Kinsey Confidential: The Kinsey Institute Sexuality Information Service

Women: Painful Intercourse | Lack of Desire | Lack of Orgasm

Men: Premature Ejaculation | Erectile Disorder | Lack of Desire |

In Women

Painful Intercourse

Sexual intercourse is not supposed to hurt, but a variety of things can make it painful:

Infection - Any infection - from a yeast infection to a sexually transmitted infection - can irritate the vulva and the vagina and make penetration painful. If intercourse is painful, your first step should be a trip to the gynecologist to make sure you're healthy. Once that is established, then you can move on.

Lack of lubrication - One sign of sexual arousal in women is that women's vaginas lubricate. This lubrication decreases the friction of intercourse; without it, penetration can sting or hurt. The solution depends on the cause:

It may be that your vagina is penetrated before you are aroused enough to produce sufficient lubrication. Slow down your lovemaking, take more time for foreplay and other kinds of sexual intimacy before having intercourse. This not only increases your wetness but also allows the vagina to expand and relax, further increasing the comfort of penetration. This is the solution in the majority of cases.

Or it may be that your body produces less lubrication than you need for comfortable penetration. In that case, you can supplement your natural fluids with a commercial lubricant like KY, Astroglide, or Wet Platinum. Remember oil-based lubricants degrade latex and should not be used with latex condoms or dental dams.

Vaginismus - If you have difficulty in introducing any object into your vagina, vaginismus may be the cause. The outer third of your vagina is a sheath of muscle that can contract and open. The most effective way to overcome this difficulty is by seeking professional support. The American Association of Sex Educators, Counselors & Therapists (AASECT) is a great resource.

Dyspareunia - Dyspareunia is the technical name for "painful intercourse." Its specific cause is generally irritation of the vulva or vaginal opening due to trauma, infection, or anxiety. If your parts seem healthy and you're lubricating just fine, and your PC muscles aren't contracted and intercourse still hurts, the treatment may be slightly longer term. The pain you're feeling may be due to vulvodynia or vulvar vestibulitis syndrome, two medical conditions recently receiving increased attention, and you should seek professional assistance and support in overcoming this difficulty.

You might find "The V Book: A Doctor's Guide to Complete Vulvovaginal Health" by Dr. Elizabeth Stewart to be of interest (vulvodynia and vulvar vestibulitis are discussed in this book). For additional information about vulvar pain, visit the web page of The National Vulvodynia Association.

Lack of Desire

First of all, it's okay not to want sex. Being able to have sex does not mean you have to want it.

If you or your partner notices a big drop in your level of interest and it bothers one or both of you, that can cause problems in the relationship. It's generally a signal that something else is going on - in your sex life, in your relationship, or in your day-to-day life. Here are some things that can affect your level of desire for sex:

Taking a contraceptive pill or other hormone kind of birth control (Depo-provera, Norplant) can cause a decrease in libido. Your desire is strongly influenced by your hormone levels, and a significant change like going on birth control can affect it. The solution is either to use a non-chemical form of birth control or to try different levels of hormones until you find the one that works best for you. Talk to your gynecologist about this.

Changes in your lifestyle - a new job or a new semester or moving to a new place - can all affect your sex drive. Stress in any form can have a debilitating impact on your sexuality. The best solution is to learn healthy ways to deal with stress: eat well, exercise. You can learn more about stress from the IU Health Center's Stress Management Page.

Another thing to keep in mind is that desire comes and goes, like any bodily function. Sometimes you're hungry and sometimes you're not. Sometimes you want sex, and sometimes you don't. Some fluctuation is normal and not necessarily a sign of dysfunction

Lack of Orgasm

Women's sexuality has taken a complete reverse over the last 50 years, from denial that women even had orgasms to the pressure to have orgasms often and easily from intercourse. (When was the last time you saw a cover of "Cosmopolitan" magazine that didn't have the word "orgasm" on the cover?). All the same, every woman can have orgasms; and every woman's orgasmic experience is very individual.

Never Had An Orgasm - Anorgasmia, or orgasmic dysfunction, is a fixable problem. Most everyone on the planet is capable of having orgasms: if you haven't had one yet, there is nothing wrong with you, you just haven't had one yet. But you can. A couple of excellent books on the subject are "Becoming Orgasmic," by Julia Heiman and Jospeh LoPiccolo and "For Yourself : The Fulfillment of Female Sexuality" by Lonnie Garfield Barbach

Can't Orgasm in Certain Situations - The most common cause of this problem is anxiety or stress. It can be anxiety about the relationship, about some other life event, or even some general anxiety that you're barely aware of. There are two good solutions: one is sex therapy or general counseling, to help uncover or alleviate the anxiety - The American Association of Sex Educators, Counselors & Therapists (AASECT) can help there. The second is an overall healthy lifestyle. You can learn more about stress from the IU Health Center's Stress Management Page.

In Men

Premature Ejaculation

PE is pretty common among college-age men, and it's typically very fixable. Here are the two common techniques you can use to train back your orgasms:

THE STOP-START TECHNIQUE means you stop your caresses at a stage just short of the point of no return and allow your arousal level to subside slightly (say for half-a-minute) and then return to being caressed and repeat the process of stopping when you feel yourself near the point of inevitable ejaculation again. The difficulty at first is knowing when to stop, but with practice (on your own or with a partner), you can teach yourself a high degree of ejaculatory control.

THE SQUEEZE TECHNIQUE means that just before the point of no return you stop stimulation of the penis, and you grasp the tip of the penis between fingers and thumb and squeeze firmly for 10 seconds or so. This reduces the reflex ejaculation response (and possibly the erection too) in the same way that biting your lip stops a sneeze. You can then resume stimulation and repeat the process if necessary.

You can read more about these techniques in the book "PE: How to Overcome Premature Ejaculation" by Helen Singer Kaplan.

Recently, several condom manufacturers have created "desensitizing" condoms such as Durex Performax and Trojan Extended Pleasure. These are also sometimes called "climax control condoms." Such condoms have a numbing agent inside of them (usually benzocaine) which is intended to decrease sensation to the penis, and thus help men delay ejaculation. So far, we haven't seen any scientific articles that have tested these condoms to see if they actually help men delay ejaculation or not.

That said, researchers have given men creams with a numbing agent (usually lidocaine) to apply to their penis, wait a little while, put a condom over their penis (so that their partner's genitals don't get irritated by the lidocaine) and then have sex. And it really did help many men delay ejaculation by a few minutes (we're not talking hours here, guys - but a few minutes are all that some guys and their partners want, anyway). Some men have skin reactions (itching, rashes, etc) to benzocaine or lidocaine - and a small percentage of men may lose their erection (after all, it is reducing sensation a little bit). If you want to try these out, you might want to sample them during masturbation to see what it'll feel like for you. Some guys may love it - and others wonder why anyone would want to reduce genital sensation even the tiniest bit.

Recent research on premature ejaculation (also called "rapid ejaculation") has looked at whether certain SSRI anti-depressants may help men delay ejaculation - and there's some evidence that this may work. Your healthcare provider can talk with you about whether these prescription medications are a good option for you.

Erectile Dysfunction

Inability to get an erection is more common in older men, but it certainly happens among college-age men. About half of all erectile dysfunctions are "organic," meaning they're caused by some physical problem. These physical problems can be anything that affects blood flow. So your first step is to go to the doctor and get checked out healthwise.

The other main cause of ED is anxiety - either about sexual performance or just general life anxiety. The best solution is to learn anxiety reduction techniques. To find a counselor in your area, check out the AASECT website or visit the Counseling and Psychological Services page of the IU Health Center for more information.

Lack of Desire - First of all, it's okay not to want sex. Just because you can have sex doesn't mean you have to. But if you or your partner notices a big, sudden drop in your sex drive, it's usually an indication that something else is going on: in your sex life, in your relationship, or in your day to day life.

For example, a changes in your lifestyle, such as a new job or a new semester or moving to a new place, can affect your sex drive. Stress in any form can have a debilitating impact on your sexuality. The best solution is to learn healthy ways to deal with stress: eat well, exercise. You can learn more about stress from the IU Health Center's Stress Management Page.

Another thing to keep in mind is that desire comes and goes, like any bodily function. Sometimes you're hungry and sometimes you're not. Sometimes you want sex, and sometimes you don't. Some fluctuation is normal and not necessarily a sign of dysfunction.