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Carolyn Chernenkoff, B.S.N.

William Chernenkoff, M.D.
co-therapists in marital & sexual counselling

Relationships didn't come with instructions . . . . until now.

 

The Sensuous Boomer

 

The Chernenkoffs are feature columnists in the magazine "The Boomer". (formerly the Wealthy Boomer)

Please click on whichever title from the "Sensuous Boomer" that you wish to read.

Erectile Dysfunction  |  Sex And The Dual-Income Couple
Vaginismus  |  When the big 'O' goes missing  |  Rapid Ejaculation

 


 

"The Sensuous Boomer"
Volume 1

Living with Erectile Dysfunction
"When the darn thing won't stand up…"



Why will VIAGRA be a success in Canada? It's the answer to a grown man's prayers. No more fumbling with pumps, rings or urethral suppositories, treatment is as easy as a pill slipped into the pocket of his sports jacket ready to be taken one hour before intercourse.

Erectile dysfunction (ED) affects 52% of males between 40-70 years of age. This is the fellow who comes into our office and says, "The darn thing won't stand up." Clinically ED occurs when there is an inability to achieve or maintain an erection for satisfactory sexual performance.

For a male to think he will never have difficulty with erections is the same as him thinking he will never get a cold or the flu. But if he has difficulty with his erections for 2-3 months he should see his physician to have an assessment to find out what is causing the problem.

The ED can have a profound effect on the male, his partner and their relationship. It can have a devastating effect on the male. Males tell us, "I feel inadequate. I don't feel like a man. I wait for my partner to go to sleep before I even come to bed. I'm so afraid she is going to want to have sex and I am going to fail."

He develops fears of performance, where he thinks… "I’m afraid I'm not going to be able to respond the way I would like to or the way I think my partner would like me to." This develops into a fear of failure where he thinks… "I know I'm going to fail so why should I even try?" He avoids the situation, and there are less and less sexual approaches. When we ask these fellows how often do you think of the problem? He says, "I think about it all day long, every five minutes it's on my mind."

ED in the male also affects his partner. When she is first aware that her partner is having difficulty, she is usually very supportive, but she often blames herself. Women tell us that they think… "What am I doing wrong? Am I less desirable? Does he still care for me? Is he giving at the office?"

She begins to question her own sexuality. If nothing changes and the problem continues she next can become angry at the situation and at him.

She says to her partner, "It's not me, it's you. It's your problem, do something about, go and see your doctor." One woman said to her partner in anger. "Don't start anything you can't finish." The last stage the female experiences is one of indifference. She may have been left frustrated so many times that she willfully prevents herself from getting aroused and stops approaching him, and she says. "I don't care if I ever have sex again."

Some female partners are supportive and positive, but even that may be interpreted by the male as pressure. A gentleman told us that one time he was finally able to get an erection, his wife stood by the side of the bed and sang "Happy Days Are Here Again."

On the other hand if the female has a low desire and interest for sex and she has sex with her partner out of a sense of obligation, her reaction to him having ED may be one of relief. This lady is not too interested in him reversing his dysfunction. Her message to her partner is, "Not tonight dear, or to-morrow night either if I can help it."

The decision of wanting to reverse the ED and having treatment needs to be a mutual decision of the couple. Relationship issues of anger, frustration, and resentment need to be treated first, otherwise the treatment failure will be high.

If the couple previously enjoyed their sexual relationship then the effect of the ED on them is that they miss the closeness and intimacy that they once had when they were able to have intercourse. They may compensate by enjoying themselves with oral or manual stimulation.

For the majority of couples with a good relationship, the hope of being able to reverse the erectile dysfunction simply by taking a tablet will be celebrated. For them it will have a wonderful positive effect on their lives, and their relationship will be enriched.

As soon as the couple focus on sensations rather than goals and fears, that is when Viagra will work the best. It will enhance the natural underlying ability to respond to sexual stimulation. One gentleman who successfully reversed his ED summed it up this way. He said, "You know I’ve learned that erections are like city buses, if you miss one there is always another one coming around the corner."
 


 


"The Sensuous Boomer"

Volume 2 Issue 1

Sex and The Dual Income Couple!

"Don't forget the sizzle when you bring home the bacon…"

 


"What sex? We have a flawless relationship, we just don't have sex." This is a common statement we hear from dual income couples. The scenario is a good relationship, great jobs, and no sex. One couple explained. "We haven't had sex for so long, we feel like two virgins trying to make out."

In 25 years of counselling over 3800 couples, the pattern that we have seen develop in couples where both are working is Inhibited Sexual Desire in the female. Women tell us. "I could live the rest of my life without sex. The trouble is I'm married and it's creating distress in my relationship." Yet once she goes ahead, she is responsive and orgasmic. Why?

She is working eight to10 hours a day, the same as her partner. She comes home… what does she do? - everything! He may help with some household responsibilities, but more as an assistant. She is still in charge. What does he do? More likely he comes home watches TV or reads the newspaper. He is shifting gears, deprogramming from a work-orientated to sensory orientated activity.

What is she doing? She is looking after the children, doing the laundry, getting dinner on the table, cleaning up after. She has three jobs: career; homemaker; parent. One woman told us. "Sex with my husband is less appealing than brushing someone's else's teeth. When I hit that pillow I just want to sleep."

She is suffering from time-and job-overload. Too much to do in too short a time. Sex is the last thing on her mind. About 10:30 p.m. guess what he's become interested in? He pokes her and says, "Do you want to? Do you want to?"

She says, "I'm not in the mood!" She's waiting for feelings of desire to surface first and then she will follow with the behavior. Why? Because every other aspect of her day is scheduled and organized … whereas this is the only segment of her life that she hopes will be spontaneous and romantic. She is waiting for the feelings of desire to overwhelm her and she will stop her housework and follow with the actions. Unfortunately, the feeling does not come for one week, one month or many years. We hear from young career couples, "We haven't had sex for one or two years." The couple gradually spends less time together, crossing paths at mealtime or during the night. Their communication begins to whither and very often power struggles begin to develop. Other reasons for lack of desire may be distress in the relationship, depression or medications. All of these are not conducive to closeness and intimacy and sex is not likely to follow.

The good news, however is that once she does allow herself to become involved in a sexual encounter with her partner, she is likely to be responsive and orgasmic, because she is confident, not afraid to touch and she knows what her body needs. How can this couple prevent or get out of the problem once it is there? First, they need to have effective communication, which is the blood supply to the relationship. It brings in the nourishment and takes out the garbage.

He needs to back off. When we ask these fellows, "Why are you constantly approaching your partner many times a day? Is your desire for sex that high?" Their answer is "No. I just want to be sure that I don't miss the one time she may be interested, so I'm checking all the time." She of course thinks she is married to a walking sex machine. The woman says " I'm sure my husband could have sex every 20 minutes. He's poking me all the time."

The couple needs to delineate all the household responsibilities into three groups, his, hers, and hire out. The working couple needs almost an army of people to help with household responsibilities in order to have time together. Getting rid of the stress from goal-oriented jobs will allow her to get more in touch with sensory intimate feelings. They need to create pockets of time together without the expectations that all touching must lead to intercourse.

And Voilà...the chances for sexual activity increase dramatically. A lock on the bedroom door is essential so that they can create a cocoon, and ensure privacy. When they are enjoying some weekend afternoon delight, it is essential to know the kids won't come bursting through the door. We also recommend that every couple have a get away weekend alone together every three months just to recharge the batteries.

To bring back the sizzle there are three magic words that any man can say to his partner, which has the potential to increase the woman's desire for sexual activity and certainly will set the stage for closeness and intimacy. That is when he lovingly looks into his partner's eyes and says, "I'll make dinner!"
 


 


"Sensuous Boomer"
Volume 2 Issue 2

VAGINISMUS
When sex is a pain!


"I think I'm made differently than anyone else. I'm sure there is a bone there; intercourse is impossible!" is what women experiencing vaginismus tell us. It often occurs in healthy, successful, hard working women who are usually able to succeed in everything they set out to do except to have comfortable intercourse.

Vaginismus is the involuntary contraction of the muscles surrounding the outer one third of the vagina; the more she tries to relax those muscles, the more she feels they want to contract. The result is that intercourse may be very uncomfortable or even impossible.

Women say: "It doesn't fit, I think we're sexually incompatible."

Some women with vaginismus feel they have been cheated. "I waited to have sex; studied to have a career; got married in my 30's; and then, wham! I am not able to enjoy sex! I did everything right; and look what I have!"

Vaginismus is a common problem that caring, committed couples may experience. Mild to moderate vaginismus, is where one or two fingers are possible to be inserted; hers or her partners, but not the penis. This usually occurs within the 30 to 50 age group. In severe cases of vaginismus, marriages are unconsummated. Usually these are diagnosed in the ages 20 to 40, where the couple has never been able to have a finger or tampon inside the vagina, let alone the penis. One married couple finally sought treatment after nine years of trying unsuccessfully every week to have intercourse. They optimistically explained: "We always thought, maybe it will work next time."

When we ask women with vaginismus, how they visualize the vagina they say: "Like a test tube, it is fixed and rigid but it should be large and wide open, so that my partner's penis can fit inside, Mine isn't like that." There is a fear anticipating intercourse.

After remaining celibate until her wedding, one woman's well meaning (but naïve) friends at work offered advice prior to her wedding : "The first night of your honeymoon, you will need to put a pillow in your mouth for your teeth to clench because the first intercourse will be intolerable!"

Guess what? …Misplaced, well meaning suggestions can have a powerful long-lasting effect. The woman had a tremendous fear of being hurt in the vagina, so whenever something approached the vagina the muscle around the opening went into spasm.

Other causes may involve gynaecological problems, past sexual abuse, or simply very negative attitudes about sex in childhood; where touching oneself is forbidden, thereby denying the normal incorporation of body structures into one's own body image. The vagina becomes something "down there." The spasm becomes a protective mechanism to prevent anticipated discomfort: The gate remains closed." The woman has a normal desire, is responsive and orgasmic; "If I rub against my partner, I can reach an orgasm."

Her partner's frustration and resentment may come out in various ways that adds to the problem.

The treatment consists of teaching the couple skills in developing touching and exploration, unleashing their sensuality and changing negative attitudes about sex to positive ones. This is combined with her utilizing graduated dilators - the first smaller than her littlest finger; the largest one about the size of his penis - to retrain the involuntary vaginal muscular contractions.

She generally has been trying to relax her muscles, while feeling anxious about inserting. The anxiety increases the muscle spasm; this is what she has been describing as "the bone." Instead, she learns to voluntarily contract her vaginal muscles for four seconds, and Voilà, when she lets go of the contraction, there is a brief spontaneous relaxation, which allows her to insert the dilator. There is a natural apprehension as the woman progresses to the next size of dilator. One lady asked: "Is the last dilator going to be delivered in the back of a Mac truck?" Women often nickname the dilators, "my buddy, my friend or the little wonder." They feel great accomplishment as retraining of the muscles occurs. At the largest dilator, she makes a transition to the penis as a dilator and she learns that she will always be in control of the penis insertion.

As therapists we have a dream - we say this facetiously - of being able to rent billboards in every major city across Canada advertising: "It should always be the female who inserts the penis in the vagina!" Signed …Anonymous.
If you see this message posted, you will know it's us.  This should apply to all couples, vaginismus or not. It is her body and she needs to be in control of what is inserted.

When the couple are able to insert the penis and enjoy it, a variety of exciting emotions surface. Women often relay to us that they jumped up and down on the bed, shouting "Yahoo." A 50-year old woman who reversed her vaginismus after experiencing thirteen years of uncomfortable intercourse told us," I feel like a new bride, only better. Now I can be an active participant in sex."

Along with the freedom and self-confidence they develop after reversing the vaginismus, these women often develop a delightful sense of humour. One woman summarized her elation by telling us: "I would like to have the largest dilator on a gold chain, around my neck and have inscribed on it: "In case of vaginismus, please insert!"

 



"The Sensuous Boomer"
Volume 2 Issue 3

When The Big "O" Goes Missing!
The Missing Orgasm!



Rob and Nancy are in a new relationship, very close and committed to one another and they just finished having sex.

Rob: "Nancy, did you - did you - reach it?"

Nancy: "No, but it was exciting and I enjoyed it."

Rob: "Oh, no! What am I doing wrong? I never had this problem with anyone before."

Nancy: "You aren't doing anything wrong. It's fine for me, but I feel I'm letting you down."

Rob: "The day you have an orgasm by intercourse, is the day I'll be truly satisfied."

The question we're often asked is: " Why can't I reach an orgasm sometimes?"

The orgasm is a result of the build up of sexual tension, which at a high enough level results in rhythmic muscular contraction throughout the pelvic area perceived as pleasurable sensations.

Having difficulty having an orgasm most commonly happens in women. One of the reasons is that 50% of women need more stimulation then the penis inside the vagina to be orgasmic - and they may not be getting that stimulation. It's like "Look Ma, no hands". Often there is the expectation that orgasm should happen with intercourse alone. Nancy was orgasmic manually and orally half of the time and happy with that.

Rob felt it was his responsibility to give Nancy an orgasm - using only the penis inside the vagina. Otherwise he felt he had failed as a lover. Often it bothers the man more than the woman, and he begins, "a search party for her orgasm." One fellow told us, "It's like putting in the crop and never seeing the harvest."

Sometimes there is a hidden agenda. "If my partner had more orgasms maybe she'd want more sex and I won't have to work so hard to get her interested."

After a period of time, Nancy began to feel a tremendous amount of pressure, from Rob. Instead of being in tune with her own sensations and pleasure, she switched over to please her partner to build his ego and she began to "fake it." She was trading her own pleasure for his approval.

For Nancy to reach her full potential of her sexual response, Rob needs to take away the pressure. He can't give her an orgasm like a "gift wrapped present." She gives herself permission to respond and the orgasm will surface as a result of the interaction between them. If the woman has been able to explore her own body and finds out what is appealing and interesting for her to be orgasmic on her own, it's much more likely she can make that bridge to be orgasmic with her partner.

Although women are now generally more confident in knowing what to do to turn themselves on and be orgasmic, sometimes there is still the romantic idea that " the knight in shining armor" will get them aroused and meet all their sexual needs. As one woman said, "Some day my Prince will come, and I'll come too!"

Often young women are expecting, "body-shaking tumultuous daytime soap-opera orgasms," but instead they may have warm fuzzies or a feeling of release and an after glow and that for them is an orgasm. Sometimes she may not even be sure if she is orgasmic. One young woman was sure she had an orgasm, but when she told her boyfriend he said, "No you didn't. You didn't look or sound like I do."

Some women hold back because they are afraid of their partner's reaction. "I want a dignified orgasm. I don't want my partner to think I'm a dirty old woman."

Do men ever "fake it?" Yes, men can feel "under the gun", and on occasion will fake orgasm. If he's aroused, has an erection and he feels ejaculation is "emission impossible" he may fake orgasm in order to draw the situation to a conclusion. It's his way of saying, "that's all, folks." He quickly flees to the bathroom and his partner is not aware of anything being amiss. Sometimes he is afraid if he can't reach an orgasm, his partner will feel rejected. She says: "If you really loved me, you could reach an orgasm."

Alcohol can delay orgasm. Not one drink, but one drink too many. He feels he will not be able to be orgasmic. She's lost interest and is counting sheep. He fakes it to save face.

Other reasons for both women and men to have difficulty with reaching orgasms are medications, low hormone levels or organic causes.

If the individual is able to reach orgasm on their own, but not with their partner, the relationship may be the problem. One lady explained: "I have no problem reaching an orgasm as long as my husband is not in the room." Often sexual feelings may be shut down due to distress in the relationship. The bedroom is a reflection of what's happening in the rest of the household.

To reverse the problem, couples learn to take responsibility for their own sexual feelings and emotions. Learning to touch their partner for one's own enjoyment takes away the pressure to perform. When the couple stop "working at sex," that is when the response will be there spontaneously.

Couples who are responsive are the ones with effective communication. Sex is a 13 letter word…communication. The communication is the blood supply in the relationship. It brings in the nourishment and takes out the garbage!

Intimacy and closeness are not just having a response and putting the genitals together, it's the whole interaction of two people. That's the greatest erotic stimulation of all.

One woman said, "I have never reached an orgasm so I don't know what I'm missing but I sure know when I'm having a good time."

(Names have been changed to protect the orgasmic.)
 


 

 

 

 

Rapid Ejaculation
"And you thought your money was going fast"

 



"My husband has a lot in common with superman… they're both very fast." This is a remark that we hear from women when the ejaculation is consistently occurring too soon.

Rapid ejaculation is the most common male sexual dysfunction…. but it is a female distress. The intense frustration is experienced not only by the male but also his partner. As one woman described, "It always seemed to happen before I was in the room!"

For some couples rapid ejaculation is not a problem because they enjoy fast passionate sex and both can reach high levels of arousal and satisfaction. But for others fast ejaculation leads to embarrassment, anxiety, and anger. One frustrated woman described the scenario, "he's like a rabbit, he starts-- he finishes, he has an immature ejaculation."

Timing of the ejaculation is of little benefit, but as a guide if the male can have intercourse without ejaculating for 3-5 minutes he is not a rapid ejaculator. The difficulty occurs if there is no love play and the only stimulation the woman has is the 3-5 minutes of intercourse.

Virulent rapid ejaculation is when the man ejaculates before the penis is inserted into the vagina. One woman complained, "He scratches my back and he ejaculates." Often there is no time for movement before ejaculation occurs. A woman described, "I feel like a sperm bank. He comes, he makes a deposit, and he leaves."

Ann and Ron typify a common scenario:

Ann: "If you really wanted to Ron, you could do something about this. I feel frustrated and used every time this happens."

Ron: "I'm sorry, Ann…. I 'll try harder next time."

Ann: "There may not be a next time!"

The pattern of the ejaculation occurring too soon is a learned response, often beginning with the man's first experiences. Either in a backseat of a car, or a parent's home where he feels he must get it over with quickly. He may even be encouraged to be fast. "If I wasn't fast, my partner would loose interest, and I anticipated the dreaded words, I think I hear my mother coming." There is a feeling of guilt and fear of discovery. This sets the stage for the ejaculation to continue to be rapid.

Later in life when he wants to delay the ejaculation he is not able. Like Ann, his partner blames him," You're just selfish, you're only interested in your own pleasure." Each time he apologizes and feels inadequate. He develops fears, "Will I be able to satisfy my partner, and will I be embarrassed?"

He tries novel home remedies to slow down ---but none of them work.

He develops ways of distracting himself so he wouldn't get so aroused. One boomer said, "I think of all the money I owe." Another fellow said, "I think of baseball to delay the ejaculation but…. I can't keep thinking about baseball." This may slow down the ejaculation but the difficulty is that it also decreases his level of arousal. As he conditions himself to not get aroused he has the potential to develop loss of erection. He may ejaculate through a partial erection.

The couple has little holding and touching because he feels it will get him too aroused. He has a tremendous urgency to get right to intercourse. His partner has little chance to get aroused. She complains, "There is no love play. We just have intercourse. Each time I'm left frustrated and there are five fingernail marks down the bedroom wall." This leads to nitpicking, put-downs and an unfriendly atmosphere outside the bedroom. The fellow develops more anxiety that makes the response even faster. He says, "I feel like I'm falling down a mountain, and I can't stop."

There is less desire and interest in both. She stops approaching because she's not getting anything out of the experience. He avoids sex because he doesn't want to feel like he is failing. They may end up with a sexless marriage.

Fortunately treatment for this problem is very successful. The couple needs therapy to neutralize the anger, frustrations and fear of performance. She needs to have optional ways of experiencing arousal and orgasm that will not depend on intercourse alone. The increased amount of love play will allow her to get aroused, and it will also take away the pressure from him.

The couple needs to understand that this is not something he is willfully doing. He says," I'll do anything to please my wife." Once the pattern of rapid ejaculation has been established it is difficult for him to change by himself. But there is an effective technique called the squeeze technique that the couple can learn together. It is not something the man can do himself, but the woman can learn to utilize so that she can delay the ejaculation. She is doing this for herself, not for him.

The pressure of her thumb on the frenulum and her first and second finger on the coronal ridge for four seconds in the early stages of his arousal delays the ejaculation. Women learn the technique with great enthusiasm. They say, "finally there's something I can do, I have some control over the situation." As she takes on this role to delay the ejaculation, the pressure is taken off the man; his fears and anxiety are removed. As she uses the squeeze technique, she is more involved in touching, and her arousal surfaces. One woman commented," I learned the squeeze technique to delay the ejaculation, but in doing so I actually turn myself on." Her partner's response was, "I love the build up…. and it's true that nice guys finish last."
 

 

Carolyn Chernenkoff, B.S.N.

William Chernenkoff, M.D.

 

Spadina Medical Clinic
2 - 806 Spadina Cres. East
Saskatoon SK  S4K 3H4


Phone: (306) 955-3030
Fax: (306) 955-4202

 

chernenkoff@sextherapists.com
 

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