Intercourse

Intercourse should be considered as another form of stimulation which can take place with or without orgasm, in the same way that sexual activity can take place with or without intercourse

Once you have learnt to share intimacy through the previous assignments, and are both confident with genital stimulation you can proceed to integrate intercourse into your pleasuring sessions.

Intercourse Exercises [Heterosexual couples]:

In private, comfortable surroundings, relaxation, cuddling and sensual stroking proceeds to mutual genital stimulation. Initially the partner who has the problem should indicate when he or she feels ready to proceed to intercourse.

It is extremely rare for a couple to be at the same stage of sexual arousal at exactly the same moment and it is unrealistic to strive for simultaneous orgasm. This is distracting, goal orientating and anxiety provoking. You should both concentrate on your own sensations and enjoyment, and indicate to your partner if you recognise that you are "blocking" or need more time or more intense stimulation.

If one partner reaches orgasm before the other, this is not a problem as stimulation can continue with hands and/or mouth. You should avoid fatigue, and may decide to stop stimulation and resume on another occasion.

There are many variations to the following basic positions, and many books are available to illustrate these.

Positions:

The "woman above" position is the most appropriate in male or female dysfunctions. Both partners' hands are free, and it allows good body and visual contact. It enables the woman to move as she desires, and allows breast and clitoral stimulation during intercourse by either partner. The woman kneels astride her partner, lowering herself onto his penis, leaning forward slightly as she guides entry of the penis into her vagina. KY jelly may be applied to the penis or vulva to make entry easy. Both enjoy "quiet" penile/vaginal containment while caressing breasts, clitoris and other accessible parts of their bodies. Then the woman starts moving slowly at first, controlling the depth and direction of the penis and speed of movement. If the man loses his erection, resume pleasuring and genital stimulation. If ejaculation becomes imminent, and wishes to delay, then stop movements or apply the squeeze technique. When the woman feels intensely aroused she may increase the urgency of rhythmic thrusting. Once both become confident after using this position, then positions may be varied, depending on preference, weight or disability.

Lateral position: Partners lie on their sides facing each other with legs intertwined. This is a comfortable position allowing freedom of movement, close body contact, deep penetration and direct breast and clitoral stimulation. It eliminates the problem of the weight of a heavy partner, and is particularly useful if one partner has a disability, e.g. stroke.

Rear entrv position: The man enters from behind while the woman is on her knees, or lying on her side. This provides good genital stimulation for both partners and allows for clitoral and breast stimulation and freedom of movement. This position is comfortable during pregnancy, and it avoids the episiotomy site after delivery.

Man above [missionary] position: The woman lies on her back, with her legs apart, and she may place a pillow under her buttocks. This allows full body contact and freedom of movement for the man, but the woman has little freedom of movement and clitoral stimulation is difficult. The man may lose his erection or ejaculate while inserting his penis, and his weight may cause discomfort, in which case one of the other positions should be used.

Homosexual Couples see Sex with Same Sex Partners.

Once a person who has had a dysfunction successfully becomes aroused and orgasmic they find it increasingly easy to repeat the response because they approach sexual activities with an expectation of success rather than failure.

When the barriers are broken down and partners are communicating well, the improvement in their relationship is appreciated much more than just the intensity of orgasm and this extends far beyond what happens in bed.

The outcome is measured by the degree of satisfaction both partners experience with the sexual expressions of their love, and that does not always include intercourse or even orgasm. Success may mean that sex is no longer the basis of anger and frustration, that it is not used as a weapon and that although there may be occasional incidents of dysfunction, both partners feel comfortable with their sex lives. Relief of anxiety, about sexual function and restored caring and mutual confidence, trust and physical and emotional intimacy are the measure of successful sex therapy [1].

If you need further information and you are not able to consult a therapist who treats sexual problems the following books are recommended:

Seven Weeks to Better Sex, Domeena Renshaw, Westcom Press, 2004

Encyclopedia of Sex, Ann Hooper

For Women Only, Jennifer and Laura Berman, Owl Books, 2001

Becoming Orgasmic, A Sexual and Personal Growth Programme for Women, JR Heiman and J LoPiccolo, 1988

Good Loving Great Sex, Dr. Rosie King, Arrow, 1998.