Can physical ailments prohibit ability to have orgasms?

Abusive BehaviorAdvice Columns and ColumnistsRuth WestheimerDiabetes

Q: My girlfriend is 23, and I am a few years older. We have sex quite often, but she is unable to have an orgasm. I have tried everything! I spend time playing with her, focused solely on her — this can go on for hours with no orgasm. She said that she's never had an orgasm, and I feel like she's being cheated out of something great. I also feel like I can't satisfy her. Is this normal?

A: Obviously it's not normal, but that is not relevant. It is very rare that a woman has an actual physical reason for not having orgasms. Severe diabetes can cause this reaction, as can depression. So in all probability, it is a psychological issue. First of all, at this point I'm sure she is so uptight about this issue that there is no way she could have an orgasm. So, while you should be commended for writing to me, you both have to calm down a bit if she's ever going to have an orgasm with you. It's possible that if you take a more laid-back attitude and certainly not try for hours, she may learn to have orgasms.

But she also may need some professional guidance. A few visits to a sex therapist might really help. If taking a more relaxed attitude doesn't work after a couple of months, I seriously suggest that she get professional help, as I'm sure it will yield the results you both are looking for.

Q: I am 50, and my new girlfriend is 48. We have been dating eight weeks. Everything is going great and we are exclusively dating each other. The other day, she mentioned an ex calling her, who asked, "Since you have a boyfriend, we can't hang out or go shoot pool anymore?" She told him, "We can still hang out or shoot pool." I told her that wasn't OK with me. She asked if I trust her; I do, I'm just not comfortable with her seeing her ex. We could have broken up over this, but we agreed to try to work through it.

She says I want her to get rid of her friends. I corrected her and said her ex.

She said her circle of friends is five guys, all exes she has been intimate with. She doesn't see harm keeping in touch. She doesn't understand what I feel. Please help.

A: A very important word in any relationship is "compromise." I appreciate your position, that her seeing ex-lovers as friends makes you uncomfortable, and I also understand that she feels that she would never cheat on you and so she doesn't understand why she can't see them, especially if she wouldn't care if you went out with an ex-girlfriend.

Both of your positions are legitimate, and yet they clash. One compromise might be that you and she go out with one of these men on a double date. Certainly if you see him with a partner, you'll feel less anxious. And there probably are some other compromises you could make. But she should understand that jealousy is a fairly universal reaction, and so she must accept that she needs to do a little more in the way of compromise, because if she loves you, she shouldn't want to make you feel bad on a regular basis.

Q: I am a 20-year-old, sexually active female. I discovered masturbation at a young age, and still have to masturbate every night before I sleep. If I don't, I cannot sleep. Is this normal?

A: Normal isn't relevant, but whether it can cause you problems is. You have become accustomed to using this method to fall asleep, and since it works, you stick to it. But I would imagine that at some time in your life, this is not going to be practical. When you're married with kids, are you going to be continuing this habit? While it's not the worst thing in the world, I would think you'd be better off if you could learn to fall asleep without masturbating.

It certainly has become a crutch, and you should try to put it aside. But if you can't, then I suppose you'll find a way to integrate it into your life.

Q: My husband is a verbally abusive man, and wonders why I can't get into sex with him. I keep fantasizing about a high school male friend. I met up with him; no sex was involved, but he made me feel special. Am I wrong for that?

A: You should not put up with being abused. Insist that you two go for counseling. If he refuses, then you have to consider leaving him. I know it's tempting to fantasize about another man, but cheating would be wrong, and living in a fantasy world doesn't get you anywhere. You have a serious problem, and you must take action. I know that what I am saying is difficult, but if you do what is necessary, your life will be much better. So rather than suffer for the next 20 or 30 years, do what you have to do to improve matters.

"Sex for Dummies" (IDG Books) is among Dr. Ruth Westheimer's most popular books. Have a question for Dr. Ruth? Write to her at http://www.drruth.com.

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