One theory holds that yohimbine works by affecting parts of the nervous system which control erection. But the jury is still out on whether this theory is correct. Researchers are still trying to determine whether or not the drug actually does enhance erection and sexuality.

In one study, researchers gave yohimbine to 23 men who were thought to have physically caused potency problems because they didn’t get erections in their sleep. These men, who ranged in age from 32 to 72 years, took the yohimbine three times a day for at least ten weeks.

What happened? For most, unfortunately, nothing. More than half of the men experienced no change in potency. However, six men found their erections were restored to normal and they could have intercourse. Four men reported improvement, but still found their erections “unsatisfactory.”

And one man found his potency only temporarily restored. Unfortunately, after five months on yohimbine, he again experienced potency problems.

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A few weeks later, Thomas showed up at another clinic, extremely tense and nervous. He had difficulty talking about his problem, but gradually, with a lot of encouragement, his story emerged.

He explained that after the “failure” of his first doctor he quickly became disgusted with traditional health care. Instead, he sought out an “herb” doctor, who prescribed a potion. (Analysis of this “drug” later revealed that it contained human placenta, ginseng and ground-up animal testicles among other things.) Although Thomas had been taking this mixture faithfully every day, as instructed, he had seen no improvement. And he would have noticed any change: He was attempting intercourse compulsively at least once a day, so he would know exactly how he was doing. To bolster his efforts, he stole some time from his business to go to peep shows to see if what he watched would produce an erection. Still, no luck. The failure of the herb medicine finally drove him to seek medical help once again.

Clearly, Thomas was a rather high-strung guy, and just sharing his story seemed to defuse some of his anxiety. He confided that a major source of stress in his life was a small bakery he and his wife owned. Competition from larger outlets was fierce and the couple worked 14-hour days just to keep their business afloat.

Despite all of Thomas’s very real pressures, he had several important things in his favor: He’d only been without erections for a few weeks, so the potency problem, while painful, had not yet become ingrained in his life. He still had a good relationship with his wife, although she did not appreciate her husband’s obsessive daily attempts to have intercourse. What she didn’t like the most, Thomas confided, was watching him berate himself after each “failure.”

Thomas was a good candidate for self-help: He was healthy, eager to solve his problem and open to a new approach. And fortunately, he could count on his wife’s cooperation.

So his doctor prescribed a self-help program—one that was far removed from Thomas’s rigid and self-defeating program of daily performance tests and peep-show tours. Instead, the self-help program called for Thomas to take the pressure off. The doctor told him not to attempt sexual intercourse at all for two weeks. He was encouraged to enjoy sexual pleasure in other ways, but intercourse was off limits. And he was to share this plan with his wife, and enlist her support.

A few days later, relieved of his pressure to perform, Thomas’s erections returned. At his next clinic visit, he reported that he and his wife were again enjoying intercourse.

It was fortunate that Thomas had not shut himself off from his wife when his problem began. Some men withdraw physically and emotionally from friends, family and work because they feel somehow less than “a whole man.” If you react like this, get professional help for your potency problem, and for the stress you and your loved ones are feeling.

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One of the most profound and far-reaching effects of the oral medications is that they are able to banish an ancient human fear. As we approach the year 2000, we can finally let go of one of man’s most relentless myths. ED is no longer considered an inevitable by-product of aging. Listen to the amazed comments of one of my patients.

“I’m sixty-eight years old,” Harold, a participant in my study, told me. “Gloria is fourteen years younger than I am. When we married twenty-seven years ago, I was the experienced one, and, to tell the truth, it was exciting to be the leader. But the last couple of years, all that changed. When I ‘failed,’ I felt that I was an old man, and a lot of my joy for living evaporated. I shut out Gloria. I knew I was doing it, and why, but I went right ahead and did it anyway. She, in turn, spent more and more time with friends. Why would she want to come home?

“But ever since I regained what I lost—and I still can’t believe a pill can do that—I want to live again. And Gloria, bless her, is forgiving.

I put her through a bad time. But now it’s behind us—permanently. Do you have any idea what it’s like to know that you can have strong erections in your sixties or seventies or even eighties? I don’t care how old I look. I feel terrific because I can do what I desire with the woman I love. Who cares about age?” Who indeed?

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During the last few months, William has been under a lot of pressure at work. His responsibilities have increased and he’s had to put in long hours. He is in the running for a hotly contested promotion, and is determined to beat out his younger competitor.

William’s doctor has been after him for years to quit smoking, so William has cut down on the number of cigarettes he smokes, but he hasn’t stopped completely. The doctor recently told William he has high blood pressure, and that he must take medication for the problem every day. And William has to admit that recently he just hasn’t been feeling his usual energetic self. Some changes in work assignments mean that he now spends most of his time at his desk. And although for years William could eat anything and remain almost skinny, in the last six months he’s put on an extra 30 pounds. Secretly, he hates the weight and thinks it makes him look older, but he’s uncomfortable admitting that it bothers him. His doctor also wants him to exercise regularly, follow a low-fat diet and lose weight. William tries to follow these recommendations but pressures at work seem to make it difficult. Often he doesn’t take a lunch break and just has a sandwich at his desk, so his once enjoyable noontime squash games have become a thing of the past. When he comes home from work, he’s so tired he just wants to rest, not jog or play tennis. And although he knows a low-fat diet will help him lose the extra pounds, he’s a meat and potatoes (smothered in sour cream) eater of long standing. Trying to change his eating habits just adds one more stress to his life.

Because Sharon also has had a rough schedule at her city planning office, the couple has been spending little time together during the work week. Saturday and Sunday are “their” days together—once they do the household chores, sort through a stack of mail, pay bills and spend some time with William’s daughters.

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1 Probably the best known rear-entry position, this is known colloquially as the “doggie”. The woman kneels on her hands and knees on the bed or floor, and her partner kneels behind.

2 The vagina is turned straight back to the man pressed against her, and she can move the angle of her pelvis to give various sensations to both. She can also sway back and forth on her hands and knees.

3 The woman will find it more restful to slide down gently on to her stomach and chest while the man takes most of his weight on his hands. (The position can also be initiated in this way.) Deeper penetration will be achieved if she raises her bottom off the bed.

4 If she lies flat and presses her legs together, the woman’s clitoris and inner lips will be stimulated indirectly, maintaining her pleasure, and her partner can remain inside, moving how and when he pleases to rekindle desire.

This position can be very exciting for a woman, if lithe enough, as excitement mounts from her partner’s penis rubbing against new areas of her vagina not normally stimulated

Attempting rear entry is highly stimulating for him as the sensation of dominance is very high

Man

The sight of a woman’s bottom is very exciting to most men. Here, he can caress much of her body and benefit from the greatest depth of penetration combined with a sense of mastery.

Woman

Rear-entry is a turn-on for many women who like feeling vulnerable. It also enables them to fantasize, their partners not being visible, and provides good access to the front vaginal wall.

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• Watching others having sex.

• Making love in public.

• Having sex with a woman other than one’s regular partner; she can be a celebrity, neighbour,

previous lover, or friend.

• Watching two women you know making love together; one could be one’s partner, the other a

relative, friend or neighbour.

• Being forced by a woman to have sex.

• Forcing a woman to have intercourse against her will.

• Forcing a woman to have oral sex against her will.

• Making love in an unusual place.

• Being part of a threesome with another man and a woman.

• Being part of a threesome with two women.

• Having a homosexual encounter.

• Watching one or more men having sex with other women.

• Being sexually abused by a woman.

• Making love to a virgin.

• Having sex with a woman with enormous breasts.

• Making love outdoors, on a famous monument, for instance.

• Having a woman urinate on you.

• Having a woman use a dildo on you in order to have anal sex.

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Massage is important because not only does it have the general effect of relaxing you and giving you the opportunity to really think about and enjoy touching, but it allows you to focus your senses acutely and deeply on the responses that are aroused in your body, and in this way increases your sex drive. During massage some people experience this “sensate focusing” for the very first time.

Massage can be particularly important for women because it can have exactly the same effect as kissing, caressing and other forms of foreplay, in that it allows a woman’s sex hormones to build up and to arouse and prepare her body for intercourse. It is helpful also for men who have difficulty in arousal or suffer from impotence.

One of the aims of massage is to give you the opportunity to discover for yourself what gives you pleasure, and you should approach it with a completely open mind. Men and women are often surprised how sexy it feels to have certain parts of their bodies – which they had never thought of as remotely erotic – caressed.

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• Have something nice planned; almost all women appreciate thoughtfulness in the form of a

bouquet of flowers or a candlelit dinner, for instance.

• Compliment your partner on her appearance, tell her she smells nice, hold her hand, give her

light, affectionate kisses and catch her eye and smile whenever you can.

• Be attentive, whether you’re at home, out together or at a party; for example, don’t ignore her

for the television.

• Once you’re in bed be attentive to her wishes and indulge in as much loving foreplay as you

can.

• Try not to fall asleep immediately you’ve climaxed; talk to her for a while afterwards and hold

her in your arms.

The myth of romanticized women and eroticized men distorts the natural interaction that takes place between the two sexes. The infinite range of human experiences through holding, touching, feeling, stimulating, trusting, talking and listening to one another is involved in sexual interaction, and it is a distortion of the male and female personality to say that love and sex is the sole prerogative of either gender.

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