Tuesday, January 15, 2008

Sex: Fact and Fiction

What’s the average penis size? How fast is premature ejaculation? Exactly where is the G-spot? Grab a ruler and a stopwatch as the experts sort sex myths from the facts.
By Rob Baedeker
WebMD Feature
Reviewed by Amal Chakraburtty, MD

If there were a roll call for the founding fathers of sex myths for men, a couple of no-brainers would surely make the list: porn legend John Holmes, whose yule-log-size penis still casts a shadow over anxiety-prone males. Ditto NBA-great Wilt Chamberlain, whose claim of having slept with 20,000 women makes Don Juan look monastic.

And then there’s purveyor-of-sex-myths Walt Disney.

“I think Walt Disney creates a lot of mythology,” says Seth Prosterman, PhD, a clinical sexologist and licensed marriage and family therapist practicing in San Francisco. “In Disney movies, people fall in love and walk into the sunset, and you get this myth that intimacy is a given once you fall in love, and sexuality is natural and follows that.”

In reality, says Prosterman, “Sex is something that we learn throughout a lifetime.”

If sexuality is a continuing education, a lot of us are scrambling to make up course credits. And in a realm that’s clouded by ego, myth and advertising that preys on anxieties, getting the facts about sex can be difficult. What is the average size of the male penis? How long do most men last during intercourse? Can men have multiple orgasms? Does the G-spot exist, and if so, how do I find it?

Penis Size: The Hard Facts

“Drastically enlarge the penis length and width to sizes previously thought impossible!” reads a website for the Penis Enlargement Patch. (One envisions a lab-coated mad scientist pouring chemicals on his own penis, then shouting ”Eureka!” and phoning the Guinness Book.) Almost anyone with an email account has been deluged by spam for such miracle-growth patches and pills, and the endurance of sex myths may explain the pervasiveness of such ads.

“We equate masculinity and power with penis size,” says Ira Sharlip, MD, clinical professor of urology at the University of California at San Francisco and president of the International Society for Sexual Medicine. “Of course, there’s really no relationship.” Still, Sharlip says, “all” of his patients want to increase their penis size.

The idea that bigger is better is “not just total mythology,” says Seth Prosterman, who has counseled couples since 1984 and notes that some of the women he’s worked with do prefer a bigger penis -- aesthetically or “fit-wise.” But, he adds, “For the vast majority of partners, penis size doesn’t matter.”
So what, exactly, constitutes a big penis? Let’s whip out some data:

• The average penis size is between five and six inches. That’s for an erect penis.

• The flaccid male organ averages around three and a half inches.


Sex Fact: We Are Not Our Penises


If you had an anxiety hiccup before you read the “erect” qualifier, consider it a metaphor for the danger of jumping to conclusions about penis size -- or about the primacy of the penis altogether.

“The idea that the penis is the most important part of your body underlies so many of men’s sexual problems,” says Cory Silverberg, a sexual health educator and founding member of Come As You Are, an education-based sex store in Toronto. “One of the biggest sex myths for men is the notion that we are our penises, and that’s all that counts in terms of sex.”

“It’s a myth that using the penis is the main way to pleasure a woman,” says Ian Kerner, PhD, a sex and relationships counselor in New York City whose book She Comes First offers a guide to “female orgasms and producing them through inspired oral techniques.” In his book, Kerner cites a study that reports women reaching orgasm about 25% of the time with intercourse, compared with 81% of the time during oral sex.

OK, OK, Size Isn’t Important. But How Can I Increase My Penis Size?

Despite the facts, the din of penis-enlargement marketing only seems to grow louder. (“Realize total and absolute power and domination in bed with your partner, with your new-found penis size and sexual performance” screams the ad for the Penis Enlargement Patch.) Men keep chasing after the mythical, mammoth-sized member.

Silverberg says male clients at his store, and in his counseling work, constantly ask him about penis pumps, whose powers of elongation, he says, are a “myth,” although he adds that some men who’ve used them report satisfaction, a phenomenon he explains this way: “I think spending more time paying attention to our genitals will probably increase our sexual health.”

Just the Facts on the G-Spot

If sex myths have such power over men’s thinking about their own anatomy, they have even more sway when it comes to female partners’ bodies -- especially the much-debated G-spot.

Named after a German doctor, Ernst Gräfenberg, who first wrote about an erogenous zone in the anterior vaginal wall, the G-spot was popularized by a 1982 book called … The G-spot. This region behind the pubic bone is often credited as the trigger for a vaginal (vs. clitoral) orgasm, and even a catalyst for female ejaculation.

At the same time, the G-spot is commonly derided as perpetuating the myth ensconced by Sigmund Freud -- namely, that the clitoral orgasm is a "lesser" form of climax than the vaginal orgasm, which requires penile penetration. As Ian Kerner summarizes, “In Freud’s view, there were no two ways about it: If a woman couldn’t be satisfied by penetrative sex, something must be wrong with her.”

The G-spot’s existence is still debated, and whether it’s fact or fiction depends on whom you ask.

“The G-spot exists,” says Seth Prosterman. “It’s a source of powerful orgasm for a percentage of women.”

“I don’t think the G-spot exists,” says Ira Sharlip. “As urologists, we operate in that area [where the G-spot should be] and there just isn’t anything there -- there’s no anatomical structure that’s there.”

Prosterman and others point out the importance of thinking of the G-spot in context -- that it may be an extension of the clitoral anatomy, which extends back into the vaginal canal. Kerner writes that the G-spot may be “nothing more than the roots of the clitoris crisscrossing the urethral sponge.”

Helen O’Connell, MD, head of the neurourology and continence unit at the Royal Melbourne Hospital Department of Urology in Australia, says, “The G-spot has a lot in common with Freud's idea of vaginal orgasms. It is a sexual concept, this time anatomical, that results in confusion and has resulted in the misconception that female sexuality is extremely complex.”

In the end, whether this debated locus of pleasure is fact or fiction may not matter that much. O’Connell, who is also co-author of a 2005 Journal of Urology study on the anatomy of the clitoris, says that focusing on the G-spot to the exclusion of the rest of a woman’s body is “a bit like stimulating a guy's testicles without touching the penis and expecting an orgasm to occur just because love is present.” She says focusing on the inside of the vagina to the exclusion of the clitoris is “unlikely to bring about orgasm. It is best to think of the clitoris, urethra, and vagina as one unit because they are intimately related.”

How Long, Part 2: How Premature Is Premature Ejaculation?

The possibilities for exploring a woman’s erogenous zones may be tremendously exciting -- which leads to another source of sex myth and male anxiety: How long can I last? And how long should I be able to last?

Premature ejaculation is “the most common form of sexual dysfunction in younger men” according to Ira Sharlip, and its prevalence is around 20% to 30% in men of all ages.

The medical method of determining premature ejaculation is called “intravaginal ejaculatory latency time” (IELT), a stopwatch-timed duration measured from the beginning of vaginal penetration until ejaculation occurs. However, Sharlip adds, this quantitative measure doesn’t tell the whole story: “There are men who ejaculate within a minute but say that they don’t have premature ejaculation. And then on other end of spectrum, there are patients who are able to last for 20 minutes, and they say they do have premature ejaculation.”

In other words, the definition of "premature" may be largely in the eye (or mind) of the beholder, and depends on a man's sexual satisfaction and his perception of his ability to control when ejaculation occurs.

If you just can’t wait for the numbers, though, a 2005 study in the Journal of Sexual Medicine found “a median IELT of 5.4 minutes.”

Ian Kerner says a common cutoff time used to define premature ejaculation is two minutes, but he adds that many of the men he works with “are not guys who can last a few minutes; they’re having orgasms during foreplay, or immediately upon penetrating. They have a hard time lasting past 30 seconds.”

But a quick trigger is normal, says Kerner. “Men were wired to ejaculate quickly -- and stressful situations make them ejaculate even more quickly. It’s been important to the human race. If guys took an hour to ejaculate, we’d be a much smaller planet.”

Sex therapists and physicians offer a number of techniques that can help men manage their anxiety and prolong their time to ejaculation. Several drugs -- like some antidepressants (used for off-label treatment) and topical sprays -- have been shown to extend time to ejaculation.

And, contrary to the common perception that distraction or decreasing stimulation is the answer (slow down, think about baseball), some say that giving in to sensation can help address the issue as well. “The way to learn [to last longer] is by getting used to intense stimulation,” says Prosterman, “to increase the frequency of intercourse, and feel every sensation of being inside your partner and enjoy it.”

Come Again? The Mythical Multiple Orgasm for Men

While multiple male orgasm is possible anywhere two or more men are gathered and talking, actual male multiple orgasm is another story. Unlike the more established phenomenon of female multiple orgasm, men’s claims of successive climaxes can stray into the realm of sex myth. At the very least, male multiple orgasm is difficult to verify and may depend on the definition of orgasm.

Prosterman says that the book The Multi-Orgasmic Man popularized “an Eastern meditative process that involves wrapping the PC [pubococcygeus] muscle around the prostate. There’s a valve on the prostate that switches on and off before urination and ejaculation. The PC muscle stops this valve from opening, allowing an orgasm without ejaculation. The idea is to keep doing that five or six times in a row.

“Out of hundreds of guys I know who’ve tried this,” says Prosterman, “I know only one who’s been able to do it.”

Is this man Mr. Lucky, or just prone to poetic license?

A 1989 study in the Archives of Sexual Behavior recorded the testimony of 21 other men who claimed to be multi-orgasmic, but Ira Sharlip says “that doesn’t happen,” referring to the phenomenon of “multiple orgasms in succession over a short period of time -- like minutes.” And there’s no such thing as separating ejaculation and orgasm, he says.

Orgasm or Orgasm-esque?


What may be at issue here is the definition of orgasm -- which, according to a 2001 Clinical Psychology Review article, has been strikingly inconsistent. “Many definitions of orgasm “depict orgasm quantitatively as a ‘peak’ state that may not differentiate orgasm adequately from a high state of sexual arousal,” the study’s authors wrote.

In other words, those men who report multiple orgasms may be able to achieve orgasm-esque states before they hit the point of ejaculatory no-return. And many men report that strengthening the PC muscles through Kegel exercises allows them to edge closer to this “point of inevitability” without cresting the mountaintop of ejaculation and descending into the gentle valley of the flaccid and the “refractory” period, where the penis is temporarily unresponsive to sexual stimulation.

Even so, both Prosterman and Sharlip say this refractory period can be short enough that it’s possible for men to orgasm, ejaculate, recover and do it again -- and again -- during the same “session” of sex.

And if that recovery period isn’t super quick, you can still enjoy multiple orgasms -- you may just need to cancel your afternoon appointments.

Sex Fact: It’s Not Always about the Numbers

In the end, there seems to be a recurring theme in moving beyond sex myths: Don’t get too hung up on the numbers.

So often the key to sexual satisfaction is not about penis size, stamina records, or a technical isolation of the G-spot. Rather, it’s about understanding yourself and your partner’s desires and recognizing that, unlike those Disney characters, real people aren’t born with a perfect, divinely granted understanding of sex.

As O’Connell remarks on the perils of over-privileging of the G-spot, “It is best for partners to explore the precise areas that turn someone on and how a partner likes to be given pleasure. That applies to both men and women, and the idea that there is any consistent 'magic spot' in either sex is just tyrannical.”

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