Improving Your Erection

There are multiple factors that affect your erection including physical, neurochemical, hormonal, psychological, and emotional. Because of this, a man needs to maximize all of these to ensure the best erection he can have. Oftentimes a man will seek help for his erections only after he has had difficulties for some time. But the best medicine is preventive medicine. This includes lifestyle choices and measures that you can adopt for overall health, and specifically for continued optimal erections.

So here are a few factors to consider when wanting to preserve or improve your erection:

1. Watch what you put into your body. Everything you eat, drink, or otherwise expose your body to, will affect your overall physical health and therefore, your erection. Diets that are high in fat, sugar, and artificial ingredients cause an increase in your body's inflammation response. Over time, this is damaging to blood vessels, especially those of your heart and your penis. Other culprits are nicotine (whether in cigarettes or in nicotine patches/gum) and excess in alcohol. Keep in mind that alcohol use of more than 1/2 - 1 drink per day has been shown to increase your triglycerides and LDL (bad) cholesterol which eventually contributes to arterial plaques and hardening of the arteries, resulting in decreased blood flow.

2. Get moving. Our bodies are designed to be active and in motion. By keeping active and engaging in regular aerobic exercise, you increase the blood flow to your muscles, and your penis along the way. One of the most interesting things about increasing your blood flow is that it becomes a signal to your blood vessels to grow and get wider. It benefits your brain, your heart, and your erection. The principle of "use it or lose it" is the best advise one can follow. In fact, if you don't engage in sexual activity at least once or twice a week, it would be beneficial to masturbate. This not only helps with prostate health, but encourages the blood vessels that contribute to your erection to maintain their patency and flow.

3. Don't be so uptight. When you have anxiety or stress, it creates a state in your body that directly opposes sexual arousal. This can interfere with getting or keeping an erection (or even reaching orgasm for some). Sometimes men are not aware of anxiety that they create for themselves, which may come in the form of doubts or negative thoughts. If you are having difficulties with your erection and have no physical cause for it, then it would be important to explore in what ways anxiety is affecting you. I believe that you owe this to yourself and the future of your sexual functioning.

4. Supplement your diet. Besides keeping a diet that works to create better health for you and your penis, there are certain vitamins and supplements that can improve your sexual performance and your erection. These days, our diets do not usually provide sufficient B vitamins and most people should be taking a B-100 Complex daily. In addition to this, Coenzyme Q10 100mg a day works as an antioxidant, may protect against high blood pressure, and may also be cardioprotective. But one of the most interesting supplements available is Epimedium (a.k.a. Horny Goat Weed). The active ingredient in this supplement works the same way as that of Viagra, Levitra, and Cialis - inhibiting PDE-5, thereby increasing the availability of NO. This directly causes dilation of arteries of the penis (and other locations) which causes erections. Look for preparations made from trusted sources that provide at least 400-500mg per dose and take twice daily. This works not just for those men who have started having difficulty with getting and keeping their erections, but also for men as they age to maintain the best blood flow they can.

Be aware that difficulties with an erection can be a signal to other existing medical problems such as heart or vascular disease, thyroid problems, diabetes, or other end-organ damage due to metabolic syndrome or drugs/alcohol. Please don't delay in seeking medical attention for any problems with your erection, paying attention to what may be contributing to it. But again, the best course of action is the preventative one.

Learning to Masturbate

The nature of things is that life isn't fair, and different circumstances of life can either be a benefit or a difficulty for us. When considering masturbation, whether your family is more anxious, or more religious, or whether you have your own room or not, or even being born a girl rather than a boy, contributes to if, when, and how you may learn to masturbate.

The reality is that men tend to have nature on their side because they have much more occasion to touch their genitals than girls. When they go to the bathroom, they touch themselves. When they get an erection and have to adjust their clothing, they touch themselves. Even just finding a comfortable position to sit or lay down, they may need to touch themselves. This brings many more opportunities for a boy to discover the pleasurable sensations he can experience from rubbing or stroking himself. Oftentimes, infants or toddlers discover this early on and engage in some form of masturbation without any instruction or direction from the outside world. We know that it is a natural activity and should not be viewed in a negative way.

For adolescent boys and men, one of the difficulties related to learning about masturbating is time and location. Many times, a man does not have the privacy that he wishes to explore his fantasies or his physical sensations, and instead rushes himself to finish the job before he is discovered or interrupted. Because of this, sometimes men teach themselves to masturbate in an anxious way that can translate to anxiety around orgasm and ejaculation in later sexual relationships. When masturbating, it is beneficial for a man to have times in which he allows himself the opportunity to explore different sensations, different intensities, different speeds, and also focus on how it feels physically in addition to focusing on his fantasy material.

With women, it is a little trickier. Women do not usually touch their genitals throughout the day except when involved in personal hygiene - and that doesn't usually bring any sexy thoughts to mind. Some girls find that certain objects or ways of sitting can produce pleasant sensations, and some even explore with their hands and fingers. Regardless, these are also a natural part of growth and development and are best approached as such.

For adolescent girls and women learning to masturbate, patience and curiosity are the keys. Nothing interferes more with sexual arousal and pleasure than performance anxiety. There is so much variation in what can bring a woman pleasure - from different materials, to different positioning of fingers or toys, to different speed and intensity. In some instances, it is a matter of time. When learning how to masturbate, it is not uncommon for a woman to be touching herself for 20 minutes or more before reaching a point where she finds an orgasm. But with women, orgasm does not have to be the goal, and many women enjoy the pleasure of masturbating for long periods without reaching orgasm. The curiosity about one's own body, the sensual nature of stimulation, and the eroticism of the exploration are the most important points. You will increase your pleasure if you allow yourself to explore your fantasies as well as your entire body, because your mind and your body work together for sexual satisfaction and pleasure.

The Benefits of Orgasm

Modern medicine still does not understand exactly the hows and whys of orgasm. But we do know that for humans, our psychological state is the major determining factor as to whether we can have an orgasm, or have difficulty acheiving one. We are, however, starting to understand more about what happens in the brain as a result of orgasm. But there is so much more to be studied and explored.

First, we know that at orgasm, both men and women release an increased amount of oxytocin. We know that oxytocin promotes feelings of comfort, closeness, relaxation, and feeling tingly all over. In women, it also causes contractions of the uterus, and may contribute to stronger orgasms. Along with this is the release of prolactin, another hormone that helps us feel satisfied and calm. There are studies demonstrating that at the point of orgasm, there is a protection against feeling pain without decreasing other sensations. Some people find that it helps relieve migraines, and others find it useful for body pain. Even though the effects of pain relief are immediate and last only a few minutes, those people regularly having orgasms experience lower levels of pain overall because of the increase in the body's natural opiods. We know that people having several orgasms per week have less chance for heart disease and stroke. I would also venture to guess that they smile more often.

Perhaps the most enjoyable benefit of orgasm is the feeling of being alive and charged sexually. When you orgasm, you feel powerful. It increases your blood flow throughout your body, but most importantly, to your genitals for increased support of those tissues and muscles. This is the best way to keep these tissues healthy, because blood flow promotes more blood flow in a positive feedback cycle. It's the flip side of 'use it or lose it.'

Even if you don't have a partner, bringing yourself to orgasm helps you gain some of these benefits. Although not all will admit it, most men will continue to actively masturbate even if they don't have a partner. I am still suprised, however, that there are several women who do not 'take matters into their own hands' when they find themselves without a partner. For some it is guilt, for some it seems inappropriate, for some it brings many negative automatic thoughts as to why they do not have a partner. Regardless, all of these cause a women to relinquish control of her sexuality and abandon an activity that her body thrives on.

I propose that we all masturbate frequently and happily. Just imagine if everyone woke up just a few minutes earlier and was able to have a little orgasm before leaving for work? I wonder if we would have a lot less road rage?

The U-Spot

It seems that it's in our nature as humans to want to put labels on everything because it helps us feel like we have control or power over things. So I was amused when someone today brought up the "U-Spot" after reading about it in Esquire Magazine. The U-Spot is not new, and it's certainly familiar to a multitude of women whose partners like to explore the area during oral sex. But for those who have not heard about the U-Spot, I thought it would be helpful to talk about what it is and why it gets the buzz that it does.

The U-Spot is the common term given to the area that surrounds the opening of the urethra in women. This area can be particularly sensitive because the female urethra is surrounded by spongy erectile tissue that fills with blood upon sexual arousal. This spongy tissue extends from the anterior vaginal wall, around the urethra, all the way to the pubic bone. Anatomists have called this spongy tissue the Skene's glands, or the periurethral glands. Some even call it the female prostate and believe this is where female ejaculate may come from. The skin that is directly over this spongy tissue, then, is known as the U-Spot. It's already very sensitive on it's own, but becomes even more sensitive once a woman gets sexually aroused.

So what am I supposed to do with this U-Spot, you ask? First let me say that if you are approaching this with a an attitude of "I've got to find this" then take a step back. So many people develop this performance-based attitude that feeds your ego, but takes away from your enjoyment and the fun of exploration. Plus, women like to feel that you are interested in her body, not in checking off a list of things to do. The sexiest attitude to take is a playful, exploratory experience and then see what feels good to her. Now that that's out of my system.....

The U-Spot feels the best when it is wet and touched gently. You do not need to put a lot of pressure on it, and many women have discovered this spot just from their partner rubbing the head of their penis up and down their labia. This is a motion that can be incorporated with stimulation of the clitoris and can be a way to reach orgasm all on its own for some women. The U-Spot can also be stimulated with fingers, but remember - gentle stroking across it is usually more pleasurable than pushing on it (it's a spot, not a button). Once again, incorporating this stroking with stroking of the clitoris above it may also be a pathway to orgasm for some women. And as with all things having to do with sexuality and anatomy, some women have very sensitive U-Spots, while some do not. When using fingers, you may find she likes to have some wet stroking all the way from the clitoris, over the U-Spot and then just into the opening of the vagina.

But most people would agree that oral sex is one of the best ways to stimulate the U-Spot. This is because it already makes the area wet and has less friction than the skin of the fingers. The easiest way to find it is to find the opening of the vagina with your tongue, then softly and slowly lick upwards towards the clitoris, as if you are licking an ice-cream cone. This way, you can see which area she is most sensitive in, and you won't overwhelm her with too much pressure or speed. Once you find the spot she likes, you can experiment with putting different amounts of pressure with your tongue, or going faster or slower.

So there's the skinny on the U-Spot, which you may already know, even if the name is not familiar. So for those women who have been deriving pleasure from this already, continue to enjoy and don't worry about the name.

Masturbation Does Not Equal Failure

In speaking to people about masturbation, one of my favorite activities topics, I find that many people equate masturbation with failure. They interpret the action of masturbating as a reminder that they do not have a partner, or are not getting satisfied with their partner. Consider, as well, the way that we are taught about masturbation - that it is unnatural, against nature, and a sin - usually by way of religious education. Our public opinion is so averse to masturbation that our government would fire a Surgeon General for not suggesting, but just agreeing with the idea that teaching masturbation to teenagers might reduce the incidence of risky sexual behavior. This, of course, was from President Clinton - who might have done better to engage in a little masturbation, in private, rather than oral sex and outer sex with a woman other than his wife. A little masturbation could have saved taxpayers the $6 or $7 million dollars that were spent investigating him.

By viewing masturbation as a failure, we are refusing to take responsibility of our own sexuality and our own sexual pleasure. The rejection of masturbation as an acceptable activity assumes that we depend on others for sexual satisfaction. By doing this, we imprison ourselves and give away the key. This means that not only does happiness in our sex life rely on having a partner, but also requires that our partner be ready, willing, and able whenever we want. For those of us living in the real world, we know that this is not always the case. In fact, for the majority of women, sexual intercourse alone does not provide enough excitement or stimulation to acheive orgasm. But with lessons learned from masturbating, women can explore with their partner different ways to provide the needed stimulation by teaching their partner to stimulate them, or by stimulating themselves manually during intercourse.

Masturbation can also be a very erotic activity to engage in with your partner. Many couples enjoy watching each other get off, while others like to get their partners off. It can be part of the beginning, middle, or end of an evening of sexual activity. Remember, there is no set format for sex unless you limit yourself to one. The only failure I see here is if a person fails to allow themselves maximal pleasure and variety in their sexual activities.

Some would argue that masturbation is not natural and is an abomination. This is to ignore the fact that masturbation is an activity that we teach ourselves and is found to occur even before birth in the womb. The extreme negative view is more indicative of other people's insecurities and neuroses rather than the reality of the natural process of masturbation. And especially for women, who have the clitoris which serves no other function than to give pleasure, it is clear that we were built for more than just reproduction.

Perhaps the biggest misconception is that we should not engage in masturbation if we do not have a partner, but instead just let our natural sexual desires shrivel away over time. Some view masturbation so negatively that they would rather completely ignore the entirety of their sexuality than to engage in masturbation. Again, here is the reverberation of the idea that in order to be sexual, you must have a partner. In my opinion, this is to sell yourself short. By doing so, you ignore all of the physical and psychological benefits of having regular sexual arousal and satisfaction. Instead of viewing masturbation as failure, I see it as a proactive, healthy affirmation and reinforcement of our sexual self. It supports healthy physiology for our brains as well as our bodies.

How do I masturbate? Let me count the ways....

Hers:

I cross my legs and squeeze my thigh muscles together which tickles my clit. I like the way it feels and I don't necessarily have to come.

I love to straddle the water jet in the pool, resting my arms over the top of the wall and just hold my body close to side until the water over my pussy in just the right spot gives me an orgasm.

When I lay down in my bed, I tuck the sheet under my hips and pull it through my legs until it's tight against my pussy. Then I tug it across my belly, up towards my chest. It puts pressure on my clitoris and makes me come.

A friend of mine told me about a shower massager. I bought a hand-held one and tried different settings until I found one I liked. I just let it spray across my clit and lips. Sometimes when I come, the water goes everywhere.

I can only come if a I use a vibrator. It takes a little while with the vibrator at a pretty high setting and in one spot, but it does the trick.

I use two fingers to rub up and down over my clit while I rub across my nipples with the other hand.

When I was little, I discovered that I could put my hips under the water stream and it tickled just right. So now, I lay myself flat in the tub, putting my legs up against the wall and let the water run over my pussy. I use my hand to pull the little hood up and it gets me right off.

I like to come best with something inside me, so I use a dildo to feel the excitement of having my pussy full while I rub my pussy with my hand.

I use a vibrator and slide it up and down my lips for awhile. Then, when I am really excited, I find the most sensitive area up at the top and focus on that spot. My orgasm spreads like a wave from that spot down my legs and up into my chest.


His:

I like to dig my fingers on the underside of my shaft, rubbing in a circle until I come.

Rubbing against the bed while I lay on my belly is my favorite way - literally, rubbing one off.

I use a sleeve filled up with lube - soft, wet, and with ridges, and I can squeeze as tight as I want.

The most intense feeling for me is just below the head, so I squeeze around with my index finger and thumb. The feeling of this tightness going up over my head and back down again lets me think of pushing in and out of my lover.

I use one hand on my shaft while the other hand cups and tugs my balls at the same time.

I started liking the feeling of having my ass stimulated when a girlfriend of mine starting touching me there. Now I have a small plug that I put in so that when I masturbate I can feel the squeezing of the muscles at the same time I feel the rush of coming.

In the shower with the hot water, I use shampoo to soap up and rub all over my hard-on all the way down to the base and my balls. When I come, I just keep washing myself off.

I used to press my erection up against the washing machine when it was on the spin cycle. My mom never figured out why I didn't mind doing laundry.

Master of Your Domain

Today I got into a very lively conversation on the topic of orgasm and masturbation. A friend of mine stated that she has never, and will never, masturbate. Instead, she wants her sexual satisfaction to come from a partner (in her case, a man). Trouble is, she doesn't have a partner, hasn't had one for some time, and isn't actively looking. So in the meantime, no orgasms for her.

Although she seemed to want to talk about sexual topics was in the pre-contemplation stage of checking out internet dating sites, she quickly dismissed any talk of masturbation. I went through my usual list of the benefits of orgasm: it increases your blood flow to your genitals, it feels good, it promotes relaxation, it feels good, it can be done without dependence on a partner or worries about catching a disease, it feels good, you can't get pregnant, it feels good. Still, she wouldn't hear of it.

Despite her objection to masturbation, I am a true believer and proponent of masturbation. I believe that it is natural and an excellent way to get to know yourself. How else will you know where to ask your partner to give extra-special attention to? Remember, everyone is different. What someone else learned with a different partner may not necessarily apply to you. You may need to give some directions. And if you've never figured out what you like and what gets you off, you could be waiting awhile for your partner to figure it out! Not that I'm against experimenting with a partner, but knowing yourself could cut down on the frustration. Plus, touching yourself helps you feel sexy as you realize that you can have such pleasure and enjoyment from different kinds of touch. And it's empowering to realize that you can do it by yourself!

This conversation with her reminded me that there are still so many myths and anxieties about masturbation, particularly for women. Here are some of the most common myths and the truth about masturbation:

Myth: It's a sin/dirty
Truth: Masturbation is a natural activity that can be found occurring as early as infancy. In fact, the clitoris only has one purpose, to feel good. It does not play any part in reproduction, except maybe increasing your desire to grind against your partner. I refuse to believe that it was meant to be ignored. And since such a large percentage of women can't come without touching this little button, I think it was meant to be touched.

Myth: You'll get hooked and you won't be able to come without it
Truth: Masturbation helps you learn about yourself and what physically turns you on. Some women can only come if they learn how to masturbate. You may find that you always have a preference for a certain angle, or a certain speed, or a certain amount of pressure, but it does not limit you to that activity alone. Once you start having orgasms with masturbation, you will discover the incredible variation and possibilities there are for women in having orgasms. You will learn that orgasms can vary from day to day, with your cycle, with your mood, with the stimulation, etc. And you can also learn that you can have orgasms on the inside, orgasms on the outside, or a combination of both. It's not altogether unpleasant either to give yourself multiple orgasms, you know!

Myth: It takes away from our sexual relationship with our partner.
Truth: For all the reason already listed above, masturbation serves to enhance our sexual relationship with our partner. It not only keeps our genitals healthy, but it encourages us to exercise our sexual fantasies as well - essential for mind-blowing sex. Women have the advantage of being able to have multiple orgasms, and some even find that subsequent orgasms are more intense than the first. And just in case you feel you're not getting enough foreplay, masturbating just before intercourse (perhaps with your partner watching as part of the foreplay!) gets you wet quick like a bunny.

So for all you Seinfeld fans, I propose that we redefine 'Master of Your Domain' as a person who actively masturbates - taking matters into their own hands. No more anxiety or shame! Just good, clean fun.

Give Yourself a Hand

"Masturbate? Who me?" "No, I don't do that anymore." "I don't need to do that now." Or better yet: "I never did that!"

I am here to say that it doesn't matter if you are in a relationship or not, masturbation is not only pleasurable, but it's healthy and it's part of a balanced sex life. First of all, your sexuality belongs to you. So even if you have a partner, you should never give up control of your sexuality. Ultimately, you are responsible for your own pleasure and your own happiness. The sooner you know that, the sooner you can share that happiness with somebody else. When you have a partner, you won't always be on the same page as them, or won't always be in the same mood as them, or you won't always have the same energy as them. But if you are in charge of your own sexuality, masturbation can help bridge those gaps. And masturbation doesn't have to be something you do by yourself. Maybe your partner can watch? Maybe they'll get so turned on watching you, they'll want to join in? Or maybe they can just get pleasure from knowing that you're getting off without any pressure on them. All of you who have been in long term relationships know that it is impossible to always be in sync with our partners all the time.

If you have never spoken to your partner about masturbation, that's the first step. Once you have open communication about different ways to have pleasure, you can bring up the topic of masturbation. Remember, doing it on your own is ok too. The main word here is balance. If it is not used to avoid your partner, or done compulsively, it is a natural part of your sex life that can actually enhance your sex life.

For those individuals without a partner, masturbation might make up the entirety of your sex life. Don't rationalize to yourself that you don't need it or that you don't want it. Both our body and our brain run on the principle of 'use it or lose it.' Masturbation not only gives us pleasure, but it also makes us feel alive. Orgasms release chemicals in our brain that help us feel more relaxed, happier, and more secure. Besides that, masturbation increases blood flow to our genitals which is important in maintaining sexual functioning over time. And every time you have an orgasm, it helps maintain tone in your PC muscles that help women keep continent after menopause or childbirth, and help men have stronger erections and ejaculation. So don't forget to give yourself a hand now and then!

If you keep touching it, it's going to fall off!

I do the work that I do because I believe that people have too much fear and anxiety that prevents them from having more happiness and success in their lives. I specifically chose the area of sex and sexuality after finding that many of my colleagues were uncomfortable talking with their patients about sex or sexual issues. This made little sense to me since, as psychiatrists, we help patients explore the deepest issues of the unconscious mind, and one's sexuality should be no exception.

My goal for patients, and society in general, is that we will be able to talk to each other about sex and sexuality without anxiety and fear. Because it not only affects us in our sex life, but this anxiety and fear is also passed down to our children in how they learn about sex and their own sexuality.

Such was the case with someone who was telling me that he and his wife were not really sure what to do about their 2 year old son. It seems that he was masturbating himself often, many times in public when out with his mom. This gentleman then told me (with a laugh) that they starting telling their son that if he kept touching it, it was going to fall off. It was clear that the reason why they chose to tell this to their son was because they themselves were quite anxious about talking to him regarding anything sexual, which came from their own anxiety with sex. I mentioned carefully that this was not a very healthy way to speak to his son about his behavior and could cause difficulties later with anxiety and shame related to sex. First of all, he is at that age where he still believes that everything his parents tell him is true. Now he has to worry that if he gives himself a little pleasure, he is going to unwillingly mutilate himself. Instead, the suggestion was made that his son be told that it is perfectly normal, but reminded that his behavior should be limited to those times when he is in private in his room, and that it is not appropriate when he is around other people, including Mommy and Daddy.

The real problem here is with the parents' anxiety related to sex and sexual issues. When we are anxious or uncomfortable thinking and talking about sex, we unintentionally communicate this to our children. This is the reason why I encourage couples to start having more open communication with each other about sex - in order to increase their comfort level and decrease their anxiety. That should be a goal for all couples in general, but certainly before starting to have children. Because children (even infants and toddlers) can sense what we are feeling, even when we try to hide it from them. And they can sense when we are anxious about something. They learn to feel this way too, which could translate into them thinking that they are "bad" or "dirty" or should feel shame. None of these things are healthy when it comes to talking to them about their bodies or their age-appropriate sexual behavior. What they do need is some truthful, calm limit setting and answers (appropriate to their age) to any questions they may have.

One lengthy, but very informative post on this topic can be found at: http://randombabble.com/2009/09/02/talking-to-kids-about-sex/ . It speaks to the importance of giving clear and truthful information to your children (at any age) which is best achieved when we are comfortable with our own sexuality and the topic of sex in general. Decreasing our anxiety and fear will allow us to increase our knowledge, our comfort level, and eventually our happiness and satisfaction based on the decisions we will make.

Thanksgiving Thoughts

I want to share my gratitude exercise for the day with you:

I am grateful that my mother required me to pick some sort of physical sport that required practice at least 3 times a week from elementary school until the end of high school. I am also grateful that she would not let me take French in high school, but instead made me take Spanish for Spanish speakers as well as typing. Boy, that turned out to be huge!

I am grateful that I finally started learning how to breathe. That certainly has improved my running, my swimming, but also my orgasms. It's amazing how that works.

And I am grateful that I learned to give myself pleasure early in life - 11 or 12 years old. I found that I could give myself orgasms in several different ways. And best of all, I could give myself multiple orgasms. All this happened long before I ever had a boyfriend. Not only was I able to discover what my body enjoyed and responded to, but I was able to learn without a doubt that I alone was responsible for my sexual pleasure. I am grateful I learned that no one is in control of my sexual pleasure but me and that makes all the difference for my happiness in my sex life now.

And finally, I am grateful that I became a sex therapist - not only because I love to teach and help increase other people's health and happiness, but because I see that your sex life is continuously evolving and being reinvented. I still masturbate pretty regularly today and every once in awhile, I discover something new that I can bring to my relationship with my partner or just enjoy by myself. For all these things and more, I am grateful.

What is sex anyway?

I like to say that we are living in The Golden Age of Rationalization. It seems that there isn't anything that we can't deny or fool ourselves about. And sex is no exception. After all former President Bill Clinton did it on national television! "I did not have sex with that woman."

Let's get something straight here. You don't want to think that you're 'not really having sex', or you want to pretend to yourself that you haven't 'really' cheated on your partner, but the truth is - there is a lot more to sex that just a penis in a vagina. (Just ask anyone having homosexual sex!) Sex starts with fantasies and desire. As soon as you start to share those fantasies and desires with another person, you are inviting them to engage in sex. Sex involves a multitude of activities that jump-starts a person's desire and arousal. And there are so many ways to reach orgasm - oral sex, masturbation, stimulation of the breasts, telephone conversations to name a few. You can even come in your sleep!

I consider that all sexual activity falls under the category of sex because I think that it's part of the erotic and intimate relationship that one shares with their partner. To have a long, healthy sex life that is satisfying through the years, a person needs to have some variation to keep it interesting and fresh, as well as some flexibility to allow for adjustment to life changes. If our sexual repertoire is very limited, it increases the chance that we will become bored or frustrated. Psychologically, the more activities we consider to fall under the realm of sex, the more we can happily share with our partners in a sexual way to enhance that sexual relationship. After a woman gives birth for example, it may be several weeks before she may be ready to have any penetration. But she can receive enjoyment from giving her husband oral sex or a hand job, or she can get stimulated on other areas of her body. Similarly, if a man has prostate surgery, he may have transient or permanent erectile difficulties, but can still find ways of giving his partner sexual satisfaction with manual or oral stimulation, or even in combination with sex toys such as a dildo or a vibrator.

But if we have a very rigid idea about what sex is, we limit ourselves and create for ourselves dissatisfaction and frustration. We would then create the reality that we could not be happy unless we had penile-vaginal intercourse just so. For your health and happiness, leave that definition to the religious texts and reproductive biologists. Instead, consider that you can have happiness and sexual pleasure with a multitude of variations of activities. Just remember, if the world ran out of pumpkins, we could still have pecan pie on Thanksgiving. (I just love nuts!)

I've got you under my skin.

Touch is such an importance aspect of how we relate to the world and how we relate to each other. As infants, it is the first way that we experience our world and learn to make decisions about what is good and what is not good for us. And as adults, it is one of the most prominent ways that we have in communicating with our partners (if we take advantage of it). The mechanism of touch is known to be an important way of feeling calm, secure, and comfortable - a way of telling our brain that everything is ok. This happens by way of C-tactile fibers found over the surface of the arms, legs, back, and forehead. These respond to a slow, light caress - a typical soothing type of behavior. More research is being done specifically in this area to elucidate the importance of these fibers.

The types of nerve endings in our skin that we associate most with sex, however, are the classic ones of light touch, vibration, pressure, temperature, and pain. Because of the many different types of sensations we can experience, our skin can be considered our own personal playground. We have so many options in how to touch our partners to give them pleasure - from our hands, lips, tongues - or maybe from feathers, silk, wax, metal, leather, glass, you name it! This holds true for most of our skin that covers the outside of our bodies. It's a little different on the inside (i.e. vagina or anus). For those areas, we can normally only sense pressure and/or pain, which is interesting since a lot of emphasis is placed on the 'penetration' part of sex, even for women. But it is really the rest of the body that gives us more sensation. This is why masturbation (mutual or single) and oral sex can be so mindblowing!

So the question is, how much do we touch our partners to find out what ways excite them and what gives them pleasure? And of course, do we increase our intimacy by allowing ourselves to be touched? Do we follow a particular basic routine within our sex life, or do we occasionally take an excursion outside the realm of the familiar to experiment with new sensations and scenarios? You may find that ways you thought would be exciting for your partner to be touched are more irritating, and what you thought was unbearable is actually the cat's meow.

Now generally men are more focused on their genitals than the rest of their bodies in comparison to women, but that doesn't mean that their skin is not worth exploring. And gentlemen, did you know that many women can have orgasms from having other parts of their bodies stimulated (backs of knees, back of the neck, behind ears, scalp, between the shoulder blades, or thighs, to name a few). So get out there and experiment! Find a new use for an old pair of gloves or an old tie. Let your skin be your playground.