I recently attended the Annual Clinical Meeting of the American Congress of Obstetricians and Gynecologists, and heard a very nice talk from Dr. Maureen Whelihan who is a sex therapist in West Palm Beach, Florida. She talked about how to maintain a good sexual relationship. Her are some of her tips:

Orgasm: 90% of her patients have had an orgasm, and most have them at least 50% of the time. In most cases clitoral stimulation is needed to achieve orgasm – manual, oral or vibration. An inexpensive vibrator she recommends is the Oral B pulsar toothbrush. Use the back (smooth) side for clitoral stimulation. Lelo is another brand of vibrator, better made, unbelievably powerful, available in many versions (some remote controlled, waterproof, USB rechargeable) and available online at www.lelo.com. 10% of women can have a vaginal orgasm-a much deeper, whole body orgasm that is difficult for most to achieve. In menopause orgasm gets less intense. Laying a warm wet washcloth across the vulva for 10 minutes before sex can increase the blood flow.

Kissing: The most important sexual activity, Dr. Whelihan calls it “the key to getting women naked.” It’s the number one thing that turns you on. It signals a wanting or craving that will make your partner think about you differently. Married couples should try to kiss at least for one minute a day! Make it a good kiss too! Having good oral hygiene is important. Use a mouthwash or brush your teeth if you have bad breath; avoid cigarettes and chewing tobacco.

Male Partner: Doctors should ask about the male partner. Erectile dysfunction is common in older men and very manageable with Viagra or Levitra. Helping men to maintain an erection longer gives women more time to enjoy an orgasm instead of rushing it. Premature ejaculation can be due to anxiety condition, and an antianxiety medication can help. Low testosterone is common in aging and can decrease desire in men. All women need to understand that men need sex. It is number one throughout their life. If the woman loses her enthusiasm for sex, the man does not understand. It is a need and ignoring it can lead to an unhappy end to the relationship.

Children: Will suck the life and energy from women. Recommend that any 2 nights a week the partner is responsible for “kid duty” all the way until bedtime. She has a free evening to exercise, get her nails done, have a glass of wine or read a sexy book and she will meet you in bed and have sex. “I can’t believe he did all those things just to have sex with me!” It teaches mutual respect for the work the other partner is doing. You must respect the other’s role in the relationship. You can also try to desensitize the kids that mom and day can be alone in their bedroom without interruption. First go into the bedroom for 1 minute and lock the door. Tell them “it is a private time for parents, please do not knock on the door.” You can gradually increase that alone time and get the kids used to not interrupting you and wondering what’s going on in the bedroom. Finally you get 15 minutes and that’s all the time you need to get sex done if you are married and motivated.

Medications: Don’t discount the negative effects of some medications on sex drive. Birth control pills and other hormones may decrease desire. Opiates are sex inhibitors. Get a good night’s sleep.

Lubes: Sex is friction in inadequately aroused women. Silicone lubes stay on the surface longer. Wet Platinum, Eros, Astroglide and Pre-Seed (for women trying to conceive) are recommended. Coconut oil, olive oil and vegetable oil work fine especially with a glass of wine and sex in the kitchen! Be very careful to not slip if it gets on the floor!

Gay sex: assuming people are straight and finding out they are not embarrasses us. We should think of “partner” instead of “husband.” The more comfortable we are with asking, the more likely patients are to tell. We need to be in a judgment-free zone.

Books: “The Guide to Getting it on” by Paul Joannides is an all-encompassing guide. “Best of Best Women’s Erotica” by Marcy Sheiner is a good collection of female erotica. “How to be a Great Lover” by Lou Paget is a great book about improving sex technique from the female point of view. “Every Man Sees You Naked” by David Mathews is a great guide for women about why men behave the way they do.

Incorporating Technology: Podcasts: www.PleasureMechanics.com – “Speaking of Sex” is fun, direct, and informative. It can be uploaded and sent to your lover to let them know what is on your mind. Apps: “Pocket Kamasutra” gives ideas (visual cartoons) on sexual positions and sex games. Upload to a text or email and let your lover know what you want to try next.

Final Thoughts: Doctors need to let patients know that they are interested in their sexual concerns. We should promote sexual pleasure as another component of overall wellness and good health. Your patient will be forever grateful.