I routinely talk to my patients about sex, libido, and orgasms. I believe that orgasms are good for your health. They flood your body with positive chemicals, reduce anxiety, and help with a myriad of other symptoms.  Like any other issue – if this is overdone, becomes an addiction, or is used in an abusive way that is hurtful to another – then, of course, that is bad and is not what I am talking about.

Normally, when people are young, they have a healthy libido and desire for sex. Often, when people age, they can lose the desire or even the ability to have sex, sometimes from side-effects of medications that they are taking. Often this can be mitigated by changing medications, lowering doses, or even getting off the offending drug.  In order to enjoy sex, there must be proper blood flow and neurologic function, lack of mental hang-ups, and hormones.

Hormones activate the biggest sex organ in our body – the brain. If hormones are low due to aging or brain trauma, then that part of the brain can effectively be “asleep”.  Having proper hormone balance can reawaken that part of the brain and bring back desire in both men and women. I only recommend the use of bioidentical hormones which are biochemically exactly the same as our natural human hormones, and only from someone who is an expert in balancing them properly. Testosterone and DHEA are two of the most important libido hormones in men and women, but all hormones are helpful and important.

From an evolutionary perspective, our job is to procreate to keep the species going, which typically involves orgasm.  An interesting idea is that our DNA may somehow know if we are sexually functional, and as long as we are, we are considered worthy of keeping around. If we stop having orgasms, our DNA could assume that we are ready to take out of the equation. Of course, orgasms won’t end mortality, but they might delay it – and certainly make being here more fun!

Proper sex education – even for married adults – can help couples realize that women do not typically orgasm just from vaginal penetration alone – there usually needs to be some clitoral stimulation.  Different sexual positions and adequate foreplay can help with this. Having regular sex is important in an adult relationship for bonding.

I usually recommend that people try to have a minimum of at least 3-4 orgasms per week – by any method. More or less is fine if that is what is comfortable for you, as long as it is happening. I have had several patients say that they don’t have an available or willing partner, so they can’t have orgasms. Not true. Especially some women seem to have a problem with the concept of a self-induced orgasm – probably from some programming against masturbation from childhood.  I counsel women that it is difficult to have satisfying sex with someone else if you don’t even know what you like or need in order to have an orgasm. Figuring that out yourself can help you have a better sexual experience with a partner.

I often encourage people to use sexual fantasy to help them get in the mood and even recommend reading certain books on this topic to help people figure out what they like. Visual stimulation can help in some cases. Nipple stimulation and lots of skin contact can enhance arousal. There are many “toys” that can help with orgasm. There are topical creams that can enhance clitoral sensitivity in women, medications and other options for erectile dysfunction in men, and many other things that can help make sex more enjoyable for both genders. If extra lubrication is needed, I recommend natural organic coconut oil instead of chemically-based gels or lotions.  Counseling can help those with hang-ups from religious training or a history of sexual trauma. I personally do not believe that any higher power would want to prevent us from enjoying one of life’s perfect gifts – again, in a responsible and healthy way. 

Overall, enjoying sex and orgasm is an important part of being an adult. I would encourage anyone who is having a problem with this issue to seek a doctor who can help you achieve this goal.

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