Tips for Lovemaking - Pt 2

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This is the second cassette in a two cassette study of sex and marriage. I am Dr. Ed Weath, a family physician who has a real desire that my patients maintain the very best physical health and a significant part of this is their peace, joy, happiness, and love within their marriage. We've been discussing the most common sexual problem in women, difficulty in achieving orgasm. A woman seeking orgasm must realize that unless she can and does let go, she is not likely to experience sexual release, and that to do this, she must understand her body and trust her partner. In addition, she must approach the sexual experience anticipating pleasure, believing that sex is intended to bring pleasure. That our creator designed the female orgasm for this purpose. A woman's orgasm is unique because is the only human function that apparently serves no purpose other than to provide pure pleasure. At the same time, she must be aware of overfocusing on achieving orgasm because this will defeat her purpose and is likely to diminish the enjoyment involved in body caressing, emotional closeness, and the tenderness that should be a part of every sexual experience between husband and wife. Sex, of course, is a form of communication. Sexual problems are often an indication of poor communication between people who may be unconsciously introducing hurts and resentments from other areas of their life into the sexual arena. Once good communication between the wife and her partner has been attained, the orgasm she is seeking often comes by itself. A couple should remember that even though physical release is important, when they strive to obtain orgasm without regard to savoring their time together, sex seems like work rather than pleasure. Orgasm lasts only a few seconds. While emotional satisfaction and gratification should occur during the entire episode, it is even possible at times for women to experience the physiological event known as orgasm without feeling much pleasure because their temporary anxiety has a blurring and inhibiting effect upon the good feelings usually accompanying sexual release. Your emphasis should be upon mutual enjoyment, emotional satisfaction, and loving physical communication. In this atmosphere, orgasm is most likely to occur. And you can make love with a relaxed attitude, anticipating enjoyment without anxiety and concentrating on pleasurable sensations rather than worrying about your performance. With adequate stimulation, the physical release of orgasm will be virtually assured. Right now, let me suggest this to you. If you're one of the many women who seldom or never experience orgasm, the psychological causes of your difficulty can seldom be precisely pinpointed. And the only purpose served by seeking something in your past is to find someone or something on which to place the blame. Then, mature approach for a Christian couple is to realize that no matter what the cause, God is able to meet your need in this situation. You start right where you are by asking him to raise your level of love and sexual interest for your husband. And then both of you should enter into a mutual loving interaction, taking positive steps to resolve the problem. I'm going to address you now as if you're a wife who has never at any time reached an orgasm. Other listeners can benefit as well, but to the pre-orggasmic wife, I want to say specifically that no matter what you might believe is the cause of your lack of orgasm of which partner has been most at fault, you can resolve the problem by following some effective procedures in cooperation with your husband. Both you and your husband need to take a fresh start as if you were just now getting married. Each must give the other the chance to perform without demand or criticism. This is not a time to keep score, but a time to practice and learn together without anxiety. A time when you realize both of you have something to learn. You learning to receive, be learning to unselfishly give. The real goal at the beginning of your mutual physical training sessions is to build up memories of pleasurable sexual feelings in combination with some new experiences and an appreciation of your husband's loving desire to give you sexual pleasure. All of this can lead to an uninhibited sexual response. Before these session, verbal view should be freshly bathed. Your husband needs to have a clean shave and his fingernails trimmed and smooth. If his hands are even slightly rough, he should use a generous amount of KY jelly to make his caresses more pleasing. Every training session must be held in a very private place with no chance for interruption. You should both be as rested and as free as possible from stress and tension. You should both take off all of your clothes and your husband is to use his fingers and his hands to touch, massage, and fondle your body anywhere you lovingly direct him while you just relax and become conscious of the pleasure gained from is carry and caresses. At first, use a gentle trial and error method, maintaining very comfortable positions in bed. Avoid any thought of hurrying or any feeling of need to satisfy your husband or any seeking for your own orgasm. You should daily for at least 4 days repeat unhurried relaxed times of receiving her husband's caresses for whatever period of time it gives you pleasure at least 30 minutes. For just these first few days, it's better to avoid gentle caresses. Then after this first phase, follow the these directions. During your session, your husband is to place himself in a sitting position with his back comfortably resting against pillow with a headboard with bed with his legs widely separated. You're to sit between his legs with your back against his chest and your head resting comfortably on his shoulder and your legs spread apart draped over his leg. This position allows freedom of access for creative exploration of your entire body. You should give specific direction for this by placing your hand lightly on his. So, you can indicate a slight increase in pressure or by general directional movement the where and how of your desires at any particular moment. This will allow both of you to learn precise physical communication without the distractions of verbal requests or detailed explanations. You should be fully aware that you have permission to freely express your pleasure and your sexual feelings without regard at this time for your husband's sexual need. Right now it is up to you to direct your husband's movement and he should refrain from any of his own ideas as to what may be stimulating to you. You may want him to stroke your breast, your upper inner thighs, or the area just above the clitoris or around the vaginal opening, alternately touching these places. A light touch is most thrilling. At this time, you will achieve pleasure by directing your husband to provide a stimulation along the shaft or sides of the clitoris and around the vaginal opening years the clitor. You may find the end of the clitoris too sensitive or too tender for a joyable caressing. There's no hurry. You should not be attempting to force yourself to reach an orgasm. These sessions may extend over two or three weeks when both you and your husband are lovingly learning exactly what it is that excites you sexually and learning to communicate with each other both physically and verbally. If at any time you feel you're highly aroused sexually, you should let your husband know that he is to continue increasing the intensity of the stimulation of the clitoris with his hand. Or you may even need to assist him with your own hand and just until you have reached your first orgasm. This can enable you to start a pattern of response that will make it much easier to experience orgasm and sexual intercourse. After you have had several orgasms by manual stimulation, you should begin having sexual intercourse in the woman above position, which usually gives you better control of your own more stimulating movements. Then use whatever positions you both desire. Building of sexual tension after actual introduction of the penis is an ability that a woman must actively learn and develop. She must put anticipation foremost in her mind, surrender to her own natural desires, and seek emotional and physical stimulation until this tension climaxes and release. Portal concentration is required. Now I want to describe for you some of the common physical conditions that may cause difficulty in achieving orgasm. Of course pain during intercourse will always inhibit pleasure leading to release. Painful intercourse is called disperunia but this is a symptom not a diagnosis. Any woman who has pain or other difficulty with intercourse should have a thorough physical examination that includes a pelvic rectal examination. Since only a minority of doctors will ask a patient about the state of the sex life, you should never just hope the doctor will guess your difficulty. Take a deep breath, blush, and tell him what is wrong. One important cause of pain is atropic vaginitis, a ping of the vaginal wall, which is caused by lack of female hormones, especially estrogen. This occurs in menopause when the amount of estrogen is reduced or it may occur at any age after removal of the ovaries or at any time the ovaries are not producing enough estrogen. This thinning of the vaginal walls can easily be corrected by taking estrogen by mouth, by injection or by applying estrogen cream up into the vagina. Atropic vaginitis is the only physical sexual problem actually caused by the menopause and it can be prevented by maintaining the proper level of estrogen through the menopause year. Another kind of vaginitis which produces pain and burning in the vagina is caused by infection. Candidasis a yeast infection and tchamonus of parasitic infection are the most common. These infections are contagious. They become chronic when ignored and demand medical treatment along with a Pday extension for men intercourse and the use of condoms for a week or two when intercourse is resumed. The husband and wife must both take medication to eradicate heronus infection. Other causes of pain in intercourse that must be discovered and treated include a drop down uterus known as uterine prolapse and indometriosis which produces irritation and scarring in the pelvic area. A much less common physical cause of painful intercourse for the wife may follow childb birth during which a tear in the broad ligament has occurred. This ligament is one of the supporting structures at the side of the uterus. Pain is experienced on deep penetration of the fenus, but it is very difficult of the doctor to find this injury until several months after childbirth. If you develop this pain one or two months after you had a baby, be sure to ask your doctor to check for this tear. If he cannot find another cause for the pain, you should see a specialist who will be able to repair the tear surgically to provide relief. Pain can also be caused by vaginismas, a term which describes the involuntary action of the muscles at the vaginal entrance as they go into spasm when a attempt is made to insert the penis. This muscular spasm may be so severe that even the little finger cannot be inserted into the vagina. This painful condition most often starts right at the time of the first attempted intercourse, but it may occur at other times such as after the birth of a baby, after a IC operation or even at the time of beginning a second marriage. Vaginismas can usually be eliminated in about one week by following this procedure. With the wife and positioned for pelvic examination on the examining table at the doctor's office, the husband is brought into the room and puts on a rubber glove. He is instructed to attempt to place one well lubricated finger into the wife's vagina. This is to demonstrate to both husband and wife the severity of the spasm of these muscles around the outer one-third of the vagina. Once Glam's index finger is in the vagina. This very firm, tense muscular contraction around the vaginal opening will become readily apparent. Like any muscular spasm, it will become painful if too much digital pressure is rapidly applied against it. But slow, steady pressure in the in the vagina downward toward the rectum over a matter of several minutes will allow the muscles to relax. The husband and wife are instructed to take three or four graduated dilators home and use them in sequence once or twice a day. It is best for the wife to insert the dilators herself until some confidence has been gained. These are called Hagar dilators. The larger size looking like a rod a little bigger than a fountain pen. Or you can use a readily available set of plastic rectal dilators which can be purchased at most drugstores. Of course, they should be well lubricated before insertion. Once the dilator is in the vagina, the wife should let it remain there for 20 to 30 minutes. When it can be easily inserted, the wife should retain one of these in her vagina for several hours each night. By using these dilators once or twice a day, the woman is gradually becoming comfortable with the idea that something can be in her vagina and it does not have to hurt. When the couple plan to get together sexually, the dilator should be inserted in the vagina and should remain in place until a wife feels that it's time for penetration of the penis. Then she is instructed to assume the woman above position, at which time she literally takes the dilator out of her vagina with one hand and within a few seconds the well lubricated penis with her other hand. It It is crucial that this transfer require only a few seconds because a longer interval and that may allow the vaginal muscles to go into spasm again. This quick change is an essential step for at least the first few times that the couple has intercourse. At some time during the week, it may be possible for the husband to begin inserting the dilator rather than the wife. Most vaginismas is caused by psychological problems and the husband's interested, loving cooperation and tender care of his wife is an important part of the treatment. If no regular dilators are available, a simple substitute for the Hagar dilators could be short sacred candles and graduated sizes. Largest being just a little bigger in diameter than a fountain pen. Felvic congestion is one of the most common causes of low back pain and pelvic pain and tenderness. In the plateau phase, the time of increasing sexual arousal, all of the wife's pelvic structures become engorged with blood under significant amount of pressure. If she proceeds to a good strong orgasm, the involuntary Muscular contractions close off the small arteries and open the venus system to produce drainage of this pool of blood in a matter of minutes. This leaves a distinct, pleasantly overwhelming sensation of comfort and warmth in the pelvic area, followed by a rather complete feeling of relaxation. Each time the stimulated wife fails to reach orgasm, this represents some injury to the pelvic organs and to her emotions, often leaving her with nervousness, fatigue, weakness, and moderate dis severe pelvic pain and low back pain which may become chronic. This also may lead to chronic vaginal discharge or heavy or irregular menstrual bleeding. Unfortunately, many women undergo pelvic operations because of this pain. This repeated congestion may also contribute to significant enlargement of the uterus which may fool a doctor into thinking that there is a disease requiring surgery. I suggest that none of you submit to surgery for pelvic pain until you have made every effort to learn how to achieve full release on a regular basis. With any of the chronic symptoms we have discussed, you should have regular pelvic examinations at least every 6 months to one year as some physical condition could arise at any time requiring medical treatment. Although the causes for sexual indifference or inability to reach orgasm are many and varied. Many of the cases I have seen began with poor preparation for marriage, a frustrating and fearful honeymoon followed by a prolonged period of disappointment, blundering, and boredom in marriage. has conditioned the wife almost beyond help. This is often aggravated by the wife's failure to be aware that it is a man's nature to be adventurous. When he realizes that wife is not being satisfied, this inclination increases as he attempts to please her. She begins to view his variety of approaches as distasteful, vulgar, or abnormal. Nothing will cool and remove the bright luster of young married love quicker than a chilly, silent, sullen, indifferent, or negative attitude. for the young husbands had tampered. For the woman who has little desire for sexual activity, all caresses must be gentle, never harsh or brusk or forced. If they are light, fleeting, and teasing in nature, they serve to arouse the imagination to a greater degree. When any caress is too prolonged or too persistent, it runs the risk of becoming boring. Even worse, this may become physically unpleasant or annoying. Skillful, gentle, appropriate stimulation of the clitoris in nearby areas will almost always bring any wife to a high level of desire in an experience of orgasm. If you continue to rarely or never experience sexual release and if loving concerned application of my suggestions are not helpful within a few weeks. In fact, if any of these problems continue and you still do not enjoy your sexual relationship with your partner, don't hesitate to seek medical help from an interested physician in whom you can place your compliment. The most difficult and distressing sexual problem among men is that of impotence. Impotence is the inability Y of the husband to achieve or keep an erection sufficient for incor. In physical terms, the erect penis contains four or five times the volume of blood it has from flaccid. When a man experience impotence for whatever reason, the vascular reflex mechanism fails to pump in sufficient blood and hold the blood there to make the penis firm and keep it erect. At times, a man may feel aroused and desire to make love, but his penis does not become erect. Another man suffering from impetence may be in the process of making love to his wife and his erection disappears. It is important to keep in mind that almost all men by age 40 have had one or more incidents where they were not potent at a given sexual encounter. This in itself does not indicate an impotence problem and may be significant only if it sets up a chain reaction of anxiety and fear in the man. Also, during 30 minutes of foreplay, an erection will normally wax and wayne three times. So, the man who realizes that this is a natural physiological process and does not overreact to it will find that he regains a direction as sexual stimulation continues and as long as he is actively involved in the pleasuring process. In this discussion, we will use the medical criterion for impotence, which is a patient's self-report of failure to achieve or maintain erection for successful intercourse and at least 50 to 75% of his attempt. The success rate is particularly high when the treatment involves the couple working together to resolve the condition. So, we really have a great deal of encouragement to offer to the husband who has sexual desire who wants to regain his sexual powers and who has a loving supportive wife ready to cooperate in the treatment. I would like to speak directly now to the man experiencing this problem. In many cases, a rather common experience of erection loss, most often due to fatigue has set up a vicious cycle of failure, anxiety, more failure, more anxiety until impotence becomes the conditioned response to what used to be the pleasures of sex. Anxiety turns into panic as the condition perpetuates itself when the husband tries to escape fear and psychic pain by avoiding his wife, virtually trying to erase sex from his life. To try not to think about it is the greatest mistake you can make if this happens to you. You need to verbalize your fears and tell your physician specifically what the trouble is, for he will not guess. Your doctor will then give you a more precise physical examination and possibly will schedule urological and endocrinological studies to rule out organic causes. Diabetes most particularly must be ruled out for 40 to 60% of diabetics eventually become impotent regardless of their diabetic control. However, these men can continue to enjoy the sexual relationship because they can almost always ejaculate normally even though they may be unable to have an erection. This of course means that both husband and wife will need to develop more enjoyable physical closeness and openness of communication so that they can learn to provide the most squeezing manual stimul. ation for each other leading to sexual release. Female diabetics do not experience a lessening of desire or orgasmic response. There's no change in their vaginal lubrication during sexual activity. In attempting to determine causes of impotence, these research figures are known. About 75% of impotent men undergoing treatment are found to have some sort of organic condition which could contribute to the impetence. In fact, impotence is sometimes of crucial diagnostic value as it may even be the first indication of an organic condition which require requires medical treatment, but also in more than 75% of the men treated, mild to moderate psychological problems are definitely associated with the impetence, such as inhibition, shame and avoidance, feelings of insecurity, personal inadequacy, guilt and hostility, and fear of intimacy. In determining the cognitive impence, there are many factors your husband must consider. Here are some of them. Alcohol. The intake of alcohol sometimes provokes some sexual desire, but it takes away much of the ability to perform or enjoy sexual union because alcohol always acts as a depressant on the neurological system. It can inhibit a person's sexual function as much as it does his coordination or speech. The husband who as an alcoholic has lost control of his drinking almost never has normal sexual ability. 50% of all practicing alcoholics are impotent. The male alcoholic retains a normal sexual desire but is apt to complain bitterly about his loss of ability to function sexually. This often drives him to seek even more escape through alcohol. Fatigue. Simple fatigue is the most common cause of decreased sex drive in a normal man. Episodes of failing to achieve erection because of fatigue may trigger the condition of impotence. Many men come home from work with so much emotional or physical fatigue they simply do not have enough energy available for a good sexual relationship. A relaxed attitude of waiting till one is rested and acceptance of lessened sexual energy when is middle-aged will avoid much of this difficulty. Wives can help by often initiating arrangements to retire at an early hour and by discouraging activities would keep their husbands from getting enough rest. Obesity. Researchers have found when obese men weigh an average of 250 pounds went on a strict 8-week weight reduction diet, their level of testosterone, the male hormone rose significantly and almost every case reached normal levels. Before losing weight, the These men had had female hormone levels twice as high as those found in men of normal weight. The main source of excess estrogen in male is a chemical change occurring in the substance found in fat cell. This estrogen is believed to suppress the testicular production of testosterone needed for a man's sexual functioning. In addition to hormonal problems, obesity also drains strength, affects the physical union and contact of body parts, and sometimes lowers the individual self-image and confidence. Nicotine recent Studies comparing male smokers and non-smokers have shown that testosterone levels in the blood were significantly lower in the smoking group, but that they rose to almost normal levels after 7 days absence from smoking. Test results make it clear that heavy cigarette smoking does decrease testosterone levels and otherwise healthy men. Dr. Alton Ouxner of Pain University School of Medicine says, and I quote, "After very long clinical experience, I am convinced that Smoking is one of the most frequent causes of impetence today, particularly among young people. Drugs. Prescription drugs such as blood pressure pills and certain other medications, especially those that produce a dryness of the mouth, can cause impotence in a man previously active sexually. Your doctor will be able to identify these for you. Illegal narcotics and stimulants are frequent causes of impotence and will rob the user of some of the greatest thrills in life. Other factors affecting or causing epotence are depression, anger, jealousy or other negative feelings that break a man's concentration in love making and drain off sexual energy. Relationship problems between husband and wife, poor learning experiences, dismay over decreased vigor, any unusual stress and wrong teaching concerning sex is sin. Another related problem is that of loss of sexual desire. We need to stress that this is not necessarily impotence. Therapists point out that there are men who can but don't want to. These are suffering from the lack of sexual desire. While men who want to but can't are the ones suffering from impotent. The impetive husband's primary problem is usually an intense preoccupation with his ability or inability to achieve and maintain interaction. He is pressured by the fear of failure. He concentrate on on his sexual response like a spectator at his own love making until self-consciousness robs him of pleasure and joy. He tries without success to command his sexual reflexes, but they're hindered by the sphere. Self-consciousness is always self-defeating and never more than in love making. It opens the door to fear of failure. The true villain and any cure for impotence must deal with this fear. The cure must also involve the wife and the positive contribution she can make toward improving the situation. Often a wife feels rejected by her husband's impotence and she is apt to react either by taking the blame and going into a state of depression or becoming deeply hostile. The only wise response is to react with material love and loyal caring and to be more concerned about her husband than about her own ego. A woman who is emotionally mature, stable, and sensitive to her husband's needs can work wonders for him. The solution begins when the husband and wife admits they have a couple problem that they can solve. That they must move to reestablish communication lines that have been battered down by periods of withdrawal and frustration. The wife must help her husband to put his fears into words. He can conspiracy of silence is now broken, and the man must be able to express how he feels. As each becomes open to the feelings of the other, a climate of understanding and tender togetherness grows. Physical communication must be renewed. In most cases, it is disappeared as each moved to his own side of the bed after times of frustration. Husband and wife must begin again to enjoy the fun and pleasure of physical affection, of cuddling and caressing, and sleeping close together. Then a sexual relationship can begin to develop again. Even though the husband may still feel that he is unable to gain an erection, the couple should agree to spend time together pleasuring each other without any demand for intercourse. The husband needs to use the new communication lines to tell his wife exactly what gives him pleasure. It will be most helpful for her to provide manual stimulation to the penis, especially the area beneath the glands or head of the penis. This is more stimulating if KY jelly is used for lubrication. Now they can enjoy caressing each other in love play without necessarily expecting an erection. There should be no demands. They should simply relax together in a warm intimate situation while he learns to let his body take over with the proper responses. In this setting of leisurely erotic stimulation without the demand of sexual intercourse, the husband may see his erection matt wax and Wayne. To observe it come and go is an important part of the training process for both husband and wife as they gain experiential knowledge. And with loving cooperation, the erection will return. When the time seems ripe, the husband will find delight in satisfying his wife by manual stimulation of the clitoris. When he feels ready for intercourse, the wife should be prepared to insert the penis, even if it is only partially erect. She can stuff the penis in the vagina and the subsequent stimulation will often increase and help maintain the erection. Usually, the men above position is best for men experiencing difficulty with erection. Never rush this love making process. There's time enough to regain full sexual powers and extended love play should be carried out in a most pleasurable leisurely and sensual matter in complete privacy. You should be aware that even after you have overcome impotence through this approach, a stressfilled situation may bring back old fears of failure and sexual performance. You can find a cure the way you found the first one by turning to your wife, sharing your fears, finding comfort and pleasure in her body, relaxing and refusing to demand any performance from yourself. Wife, you must be very careful not to make your husband feel inferior. Never put him under pressure. Never seem to judge his sexual performance. You must be responsive and seductive not come on too strong or seem to make sexual demands. While therapists report a cure of 50 to 75% or impotence, I have observed a rate a cure much higher for the Christian husband who knows how to use his spiritual for resources in dealing with the problem of fear. God has given us resources far greater than the spirit of fear and resting in that marled will provide the Christian husband with a stability and relaxation that can go far in solving most impotence problems. The Bible says in 2 Timothy 1:7, "For God has not given us a spirit of fear, but of power and of love and of a sound mind." Every situation in life in which we see our own inadequacy can be an opportunity to see the power Christ undertake for us. This certainly includes the problem of impotence. One therapist has observed that sexual problems are the most prevalent medical complaint in the whole world. Whether the doctor hears about them or not, they are more common than the common cold. It's just that with the present increase in sexual knowledge, people are only just now beginning to openly complain about their sexual problems. A less common problem which men may suffer from is that of inhibited ejaculation, sometimes called retarded ejaculation. This is typically described as the inability to ejaculate during intercourse at least 1/4 of the time. Researchers tell us that alcohol is so frequently responsible for inhed ejaculation that the physician should suspect alcohol involvement until proven otherwise. Certain medications such as valium can cause this difficulty. In other cases, it is a psychological factor which inhibits the ejaculatory response just as though the patient anticipated punishment by an electric shock each time he ejaculated or even had an impulse to ejaculate. In many cases, there simply is not enough physical stimulation at the glands of the penis and intercourse. Well lubricated manual stimulation of the glands of the penis by the wife may be necessary. Why? I hope you will not look on this ejaculatory problem as a sign of personal rejection. You need to lovingly accept the situation while working with your husband to overcome the problem. Therapists agree that he needs to learn to ejaculate in any way that he can and then move from that to conditions under which his partner can help to reduce the ejaculation. Although at first it may only be by manual stimulation. The goal is to identify his wife with sexual pleasure leading eventually to ejaculation during intercourse. There are some men who require an unusually long time of intercourse to reach the point of ejaculation. These also can be benefited by additional manual stimulation provided by their wife. While discussing sexual problems unique to men, I'm going to mention something that may be of help to you if you're over 40. The narrowest part of the man's urethra, the tube from the bladder to the outside, is just below the prostate gland and is called the membrinous urethra. Just below this part is a section called the bulb of the urethra, which is a larger diameter and is of particular significance to the man when he reaches the early 40s. At this age and after, he often has some urine continue to drain from the penis after he's finished urinating. This is, of course, very inconvenient. The in this part of the urethra can be easily pushed on out by reaching with fingers placed behind and above the scrum and in front of the anus and then pressing upward and forward very firmly. Each man with this problem will need to practice this and experiment to find the exact spot to push to help himself. I have been asked many times what is the normal frequency of intercourse. Normal is whatever is mutually satisfying to both of you. If you desire to have sexual intercourse every single night and both enjoy this and give you you feels put upon and this is normal. Although I have found almost no wives who really want intercourse every night judging by the comments they've made to me is their position. Be aware of engaging in daily intercourse just because it is habit. Sex with your partner should never be boring or routine. To sum up our discussion of sexual problems, more than 80% of them are functional in nature. They do not have a primary organic cause. The basic emotion interfering with sexual function is anger which the husband or wife may express as hurt, resentment, disappointment, rage, isolation, frustration, and so forth. Obviously, it's hard to love sexually or otherwise when you're angry. While hiring and wife are trying to resolve some of the problems we have described in these cassettes, they can become easily discouraged. If they are occasional and inevitable failures result in criticism and loss of self-esteem, sooner or later, they will lose their confidence and give up their efforts. So, Remember always to encourage each other. And when failure does come in the sexual relationship, accept it as a shared responsibility which the two of you together can remedy. A meaningful sexual relationship contributes so much strength to a marriage, not simply because of the physical pleasure husband and wife experience, but because of the powerful sense of emotional well-being that comes when each partner knows that at times of greatest vulnerability, the other can be relied on to provide warmth, comfort, protection, and love. I advise young couples to prepare for their later years sexually as well as financially. Retirement will not mean retirement from the pleasure of lovemaking if you maintain an active sex life now and continue to do so. You should be making emotional investments in your relationship right now. Maintaining open communication line, establishing the habit of physical closeness and affectionate touching, living in an atmosphere of companionship, helpfulness, and mutual support. In other words, developing a care ing relationship with all that you do and say. Every refusal to allow resentments to come into your relationship now is an investment in future pleasure and the wonderful close that can continue throughout your life together. As you look forward to your later years, expect to love each other more and more. This has been the experience of many older couples who have overcome anxieties and inhibition, have put new information into practice, and have learned how to please each other sexually. They say that their lovemaking is enhanced by mature appreciation of each other, a deeper rob, a greater skill in physical communication, and that actually sex is better than ever for them. The maximum which applies best to sex after 60 is simply use it or lose it. The couple who keep active sexually while remaining in reasonably good health can continue to enjoy sex into the 80s. Of course, there will be changes in their physiological responses, but these begin to show themselves in the 50s and can be gracefully adapted to without any loss of sexual pleasure. The major difference between the sexual response of the aging male and that of the younger man is the duration of each of the four phases of the sexual cycle. The older man, especially after age 60, is slower in achieving erection and in the completion of the sex act. After age 50, there is a lengthening of the recovery period. 12 to 24 hours may elapse before the man can achieve erection and ejaculation again. What does this mean to the older couple? When men need more more time and more direct stimulation to attain erection. They're able to maintain the phase of excitement for a longer period and thus a more enjoyable time of foreplay is possible for the couple. Because their need to ejaculate is less urgent, they will have more time in which to give their wives full satisfaction during intercourse and so they can actually become better lovers. Their ejaculation period will be shorter and their relaxation period will end more quickly. But this will have little effect on the pleasure both partners experience. Here's an important fact for older men. They do not need to ejaculate every time they have intercourse. They should never force an ejaculation when they feel no physical need for it. Our counsel to these husbands is ejaculate only when you feel like it. At other times, enjoy intercourse without it. Wives after 50 have less lubrication and it is produced more slowly. The vaginal wall become thinner, less elastic, and more easily irritated by sexual intercourse. This can be remeded by estrogen replacement therapy by oral tablets or by regular insertion of estrogen cream into the vagina. Older women have a shorter orgasm lasting perhaps 6 seconds instead of 12. But the physical pleasure is the same and the emotional gratification can be greater than ever. While men's sexual powers decline very slightly with advancing years, women continue to increase in desire and are likely to take a more active role in the sex relationship, particularly with the fear of pregnancy gone. It is important for them to provide plenty of manual and visual stimulation for their husbands and to become interesting and enthusiastic partners in sexual love making. Indeed, sex after 60 can be better than ever. Whatever your age, remember that growing older is not synonymous with illness. Impotence is not a natural development of aging. You will always be a sexual being with sexual thoughts, desires, and needs. Aging together does not mean the end of sexual pleasure for you and your partner, but with preparation then Now you will be able to enjoy sex together throughout the years of your marriage, even into the 80. As in every age, touching, caressing, closeness, companionship, caring, and supportiveness are essential for a continuing love affair. And these exchanges can endure even when health problems may affect your sexual relationship. Please refer to our book, Intended for Pleasure, for specific sexual counsel when physical disabilities and serious illness occur. And now, a word especially for the woman going through menopause. Very Observe estrogen as a possible cause of uterine cancer has discouraged many women from benefiting from carefully regulated estrogen therapy that can alleviate most of the unpleasant menopausal symptoms. This is a definite relationship to the wife's enjoyment of sex with the general emotional health of the marriage. When a woman suffering from lack of estrogen is nervous, tense, tired, and plagued by headaches, she is not likely to be a cooperative sex partner no matter how loving the environment her husband provides. These menopausal Symptoms can inhibit or negate sexual thoughts and desire. It is a fact that uncontrolled, inappropriate emotional reactions are common when estrogen levels are chronically depressed. These disturbed mood states do not inspire the husband of the lover. They will certainly stand in the way of a fulfilling sex life and can seriously damage the marriage. Doctors today are emphasizing that there's no proof that estrogen increases the death rate for uterine cancer when it is judiciously and correctly used. And on the other hand, Estrogen therapy contributes to the woman's health and well-being in a number of ways. So, do not rule this therapy out. If you're suffering from estrogen deficiency, seek a concerned physician's counsel for your own situation. If you take estrogen, see your doctor for a pelvic exam at least yearly, and always go for an additional examination if you have any bleeding after the menopause. One final thought, a wife who continues an active sexual relationship in the menopause years, had been found to suffer far less ment of probable symptoms and the wife is sexually inactive. Now we're going to turn to the topic of family planning. A family doctor is often asked about the details of family planning, either achieving pregnancy or preventing or spacing it. One out of every eight couples in the United States is childless because of an infertility problem. Because 78s of the couples do not have this problem, the great majority of questions that doctors ask relate to contraceptive methods. As I discuss various methods with with you an answer to the questions frequently asked. Please remember that I am not recommending these methods but only giving you medical information. Family planning is a private matter which you and your partners must take a responsibility for. The decision is yours. I will share several personal convictions with you. I believe that every child who is born should be considered a gift from God. I am totally opposed to abortion except when the life of the mother is at stake. I also believe that when both partners as knowledgeable and maturing Christians. They should have as many children as they feel they can properly train for a productive Christian life. The Bible says, "Woe, children are inherited from the Lord, and the fruit of the womb is his reward. As arrows are in the hand of the mighty man, so are children of one's youth. Happy is the man who hath this quiver full of them." That is found in Psalm 127:es 3-5. These factors should also be considered. First, it is desirable for a newly married couple to have some time for adjustment to each other, running to communicate before the responsibilities of a young family come upon them. Second, the health of the wife is always an important issue. A wife may be capable of bearing 20 children, but this would hardly be recommended as best for her health. Third, it should be understood that fear of pregnancy often inhibits enjoyment of the sex relationship. The only direct Reference to birth control in the Bible is found in Genesis 38, which refers to Cortis and Eruptus or the withdrawal method. Verses 8-10 read, "And Judah said unto Onen, go in unto thy brother's wife, and marry her, and raise up seed to thy brother." And Onen knew that the seed would should not be his. And it came to pass when he went in unto his brother's wife, that he spilled it on the ground, lest that he should give seed to his brother, and the thing which he did displeased the Lord, wherefore he slew him also. We know that the Hebrew custom of that day dictated that if Onan fathered a child by Tamar, his dead brother's wife, the child would not legally have been his, but it would have been considered to be a child of his brother. Even though Onan complied with the command to marry his brother's wife, he perverted the purpose of the marriage, which was to produce a child. He deliberately disobeyed this order given by his father Judah, and therefore he did not fulfill his spiritual and moral responsibility to his dead brother. It was not just the physical act, but the spiritual disobedience that displeased the Lord. This Disobedience demanded the most severe discipline God could give. Requiring Omen to marry his brother's wife was apparently done for two reasons. One, to provide an offspring for the deceased brother and preserve his name in his memory, and to provide an heir for his property. The second reason was to serve the interest of the wife, otherwise she would be destitute. I think we can be safe in saying that some of the most interested people involved would be the brothers of the fellow considering marriage in that day. He could probably expect much help in choosing a wife. This frequently used birth control practice known as cortisenterus or the withdrawal method is one of the most ineffective of all methods. This is because some sperm are usually present in the slight lubricating fluid secreted from the penis during sexual excitement before ejaculation. Only one sperm is actually needed to fertilize the egg, and that one may be well on its way before ejaculation occurs. To attempt to use this method, the man must withdraw completely from any contact with the woman's genitalia before he actually ejaculates. Cotus interruptus also is undesirable because it imposes great restrictions on both partners at the very time each should feel the most free in the sex act. I should interject a warning here to the unmarried who indulge in heavy petting. Even though there is no actual entrance of the penis into the vagina or even contact with the vagina, it is possible for enough semen discharged around the outside of the woman to get inside and produce pregnancy. I have been responsible for the obstetrical care of three virgins who became pregnant this way. Even though two Two of them did not know what intercourse was, and one of them was only 12 years of age. She was playing with a friend and did not realize she was pregnant until in her sixth month. She would not have known then if her mother had not noticed her increasing size. I realize this is an extreme case, but take it as an important warning. You can imagine that no one involved in circumstances such as we have just described would share this knowledge with even the closest friends. So, it may be a problem few people are aware of. Now, before we discuss the more complicated means of limiting pregnancy, both natural and artificial, you will need to understand some of the processes involved in the woman's menstrual cycle. The menstrual cycle prepares, renews, and refreshes the reproductive system for 30 to 40 years of a woman's life. Continuous daily activity, mostly unseen and unfelt, occurs in the reproductive organs as a result of the stimulation by the female hormones estrogen and progesterone. Only one step of the whole cycle has always made itself plainly known, that is bleeding or minration. named for the Latin word menus meaning month. It is approximately a monthly shedding of the lining of the uterus which makes way for a new lining. This renewal of the seed of reproduction is the only instance in nature where a loss of blood does not signify injury but is in instead a sign of good health. The first day of menstrual flow is counted as day one of the menstrual cycle. A fact to remember if you intend to practice natural family planning on this day that the flow starts the inner lining of the uterine cavity has grown to be nearly twice as deep as it was after the last ministration. The menstrual flow is caused by the shedding of the thickened lining. The shedding takes place because the supply of estrogen and progesterone is discontinued. The fully developed lining of the uterine cavity is composed of thousands of microscopically small blood vessels with millions of cells of a soft spongy tissue packed around them. The blood vessels actually support the tissue and at the same time carry nourishment through them. These soft tissues rich in blood supply have stood in readiness for the possible arrival of a fertilized egg. Had there been a fertilized egg, the supply of the one hormone for gesterone, meaning for gestation or for pregnancy, would have continued to maintain the uterine lining and prevent ministration. If the little egg is not fertilized, it dies and the den estrogen begins. When the supply of the two hormones stops, growth of the lining stops and within 2 or 3 days, the network of tiny blood vessels begins to shrink inside. This deprivives the surrounding tissues of both support and nourishment. The whole structure gradually becomes detached and small pieces of lining start to shed. Within a few hours, some of the weakened blood vessels open, only a few at a time, then steadily increase in number. Each tiny vessel empties its trumpets. This is how the flow begin and soon increase it. As soon as each area of old lining has been shed and washed away, the blood vessels in that patch return to their original state, become se and are again closed. Finally, only a few patches remain to be cleared away. The flow then tapers off and ends. What had recently been a deep red spongy lining of the uterine cavity is now reduced to a smooth pink surface ready for new growth. The total amount of the average menstrual flow is only about 2 or 3 ounces. Only four to six tablespoons of liquid. Of course, it varies. The amount of growth and shedding tends to be consistent so that most women find they always minrate the same number of days. The average number of days is four to five, but for some women it may be only two. For others, equally normal, it may be a full week or more. The number of days between one ministration and the next is generally far less consistent than the number of days of flow. The average length of the cycle from day one of ministration to day one of the next cycle is between 26 and 32 days. This is only an average, however. Almost all women occasionally vary at least 2 or 3 days. Some are always quite irregular. This is why the practice of natural family planning requires careful recordkeeping and skilled observation of signs indicating ovulation. The time when the egg is released from the ovary ready for fertilization by the male sperm. Each woman establishes a general menstrual pattern throughout the years which becomes normal for her as she should expect some unpredictable variations to occur at times. A girl or woman ministrating should be free to engage in any activity just as though she were not ministrating. Specific Typically, she may go horseback riding, swimming, engage in any strenuous games, or she may wash her hair or bathe. Studies at the University of Illinois 20 years ago proved conclusively that bath water does not enter the vagina, and members of their champion women's swimming team are not bothered in any way way by full competition. Listen, very effective and harmless medications are now available for the mild to severe menstrual cramps, which some women experience. The cramps are caused by the formation of prostaglandins. chemicals that stimulate the uterus to abnormally contract. Ask your physician for a prescription for antiprostaglandins which prevent the development of these chem chemicals and thus actually prevent pain rather than simply relieving it. There is little reason to suffer from menstrual cramps in the 1980s. Mothers are sometimes concerned that the use of a tampon for menstrual hygiene will destroy a girl's virginity. Only penetration by the penis does this. Tampons are so slender that they can be inserted by most virgins. without breaking or stretching the hon. In a rare case, if needed, a girl can slightly dilate the hon for tampon usage by inserting one or two fingers in the vagina and applying pressure for 20 seconds twice a day for 2 weeks. While lying down, simply push your fingers downward toward the coxix or tailbone. In answer to some question from concerned mothers, no, there is no sexual stimulation from a tampon as almost all of a girl's sexually sensitive areas are well in front of and above the vaginal opening. A more serious consideration is the occurrence of toxic shock syndrome in a few teenage girls and young married women. The United States Center for Disease Control has connected the use of tampons with this rare but sometimes deadly infection, particularly tampons made of synthetic materials rather than cotton. This infection is caused by stafllocus bacteria that can grow rapidly in the blood accumulated in a tampon. Almost every case studied has involved the continuous use of tampons night and day throughout the menstrual period. Let me quote Dr. William Ledger, chairman of obstetrics and gynecology at New York Hospital Cornell Medical Center. He writes, "Why did this syndrome suddenly appear in women after years of widespread tampon use without difficulty? Is it used solely to new synthetic fibers and tampons that may array the vagina? Or the new tampon design that allows this foreign object to be in the vagina for a longer time, or to the emergence of a new strain of staflloccus?" The answer is unknown. On the basis of information currently available, Dr. Ledger says, "I believe Tampon can still be used if the patient prefers this method with personal hygiene. I would however advise against the use of the reli tampon and recommend that the patient not use a tampon while sleeping at night. End of quote. These are also the current recommendations of the Centers for Disease Control, but they may be modified as more learn is learned about toxic shock syndrome. Niscal blood in itself is perfectly harmless in content to both man and woman. The source is uterine rather than vaginal and no tissue damage. occurs because of intercourse during ministration. The wife's sex drive ordinarily does not diminish during the menstrual period. So if both partners desire intercourse at this time, it is perfectly all right. If the wife has a diaphragm for birth control, she may insert it during the time of light bleeding and have intercourse without any blood coming into the lower vagina. Some of you wives who have chosen not to use artificial means of contraception may even wish to purchase a diaphragm just in order to make sex during the period the safest part of the cycle, a more pleasurable experience. Many women complain of premenstrual tension for a period of up to seven days before menstrual bleeding begins, caused, of course, by the drop in estrogens. Symptoms may include fatigue, anxiety, depression, irritability, and also some vague swelling and soreness in the breast and pelvic organs because some of these body cells retain extra fluid at this time. If you have wide emotional swings before your period, be on guard to avoid offending others, especially those you love most in your her own family. The symptoms will take a dramatic change for the better about the time the menstrual bleeding start. Understanding and carefully charting your own monthly cycle is the key to successful family planning that will enable you to use natural rather than artificial means of birth control if desired. Since artificial methods such as the pill and the IUD do carry some element of risk for mother or baby, more and more couples are learning to use what has been called the cytoothermal method. Of course, this method is equally useful for conceiving at the desired time. and even as an aid in selecting the sex of your baby through careful planning and the right timing. The central thermal method differs significantly from the old ribbon method which had a very high failure rate because it was too difficult to predict the fertile period each month. The central thermal method is based on the fact that during a woman's periodic monthly cycle certain bodily signs occur just before, during, and after the fertile phase of her cycle. The couple using natural family planning learned to observe and interpret these signs to avoid sexual intercourse during the fertile time unless they want a pregnancy. The efficiency of natural family planning systems has been aided greatly by the discovery that the hormone progesterone produced by the ovary after ovulation causes an easily measured basal body temperature elevation which persists until menstruation began. The ovulation method teaches women to recognize when they're ovulating by watching for changes in the cervix and in the amount and characteristics of the cervical mucus. The symptotoothermal method adds the cervical mucus observation for the daily temperature of taking and calendar calculations plus awareness of other signs which indicates the fertile phase of the cycle. An intelligent practice of this method can achieve a success rate equal to artificial contraceptive methods. However, the natural method usually requires about 10 days of absence out of every month. The supporters of this method say that this period of absence can be a time of courtship, renewing the romance of marriage and looking forward to when husband and wife can come together again. Actually, for an excellent explanation of the simpler thermal method, I suggest the book by John and Sheila Kipley entitled the art of natural family planning. It gives thorough instruction in every detail of this rather complex method. The theology of the book is oriented toward members of the Catholic Church as much of the research was encouraged by them. It can be obtained by writing the coupletoouple lead post office box 11084 Cincinnati, Ohio 45211. My observation has been that it may take several months of study and practice before you are knowledgeable enough to precisely and successfully follow this method. In a study of 1,247 couples of varied background using the simpler method, it was found that there was a surprise pregnancy rate of 11%. Because some couples admittedly took chances with intercourse during times that possibly were unsafe. As I give you further statistics on pregnancy rates for each contraceptive method, you need to understand that the first figure given in each case represents the method. rate when followed perfectly and the second figure shows the range of the user rate reflecting the varied care taken by individual user. The most effective of the artificial contraceptive methods apart from sterilization is the estrogen and progesterine combination pill where statistically less than one pregnancy per 100 women occurs per year. However, there is a definite relationship between the use of the pill and blood clot disorders. Death from blood clot complication occur in three of every one 100,000 women taking the pill. To put this into perspective, the mortality rate from becoming pregnant is 22.8 deaths per 100,000 women and 100 deaths per 100,000 women who have illegal abortions. Statistically, the field is less of a hazard to life and health and is smoking, driving, or swimming. For example, a woman who drives 12 miles on urban freeway takes all the risk of dying that she would if she used oral contraceptives for her entire reproductive life, approximately 30 years. years. However, the woman who smokes should realize that the pill becomes extremely dangerous to her. So much so that the experts today state that any woman who wants to use the pill should give up her smoking habit. Otherwise, she should choose another means of contraception. It is known that the incidence of fatal blood clots and strokes quadruples in the 20 to 34 age group of smokers and is 25 times as high in the 35 to 44 years age bracket. So, if you smoke do not use the pill. Strong evidence also links birth control pill with an increased incidence of gallstones in younger women. Oral contraceptives are suspected of having caused 10,000 new cases of surgically documented gallstones in the United States alone. In brief, the pill is based on the discovery that the hormones estrogen and progesterone and the right combination can actually prevent ovulation. These are the same hormones that halt ovulation during pregnancy. Therefore, a few women on the pill experience symptoms like those in early pregnancy such as breast tenderness, morning sickness, or a full feeling when the tablets are first taken. If you suffer nausea and vomiting at first, take your pills after dinner when food is in your stomach, which can slow their absorption and neutralize these unpleasant effects. The symptoms usually disappear within a few days as the body adjusts. If you take the pill, the pill will control the timing of your menstrual periods, so you may occasionally miss a period or have some spotting. clean period. If this occurs for more than two consecutive months while you're taking the pill regularly, return to your doctor for a checkup. Usually, the pill makes menstruation more regular and menstrual cramps are almost always eliminated. We know of no harm in continuing your pills a few extra days if you occasionally desire to postpone a menstrual period. Ovulation usually will begin again in the first menstrual cycle after the tablets are discontinued. However, failure to minrate has been reported by a number of women who discontinued the pill. It may take up to 90 days to resume ministration. Many women ask if taking the pill will delay the menopause. The use of the pill may in some instances cover up the onset of menopause, but there's no evidence that its use will delay it. What about discontinuing the pill to become pregnant? Experts recommend that women who discontinue oral contraceptives with the intent of conceiving should use an alternative form of contraception, such as a condom or diaphragm, for 3 months before attempting to become pregnant. The most drastic methods of contraception are the sterilization of the woman or the vasectomy of a man. The vasectomy involves removing a section of the tube called the vas de which ordinarily carries the sperm to be stored in the siminal vesicles to await ejaculation. The surgical procedure is usually performed in your doctor's office and requires only a small injection of a local anesthetic to deaden a small area on the front and side of the scrotum. If a short section of the vas is removed, the operation can can possibly be reversed in the future. However, the length of the section of the vast which is removed determines more than any other single factor the failure rate of the operation. In even the best performed vasectomies, it is possible for a new channel to develop through the scar tissue between the two cut ends of the cord. And the failure rate is about two per 1,000 men.

2 Timothy 1:7