The Truth about Viagra & Having better sex in your 50s, 60s & 70s

The Truth about Viagra & Having better sex in your 50s, 60s & 70s

Blowing away myths and misconceptions about sex and ageing.

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Many people assume that as you age, your sex life declines, but you are built to be a sexual person from the day you were born to the day you die.

Even into your 60s, 70s, and 80s you can really enjoy sex, and sex can even get better in many ways over time.

Why do couples stop having sex as they get older?

When couples stop being sexual, at 50, at 65 or 75 in over 90% of the cases it’s almost always the man’s decision; and the reason is that is he’s lost his comfort and confidence with erections, intercourse and ejaculation,  and this becomes frustrating and embarrassing and so he avoids it.

He often makes this decision on his own and without discussion with his partner. Sex has become more of a hassle than a pleasure, but that doesn’t have to happen.

There’s all kinds of ways that people can enjoy being sexual in their 60s, 70s and 80s. The most important concept is that, unlike in your 20s and 30s where your sexual functioning was autonomous, you didn’t need anything from your partner in order to experience desire, arousal, and orgasm; it becomes different as you get older.

For sex to be enjoyable and satisfying, it’s got to be seen as a team sport. You need to think about your partner as both your intimate and your erotic friend.

Rather than the way you learn to be sexual which is totally predictable intercourse, when you are over 50, you will be more satisfied if you adopt what Barry calls the Good enough sex model, which is that not all sexual experiences flow into intercourse.

Not all sex needs to flow into Intercourse

When it doesn’t flow into intercourse, rather than apologizing or panicking, you comfortably transition either to an erotic non intercourse scenario or a cuddly sensual scenario and then take a rain check and go back to being sexual later on.

Sex is definitely something more than just wiggling your genitals around until they go pop.

If you define sex as the way most men learn sex in their adolescence and young adulthood, they get one easy erection, they go inside the woman at the first erection and they ejaculate. Actually the big problem for young males is ejaculating prematurely and it’s very predictable. but interestingly, these are the men who tend to stop being sexual in their 50s and 60s.

But if you can adapt to this new way of understanding and thinking about sex, then you can continue to be sexual into your 80s.

The truth about Viagra and Cialis

The pro-erection medications, like Viagra, Cialis and Levitra have probably caused more Sex-less marriages than anything else in history.

They are, in fact, helpful, and safe medications for a great majority of men, however they don’t function at all the way they appear to in the ads. The ads are hyped and they are totally misleading for men and couples.

What they promise is a return to the kind of erection you had in your teenage years, that you will have the automatic erection, 100% of the time, and  you’ll go straight to intercourse.

Then, when that doesn’t happen, it can be hard not to feel like a failure.

In reality when you take Viagra, Cialis, or Levitra, between about 65% and 85% of the time you are going to have an erection sufficient for intercourse.

But the medication does not give you an erection. It does not create the desire.  When you are feeling desire and are aroused, it allows your vascular system to be more efficient, so that you maintain your erection longer, which is why it is helpful.

In very simplistic terms what the medications do is decrease the blood flow out of the erectile tissue of the penis. Basically they constrict those blood vessels so that there is more blood in the spongy tissue of the erectile area of your penis and therefore it is a little easier if you have the proper psychological motive and are being stimulated.

They all basically have the same success rate, about 65% to 85% of the time.

The mistakes men make with Viagra and Cialis

 

There are 2 major mistakes that men make with Viagra,Cialis and Levitra.

  1. They expect that they are going back to an automatic erection. That’s not true, you need both psychological but also physiological stimulation; that is, you need manual or oral rubbing stimulation.
  2. Then, the biggest technical mistake that men make is they are afraid they’re going to lose their erection, so as soon as they get an erection, they move to intercourse as soon as possible for fear of losing it. It’s a very understandable mistake but it’s a very self-defeating pattern. A man should only transition to intercourse at higher levels of arousal.

Consider arousal being on a 10 point scale, where 5 is where you are just beginning to get aroused and get an erection and 10 is reaching orgasm. Most men move to intercourse when their arousal is about a 4 or 5 and then they get more aroused during intercourse.

It is far better to wait to transition to intercourse when your arousal is at 7 or 8 (when you’re highly aroused) rather than earlier.

Of course as young men, you may have had experiences where, if you wait too long, you don’t have enough control over ejaculation or orgasm,  and so you’ll come sooner than you want to, so in your senior years, it’s easy to assume when you feel it’s ready and it’s working, then it’s best to just do it now, fearing that more play might make you have less control.

But in fact the reality is just the opposite.

For men over 50, some 15% to 20% of men at least on occasion experience ejaculatory inhibition. Again what’s happening with them is they’re playing with sex by the old rules rather than new healthy rules in your 50s, 60s, 70s, and 80s.

So many men try to force erection at low levels of arousal, which results in them running out of steam and they don’t ejaculate. Then they worry that that might have an erection problem, but in fact it is more a problem of ejaculatory inhibition as they are not aroused enough.

So, you will need more stimulation before transitioning to intercourse at higher levels of arousal, and also  multiple stimulation during intercourse.

In reality, very few men go back to 100% erectile functioning. However, the great majority of men can enjoy sex more, and enjoy intercourse more, but that 65-85% is a good guideline.

The Advantages of getting older

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As men and women age though, two things develop, both of which are very positive for them.

  1. They need each other more.
  2. Sex becomes more of a team sport. They need each other, and they can develop an enjoyment of a shared sensual, erotic and the intercourse experiences.

What exactly is good sex?

In our western world we are very confused about the whole idea about sex.

In our minds we have this thought that if it doesn’t include penetrative sex and actual shooting of fluid then it isn’t sex.

Most men are really, really orgasm focused.  Many men have learned that sex is highly controllable and highly predictable, and the whole idea of pleasuring and foreplay is seen as for the woman only.

Men basically learn to think about sex as intercourse or nothing. You either hit a home run or you didn’t play the game, or you failed the game.

A Great Exercise to boost your sex life

But, there’s a much better way of thinking about it and that is Barry’s concept of Five gears of touching. It’s like a stick shift car.

The first gear is affection and touch which has great value in it itself. Whether it’s holding hands, hugging, kissing, that kind of thing. Affection is very important in terms of intimacy but it’s not basically sexual.

The second gear is when it starts being sensual. Sensual refers to non-genital touching, it refers to cuddling together like kissing, holding when you wake up in the morning or when you go to sleep at night. It refers to body massages that are non-genital. The way to think about sensual touch on our 10 point scale of arousal is sensuality allows you to feel 2 to 4 on that scale.

A third dimension of touch is more playful touch and what you mean by that, it can be nude, it can be semi-nude, it can be clothed. It mixes genital and non-genital touch. It’s things like doing whole body massages including genital pleasuring. It means taking showers or baths together. It means dancing in sexy or erotic ways and again in terms of arousal scale, it’s thinking about playful touching going from a 3 to a 5 or 6.

The fourth kind of touch is erotic non intercourse touch. That includes manual stimulation, oral stimulation or rubbing stimulation. Whether it’s taking turns or mutual and erotic non intercourse touch has great value in it of itself or as a way of leading into intercourse so we can be anything from a 5 to a 10 on our arousal scale.

The fifth gear is intercourse. It’s best to think of intercourse not as a pass/fail test but as a normal other dimension. Most of the time sex will flow to gear 5, but when it doesn’t, it doesn’t mean it was a failure or there’s something wrong with you.

So, if you switch to intercourse and see it as a pass/fail test at a 3 or 4, it’s likely to give you trouble rather than enhance your good feelings about sex. That’s the danger that a lot of men fall into. It’s a totally unnecessary danger.

If you want to enjoy intercourse in your 60s, 70s and 80s you need to see intercourse as part of the sexual experience and not the pass/fail test of the sexual experience. You can enjoy it as a natural continuation of the erotic flow.

It’s best to transition into intercourse at 7 or 8 in arousal, and also have multiple stimulations during intercourse.

If, at 15% or 20% of the time where it doesn’t flow into intercourse, rather than panicking or apologizing, you can be comfortable switching to erotic non intercourse sex whether for both of you or just one of you; or just decide and say “This isn’t going to be sexual night but let’s make this a sensual cuddling night” and then be sexual the next couple of days when you’re feeling more open and receptive to being sexual.

You can just take that rain check rather than just panic.

For the average, orgasmic woman, she’s orgasmic 70% of the time, not 100% of the time, so she understands that love making and orgasming is a variable process.

Also, the idea that you need each other is a large factor because most men feel early in their life that they don’t need a woman; but as they age, they come to understand that they do.

distand the new closenessIt’s much better and healthier to see the physiological changes in your body and relationship changes as a challenge and finds ways to meet that challenge so you can really enjoy sex as you age.

When you do so, it’s not only good for your psychological wellbeing, it’s good for your physical health. Men who are in healthy relationships including a relationship that involves touching and sexuality live longer and have a better quality of physical life.

 

Along with good eating patterns and reduced drinking and not smoking, regular exercise is also really healthy for your physical and sexual health too.

There’s a lot of evidence available, and it’s even more true of men than women, that for men being able to enjoy an active pleasurable love and sex life with their partner well into their 80′s means life can remain vital, enjoyable and loving until the very end.

If you would like help in achieving this healthy well rounded love and sex life at any age, please give us a ring and one of our psychologists or Sex Therapists will be able to assist you.

To Check which of our Psychologists are closest to you, please use our Find our Psychologist Search box on the right hand side of the page.

Or phone us on 1300830552 for more details and assistance.

Julie Hart  (Adapted from Chip August’s Interview with Barry McCarthy, Psychologist, Sex therapist & author of 5 books on Sexuality)

The Secret to more sex and why women in particular, lose interest in sex.

Always the hottest topic, sex, and our need and desire for it, and the differences in what men and women want, is never far from most people’s minds.

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Sex and lovemaking can be either the most delicious, or dissatisfying part of your life. Sex can be a way for you and your partner to open your hearts, surrender your bodies, and share the most fun and ultimate pleasure together, or it can be a most frustrating and empty experience.

Depending on how you do it, sex can be an intimate ravishment, or a total flop. The most recent studies have shown that 1 in 3 women are turned off sex, whereas the figure is closer to 1 in 6 for men. It seems that from the 2008 Durex Sexual Wellbeing Survey of 26,000 people around the world, as well a recent Australian study, women in particular often feel they lose interest in sex because the kind of sex on offer is not what turns them on.   And here’s why:

The 2 Essential keys to understanding Great Sex.

1. Great Sex: Different pathways   In truth, what we all want (both men and women) is a fabulous, warm, intimate, fun, pleasurable sex/love life with our treasured life partner. The great difference, we discover, is that naturally, the pathway to that is different for men and women. Men seek it through physical sex first; and through having sex with his woman, he opens more emotionally and connects. On the other hand, a woman needs the emotional intimacy, closeness and loving appreciation first, before she feels she is willing to open her body to this “disconnected emotional stranger”. This is hugely important difference that needs to be taken into account in order for sex and lovemaking to be great for both of you..

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2. There are greater rewards for a man by delivering what his woman desires first.   When you have made your woman truly happy, she is more than happy to grant you your wishes in return.   It is amazing to see the turnaround in a woman who is truly satisfied, both emotionally and physically… the glow on her face when she is well loved and “orgasmed” out… and her strong desire to do anything she can to show her man just how much she appreciates him. This is a secret that very few men even know, let alone use to their advantage.   Relationships that last the longest, and are the most successful are those in which the woman is getting her desires fulfilled, giving the man a double win by first knowing he is responsible for his wife’s delight, and in addition, have an appreciative wife wanting to give it to him in return. A true Win/Win for both of you.   Having had the great honor of sharing the intimate details of thousands of couples’ love lives in my counseling practice, and having access to the latest world research and trainings on sex, love and relationships, I’ve come to understand that most men have not even scratched the surface of how to get the best from their woman, their sex life, and their relationship.   The good news is that 70% of women would like more sex. And here’s what they are looking for:

Emotional Connection and Intimacy

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Sex for women, is like the glue in the relationship. It helps her “bind” to her chosen man. For most women, the emotional is indivisible from the physical, and the emotional preceeds the physical .   Her desire for her man is fed by feeling close to him and by his presence. Your woman wants to feel emotionally connected to you, before, during and after sex.

Tip 1: Take the time to sit and talk with her daily, with no distractions of TV, phones and kids. Just by taking the time to talk and listen to her, she feels closer to you, and more open to other things.

ROMANCE. Women love lots of it.   Women like to be treated as the uniquely special creatures that they are. Attention, and affection go a long, long, long way, guys, together with your appreciation of her, as an individual and as a woman.

Tip 2: Call her through the day to say you love her, organize a weekend away just for the two of you, surprise her with a single rose, tell her what you love about her. Try something new every week. Women never tire of you finding them attractive. And women love to look forward to things – allude to a special surprise at a certain time.

sensual touch

 

FOREPLAY. No, this is NOT a golf term!   Foreplay is what builds desire in a woman. In the bedroom, women want to be warmed up first, and she would love you to explore all of her body more. Feeling her man’s hands caressing her whole body can be a great turn on for a woman.

Tip 3: Take much more time, look her in the eyes, and learn the art of erotic touching and teasing, before going for the genitals, and you’ll be her hero in bed. 

SUPPORT. Just as important as in bed, a woman wants your support, in general.   Most women are tired from handling work, kids, and the endless household tasks at the end of the day. Resentment can often build if she has been left to shoulder more than a fair share of the workload. Be aware that this is very important to a woman. A little help goes a long way.   Resentment and anger is the number one killer of passion and sexual openness for women.

Tip 4: Offer her plenty of support around the house, and she will feel cared for by you and far more open to you.   She also needs some time off to rejuvenate, and revive her sensual self with some of those femininely nurturing trips to the hairdresser, facials, and massages. Believe it or not, this nourishes her femininity. (In the same way, having a beer with your mates “nourishes” males). Even buying clothes that she feels beautiful in, helps her love who she is as a woman, and feel beautiful and more open to being sensual.  

ORGASMS. ALMOST ALL women have not yet explored their full orgasmic potential…, yet! Studies show that 80% of men report they have orgasms almost every time they have sex; in contrast women have orgasms only 36% of the time.   Orgasms, and various types of orgasms, and even multiple orgasms, are another area that most women would like to explore. More complicated and variable than the male orgasm, the female orgasm can be a wonderful unfolding mystery. All orgasms are not equal for women. And through exploring and experimenting, men, too, can extend their orgasmic potential far more than you ever thought possible.

Tip 5: Make it your mission to explore your orgasmic potentials together.

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FUN AND VARIETY. It’s true, Girls DO want to have fun as much as men. Most women would love more playfulness, variety and adventure just like men would. A man who is willing to create delightful experiences, both in and out of bed will win her heart far more easily. Why not both provide some fun and variety?  

Tip 6: Broaden your sexual-loving repertoire by being playful, warm and caring, deep and meaningful, short sessions, long sessions, new positions, and give and take.

Difficulty Orgasming: How can I experience more pleasure?

Is Your Orgasm Hard Work or Impossible?

About 10% of women are non-orgasmic. It is between 5 to 10 times harder for a woman to have an orgasm than a man. While men only take on average 2 and a half minutes to get there, it takes women around 12 minutes.

It is an interesting fact that women are more likely to bond long term with men who can make them come.

Numbers

While 80% of men report having orgasms almost every time they have sex, women have orgasms only 36% of the time.

More complicated and variable than the male orgasm, the female orgasm is a continually unfolding mystery.

However, women are born orgasmic. If left in their natural state, and raised in a relaxed environment, young girls and women are capable of experiencing orgasmic states frequently, on a daily basis, without any effort.

This is not the orgasm we see in porn or the movies. It is not about muscle spasm. It is spontaneous in nature, requiring no deliberate stimulation. The warmth of the sun or the feel of the breeze on her skin can trigger tingling ripples of delight through a woman’s body, like a shiver. Learning about the world comes through the messages her body gives her.

The Key is Relaxation

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Knowing your body comes from allowing yourself to feel. The key is to be relaxed. For women to reach their sexual potential they need to become accustomed to being relaxed in everyday life. In any given sexual encounter with a partner women need to be relaxed. To be orgasmic, women must allow themselves to be receptive and sensual and drop any need to ‘be in charge’ (of themselves or another).

Women and their partners need to be patient and respectful of their differences. It’s important to have:

  • no agenda
  • no goal
  • no desired outcome

Women also need a beautiful, sensual and safe environment with no sources of distraction.

Many women (up to 50%) report lack of sexual desire. This many women cannot be dysfunctional! It is a signal that our modern lifestyle is at odds with a woman’s natural way of being. Many women have lost touch with their sensuality.

It is normal for women to feel sexual desire AFTER sexual activity has already begun. This is not common knowledge. Many women talk as if sexual activity can only happen if they’re already ‘in the mood’. And by sexual activity I do not mean intercourse.

Female sexuality is not logical or sequential. Women enjoy mystery, and the unpredictable. Women like to be wooed, teased, tantalised .…. by the promise of what may come! This can happen at any time of day…and quite unexpectedly.

Anticipation builds sexual arousal. Touch is not necessarily required. Women can become aroused by a partner’s tone of voice, or breath against her skin, or …… just a look, in complete silence!

And what worked yesterday may never have the same effect twice. Repetition leads to boredom.

Women need to educate themselves and their partners. Like food and water, we all need space to connect with ourselves, to feel our bodies, to hear our inner body knowing, and to respond to it.

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Rushing, having an end goal, and engaging in excess stimulation will derail this process. Being in tune with yourself is more important than what you or your partner does. Aim for mutual giving and receiving of pleasure (not orgasm).

Orgasm comes when it’s ready, when you are totally relaxed and your body is overflowing with pleasure. The orgasm I speak of is not limited to muscular contraction of the genitals. It’s not the kind that is over in a few seconds. I am speaking of the wave after wave of pleasure which spreads through a woman’s whole body, that need never end. These orgasmic waves have a sense of timelessness. All sense of time is lost. Many women have never known this space. It takes time, yet minimal effort, for a woman to reach this state. (Allow an hour or more.)

It takes at least 20 minutes for a woman’s body to fully prepare for sexual intercourse, to give her vagina sufficient time to fill out and lubricate, and for her lips to fully open in readiness. A woman needs this preparation time, to quieten her mind and relax into feeling her body.

Women, in their natural state, are open and receptive to sensual pleasure. A woman’s body responds as she relaxes. More and more sensations are experienced as you relax, breathe, and let go of mental chatter. Women are capable of extended orgasmic states and ecstasy. There is no limit to the pleasure women are capable of feeling, other than the limits we put on ourselves.

The 4 Stages of Sexual Experience

If you are experiencing difficulty reaching orgasm (climaxing) it’s important first to understand the four stages of a sexual experience:

1. Desire

2. Arousal

3. Orgasm

4. Refractory period

In women, steps 1 and 2 can be (and often are) in reverse order as I’ve already discussed.

However, orgasm usually only happens if desire and arousal are already well established.

Range of orgasms for women

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Only 30% of women report that they can orgasm through intercourse alone, and 40% say they need clitoral stimulation in order to orgasm.

After masturbation, receiving oral sex is the most common way women have orgasms.

Clitoral stimulation is approximately twice as likely to lead to an orgasm as vaginal stimulation.

The problem is that many women feel inadequate if they can’t orgasm through vaginal penetration alone. This is one of the biggest reasons why women fake orgasms.

The position many women feel is most likely to have an orgasm is with the woman on top, doggy style, and the man entering from behind.

Penetrative orgasms are most likely achieved when G spot is stimulated.

Many women say they can only have an orgasm when penetrated if preceded by masturbation of oral sex.. They like the more direct stimulation of the clitoris close to the point of coming, and then like to finish off with intercourse.

Woman first need to get to know their bodies and what turns them on. Then, by building more and more pleasure, the body responds by overflowing into orgasm.

Orgasm is a reflex. It cannot be forced. However it can be prevented by negative thinking and body tension. The key is to relax mentally and physically and let your body do what it already knows how to do.

If you would like some help in discovering what’s stopping you from having great orgasms, let us explore some of the factors with you and help you achieve the wonderful orgasms your body was designed to enjoy.

To Check which of our Psychologists are closest to you, please use our Find our Psychologist Search box on the right hand side of the page.

Or phone us on 1300830552 for more details and assistance.

Premature Ejaculation: How to last longer in bed

The term Premature Ejaculation means different things to different people. Broadly speaking, it refers to a man ejaculating before he is ready or his partner is ready, with minimal sexual stimulation, and usually before or within a few minutes of vaginal penetration.

Only if it causes distress is it considered a problem.

Premature Ejaculation (or PE) is widely believed to be the most common sexual problem experienced by men, affecting about 20-30% of men at one time or another, and is very common with younger men in particular.

Some evolutionary theorists speculate that quick ejaculation evolved in our cave man era so that men could reduce the chances of being attacked by a predator while copulating. That’s efficiency!

Many meanings

It is important to understand that early ejaculation can have many different meanings, effects and consequences for the man and his partner. For example, many men with Premature ejaculation worry that they are letting their partners down, when in fact their partners are not bothered by it. So it is important to explore what it means for each partner.

Some men experience premature ejaculation only occasionally, while others live with it their whole lives. Premature Ejaculation can run in families: 91% of men with lifelong PE have an immediate male relative with lifelong PE. 

However, all is not lost. Most men who ejaculate too quickly can learn to extend their arousal to last longer and increase sexual pleasure for themselves and their partner.

Ejaculation normally results when sufficient physical and/or mental stimulation is present. Ejaculation is a spinal reflex, controlled by the sympathetic branch of the autonomic nervous system. A reflex is something that happens automatically without you having to think about it (such as heartbeat, breathing, and pupil dilation).

Ejaculation is usually accompanied by orgasm, which is what makes it a pleasurable sensation, however ejaculation can also occur without orgasm, and vice versa.

You can learn to slow it down

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A man cannot force himself to ejaculate, just as a woman cannot force herself to reach orgasm.

However, men can learn to delay ejaculation by maintaining sexual stimulation below their critical threshold (ie. below the ‘point of no return’).

Learning where this ‘point of no return’ is and learning how to back off before reaching it is the key to delaying ejaculation.

Stress contributes a great deal

The sympathetic nervous system (that controls ejaculation) is also activated when we experience stress. So a man who is regularly anxious or stressed is more likely to experience premature ejaculation. Stress can also take the form of over-excitability. Young men especially can experience premature ejaculation due to getting over-excited.

Learning relaxation and breathing techniques to control stress and excitement levels can be a big help in extending lovemaking.

In my practice, I’ve seen many men with high powered or stressful lives who experience premature ejaculation. Doing things ‘quickly’ has become a habit, in all arenas of life. While this habit may serve its purpose in work situations, it’s not so useful in intimate lovemaking.

Fortunately all habits can be changed if there is sufficient motivation to change.

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Here’s a list of health and lifestyle issues that can contribute to Premature Ejaculation:

Physical health:

  • Arteriosclerosis
  • Diabetes
  • Endocrine problems
  • Epilepsy
  • Multiple Sclerosis (MS)
  • Urinary tract infections
  • Prostate infections

Drugs, Alcohol & Pharmaceuticals:

  • Drug use, such as heroin and cocaine
  • Reliance on alcohol to dull sensation
  • Some prescription medications, such as tranquilizers

Mental health:

  • Anxiety disorders & depression
  • Anger, frustration
  • Poor self-image
  • Poor self confidence
  • Stressful events (divorce, death, financial or work-related)

Relationship issues:

  • Power struggles
  • Fear of intimacy
  • Demanding partner
  • Unrealistic expectations

Premature Ejaculation is primarily a learned behaviour. While many sufferers of PE often seek medical solutions, there is no magic pill for unhelpful habits.

As with any sexual challenge, it’s quite common for both partners to be contributing in some way to a pattern of premature ejaculation.  Consequently, sex therapists generally prefer to see both partners, since changing both people’s bad habits leads to the best outcomes.

What can you do?

If you would like to overcome your premature ejaculation and recreate a healthy and happy sex life again, come and talk with our Sex Therapist or Relationship Psychologists.

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He/ she will explore what factors are contributing to your problem and give you strategiesthat will help.

Phone 1300 830 552 to enquire or make an appointment.

To Check which of our Psychologists are closest to you, please use our Find our Psychologist Search box on the right hand side of the page, or phone us on 1300830552 for more details and help.

Alison Rahn, Sex Therapist © Copyright 2012 http://www.alisonrahn.com.au/

References

Hertlein KM, Weeks G, & Gambescia N (Editors) (2008) Systemic Sex Therapy; Routledge

Leiblum SR (Editor) (2006) Principles and Practice of Sex Therapy; Guilford Publications, Inc.

Rathus S, Nevid J & Fichner-Rathus l (Editors) (2005) Human Sexuality in a World of Diversity, 6th edition, Boston : Pearson Allyn and Bacon

Waldinger MD, Hengeveld MW, Zwinderman AH, & Olivier B (1998) An empirical operationalization study of DSM-IV diagnostic criteria for premature ejaculation, International Journal of Psychiatry in Clinical Practice, 2:4, 287-293