s idea of a good sex life is having sex once a week, primarly in the bedroom and the other person’s idea is having sex twice a day, regular threesomes or stead visits to sex clubs, the compatibilty isn’t there. It’s important to have the conversation early about what a good sex life looks like to you and your partner. If you find your expectations or needs are developing and changing, make it clear to your partner that you want to explore those needs.
These are some simple, basic signs that will help you decide if you are sexually attracted to someone. Let’s stop the stigma that physical reactions lack significance or are merely temporary. A strong physical relationship can be a huge determinant of a strong, long-term prognosis in a relationship.
If you’re looking for something long term, look for these indicators early and it can help you understand if you are compatible and maybe even help you decide if you should move forward in your relationship.
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 received a (not so unusual) call today from a woman trying to figure out if she should set up a consultation. During our 10 minute phone call she basically told me that:
She was interested in sex but her husband seemed totally disinterested. He maybe wanted to have sex once a month — usually if she reminded him that they hadn’t had sex in a while. He often had a hard time keeping his erections. It took him 45 minutes of hard work to ejaculate.
“Hmmm,” I responded, “it sounds like he should see a male sexual dysfunction specialist.” “Oh,” she replied, ”but he refuses to see a doctor. And (now here’s the punch line) I think maybe I’m not erotic enough and interesting enough and that’s why he’s having problems.”
Oddly enough it is often hard for a woman to accept that she is not the problem in a sexual relationship. It’s hard, I’ve found, because women seem to naturally take the blame for so many things that aren’t their fault.
It might also be hard to accept that you’re not the problem because that means that you can’t be the solution. If the problem is not yours, it’s also not yours to fix, and that’s a hard reality for some women to accept. It means giving up an element of control.
So for the woman on the phone, she needs to talk to her husband and see if he can shed more light on the situation. He claims he loves her, is turned on by her and just has a hard time. That leaves many more questions to be answered, but they are all questions which need his participation to answer: Is his testosterone low? Does he have blood flow issues? Is he having an affair? Is he watching too much porn? Is he gay? Is he over-ridden with guilt?
Obviously we can’t answer those questions, and whether he chooses to participate in finding answers or not will be his decision.
I can tell the women one thing though: it isn’t her fault.
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