Healthy Sexual Function

Healthy Sexual Function


Sometimes, in a relationship, we avoid certain topics because we don’t want to mention something that could ruin the relationship. It can be especially difficult to talk about sex and sexual issues; however, there are some important topics to discuss with a potential or current sexual partner(s).

How do I find the right words to use?

Finding words that you and your partner(s) are comfortable with is often a challenge. It is also important to define ambiguous terms so that everyone is on the same page. For example the word abstinence, for some individuals, means no vaginal-penile intercourse but does include “outercourse” where someone engages in everything but penetration. For others, abstinence means no genital contact. If one partner was using abstinence in a sentence, such as “I think we should practice abstinence,” the meaning would be unclear unless they discussed the definition of abstinence. Additionally, having a clear understanding of terms is important for gaining consent.

How can I communicate intimate thoughts to my partner?

Discussing what is sensual or erotic to you is important. When things are getting hot and heavy, saying what really turns you on or what you don’t like may be difficult. However, telling your partner what does and does not feel good will make the sexual experience more pleasurable for everyone.

Talking about what you find pleasurable may be easier during a time when you’re not physically involved because you are not distracted. Sometimes, describing what we like sexually may be difficult, so saying “Why don’t you try this? and I like it when…” Showing your partner may be the easiest and most comfortable way to communicate your sexual needs. You know your body better than anyone, so it just makes sense to communicate your sexual desires.

In today’s age of sexually transmitted infections, it is extremely important to communicate about the sexual histories. Although you may be uncomfortable discussing such experiences, being understanding and nonjudgmental can help ease the tension.

Communication is not always easy and sometimes it can be downright difficult. However, communication is an intimate aspect of any relationship, especially a sexual one.


Orgasm, the Big O, climax is often thought of as the pinnacle of sex, or the sole purpose of a sexual experience. This type of thinking can lead to unrealistic expectations that are difficult or even impossible to achieve. There is more to sexual activity than just orgasm. As a society, we have been conditioned to think of sex as vaginal-penile intercourse with orgasm as the goal. In reality, there are many enjoyable sexual activities besides intercourse, some of which may result in orgasm, some of which may not. The fun exists in the exploration.


What is libido?

This is a word we hear often, but what does it mean? Libido means sexual urge or instinct. You might also think of it as your sex drive.

What is a "normal" amount of libido?

Sexual urge, sex drive, or libido is different for everyone. There is no “right” or recommended amount of libido. Like many other aspects of your sexuality, your libido should be the amount of sexual urges and sex drive that feels right for you.

What affects a person's libido or sex drive?

There are a number of things that can affect someone’s libido. Visually, we all experience turn-ons and turn-offs. For example, for some individuals seeing a partner partially naked may do more to impact sex drive than seeing a partner fully nude. Body chemistry or pheromones may impact your libido, but we do not know the extent to which they influence sexual attraction or behavior in humans. The meanings of specific words or phrases along with hearing certain sounds, voices, and songs may result in an increase or decrease in sexual urges. Touch can also play a big role in libido as it has the most direct effect on sexual arousal and response. In addition to what we have included here, there may be a number of other situations, objects, scenarios, tastes, smells that you notice as affecting your libido. There is variation within and between individuals in terms of the factors that influence libido.

What can I do about a decreased sex drive?

It might be worthwhile to initially consider any life changes that could have led to a decrease in libido. Decreased libido might simply be the result of a busy time at school or work, added stress, hormonal changes, illness, or relationship troubles. Additionally, taking some kinds of medication can also impact your sex drive. If after considering these possible factors, you are still concerned, you should speak with a professional counselor, therapist or health care provider.


Most of us do not sit around talking about masturbation. Let’s face it, masturbation is one of those topics that people rarely discuss. When it is mentioned, the remark often causes nervous laughter.

Why don't we talk about masturbation?

Individuals approach the topic of masturbation in a variety of ways due to diverse personal and cultural beliefs. Since the topic of masturbation tends to be a more private matter, you may not hear masturbation spoken about in public very often. However, it is a topic that is worth learning about and discussing. Let’s talk briefly about masturbation, or self-pleasure.

Think of it this way: it may be easier to tell someone else what feels good to us if we have taken the time to explore our own body and sexual potential.

Self-pleasuring is one way that we can get in touch with our bodies. It is a way to explore our bodies without having to worry about the needs and demands of a partner. Masturbation gives us time to discover what feels good to us.

What is masturbation?

Some people spend time touching their bodies or genitalia with their fingers; others may lie still and contract the muscles around their genitalia. Still others don’t touch themselves at all and engage in mental stimulation- fantasies about locations, partners, positions. This is an individual process; what may be pleasuring to one person may not be gratifying to another. Once you’ve discovered what feels good, you can tell (or show) your partner after receiving consent. By knowing what turns you on, other sexual experiences can be even more satisfying. Just like everything else, some people don’t find masturbation enjoyable. Like other sexual activities, if it doesn’t feel good to you – mentally or physically – trust your feelings and don’t do it.

So what is an orgasm anyway?

An orgasm is different for everyone but typically an orgasm involves involuntary muscle contractions associated with a release of built-up tension or pressure within the pelvic area. What an orgasm feels like can vary by partner or by type of stimulation (sensation, penetration, touch) and is due to the different nerve pathways between and among people. Some women say they can feel contractions in their vagina, uterus and rectum, whereas others experience just tightness and the sensation of having to urinate. Typically, women require some sort of clitoral stimulation through oral or manual stimulation either solely or in combination with some sort of vaginal or anal penetration.

A male orgasm can be (but is not always) associated with ejaculation. Having multiple orgasms is possible but requires a good understanding of your body. A common myth is that people should achieve orgasm simultaneously. This is often difficult because some people require more time to become aroused than others and therefore more time to achieve orgasm.

Being comfortable with yourself and your partner(s) is important to achieving orgasm. Additionally, not putting pressure on yourself or your partner(s) is also key. As mentioned earlier, there are a variety of fun ways to gain sexual pleasure, happy investigating.

Common sexual concerns and questions

Many people have questions and concerns regarding their sexual health and activity. They wonder what is “normal”. They wonder what is considered a normal frequency for having sex. They wonder if their body works right.

Typically, we are born with sexual responses and desires. Sometimes, due to the environment, physical problems or negative sexual experiences, sexual functioning can be impacted and professional help is needed. Generally, all sexual activity is “OK” if between consenting adults.

Some of the more common concerns we hear at the Health Center include:

Consent is agreement or permission expressed through affirmative, voluntary words or actions that are mutually understandable to all parties involved, to engage in a specific sexual act at a specific time. Consent cannot be given by someone who is incapacitated (unable to understand the facts, nature, extent or implications of the situation due to alcohol, drugs, a mental disability, being asleep or unconscious. Remember NO person has the right to use or abuse another individual.

An orgasm is the point at which all the tension in your body is suddenly released in a series of involuntary muscle contractions. Although the definition seems clear, an orgasm is a unique experience for every person. It can even feel different for the same individual, if the stimulation, partner or position is different. It is important that you feel comfortable with yourself and not worry about what your friends have told you or what you think you are supposed to feel. Sometimes, worrying about whether or not you are going to orgasm makes your body tenser and actually prevents you from having an orgasm.

There is nothing wrong with your partner. In a U.S. probability sample of women ages 18 to 94, 37% reported needing some clitoral stimulation in order to experience an orgasm, whereas only 18% reported that vaginal intercourse was enough (Herbenick, Fu, Arter, Sanders & Dodge, 2017). In a heterosexual relationship, the man may reach orgasm more quickly than his female partner and the couple may end intercourse before the woman has had an opportunity to orgasm. Another possibility is that a thrusting penis or other object may not be enough stimulation and more direct stimulation of the clitoris may be needed as mentioned before. Alternate positions and activities, such as manual or oral stimulation, may be pleasurable to the point of orgasm.

Sometimes, it is easier for an individual to have an orgasm while masturbating. First, you may feel more relaxed when masturbating than when you are with a partner. We often feel a lot of pressure to act a certain way or to do a certain thing when we are with someone else. This pressure can cause the body to become so tense that achieving orgasm would be extremely difficult, perhaps even impossible. Or perhaps you are concentrating too hard on your partner’s pleasure and are not focusing on your pleasure as much. Finally, when you masturbate, you may be touching yourself in a way that your partner does not or cannot replicate.

There is no danger in masturbating. Masturbation can be an excellent source of sexual relief and does not thwart your ability to engage in other sexual activities.

Almost all individuals experience pain with sex at some point in their life. For women, some common causes of pain include insufficient lubrication – the vagina is not wet enough to be able to handle the insertion of the penis, toy or finger. Using lubrication can help with this issue. A local condition, such as a yeast infection, may become irritated by the penis, object or finger also causing discomfort. Treat any yeast infections before engaging in sexual activity. Sometimes spermicides cause irritation. A tightness around the vaginal opening may be a source of pain as well, and can be caused by tension or lack of arousal.

During or around ovulation, the area surrounding the ovaries may be sensitive causing painful intercourse. A pain deep in the pelvis could also be caused by several physical reasons, such as endometriosis, cysts on the ovaries or an infection in the cervix, uterus or fallopian tube. All of the conditions listed above are treatable.

Also, there is a condition called vaginismus, the involuntary tightening of vaginal muscles near the opening that makes any form of penetration difficult or impossible. Such a condition is usually a physical response to a fear of penetration and is treatable.

Men can also experience pain during sex; it usually occurs with ejaculation and sometimes with erection. If his partner is dry, he could also experience skin irritations. Any of these difficulties should be discussed with his health care provider.

No, sometimes an individual can get skin irritations during masturbation or having rough sex with a partner, particularly if the skin is dry. However, any unexplained bumps, sores, or breaks in the skin should be examined by a healthcare provider. An appointment should be made while the area is sore or irritated.

Here are some suggestions to increase this time:

  • Increase the frequency of ejaculation through masturbation.
  • Using a condom can also increase the time of erection to ejaculation because it decreases the sensitivity of the penis.

There are other, more specific techniques, which can be used. All require good communication with a partner. Listed below are two different techniques:

  • A common one is the start-stop method. The penis is manually stimulated, but stopped before ejaculation until the feeling subsides. The stimulation is started again and continued until just before ejaculation and again stopped. After three times, the penis can be stimulated to the point of ejaculation.
  • Another method to try is the squeeze method. Similar to the start-stop method, it may help to reduce premature ejaculation. The squeeze method involves masturbating up until the point right before ejaculation, and gently squeezing and holding between the shaft and tip of the penis with the thumb and forefinger to prevent ejaculation.



There are many excellent books written for people who are interested in learning more about sexuality or improving their sex life; some of the better ones are included below.

  • Because it Feels Good: A Woman's Guide to Sexual Pleasure and Satisfaction. Debby Herbenick, Rodale, 2009
  • Doing it: Real People Having Really Good Sex. Isadora Al-man, Conari Press, 2001
  • Getting Off: A Woman’s Guide to Masturbation. Jamye Waxman, Seal Press, 2007
  • The Good in Bed Guide to: Anal Pleasuring. Debby Herbenick, 2011
  • Great in Bed. Debby Herbenick & Grant Stoddard, DK Publishing, 2012
  • Orgasms for Two: The Joy of Partnersex. Potter/Tenspeed/Harmony, 2003
  • Read my Lips: A Complete Guide to the Vagina and Vulva. Debby Herbenick and Vanessa Schick, Rowman & Littlefield Publishers, 2011
  • Sex Made Easy: Your awkward questions answered-for better, smarter, amazing sex. Debby Herbenick, Running Press, 2012
  • She Comes First. Ian Kerner, Harper Collins, 2009

The Classics

  • Becoming Orgasmic. Julia Heiman, Prentice Hall, 1988
  • For Yourself: the Fulfillment of Female Sexuality. Lonnie Garfield Barbach, Signet Books, 1975
  • The Good Vibrations Guide to Sex. Cathy Winks and Anne Semans, Cleis Press, 1994
  • The Guide to Getting it On. Paul Joannides, The Goofy Foot Press, 1996
  • The New Joy of Gay Sex. Charles Silverstein and Felice Picano, Harper Collins, 1992
  • The New Our Bodies, Ourselves. Boston Women’s Health Collective, Simon & Shuster, 1992
  • Sex for One: The Joy of Selfloving. Betty Dodson, Three Rivers Press, 1996
  • Sexual Awareness: Enhancing Sexual Pleasure. Barry and Emily McCarthy, Carol and Grof Publishers, 1993
  • The Whole Lesbian Sex Book. Felice Newman, Cleis Press, 1999


  • Go Ask Alice: Columbia University’s Health Question and Answer Internet Service
  • Dan Savage: The Stranger "Savage Love" column