"For many couples, the intimacy, exploration, sensuality and connection of sex can be lost when it becomes goal-oriented, focusing on orgasm as the ultimate experience," they write. Nonetheless, there is no need to "grin and bear" sex without orgasm if you can do something about it. Possible solutions include:
- Counseling: The Bermans prescribe counseling for victims of sexual abuse. The treatment process is long and arduous, but it can help an abused woman reclaim her sexuality. "The first step is acknowledging what happened, the second is acknowledging that it wasn't your fault and the third is purging the shame," they write. All three steps are crucial to recovery.
- Changing meds: You may need to switch or even eliminate prescription drugs that have a negative impact on sexual function. Of course, you must work with your doctor before making any changes to your medication regimen. Depending on a woman's history, the Bermans generally advise taking antidepressants known to have less sexual side effects, including the medications marketed as Celexa, Wellbutrin, BuSpar, Serzone or Effexor. Sometimes, you can also change the way you take the drug to reduce side effects. For instance, there is now a version of Prozac that can be taken weekly instead of daily.
- Communication: To have satisfying sex, you and your partner have to become experts in arousing each other, which requires honest communication. "Every woman is different," say the Bermans, and as such, it is every woman's "responsibility to tell a partner what she likes." If you feel uncomfortable talking about you want, the Bermans suggest introducing erotic books or videos to start the conversation. Stay on a positive track with statements like: "I would really love it if you would do more ________."
- Kegel exercises: Toning your pelvic muscles with Kegel exercises can help you achieve more intense orgasms. To strengthen these muscles, start and stop your stream of urine several times. The Bermans recommend working up to five sets of 10 contractions a day. The longer you hold the contractions, the stronger your muscles will become. Think of all the fun you can have at boring meetings and standing in line at the grocery store!
- Hormones: In their book, the Bermans describe a 38-year-old patient whose ability to reach orgasm improved after she began taking methyltestosterone, a synthetic form of testosterone sold by drug companies. The patient did not have any medical problems, but she did have very low levels of testosterone available for use by her body.
How do the Bermans comfort a woman who has never been able to have an orgasm? Because "there is no orgasm pill at this time," says Jennifer Berman, you have to be "sensitive and supportive and explain the limitations of what is available now. We also explain our working knowledge of anatomy and attempt to provide alternatives toward sexual fulfillment."