INTERVIEW WITH SEXOLOGIST: I Have Several Young Men In Therapy Who Do Not Know How To Talk To A Girl

"Frequently changing partners leads to emotional emptiness," says MUDr. Dana Šediva. In an interview with Refresher, a psychiatrist specializing in sexology revealed what she thinks about today's relationships and why so many people are not satisfied with their sex lives. In addition to consulting in her own clinic, she is also the vice-president of the Slovak Sexuological Society.

There are people who are uncomfortable with toys, and even if we recommend them, they don't even want to hear about it.

We talked to her about what clients most often come to her with and when the turning point occurs and they admit they need help. Her youngest clients are still high school students, the oldest are in their 80s. According to her, more than by technology, healthy relationships are threatened by communication, in which today's young people are inexperienced and often don't even know how to approach someone they like.

Are erotic toys widespread?

There is a group of people who have included erotic aids in their sexual activities since the beginning of their sexual life, as they consider it to be a normal thing, they are comfortable with the form of stimulation they provide. Others worked their way up to them out of curiosity. However, many reject them out of principle, others have not even tried them and do not miss them. It's a matter of taste and sexual scenario. The younger generation probably feels less shy than the older generation, it is related to greater openness, but also to the pornography on which they were "raised".

So are single people more likely to use them?

Basically, it doesn't have to be about whether someone is single or married. It's more about experimentation, about what suits who. There are people who are uncomfortable with gadgets, and that should be respected.

When do you recommend your clients give sex toys a chance?

We can include them in couple sex therapy for female sexual dysfunctions, if the woman does not refuse it, or also within autoerotics. For example, with dyspareunia (unpleasant sexual intercourse), algopareunia (painful sexual intercourse) or with vaginismus (vaginal penetration is not possible due to muscle spasms). These are fairly common dysfunctions, around 9% of women suffer from dyspareunia or algopareunia, another 2% have vaginismus. Women who are physically healthy suffer from them, libido and the ability to orgasm can be preserved. The causes are mainly psychogenic - modulating influence of the past, character traits, partner problems, depression, fatigue syndrome. It can be a primary sexual dysfunction, which is present from the beginning of sexual life, or a secondary one - it arises only after a period of normal sexual reactivity.

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How serious is vaginismus?

Vaginismus is a reflex spasmodic contraction of the muscles of the vaginal entrance and pelvic floor, which makes penetration impossible. Even a gynecological examination is not possible with it, some women have a problem touching their genitals themselves, sexual stimulation and penetration is impractical due to the contraction of the vaginal muscles.

Not even a sadist likes going to the dentist.

So how do toys help with vaginismus?

During therapy, you cannot ask a woman with vaginismus to have sexual intercourse, not even with a man she loves. It simply cannot be done. Therefore, we recommend different vibrators of different diameters to gradually increase their sizes. We prefer to start with the anal ones, which are thinner. In this, today's time is fantastic, you can buy really everything. 30-40 years ago it was impossible to get it, even though there were many patients.

Are toys also used for men's problems?

Yes, for example, in cases where a man is unable to have an erection, or the erection is insufficient and it is long-term, or permanent condition. Affected are e.g. men with diabetes, high blood pressure, prostate diseases, after injuries. More or less all diseases that affect the vascular and nervous system can negatively affect the ability to achieve and maintain a satisfactory erection. We try to put these couples through psychotherapy and teach them to try to use what today's time has to offer.

We try to help people who can't help themselves. For some women, vaginal stimulation is alpha and omega, the problem arises when it is not possible for some reason on the part of the partner. We also help in communicating their ideas, for example if a man wants something and his partner refuses it. Where it will help survival and prevent partners from worrying and giving up on intimacy, we recommend sexual aids.

How do they react when you suggest they try an erotic toy?

Depends. It is a very intimate topic that many people cannot openly communicate about. If there is a problem, it is appropriate to seek a sexologist, we do not recommend confiding in a third person from the immediate area.

Won't the toy disturb the intimacy between the partners?

If it is by agreement of both partners, then no.

You also meet clients with sadomasochistic tendencies. So isn't it the case with them that everything is allowed in bed?

Sex can be anything that suits both partners and does not cause physical or psychological harm. Sadomasochism is a sexual deviation, it is a different innate sexual script. In the couple's sadomasochistic sexuality, it is not a real suffering, but an indicative one, a role-playing. As soon as a certain threshold of pain is exceeded in a masochist, the instinct of self-preservation begins. Fear or pain of a certain intensity can completely cancel the sexual atmosphere. Not even a sadist likes going to the dentist. It is tied only to the sexual act.

Can a toy completely replace a person?

No, that is not possible. They won't replace your relationship, but they also won't destroy anything, regardless of gender.

So it's not possible to "ruin yourself" by masturbating alone for a long period of time and then entering into a relationship with someone new?

Autoerotics is very beneficial. If a man knows his body, he has no qualms about touching it, he can only benefit from it in a couple's life. In the past, we often encountered sexually unawakened individuals who had a problematic relationship to nudity and sexuality stemming from infantile or religious attitudes. They jumped right into marriage and started having problems. Not everyone has the expected erogenous zones. Touches on the breasts, nipples, or testicles can be so disturbing for some that they kill the sexual atmosphere. It is good if individuals are aware of this and know how to communicate it with their partner. 

It's better to have good sex with a toy than to have a bad relationship.

But there are cases when it doesn't work out with a partner anyway.

Psychogenic sexual dysfunctions form an extensive chapter of professional publications. These are disorders where the individual does not feel sexual desire or is unable to perform sexual intercourse despite the fact that the anatomical-physiological prerequisites are met and is not aimed at unusual sexual goals. There are several reasons. In the case of some female sexual dysfunctions, such as libido or orgasm disorders, the evaluation can be problematic, often it is only a slow eroticization of the woman.

Female sexuality is more vulnerable to past experiences, situational influences, stimulation techniques and the quality of the partner relationship. For example, young women who have not experienced a couple orgasm come to my clinic. They try to find the answers by alternating partners, or they are "helped" by their friends. Clients are usually taken aback by the question of how many of those men they really loved... for most of them, not even one. Then it is not surprising that they do not experience a partner orgasm, while they can achieve it independently.

So what is a person to do, if they experiences greater satisfaction with a toy than with their partner?

We must distinguish between satisfaction as an orgasm and then satisfaction in the sense of sexual satisfaction. An erotic aid does not replace a relationship, it may cause a climax, but it will not satisfy you emotionally. If the partner experiences the most intense excitement through vaginal stimulation and the man is unable to do so, for example due to stamina or erectile dysfunction, there is no need to philosophise about it too. Include erotic aids in couple sex.

Can this still be worked on and improved?

Everything can be worked on. But it is better to have good sex with an erotic aid than to have a bad relationship.

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What do you think about innovative erotic toys, for example womanizer clitoral stimulators or smart toys with a mobile application controller?

In principle, nothing new will be invented anyway. Maybe a new model, packaging, new technology. But it's still the same thing: the important thing is to adequately stimulate the clitoris, so that it's neither too much nor too little, and neither too soft nor too strong. Air stimulators are good because they can be regulated. It is the same with the shower, where you can regulate the flow of water.

Do you think we will ever have sex with robots in the future?

If they achieve humanoid quality, it is very likely. It can even be very pleasant at a certain stage of life, you turn it on, you turn it off, especially if he also cleans and cooks... (smile)

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How old are your clients?

The youngest are high school students, the oldest client is about 80 years old.

What do they most commonly come to you with?

Most often due to sexual dysfunctions, couple discord, problems with excessive watching of pornography are increasing. They also come with sexual problems that result from dysfunctional relationships, for example after infidelity.

Who suffers in case of infidelity when we talk about sex: the cheated or the one who cheated?

The cheated one suffers. The cheater often only fakes the suffering and muddies the water in order to get out of it more easily. The cheated person has a feeling of humiliation, low value, feels confused, does not know how to react. Some infidelities are an escape from a dysfunctional relationship, others are the result of long-term unmanaged communication, others are just a used opportunity. Or it is a manifestation of severe narcissism - creativity knows no bounds here.

What do you think about open relationships, where two people are dating but also sleeping with other people?

Many people "swear by" open relationships, they claim that they are comfortable with them, that if they know about the other's affairs, it is not infidelity and so on. It's about decisions, sometimes about a way to keep your partner at any cost. Jealousy is an evolutionary strategy to keep a partner, to possess him. Men marry to have exclusive access to their women. If a man makes her available to another partner, what does that mean? I think that's clear...

Does this mean we are monogamous?

It seems that we are biologically determined to form a series of monogamous relationships in life, and to be faithful to one partner at some point. But since we live in a civilization and are bound not only by biological factors, but also by cultural and sociological ones, we have adopted the model of marriage for life, at least we strive for it. There are many rational and practical reasons for this. It would be ideal if we could be faithful all our lives, but conditions, possibilities and people change over time.

What are the differences between women and men when it comes to sex?

We can realize this by asking: Why are there no brothels for women? Because... who would go there? There is no demand for such a service from women...

It goes against the biological nature of the human species, it has many levels. Moreover, women are very vulnerable in bed. Intimacy therefore belongs to a man who takes care of them, protects them, does not abuse his power. Men, as long as they love, want their woman to accept and admire them, they worry when they can't satisfy her, they can't stand her crying. Couple sexuality is a buffer zone, a glue between two sexes that must get along and raise offspring.

Do women or men visit you more often?

It's half and half.

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Where is the threshold at which they say it's time to see a specialist?

They come when the problem has flipped from the sexual area to the relational area, resulting in anxiety, disagreements and misunderstanding. The problem can come even after years of normal sexual life. Sometimes they put it off so much that they hardly communicate with each other and other things in the relationship don't work anymore.

Do women or men care about penis size more?

It depends. 

Do women care about it?

Mostly only in cases where the penis is really too small. Even if a woman loves her man, she feels nothing during sex. It is very difficult to solve. Not all women find it important, but for some, vaginal orgasm is essential.

Can the issue of a too small penis be solved in a relationship?

It depends on the quality of the relationship. Sometimes a woman convinces herself that it is not important, but over time she reconsiders her attitude. The solution can be various sexual aids, but this can have a devastating effect on a man, because it is a very sensitive topic.

After all, many women say that even sex without orgasm can be good.

Yes, with women, but men don't take it that way. We have to explain to men that a woman simply considers them the best partner, even if her body doesn't react the way he would imagine.

And when the penis is too big, how does it affect the quality of sex?

Apart from pornography, big penises are not really that popular. Here, too, the golden mean applies. Men with too big penis have to constantly check themselves during sex, keep at bay, they don't have the closest contact they desire. Certain positions are also problematic.

Sexuality is not separate from relationships.

Now we talked about penises, but let's try to look at the opposite case. Are men, or even women, used to dealing with what the vagina looks like?

Men almost don't deal with. But due to the influence of pornography, attention has also shifted to these parts. More and more women are concerned about it. They compare themselves, they don't consider themselves good enough, they are strict with themselves. In the past, the size of the breasts was discussed, now also the size and shape of the vagina.

Much has already been said about how pornography affects the relationships and sex lives of consumers. How do social media and various dating apps come into this?

Social networks are rich in fake statuses and emotions, they rarely copy reality. There are also happy acquaintances on social networks, but the vast majority of people have not had time to learn to communicate face to face. Many have not learned to pick up and keep a partner. I have several young men in therapy who don't know how to approach a girl. Girls complain that they have no real place to meet, they fall into despair when their partner relationship breaks up, they are horrified to find out that profiles on social networks are just a fantasy, a pose... many try older men, hoping that they already have some common sense and experience.

We recently tried Tinder for ourselves for 30 days and met almost twenty men. During the experiment, we confirmed that many people are really looking for sex there. Could it be that women just go to Tinder when they're looking for sex, and that's why the in-person communication falters?

There is no generally applicable answer. Looking for casual sex is more natural for men, the reasons are biological and notorious. It is questionable whether girls go there primarily for sex. 

Isn't it because they feel lonely and are looking for company?

In the last decade, we perceive that there is a misunderstanding of gender differences. They are biologically given. They can be twisted, deformed, adapted, but not permanently silenced, they are our essence. Sex has always been what men wanted and women were willing to give them under certain circumstances. The man at least feigned love, the promise of marriage, or financial benefits. Today we witness an unprecedented phenomenon that girls agree to sex without love, relationship, any benefits, as if they are not asking for anything... and still feel strong and emancipated.

A man who is given such sex has reached an ideal state, doesn't even have to try to pretend. And that it does not ultimately bring satisfaction to the girls is to be expected. Emancipation gives women the opportunity to be financially self-sufficient, to choose the life they want to have and to choose a partner, even to leave him. But women's sexual satisfaction is created differently than men's.

Do you also have female clients who have this lifestyle and find that it doesn't work?

Many young women come to the clinic asking to find out "if they are normal." Many are looking for love in this way, it is not unusual for them to develop sexual dysfunction in this way.

So you're saying that changing partners won't work for women?

Alternation without love is not. Times are changing, in the past people didn't have such expectations and demands on each other, and especially they didn't compare themselves. Rarely did a woman change her man just because he didn't have enough stamina in bed.

And what do you think about the so-called friendship with benefits?

Friendship with benefits is a dead end for girls. That is, if we do not count those who try to awaken love in a "friend" and take the relationship to another level. For guys, it's an opportunity to have casual sex available.

How do you think today's couples are different from ten years ago?

The history of relationships that women in particular have behind them is changing. In older generations, girls married young, took their first or second sexual partner. Sexuality was taboo, it stayed at home, pornography was limited. Sexual problems were not discussed, people remained in dysfunctional relationships for various reasons.

Today we have easy access to information, do you see this as something positive?

Much has been written about sexuality, but much of it is half-truths or untruths. It can be difficult to choose from such a lot. There is a lack of state-guaranteed texts for schoolchildren, which would provide them with basic information about sexuality, with a warning about the risks of manipulation. At the same time, there is also a lack of campaigns that would point out and prevent socially dangerous phenomena such as sexual violence and abuse.

Can you share your top sex tip for young people?

There is no top council. Basically, we all want to be loved. If we find love, we must hold on to it.