In an interview with DoctorTipster.com, sex therapist Dr. Zvi Zuckerman talks about the most common sexual complaints he has encountered when working with patients.
Men Reach Out for Treatment More Than Women
Dr. Zuckerman explains that most people who approach a clinic for consultation are men, which represents about 65% of the clients. “Men mostly seek treatment for premature ejaculation, which bothers them a great deal,” adds Dr. Zuckerman. “Some come in for erectile dysfunction issues, and these issues usually have a psychological or physiological background. A relatively small group consults regarding a problem of reaching orgasm with ejaculation. Occasionally, some men come in with sexual identity issues, for example: homosexuals or transgenders.”
The Most Common Complaint – Premature Ejaculation
“About 30% of the men ejaculate within less than 1.5 minutes,” Dr. Zuckerman estimates. A most surprising fact. He describes premature ejaculation: “The modern definition is diagnosed according to the time it takes to ejaculate from the moment of penetration. A high percentage of the population ejaculates within 1 minute or less, and this percentage increases with every passing second. Research reveals that it is a hereditary issue for about 90% of those who suffer from it.”
Dr. Zuckerman explains that these issues significantly impact relationships: “Men create defense mechanisms for themselves to cover this issue, but it leads to disappointment and anger. There are behavioral theories that explain how the first sexual encounter affects the sexual relations throughout your life. This first pattern will remain consistent and most times hurt the quality of the patient’s sex life. This theory leads to a treatment method which aims to teach the man how to control himself. It is conducted in exercises of stimulation and pause or a squeeze at the glans of the penis, until the man reaches the point of complete control over the ejaculation reflex.”
So, size does matter?
“Many men believe that their penis is too small. We explain to them that their penis is within the normal range.”
“The issue of whether it is too short, small or thin preoccupies them quite a lot, and causes them to feel inferior, shame, low self-esteem and to avoid taking control over their sex life,” he says.
“When accurately measuring the length of the penis during erection, it generally turns out that the size is within the normal range.”
“In fact, there are very few men who fall within the category of having a too small penis. Most of the time what you need to do is reassure the worried man and get him to understand that his penis is large and long enough to satisfy and impregnate a woman.”
“Additionally, there is a need to understand that size matters for better and worse.”
“Some women would like to feel their partners’ penis in order to reach an orgasm, with a certain penis size or in a certain sexual position. On the other hand, men with too large a penis might cause their partner pain if she has a narrow opening. It is better that the couple experiment slowly, to ensure that they suit each other with respect to size.”
And what about women?
Mostly women approach the clinic “because they have vaginismus, the inability to have sexual intercourse due to unconscious fear of pain or past trauma. They tighten the vaginal muscles, and so do not allow their partner to penetrate or have sexual relations with them. Some of them are very young, but there are also women who come in after ten years of marriage or more. This issue is treated using the Paula Method, a muscle relaxation method which is effective, reliable and fast.”
“Women also approach due to intense pain during sexual relations which is caused due to Vulvar Vestibulitis: an inflammation in the vagina entrance. In addition, some women simply have a narrow vagina, and their partner has a relatively large penis. Others have problems reaching an orgasm. In many cases, older women do not wish to spend their lives without experiencing an orgasm.”
“Younger women, or those in their mid-life, complain of no sexual appetite, no desire. The causes are mostly daily issues: hard work, exams, or taking medicines. Another issue is a relatively cold relationship between the partners. A middle-aged woman that has had a more fulfilling sex life in the past may claim that her desire for her husband has disappeared whereas the husband is still at the peak of his sexual capabilities. There are women that say, ‘I can live very well without it; sex is not something I miss’. The frequency decreases to a complete halt and the main cause for it is a decrease in Estrogen hormone. The treatment provided is hormonal (after taking a blood test) which might return things to the way they were.”
Dr. Zuckerman emphasizes: “There is no doubt that stress and anxiety affect sexual function. Many men and women are stressed over layoffs. According to a survey I have conducted, it appears that workaholics, mostly in hi-tech, work many hours per day and cannot function sexually as in the past.”
The doctor prescribes: Enjoy sexual relations
And there is a positive message here: “Consider sex as a necessity which you have to fulfill, just as eating. The implications of negligence on the relationship are extremely severe. It is possible, and even recommended, to learn how to have a lot of sex and enjoy it. If one of the partners is interested in oral sex, or other types of relations, it is recommended to try and convince your partner, but often times the partner might say “no” and one of the partners will have to give up on it. It is important to remember that you cannot change behavior patterns which are rooted deep inside, and you cannot make one of the partners do something they do not want.”
About Dr. Zuckerman
Dr. Zuckerman is a certified sex therapist with over 35 years of experience in the field. He is a partner and professional consultant for the Between Us Clinic. Together, they have created the PE Program, a home exercise plan for treating premature ejaculation, accessible via the Internet. Dr. Zuckerman studied Marriage and Sex Therapy in the University of Pennsylvania and has been certified as a Sex Therapist and a Supervisor of Sex Therapy for the American Association of Sexuality Educators, Counselors and Therapists (AASECT).