Sex Therapy
Principles and Practice of Sex Therapy
Fourth Edition
Ed. Leiblum, S.R.
©Copyright 2007 The Guilford Press
If you want a serious reference for all therapies pertaining to sexual function then look in the above textbook. If you would prefer to meander through an assortment of therapies that I happen to find entertaining, then come with me.
Erectile dysfunction (ED) has received enormous attention recently due to the development of a very simple treatment.
Viagra®
Sildenafil (Viagra®) was developed to inhibit the phosphodiesterases that catalyze Corpus Cavernosum (penis) specific cGMP.
penis specific phosphodiesterase (PDE5A)
When cGMP in your penis increases, the smooth muscles relax and allow blood to flow in. You might be familiar with drugs like theophylline which do the same thing in the lungs so that people with asthma can breathe. The beauty of Sildenafil is that it only does it in the penis, and a little in the nose and eye, whereas theophylline does it all over the entire body.
The phosphodiesterase inhibitors such as Sildenafil (Viagra®), Tadalafil (Cialis®), and Vardenafil (Levitra®) only treat erectile dysfunction that is caused by medical conditions such as diabetes and cardiac illness. These conditions reduce blood flow to the penis. Should you suffer from erectile dysfunction that is related to psychological issues, I highly recommend the new super placebo called Enzyte®.
The beauty part is that Enzyte® is "all natural." It is made from only 19 things, most of which we really don’t know for sure what they do (Tribulus terrestris; Yohimbe Extract; Niacin; Epimedium; Avena sativa; zinc oxide; maca; Muira Pauma; Ginkgo biloba; L-Arginine; Saw Palmetto, gelatin, rice bran, oat fiber, magnesium stearate, silicon dioxide.) . You should ignore the fact that Berkeley Premium Nutraceuticals, Inc., is currently under a class action lawsuit for false advertising or that "nutraceuticals" isn't really a word. Instead, you should totally buy into the advertisements and believe everything they say. This will heighten the placebo effect and treat your psychologically induced erectile dysfunction.
Since Enzyte® will likely be off the market soon, may I suggest one of the other male enhancement products. Let's see…you could try some Passion RX or maybe you would prefer some Zenerx ? You could also try Naturamax, Himalayan Niagra, Spermomax, The ProSolution™ Pills, VolumePills™, ProEnhance™ herbal patch, Maxman III, Bali Mojo, ViSwiss, Vicerex, VigRX, ProVigraX, ProCalis, ProVIGRA2go, Prelox®, ViaDrene™, Kama Raja, Erexin-V™, Provigro™, ExtendaRX, or Pro-Erex.
You may also choose V.MAX or Rhino Max but, unfortunately, they were both busted by the FDA for actually using a Cialis® precursor in their product.
OK, just not buyin' what 'ol Bob is sellin'? Why don't you pick up some Horny Goat Weed?
All the products listed above are combination pills. They all contain some random assortment of the same ingredients found in Enzyte ®. Every one of these ingredients is also sold separately. Although I think that horny goat weed is by far the funniest, there are a number of other herbs and spices to choose from.
If you want a single ingredient herbal remedy, you could get some Ashwagandha. Or, how about having your sweetheart pick you up a bottle of Catuaba. Actually, you could get some Cistanche Bark, Cnidium monnieri (She Chuang Zi), Cistanches, deserticola, Damiana, Dodder seed, Ginseng, L-arginine, LJ100, Maca Root Extract, Mucuna Pruriens Extract, Muira Puama, Passion Flower, Rehmannia, Rhodiola rosea, Shilajit, Suma, Trimethylglycine, Tongkat Ali Extract (Eurycoma longfolia), Tribulus Terrestris extract, or Yohimbine. In fact, these are only the products that are most directly marketed for sexual performance. In reality, every "natural" product on the market says somewhere in it's literature that it might also improve sexual health.
Not looking for a pill? Perhaps, you might need a more salient placebo. Well, step right up to the wonders of magnetic therapy.
The TEK Magnetic Strap (patent pending) is a simple to use, non-invasive, drug-free method which may increase blood flow needed in order to gain and maintain an erection.
If you are really serious about pumping up that penis of yours, then you will need this clever little device. Quick Extender Pro™ is the top name in penis enlargement.
Sorry if I confused you...I was talking about impotency treatments, not penis extenders, but then I showed you the Quick Extender Pro ™. I don't know what came over me. I guess it's just that the Quick Extender Pro ™ is so fucking hilarious.
Oh alright, enough of this nonsense. Let's look at a real treatment for ED. I mean a treatment for physiologically based ED. The funny thing is that this treatment will appear to be more far-fetched than the bogus treatments but I assure you that this one is quite real.
This treatment is for men who have lost the ability to fill their penis with blood in order to have an erection. It's a way to fill the penis with an artificial fluid using a Penile Prosthetic device.
When the time is right you simply reach down to your scrotum and squeeze. Your penis fills with some kind of silicone solution or something and voila! You now have a rock hard boner.
What about the ladies?
Yes, they don't exactly have erectile dysfunction like the men but they do have several forms of what I call "receiving the erectile" dysfunction. There was a guy back in 1949 named Kegel who figured out that girls could do some exercises to strengthen their pelvic muscles. The initial application, of course, was for stress incontinence which is a condition that a lot of women have after bearing children. It didn't take long for the girls to figure out that these exercises improved many aspects of sexual function and they are quite popular today.
There are also some surgical alterations that can improve sexual function such as the ever popular breast augmentation or liposuction or any of a number of plastic procedures. However, my favorite procedure and the only one that I think is truly worthwhile, may be a little stitch that the girls don't even know about. It's called the Groom's stitch.
You see, because obstetricians have traditionally put women on their backs to deliver babies, the posterior part of their vagina often gets torn as the baby passes out. No problem, the doc simply throws in a stitch or two and the girl feels nothing. The entire area is still in trauma from having just given birth. Hopefully, nobody notices and life goes on.
If you are the groom and you know about this then you can tip the obstetrician in advance and he might put in an extra stitch or two. If you are lucky you will have a wife who is tighter after giving birth than she was before.
Dyspareunia and Anorgasmia are probably the most common things that women complain about in regards to sexual function. I discussed them in the previous chapter. A point that I want to restate is that these conditions in women along with erectile dysfunction in men are frequently related to real physical illness. Should you experience these things then the first step is a complete work-up by your primary care physician. If it turns out to be psychological then the danger is not so immediate and you will be pointed in the right direction to get the appropriate help.
Anorgasmia can frequently be psychological. As I mentioned in the previous chapter, one major cause might simply be that you are with someone you don't love. I think women do this more than men do. Women get married for security and reliability and protection etc. Men get married in order to screw a hot little body. Therefore, I think that women more frequently find themselves in a marriage with someone that they are not passionate about.
But let's assume that your woman really loves you and is physically healthy and is not having orgasms. This is actually a pretty common scenario. As a warm and caring husband, what can you do? Well, first of all you can be a warm and caring husband. Ever think of that?
OK, the answer might be as simple as anatomy. Some women have a clitoris that is close enough to the opening of the vagina that they easily have clitoral orgasms on intercourse and others do not. Some can have clitoral orgasms but not vaginal orgasms. Some have a great big easy to hit G-spot and some have theirs tucked away behind a little crease. Perhaps the size of the woman's vagina and the size of the man's penis are just not a perfect match. Do you get the idea?
The point is that you may have to experiment and explore a bit in order to best please her.
That was the easy answer, now for the more difficult one. You may have to actually become a woman. Not literally of course but in your mind. You may have to try and think like a woman and get inside her head and really try and understand what she is feeling. It is often the case that your woman is not enjoying sex to the degree that she could simply because you are not taking care of her emotional needs like you should. Don't stop reading!! Come back all you guys. OK, I'll shut up about the emotional stuff.
I guess that I need to talk about this in a way that men can relate to. OK, pretend that you have just bought your first car. It is a bright red 1958 Plymouth Fury named Christine. You make sure that it has plenty of gas and that the oil is just right and she is polished and the valves are clean and there is air in the tires etc. You even spend a little extra for a double overhead cam and when you drive down the street she purrs like a kitten. You think that you are doing everything right and you are dumbfounded when Christine chases your girlfriend down the street and side swipes another car that you were looking at.
Here's the thing. The car is jealous. You must make it feel as though it is the most important thing in your life. Don't fraternize with other cars. Take Christine on long rides just the two of you. Introduce your girlfriend to her and whisper to your girlfriend to say very nice things to Christine. Tell your girlfriend to frequently remind Christine that Christine is your real main squeeze.
You just have to do these things. You have to tell your woman that you love her and she is the only one and take her to dinner and treat her right. For her, this is foreplay.
If you think you are doing all this stuff right but she is still not enjoying sex like she should, then there might be psychological or even psychiatric issues that you are unaware of. Have her go for an evaluation. She could just be depressed and need a medication. She might have an anxiety condition or be obsessive-compulsive. These things can be treated. She might have an issue with a parent or a previous lover or maybe she was abused. These things can be treated.
Oh, and of course, you might benefit from a little evaluation, too. You think?
Sex for the Disabled
