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Couples with Sex Issues in a Marriage

Sexual Disconnect

James and Yelena have been married for 22 years and have three grown children, now out of the house. Sex was never particularly enjoyable for Yelena, primarily because James was uninterested in much foreplay and Yelena felt it was unfeminine to make any sexual demands of her husband. However, because of her love for James, she accommodated his desire for sex two or three times a week, and consistently "faked orgasms."
James also does not think "a real man" should receive any "help from his wife to get an erection, even when his erections became less firm and less predictable. As a result, over the last two years, James rarely initiated sex and Yelena felt relieved, thinking she would now be "excused from sex." Furthermore, she is in perimenopause, and has begun to experience increasingly uncomfortable penetration. Suddenly, James' vigor and sexual interest has returned with greater intensity than ever. Yelena discovered he was secretly taking Viagra, which he obtained over the Internet.

Discuss how effective you think Viagra will be for improving James' sex life, and why?
Suppose Yelena's discovery that James is using Viagra secretly is the "last straw" for her after years of not addressing her unsatisfying sexual life with him, and she demands that they seek marriage counseling and focus on their sex life.

In this case:
What part of this dilemma should a counselor point out is Yelena's responsibility to acknowledge and address? Additionally, what special issues regarding her perimenopause will need to be addressed?
What part of this dilemma should a counselor point out is James' responsibility to acknowledge and address?
Discuss specific treatment options for this couple that are supported by accredited research, such as .gov or .edu. Write at least 3 pages long with accredited references, no Wikipedia.

Grading Criteria for this Notes

Discuss how effective Viagra would be for improving James' sex life, and why?
Explain Yelena's responsibility and what special issues regarding her perimenopause will need to be addressed.
Explains James' responsibility to acknowledge and address.
Discuss specific treatment options for this couple that are supported by research.

Solution Preview

Discuss how effective Viagra would be for improving James' sex life, and why?

Viagra is a drug that is designed to help men when they have some type of erectile dysfunction. Since James has been experiencing issues with his erections being less firm and unpredictable, using Viagra would definitely help him to be more consistent. However his obscurity of intimacy would not be improved by using Viagra.

The drug will enhance his durability while he is aroused but the missing element is he is lacking complete intimacy with his spouse.

"Viagra does not cause a man to be sexually aroused. Viagra is only effective if you are sexually aroused. To understand how it works you need to understand the mechanics of how a man gets an erection. When you get sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO). The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells. If you are not turned on, your brain will not stimulate the release of any nitric oxide and you will not produce any cGMP" (bpas, 2010).

Explain Yelena's responsibility and what special issues regarding her perimenopause will need to be addressed.

Yelena's responsibility is to express what her desires are for sex, such as her need for more foreplay to become aroused or her lack of reaching an orgasm to fully enjoy sexual pleasures. Also she needs to ...

Solution Summary

This article will provide problems and solutions around couples experiencing sexual issues in their marriage.

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