Q:   Does size matter?
A:  

Size matters to people psychologically — men and women often feel that size changes effectiveness. If a man is well below average (in size), then yes, that might matter because the vaginal walls depend on pressure for sensation.

However, the most important and sensitive part in some women is what we call the G spot, which is a few centimeters in and can be stimulated by rhythmic pressure from just the tip of the man's penis. Not all women find that erotic; some people aren't easily orgasmic from that. What's more important to a woman, rather than size, is the quality of interaction — does her partner ask what turns her on and pay attention to that?

A lot of research supports that what's essential is what goes on before the sexual touching even starts — the quality of the relationship, the sense of safety and trust, how the partner approaches sex. Has he helped her through the day, treated her nicely, helped with her workload? Does he start touching her lovingly in nongenital areas?

Research shows the effect of size is very much overstated in terms of what leads to sexual satisfaction. Most women don't easily orgasm with intercourse, anyway, so stimulating the outside can be more important. The vulva can be stimulated with the hand, with the mouth, and in many ways that have nothing to do with the size of the penis.

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Q:   Does sex with the same person have to get old?
A:  

There is a natural calming down of sex with the same person after about six to 18 months — that's because in-love feelings at first cause euphoria from changes in brain chemicals. People get blinders on, and think their partner is wonderful, and will start lubricating with just a kiss or from just about any touch. That neurochemical reaction is limited in terms of time.

People in satisfying long-term relationships have developed a calm sense of enjoying each other, trusting each other and being good friends — and the sexual arousal comes in spurts. If a couple does not communicate sexually — if they desire variety but aren't open to trying different things — then the sex can get stale. But that's true of relationships in general — that people need to keep growing.

People can be disappointed when the euphoric feelings go away — they don't know it's normal and can mistake it for losing the feelings of love. But sex can still be meaningful and passionate, though not in exactly the way it was in the beginning.

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Q:   Do women having an orgasm tend to scream like in the movies?
A:  

It depends on the woman. Of the educationally made films I've seen, most women don't scream. Some women have learned to be silent during sex, though making sounds is perfectly OK. Some people moan, some make other noises, but mostly not like you see in pornographic movies or in the Stepford Wives, where the women are programmed to feed the male ego by screaming out, "Oh John, it's so wonderful!"

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Q:   Are there women who will never be able to achieve the Big "O"?
A:  

There are women who can't achieve orgasm because of permanent neurological damage, like from a pelvic injury, or women with advanced diabetes or alcoholism, or who are deficient in testosterone, or who need certain medications, such as Prozac, that suppress orgasm. But those issues are unusual.

Many other women simply don't know their bodies and what it takes to produce orgasm. A women's equivalent of the penis is the clitoris, which is on the outside and often doesn't get stimulated effectively during intercourse. Some women need to learn more about their bodies and to speak up to their partners about what they need.

If you have questions for AASECT, visit the organization's Web site at AASECT

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