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Sex Q&A:

Ps.: These questions and answers have a merely informative purpose and do not intend to replace a consultation by a specialized professional. In case you have any difficulties concerning your sex life or your love relationships, I suggest that you seek the help of an expert in the field.

"I am a 35-year-old woman and I have a doubt. When I masturbate, I can reach orgasm, but when I have sex with my boyfriend, I feel nothing or almost nothing. What may be happening to me? "

Many can be the causes for the reduction of your sensations during sex. An important point to be mentioned here is that, in fact, most women do not reach orgasm with penetration, but with masturbation, oral sex and the use of vibrators. This is because masturbation as well as oral sex and the use of vibrators are practices that involve direct contact with the clitoris, which is the female organ of pleasure par excellence. During penetration, the direct contact of the penis with the clitoris may occur, but it will depend on how the woman places her body to make it happen. And that needs to be learned, since it involves sexual self-knowledge.

Another point is the question of motivation for sex. There are situations where women have sex with their partners because they think they have the obligation to do so, either for fear of losing them or for any other reason unrelated to their desire. Usually, when this happens, these women tend to feel little pleasure in the sexual encounter. The solution in these cases is to try to understand what can be modified in the relationship, in order for the desire and the sensations to increase. Sometimes, a few modifications may solve the problem. There are, however, situations where there is none or hasn´t ever been any sexual interest in the partner at all. What usually occurs is that when a woman is with a partner who arouses her and / or has erotic fantasies that inhabit her imagination, her erotic feelings tend to emerge.

It is important to bear in mind that each case is different and, therefore, an assessment must be conducted, so as to understand what is happening and what can be modified.

"How is the vaginal pain that happens during intercourse treated? What should I do?"

Dyspareunia is the technical term for the condition in which there is pain during the sexual intercourse, particularly the irritation of the vulva, the vaginal opening or the vagina, which may occur due to some trauma, infection or anxiety. It is possible that a woman feel pain at different times of her life and for different reasons. Pain can come from hormonal changes, anxiety, lack of interest in sex and other possible health conditions. There may be pain as a result of insufficient lubrication, as well as vaginal infections or other vulvar problems.
The first thing to do is find a gynecologist to rule out possible organic causes of pain. At the same time or after that, I suggest that you look for a psychologist specializing in sex therapy to help you deal with the psychological component of this pain, through specific procedures for this type of treatment. During the psychotherapeutic process, the psychologist will identify together with you what the reason(s) for this pain is or are and will draw up a treatment plan for the solution of this problem.

"I´m 51 years old and for about 10 years I have had erection problems, and I had to go through periods of total lack of erection. Currently, I can have erections some times, but I have a hard time keeping it. I tried to use sildenafil, but it does a lot of harm to me, and has little effect".

* Approximately half of all erectile dysfunctions are of organic origin, that is, they are due to a physical problem.This physical problem can be anything that affects blood flow. So the first thing to do is look for a urologist to make sure that you are physically well.
On the other hand, another cause of erectile dysfunction is anxiety, not only that anxiety related to sexual performance, but also the one that is related to life in general. The best solution in these cases is to learn anxiety reduction techniques with the help of a psychotherapist who has experience in this area. Alcohol and amphetamines can temporarily reduce the erectile function. Medicines for erectile dysfunction can help strengthen light erections, but cannot directly produce arousal. There are several other effective procedures that can be used by a psychosexual therapist.

* According to the American Psychological Association.

"My partner lost her sexual desire. What can be done?"

There can be many causes for the occurrence of inhibition of female sexual desire. It is possible that a woman has her desire diminished or inhibited, for example, for family education issues, such as rigid religious beliefs, shame about sex, lack of information about sex and knowledge of the body. It is also possible that desire loss occur for traumatic issues such as abuse and other forms of sexual violence. Desire can also be inhibited by relational issues, such as lack of assertiveness and other difficulties in the couple’s relationship. There are also other possible reasons, that may be identified and treated by a therapist who specializes in the area.

"How long therapy should take for a sexual problem to be solved?"

There is no predetermined length of time. In general, the process tends to be short. This happens because, once the problem is solved , the process is finished. After the sexual problem is solved, some clients wish to start a new process, to work with another issue. This is a possibility, but that may happen or not.

"I do not think I have a proper sexual dysfunction, but I have some doubts that sometimes leave me with a little insecurity during sex. Would it be possible for me to see a psychotherapist just to ask questions? "

Yes, the process of sex therapy not only serves to assist the client in solving sexual dysfunctions, but also includes a psychoeducational work, through which the client can have their questions answered. In some cases, only the psychoeducational work is enough to solve the client’s problem.

"I'm only 25 years old and am having trouble having sex because I lose my erection shortly after starting to penetrate, sometimes I can not even penetrate. I've been to a urologist and he told me that my problem is psychological. What could be causing my problem?”

Contrary to what many people think, the emergence of problems with erection in young men is quite common. There can be many causes for the occurrence of this problem and are usually related to the client’s life history, as well as to the things they have learned about sex, which directly influence the way they perceive and experience their sexuality.

One of these causes may be a possible difficulty of the client in expressing himself or herself assertively, having, therefore, difficulty in communicating to their partner where and how they like to be touched, what they expect to happen during sex, etc. There is training for that.

Another cause may be anxiety. Epinephrine secreted in the body during the anxiety state produces, in addition to other symptoms, muscle contractions that reduce blood flow in the penile region. This reduced blood flow leads to loss of erection. In this case, it is important that therapy, by using techniques and procedures for this purpose, initially focus on reducing overall levels of anxiety of the client, so as to work on their sexual problem afterwards.

It is also a common cause for this type of problem the maintenance of myths or dysfunctional rules about oneself, one´s partner and sex itself. Examples of these rules are: “a man who is a man is always ready for sex”, “a man has the responsibility to provide an orgasm to their partner”, “I do not have a penis big enough to have sex”, etc. Normally, perfectionism tends to produce problems in this area, since people with this behavioral pattern tend to judge themselves negatively when falling below the standards of perfection that they often expect to achieve. When inadequately and negatively judging themselves, they tend to show symptoms of anxiety, such as, for example, the aforementioned muscle contractions. These patterns are learned throughout their life history and can be changed through therapy. When these standards are modified, the physiological responses corresponding to them are also modified.

There are still several other possible causes for the failure to obtain and / or maintain an erection, which, when identified, need to be addressed, so that the problem can be solved. It is of the utmost importance to note that the client’s commitment to their process of change is critical. The higher their commitment to the process, the best the results tend to be.

"Hi, I'm a woman, I am 29 years old and am overweight. Because I am embarrassed to take my clothes off, I haven´t had sex with anyone for a long time. And because of that I cannot have a relationship. I´ve already gone on a diet several times, but to no avail. What should I do to solve this problem? "

Hi, overweight may bring physical and psychological problems to people. Therefore, it is important that you see a medical professional to take care of your physical health and a psychotherapist to take care of your psychological health.

Regarding the psychological aspect, an important point here is to understand that the vast majority of people have physical characteristics that do not match the standard set in our culture. Having characteristics that differ from the standard can be, in many cases, considered more attractive to many people. The way we perceive ourselves is different from the way others perceive us. This means that even if there are people who do not like your body or a feature of it in particular, it does not mean that all other people have the same opinion. A realistic thinking is “different people like different things”. If some of these people express any dissatisfaction with your body or part of it, remember that these are only “some” people, not “all” of them. Allowing yourself to meet new people increases your chances of finding someone who likes you just the way you are.

The psychotherapeutic process can help you put into question beliefs / dysfunctional rules you consider to be absolute truths in your life. When you change the way you think, you also change the way you act toward others. And that tends to change the way others react to you. The idea is not to think in a positive way, but to think realistically. The purpose of these changes in thoughts, feelings and actions is to change your life for the better. There are several scientifically validated procedures, which can be used by a psychotherapist who has theoretical knowledge and practical experience in the field.

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Cj. 71, 72, Bela Vista, São Paulo, SP

Clinical Psychologist and Psychosexual Therapist (CRP 06/118772) with experience in treating adult Brazilian and Foreign clients (individual and couples), in English and Portuguese. Cognitive Behavior Therapy (CBT) specialist certified by both the Institute of Psychiatry, Clinics Hospital, Faculty of Medicine, University of São Paulo (Brazil) and Proficoncept, which is certified by DGERT (European Union). Received specialized training in Psychotherapy with a Focus on Human Sexuality from the Paulista Institute of Sexuality. Member of the Brazilian Association of Psychology and Behavioral Medicine (ABPMC).

Specialist in English Language: Translation Methodology (FAFIRE). Having worked as an English Language Teacher for about 10 years (Brazil and China) and lived with people from different cultures, keeps the PsycBlog. It is a Blog with Psychoeducational Resources on Psychology and Sexuality.

Main interests include Psychology, Sexuality, Translation Studies, Foreign Languages, Traveling and Photography.