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Authors: Debby Herbenick

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There is reason to be hopeful, though: just because one position doesn't feel like it used to doesn't mean that another one might not feel better than before. I hear this so often from new mothers that I believe it's worth sharing with you to encourage you in your exploration.

41. What to do if . . . you've been told that you need a hysterectomy and wonder how this will change your orgasms

Fortunately, having a hysterectomy doesn't mean doom for your orgasms. Some research has found that one of the best predictors of a woman's sex life after a hysterectomy is the sex life she had before she had the hysterectomy. In other words, if your sex life wasn't all that satisfying beforehand, a hysterectomy is unlikely to make it better (though of course other health issues may be much improved post-hysterectomy). And if you
generally had a good sex life beforehand, chances are that once you recover from the procedure you should be ready to resume your sex life as before.

In a 2004 study published in the
Journal of Obstetrics and Gynecology
, researchers from Northwestern University's Feinberg School of Medicine tracked women before and after hysterectomy.
12
They found that most women didn't expect their sexual desire or orgasm to change and they were right: neither changed. What did change, however, was that they (fortunately) were less likely to experience painful sex after their hysterectomy.

This isn't to say that nothing ever changes with a hysterectomy. Sex (and your orgasms) may feel slightly different after the operation. Some women who are very tuned in to feeling their uterus contract in relation to orgasm notice the absence of those contractions after their uterus is removed. This happened to a friend of mine, who said that her orgasms initially felt less intense after her hysterectomy but, with time, she no longer noticed the absence of those contractions. She developed a “new normal” for herself. And besides, the uterus is only one part. There are still plenty of other contractions that can be felt as part of orgasm.

Some women, in addition to having part or all of the uterus removed during the hysterectomy, also have one or both ovaries removed at the same time (a procedure called an “oophorectomy”). If you are having a hysterectomy, ask your health care provider if he or she is also planning to remove your ovaries and, if so, (a) if it is necessary to do so and (b) if it is, then what their plan is for managing your hormones after removal. If a woman has not yet reached menopause, removing both ovaries is often called “surgical menopause” because it effectively puts a woman into menopause, with potentially uncomfortable side effects including hot flashes, vaginal dryness, and painful sex. Not all women experience these side effects, but it is important for you and your health care provider to communicate about these issues so that you can get the health care you need.

42. What to do if . . . you lose arousal just before orgasm and are sure it's “gone”

Wait it out! All too often, women are convinced that their sexual arousal is gone in the instant they think of something distracting (such as
work that needs to get done, laundry that needs to be folded, or a lunch box that needs to be packed) or upsetting, such as a fight they had with their partner. A good bit of news is that our bodies are slow to catch up to the ways our minds race. Just because you think your sexual arousal is gone doesn't mean that it is. It takes as long as ten minutes for a woman's aroused body to become physically “unaroused” (for blood flow to move away from the genitals, etc.). So if you think it's gone, think again. And if you want it back, try to refocus your mind back to the sexy situation you're in. Try to use mindfulness techniques to focus on how the vibrator feels on your clitoris or how it tastes to kiss your partner. With an inhale, focus on how your partner's hair smells and with an out breath, focus on how it feels to touch his or her skin. Soon enough, you're likely to feel just as aroused as your body still is.

43. What to do if . . . he comes too quickly for you to orgasm

When two women have sex, sex doesn't necessarily end the second the first one of them has an orgasm. Put a man and a woman in bed, though, and things get tricky. Some couples are convinced that sex is over as soon as a man ejaculates. There is some truth to this, of course, if one is speaking strictly about penile-vaginal intercourse—but since when is penile-vaginal sex everything sex has to offer? If you're happy being pleasured another way, then turn to oral sex, sex toy play, or something else you find enjoyable or even orgasmic. If you prefer to have your orgasm during vaginal intercourse, you have a few options:

•
See if you're able to work together to prolong his orgasm and help him last longer.
Desensitizing condoms or even plain old thicker condoms may help him to last longer (see
chapter 5
for additional tips on helping him last longer).

•
Spend more time in foreplay before letting him inside you.
Some women find that they orgasm more quickly when they are highly aroused. If this sounds like you, do something extra arousing before proceeding with intercourse, whether that's oral sex, dirty talk, tying
your partner up, getting a good spanking, or having your breasts played with. Try to choose something that's highly arousing to you but perhaps only moderately arousing to him—after all, you want him to have fun but you don't want it to push him over the orgasmic edge too soon.

•
Don't let it stop you.
After men ejaculate, their penis loses some of its rigidity. However, many men still have enough “fullness” or hardness to pleasure their partner. Unfortunately, men sometimes feel like they need to pull out as soon as they ejaculate. Not so! (Unless, of course, you're using withdrawal as birth control, in which case he should have pulled out several moments before ejaculating: never, ever use withdrawal as a birth control method with a man who finds it difficult to control when and where he ejaculates.) If he keeps his somewhat-hard penis inside your vagina, you may still be able to have an orgasm. Don't give up!

Finally, try not to let the mismatched timing of your orgasms get in the way of pleasurable sex. Orgasm really isn't everything, and it would behoove you to help your partner feel good about his sexual performance rather than guilty or ashamed of it. All too often I hear from women who accuse men who come quickly of being “selfish” or “only in it for themselves” or who grow visibly upset or angry when he ejaculates. To the extent that you can stay calm and find another way to ask him to pleasure you, or to pleasure yourself, it may make your sex life together better and feel more rewarding.

44. What to do if . . . you're on the verge of orgasm but can't seem to get over the hump

Know that you're not alone. Millions of women try to have orgasms and find it very difficult to do so. It's generally thought that nearly every woman is physically capable of having orgasms. Some women seem to have an easier or more difficult time than others. It's not your fault if you find it difficult.

The process of learning to experience orgasm can take time, exploration, and a great deal of patience. One friend was certain she would never have an orgasm. It took her more than a decade of trying but one day she learned to. When she told me about the time it finally happened, she had tears in her eyes because she was so happy and had tried for so long. Although having an orgasm isn't important to everybody, it mattered to her a great deal and she had all but given up on the possibility.

Other women have an easier time learning to experience orgasm, alone or with a partner. Trying to experience orgasm alone during masturbation involves less pressure because no one is there asking “have you come yet?” Also, there's no internal pressure to have an orgasm and make your partner feel like they're great in bed. For these and other reasons (such as not being hesitant to display your “O” face during masturbation), exploring your sexual response in private is often a more effective way to learn to have an orgasm than trying with your partner.

Everyone is different, though, and some women feel very supported and encouraged by having their partner help them along the way. Some make it quite a fun affair and may use fantasy, new sex positions, porn, role-playing, relaxation, massage, or vibrators to enhance a woman's sexual arousal and chances of having an orgasm. If you have never had an orgasm and want to, try to focus on making your private and partnered sexual experiences pleasurable and relaxing. If you keep exploring things that you find pleasurable and arousing, you may ultimately hit upon something that helps you experience orgasm. Try to open your mind to the possibility that you may be most aroused, or most easily orgasmic, by ideas or fantasies that are different than you perhaps imagined. Some women and men are most aroused when fantasizing about group sex, sex with a stranger, or being very dominant or submissive. It's also the case that watching porn is sometimes highly exciting to women in ways that surprise them. And some women who consider themselves heterosexual and only have sex with men (and only want to have sex with men) find that fantasizing about being sexual with women is what sends them over the edge. Similarly, some women who identify as lesbian and only have sex with women are sometimes unexpectedly aroused by imagining having sex with a man (or multiple men).
The mind is a curious place and certainly nothing we've figured out. Why does one fantasy arouse someone to the point of orgasm yet disgust another person? We don't know. And why do many of us have sexual fantasies about things we would never want to do in real life? Again, there are many theories, but we simply don't know.

Finally, you might find it helpful to read
Becoming Orgasmic
by Julia Heiman, PhD, and Joseph LoPiccolo, PhD—a very good book that is entirely devoted to helping women learn to experience orgasm—or to meet with a sex therapist.

45. What to do if . . . you crave a multiple orgasm

Not long ago, one of my college students stayed after class to ask how to have multiple orgasms during intercourse with her boyfriend. She had previously had orgasms occasionally during intercourse but she couldn't reliably have them. She had experienced multiple orgasms only one time before, if I remember correctly, and she wanted to know what she could do to make them happen. I told her what I tell everyone else who asks this question—the advice worked for her—and what I'll now share with you.

Though a very small number of women have orgasms extremely easily and without trying to at all, most of us have to put in at least a little (or a lot of) effort to experience orgasm—if indeed we want to, and of course, orgasm isn't important to everyone. For most women who are into orgasm, though, we
try
to have orgasms; they don't just drop out of the sky. In my professional and personal experience, then, multiple orgasms seem to be helped by

• Being open to the possibility of them

• Going forward even when you think your arousal is done and gone, and

• Taking charge of your sensations

There is a lack of scientific research on the topic, but this has been true for me so I am basing this approach on my own experience—something that, as a scientist, I realize has its limitations. Your experience may be different.

In my case, after I learned to experience orgasm during intercourse, I felt very happy and satisfied with my experiences, just as I had before I learned to do so. I had heard from plenty of women who found it difficult to have orgasms and thus knew that I was fortunate that I had not only learned to orgasm during intercourse but that I had practiced it enough that I could do it reliably. For the longest time, though, I didn't try to have multiple orgasms. I was truly content with one, just as I had previously been content with none.

In my experience, multiple orgasms had often been talked about loudly and openly by women who almost seemed to be bragging about it, as if having an orgasm was a competition. Or else I heard about it from men who also seemed to be boasting about the tons and tons of orgasms they were giving women all over the world. I don't know if it's just me or if others feel this way, but all that bragging left a bad taste in my mouth, and I guess I didn't want to be one of “those women.” I had experienced multiple orgasms during masturbation and never really saw the need to do so during intercourse. Wasn't one orgasm enough? It was for me.

Then I met an interesting person who changed my thinking. I had been asked to give a sex talk to a small group of women who were friends with each other. They had flown to be together for a girls' weekend and hired me to travel to the city, drink wine with them, and talk with them about sex. In a beautiful suite at a luxury hotel, I sat with these women, who ranged in age from their early forties to their early fifties. While we were talking about orgasm, they started asking each other about it. One of the friends turned to another—a sophisticated and conservative-looking woman in her early fifties—and asked her point-blank if she had multiple orgasms. Blushing, she said (almost reluctantly) that she did. Her friends grew excited in the way that groups of girlfriends do, and they asked her for more details. After all, as it turned out, none of the rest of them had had this experience. The woman shared a few details: She and her husband, being empty nesters, had more time for sex than they had earlier in life. Sometimes, she said, they would pour glasses of wine, retreat into the bedroom, and make love. She would have an orgasm or two and then they would stop and talk, drink some more wine, and continue with their lovemaking, with more orgasms
to come here and there.

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