My Husband Doesn't Ejaculate

Q. My husband does not have a problem getting an erection, nor does he lack desire to have sex, but he almost never ejaculates. Is it possible for a man to feel satisfied by intercourse even though he does not ejaculate? I know he used to be able to ejaculate if he masturbated but cannot now. Can you help me out here? I enjoy sex and want to make sure he does too.

A. It's important to recognize the full extent of the male sexual response. The arousal phase marked by erection also includes other physiological changes including increase in heart rate and blood pressure, rate of breathing, flushing of the skin, increase in muscle tension, nasal congestion as the "erectile tissue" of the nasal cavity become engorged, lubrication of the urethra (producing a sticky discharge from the end of the penis), and a shifting of blood to the pelvic area. As orgasm approaches, all of these changes increase until the orgasmic release occurs.

Orgasm is most obviously signaled by ejaculation, the forceful emission of seminal fluid from the penis. This produces only a part of the pleasurable sensation of the orgasm. The contractions of the vas deferens and outer leg muscles in a rhythmic cycle; the intense muscular contraction of large muscle groups such as the buttocks, thighs, and abdomen; sweating, a respiratory response; and the relaxation that follows all contribute to the intense pleasure of orgasm. These may occur to varying degrees during a particular sexual experience.

Consequently, a man may have a satisfying experience without ejaculation. If the other aspects of arousal and orgasm are present, there may be no cause for concern. One explanation for this may be that he is having "retrograde" ejaculations. In this condition the seminal fluid is directed back up the urethra into the bladder rather than externally out of the penis. This is not a dangerous pattern, and a urological evaluation can identify whether this is the case.

It is also possible for ejaculation to be inhibited by psychological factors (such as fear of pregnancy or guilt over sexuality), physical factors (such as fatigue or alcohol use), or as side effects from some medications (such as tranquilizers and antidepressants).

From your question, we assume that you and your husband enjoy your sexual relationship and have not suffered from the lack of his ejaculatory response. Since many women find the "mess" of ejaculation to be a problem, you may have had an unusual blessing to celebrate. If your husband has in fact been frustrated or disappointed, a urologist should be able to identify the cause and reassure both of you that there is no serious reason for alarm.

Good Income Equals Good Sex

Q. My wife's sexual desire seems to be tied to my income. When I make more money, sex is good and frequent. When my income is down, there is no sex or desire. We are both Christians, but I fear this problem is leading us toward divorce.

A. There are many aspects of a marriage relationship that impact a couple's sexual intimacy, and money is a common one. This may relate to the symbolic meaning of money, to fears associated with financial insecurity, to a "barter" attitude about sex and money, or to relational patterns that are subtly tied to work. Identifying how your wife's sexual behavior relates to your income is crucial to effecting change. It's equally important to recognize that sexual intimacy is dynamic between two people and rarely the problem of just one partner. So while you work together on understanding her behavior, work on what you may be contributing to the problem (besides a variable income).

Money as a symbol is a place to start. Ask yourselves what money means to each of you. In our culture it is most often associated with power and a sense of competence or prestige. When your sense of personal worth is linked to wealth, your relational world can be im pacted by changes in your finances. Being able to have the manifestations of wealth becomes the basis of your self-acceptance. If these evidences of value or importance wane, it becomes a threat to your well being. That, in turn, can affect your feelings of sexual attractiveness or playfulness. Similarly if money means "power," a mate who is financially successful may be more attractive.

The presence or absence of wealth is often connected with inner feelings of safety and security. Depending on a person's childhood economic experience, one may become quite anxious if assets are threatened. That fear can easily be the overriding motivation toward withdrawal, just as the sense of security may prompt engagement with others. Sexual responsivity is especially sensitive to underlying anxiety for whatever cause.

It is not uncommon for sex to be conditioned to other life performance issues. Some couples drift into patterns of using sexual favors as a reward for or motivation toward some desired behavior. This is a potentially dangerous basis for intimacy since there is usually some feeling of resentment attached. If an individual's primary "love language" has been material gifts, the level of income and the goodies that it provides may be the most important indicator of being loved (see Gary Chapman's The Five Love Languages). This bartering system may not be entirely conscious to marital partners and may be somewhat threatening to discover. Most of us like to think we don't live life manipulating others to get our way.

Finally there may be less obvious relational patterns at play. If your hours at work or traveling increase as income decreases and then level off as income is produced, you may be more or less engaging or loving during times of economic threat. When your income is up, your mood may improve and your loveable quotient increase. When you are in an economic slump, the usual pleasurable support activities of life may be reduced. Not being able to eat out, or go to a movie, or have a baby sitter may impact your marriage negatively.

Whatever the factors may be, it is vital to talk together or with a counselor about your concerns. One thing is for sure: all aspects of the problem (money and sex) will be intensified by divorce.

She Makes Me Feel Cheap

Q. My wife and I have been married for five years. It's hard for me, emotionally, to have sex with her. There are times she says or does things to me that she knows will upset me. Or she will embarrass me in front of others. Then five minutes later, she's all sweet and lovable and will want to be intimate. Then I feel cheap, because she never says she's sorry. Sex is just not enjoyable. I do it only to please her. How do I enjoy sex with my wife?

A. We'd like to see you develop the kind of joy-filled, playful, and breathtaking excitement that sex can be for young married folks. We see it as a reasonable expectation and something worth working for (key word: working).

A couple's sexual relationship is often a good barometer for their overall relationship. We certainly see that time and again in those we counsel. Usually, as basic attitudes and skills are developed, sexual enjoyment comes right along. So, there are some foundational principles we'd like to share with both of you.

The first is that marriage is a life-long process. It doesn't just happen automatically. If it did, there wouldn't be a 50 percent divorce rate, right? We heard Les and Leslie Parrott at a seminar recently, and they talked about giving a basic relational skills course at their college. They discovered that the vast majority of their students didn't have a clue about relating well to a marriage partner. Concepts like courtesy, mutual respect, apologizing, accepting the differences, and resolving conflict were foreign to them. Yet, marital intimacy depends on these skills daily.

The good news is you're asking for help early in your marriage rather than waiting until the resentments are layered like coats of paint on a thrift shop chair. You can begin now to peel away the hurts and get down to the valuable mahogany.

Your question indicates your awareness of several problems. The most important is the lack of mutual understanding between you. You haven't been in touch with how your mate is perceiving the relationship. I wonder whether you've taken the time to identify your differences in emotional sensitivity, expectations, sexual preferences, and styles of dealing with conflict. One way you can approach that task is to each write out a history of your relationship. You describe events that seem important to you, how those events impacted you emotionally, and what you concluded about each other afterward. For instance, you might describe a time when your wife did something that "embarrassed you in front of others," how you felt when that happened (ashamed? angry? discounted?), and what conclusion you came to ("I can't trust her," "I'm overly sensitive to criticism," or "she enjoys putting me down").

Next, share your histories with the perceptions you have. The primary goal is to understand the other person's point of view—not to prove who's right or wrong. You work toward establishing understanding, not blame. A secondary goal is to exchange forgiveness for the areas of hurt that have been there. You'll probably find that each of you has many blind spots toward how your mate has been perceiving the relationship. For instance, you are painfully aware of the insensitivity your wife seems to have toward your feelings. These may be some of her "blind spots." Yours may be the things you do that are fueling her apparent hostility motivating her "doing things she knows will upset" you. As each of you really hears the other, the need to justify your own behavior should diminish.

The second principle is that each person can only control his or her behavior and beliefs. As much as you'd like to change your wife, that is an exercise in futility. With better insight into yourself, you can begin to focus on what you can do to be a better mate. Those changes, coupled with more honest communication between you, offer real promise of mutual change. A visit with a marriage counselor can also facilitate the work you are doing.

Prozac's Depressing My Libido

Q. I have been on Prozac for over four years. Even before going on Prozac I didn't have a strong sex drive, but now it is practically nonexistent. The problem is that this doesn't bother me. I'm happy and really don't feel deprived. Of course, my husband doesn't feel that way. I want to want him but feel like I'm faking it. I don't think I could go off my anti-depression medication. My doctor has given me Wellbutrin, which is supposed to boost my libido. So far it hasn't. Any suggestions?

A. Don't go off your anti-depressants, just yet—and certainly not to develop your libido. Depression decreases libido, as do most of the anti-depressants. Welbutrin may increase libido so it is certainly worth a try.

The fact that your sexual drive has never been very high is not uncommon in women. The most important factor affecting the level of interest is the emotional intimacy in the marriage. A second factor to consider is your thought life about sexuality. Thinking about positive sexual experiences several times a day has been shown to increase a woman's desire. A third factor that can also be controlled is general health. Maintaining an appropriate weight and a proper exercise program are essential. Finally, exploring your underlying attitudes about sexuality is important. There are many messages to girls that leave negative beliefs about sexual expression. Overcoming the conditioning that says enjoying sex is sinful can be hard to do, but possible.

You may never have as high a libido as your husband, but you can enjoy mutually satisfying sexual intimacy.

I Forgot How to Have an Orgasm

Q. I've been married for ten years to a man I love deeply. I enjoy having sex with him but ever since I became a mother eight years ago, I have been unable to have an orgasm. My body feels different and what used to work to stimulate me doesn't work now. I am very open with my husband and have shared this with him—he lets me know how totally attracted to me he still is—but the problem is that I don't know what works anymore. We've tried a lot of different things, and I get very close, but I never "cross the finish line." I think part of it is I'm so overly aware of everything around me and so focused on pleasing my husband and mothering my kids, that I have no idea how to focus on myself. I've tried everything, but I just don't know how to get it back.

A. Let us commend you. It sounds very positive that you and your husband are communicating and cooperating in positive terms. That accomplishment is frequently the biggest barrier to orgasmic success.

Although it is possible that child birth caused some physical change in your sexual physiology, the fact that you're able to get very close to achieving a climax probably rules that out. It is likely that your assessment that your distractibility is coming into play is correct. "Crossing the finish line" requires abandonment. It seems your concern for your husband's pleasure and your children's well-being is exerting too much control. There is help. The technique, which is too much fun to be called work, has been outlined by many therapists.

Basically it is designed for a couple to spend regular time learning (or re-learning) to pleasure each other. The initial sessions together are devoted to "non-sexual" touch of massage, showering together, etc., but with no breast or genital stimulation. The purpose is to enjoy touch without the anxiety of sexual performance. There is a gradual progression over several sessions to include kissing, breast stimulation, and ultimately genital fondling with each partner being the total focus of the "pleasuring" in any given session. These would be continued until each is comfortable being the recipient of the lovemaking to orgasm. Ultimately there is mutual stimulation to orgasm eventually ending with penetration and genital union. Giving yourself permission to receive the sexual gratification will unlock your sexual responsivity. There is a detailed outline of this playful procedure in chapter seven of Intended for Pleasure by Ed and Gayle Wheat (Revell).

Real Sex columnists Melissa and Louis McBurney, M.D., were marriage therapists and co-founders of Marble Retreat in Marble, Colorado, where they counselled clergy couples. Louis McBurney passed away January 20, 2009.

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