DOCTOR'S ADVICE: A wife's problem

Q: My husband and I have been married for 10 years, and we are very happy. We have two lovely children. But there is one problem, Doctor.

I seem to have a lot of difficulty having an orgasm during intercourse. This has always been the case, so I can't say things are getting any worse. In fact, I think I could do it more easily now than when we first got married.

However, if we are fooling around and petting, I find I can have an orgasm quite easily. And there are occasions when my husband is away, when I feel I have to do it myself. On those occasions, everything seems to work OK.

So really, it is just during sexual intercourse that I often seem to be unable to discharge.

I think there must be something wrong with me, but my husband does not agree.

We have heard that there are certain positions which can help women like me. Is that true, Doctor? And if so, what are those positions?

A: There is one simple fact that many people are not aware of. Most women cannot easily have an orgasm in straightforward face-to-face sexual intercourse.

Survey after survey has shown this fact. But unfortunately, people still believe that women should be able to climax as a result of intercourse alone. That is a myth.

And that myth is perpetuated by romantic novels and pornographic books, which nearly always suggest the 'heroine' can climax with great ease, just because a man has sex with her!

You see, the truth is that most women need quite intense stimulation of the clitoris if they are going to have an orgasm. Ordinary face-to-face intercourse doesn't usually provide much clitoral stimulation. And that is the simple reason why so few women climax as a result.

So what is the remedy? Well, there are two main possibilities:

The couple can try positions in which the man's pubic region grinds against the clitoris;

Or they can try positions which allow the man's fingers to reach the clitoris and stimulate it.

There are two sex positions in which the man's pubis grinds hard against the clitoral area. Sexual experts call them 'the CAT position'.

'CAT' stands for 'coital alignment technique'. It describes an intercourse posture in which the man lies much further up on the bed, so that his head is far above the woman's. In fact, he is so far up that his pubic hair and the base of his organ are pressing on the clitoral area. You can see a picture of the CAT position by simply looking up coital alignment technique on Wikipedia.

A variation of this position is to do it upside down. In other words, the woman is lying on top of the man. Again, his head is a lot further up the bed than hers.

Finally, there are many positions in which the man's hand can get to his woman's clitoris, so as to stimulate her and make sure that she orgasms. Of the dozens which are available, I would strongly recommend the spoon position.

This is how it works. You lie on your left side and your husband lies behind you. He is also on his left side. He enters your vagina from behind. At the same time he reaches around with his right hand, and uses his fingertips to bring you to a climax.

I hope this helps you. Please remember: there is nothing wrong with you.

Q: I am a 39-year-old man, married with three children.

But when I was 16, I was brutally raped by a man in Miami. This was a terrible experience, Doctor.

What I am wondering now is whether I could have picked up HIV from that event?

A: What a terrible thing to happen to you! However, if you have remained well over these last 23 years, I think it is very likely that you were not infected with HIV at that time.

Also, back in 1988, there was relatively little HIV in Florida, though there was certainly some. If you are worried, why not just take a blood test to reassure yourself?

In addition, you would probably benefit from some counselling to help you come to terms with the memory of that ghastly experience.

Q: Doctor, two months ago, I had 'Mirena' fitted into my womb. The reason for this is that my menses were very heavy.

But since the insertion, I have had two pretty bad periods, with a little bleeding in between. So why is this device not working for me?

A:As you know, Mirena is the hormone-loaded coil. It is a good contraceptive, and it also treats heavy periods. Furthermore, it can be used to treat menopause symptoms.

However, very often it takes some months before it really works. So my forecast is that later this year, your period will become much lighter and more manageable. Good luck!

Q: Doctor, I am a healthy man, but I get a little tired sexually these days.

Would doing special exercise help my virility, as I have heard?

A: There are pelvic floor muscle exercises, which are done by many women, though not by many men. Recently, there have been reports that these exercises can help a man get good erections and maintain them longer.

So far, there is no scientific proof of this. But it would do you no harm to practise the exercises, maybe four times for the day, over a period of six months.

You can find out precisely how to do them by googling 'Kegel pelvic floor exercises'. Basically, they involves forcibly contracting the muscles which 'hold back' the urine. In men, this produces a distinct twitch in the penis.

If you continue to feel very tired, please check with a doctor, and ask him to check a urine specimen for you.

Q: My husband is a lecturer, and has a really well-modulated voice. Sometimes he reads me rather naughty stories in bed, and I must admit that this turns me on.

But one thing puzzles me. These stories always suggest that women should really be absolutely crazy about male fluid, and should love the taste of it.

I am real bewildered by this, Doctor, since the fact is that I have no interest in this particular fluid.

Am I abnormal?

A: These erotic stories are usually written by men, and they tend to give a totally false view of female sexuality. Again and again, they give the impression that women should be desperate for the taste of seminal fluid.

Now this is foolishness! In the real world, most women couldn't care less about the taste. Some of them actively dislike the taste, and try to avoid it.

So you are not abnormal. Just take these stories with a large pinch of salt!

Send questions/comments to: editor@gleanerjm.com and read more doctor's advice in the Saturday Gleaner.