I'm a happily married straight man. My wife, who is 33 years old, cannot orgasm through intercourse since we had our last child. Her explanation is that she has this constant sensation to pee. Now we find other means to please her through toys, oral, etc. Are there exercises or other means to get her to climax through intercourse? Is this common from childbirth?
—Climaxing Liberally Is Fun
"Failure to orgasm with penile penetration is not a medical condition," said Dr. Jennifer Gunter, an ob-gyn, writer (drjengunter.wordpress.com), and kick-ass tweeter who practices in the San Francisco Bay Area. "If a woman can orgasm with other methods—oral sex or masturbation or toys—then that means everything is working just fine. Remember, it's not how she gets to the party that matters, it's that she got to attend the party."
As all straight men need to be aware, CLIF, only a small number of women—less than a quarter—can get off from vaginal intercourse alone, aka PIV.
"Most women require clitoral stimulation to have an orgasm, and often the mechanics of penile penetration just don't produce the right kind of friction," said Dr. Gunter. "It's possible that the subtle anatomical changes post-childbirth have altered the friction mechanics of your coupling. Introducing a vibrator during sex might help."
And while we're on the subject of clits, CLIF...
We abbreviate sign-offs around here, as everyone knows, and like PIV for your wife, CLIF, your sign-off didn't quite get you there. You could've gone with "Climaxing Liberally Is Terrific" or "Tremendous" or "Totally Spectacular," but you didn't. Perhaps it was an innocent brain fart—perhaps I'm reading too much into this—but if you didn't spot the near-CLIT staring you in the face in your sign-off, CLIF, it seems possible that you may have overlooked your wife's clit, too. Also possible: Your wife wasn't actually having orgasms "through intercourse" before she gave birth to your last child. You're clearly invested in climaxing together—just like in the movies and porn and other fictions—and your wife, like many women, may have been faking orgasms to please a male partner. Tired of faking orgasms, your wife seized on the birth of your last child to explain why she "suddenly" couldn't come from PIV alone anymore.
What about your wife's constant sensation to pee during intercourse?
"That's something to be looked at," Dr. Gunter said. "After childbirth (and sometimes just with age), women can develop an overactive bladder or pelvic-muscle issues, and these could be exacerbated during penetration, making a woman feel as if she needs to empty her bladder. Worrying about peeing during sex might be holding her back. It might be worth a visit to a pelvic floor physical therapist and/or a urogynecologist if this sensation to pee during sex is bothering her. But if neither the lack of orgasm with penile penetration nor the urgency to pee is bothering her, and she is having orgasms other ways and is happy with that, I would be happy with it, too. After all, it's her orgasm, and stress or pressure to orgasm a particular way might negatively affect her party."
Follow Dr. Gunter on Twitter @DrJenGunter. Do it: She's amazing and hilarious, and she kicks right-wing, anti-choice, sex-negative ass up and down Twitter on a daily basis.