How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!

Dear How to Do It,

I’m a straight, 24-year-old male who has never been able to orgasm. I have an otherwise healthy sex life and personal habits. I eat well, regularly exercise, and have even undergone blood testing to confirm that my testosterone levels were in a safe range (they came back somewhat above average). I am able to attain and sustain an erection with no issues (although I sometimes struggle to maintain a solid erection when receiving head or when on bottom), and almost always ejaculate when solo or in partnered sexual encounters. I’m circumcised and there are no physical abnormalities in the shape or size of my genitalia.

It wasn’t until a few years after beginning to masturbate that I realized that my peers were experiencing something quite different than I ever had. The condition is referred to as ejaculatory anhedonia or orgasmic anhedonia in scientific literature, which there isn’t much of, and most of the other cases I’ve heard about involve sudden changes or conditions (i.e., paralysis, severe trauma, antidepressant usage) that don’t apply to me. For me, ejaculation is just an involuntary physical spasm, like a sneeze. I still have sexual urges and desires, and so sex can be a relief in the same way that trail mix after a long hike is, and it’s been the same my whole life. But when I finish, there is no pleasurable, heady, or even stirring sensation. It hasn’t prevented me from developing meaningful romantic connections, but I don’t like having to fake anything or explain why I’m not too vocal. I’ve also heard a lot about how great the sensation is, and I can sometimes feel alienated or dehumanized. I was much more bothered by it when I was younger, including experimenting with men to see if I was just hiding something from myself, but nothing was different. Since then, I’ve learned to live with it, and I haven’t given the issue too much mental real estate recently. Is there anything I can do to make myself orgasm when I ejaculate?

—O No

Dear O No,

While it sounds like you’re managing this well—and while I’m happy to read that you’re getting some release from sex—I’m sure this is extremely frustrating for you. I imagine that hearing other people talk about the pleasure of orgasms is something like staring into the window of a bakery while being broke and hungry. You don’t need that five-layer red velvet cake, but it sure would be nice. For some expert help, I reached out to my frequent urologist source, Dr. Charles Welliver, professor of surgery at Albany Medical College and an American Urological Association member. In an email, he told me that like many orgasmic/ejaculatory problems, this is a tough one. “There just isn’t good research on these problems and the research done thus far has been unfruitful in improving our understanding,” he wrote.

“An important point to make is that ejaculation and orgasm are different,” he continued. “They usually do go together (and are appropriately grouped) but orgasm is the physical sensation and ejaculation is the physical process of expelling ejaculate. In some conditions, guys don’t have ejaculate (usually prostate surgery) but still have orgasm. His problem does sound orgasm specific as the physical part of ejaculation sounds to be present.”

Welliver said that in the event that he was treating you, he’d ask about general anhedonia—that is, “Does he find pleasure in things other than sex?” Additionally, Welliver wrote that he’d check to make sure you have normal levels of prolactin, “as prolactin and oxytocin are involved with orgasm in men in a way that is not completely understood. … I can’t say I have ever checked an oxytocin level on someone or would even know how to interpret those findings. If his prolactin is abnormal, that can point towards a benign pituitary tumor. This is a long shot and I don’t really suspect an issue but if I were seeing him, I would check a prolactin to be sure. Simple blood test.” Finally, the doctor recommends visiting a sex therapist. “I’m always on the lookout for repressed sexual baggage with something like this,” he wrote.

Additionally, in a 2002 article in the Journal of Sexual and Reproductive Medicine, Dr.

Stacy Elliott, a professor at the University of British Columbia, reported that anhedonic ejaculation is, “usually associated with neurological disease (multiple sclerosis and peripheral neuropathy) or, occasionally, psychiatric disorders.” I don’t mean to scare you, and I know it doesn’t get you closer to the sensation you’re looking for, but this, too, perhaps is worth investigating with your doctor, just in case. Additionally, there are notes online from a 2016 presentation on anorgasmia in men that Elliott gave at the Fall Scientific Meeting of the Sexual Medicine Society of North America. (Elliott, unfortunately, did not respond to my interview request.) In addition to checking testosterone, she recommends pelvic-floor awareness (are you doing Kegels?), and potential psychiatric diagnosis/treatment. Elliott describes several other related orgasm disorders in the notes and various treatments (like vibrators). It’s worth reading through for potential help. I think the most important thing for you right now, though, is to rule out potential causes with your doctor and see a sex therapist for more help. Good luck!

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Dear How to Do It,

I’m a woman, and I have been dating my wonderful boyfriend for a little over three months now. In addition to having great chemistry and emotional connection, we’re very in tune with each other sexually. My only issue is that I absolutely despise receiving oral sex—it makes me feel extremely insecure and self-conscious. I trim but don’t completely shave down there, and even if I’ve recently showered, I tend to smell—not horrible, and not like there’s a medical issue, but a “normal” smell. I also sometimes have visible (white) sweat that I’m very self-conscious of. I do like the sensation of receiving oral, but I’m so anxious and worried that the experience is unpleasant for him that I can’t actually enjoy it. He says he’d love to give me oral sex and that my concerns are a non-issue for him, but he doesn’t pressure me in any way. Is this something worth working on? Should I accept that I feel the way I feel about it, or should I work on accepting that my body, like everyone’s body, grows hair and smells a certain way, and that I can be confident and trust my partner when he says he enjoys giving me oral?

—Muff Stuff

Dear Muff Stuff,

There are clashing ideals at the crux of your issue: your lack of sexual obligation versus the mental health imperative to mitigate anxiety. You don’t have to do anything you don’t like, so if you’re doing fine not receiving oral, you need not introduce it to your sex life. At the same time, your distaste for cunnilingus stems from fears for which no material proof exists. You acknowledge that your body odor is not particularly pungent, and that your boyfriend isn’t pressed at any rate.

Unless you have trauma or some other deep-seated issue attached to oral sex that you didn’t mention and because you actually enjoy the sensation, I think this is worth working on—slowly. Consider a sex therapist to help you with this issue, or perhaps ease into it by allowing your boyfriend to explore your body while you are clothed. See if you can be comfortable with his head near/between your legs. At any sign of discomfort, stop and try again later, if you are so inclined. I urge this because life is so much easier when you can relax and not worry so much about the entirely human condition of sometimes smelling a little funky. (It can also be extremely liberating to be appreciated for your body odor.) You can certainly live a healthy and happy life without oral sex, but for the pleasure you’re potentially leaving on the table, I think working through this is worth a shot.

Dear How to Do It,

My wife and I were 21-year-old fundamentalist virgins when we got married. Over the past 20-plus years, we’ve had a good marriage in every way except one: sexual expression and enjoyment.

My wife isn’t as into sex as I am. I understand that it is normal to have differing libidos. But in our case, the difference is fairly wide. In the early years of marriage, we’d have sex every other week on average. Over the years, that has turned into once every few months. I used to think this was because she didn’t find me attractive. Or I assumed I was just perverse. I’d masturbate at least once a day. My wife has never masturbated. And so I just assumed she was purer than I was.

Over the years, we’ve changed in a lot of our perspectives, but our sex live has been very slow to change. Due to our fundamentalist upbringings, it was hard to even talk about. Over time, I’ve learned that my wife doesn’t find bodies attractive. She tends to only want sex for the physical closeness, but is mostly indifferent to having an orgasm.

For a long time, I was resigned to this reality. I love my wife. I’ve known her since I was 14 years old. She is my life partner. If we’re unable to have sex as often as I’d like, then I’d rather have a low-sex marriage with her than be jeopardizing that marriage by cheating or raising the idea of an open marriage or polyamory.

But in the past few years, I’ve reconsidered as I’ve come to learn more about myself. What I once assumed were the thoughts of a midlife crisis continue to persist. I don’t think I’m as straight as I used to think. I find myself attracted to a lot of different people of different gender expressions. And I’ve begun to question my own gender expression. I’m feeling increasingly sad that my culture and upbringing didn’t give me space to explore facets of sex and gender before entering into a life-long magnanimous commitment based upon the assumption of a male-female gender binary.

I feel stuck. I want to express myself in ways that I can’t in my marriage. But the idea of losing my best friend and the mother of my child is too painful to bear. Can I be happy giving up self-exploration out of love and commitment? Or should I risk it by bringing this all up and suggesting polyamory, an open marriage, or some other way for me to explore my sexuality? And risk exploring gender expression even though it could make my wife insecure and anxious?

—New Leaf

Dear New Leaf,

You’re at a well-trodden crossroads—when deciding whether to come out, or even just to explore your sexuality or gender expression, many are daunted by the question of whether it will be worth it for its potentially life-upending effects. But I’ve never heard anyone later say, “I wish I hadn’t come out.” Maybe that’s a taboo sentiment that people are feeling but not saying, but my sense is that the vast majority of those who come out are glad to have done so.

Yes, you have a commitment to your wife, but you also have one to yourself. A life of service is a noble one, but I have to wonder how good a partner you can actually be if you aren’t being true to yourself. I’ll paraphrase something I heard Barbra Streisand say during the commentary track for The Prince of Tides: Keeping secrets is a burden. It may seem obvious, and it’s certainly been said before, but I like the succinctness there. When you’ve got your hands full with a burden, they aren’t freed up to help others.

As an out gay person, it’s easy for me to be idealistic about this stuff. But I think part of our job as humans is to keep evolving into our truest possible form. That’s an ongoing process. It could be tragic for you to look back on this 20, 30, 40 years from now and think, “If only I had let myself be what I was.” Your wife may or may not be able to handle this, and this will change the terms of a relationship you’ve both been in for a very long time. But that’s not your fault, and these feelings aren’t going to go away. I think you have to open up to your wife and see if she has the capacity to love you for all of you.

Granted, I’m responding to this question in the middle of a pandemic that has forced responsible people to freeze in place. It’s probably not the best time to make major announcements that could change your relationship while you remain necessarily fixed in proximity. The conversation is an important one to have, but timing is everything. You owe it to her to show her exactly who you are, but only when she has the freedom of mobility, should she feel the need to exercise it in response.

This will be difficult no matter the outcome, but you can do it. I wish you the best.

Dear How to Do It,

My wife of almost 10 years and I typically have a vibrant sex life (4+ times a week, with several of those being multiple orgasms not just for her, but for me as well.) She’s quite vanilla, but happily goes along with some light kink that I’ve come up with. With the coronavirus outbreak, she’s still working up to four days a week in a non-public job deemed essential, and often comes home very tired and stressed from situation. I don’t want to ask her for sex those nights (and she occasionally initiates anyway), but I’ve been thinking this could be a good time to initiate sexting. I don’t want her to think I find her less desirable all of a sudden, and this seems like a good solution. BUT! She’s very easily embarrassed. By her own admission, she’s a bit of a prude until she’s worked up, and is generally uncomfortable/nervous about sex outside the moment. I don’t want to drop her right into the deep end, but I’d love any advice on easing into a sexting situation with her.

— Nude Prude

Dear Nude Prude,

I don’t know how you come away from assessing the situation thinking that this could be a good time to initiate sexting. The woman is tired. Fatigue and stress can wreak havoc on a person’s libido, and you established that it takes a minute to get her motor running. Without an engaged libido from all parties, there’s little point to sexting.

But so as not to leave you high and dry—your desires, after all, are valid—let’s entertain your specific ask. You’re better off having a conversation with her than springing anything on her. I understand the power in showing over telling, but the situation calls for extra consideration. People are responding in a range of ways to the pandemic/lockdown—for some, it’s making them hornier and for others, it’s a complete and utter turn-off. See where she is, and continue to exercise the same prudence you have by not initiating sex when she is tired and stressed. Keep doing what you’re doing, and don’t focus so much on introducing something novel to your shared sex life during these extraordinary circumstances.

If you simply must dip your toe in, send her a text telling her that you’re horny for her or that you can’t wait to see her later, wink wink. Allow her response to dictate where things go. If she’s not into it, do what you should in any situation in which there is a disparity of desire: Defer to the person who says no.

— Rich

More How to Do It

I have a dilemma. I’m a married woman, and my husband and I have a great relationship. I’m the one who pretty much takes care of everything outside the bedroom, so I prefer my husband to be more dominant and take charge in the bedroom. However, he tends to be a considerate lover, which means he asks a lot of questions like, “Are you OK?”; “Does this feel good or right?”; “Am I hurting you? Other than the occasional “you’re on my hair!” moment, which I am vocal about, the other questions are totally unnecessary. I’ve reassured him before, during, and after that he’s doing great, and I have brought up several times that I find the questions distracting, especially when I’m in the middle of an orgasm and they take from the moment. How do I start nudging him to be a little more dominant and to stop asking questions?