Dr. Patti's Frequently Asked Questions
Is there anything I can do to stop premature ejaculation?
Yes. There is a "squeeze" technique where you grasp the head of the penis with two fingers underneath and the thumb on top, or, squeezing at the base of the penis. This should be done for approximately 4 seconds each time stimulation is interrupted.
Similarly, there is a "stop-start" exercise which is exactly that. Stimulate - stop - stimulate - stop - stimulate - stop. The stops should last for several seconds
There is also a technique requiring you to learn to control what is called your P.C. muscle. The P.C. muscle is the support for the genitals in both men and women. There is a definite correlation between good tone in the P.C. muscle and orgasmic control.
A quick way to identify the P.C. muscle is to urinate, then stop the flow of urine by squeezing your P.C. muscle, then urinate again. Yes, that was the P.C. muscle. After a few repetitions you should be able to tighten this muscle without the involvement of urination. Each time you feel close to orgasm, tighten the muscle and breathe deeply, bringing your level of arousal downward.
Keep repeating the steps - peaking, squeezing, breathing slowly (the quicker the breath flows, the quicker the semen flows).
Lately I have been experiencing difficulties getting or maintaining an erection. What can I do?
Erections can be affected by physical factors, such as high blood pressure or diabetes, as well as emotional factors - often stress alone can be the culprit. To help determine the cause you should discuss the problem with a medical doctor familiar with your health history.
While there are many new drugs, like Viagra, to treat impotence, there are also techniques where a drug, like prostaglandin-E, is actually injected into the penis to act directly on the blood vessels in the spongy part of the penis. With most medications, there is a time period needed for the drug to take effect - generally 10 minutes to one hour. There are also devices that can be implanted in the shaft of the penis to create erections. All of these remedies must be properly administered under a physician's care.
Emotional stress, anger, sadness, fear, or performance anxiety can all make an erection go away - or never happen. If not medically influenced it may be that you are emotionally troubled about a situation which despite heroic efforts by your partner to arouse you, fail to turn you on. Try to relax. Communicate with your partner that it isn't her fault. Relax and the fire may return. If it becomes an ongoing problem - seek professional help.
As men and women grow older, do their sexual interests change in similar ways?
Not necessarily. Sex is a very personal and integral part of anyone's life. As such, changes in sexual interests can vary widely for a variety of reasons. Virtually all health issues affect our sexuality. Men and women typically differ in how they are effected by aging. Ailments such as arthritis, diabetes, vascular problems - and medications used to control such conditions - can have significant impact on sexual interest.
Areas effected can be erection and ejaculation in men; lubrication and libido in women. Both men and women can begin to lose the ability to focus on and enjoy sex undistracted. It is extremely important, as always, to communicate with your partner as to those perceived changes, and, if necessary, talk to your medical professional for treatment possibilities.
Recognize that as we age, sexual satisfaction often seems based more on the quality of a relationship than on the mechanics of the sexual act.
How can I tell if someone may have a sexually transmitted disease (STD)?
It may not be easy. There are many types of STDs and therefore a wide and varying range of symptoms. While many STDs have visible symptoms, many do not. Others like syphilis exhibit symptoms that disappear when the disease gets worse.
Any rash or discharge from the penis or vagina should be checked by a physician - especially if it is painful or smells bad. Open sores around the anus, mouth or genitals are an obvious cause of caution.
Condoms and safe sex techniques are always appropriate when having sex with anyone other than a long-term, strictly monogamous partner. As a relationship develops, before agreement to sexual activities, you should not be afraid to ask some basic questions. It's not easy - but it's imperative. You want to find out not only his or her overall attitude to sex, but also those sex practices relevant to your health.
In this day and age, anything other than a straightforward approach emphasizing your concerns would be less than prudent. Explain that you are interested in having sex with him or her but that you need to feel comfortable with the kind of sex you plan to have.
My wife and I have pretty limited sexual experience. How can we get ideas for trying something new?
The ideas may be easier to find than the courage needed to explore and try them. If you and your partner are truly motivated in seeking to expand your sexual horizons, you can pick up ideas in various ways:
* Fantasies - communicate some of the fantasies you may have already thought of to your partner
* Erotic films and magazines - rent some tapes or buy some magazines that feature topics or storylines that appeal to those fantasies
* Romantic novels - read some books of erotic fantasies to each other
* Friends - talk to some of your closer friends about their experimentation
* Your senses - think of what would delight your eyes, ears, nose, tongue, etc. Use your most important sex organ (your brain) to imagine the delights of touching, smelling, tasting all parts of your lover's body.
My partner gets really upset if I try to talk about our sexual activities. She thinks it's gross and unromantic. What can I do?
You can try to approach the subject by explaining you are simply trying to find out her feelings and desires to make your relationship that much more satisfying and rewarding - for both of you. The key to all relationships is communication. You may simply need to change your approach to a more silly, friendly manner versus coming across clinically. Explain to your partner that since she is a unique individual and your relationship means the world to you, you need to be aware of her wants, desires, turn-ons and turn-offs.
Whether you are single or married, you might want to seek professional counseling to discuss the inhibitions or reasons behind her reluctance to talk about sex. Remember though, there are many ways to "communicate" without words. Use your senses to pick up on what turns her on or off as you engage in sexual activities. Go with the flow. Maybe she will begin to open up on her own. If not, and it becomes a threat to your relationship, definitely seek professional help - especially if her refusal to talk about sex becomes a hindrance to other nonsexual aspects of the relationship.
I always have considered myself "straight", but lately I find myself wondering what "gay" sex is all about. How do I find someone to "do it" with? Am I gay?
No, you are not necessarily "gay" or homosexual. Yours is actually a fairly common fantasy. Some prefer to call it "same gender" sex to keep it in perspective. One of the best places to start looking is among your closest friends - one who may not want to participate in your fantasy, but as a friend would probably be supportive of your fantasy or has a friend who might be interested.
You can always go to a bar where gay or bisexual people congregate, but as with any pick-up bar recognize the inherent risks of getting into unsafe situations. Personal ads are also a source.
Once you think you have located the Mr. or Ms. Right for fulfilling your fantasy, relax. Get to know the person a little better. Communicate your desires and preferences. Explain your trepidations, if any. Don't do anything that you don't want to do. Apply the same precautions and rules of conduct to your "same gender" sex as you would in "straight" encounters. Safe sex always must come first.
I love my wife and I know she loves me, but over the last few years I find that I have lost most of my sexual desire for her. What can I do?
Yours is one of the most difficult problems facing couples and therapists today. If it is any comfort, you are not alone. The reasons for loss of desire can be multi-faceted and need to be dealt with realistically. Obviously, it will require a commitment on your part to face the problem and include your wife in a frank and honest discussion of your concerns and feelings.
The erosion of desire may be associated with changes in your medical condition, hormonal or otherwise, accumulated anger or stress, a desire to try new things, or, especially in older couples, a fear of growing old as you watch yourself or your spouse age.
Dealing with the issue by changing partners, having affairs, etc., is self-defeating and will ultimately lead to a loss of the partner you still love - if not as a result of guilt, then as a result of your partner feeling betrayed. As with other emotional conflicts, discussing the situation with your spouse can be helpful and hopefully will lead the two of you to some life changing revelations. For all you know, your wife may feel the same as you do. Certainly, the relationship will only thrive if you both can rekindle the desire that you once shared.
Why not spice up your love life with a few toys and some well planned touching and caressing? Look back at how you used to make love. When did the romance begin to fade and a sense of marital duty take its place? Create sex you both enjoy more and the desire will return. Communicate your concerns. Work together as partners to bring the sizzle back into your love life.
My partner seems to take it personally when I tell him something turns me off. What can I do?
The art of communication: How do you tell him? Where do you tell him? When do you tell him? Most people have a fragile sense of sexual adequacy. While most partners really want to know how we feel, hearing that their partner is turned off often makes them feel that they have failed as that "sexual expert" they think they are supposed to be. Somehow, hearing that a partner is turned off means that they have failed as an expert or mind reader. For these and other reasons, many people feel threatened when presented with a turn-off.
Talk with your partner outside the bedroom. Tell him that he doesn't need to take your turn-offs so personally. You want to make your sexual activities incredibly satisfying for both of you. He too should be frank about what he likes and dislikes with you. Keep the conversation positive. Touch his hand or arm while you talk. Keep the conversation positive, emphasizing what you like more than what you don't like.
What should I do if I suspect my partner is having an affair? Everyone gives me different advice.
Why are you discussing this with everyone? The only one you should be discussing your suspicions with is your partner. Sit down quietly and explain that you need to talk to him/her about something really important to your relationship. Don't scream. Don't try to trap or test your mate. Present the facts as you see them, not as damning evidence but as information that needs to be explained.
Describe the type of sexual/marital agreement you expect both of you to honor and ask if he/she is willing to commit to that type of relationship.
If your partner's explanation seems reasonable and truthful, and he/she seems committed to the type of open communication you desire, drop the suspicions. If you still have doubts, counseling may be in order. In either case, do not create a more difficult situation to resolve by asking everyone else's advice before sitting down with your partner and having a frank discussion of your concerns.