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Authors: Ian Kerner

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In the preface, I spoke of the Woman on the Shaky Bridge as a poetic ideal. But, in reality, our sex lives are often far from perfect. That’s why I keep a framed photo of the Capilano Canyon Suspension Bridge on my desk—not only to show my patients, but also to remind myself, as a man and as a husband, that I have to be willing to venture across that bridge too if I want to find the exciting woman at its center. It’s all about meeting each other halfway and taking the journey together, one in which we never stop growing.

 

Pop Quiz

 

Feel free to read
He Comes Next
in whatever manner you find comfortable. However, if you’re inclined to skip Part I and go straight to the techniques in Part II, then I ask you first to consider a few simple questions.

 
  • What’s the best sex toy money
    can’t
    buy?
  • Name the three types of erections all men experience?
  • Is your guy faking it? That’s right—
    faking it
    . How do you know for sure?
  • How can a properly administered pelvic massage actually help to lengthen your partner’s penis?
  • If, as the poet Ogden Nash wrote, “candy is dandy, but liquor is quicker,” what are the brain’s natural sex-stimulants, and how do you get them flowing?
  • What’s the difference between orgasm and ejaculation, and are the two inextricably linked?
  • Do you know the difference between a “local” orgasm and a “global” one and how to stimulate the latter?
 

If you’re unsure about any of these important questions, then, in the spirit of
She Comes First
, think about postponing
your
immediate gratification and read
He Comes Next
from start to finish.

 

Postscript

 

When I got back to New York from my national book tour, I had almost forgotten about Charlie (the George Clooney “womanizer”). So, when I ran into him at the coffee machine and, on cue, he said, “Doc, last night I had the most
amazing
sex. She was
incredible
. Can I just tell you…,” to his amazement, I said yes and dragged him into my office to get the 411.

The first thing I learned about Charlie’s sex life was that all the various women he’d gone on and on about were, in fact, one woman: his wife of nine years and the mother of their two children, with a third on the way.

Charlie never stopped being in love with his wife, and the sex, to this day, remains fantastic.

Want to know his secret?

I’ll tell you.

But first…

Dear Ian
 
 
Dear Ian,
     
Doesn’t being a sex therapist take some of the awe and joy
out
of sex for you? After all, sex is more than just mechanics and positions (Insert A into B and twist until secure)—it’s an expression of love. And isn’t love ultimately mysterious and unknowable?
 

—Latitia, twenty-eight, advertising production manager

 

W
HAT A GREAT QUESTION
to help me frame my preliminary thoughts on male sexuality. The more I learn about the nature of love and its expression through sexual intimacy, the more I
am
in awe of it. But sometimes I think we use the concept “love is a mystery” to avoid responsibility for the hard work true intimacy entails. We live in a culture in dire need of sexual education. Despite or, perhaps, in accord with our country’s prurient, almost pubescent fascination with the “look” and “fashion” of sex, we remain sadly sophomoric in flesh-bound
pleasure-training.

The number two reason for divorce in this country, after financial conflict, is sexual dissatisfaction, and a crucial part of the problem is lack of communication and poor information. When it comes to talking about sex with a partner, breaking the ice is like breaking an iceberg, and all of us know what happened to the
Titanic.

To give you a sense of my clinical philosophy, let me briefly explain how I approach a new patient or couple. Sex therapy generally follows a model called PL-I-SS-IT, which stands for permission, limited information, specific suggestions, and intensive therapy. First, a patient needs
permission
to confront an issue openly and safely with a therapist or counselor. Second, they need accurate
information
—ranging from physiological facts to psychological reactions—to tackle their problems. Next, they need
specific suggestions
to get them back on the road to sexual health. In some circumstances, they may also need
intensive therapy
, though most of the time the first three steps will do the trick.

I’ve adapted the Pl-I-SS-IT model to accommodate my own working version, which I call the “See Me, Feel Me, Touch Me, Heal Me” approach to counseling. (Yes, I listened to The Who a lot growing up.) For counseling to succeed, a patient must, first and foremost, be seen. This is important when you consider how many people are leading lives of quiet desperation when it comes to personal relationships. Next, that individual must be felt. Their emotional turmoil must be communicated effectively and experienced by their partner. The third, and touchy, part takes the form of sex and intimacy assignments that are done at home and then discussed in subsequent sessions. All of this must occur before a person can
even begin
the process of healing. So, to answer my reader’s question, love
is
indeed mysterious. Sexual ignorance, however, is not. It’s a function of laziness, prejudice, and fear. The more we learn about sex, the more there is to appreciate, understand, and savor.

Hey, just because we hit an iceberg doesn’t mean we have to go down with the ship!

PART ONE
 
The Male Body
1
Beneath His Armor:
Inside the Male Body
 

S
EX HAS A LANGUAGE
all its own. You know that old saying, “Sometimes the best defense is a great offense?” Well, it just doesn’t cut it. When we talk about sex, sometimes the best defense is, in fact, no defense at all.

Picture this: A guy gets up in the middle of the night to go to the bathroom and slowly winds his way through a dark room cluttered with furniture. One hand is out in front of him as he gropes for the bathroom door and light switch, but what do you think the other hand is doing?

Protecting his genitals.

Sounds obvious, right? Men protect their privates. And why shouldn’t we? After all, nobody wants the family jewels getting chipped.

But what if I told you that this idea of self-protection goes far beyond a simple reflex and is, rather, the key to fathoming the inner recesses and dark corners of male sexuality?

Allow me to elaborate. Men’s genitals grow outward. From an early age on, boys intuitively protect them. But over time, this instinctive desire to protect manifests itself as a permanent sense of inwardness, a physical “pulling in” that ultimately extends to the entire pelvic area. (If you don’t believe me, the next time you’re on a dance floor, take a look at the guys around you. They’re all arms and legs, as if they’re doing the “Dance of the Missing Middle.” No wonder Elvis was anointed king.)

Over the years, I’ve talked to countless physical therapists, chiropractors, as well as dance and yoga instructors, all of whom concur that the adult male pelvis is frequently in a state of tension. All of these professionals, in one way or another, work with guys to help them “open up”—sometimes to help manage back pain, sometimes in the course of facilitating recovery from an injury, and other times just to get them through that first dance at their wedding reception without looking like Frankenstein.

As a sex therapist, my first goal is to help you open up his pelvis, so he can experience sex in a way that’s less inhibited and more sensual and exciting.

But this sense of pulling in is more than just physical. Men are shrouded in layers of protection—physical, emotional, psychological—that find a nexus in the pelvis, but permeate throughout the body and mind. In this sense, every man is a knight in shining—or not-so-shining—armor.

Now I know what you’re thinking:
Hold on a minute. Protection? Please! I’m the one that could use some protecting—every time he pushes my head down and expects me to open wide and say, “Ahhhh.”

But that’s
exactly
what I’m talking about. For most men, sex begins and ends with the penis and rarely extends beyond it. From a fear of having his testicles rough-housed to sensitivity around the perineum (the area between the testicles and anus that is rife with nerve endings and shields the male G-spot) to a nobody-touches-me-down-there attitude about his butt, the male sex experience is one that’s controlled, circumscribed, and the living embodiment of uptight.

Some of these protections are physiological and involuntary—like the “cremaster reflex,” which is triggered when you touch his inner thigh. The testicles literally pull up and in. But many of these are largely conscious and psychological in nature.

The journey to, and through, manhood is very much a journey of learning to stay in control. As R. Louis Schultz, M.D., wrote in his seminal book, forgive the pun,
Out in the Open: The Complete Male Pelvis
:

 
To live in society, we all require a degree of control. Too much control, however, and we can become automatons. Control is always being right. Control is not letting your feelings influence your life. Control is not letting the joy of life be a goal. Control is not expressing your feelings. Control is being neutral or neuter. Control is not being sensual. Control is lessening the enjoyment of sex. Control is not being aware or responsive to the feelings of others, since you are not aware of your own feelings. Control is always being on an even emotional plane.
 

I quoted this passage at length because, even though Dr. Schultz’s astute observations are based on his experiences as a physician and deep tissue massage expert, I’ve too often heard in counseling these exact complaints from women about men: “He’s disconnected from his feelings;” “He won’t let go; he keeps everything inside;” “We have sex, but we don’t make love;” “He won’t talk about sex; he walks away the minute I bring up the conversation;” and so on and so on.

Dr. Schultz continues on the subject of control and its physical manifestations: “To achieve such control is not to feel, to become numb. This can apply to the entire body and is especially true in the anogenital region. Protection begins by pulling in the offending penis and anus.”

 

IMAGE

 

Later in our discussion, when we talk about the male mind, this area—the anogenital region, or complete pelvis as Dr. Schultz has dubbed it—often figures heavily in sexual desires and fantasies. Although it’s heavily guarded and sometimes taboo, the pelvis is ultimately a region that signals abandon and capitulation, an area of letting go and surrender to which men want to succumb, but are timorous. Beyond the penis is a whole new world of erotic pleasure to discover and explore. But, unless he’s a Chinese contortionist, it’s completely virgin territory, the physical equivalent of the Forbidden City.

So let’s take a look at the complete pelvis, and why—for both physical and psychological reasons—its various parts are subject to layers of protection.

 

Head Case

 

Commencing our journey at the penis, the part that gets the most attention is the glans, or head. This soft, fleshy area swells during arousal and is replete with sensitive nerve endings. From the ridge of the corona to the underside of the frenulum (which many men consider their “sexual sweet spot”), the glans is indubitably the most physically sensitive part of a man’s body.

 

IMAGE

 

Like a woman’s clitoral head, the glans is incredibly sensitive to touch, especially after orgasm or in the early stages of arousal. The glans is the area that most men stimulate heavily, even exclusively, during masturbation. For some men, their pursuit of pleasure never extends beyond the head of their penis. As author Sally Tisdale wrote in her book,
Talk Dirty to Me: An Intimate Philosophy of Sex
, “Male sexuality seems different from mine fundamentally because nothing need be involved but the head and shaft of the penis, no other part of the body need be troubled, touched, undressed, or soiled….”

But the glans, by dint of its very sensitivity, is also a protected area, both physically and psychologically. And when it comes to physical stimulation of the glans, the complaints of men are not dissimilar to those of women, who often protest about guys who make a mad rush for the clitoral head. As one woman told me, “Every time he goes down on me, it’s like the running of the bulls at Pamplona—I just want to get the hell out of his way!” But women aren’t the only ones who get rushed. Here, from the annals of persecuted penises:

“She milked me like I was a fucking cow!”

“She bit into my cock like it was a stick of pepperoni!”

“Watch the teeth;
watch the teeth
!”

One guy, a police officer who’s seen more than his fair share of mayhem, said of his wife’s oral abilities, “I’m telling you, I’m more scared of her blow jobs than I am of rushing a crack house. At least in the crack house, I can suit up. What I really need is a bulletproof vest for my dick!”

Another type of protection that finds its focus in the glans is the fear of premature ejaculation (PE). Almost every guy struggles to some degree with PE. It’s been reported that PE is
three times
more prevalent in the United States than erectile disorder. Countless reports cite that the anxiety of ejaculating too quickly significantly decreases men’s enjoyment of sex.

Sex and the City
star Kim Cattrall wrote in her book
Satisfaction
, “Premature ejaculators were the bane of my existence.” And I can assure you from a guy’s perspective that it’s no fun being the bane of any woman’s existence, especially when it comes to sexual performance or Kim Cattrall. While we’re inundated with commercials for Viagra and its competitors and impotence seems to have gone mainstream (with its media-friendly metamorphosis into erectile disorder), premature ejaculators still suffer in silence. (What I find interesting is that many women seem to regard premature ejaculation as a compliment and a sign of explosive passion, whereas erectile disorder is almost always interpreted as an insult or a lack of sexual attraction.)

What it all comes down to is that the sensitive glans is an area of conflict. There’s nothing more enjoyable than having it stimulated, but all too often, the pleasures prove nerve wracking and overwhelming. As Dr. Alex Comfort wrote of fellatio in
The New Joy of Sex
, “A few men can’t take even the shortest genital kiss before ejaculating.”

Bad masturbation habits don’t help matters. By focusing on the head during self-pleasuring, men have hard wired themselves for rapid ejaculation, which can lead to a lifetime of sexual failures. I’ve counseled guys who have been so distraught over PE that they’d rather not date at all or they’ve broken off potentially meaningful relationships with women—often without even telling them why. Instead, they continue to masturbate alone with a library of triple-X DVDs for feminine fodder.

But suffice it to say that our culture’s myopic focus on intercourse and the ejaculating penis (the all-important money shot), with the hyper-sensitive glans at its center, has inspired men to devise ways to insulate themselves from too much pleasure to postpone ejaculation. Chronic sufferers of PE have been known to wear double condoms, imbibe alcohol, apply numbing agents, run baseball statistics, even think about dead people—
anything
to reduce the pleasure. But, in truth, their efforts are misguided. Rather than reduce pleasure, men should be encouraged to
increase
and
distribute
pleasure—to extend the sexual experience to areas beyond the glans. In short, to
slow down
.

 

Q
UESTION TO MEN:
“Have you ever named your penis, and/or what did/would you name it?

ANSWER:
Spike, Godzilla, King Kong, Pee-wee, Sea Monkey, Nervous Nelly, Iron John, the Little Engine That Could (n’t).

QUESTION TO WOMEN:
If you could, what would you name your guy’s penis?

ANSWER:
Speedy, Zippy, Weary, Wrinkly, Lazy, Woody (as in Allen—neurotic and hesitant), the Little Engine That “Shoulda, Coulda, Woulda.”

 
 

The First Cut Is the Deepest

 

In uncircumcised men, the glans is covered with a prepuce, or foreskin, from which it emerges during arousal. Circumcision, a common practice in the United States, but not elsewhere in the world, is increasingly becoming a matter of debate, with many likening it to genital mutilation.

There are those traditionalists—often members of the medical establishment—who maintain that the foreskin is an unimportant, functionless flap of skin that inhibits hygiene and can potentially cause infection in both men and women.

 

IMAGE

 

But another school of thought holds that the foreskin plays a significant role in both sexual pleasure and hygiene. The foreskin is filled with nerve endings, and any uncircumcised male will tell you that stimulating it is a source of tremendous pleasure.

But for most uncircumcised men in the United States, the foreskin often creates an extra layer of protection that is entirely unwanted. Uncircumcised males are sensitive to their foreskin’s strangeness and often encounter confusion, or even disgust, from both men and women. As an example, one woman told me that when she first encountered a former boyfriend’s foreskin, she joked, “Now what the hell am I supposed to do with
that
?” From that time onward, the poor guy experienced erectile disorder and was unable to get an erection in her presence.

An uncircumsized patient once told me that, as a teenager, he caught so much flack from the guys in the locker room about his foreskin that he became terrified that they were going to try to circumcise him. As a result, he dropped out of team sports altogether and avoided locker rooms for most of his life.

 
Dear Ian,
     
So, I was about to go down on my new boyfriend for the first time when I was stopped in my tracks by a foreskin. Hel-lo! I’ve only been with normal guys before, and it kind of freaks me out. What should I do?
 

—Jenny, twenty-six, legal secretary

 

First of all, please be advised that while circumcision is prevalent in North America, it’s much less common in Europe and other cultures. So taking a global perspective, it’s really far more normal for a guy
not
to be circumcised.

Also know that the foreskin can play a pivotal role in both his pleasure and
yours
. The foreskin is filled with sensitive receptors that turn him on. And when it retracts behind the glans, it creates a wider ridge that many women find especially stimulating during sex. Some women refer to the bundled-up foreskin as a built-in “G-spot stimulator.”

Also, uncircumcised men are usually hypersensitive about hygiene, so know that he’s probably cleaner than most guys. (I once did a survey of women, “Which matters more, a big penis or a clean penis?” Clean won hands [
and
mouth] down.)

But it’s all right to tell him that you’ve never been with a guy with a foreskin before. You probably won’t be the first. Just remember to express yourself in a loving, constructive manner and recognize that not only will it not hinder great sex, but also it will probably enhance it. As one woman told me, “a foreskin is the best sex toy money
can’t
buy.”

 

Shafted

 

Continuing our journey of the penis, the shaft is the middle section and consists of three cylindrical spheres of soft tissue. In his clever book,
Talking Cock
, author Richard Herring dubs the corpus cavernosum, the two larger cylinders, “‘the lung of desire’ because it almost seems to ‘breathe in’ blood during arousal. And it holds that breath until its work is done. It’s not a ‘hollow chamber’ as the translated Latin would have us believe. It is full of sound and fury. It’s a sensational, expanding hive of blood.”

 

IMAGE

 

Think of it as the hydraulics of desire. A system of “valves” enables blood to be retained in the penis and then allows blood to be expelled post-ejaculation, which returns it to a flaccid state.

 

Does Size Matter?

 

In many men, the penile shaft is the focal point of anxieties around size. We already know that many guys worry that they’re too small, but there are also some guys who worry about being too large. Penis size plays a significant role in performance anxiety in men of all shapes and sizes.

So, does size really matter? It’s a subjective question. It matters if it matters to you. The clitoris is the powerhouse of the female orgasm, so technically deep penetration is not necessary for a woman to experience orgasm. However, the G-spot is reached inside the vagina, and a clitoral orgasm enhanced by G-spot stimulation would require penetration either with a penis, hand, or sex toy. But as the G-spot is only one to three inches inside the vaginal entrance, nearly any penis will do, unless the guy has a micro-penis—a truly “teenie-weenie”—a condition which, according to BBC News, afflicts one in 200 men, with a penis less than two and a half inches in length, erect. In fact, when you consider that virtually all of the sensitive nerve endings that contribute to the female orgasm are located within the first inch or so of the vaginal entrance, girth (thickness) matters more than length.

Looks are often deceiving. A small nonerect penis will often double in size when erect. And while most heterosexual women enjoy the physical sensation and/or emotional closeness of penile penetration, because the vagina is actually a compressed tube that “tents” during arousal and wraps itself around the penis, size matters less than is generally assumed. But sex goes beyond the mechanics of orgasm production. It’s a physical, psychological, and emotional experience, all of which affects how a particular woman will ultimately feel about penis size.

Why does size matter? The question, itself, is a Pandora’s box. When asked to describe the best part of sex, many women cite the first moment of penetration, not the orgasm. When asked why, almost all mention the sense of anticipation and connectedness. In fact, most sexual positions, especially the beloved missionary (the most popular in the world, according to anthropologists), often miss the clitoris altogether. But whether it’s a result of cultural or emotional factors or simply the procreative possibilities so signified, intercourse often seems to carry emotional pleasures for women that outweigh the physiological component of sexual response. Thus, according to the semiotics of desire, size seems to be an emotional, rather than a physiological, signifier of sexual pleasure.

 

What Other Women Say About Size

 

“These days, what matters most is that it works. More and more, a good man is hard to find, or should I say a
hard
man is
good
to find!

“I don’t mind if it’s short, but hopefully it’s also thick.”

“It’s all about a good fit. But that depends on the person more than the size of his dick. The fit has to be emotional and physical.”

“If you love the man, then you love his penis.”

“Size is irrelevant. Because most men don’t know what to do with it, anyway.”

“I like guys with small dicks because they work harder. Guys with big dicks are lazy.”

“The great thing about the vagina is it’s flexible—one size fits all!”

“Most guys don’t last enough for me to really notice one way or the other.”

 

 

 

Those women who insist that size does matter almost always do so in the context of a guy’s ability to use it well. Men miss this latter bit, especially the “ill-cliterate” ones. Many guys seem to assume that having a big penis is tantamount to being a good lover or, conversely, that having a small penis dooms you to the sexual sidelines. So, while for many women, bigger is immediately perceived as better, all else being equal, it is largely a matter of first impression. When push ultimately comes to shove, the majority of women feel that bigger does not
automatically
equal better. Much the way men may regard a woman’s breasts as more or less erotic depending on size and shape—largely owing to cultural tropes of desire—penis size, like breast size, has nothing to do with the actual physiology of orgasm or the propensity for sexual and sensual pleasure.

For many guys, penis size is really more a matter of vanity than a concern for female pleasure. Like a fancy sports car or a nifty Rolex, it reinforces a sense of masculinity. And unlike women, who are likely to have honest conversations with other women about breast size and insecurities therein, men rarely, if ever, have a heart-to-heart about their penises (though it’s funny to imagine—“Hey Jack, do
you
think my pecker’s too small?”) All a woman needs to do is look around to know that she lives in a world populated by breasts of all shapes and sizes. (The problem is that men are looking and judging, too.) But when it comes to a guy worrying how he measures up, he doesn’t have much to go on, unless he sneaks a peak in the locker room or the urinal, at the risk of getting caught (and potentially beaten up). This means that guys tend to get much of their feedback about penis size from porn, that is, the awfully “tall tales” of other men.

Also consider the fact that when a guy looks down at his own penis, the angle is likely to make him look smaller than he actually is, and you’ll start to understand why, from pumps to pills, there’s a massive market for all sorts of phony penis-enlargement products.

 
Dear Ian,
     
My boyfriend keeps saying he knows he has a small cock and apologizing for it, or he makes little self-deprecating remarks, and the truth is he
does
have a small penis. Whenever he makes a comment, I just act like I didn’t hear him, but it only makes matters worse. Next time he goes on and on about his small penis, what should I do?
 

—Liz, twenty-eight, retail clothing buyer

 

Ask most women, and they will tell you in no uncertain terms that, when it comes to their beloved joysticks, men make far too much of far too little. In short, perhaps I should rephrase, men place way too much stock in penis size. In a recent survey I did of college guys, I asked, “If you could ask your girlfriend anything about your sex life, what would it be?” I was sure they’d want to know if she’d ever faked it, but do you know what the number one response was? “How does my dick measure up to other guys she’s been with?”

As a woman, you can’t underestimate just how much of a guy’s sexual identity is wrapped around his penis. So, let me turn the question around: Does it bother
you
that he has a small penis? The truth is that whenever I talk to women who complain about their guy’s lowly lower measurement, once we get around to discussing the real issues, the problem is rarely about
his
size, but rather
her
lack of orgasmic fulfillment. Whether you’re satisfied or dissatisfied with your guy’s size, you need to reframe the conversation to focus on quality, not quantity. Because unless you’re ready to break up with him over the size of his penis, there’s not a whole lot either you, or he, can do about it.

I’ve certainly met plenty of women who have broken up with a guy because of sexual dissatisfaction, but I’ve never met a woman who left a guy solely because of inadequate penis size. You know there’s an old joke that goes, “A bastard is a guy who makes love to you with a three-inch penis and then kisses you good-bye with a six-inch tongue.” This is just one more way of saying that there’s more to sex than penis size. My advice is that the next time he makes a joke about his size, use it as a launching-point for some genuine communication. Ask him why he cares so much about his size. If he says it’s because he wants to pleasure you or that he believes size is related to pleasure, take the opportunity to set him straight. As one woman I know told her husband, who was insecure about his size, “Look, yours isn’t the only penis I’ve known, but it’s the only one that’s been worth knowing.”

If that’s still not enough, for those on the small side, it’s been estimated that one to three inches of the penis is typically pulled into the perineum: The tighter the pelvic area, the more likely that the muscles in his perineum are pulling on his penis and drawing it into the body. When a man’s pelvis is opened up through relaxation, breathing, and massage, all of which we will discuss later, it may actually lengthen his penis!

 

 

 

In many cases, the issue of size comes up when a man is too big. Many women panic at the sight of a big penis and worry about getting hurt. In some cases, it actually
can
lead to injury. Rarely does this mean you can’t have sex with him, but it does mean taking it more slowly, making sure you’re amply aroused, and keeping plenty of lubrication on hand(s). One female patient of mine was so afraid of the size of her fiancé’s penis that she thought she might call off the wedding. What made the situation worse was that her girlfriends teased her about it and told her they’d kill to be in her shoes. But it’s a genuine anxiety and one that’s likely to be more damning to sexual relations than concerns over small penis size.

Despite some unpopular views, Sigmund Freud certainly warrants respect for heralding the primacy of sexual dynamics in the formation of gender identity. A product of his Victorian age, one of his quack “theories” was that the clitoris was an immature source of pleasure—a diminutive penis, as he conceived it—and that the “true” or mature female orgasm was physiologically rooted in the vagina. This theory was later debunked by Anne Koedt’s brilliant essay, “The Myth of the Vaginal Orgasm.” Another was his oftmaligned conviction that women suffer from penis envy. His theory went something like this: A young girl sees her dad’s willy, becomes agitated that she doesn’t have one, assumes that her mom castrated her, and spends the whole of her existence seeking completion through the anatomical supremacy (i.e., projectile appendages) of her husband and sons.

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