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Q. Sometimes when I look at a woman I become aroused. I'm happily married and don't intentionally set out to get turned on, it just seems to happen! Is that wrong? How long is too long to look at a woman—especially if it's at the movies or on television? I know the Bible talks about lusting in your heart, but that leaves a lot of gray area.

A. Yes, it's certainly a normal male physiological response to become aroused seeing an attractive woman. Short of having some serious, disfiguring surgery, that tendency may remain into old age. But here's the real issue you've identified: What does a guy do in response to that arousal? As we see it there's a continuum of acts that might begin on the most aggressive end of the spectrum with a sexual assault of some kind. Moving down the spectrum would include fantasizing about that female or women in general leading to self stimulation. Further down the continuum would be to transfer the arousal to your relationship with your mate. All of these entail dwelling on the stimulating image, allowing the arousal to be a focus in your mind. That's where the "lusting" process begins.

A significant change on this spectrum is when you come to the point where you acknowledge, "Wow, didn't God do well when he designed women?" then remember your spouse is God's gift to you and look away. That may include changing channels or walking away. Most spouses understand our male wiring and aren't too threatened by this last response. On the other hand, most wives resent their mate's captivation with any other form.

Q. My husband and I were both virgins when we married. I was told sex for the first time would be painful, and it was—and still is. I've consulted my gynecologist who suggested going slower and trying a lubricant. We did, and it worked—but I felt no pleasure. Now when we make love, I just lie there and let him have his fun while I'm either in pain or not feeling any enjoyment. Can you help us?

A. It's sad you were taught sex was going to be painful. It doesn't invariably cause pain, and what discomfort you felt can easily be overcome. Proper lubrication and a slow, relaxed time of foreplay can usually lead to a pleasurable experience. The most regrettable factor is that experiencing pain in any activity, including sexual intercourse, creates anxiety about the possibility of having pain again. That fear becomes a barrier to arousal.

It's possible, however, for you to overcome that barrier and develop a mutually enjoyable relationship. The first step is to talk about your sexuality together. What were your expectations and early life experiences? What are the physical stimuli that have been pleasurable? Are there specific situations that trigger a shutdown? What situations are most romantic to you as a couple? These beliefs and desires form the foundation of sexual intimacy. That's the first step. Get to know each other. If you discover guilt or resentment about your lack of sexual intimacy, bring grace and forgiveness to each other.

The second step is to reprogram your behavioral responses. An effective way to do this is to learn to "pleasure" each other. For now, forget about having intercourse and focus on having fun. Take turns bringing the pleasure of physical touch to your mate. Begin with such things as back rubs, foot massage, and scalp or neck stimulation. Anything your mate enjoys except genital touch. Finding ways to bring enjoyment will allow bonding and displace fear. When these actions become natural and positive, begin to move toward some erotic stimulation. At first this might be kissing around the head and neck and going south from there. Breast stimulation, thighs, buttocks, and finally genital massage can begin. Allow these to develop only as far as they feel good. Don't rush or force each other.

Ultimately the pleasuring should go to orgasm, but still taking turns and still avoiding intercourse. When you can each achieve climax in this way, you may move toward mutuality, both of you pleasuring and receiving pleasure. Don't worry about genital union until it's a natural and desired culmination of your play.

If, however, you still experience pain, consult your gynecologist to check for any physical problems.

Remember, pain isn't inevitable and sexual satisfaction is a reasonable expectation. Enjoy!

Q. Shortly after my husband and I wed, I became pregnant. We ended up losing the baby, but since then our sex life hasn't been the same. Sometimes my husband won't make any advances toward me for several weeks, and he rejects my advances. What should I do?

A. Losing a child is probably the most difficult event a couple ever has to face. The ramifications are complex, involving spiritual, relational, and emotional components. Any of these may generate conflicts that interfere with intimacy.

Often resolving these issues depends on the readiness of each person to explore and expose deep feelings. Think about some of the common complications of losing a baby.

Spiritually: The question of God allowing this hurt in your lives can generate anger and guilt. Either of these can cause distancing from intimacy. Risking God's disfavor in a second loss may be too threatening. Understanding how a loving God can allow the death of a child is impossible. It can only be accepted by faith. Feeling blame or wanting to blame each other is a natural reaction to an inexplicable tragedy. You'll need to abandon these dynamics; setting blame is useless.

Relationally: There are frequently unspoken feelings between a couple regarding pregnancy and childbirth. One person may eagerly anticipate starting a family while the other has reservations. One may need to feel in control of conception and resent loss of agreement on that issue. For any expectations to be clouded by the loss of the baby can add to disappointment and resentment. Those feelings may be expressed in passive aggressive withholding of sexual intimacy.

Emotionally: A miscarriage may not be given the significance it deserves. It's an important loss you must grieve like any other.

Men are often less in touch with feelings and prone to minimize or deny the pain. The attitude of "just get over it" does nothing to help a mate mourn the loss of a life she felt within her womb. In rare cases, those emotions can be reversed with the husband left with grief he can't express and a mate who wants to dismiss the loss and get on with life.

There are other dynamics that may come into play. Either may feel guilty about premarital or extra-marital sexual experiences that they connect with the loss. There may have been some physical activity that gets associated with the miscarriage, for instance a boisterous sexual encounter.

These factors may spawn fears or bitterness that make further sexual intimacy problematic. Talking about these difficult issues can bring a couple to forgiveness and resolution. Counseling about conflicts may be useful as you identify them.

Q. During sex, my wife and I usually enjoy an extended foreplay. When it comes to penetration, she wants to enjoy it as long as possible, but most of the time I prematurely ejaculate. I want her to prolong her satisfaction without worrying that I won't be able to wait. Can you suggest a remedy?

A. Ah, the dream of every couple is to get great timing with exquisite genital union culminating in simultaneous orgasm. We did that once! Wow!

The quest for that perfect technique has taken many turns. One of the oldest was it was the female's "duty" to provide relief for her man. For those unfortunate ladies, premature ejaculation was probably a blessing.

Another approach was for a sensitive man wanting to provide pleasure to his wife to think about baseball or his work schedule to divert his attention, thereby delaying ejaculation. I'm not sure that was physiologically effective, but I can guess it wasn't nearly as much fun.

A third technique, which is somewhat more enjoyable, is to avoid stimulating the penis while providing manual or oral massage of the clitoris until the woman is nearly to orgasm, then have penetration. Unfortunately that has no guarantees either. Some guys have such a rapid response that little or no penile stimulation is needed for climax.

The most effective approach seems to be the "squeeze" technique, which conditions the male for a slower ejaculatory response. This procedure requires cooperation of both partners. The husband lies on his back (undressed) and his wife stimulates him to erection. His penis is stroked until he approaches ejaculation, then on his signal his mate applies pressure with both thumbs to the penis just below the head for several seconds. When the sense of urgency has passed, they pause, and then resume the stroking. Again, the "squeeze" is applied as ejaculatory inevitability is recognized. The pattern can be repeated several times then climax achieved through stroking or with penetration. Each time this is repeated the quickness of the man's response is decreased.

One factor, also useful to better understanding the problem, is that premature ejaculation is probably a genetically determined trait that isn't a sign of sexual inadequacy. Anxiety related to sexual performance only hastens the ejaculation; therefore a calm, relaxed acceptance of the pattern will definitely enhance the reconditioning.

All–in–all this is a situation that can be improved. Fortunately it takes lots and lots of practice!

Melissa and Louis McBurney, M.D., are marriage therapists and co-founders of Marble Retreat in Marble, Colorado, where they counsel clergy couples.

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