10 Truths I've Learned After 26 Years Of Researching Sex

It could be argued that we live in the most sexual era of all time. Sexual barriers have fallen, contraception allows us to separate reproductive consequences from sexual experiences (usually). Online dating has made it exponentially easier to find sexual partners. And internet porn is available to all with a simple click or two of the mouse. And yet, after working for 26 years as a specialist in sexual medicine, I've learned that most people don’t know some of the most basic things about sex.

Here are 10 things I wish everyone knew:

1. Human beings are sexual from cradle to grave.

Little boys and girls touch themselves in the genital areas before they have any idea what it’s all about. Parents changing diapers of infant boys know that it's common to see them with an erect penis. As we age, the drive for sex may be diminished, but some men and women continue to be sexual into their 90s.

2. Sexual urges are normal and universal.

If there were no sex drive, and no sex, there would be no humans. Just as there would be no snakes, dolphins, pigeons, or salmon without the urge to have sex. We often use terms that make us more comfortable in talking about this, like “mating.” What those animals are doing, though, is having sex. And that’s what humans do, too.

3. Sex is the “special sauce” in relationships.

Whenever you see a couple really enjoying themselves in public, say at a restaurant, you can bet they’re having fun in the bedroom. And perhaps elsewhere, too. Sex is an activity unlike any other in our lives. When it goes well between two people, it becomes a private yet shared experience that adds levels of depth and intimacy.

4. Pornography isn’t real.

For most people, porn is the only way they'll ever see others having sex. Because we don’t tend to talk openly about our own sexual experiences (especially men), and with our built-in insecurities about our own sexuality, it’s easy to imagine that what occurs in porn is what everyone else is doing. It’s not. Men don’t look like that. Women don’t look like that. No one talks like that.

And many of the situations, positions, and activities will never be experienced by regular folks. On the other hand, if you see something you like, and your partner is open to it, by all means try it out! Could be fun.

5. Men are hormonal, too.

Testosterone is a key hormone driving male sexuality, but also other aspects of maleness. When testosterone levels decline, men may behave “hormonal,” just like women. Not only does sex drive diminish, but men may become cranky, tired, and feel depleted. Testosterone levels decline with age, but they can also be reduced in men of any age. Stress and inadequate sleep are two common causes in younger men. Restoring testosterone levels to normal improves these symptoms if they have a hormonal cause.

6. Boring sex is common.

Many couples have the experience that sex was exciting early in the relationship, followed by settling into a sexual routine that is predictable and boring. This doesn’t mean a relationship is on the rocks. Life can’t always be exciting. However, the key to keeping sex fresh is a little variety. This can be as simple as the woman wearing something different to bed, or the man whispering in her ear how much he wants her.

7. Men want to be “givers.”

I know, this may sound crazy, since we tend to think of men as selfish in bed and concerned only with their own pleasure. Yet behind my closed exam room door, men tell a very different story. Once they develop feelings in a relationship, it is critical for their sense of manliness and honor to be able to provide sexual pleasure to their partner.

8. Sexual problems are common for men.

Men want to be great lovers, but there are challenges. Insecurity, anxiety, and awkwardness can lead to disappointment in the bedroom, particularly early in relationships. Erectile dysfunction affects about 50% of men between the ages of 40 and 70 to some degree.

Premature ejaculation affects 20% of men, regardless of age. And one-third of men over 45 years have low testosterone levels, which in turn may contribute to low desire or erection problems.

The good news is that all these problems can be successfully treated. Best treatment for early-relationship jitters? Be patient and kind to each other.

9. Sexual problems are common for women.

Women may be more in control of their sexuality and bodies than ever before in history, but that doesn’t mean sex always happens easily. Like men, women may be nervous, particularly early in relationships.

Women may have issues with low desire, or difficulty with arousal or lubrication, or pain. A history of trauma may make it difficult for a woman to be physically intimate even with a partner she truly loves.

Fortunately, most of these problems can be overcome. The best initial approach? Be patient and kind to each other.

10. One person in a relationship will always want sex more than the other. (And it's not always the man.)

More and more, I see men in my medical practice requesting pills like Viagra or Cialis to help them “keep up” with the sexual desires of their wives or girlfriends.

What to do? Understand that the usual discrepancy in desire in a relationship means nothing more than the fact that we are each our own person, with our own rhythms, emotions, and biology.