May 2009: The Sex Files

May 2009: The Sex Files

Many women find it difficult to have an orgasm. Or perhaps, a woman can have an orgasm when she is by herself, but not with her partner. Often these women don’t realize that this is a very common problem and naturally, they feel quite alone in their struggles. On top of that, occasionally a partner will claim that he “has never experienced this with any other girlfriend before her.” Insensitive comments like that can turn this issue into a real burden for the relationship. Usually, the harder she tries to reach the point of orgasm, the more difficult it gets.

First step to ecstasy? Think pleasure, not pressure.

So what type of help is there in such a case? When someone comes to my practice with this problem, I first tell her (or even better both of them if she brought her partner in with her) to relax about it, well knowing that if I overwhelm her with suggestions on what to do differently, I will only add to the burden she already feels. I also inquire about medications she might be taking. Some antidepressants can make orgasm difficult.

I then get them to think about what pleasurable things they might want to explore during lovemaking. “Forget about reaching orgasm for now,” I tell them, “but find out how you like to be touched and stimulated, and what your partner likes.” Ironically, the more they relax and start having fun, the bigger are her chances to experience an orgasm with her partner. Replacing “pressure” with “pleasure” is crucial.

A great start is to do sensate focus exercises, which were developed by sex researchers Masters and Johnson in the ‘60s but never have lost significance. I ask them to stop having intercourse for a while. Instead I give them the assignment to create a relaxing atmosphere at home and to free up some time for each other. They are to touch each other’s bodies from top to toe, but to avoid touching their genitals or other arousing body parts such as nipples. I explain that the purpose of the touching is not to be a prelude to intercourse, with the goal of reaching orgasm, but an enjoyment in itself. I specifically tell them to explore different pleasant strokes and to find areas of their bodies that are pleasurable to have touched and caressed.

If my clients need more explicit instructions, I suggest getting the DVD “Sexual Pleasure for Couples” (or if they are gay, “Lesbian Sexual Pleasure” or “Gay Male Sexual Pleasure”), all available at

I ask them to be sure to communicate to each other what feels good and what doesn’t. Learning to communicate about these feelings is important, especially if you are a woman who can get herself to orgasm but who has a hard time telling or showing her partner what type of stimulation she likes.

With all these instructions in hand, quite a few clients leave my office reluctant, wondering how just touching each other without intercourse for a while should help. However, they often return after a couple of weeks, surprised about what sensitive and erogenous spots they have discovered on each other’s bodies. One recent couple put the whipped cream and chocolate sauce to use and found out that licking it off their partner’s various body parts added delicious fun in the bedroom.

Fun really is the key here. The more relaxed the couple is, the better are her chances to experience an orgasm. Being less tense often will allow her to become more turned on, which also helps orgasms. Once they have fully embraced the concept of “pleasure instead of pressure,” I suggest ways of perhaps stimulating her clitoris differently, or making a vibrator part of their loveplay.

Helpful resources: The book Becoming Orgasmic by Heiman and LoPiccolo, and the brief article, “20 Helpful Hints for Women to Reach Orgasm” by Cynthia Lief Ruberg (available on the website The website sells a DVD, “Becoming Orgasmic.”