Sexual Healing by Dr. Margarita Kressin

When I was doing my fellowship in Los Angeles, a patient came in (let’s call her Anna) who has never had an orgasm in her life. She certainly was quite distressed about it the older she got, and the more she and her girlfriends talked about it. She felt she was missing something. She was married with two kids, a loving and supportive husband, and quite successful professionally.

Anna had some abuse issues in the past and made some relationship mistakes. She had her meeting with our psychologist who found out other psycho-social issues that could be contributing to her problems. She was told to continue counseling with the psychologist.

She then saw my mentor and me. She exercised, ate healthily, and was a picture of health. She underwent nerve testing as well as blood flow testing, and we found her sensation was somewhat deficient.

She then saw our physical therapist to deal with her pelvic muscle to see if this was contributing. They were normal.

We then sat down and gave her the news. Some psychological issues needed to be worked on and, unfortunately, there was nothing to attribute to her decreased sensation. There wasn’t a magic pill we could give her to make the orgasms happen.

After explaining to her that up to 25 percent of patients do not orgasm*, one, she was surprised; and two, she was willing to do anything to not be in that 25 percent.

She was surprised since everywhere she looked — TV, magazines, movies — everyone seems to be having orgasms … and in concert with the guy! If everyone is doing it, why can’t she?

Our clinic in Los Angeles was a self-pay clinic**. Her bill was $2,600. How much are you willing to pay to find your orgasm?

* Paik A & Laumann EO (Chapter 2.1) Prevalence of women’s sexual problems in the USA. Goldstein I, Meston CM, Davis SR & Traish AM Eds. Women’s Sexual Function and Dysfunction. Abingdon: Taylor and Francis, 2006;23-33.

** Many clinics in California are turning into cash pay because of the HMO environment.

My name is Margarita Kressin and I am a practicing urologist at Froedtert & the Medical College of Wisconsin. My areas of expertise are male and female sexual dysfunction and male infertility. I also see women with incontinence and other urinary issues since these affect women’s sexuality immensely. My work involves helping men and women regain, reclaim, and rejuvenate their sexual lives. I also work with spinal cord injured men so that they have the ability to have children.

When asked why sexuality and fertility? I (and some of my colleagues in my department) often feel they are mostly overlooked when dealing with other medical issues. Not to downplay the medical issues such as cancer, heart disease, spinal cord injury, etc …; and I do think that when the patient first hears these words that perhaps fertility and sexuality are the furthest things in their minds. But I also think this is when physicians need to step up and let patients know their options. Many patients will survive these medical conditions, and sexuality and fertility may become an issue in their future.

Sex especially is not something most physicians are comfortable discussing with their patients. I often say to both physicians and patients, this should NOT be a two minute conversation. Physicians as it is do not get adequate sexual education. So how else can they educate and discuss this with their patient?

And so here I am. My colleagues and I hope to educate patients, their partners and physicians about these issues. Please let me know if there are topics that you wish I would cover by clicking on the Feedback link below. If you wish to remain anonymous, please leave your name blank (it is optional) and it will not be printed as part of the feedback.

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The following is feedback received for this blog:

Could you please talk about Premature Ejaculation in men and some of the ways in which it is addressed. Thanks In the second year of our three and 1/2 years of marriage, we discovered my sperm count was low and also the reduced motility. We had a few of my wife's eggs and sample of my sperm studied and none of the eggs were impregnated. I am 39, almost 40, and my wife is 36 and has always dreamed of mothering our own children. What does acupuncture accomplish, Omega-3, which foods are helpful, we exercise reasonable, ride our bikes ... Is there still time after Jun08 to slow down, meditate, and are we still young enough to continue with this expensive approach to conceiving a healthy child? Thank you! I had a penile implant done 16 years ago prior to the new medications. The implant lasted 13 years and now no longer works. Pills dont really work for me now. Are there any options?

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