I can’t seem to enjoy sex

Dear Dr Mitchell,

I am 19 years old and I have problems during sexual intercourse. I can’t seem to enjoy sex, I feel no pleasure in doing it at all. I lost my virginity one year ago and I had sex four times after that. My boyfriend was very gentle. What’s wrong with me? Am I abnormal? Or do I need to visit a gynaecologist?

The problem that you are experiencing with sexual activity is a very common one that is seen in many relationships. Lack of interest and satisfaction in sexual activity may be due to several factors. It may be due to lack of arousal or failure to achieve an orgasm. Orgasm failure is a common complaint in many women with only 50 per cent of women experiencing the intense pleasure at the peak of sexual arousal, every time sexual intercourse is attempted. The other 50 per cent of women need more stimulation other than just penile penetration. Arousal is usually achieved following psychological and physical stimulation. This may include sexual thoughts, fantasies, words, visual stimuli, music, alcohol or drugs.

Psychological influence can be so strong that both men and women have achieved a normal orgasm without any physical stimulation. As long as a man achieves an erection, orgasm for him is generally automatic. Psychological stimulation may occur due to various actions and thoughts and this may lead to suppression of erotic fantasies. Under these circumstances physical stimulation for several hours may only produce a sore clitoris and a frustrated female partner.

Failure to achieve an orgasm may also be due to:

1) Lack of knowledge and experience. A number of women and men have little or no knowledge of the sensate areas on the genitals which need to be stimulated to achieve an orgasm. Each person has their own erotic areas which must be explored and learned by both male and the female. No two women respond in identical ways so it is important that each female teach her partner which areas on her body respond best to various forms of stimulation. Your partner must be aware of his need to learn. The clitoris and labia are the most sensitive and responsive areas but the quality of the stimulation is what makes the difference. Some women believe that their role is to be a passive partner to their “experienced” male partner, whilst the male is most often too ashamed to admit that he is a novice in sexual activity.

Education early in the relationship will prevent problems in failure to achieve an orgasm and the consequent frustrating interpersonal relationships with associated reduction in sexual drive by one or both partners.

2) Attitudes and beliefs also affect one’s ability to achieve an orgasm. Children are taught rigid moral, religious and social codes as they grow. Some are taught to fear and avoid sexual contact and activity and as a result fail to achieve an orgasm.

3) Hostility to one’s partner and poor interpersonal relations can also cause failure to achieve an orgasm. The ability to communicate verbally, physically and sexually is an important prerequisite to a good sexual relationship.

Boredom and monotony also cause failure to achieve an orgasm and lack of interest in sexual activity. Boredom causes distraction and difficulty in achieving an orgasm. The fact that you are so young is also significant. It is important that you are ready emotionally for sexual activity; otherwise there will be a lot of guilt from being involved in activities that have to be hidden from parents and close family members.

There is also the fear of pregnancy and contracting a major sexually transmitted infection such as HIV. It is important that you use an effective form of contraception in addition to a barrier method such as the female or male condom. It is also important that you have your partner do an HIV test before continuing in a sexual relationship with him. Even if he has a negative test you should still use a barrier method as this is the only means of effectively preventing the spread of HIV. I think it would be a good idea to become involved in other fun activities with your friends instead of immersing yourself in a dysfunctional sexual relationship at such a young age.

When you are older and in a stable and meaningful relationship then sexual activity will become more satisfying and you can then work on any issues that you have with your partner.

Best wishes.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via e-mail to allwoman@jamaicaobserver.com or fax to 968-2025. We regret that we cannot supply personal answers.