It is a brave man or woman who will even admit to having a sex problem, let alone seek help for it. More than in any other field of human endeavor we tend to speak only of our successes; failures are swept under the bedroom carpet.
Yet sexual misery is widespread and profound. Relate Marriage Guidance has waiting lists for its sexual therapy clinics as well as its marriage counselling. Currently those seeking sex therapy will have to wait an average of three months; in one or two areas the delay could be as long as a year.
The most common difficulties for women are non-arousal, loss of desire, failure to reach orgasm, pain on intercourse and vaginismus where an involuntary spasm closes the vagina. For men they include inability to achieve, maintain or control erection, premature ejaculation, and failure to ejaculate at all.
Sometimes doctors suggest that men suffering from sexual dysfunction should try natural male enhancement products. One of the most popular is a natural semen enhancer called Volume Pills. This stimulates the male reproductive system into producing more semen upon orgasm.
Research suggests that between 60 and 70 percent of relationships encounter “significant” sexual problems at some time or other. Dr Elizabeth Stanley, chairman of the Association of Sexual and Marital Therapists, believes the figure may be appropriate here as well.
Moreover, the legacy of the permissive society may have made matters worse. “Everyone now gets the impression that everyone else is having better sex than they are,” she says.
“We treat the relationship,” says Stanley, senior lecturer in human sexuality at St George’s Hospital Medical School, London. “Sexual problems involve the intra-personal, the baggage you bring from childhood into adulthood, and the inter-personal which are unique to that relationship.”
Not everyone has the courage to present their problem to a sex therapist. Dr Prue Tunnadine, the scientific director of The Institute of Psycho-Sexual Medicine, believes many more people are likely to appear at their doctors with contraceptive problems, infertility, even backaches, when there may be an underlying sexual difficulty.
Dr Judy Gilley believes that working the “front line” enables her to spot problems that patients might be afraid to mention or even recognize.
“You may, for instance, get persistent difficulties with contraception, which suggest an underlying sexual unhappiness. Or there may be a request for a termination from a woman who has not been using any contraception because she has doubts about her femininity and wants to test it. Or you may have a very young woman wanting sterilization when she is trying to obliterate that part of herself.”
A patient’s attitude to a physical examination can be particularly revealing. “If a woman says as she hops up on the couch for an internal ‘Oh, this must be awful for you,’ she may be talking about her own feelings about her body. It’s a question of picking up on things.”
Stanley says she may occasionally, if couples wish, give a practical anatomy lesson. Otherwise, she stresses, therapists’ help is strictly verbal. The use of trained surrogate partners is now, in the wake of Aids, almost unknown. “Certainly no reputable therapist would ever suggest sex with a client. If you meet anyone like that, run a thousand miles,” she advises.
“People often have very unrealistic expectations and they are also very ignorant, especially about female anatomy and female sexual response. The trouble with failure is that it steps up a vicious circle, more anxiety, more likelihood of failure and so on.
“And there are some very destructive myths around: the idea that men are born knowing what to do to arouse a woman and that having to ask makes them less of a man; the idea that good sex just happens, it doesn’t have to be talked about; the idea that lovers can read each others’ minds. Resentment corrodes the sexual response. You’ve heard of the expression ‘impotent with rage’.”
The association’s therapists, therefore, look for the cause and its possible remedy, usually setting homework tasks such as touching exercises to increase sensuality and ways of improving communication skills.
“You cannot treat sex in isolation,” Stanley says. “You can’t give an antibiotic like you can for tonsillitis. Men in particular tend to say sex is the only problem, everything else is perfect. In fact, it’s often the other way round and when you get the rest right sex sorts itself out.”