I've just described a typical "party plan," a marketing technique that melds a social event with direct product sales. Party plans are nothing new - Tupperware, Pampered Chef and Mary Kay have been around for decades.

What makes this scenario different is that the consultant isn't hawking egg slicers or lipstick. Instead, she's sharing the buzz on the latest vibrators, lubricants and other bedroom accessories.

It's a creative, blush-free way to bring these products to women who may be squeamish or shy. But are the attendees walking away with more than just a bag of sex toys?

Sex toy parties have been around since the 1970s, although they didn't truly begin to gain popularity until the '80s and '90s. These days, such get-togethers have gone mainstream, and most women I know have attended at least one, often at bachelorette parties.

It's estimated that there are tens of thousands of consultants in this country, working for Pure Romance, Passion Parties, Intimate Expressions or one of the many other franchises.

As with other party plans, consultants give product presentations, with the host typically receiving merchandise or a discount in return. But that may be where the similarities between sex toy parties and, say, Tupperware parties end.

Sex toy parties go beyond simple commercialism and can teach women about their sexuality, according to Patty Brisben, founder of Pure Romance.

"We are not about the sale of a product - we are about the education behind it," she says. "Our mission is to provide a very safe environment for women to learn about and discuss sex and sexuality. The bottom line is that people will not use their products if they don't know how to use them or are intimidated."

In fact, party-goers may rely on consultants to expand their knowledge about sexuality in general: A 2009 study by researcher Debby Herbenick and others at Indiana University's Center for Sexual Health Promotion found that sex toy party consultants are often asked for accurate sex advice and may even have backgrounds in health or sexual education.

Similar research by the same authors, published in the November 2009 issue of Sexual Health, suggests that such parties allow women to learn more about specific topics, including increasing desire/arousal, orgasm, erection and ejaculation, and vaginal dryness and lubrication.

"Female in-home sex toy party facilitators have the potential to provide a diverse group of women with opportunities to access sexuality information, products, and communication," they write.

While other party plans might involve testing out a recipe or demonstrating a makeover, sex toy parties tend to have greater goals. Passion Parties, for example, are primarily geared to women in couples; their mission involves fostering "passionate monogamy." Surprise Parties seeks to help women achieve sexual fulfillment. And Pure Romance focuses on female empowerment.

"Sex toy parties should be a platform for women who want to be responsible for their own sexuality," says Brisben. "We are the place for women to start getting a better understanding of their needs, their wants, and their desires. And when you understand the mechanics of what makes you feel good and why, it allows you to know what to ask for."

Whether you're easily embarrassed or totally comfortable talking about your sex life, sex toy parties can be a great opportunity to chat with your girlfriends, learn something new, and become a little - or a lot - more in tune with your sexuality.

Who knows - you might even leave with a few new treats. Above all, have fun. Isn't that what parties are all about?

One of the most common, and least acknowledged, is the use of hormonal birth control. Most birth control pills and other hormonal birth control methods use some form of estrogen. The effect this has in the body is to increase the body's production of Sex Hormone Binding Globulin (SHBG), a protein that transports hormones around the body in the bloodstream. The trouble is that while hormones are bound to SHBG, they can't be used by the tissues. The hormone that has the highest rate of binding to SHBG is testosterone. So when a woman uses hormonal birth control containing estrogen, she is effectively decreasing her levels of available testosterone. Since testosterone helps fuel sexual desire, fantasy, and also lubrication in response to arousal, many women are left feeling very blasé about sex. Oftentimes, it is not an issue for women in their late teens or early twenties. But as their hormone levels start to decrease naturally with age, it can become a very surprising reality.

A similar phenomenon occurs during menopause, either natural or surgical-induced because of removal of the ovaries. The onset of low sexual desire is usual less noticeable with naturally-occurring menopause because of the gradual decline in hormone levels as opposed to the abrupt plummeting of hormones after surgery. Since a woman's ovaries produce about half of her overall testosterone, once they are no longer there, or no longer receiving the message from the brain to make sex hormones as in natural menopause, her desire seems to also crawl back into its shell. Interestingly enough, a woman's level of desire can be fairly well preserved depending on her psychology and her level of sexual activity.

Studies show that women who had a satisfying sex life before menopause tend to have greater sexual functioning and sexual satisfaction after menopause as well. Remember that a woman's arousal is fueled not only by good physical stimulation, but also by an inviting emotional environment. It's difficult to say which is more important, a woman's attitude towards sex and enjoyment in her sex life overall, or having good blood flow with regular sexual activity. Those women who continue to have regular penetrative sex (at least once a week either with intercourse or in masturbation with a dildo or vibrator) end up having better blood flow to all of the tissues of her sex organs.

Obviously, lifestyle and the satisfaction with your relationship also contribute greatly to a woman's level of sexual desire. Being out of shape, being exhausted, or carrying pent up anger or resentment all tend to squash the life out of any sexual desire that was there before. But there are solutions. It's never easy to make the lifestyle changes that lead you back to balance, but the payoff is great. Similarly, if you suspect that you may be having hormonal causes or other physical causes keeping you from desiring sex, such as pain or discomfort, please speak to your gynecologist about it. If you find that your doctor is willing to have a reasonable discussion with you about it, please pass her name along to other women. If your doctor leaves you feeling embarrassed, foolish, or belittled, there are other doctors to choose from.

The health benefits of sex are many:  It cuts your risk of heart attack or stroke. It burns calories. It boosts your immune system. It soothes nerves. And not only is this activity good for your health, but it feels fantastic, too.

But what if you've already suffered from a heart attack? Do the benefits still exist? Will sex push you over the edge? When is it safe to have sex again, and how cautiously should you proceed?

It's no surprise that many heart attack survivors worry about rebooting their sex lives after a hospital stay. Aside from performance anxiety, the majority of survivors experience post-heart attack depression and anxiety, which is understandable considering how helpless a heart attack can make you feel. Despite your best intentions, and your most careful preventative measures, you've been betrayed by your body. Will it happen again? Can you even hope to stop it?

Still others worry that sex in particular will cause another heart attack and, quite possibly, death. We've all heard those bizarre stories of sex-induced death, courtesy of the tabloid rumor mill.

In reality, sex only raises the heart rate to about 130 beats per minute. Blood pressure also rises, but just a little. This rise in heart rate and blood pressure is actually comparable to the exertion you experience during many of the routine, physical activities you do throughout the day, such as carrying in the groceries, or trudging up a set of stairs. If you can already do these activities without feeling tightness in your chest or shortness of breath, you're probably good to go.
(And if it makes you feel any better, sudden death during sex is extremely rare; less than one percent of heart attacks are attributable to sexual activity.)

Still, it's smart to show caution. Have a chat with your doctor before resuming your regular sex routine. Your doctor will most likely give you the green light within 4 to 6 weeks after your heart attack, and stable heart attack patients may even be able to return to sexual activity within a couple of weeks.

But bypass patients, for example, may have to wait longer to resume regular, sexual activity. They may also be advised to avoid positions that put added pressure or weight on the sternum for at least 6 to 8 weeks. During this time period, a side-by-side position may be smarter.
And all patients should have sex only when they're feeling rested and relaxed.

A cardiovascular workout can be helpful for getting you back into shape... for activities both in and out of the bedroom. 

How? A good program can improve your heart's ability to function, lower your heart rate and reduce your risk of heart-related complications in the future.

"But before you run your next 5K, consider entering a structured cardiac rehabilitation program," says Logan Levkoff, a sex educator and author of How to Get Your Wife to Have Sex With You. "A health professional will be able to develop an exercise program just for you -- based upon your fitness level and the severity of your heart disease -- that includes both strength training and aerobic exercise. Later on, you'll gradually be able to increase the intensity your workouts (and the intensity of your sexual gymnastics)."

So don't let your heart condition ruin your sex life. Instead, let your sex life improve your heart condition.

Just remember to be smart about it.

Dr. Madeleine M. Castellanos is a psychiatrist in New York City specializing in sex therapy and author of the book A Man's Guide to Male Sexual Issues.  She is a contributor to goodinbed.com. She is committed to helping others learn about their own sexuality and how to achieve physical and emotional balance in their sex lives. You can visit her blog at http://www.ReclaimYourSexuality.com.

phenotypic plasticity

The reason I want you to know this is that I've been attempting to read "Sex at Dawn," a book that argues (as far as I can tell) that we are not designed for monogamy but rather for, I guess, non-monogamy in whatever form that might take. I can't tell you specifically what it is the book says we're meant for because I'm having a really hard time getting through it. Because it pisses me off.

It pisses me off because we live in this moment of cultural awareness, where people are ditching their running shoes and running barefoot, like we did on the savanna, in our earliest evolutionary days; we're ditching bread and eating "paleo," like our pre-agricultural revolution evolutionary forebears; and apparently we're looking to our pre-historic, pre-agriculture ancestors for tips about love and relationships.

It makes sense for nutrition and shoes in a way that it does NOT, for love and relationships. It is both lacking in science and hopelessly misguided. Lacking in science: our social structure doesn't leave a fossil record, so anyone who proposes an idea about how we lived on the savannah is basically just making up a plausible story. Misguided: welcome to phenotypic plasticity.

Phenotypic. As in phenotype. The observable manifestation of a genotype. The color of your eyes, your height, your immunity to infectious disease, your temperament.

Plasticity. Flexibility. Adaptability. Changeability.

Phenotypic plasticity, then, is the capacity for a phenotype - the observable expression of a gene - to vary depending on the context in which is develops and expresses itself.

Imagine if the color of your eyes were determined not just by your parents' genes but by your level of nutrition early in life. That's the kind of thing.

It turns out that, very approximately, the more complex a trait is, the more plastic it is likely to be. Unsurprisingly, human sociosexual systems are MASSIVELY plastic.

What influences human sociosexual systems? Christ, a BUNCH of things. Population density and resource abundance are two biggies - and resource abundance appears to be relative rather than absolute, so even the unprecedented abundance of the C21st western world can be interpreted biologically as scarcity, if you're among the "have nots."

The result is that for most (about 80%) of human history (and I do mean history), we've been a nominally polygynous species. That's our mid-level abundance structure. When resources became more abundant, we transitioned into a model of nominal monogamy. And in circumstances of extreme resource paucity, we generate polyandrous cultures. (There's only one example that I've read about, the one in Tibet, in which multiple brothers marry one woman.)

Before then, what social structure did we have? FUCK KNOWS. I enjoy Sarah Blaffer Hrdy's picture of us as tribes of women and children, visited by wandering males. But there's no more reason to believe that theory than any other.

And extant pre-literate cultures don't provide one helpful model to follow, they simply VARY. Just one example: the Canela of Brazil include in their wedding vows, "Don't be jealous of your spouse's other sex partners."

This is easy to understand in the context of nutrition: traditional Esquimo diet consists almost exclusively of fish and other sea-dwelling animals, because that's what's available, right? Until we developed agriculture, we ate what we could get.

With sex and love, it's less directly about what our environment affords and more about how the affordances of the environment shape resource distribution among the population of humans.

(Obviously it's all much more complicated than this.)

So no. We are not "meant" to be monogamous, nor are we meant to be polygynous or polyandrous or polyamorous or anything else. We are meant to be successful at bearing, birthing, and raising offspring to reproductive age, who then bear us grandchildren. And we, as a species, will do whatever it takes to make that happen.

The controversy stems from the word "addiction."  In the strictest sense, addiction occurs in response to a substance, with a pattern of tolerance and withdrawal.  Although some form of  desensitization and withdrawal have been observed in relation to excess sexual behaviors, many people consider this more of a compulsion than an addiction.  Many refer to an adherence to a certain behavior as more of a habit than an addiction, although some see no difference.  This has caused some fierce debate not only as to how to define it, but also how to treat it.

There are those who absolutely cannot control their hypersexual behavior.  Examples of these would be the hypersexuality that is often seen in a severe manic episode, Kluver-Bucy syndrome (which occurs when both temporal lobes of the brain are damaged by trauma or disease), methamphetamine use, and some other neurological conditions or certain kinds of brain trauma.  All of these are accompanied by distinct and noticeable changes in personality and activity level.  Treatment in any of these cases would require ongoing treatment with a psychiatrist or a neurologist, and medications are used.  As you can see, these are not typically the types of "sex addiction" you read about or see on the news.

Excluding people such as those mentioned above, I tend to be of the camp that understands excess sexual behavior as a compulsion for some and an impulsive behavior for others.  By compulsion, I mean that the person feels driven to act out this behavior and feels quite anxious or uncomfortable if they cannot.  Think of the person who cannot leave the house because they have to continue to check to make sure the stove is off.  If viewed this way, one could start to make a distinction between some excessive, compulsive sexual behaviors, and other sexual behaviors.  Still others tends to use sex in an impulsive way, not feeling compelled to act, but wanting to do it anyway.

Another difficulty with the use of the term "sex addiction" is that it is a bucket term that can include anything from excess masturbation, to excess time viewing pornography, to promiscuous sexual activity with one or more partners, or any combination of the above.  The reason why someone might engage in impulsive or compulsive sexual activity can be varied too.  Some people act out this way because it is the only way they feel comfortable with closeness to another person, some have low self-esteem and are trying to get approval, others find that they get a much quicker arousal response from intense stimuli or interactions and find this easier than the lower intensity of a long-term relationship.

You can see with all this variation, treatment is not often simple and usually requires interventions on both a behavioral level and a psychological level.  For this reason, there are many who believe that simple 12-step programs or quick "rehabs" are an over-simplified approach to a multi-factorial problem.  The other issue is that sex is a normal part of our lives for which we have natural cravings and direct physical response.  Because of this, those that understand the complexity of treating eating disorders have a much better appreciation for the complexity of excessive sexual behaviors.

Most commonly, however, women reach orgasm via stimulation of the clitoris.  This means that a woman usually requires stimulation on the vulva (the outside) with specific attention to her clitoris in order to peak to orgasm.  How she is stimulated is not so specific and can range anywhere from a tongue during oral sex, to fingers rubbing in heavy petting or masturbation, a vibrator, a stream of water, or even the vibrations of rubbing through her clothing sitting on top of a washing machine.  She can pick any of these or change it up.

There are many women who can reach orgasm by clitoral stimulation, but don't think they are normal because they can't have an orgasm with penetration.  They feel that there is something wrong with them because, unless they can find a position where they can rub their clitoris against their partner's body, they can't reach orgasm.  And there are plenty of men too, it seems, that want to know what is wrong.  Why isn't there partner having an orgasm when they have intercourse?  Is there something wrong with her?  Is there something he is doing wrong, or something different he needs to do?  The reality is, there is nothing wrong and she is probably perfectly normal.

Only about 30% of women can reach orgasm with intercourse or penetration alone.  When these women are reaching orgasm from penetration, it is usually due to rhythmic stimulation of their cervix, found at the top of the vagina.   Many women describe this orgasm as happening "on the inside," as opposed to the orgasm they get from stimulating the clitoris, which they feel more "on the outside."  So that leaves approximately 70% of women that cannot have orgasm with simple intercourse or penetration.  These women are the norm, not the other way around.  I repeat, only having orgasms from stimulation of the clitoris is normal and is the most common scenario.

It is actually two different pathways that lead to these two different types of orgasms.  The most common orgasm, achieved through clitoral stimulation, is mediated through the Pudendal nerve.  Interestingly enough, the Pudendal nerve also transmits sensations from the lower third of the vagina where the G-Spot is located, as well as between the clitoris and the opening of the vagina, where the U-Spot is located.  The orgasm that occurs from cervical stimulation is mediated through the Hypogastric nerve.  Sometimes a woman can have both of these nerve pathways stimulated at the same time during intercourse and she can also experience a "blended" orgasm, which she feels both on the inside and on the outside.

Orgasm should never be a mission and sex should focus most on pleasure and closeness.  With that said, it is not unreasonable to suggest that a woman receive plenty of oral or manual stimulation before, during, or after intercourse (her choice) so that she has maximal opportunity to have an orgasm (or two or three).

For men, blood flow works to fill up erectile tissue producing an erection and stimulation of the prostate gland to start exuding pre-ejaculatory fluid. Women also benefit from blood flow to their erectile tissue (which is mostly internal) with increased size and sensation of their clitoris as well as lubrication at the vaginal opening in response to sexual arousal. Good blood flow to the brain also encourages a good energy and arousal level and proper flow of hormone signals back and forth from brain to genitals. So how do we ensure and maintain good blood flow?

1. Arteries - Arteries are the channels through which our blood is transported throughout the body. When they are in good shape, they respond by relaxing to allow more blood flow whenever the need arises. Hardening of the arteries, or atherosclerosis, limits the ability of the arteries to respond to hormonal signals, decreasing their response to sexual arousal. Without the proper response, there may not be enough increase in blood flow to engorge the erectile tissues in either men or women. Keep your arteries healthy by eliminating trans fats from your diet. Eating a balanced diet low in sugars and high-glycemic carbohydrates also keeps your body from producing too much triglycerides, which clog up arteries by sticking to their walls. Also, consider reducing the amount of fructose and high-fructose corn syrup (corn sugar) in your diet, since the body does not treat these the same as sugar and instead increases your triglycerides. High blood pressure also decreases the availability of blood to the tissues because the arteries tend to tighten up. Watch your salt intake and take 5-10 minutes each day to practice some quiet relaxation or meditation. These are proven ways to protect against high blood pressure.

2. Nerves - Nerves transmit all the signal back and forth from all areas of your body to your brain. They also send signals to arteries, tissues, and muscles to respond to sexual stimuli. If the nerves are not healthy or not working properly, you lose sensation and your body does not respond as quickly or as completely as it should. The biggest culprit damaging nerves is diabetes and elevated blood sugar. Nerves are damaged by chronic exposure to high blood sugar, and diabetics often get neuropathies in later life if they have not kept good control of their blood sugar. Eating smaller meals more frequently rather than a few very large meals a day helps your body maintain a more steady blood sugar level without the spikes that damage the body and without the lows that make you insanely hungry. Watch your alcohol intake too, since it tends to cause uncontrolled blood sugar, but also produces toxins that pickle your nervous system as your body metabolizes it.

3. Tissues - Our bodies are designed to be in motion and be put to use. Our modern lifestyle allows for the opportunity to sit on our behind for most of the day, decreasing blood flow to our legs, our genitals, and putting a great deal of strain on our lower backs. We have to get up and move for at least a few minutes every half hour or so. Now we're back to "use it or lose it" again. This is simply how the body works. You want to have good blood flow to your genital? Use your genitals - have sex. Those people who have sex at least once a week have a better chance of keeping their sexual functioning as they get older because they are encouraging regular bursts of blood flow to the area.

4. Overall - Our bodies are constantly responding to the environment around us, including stress and anxiety. When we become anxious, our muscles become tense putting pressure on small blood vessels. This can effectively cut off the blood supply in the arterioles and capillaries, resulting in sore, tired muscles with the sensation of knots. Anxiety also clamps down on blood flow to the genitals because it activates the fight or flight response. Becaus of this, it tends to work against sexual arousal and is often the cause of sexual dysfunctions.

So what are you doing to keep optimal blood flow and healthy sexual functioning?

Even though using a condom properly can be easily learned, there are occasional mishaps and slip-ups. Since most condoms are made of latex, they are very stretchy with a resilient ring that pops back into place when squeezed. Add the fact that some condoms are pre-lubricated and you could find your condom flying out across the room as it slips through your fingers. Other times, opening the package becomes the challenge, as you struggle with your slippery fingers to get this little scored pouch to open up. Always try to open close to the edge rather than the middle, since the condom could be torn if you open the package in the middle a little too vigorously. For this same reason, you should try to use your fingers rather than your teeth.

In order to decrease the chance of breakage, you should always make sure that you are not working with an old, expired condom. The package can only keep it's integrity for so long, which is why you need to check the expiration date on the package while the lights are still on (and hopefully in time to get a replacement if necessary). Don't keep the condom in a wallet for too long, and never let it stay in the car because heat or extreme cold damages the latex. If the little package looks kind of deflated, don't use that condom. Also, when using a male condom, leave yourself a little room at the tip by squeezing the air out of the tip as you put it on. This not only leaves a little room for the semen after ejaculation, but it also creates less tension on the tip of the condom during thrusting. Many condoms have a reservoir tip, but still take out the air as you put it on.

If you're in the dark and you can't figure which way the ridge is facing, and you don't have it so that it rolls outwards, you may end up putting a lot of force on the condom just to get it down the shaft and can break it. Always check the ridge prior to putting the condom on the penis to make sure it will roll down easily. Use lube only on the tip of the condom on the inside, but plenty as you need it on the outside since too little lube can result in too much friction leading to breakage. If you put lube all over the penis before putting the condom on, however, the condom could easily slide off the penis during intercourse and you could pull out to find the condom deep inside the vagina or rectum. Use only condoms that approved for sex and not "novelty condoms" that may not protect against pregnancy or STIs. Only use water-based or silicone-based lubes since oil will disintegrate latex. Keep in mind that silicone lube is not compatible with silicone toys (dildos, vibrators, rings, etc.) and that many condoms come pre-lubricated with a silicone-based lube.

If a condom should break on you, do yourself and your partner a favor and stop what you are doing and replace the condom. Don't just ignore it or think it's too embarrassing to mention. Sure it cuts into the action, but that's a better alternative than an unwanted pregnancy or STI. You can even tell your partner that you were so into the action that you actually broke the condom! It's just a matter of respecting both yourself and your partner's wishes and sexual health.

First, there is often the misconception that a woman's vulva or vagina is "dirty." Nothing could be farther from the truth. Actually, there are more bacteria in a person's mouth than there normally found in a woman's vagina. The vagina is also continuously refreshing itself. In fact, the vaginal mucosa and cervix exude secretions to clean itself out daily and have even have antibodies that serve as a first line against infections.

Psychologically, some men have a very difficult time getting past the fact that the urethra is very close to the vaginal opening. It doesn't seem to bother them, however, that the same opening is very prominent on their penis when a woman is going to give him oral sex. Urine is sterile, so it does not infect or contaminate the vagina or labia. If a woman has proper hygiene, there is nothing "dirty" about it. And the lubrication that she experiences during arousal is very similar to a man's pre-ejaculatory fluid, clean and clear.

Still, other men feel very uncomfortable when they think of themselves in the position of having their face up to a woman's pussy. They may feel a lack of control and a feeling of being in a position of subservience or subordination when they eat a woman out. In actuality, the giver of oral sex is in the most powerful position, controlling the speed, intensity, and pleasure of oral sex. But some men have difficulty experiencing it this way, and instead feel that it is a ridiculing or demeaning position.

Unfortunately for female partners of such men, these beliefs can be deeply ingrained into a man's psychology and are often difficult to change. If the hesitancy started because of a lack of education, it's just a matter of learning about the cleanliness of the area and the ease with which it can be washed. If, however, it has become a very rooted negative idea in his psyche, it may be very difficult or impossible to work with. These men will never realize the power they can have in giving their women immense sexual pleasure unless they face their own fears and insecurities. Powerful is the man who not only learns how to give his woman one of the best pleasures she can experience, but also delights in doing so.

For a wonderful guide to all aspects of cunnilingus, please get yourself a copy of my colleague's book She Comes First: The Thinking Man's Guide to Pleasuring a Woman.

But who remembers to do their Kegels? They are simple and can be done almost anywhere, but it is often difficult to remember to actually do them. Well before there were Kegels, there were Ben Wa Balls. Even though there have been literally hundreds of different kinds made with varying size, weight, materials - all function with the same basic idea. By placing the balls inside the vagina, they stimulate a small contraction of the PC muscles by either the weight of the ball themselves, or by a small amount of vibration that is produced when a woman is moving around with the balls inside of her vagina.

One very early design of Ben Wa Balls was a hollow ball with mercury inside, so that as a woman walked and changed position, the mercury would move inside the ball and produce a very small movement that stimulated the muscle to contract. Unfortunately, mercury poisoning was an undesirable consequence, so the design changed to just weighted balls. There was still some contraction necessary to keep these from falling out of the vagina, so that it would strengthen the PC muscles as they were worn.

A wonderful improvement to this design is to have one ball inside of another, like you can find with the LELO Luna Beads. The small inner ball moves inside of the larger hollow one creating a tingly vibration that stimulates the muscle to squeeze. This contraction improves the tone of the PC muscles, but can also be pleasurable at the same time. Many women also like this ingenious design because the inner vibration is more stimulating than just the weighted ball. It increases blood flow to the area as the muscles are worked and feels good too. Better yet, it reminds your brain to think about sex every time you feel a tingle. All of these work together to improve a woman's sexual response and enjoyment.

As more and more people are getting their sex ed and ideas about human anatomy from porn, I see an increasing number of men who think that their penis is too small. They may the point that guys in porn films are usually chosen because of their size, their ability to get it up and keep it up, and their comfort in being able to do sex scenes with twenty people standing around and sometimes breaking for lunch.

Although there is a great deal of variation, the average penis when erect is about 5 1/2 - 6 inches long. Considering that the average vagina is about 3 inches deep, an average size guy will certainly be able to reach her cervix with his erection. Even when she is aroused and the vagina expands another inch or so, it still isn't as deep as the length of the average guy. And for men that are enjoying anal sex, it only takes about 4 inches to stimulate the prostate with anal penetration.

But back to the problem of being too big. When you ask women, most would agree that girth is usually more important than length when it comes to enjoying being vaginally penetrated. This is because of all of the erectile tissue that surrounds the opening of the vagina which is stimulated when she is penetrated. The average width of an erect penis is about 4 3/4 inches around. Usually it isn't until about over 6 inches in circumference that some partners will start to feel it becomes a little challenging.

If a guy is too wide, it could be quite uncomfortable for her, especially if it causes too much stretching of the labia. When a woman is premenopausal, she has more elasticity of the tissues, which allows them to stretch gradually to whatever she needs. This becomes more difficult after menopause because of the decrease in both estrogen and testosterone. If her partner is quite wide, she may need to learn some relaxation breathing as well as learn to relax her PC muscles and use plenty of lube. This should be done gently, and at her pace to prevent tearing of the tissues. The same is true for the bottom in anal sex (the one being penetrated) if the top has a wide erection. Girth also becomes an issue if a man's erect penis is too large to fit in one's mouth, which could seriously place limits on the amount of oral sex he can receive.

When it comes to length, a woman's vagina stretches during intercourse. But many times women find it uncomfortable to be knocked about by the head of her partner's penis if he is thrusting too deep at an uncomfortable angle. If she has pain with deep penetration, she may have endometriosis that forms scar tissue which prevents stretching of the tissues. Otherwise, you may be hitting her cervix a little too directly. Changing the angle by changing positions could be helpful. In considering long erections for oral sex, it is important to remember that the tip of the erection and the area just below the head are the most sensitive parts. This means that a man does not have to have his entire erection completely in his partner's mouth in order to get a good blow job. If he does like to have it completely taken into the mouth, he is probably more excited with the visual image and the idea of it getting completely enveloped rather than the actual physical sensation.

Too big usually comes down to the comfort level of the partner. If it seriously interferes with the amount of sexual intercourse a man gets, then he would probably consider himself too large. If you have a very large penis, give your partner time to lube, relax, and stretch. Breathing and getting very aroused are extremely important. You almost never find a penis so large that a man would pass out when erect. That would require about a liter of blood to be displaced by his erection alone, and his body would already have accommodated over time by maintaining a larger than average blood volume. But it is interesting to think about.

Perhaps you feel that you no longer have any interest in sex or sexual pleasure as you used to in the past? Maybe your brain is cooperating, but you feel that you body has jumped ship because your clitoris is just not as sensitive as it used to be or it may even be painful to stimulate? Many women have experienced a decrease in sexual pleasure and desire because of the effects of lowered testosterone, and my question here today is do women need testosterone?

There is no exact level of testosterone that correlates with good sexual functioning and appropriate levels of sexual desire. Instead, doctors go by a normal range in men that is known to decline in men as they age. Women also produce testosterone from both their ovaries and their adrenal glands. In women, testosterone is present in about one tenth of the amount usually found in men. Since testosterone maintains erectile tissue and part of a person's desire for sex, it helps support the clitoris and it's adjoining erectile tissue as well as a woman's libido. As a woman ages, her ovaries gradually decrease production of both estrogen and testosterone and almost completely stop at menopause. If a woman has her ovaries removed, the decline in hormones is abrupt and more drastic.

Women may find that they have lost sensation in their clitoris compared to what it used to be. Also, they may find that it becomes difficult to lubricate when they are sexually aroused, even after considerable amount of stimulation or even orgasm. The glands which produce this lubrication that surround the opening of the vagina can also become easily irritated as the tissues there become frail due to the lack of support from testosterone. Testosterone is also responsible for helping maintain muscle mass as well as aids in the production of red blood cells.

If a woman is experiencing any of these symptoms as well as a significant change in her level of sexual desire, she may benefit from having some testosterone replacement. Currently, testosterone is not FDA approved for use in women without the use of estrogen. This means if your doctor decides that testosterone replacement might be of benefit to you, you would have to use a product off-label which usually means using a testosterone gel at one tenth of the dose given to men. Another option is to have your doctor work closely with a compounding pharmacy as I do with my patients. Since there is the potential for side effects, this must be done under the supervision of an MD and monitored carefully.

But even some women who are far from reaching menopause may have difficulty with low testosterone. The most common cause of this in today's society is hormonal birth control. This includes the pill, cervical rings, injections, and hormone-coated IUDs. All of these raise the level of protein that attaches to estrogen and testosterone, leaving less of the free hormone to circulate and have its effect on the tissues of the body. Since testosterone is bound very tightly to this protein, even a small increase in the protein's production can drop the level of free testosterone (bioavailable testosterone) to problematic levels.

The effects can be so dramatic for some women that they may develop vulvodynia, which is pain at the entrance of the vagina and surrounding tissues. Oftentimes, doctors may advise women to find an alternate method of birth control that does not include hormones so that levels may return back to normal. In some cases, however, it may take years to correct itself and more intense treatment is needed. Regular exercise, 7-8 hours of good quality sleep nightly, not having excess fat tissue, eliminating chronic stress, and having a good diet rich in zinc are all natural ways to increase testosterone.

Human Papilloma Virus is known to be an extremely common virus that is transmitted by skin to skin transmission, with some estimated 50-75% of sexually active people contracting some form of it in their lives.  There are many different strains, but not all are the cause of disease. Some types of HPV cause genital warts, or condylomas (types 6, 11) while others have been associated with cancers of the cervix, vagina, anus, penis, and more recently, throat (types 16, 18) .  HPV has been the focus of much press in the recent years with the advent of the vaccine against HPV, which protects against HPV types 6, 11, 16, and 18.

What seems to be quite alarming is the rate at which it is now causing cancers of the throat, including base of the tongue, tonsils, and pharynx.  Since the virus can be passed along by saliva transfer, not just oral sex, but kissing too can be a method of passing the virus from one person to another.  Most people know of the importance of wearing a condom during sex, but not too many think about protecting themselves from kissing.  It is unclear if this will indeed reach epidemic proportions, but the vaccine protecting against the most carcinogenic strains could make all the difference starting with our current generation of young adults.   It was developed to help prevent cervical cancer in women.   But since the development of throat cancer is more common in men, this is a strong argument to have the vaccine to be administered to both boys and girls. The vaccine will prevent a person from contracting these particular strains, but cannot protect you once you have already been infected.

The clitoris is made up of erectile tissue that becomes engorged with blood when a woman gets aroused. This is exactly what happens in the erectile tissue of a man's penis when he gets an erection, except that a woman's erectile tissue is completely internal apart from a tiny shaft and tip of the clitoris. If you imagine the same amount of erectile tissue that is found in the penis being located inside the woman's body, you get an idea of the extent of the true size of the clitoris and its related structures. The difference is that the erectile tissue in women is spread out to surround the opening of the urethra and the vagina, while a man has the majority of his erectile tissue projecting outside of his body in his penis.

Under the surface, the clitoris extends in an inverted "V" shape under the pubic bone to each side. Connected to this is erectile tissue that completely surrounds a woman's urethra. This contributes to the pleasure that a woman experiences with stimulation of the U-spot and the G-spot, as well as makes female ejaculation possible. Next, on each side of the vaginal opening, there is a pouch of erectile tissue that makes up the vestibular bulb. These 2 bulbs of erectile tissue can significantly increase in size when they fill up with blood. They then create an enjoyable feeling of pressure when they are stimulated, such as by penetration or pressure on the labia majora. Finally, behind the opening of the vagina is more erectile tissue that completes the network of erectile tissue encircling the vaginal opening.

The clitoris and the surrounding erectile tissue is very responsive to both psychological arousal and physical stimulation. There is plenty of room to experiment and a multitude of ways to give pleasure to a woman through her genitals. Keep in mind that there is a whole network of erectile tissue and you will start to understand how a combination of sensations heightens her pleasure, which can include outer and inner stimulation. Let her be your guide, and always err on the side of slow and soft and then build up to harder and faster as she lets you know.