It was a chilly, gray January day when my new clients Amy and Noah came for their first appointment. I brewed us all some tea and lit a candle, and we got comfortable in my office.
“What brings you in today?” I asked.
“I’m going to get right to it,” Noah started. “We’re here because Amy has never had an orgasm.”
“It’s true,” she said. “I haven’t.”
I asked them some questions about their relationship. They’d married young, right out of college and had two children shortly thereafter. They said they didn’t have any relationship conflict or major stressors. Then I asked them what made them seek counseling now.
“Well,” Noah said, “I hope we have a long, happy life together. Her pleasure and fulfillment is a part of that. It’s not that she doesn’t enjoy our sex.” He glanced at her. She nodded in agreement. “I just think she could enjoy it significantly more if she were able to have orgasms.”
“It’s hard for me to know for sure since I’ve never had one, but if it’s anything like I see in the movies, he’s probably right. It looks amazing, but I’m just not sure how to get there.”
I asked them specific questions about their sex life and assessed what they’d tried so far. What I learned didn’t come as much of a surprise. They usually spent some time kissing and caressing, then started intercourse, which typically lasted for about five minutes before Noah climaxed. They both expected that Amy should be able to reach orgasm at some point during intercourse, ideally at the same time as Noah.
“Well,” I began. “The good news is that I love what I’m hearing in terms of your motivation for therapy. You clearly care about each other and want each other to be happy and sexually fulfilled. The bad news is your expectations about how Amy should reach orgasm are off.”
I explained that, while some women climax during penetration, the majority need external stimulation of the clitoris in order to get there. Furthermore, most need more than five minutes.
Then I turned to Amy and asked if it was OK if I asked her some questions about self-pleasure.
“Sure,” she said. “There’s not much to say.”
“What do you mean?” I asked.
She cupped her hands around her tea and took a sip. “If you’re referring to masturbating, I don’t do it. It’s not something I ever felt compelled to do, and now that I’m married, I feel like I shouldn’t have to.”
“Let me ask you this question,” I started. “Let’s take the idea of sexuality out of the equation for a minute. What else do you routinely do that brings you pleasure? Do you take baths, do you go for hikes?”
“I do enjoy baths,” she said. “Noah spoiled me with a great soaking tub. I also love to bake and garden. All these things bring me a lot of pleasure.”
To find out how to rest of this encounter went, you can read the rest of the article at HealthyWomen.org.