A Sex Therapist Explains Your Most Common Sexual Issues (And What To Do About Them)


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Everyone’s talking about dicks these days. If it’s not Donald Trump reminding America what big hands he has, it’s dudes getting their balls pumped full of botox, this guy making headlines for his two-week-long erection, and every one of your friends — those mature and responsible adults — making bad puns about 2017 being The Year Of The Cock.

It’s enough to make you never want to talk about male genitalia again. Except we’re going to. Because now seems like the perfect time to enter the national discussion of dicks in a different way. No drama, no sensationalism, just some hard truths. Let’s start with this one: Everyone has penis problems. Yep, everyone. Everyone worries about penis size, the turgidity of their erections, and when it’s too soon, too late, or just right to come.

The good news? It’s normal. All of it.

The better news? We enlisted the help of Vanessa Marin — a licensed sex therapist who’s helped countless men with their penis woes — to drop some hard truths about the most common complaints guys have, the mental toll these problems take, and what you can do to change how you think about them.

Because, here’s a spoiler: It’s probably not your penis that’s the problem. It’s your dumb old brain.

Premature Ejaculation

You already know what this is, probably because you’ve experienced it at least once. You know what, though? That’s totally okay, because Marin says that premature ejaculation is absolutely normal once in a while. In fact, the only thing that makes it abnormal is the fact that most dudes don’t think it’ll ever effect them.

“I think a really important thing to know is that premature ejaculation is something that’s going to happen to every man out there multiple times in his life on a somewhat consistent basis,” Marin says. She knows that it often feels like you’re the only one — and it doesn’t help to tell you that’s not true — but while many men see premature ejaculation as an “all or nothing” problem, the reality is that most men will suffer from this minor malady at least several times throughout their lifespan.

You breathing a sigh of relief? It’d be great if you were, because according to Marin, the reason that premature ejaculation happens (most of the time) is due to anxiety — both anxiety before the premature ejaculation occurs as well as anxiety that comes on after the episode, when you’re at your most vulnerable and trying to explain that “this has never happened before.”

“I think the fact that many men don’t understand that it’s something they can anticipate and prepare for and that leads to creating even more anxiety,” Marin says. “It happens once and then all of a sudden you’re thinking about it every single time after, creating this self-fulfilling prophecy.”

So what should you do? Remind yourself that premature ejaculation is not a permanent mark against your masculinity, work through it, and then try again. If you don’t feel confident, that’s cool but before you write off your sexual prowess completely, Marin says that a little reality check is in order.

“It’s a blow to your confidence to feel like you’re not in control of your body, even though none of us are really in control of our bodies,” Marin says. “We all have this illusion that we are. Having that experience definitely makes your self-confidence decrease and leads to a feeling of powerlessness as well. That can be tricky to deal with.”

What can that kind of anxiety do to a person? Well, it could cause you to withdraw or to lash out at your partner (although Marin says this is much less common). Most guys, she says, feel really self-conscious because they’re trying their best and are perplexed by what’s going on. You may be feeling absolutely powerless when premature ejaculation happens to you, and that may actually lead to even more issues in your future.

No worries, though, there’s a lot you can do to alleviate this condition. For starters, you may consider some of the techniques mentioned in this piece on Bedsider. Doing yoga before sex may seem a little unmanageable, but it’s not the only way you can calm your nerves. Consider a few minutes of meditation. And then consider a few minutes of conversation, too. Since so much of the reason premature ejaculation occurs has to do with anxiety, talking with your partner (if you feel comfortable enough) may alleviate some of the stress.

Marin also recommends kegels (she suggest you check out the kGoal boost from Minna Life, even if it “may look weird”) and varying your masturbation practice to encourage a longer lasting time. “Learn to find your ‘point of no return,’” she says, “and then back yourself down from there.” This will allow you to take back your focus, making it easier to concentrate on sex with a real, live partner.

Penis Size

“The number one sexuality-related anxiety that men have is around the size of their penis,” Marin says. That means if you’ve worried about whether your genitals are big enough you’re in good company. All men have worried about whether their penis is the right size — even guys who would be considered well-endowed by general standards. Marin says she’s worked with men who, despite being on the “larger end” of the penis size spectrum, still obsessed over size.

“All men worry about the size of their penis one way or another,” Marin adds.

Here’s the thing, though: Your worries about your size are all in your head. In fact, study after study has shown that it’s unlikely that your partner cares about the size of your penis. A 2015 study even ranked what single characteristic women most cared about when it comes to their partner’s genitals and found that penis size was at the bottom of the list, right down there with “appearance of scrotum.” What did women care about the most? General cosmetic appearance (you got this!) and the appearance of pubic hair (get some clippers!).

“There’s no one-to-one correlation between the actual size of your penis and what your confidence level is,” Marin says, but that doesn’t mean that narrative isn’t forced on you everywhere you look, from pornography, to television, to your own inbox where you’re constantly spammed by marketers who want to help you “increase size” via pills, creams, and dietary supplements.

What can you do to quell your ever-growing concern that there’s something wrong with your “manhood”? Marin says that you’re going to need some maturity and some perspective. That means that you should see your concerns not as a mark against you but as an opportunity to grow.

“You can learn how to not put so much emphasis on your penis during sex,” Marin says, “and I think this is particularly impactful for heterosexual men. In reality a penis is not the most satisfying way to pleasure a woman. You’re probably going to have more success with your hands or your mouth.”

Wait, so who are you worrying about your penis size for? Most likely it’s yourself.

“A lot of guys don’t realize the vagina is only so big,” Marin says. “It does a lot of expanding during sex and when it’s aroused, but a penis is not going to feel very good for the vast majority of women. It’s going to be slamming against her cervix, and she’s going to be unhappy.”

Marin recommends that you recalibrate your thinking, funneling the feelings of anxiety you’re experiencing into something more productive — like learning how to become a better lover whose primary goal is to pleasure your partner. If you’re at a loss for where to start, she recommends She Comes First by Ian Kerner, one of the most well-known guides to female pleasure.

“My issue with a lot of sex books is that there’s just not very much actual helpful information. It’s very broad,” Marin says. “It’s all, ‘just relax,’ or, ‘just chill out, don’t think about it.’ Kerner goes into super crazy detail about exactly how to finger a woman, exactly how to go down on her, and provides specific techniques and routines that you can string together. It’s obvious that he spends a lot of time researching and testing out all of these different methods.”

Don’t buy it? Kerner’s guide, Marin tells me, is especially good because he wrote it after facing his own struggles with confidence issues and premature ejaculation. “He had to kind of figure out, ‘Okay, I can’t last very long during intercourse so how else can I learn how to pleasure my partner?’” Marin says.

But even if you don’t read the book, there’s something else you can do to improve your sex life: let go of the harmful narrative that you can only use your penis to pleasure another person.

“The penis is not really designed to hit the hot spots on a woman,” Marin says. “You can sort of use it to rub against her clitoris, but that’s not how we tend to do intercourse in this culture. It would be as if a vagina was somehow designed to rub the guy’s balls but not really go anywhere near his penis.”

“Yeah, it can be fun and that can be pleasurable but it’s not going to be the thing that’s going to make the vast majority of people orgasm or experience their peak level of pleasure,” she adds. “It sounds like lip service to say, ‘Oh, de-emphasize intercourse,’ but I think that it’s really something that not a lot of people realize they should be doing.”

Erectile Dysfunction

Some more welcome news: Like premature ejaculation, erectile dysfunction is something every man will experience during his lifetime. Is it going to make you feel powerless and anxious? Absolutely. But Marin points out that one (or even several) instances of not being able to get it up doesn’t mean that all hope is lost. And the reason we feel that it is, she suggests, is due to the enormous societal weight we place on the erection.

“So many men tie their entire masculine identity into their ability to get erect,” Marin says. “ There’s all this symbology around the erect penis. I think it gets really built up and I think there’s something very scary about this happening when the man is feeling really turned on in the moment.”

“He wants to have sex or be sexual in some way. He’s ready to go and it’s scary noticing that your body is not responding to what you want in your head,” she continues. “It can create a really intense disconnect and just make a guy feel like he’s spinning wildly out of control. I think men are really socialized to believe that power and control are some of the most important characteristics that they’re supposed to have. Those are the ways to define their masculinity. That sense of not being in control of the most masculine part of your body can be really traumatizing.”

If you’re nodding along (even reluctantly), it means that you’re ready to make a change. The first thing to do is to recognize how normal not being able to get erect is. If you normalize the experience, by recognizing that it happens to everyone, then you’re more likely to escape the situation relatively unscarred; if you’re concerned about what not being able to maintain an erection means about you in a terrifying, existential way then you’re going to have more trouble.

Think of it like this: If you experience a loss of erection, worry about it endlessly, and then try to get back in the saddle, what’s going to happen? Chances are, you may have put so much thought to your moment of embarrassment that you’ve probably made it harder for yourself to stay hard. Imagine trying to have sex when you’re so anxious. Doesn’t seem great, right? And if that anxiety leads to further erectile problems, then you’re going to have an even more difficult time trying to bounce back.

“Being able to take the focus off of the penis can be so beneficial,” Marin says, “if you can feel confident in your ability to pleasure your partner in other ways. For most men all that they need in that moment is ten minutes of doing something different. So many guys just get stuck in their head with thinking, ‘I want to have an erection. Why am I not having an erection?’ It just makes the issue even worse.”

Something different like another sex act or, like, a walk around the block and some ice cream? Marin’s advice doesn’t require putting on your clothes, going outside, or even watching TV. If you experience an erection emergency, she says, you can overcome it by taking a break, taking a breath, and trying to engage in another sexual activity. She suggests performing oral sex on your partner or using your hand. Once you take the focus off the penetrative aspect, you may find that it’s easier to stand at attention.

“The vast majority of the clients that I work with. when we kind of pull back all the layers and try to figure out, ‘okay, when does this start, what happened?’ 99% of the time there was just one totally innocuous experience where there was nothing different, no defining characteristics,” Marin says. “It was just a random night that they were trying to have sex and it just happened. From there it ended up snowballing. You can anticipate it so much, be so anxious about it that you create the self-fulfilling prophecy.”

If this happens to you, don’t panic and always do your research. While the movies (and Viagra commercials) may make it seem like erectile dysfunction isn’t something that affects most people, it’s important to understand that that’s not true. Sometimes the reason is purely biological — age, conditions such as diabetes, medications you might be on — but most of the time, Marin says, it’s due to anxiety.

“Sometimes, I work with men whose erectile problems are actually a symptom with larger relationship issues they’re having,” she says. She’s reminded of a time she worked with a client who was cheating on his partner. When he tried to have sex with the woman who he was having an affair with, however, he’d find that he was completely unable to perform. That’s a sign that your mind is telling you something.

Another client Marin worked with suffered erectile problems when he and his wife were trying to have a baby. It turned out he wasn’t so sure about it. “Your body’s kind of doing that for a reason,” Marin says.

You can work through it, though. One of the best ways to do this? Stay present in the moment and really invest yourself in the sexual experience. Turn off your phone, don’t try to multi-task, and think only about your partner.

If you’re having relationship issues, Marin says, it’s important to address them with your partner. And frank and open communication about the erectile dysfunction — even if it feels awkward as hell — can help you through the problem. That way, you can hopefully avoid both the shame and the recriminations (both from the outside and from within) that stem from not being able to get erect. If you’re really worried, though, you can always see a doctor (if you suspect your problems are biological) or a therapist to talk about the bigger picture.

Anorgasmia

If you asked most guys if they’d rather suffer from premature ejaculation or an inability to finish, most would probably say they’d rather take the latter. Why? Because it’s less embarrassing and thus potentially less scarring emotionally. That’s fine, but here’s the problem: there are guys out there who can’t finish. Because that side of the story isn’t often told — it may even seem like a blessing to outsiders — guys who can’t orgasm (at least not with a partner) have fewer resources when it comes to dealing with this problem.

“Guys who are experiencing it just feel crazy amount of shame and anxiety because they feel like they must be the only guy in the world that isn’t able to orgasm,” Marin says. “Every year it seems like I’m getting more and more clients that are talking to me about this. It’s something that’s definitely on the rise.”

But we don’t talk about it culturally, she adds. It’s just not something that’s discussed. And that can lead to feelings of shame and alienation.

What’s going on? Barring any medical issues (many anti-depressants list Anorgasmia as a side effect), Marin says that an inability to orgasm with a partner may have a lot to do with one’s masturbation habits.

“Typically it tends to boil down to two different things when I work with this issue,” she says. “Sometimes, it can be due to masturbation habits like ‘the death grip‘. That can make it much, much harder to orgasm with a partner. What I’ll do in that case is go back and really adapt that person’s masturbation habits, get them to lighten up their grip, go a bit slower.”

“The second thing that I see happening,” she continues, “is men that are afraid to ask for what they want sexually. There’s this idea of, ‘I’m just supposed to pound it out and then I’m going to orgasm,’ when they might want more foreplay or they may prefer oral sex or hand jobs. Sometimes it’s even trying to feel more of a sense of connection or intimacy; if they don’t have that it’s hard to get there.”

In order to combat this, Marin suggests that you switch up your masturbatory habits — try your non-dominant hand or consider using a male masturbation toy — to acclimate yourself to what sex will be like when you’re engaging with someone other than your hand. Because a vagina (and other sexual openings) won’t have the same grip strength as your palm and digits, it’s going to be a much different experience. As long as you recognize it, normalize what you’re feeling, and try to switch up your habits — Marin also suggests that you consume porn more mindfully, keeping focus on the actual act of masturbation rather than making the images the focus — you should eventually get where you want.

Communication, though, may be the most important change you make. If you’re unable to orgasm due to the fact that you’re not getting what you want, talk to your partner about what’s missing. And don’t blame them or yourself. Many times, both the person unable to orgasm and their partner feel like there’s something wrong with them (or the relationship). That may be true in some cases, but it’s usually a very simplified generalization. So discuss your feelings with your significant other, be open to changes, and your anorgasmia could soon be a thing of the past.