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One of the most worrying male sexual problems is impotence - or erection problems. It is a truly distressful experience for both partners and affects the general relationship of the couple. The decreased self-esteem of both parties often leads to communication problems and even, on occasion, the break up of the relationship.

- Physical versus psychological causes -

Today’s estimates indicate that in the USA alone approximately 10-20 million men suffer from various degrees of impotence at some point in their life.
In spite of the widespread believe that erectile problems are mainly caused by psychological factors, since the 1980’s it is revealed that perhaps about 80% of the erectile dysfunctions start with a physical factor. These could be surgical trauma, accident, diabetes, circulation problems, neurological problems, drug or alcohol abuse or as a side effect to medication.
However it is important to consider the interaction between the psychological and physical causes as a maintaining factor of this problem.

- Performance anxiety- the vicious circle -

One should also make a clear differentiation between erection problems which are persistent, and those which are present in some situations but not in others.
In sex therapy it is described as situational erectile dysfunction - and is referred to it in an enormously rarefied tome- the DMS IIIR (Diagnostic Manual of the American Psychiatric Association) - as a “…persistent or recurrent partial or complete failure in males to maintain erection until the completion of sexual activity”.
If a man fails to perform for any reason which, in certain circumstances, is quite common, he may well start worrying. Later on, the specific cause of his failure may be sorted out, but the anxiety remains, setting a vicious circle in motion: he worries because he cannot perform, and he cannot perform because he worries.
This kind of anxiety can interfere with the man’s excitement level and as a consequence he will lose his erection.
The more often he worries about his erections the more likely he is to lose them.
Most negative emotions like anger, resentment towards the partner, guilt and negative past emotional experiences can interfere with the excitement level. It is because it is not just a biological dynamo that powers sexual activity (like hormone level etc.) but also the processing of information in the brain.
Both biological and emotional factors can negatively and positively influence sexual arousal. A useful analogy in this instance would be that of a circuit, the point of which could equate to the brain (fantasy, sexual thoughts), perception (sight, hearing, smelling etc.) touch and emotions towards the sexual partner.
If a certain stimuli is negative at any given point on this circuit (e.g. painful stimulation, undesirable appearance of the partner) then the person would lose his or her sexual excitement; rather like turning the light on and off. If a man feels anxious or guilty during sexual activity, then it matters little how willing and pretty his partner is. Click, out goes the light.

- Feelings towards each other -

The most common secondary problem that arises is how the partners cope with this problem. Most people desire to please their partners, and it is fine until this desire gets out of hand. The person could become a victim of his own feelings; that of wishing to please the partner at any cost, and the expense of his or her own needs.The result could be lack of confidence in self.
If the partner is unsatisfied she may well react with anger, and in turn both feel unloved and rejected. These are obviously not ideal conditions for love making.
From the above explanation it is obvious that relationship issues play a complex part in performance anxiety. Erectile problems, as in most sexual problems, cannot be treated independently. They have to be managed in the context of a relationship. That is the reason why relaxation and experimentation with tranquilizers alone are often times in vain though in some instances they can help.
Most of the time it is advisable to seek professional help to unravel the underlying psychological issues of the problem.

- The possible cure -

When the relationship problems are resolved and communication is reestablished between the partners, then the sexual problem can be targeted.
The most common technique used is called sensate focus: this involves teaching the couple to focus on their own feelings and sensations, and to participate together on homework assignments.
The idea behind this is to allow people to become relaxed with each other both physically and mentally, thereby allowing them to recognize their own feelings. In order to reduce stress and performance anxiety, the couple is advised to refrain from intercourse for an initial period of a few weeks. The couple is told to caress each other, but not in a sexual context. This hopefully reestablishes sensuality and intimacy in the relationship; both partners do not worry about penetrative sex, as they are not allowed to have it. There are different stages in this therapeutical process and the couple goes through them gradually. Most of the time guidance from a qualified therapist is essential, giving important feedback to the couple as they progress.

Ed Note: This is a condition most often associated with women.

Why do some women have difficulty in achieving orgasm? There are a number of reasons why a woman may not be able to achieve orgasm, some physical others psychological.

Possible physical issues:
inadequate stimulation
medication treating another illness
injury or accident which affects genital receptiveness
conditions which interrupt nerve supply to the genitals

Possible psychological issues:
stress or anxiety
relationship problems
depression
cultural or religious guilt associated with sex
Know yourself

Being comfortable with your body is the first step to becoming orgasmic. Explore your beautiful body by yourself and be secure in all your minor flaws. We all have them, why should you be any different?

A wonderful first step is to take an evening to yourself and explore your body. Draw yourself a nice warm bath and then let any tension fade away. Next head into your bedroom and lock the door. Take a personal mirror and explore your genitals. Unlike men, women’s genitals are hidden from their eyes. So take a moment to see what your partner sees. Explore your beauty. Once you’re more comfortable an orgasm will be much easier to achieve.

If you’ve never masturbated before, then this is a good time to start. Allow yourself to totally relax and get wrapped up in the moment. Concentrate on the sensations that feel extremely pleasurable. Remember the techniques you used and teach them to your partner.

Make sure that you are in the mood
You should feel relaxed and comfortable so that you can fully appreciate sexual intimacy with yourself or your partner. In ideal circumstances you should be relaxed and stress free. For many women, the late evening is the worst time to engage in sexual activity. If you’re tired and wound up from a hectic day, wait for a relaxed Sunday afternoon when the kids are out of the house.
Additionally, if you’re angry at your partner, it may not be the best time to engage in sexual intimacy.

Communicate with your partner
Tell him/her what you find sexually stimulating. Many women can not achieve orgasm from intercourse. This is not a sexual dysfunction, it just means that your partner has to explore what you find most pleasurable. If you’re not sure, then you should do some exploring together. Make sure you give feedback and don’t be afraid to something “isn’t that great.”. If the stimulation provided by your partner isn’t strong enough, you may want to explore the use of a vibrator. Honest communication will help you achieve orgasm and make your partner a better lover.

Be adventurous
Oral sex or manual stimulation of the clitoris may be too infrequent for some women to achieve orgasm so an alternative method of stimulation is advised. Explore the entire genital region and find your most erogenous areas. Concentrate on what turns you on the most.

Be positive
Some women go through a stage of arousal where they are not becoming further excited. Many feel that this is where their arousal will end and that they will not be able to achieve an orgasm. Once a woman believes that she is not going to be able to have an orgasm, that is often exactly what happens.

Touch yourself
It is okay for you to touch yourself during sexual intimacy with a partner. Self stimulation is encouraged, and often accentuates the feeling of intercourse.

Joe and I have both shared the different techniques of oral pleasure. Once you have these down to a science, I don’t believe anyone would object in a lesson on how to make your orgasms longer and more intense.
You are literally sitting on the four basic muscle groups; inner thigh, butt, pubococcygeus, better known as PC, and abdominal. An orgasm is basically defined as a strong muscular contraction in the genital region including the PC muscles. So the stronger your PCs and the muscles that connect with them are, the more likely you are to have an orgasm and the more intense it’s likely to be.

AB-ciser:
Underneath your lower abdominal lies a newly discovered spot, “inner clitoris”. The more stimulation the inner clitoris receives, the higher your arousal and the more intense your orgasms. Strong AB muscles can help push this hot spot against his penis as he moves in and out.
Sit in a seat, straight up and pull your belly button in for a second, then release. repeat for as many repetitions as you can, breathing properly. You don’t want to hold your breath.

Thighmaster:
When you press your legs together as much as possible and flex your inner thigh muscles, you create friction on the outer part of the clitoris and the inner folds of the vulva
Sit down and squeeze your knees together, pushing them against each other for about 10 seconds. Do this 10 times, three times a day.

Butt Crunch:
Flexing these muscles can cause your whole pelvic area to become engorged with blood. The reason this is beneficial is the more blood flow, the more pressure is created surrounding and within the muscular tissue. And the more pressure builds up, the more incredible it will feel when it’s released with your orgasm.
Lie on the floor with your knees bent, feet flat on the floor. Lift your pelvis as high as you can while squeezing your knees together, then release. Do 20 squeezes and releases, holding for a count of five. Work your way up to four sets of 20 squeezes.

The PC Wonder:
Studies have shown that women with stronger PCs are more orgasmic, more frequently. Because the greater the muscle mass the more blood it can hold. And as stated before the more intense the sensation when that blood is released during orgasm.
First you need to find the muscle. Insert your index finger into your vagina about one inch, then try to squeeze it. When you feel the pressure on your finger you have found it, but make sure your abs and butt aren’t clenched too. Another way to know if you are exercising the right muscle, next time you go to the bathroom, stop your urine stream. This is the muscle that you want to exercise. Now squeeze the muscles alone, holding to a count of 10. Do 20, 10-second hold. These are called Kegels. Try doing this five times each day. Give these exercises a try and WOW your boyfriend or husband the next time you make love with a grip he won’t soon forget.

Guys don’t think that Kegel exercises are just for women. Men also have a PC muscle that causes the same intensity as a woman when exercised and also knowing just when to use it.

And for you guys that are still snickering about Kegels, you’d better practice because Joe is planning to show you how to obtain multiple orgasms with you newfound strength.