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CASE STORY
ANN: A Woman’s Difficulty with Orgasm, Part 1
“I am here because I am very much in love with my fiancé, but I can’t reach an orgasm with him. I so want to have orgasms together when we have intercourse. I get very excited, but I can’t come. It’s very frustrating!”
Ann, a 28 year-old, attractive brunette, stated her problem as soon as she sat down in my office. After establishing that she had a recent medical check up, no medical problems, and that she was not taking any medications except contraceptive pills, we proceeded to work on her problem during several weekly sessions.
Ann had been able to reach orgasm only by masturbating. She didn’t consider not having orgasms with her partners a problem until she fell in love with Ben, her fiancé. Until now, satisfying her partner was all the pleasure she sought. She said she enjoyed sex and proudly claimed expertise at what she referred to as “blow jobs.” As she spoke of her sexual experiences, it seemed that she enjoyed having complete control of the situation. She didn’t teach her partners how to touch her to an orgasm and she expressed dislike for receiving oral sex.
As we discussed her sex and relationship history, she admitted to a very prudish upbringing where sex was never discussed. She recalled masturbating when she was about 7 years old. She didn’t remember if she had orgasms at that time, but she did remember the secrecy and enjoyment of masturbating. This continued through her adolescence and teenage years.
With no one at home discussing or teaching her about sex, Ann fashioned her sexual expectations from books, the media, and erroneous information from her friends. Because of her strict upbringing, she didn’t date often and had little experience with men.
Going away to college gave her the freedom to start dating without the vigilance of her family. But she found her romantic expectations constantly challenged by the realities of dating. Her lack of experience and information, and the negative connotations about sex she had received at home, made her anxious and fearful of relationships and sex.
Ann limited her sexual exploration to kissing and light petting, until one night when she and her date were drunk and he penetrated her. The next day, she wasn’t even sure she had had “sex”. All her romantic notions about the passion and pleasure of her first intercourse had vanished. She continued to engage in casual relationships that involved intercourse, but she had never had orgasms with her partners.
Then she met Ben through mutual college friends. After several months of dating, they were engaged and moved in together. She was very much in love and kept expecting to be able to reach orgasm while having intercourse with Ben. But it wasn’t happening. She didn’t tell him she wasn’t climaxing so he was unaware of her problem.
Ann thought she was supposed to have orgasms through intercourse. Not being able to do so, she felt like a failure. She felt guilty about masturbating and did not want to show Ben how she could bring herself to climax. She also would not allow him to give her oral sex. She told me it was “too embarrassing.” When he would try to go down on her, she would start worrying about how she smelled, if he was turned off by her genitals, or if he was getting bored and tired. She couldn’t relax enough to enjoy it.
SEXPERT’S COMMENTS
In the case of Ann, there were several issues to contend with:
- Her hesitancy to tell Ben about her problem;
- Her inability to let him make love to her orally;
- Her focus on intercourse as the only way to have orgasms.
Because of Ann’s romantic, unrealistic expectations about sex and love, and because of her feelings of guilt about masturbating, education on these matters was our first step.
First, I wanted to dispel her mistaken assumption that women experience orgasm easily through intercourse. NOT SO! To the contrary, studies have found that about only 25% of women can climax regularly from intercourse alone. And nearly one third have difficulty reaching orgasm through ANY MEANS. The myth that intercourse is the “right” way to experience orgasm made Ann, and many other women, feel pressured to “perform,” and has encouraged them to fake orgasms they aren’t having.
As to feelings of guilt about masturbating, masturbation is a common practice for women and men. Studies report that about 70% of women and about 94% of men masturbate to orgasm. Other studies show that women who masturbate to orgasm report more satisfaction with sex and with their partners.
For Ann, since she didn’t want Ben involved in therapy at that time, educating her about other ways to reach orgasm was our next step.
So Ann could relax and not be so performance conscious while having sex, I started relaxation training with her. Her first exercise was a simple diaphragm breathing technique:
- Sit with your back straight to open the chest area; feet flat on the ground; your hands palm down on your knees.
- Breathe in slowly through your nostrils to a count of four. Take the breath down to your stomach.
- Exhale slowly through your nostrils to a count of four.
- Repeat four times, each time saying to yourself on your exhalation, RELAX.
Ann practiced this relaxation technique daily until she became comfortable with it. Then we discussed that it was important for her to tell Ben about her difficulty with orgasms. It took several weeks before she was able to start discussing this with him. Unconsciously, she had always been fearful of exposing what she considered a weakness to her partners. She felt they would reject her and abandon her. So instead, she concentrated on pleasing them, assuming that then they would not leave her.
Ben was supportive of Ann’s desire to experience orgasm while having intercourse and he pledged his cooperation. Our next step was for Ann and Ben to engage in “romantic” times when pleasuring each other, not intercourse, was the goal. Setting a relaxing atmosphere without any performance anxiety was the purpose for this phase of treatment.
Next, Ann was encouraged to show Ben how she masturbated to orgasm. He found this very arousing and it freed him to show her how he liked to have his penis touched. Asking Ben for what she liked was very difficult for Ann. She had a history of having to take care of herself emotionally and she did not trust anyone else to do so.
Sharing their masturbating styles brought a new level of intimacy to their relationship. But, Ann was still embarrassed about Ben going down on her so we postponed work on this until a later time.
Next, Ann and Ben practiced manual penetration: he would thrust his fingers in her vagina while stimulating her clitoris until she climaxed. Ann was ecstatic that she could let him bring her to an orgasm.
Our next step was for her to masturbate while he penetrated her with his penis. This was most easily accomplished “doggy” style, with Ben behind her, holding her shoulders while he slowly thrust from behind. She was free to stimulate herself in the way she liked and she was able to climax. It took a while for them to coordinate this so they could come together, but eventually they achieved what she had come to my office for: climaxing together while having intercourse.
Though she still needed clitoral stimulation to climax, Ann was very happy with the progress she had made. She was particularly pleased and relieved that she could trust Ben. He listened to what she needed and wanted without running away and abandoning her.
Busy with her wedding plans, Ann postponed work on her next goal: to achieve orgasm through intercourse alone. For now, she expressed great satisfaction with having orgasms with Ben and no longer felt there was a “right” way to climax.
If you would like to know how Ann learned to enjoy oral sex and how she was able to achieve orgasms through intercourse alone, click here.
SUMMARY
Lack of accurate sexual information leads many women to unrealistic expectations about sexual experiences.
Intercourse is not the only or “right” way to achieve orgasm.
Your physical health, medications, your feelings about your body, your genitals, about your relationship and your desires influence your sexual experiences.
Orgasm problems are common and can be helped.
If you feel that you need more counseling for your difficulties than was offered
in the case story, you may contact me
about your specific problem via email
counseling or telephone counseling.
THANK YOU FOR YOUR INTEREST IN SEXPERT COUNSELOR.
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