James W. Hicks, M.D.

Archive for the ‘Sexploration*’ Category


In Sexploration* on October 26, 2010 at 7:48 pm

The experience of orgasm is similar for men and women. Pleasure builds until you feel a sense of inevitability, at which point your skin flushes, pulse accelerates, and breathing quickens. As the wave of tension and release surges through you, your muscles clench and spasm. Vaginal and anal muscles contract, squeezing the penis or other penetrating objects even more tightly than before, and the man’s throbbing erection may bounce up and down as it ejaculates.

Men can reach orgasm within a few minutes of intercourse or masturbation, or even faster if they are highly aroused. Women benefit from longer foreplay and stimulation of multiple erogenous sites.

By the time a man reaches the point of inevitability, spermatic fluids have accumulated in the prostate and other glands and ducts, from which they are forcefully ejected in a series of muscular contractions. The head of the penis becomes uncomfortably sensitive to touch during and after orgasm, so he may need to stop thrusting or withdraw his penis. If you are jerking or sucking a penis when the man starts to come, you should adjust the pace and tightness of your grip; do not squeeze harder or you may stymie the ejaculation.

Male ejaculate consists of sperm floating in a mixture of cholesterol, sugars, salts and protein, which has a sweet and salty taste and a faint smell of chlorine. Semen can vary in consistency from watery to gelatinous (or a mix of both), and the volume depends in part on the length of arousal and the number of days since the last ejaculation. A tablespoon is a typical amount, and maximum volume is reached after about five days. A thinner, slippery “pre-come” may also drip from the tip of the penis during arousal, and this contributes to lubrication during intercourse. Women also exude lubricating fluids and may ejaculate a small amount from the pee-hole at the time of orgasm.

Men experience a refractory period after orgasm, during which it is difficult to become erect again, and this refractory period becomes longer and longer with age. (Adolescents and young adults may be able to get hard again within a few minutes if they are sufficiently psychologically aroused.) Women have an advantage over men in their ability to reach orgasm multiple times in succession.

The Vulva

In Sexploration* on October 15, 2010 at 11:53 am

If a woman undresses in front of you, you probably will not see her sexual organs, because they are folded together between her legs and covered by a triangular patch of pubic hair. The pubic hair grows from the skin of the lower abdomen and from the labial mounds between the legs. It is generally curlier than hair on the head, though it may be fairly straight in women of Asian or Native American background. If the woman has shaved her pubic area, you may see a cleft where the two labial mounds press together, concealing the rest of the genitals, though the inner labial lips may protrude a little, depending on their size. Only when the woman spreads her legs while sitting, lying, or bending over, do the labia unfold to reveal the nestled, elliptical structures around the vagina.

The labial mounds are fatty folds of skin that have hair and sweat glands. They are anatomically similar to scrotal skin in men and similarly sensitive to touch; running fingers through the hair can increase blood flow and lubrication to the region. Inside the labial mounds are the even more sensitive, thinner labial lips, which are hairless and usually darker in color. The lips come together at the top in a hood which can be gently pushed back to reveal the clitoris, a small knob of tissue that is the focal point for sexual pleasure in most women. The hood of the clitoris, also called the prepuce, is analogous to the foreskin of the male penis. Pulling gently on the hood or labial lips will also stimulate the clitoris.

Below the clitoris and between the labial lips is a small area of pink or reddish skin which serves as the floor into which the vagina opens. Doctors refer to this area as the vestibule. There is a tiny mound for the urethral opening, or pee-hole, in this area, midway between the clitoris and the vaginal opening. When a woman is sexually aroused, the urethra closes, and lubricating fluids are released from ducts opening invisibly into the urethral mound. Some women ejaculate a small amount of clear or milky fluid at the time of orgasm.

In girls, the reddish skin of the vestibule is continuous with the hymen, a small curtain of mucous membrane that incompletely covers the opening to the vagina. The hymen is rich in blood vessels and may bleed a little when it is torn during first sexual intercourse. This was (and in parts of the world continues to be) an important sign of virginity, especially for girls who married at an early age. The hymen becomes increasingly translucent, thin, and elastic with age, so many women now do not experience any bleeding by the time they first experience penetration. During childbirth, the hymen stretches to the point where it is no longer visible, or only tiny remnants may be visible around the edge of the vaginal opening.

The Mouth

In Sexploration* on October 10, 2010 at 4:15 am

From the time we are infants, we derive pleasure and give and receive affection through our mouths. Freud thought oral sexuality was a developmental stage to be abandoned after breast-feeding, but the pleasures of the mouth are a unique and crucial part of the sexual repertoire. Teenagers who are not yet ready to have genital intercourse can enjoy kissing, necking, and even oral sex, and some men and women continue to prefer oral sex to other forms of intercourse. Kissing remains the most affectionate form of sexual expression, which makes it essential for some and a taboo for others (for example, a macho type will seek a blowjob from a man but turn away from his kiss).

Lips come in a variety of shapes and sizes that contribute to appearance and the quality of stimulation they provide. The skin of the lips has a dry surface on the outside and moist mucous membrane on the inside (which makes it similar to the entrance of the vagina). Fat lies beneath the surface of the lips, making them soft, while a thin muscle circles the mouth and allows for the pursing of the lips. This muscle is involved when you press lips together during passionate kissing, when you pucker around a nipple or clitoris, or when you encircle the shaft of a penis during fellatio. Since the outside of the lips are naturally dry, these activities may be more pleasant if they are wetted with saliva, lipstick, or petroleum jelly.

The lips work together with the muscles of the cheeks to create enough suction to lightly bruise the skin of the neck when making a “hickey” or love-bite. Some people also use their teeth to gently bite and tug on the nipples, labia, or foreskin during sex. This requires some control and attention to not hurt your partner. Some people also enjoy the light pain that comes from being bitten on the skin, and a full chapter is devoted to this form of love-making in the ancient Indian Kamasutra.

The tongue is essentially a muscle surrounded by mucous membrane. The muscle fibers run in all directions, so the tongue is able to stretch, curl, flick, and move dexterously. The upper surface of the tongue is textured, in order to better grip food, which contributes to the wet sensation of friction which makes a probing tongue so exciting.

Blue Balls

In Sexploration* on September 30, 2010 at 5:34 pm

If a man has been sexually aroused for some time and does not reach orgasm, he can develop a painful, congested feeling in his lower abdomen and testicles, commonly known as “blue balls.” Surprisingly, this phenomenon is almost completely ignored in the medical literature. Because there has been little medical investigation, we can’t be certain whether the discomfort comes from venous congestion or from the build-up of seminal fluids.

Some consider blue balls a myth that young men use to pressure their girlfriends into sex. I’m sure the complaint has been used for that purpose, though there is really no excuse, since the discomfort is easily and safely relieved by masturbating to orgasm. But some people have a personal or cultural belief that masturbation is sinful or that it depletes masculine vigor. Of course, relief can also come in the form of a “wet dream” in the early morning during REM sleep, when men naturally and involuntarily develop an erection. Or you can fool around with a sympathetic friend with the excuse that you are “horny” and “need relief.”


In Sexploration* on September 21, 2010 at 1:29 pm

Studies have found that men spend more time staring at a woman’s breasts than at her face or other parts of her body when judging attractiveness. Clearly breasts play an important role in attracting a mate. They come in a wide variety of sizes, and no particular size has been found to be more attractive. Everyone has his or her own preferences.

At puberty, women’s breasts expand into their adult shape over a couple of years as they accumulate fat. The nipples and areolas also enlarge and become darker in color and more sensitive to touch. The areolas develop a bumpy texture on account of lubricating glands just below the skin. Women’s breasts become more firm and sensitive during pregnancy and, to some extent, each month during the week leading up to ovulation. At those times, the breast may be too tender to manipulate sexually. The breasts become thinner and less pert after menopause, when the glandular tissue shrinks and is replaced by fat.

Some women consider their breasts uncomfortably large and seek surgical breast reduction. But about twice as many undergo surgery to augment the size of their breasts. The breasts are expanded by slipping saline implants, which are like water-filled balloons, beneath the breasts or underlying chest muscles. Though augmented breasts may not feel quite the same as natural breasts, and some firmness or rippling of the skin may occur in reaction to the implants, most women and their partners are satisfied with the results. Women who have had surgery to reduce or augment their breasts may have small scars near the armpit or at the fold on the underside of the breast, or sometimes around the areola.

Many women and men derive sexual pleasure from rubbing or squeezing their nipples or breasts, or from having them squeezed or sucked by a partner. The nipples are particularly well supplied with nerves that are sensitive to touch, and with tiny muscles that cause them to perk up. Some men enjoy rubbing their erection in a woman’s cleavage, but that is unlikely to be particularly stimulating for the woman, unless it is accompanied by nipple play. If you suck a woman’s nipples after she has given birth, you will stimulate the release of a sweet and fatty milk.

Men can develop breasts just like women, but this rarely occurs unless a man is obese or takes female hormones. For most men, the breasts consist only of the nipples and areolas. Men who develop “man titties” often consider them embarrassing and seek surgical breast reduction. I suspect some men and women might find breasts to be an attractive feature in otherwise masculine men, but I find no mention of this in the literature.

Sexual Addiction

In Sexploration* on September 17, 2010 at 7:06 pm

Does sexual addiction exist?

Mental health professionals have been slow to recognize the problem, in part because of traditional assumptions that only drugs and alcohol are addicting, and that sexual deviancy depends on what a person finds arousing rather than on ones sexual appetite. But as the internet has brought pornography, chat, and escorts into everyone’s home office, and self-help groups have popped up for sex addicts, the profession has woken up to the challenge.

Like gambling, sexual behaviours can spin out of control. You become increasingly preoccupied with cruising for partners, hoarding pornography, fantasizing about sexual encounters, and masturbating to the point of exhaustion. You spend increasing amounts of time in pursuit of sexual gratification, to the point that you begin to lose sleep or fall behind at work. Your loved ones notice a change, and you waste even more energy trying to conceal your pursuits. You may try to cut back, but find it difficult to reign in your habits.

In an article in The Spectator, the author nicely describes his own experience becoming addicted to internet pornography, and his eventual recovery.

Why mention sexual addiction in a blog about flexible sexuality? If you are ashamed by your homosexual or bisexual urges, you should be reassured that those desires are natural and not themselves signs of deviancy or addiction. I don’t believe that any sexual orientation is inherently more hypersexual and vulnerable to addiction, except perhaps for the supersexual type. Even then, addiction is defined by the loss of control, not by how much or how often you want to have sex (which varies considerably from person to person).

But I suspect that sexual addiction is much more common than we realize and that some people who come across this blog might have worries about controlling their urges. If so, recognizing the problem and deciding to do something about it is a good first step.


In Sexploration* on September 7, 2010 at 8:56 pm

About three-quarters of men in the United States are circumcised, slightly down from a peak of 80% fifty years ago. Rates are highest among white men, while only two-thirds of African-Americans and half of Latinos are circumcised. In no other country in the world are men circumcised at birth so routinely, unless for religious reasons. Circumcision was once thought to prevent boys from masturbating and becoming morons. Though that Victorian myth has been debunked, three-quarters of American mothers still consider a circumcised penis more visually and sexually appealing and more hygienic and request the procedure for their newborn boys.

The foreskin of uncircumcised men cloaks the head (or glans) of the penis in the flaccid state, often covering it completely like a drawn purse, except when it is manually retracted. The foreskin is like a cuff, with skin on the outer surface and a pinker mucous membrane on the inside. This inner surface is similar to the mucous membranes of the lips, vagina, and anus. When the penis is erect, the foreskin unrolls over the lengthening shaft, and the penis becomes virtually indistinguishable from a circumcised penis, except that the unrolled portion may be moister and pinker.

Medical journals continue to debate whether circumcision (or “male genital mutilation,” as some refer to the practice) affects sexual functioning in men. The foreskin contains specialized sensory nerve cells that detect vibration and motion, and glands which secrete lubricating fluids during sexual arousal, and these would be lost during circumcision. The head of the penis is probably more sensitive in uncircumcised men, because the mucosal surface turns into normal skin if the foreskin is removed. But it has been difficult to scientifically prove any difference in sensitivity, or whether greater sensitivity is good (easier to arouse) or bad (more tender) for uncircumcised men. Also, men with intact foreskins can accumulate a greasy white substance, called smegma, though this is rarely noticeable and easily cleaned. A number of studies have shown that men who are circumcised as adults are generally happy with the results, and circumcised men may have more oral sex, more anal sex, more frequent masturbation, and less sexual dysfunction.

There is no objective medical or aesthetic reason for prefering a cut or uncut penis. For most men, the choice was made for them by their parents. Otherwise, it comes down to personal preferences one might have in a partner, if one cares at all.


In Media, Sexploration* on August 29, 2010 at 2:19 am

Many of us discovered our sexual preferences in adolescence while flipping through an older friend’s or relative’s stack of pornographic magazines. Now everyone is more likely to find pornography on the internet. A wide selection of pornographic studios provide free content to thumbnail gallery posts (TGPs), so you can browse and see what catches your interest. Most straight TGPs (for example, PicHunter) have links to gay, bisexual, and “shemale” material, so you may have already taken a peek at same-sex or transgender pornography, if only out of curiosity.

All pornography involves acting (not all of it very good), and a single twenty minute scene may have actually involved hours of uncomfortable intercourse. The real sexual orientation of the models may have little relation to the acts they perform (i.e., they may be versatile or simply miscast). So don’t be surprised if the participants don’t always look like they are having fun.

Most “lesbian” pornography, unfortunately, is aimed at straight men rather than women and may seem particularly artificial in its depiction of female passion. But there is at least one good, free lesbian TGP that depicts women who look and behave more naturally, at RealLesbianPorn.

Some gay pornography exploits the gay-for-pay concept by presenting “amateur” straight men who have been tempted to explore their gay side for money, only to find they enjoy it. This may hold particular appeal for bi-curious viewers who can identify with the models. Gaysexer is a good TGP with a wide selection of studios and model types. Gaydemon organizes its thumbnail galleries by type of model and action and includes bisexual and shemale directories

“Bisexual” pornography typically involves threesomes in which two men have sex with each other and another woman. Again, it is created for men but may appeal to women who are turned on by gay sex. “FFM” (female-female-male) porn rarely features women who appear genuinely interested in each other. PenisBot has straight, gay, and other galleries, including a fairly good selection of bisexual images.

When browsing through pornography on the web, beware of fake TGPs that endlessly redirect you to other TGPs and studios or that carry malware. The sites listed on this post seem to be relatively safe. Video clips may carry more malware than photographs.

Penis Size

In Sexploration* on August 7, 2010 at 8:02 pm

The size and appearance of the penis varies considerably from man to man, and from soft to hard. You cannot always predict the size of an erect penis from its flaccid state: a penis that is thick and long may become harder but not much bigger in erection, and some tiny penises can become surprisingly large when aroused.

Men tend to be concerned about penis size, much more so than women: the largest recent internet survey found that only half of men were satisfied with their penis size, while almost all women were satisfied with the size of their partner’s penis. A smaller Croatian study found that more than half of women consider penis length and girth only somewhat important, while another quarter found both features unimportant.

Broad and reliable surveys of penis size do not exist, but a number of small studies suggest that most men have a penis that measures approximately 4.5 to 6 inches (12 to 15 cm) when erect, measured across the top surface from the juncture with the pubic skin. Since erections are not easily elicited in clinical settings, some researchers measure the stretched but flaccid penis, which provides approximately the same results.

There is probably some truth to racial stereotypes about penis size, though the scientific data is lacking and there is a wide range of individual penis sizes within any group. Pornographic films tend to depict men of African descent with large penises and East Asian men with small penises, but these actors may be selected precisely because of their desirable stereotypical attributes. Penis size also tends to correlate with body size, which may partly explain differences across racial groups.

Two studies have found evidence that men who have sex with men have larger penises than those who have sex exclusively with women, though the significance of the findings are debatable. The more recent of these studies also found that gay men with smaller penises were twice as likely to be the receptive “bottom” during sex compared to men with larger penises, which presumably reflects cultural expectations about masculinity and sexual roles. The same stereotype plays out in pornography, where large penises are featured and, in gay porn, where the larger man usually “tops.”

Vaginal versus Clitoral

In Sexploration* on August 7, 2010 at 6:42 pm

For nearly a century, scientists have debated the best way for a woman to reach orgasm: by stimulation of the clitoris or manipulation of the G-spot? Freud famously thought that women who derived pleasure from the clitoris were infantile and neurotic. Kinsey’s group, on the other hand, found that the vast majority of women masturbate by stoking and pulling the clitoris and labial lips, in preference to the vagina, and those findings have been replicated repeatedly.

Recent surveys of Czech women found that ninety percent had reached orgasm by stimulation of the clitoris, while only three-quarters had experienced orgasm by vaginal stimulation. A recent British study found that even the women who believe they have a G-spot (a little more than half) find their clitoral orgasms to be more satisfying than their vaginal orgasms anyway. A telephone survey of nearly twenty thousand Australians found that women were much more likely to reach orgasm if their partner pleased them with fingers and cunnilingus before vaginal intercourse, while only half reached orgasm from vaginal intercourse alone.

Anal Intercourse: a View from the Bottom

In Sexploration* on July 25, 2010 at 10:27 am

Both men and women, regardless of sexual orientation, can receive sexual pleasure through stimulation of the anus.

You can explore this on your own by sliding a lubricated finger into your anus while in the shower, on the toilet, or during masturbation. In fact, the tight anal sphincters should be stretched this way, by slowly sliding in one, then two, and perhaps three fingers, before you are penetrated by a larger dildo or penis, so that you can get used to the feeling. Otherwise you may be tense and unprepared, and intercourse may be uncomfortable or painful, at least at the start.

The anus does not possess as many glands as the mouth, penis, and vagina, so you will need to use a lubricant. Petroleum jelly (Vaseline) is ideal for self-exploration, and silicone-based lubricants provide the most slipperiness, but water-based lubricants are safest for use with condoms, because they don’t weaken the material. Stay away from soap and lotions, which can sting and irritate the mucosa.

The most important principle, when you first try anal intercourse, is to go slowly and relax. The firmer the penis (or dildo), the more easily it will go in. You should try to push out with your anus against the head of the penis, rather than instinctively squeezing in. You may want to sit on your partner in order to have the most control over the angle and pace of the penetration. The anal sphincter is slightly narrower from side to side than from top to bottom, and penises tend to be flatter from the top surface to the bottom, so you might find it easier to be penetrated while lying on your side with your top leg pulled up towards your chest and your partner striding you perpendicularly.

Rates of pain during anal intercourse among women have not been studied. A study of men who have engaged in receptive anal sex (as a “bottom”) found that one quarter almost always experienced some pain, though it was usually mild or transient and partly related to anxiety. There are two anal sphincters, and the pain often occurs when the penis is partly in and reaches the deeper sphincter, taking both partners unawares. So go slowly until the penis is all the way in.

During your first experiences with anal penetration, you may feel uncomfortably like you are about to pass gas, because that is how the sphincters usually interpret the sensation of being stretched. You will get used to it. For hygienic reasons, you should defer being penetrated in the ass if you have a full sensation in your bowels, and some people even use a saline enema to empty their bowels before sex. After anal intercourse, some mucous and lubricant may be smeared in the crack of your buttock, and you may feel like you need to go to the bathroom.

The G-Spot

In Sexploration* on July 7, 2010 at 7:19 pm

Both men and women are confused about the anatomy and function of the female sex organs. Important parts of the female genitalia are embedded in the body rather than hanging out, like their male counterparts, so they are difficult to study, but scientists have also mischaracterized or ignored the area for centuries. Vesalius, a classical anatomist from the Italian Renaissance, went so far as to claim that the clitoris was a myth or an abnormality that should be removed. Sixty years after physicians “discovered” the G-spot and female ejaculation, scientists continue to debate their existence or characterize them as feminist myths.

Medical studies conducted in just the past decade have revealed the clitoris to be a more complex organ than had been realized previously. The clitoris is much more than the button of sensitive tissue visible under the labial hood; it includes long tubes of erectile tissue, similar to those found in the male penis, which extend deep into the pelvis, where they straddle the vagina like a cowgirl gripping a bronco. Squeezed between the vagina and clitoral tissue are several types of sexual glands. The entire organ is richly enervated and sensitive to the thrusting, stroking, tugging, vibrating, distending, and contracting motions that a woman experiences during intercourse.

Some scientists have begun to refer to a “clitoral complex” that includes the visible head of the clitoris, the deeper erectile tissues, the sexual glands, and the especially sensitive adjacent area of the vagina, often referred to as the G-spot.

The G-spot was named after Dr. Gräfenberg, the doctor who first noted that some women were aware of a point of maximum pleasure just within the vagina. The area is usually described as dime-sized and located about an inch inside, on the front side of the vagina. You can reach the area by sliding a finger into the vagina and bending the finger in the direction of the bellybutton.

Ever since Dr. Gräfenberg’s “discovery,” scientists have debated whether the G-spot exists, and most have been distracted by the hunt for a distinct organ rather than a sweet spot. It turns out that the location of the G-spot corresponds to the area where the deep, erectile tissue of the clitoris pushes up against the wall of the vagina, especially when the erectile tissue becomes engorged with blood and the vaginal muscles contract, as they do during sexual arousal and vaginal penetration.

Anatomy of a Blowjob

In Sexploration* on July 3, 2010 at 7:43 pm

I assume that readers of this blog are not completely inexperienced in the sexual arts, but some of you may have more confidence with one gender or the other. Knowledge is power, so I’m inaugurating a series of posts that will describe the details of sexual intercourse.

Men and women have similar mouths. For the purpose of this post, the inside of the mouth is best described from the perspective of the penis. During oral sex, the penis is gripped by the lips and tongue as it slides against the slippery hard palate at the roof of the mouth. The muscles of the cheek create suction, and the penis may find itself sliding between your gums and cheek, or it may head straight to the back of the throat, in which case it pushes against the soft palate and tonsils.

The pressure against these fleshy structures typically triggers a gag reflex, which is designed to protect you from choking on food. If you want to “deep throat,” or take a penis deep into your mouth, you must learn to suppress the gag reflex by concentrating on relaxing the muscles at the back of your throat. This is not difficult, at least if you have a patient partner. (And unless you’re giving a quickie in an alley, what partner wouldn’t want you to take your time?)

A penis will also block your airway if it is thrust deep enough, so be sure to come up for air periodically.

The inside of the mouth is rich in salivary and mucous glands that secrete slippery liquids which help us digest food, and these glands are also triggered by any probing of the mouth during deep kissing and oral sex. Deeper penetration to the back of the throat causes the release of the thicker, more mucous fluids. Saliva mixes with your partner’s sexual secretions during fellatio, creating a slick and salty film that tastes nice and makes sex more comfortable (the same is true during cunnilingus).

What kind of blowjob do men prefer? It’s a matter of taste and anatomy, so you’ll have to experiment with your partner to see if he prefers the tightness at the back of your throat or the teasing licks of your tongue. The head of the penis is very sensitive, especially in uncircumcised men, so gripping the shaft in your mouth may be more pleasant than directly sucking the tip.

If a man ejaculates while his penis is deep in the back of your mouth, some of the semen may go down your throat or up into the back of your nasal passages, which lie directly above the soft palate. Most of the semen will remain in your mouth and can be spit out or swallowed, according to your preference.

There is truth in the old joke that, like dogs who lick themselves, we would all go down on ourselves if we were limber enough to do so. Surveys show that the vast majority of men would like to be given a blowjob. Many consider fellatio a form of making out rather than sex, and an otherwise straight man may feel comfortable getting a blowjob from another man and consider himself a lucky bystander whose sexual orientation is not called into question. But there is a double standard, and the “cocksucker” is often assumed to be gay. This is silly and fundamentally sexist; neither the giving nor the receiving of a blowjob is intrinsically more heterosexual or homosexual.

Female Ejaculation

In Sexploration* on June 20, 2010 at 9:26 am

Do women ejaculate?

How can that even be a question, given that women have been reaching orgasms for millenia? Wouldn’t someone have noticed? But just a few hundred years ago, physicians thought that the clitoris was an abnormality to be removed, and Freud thought clitoral orgasm was a sign of emotional immaturity. So we are still learning.

In fact, the medical literature continues to debate whether women ejaculate at orgasm. Some researchers believe that any fluid that might be released is really just urine.

But the most recent scientific studies have found that women do ejaculate a variable amount of liquid, and that the liquid is similar in content to male ejaculate, except of course that it lacks sperm. The ejaculate, which is released by glands located within the ureter, or pee-hole, is clear or slightly white in color. The amount is often small and perhaps unnoticeable in the midst of the muscular contractions that accompany orgasm.