Editing Sexual intercourse (section)

===Duration and genital complications===
{{see also|Intravaginal ejaculation latency time|Coitus reservatus}}

Sexual intercourse, when involving a male participant, often ends when the male has ejaculated, and thus the partner might not have time to reach [[orgasm]].<ref name="Wincze">{{Cite book|author= John Wincze | title = Enhancing Sexuality : A Problem-Solving Approach to Treating Dysfunction| year = 2009 | publisher = [[Oxford University Press]] |pages=56–60 | isbn = 978-0-19-971802-3| url=https://books.google.com/books?id=8YxbeHsgiGMC&pg=PA56}}</ref> In addition, [[premature ejaculation]] (PE) is common, and women often require a substantially longer duration of stimulation with a sexual partner than men do before reaching an orgasm.<ref name="Weiten, 2011" /><ref name="Porst">{{cite book |author = Hartmut Porst |author2 = Jacques Buvat|title =Standard Practice in Sexual Medicine| publisher = [[John Wiley & Sons]] | year = 2008|access-date=October 22, 2013 | page = 189|isbn = 978-1-4051-7872-3 |url=https://books.google.com/books?id=S4GJio79XOUC&pg=PA189}}</ref><ref name="Emmanuele">{{cite book|author1-link=Emmanuele A. Jannini|author = Emmanuele A. Jannini |author2 = Chris G. McMahon |author3 = Marcel D. Waldinger|title =Premature Ejaculation: From Etiology to Diagnosis and Treatment| publisher = [[Springer Publishing|Springer]] | year = 2012|access-date=October 22, 2013 | pages = 159–162|isbn = 978-88-470-2646-9 |url=https://books.google.com/books?id=iCXF3sWtgegC&pg=PA159}}</ref> Scholars, such as Weiten et al., state that "many couples are locked into the idea that orgasms should be achieved only through intercourse [penile-vaginal sex]," that "the word ''foreplay'' suggests that any other form of sexual stimulation is merely preparation for the 'main event'" and that "because women reach orgasm through intercourse less consistently than men," they are likelier than men to [[Fake orgasm|fake an orgasm]] to satisfy their sexual partners.<ref name="Weiten, 2011" />
[[File:Indiaerotic8.jpg|thumb|left|Painting of a couple (an Indian prince and lady) prolonging sexual intercourse]]
In 1991, scholars from the Kinsey Institute stated, "The truth is that the time between penetration and ejaculation varies not only from man to man, but from one time to the next for the same man." They added that the appropriate length for sexual intercourse is the length of time it takes for both partners to be mutually satisfied, emphasizing that [[Alfred Kinsey|Kinsey]] "found that 75 percent of men ejaculated within two minutes of penetration. But he didn't ask if the men or their partners considered two minutes mutually satisfying" and "more recent research reports slightly longer times for intercourse".<ref name="Reinisch">{{cite book | title = The Kinsey Institute New Report On Sex| publisher = [[Macmillan Publishers|Macmillan]] | year = 1991 | pages = 129–130| access-date = August 30, 2012 |isbn = 978-0-312-06386-3| url = https://books.google.com/books?id=KsW6wPiXEd0C&pg=PA129 |author1=June M. Reinisch |author2=Ruth Beasley |author1-link=June Reinisch }}</ref> A 2008 survey of Canadian and American [[sex therapists]] stated that the average time for heterosexual intercourse (coitus) was 7 minutes and that 1 to 2 minutes was too short, 3 to 7 minutes was adequate and 7 to 13 minutes desirable, while 10 to 30 minutes was too long.<ref name="Carroll"/><ref>{{cite journal |vauthors=Corty EW, Guardiani JM | title = Canadian and American Sex Therapists' Perceptions of Normal and Abnormal Ejaculatory Latencies: How Long Should Intercourse Last? | journal = The Journal of Sexual Medicine | volume = 5 | issue = 5 | pages = 1251–1256 | year = 2008 | pmid = 18331255 | doi = 10.1111/j.1743-6109.2008.00797.x }}</ref>

[[Anorgasmia]] is regular difficulty reaching orgasm after ample sexual stimulation, causing personal distress.<ref name="Bullough">{{cite book |author=Vern L Bullough |author2=Bonnie Bullough |author-link=Vern Bullough |author2-link=Bonnie Bullough | title = Human Sexuality: An Encyclopedia | publisher =[[Routledge]]|page=32|year = 2014|access-date=December 6, 2014| isbn = 978-1-135-82502-7 |url =https://books.google.com/books?id=-cqlAgAAQBAJ&pg=PA32}}</ref> This is significantly more common in women than in men,<ref name="Rosenthal">{{cite book |first=Martha |last= Rosenthal| title = Human Sexuality: From Cells to Society | publisher =[[Cengage Learning]]|year = 2012|page=150|access-date=October 22, 2013| isbn = 978-0-618-75571-4 |url =https://books.google.com/books?id=d58z5hgQ2gsC&pg=PT170}}</ref><ref name="Weiner2">{{cite book |author =Irving B. Weiner |author2 =George Stricker |author3 =Thomas A. Widiger |author3-link=Thomas Widiger|title =Handbook of Psychology, Clinical Psychology| publisher = [[John Wiley & Sons]] | year = 2012|access-date=October 22, 2013| pages = 172–175|isbn = 978-1-118-40443-0|url=https://books.google.com/books?id=A_NaK3cwQSsC&pg=PA172}}</ref> which has been attributed to the lack of [[sex education]] with regard to women's bodies, especially in [[Antisexualism|sex-negative]] cultures, such as clitoral stimulation usually being key for women to orgasm.<ref name="Weiner2"/> The physical structure of coitus favors penile stimulation over clitoral stimulation; the location of the clitoris then usually necessitates manual or oral stimulation in order for the woman to achieve orgasm.<ref name="Weiten, 2011"/> Approximately 25% of women report difficulties with orgasm,<ref name="Carroll"/> 10% of women have never had an orgasm,<ref name="Plotnik">{{cite book |author1=Rod Plotnik |author2=Haig Kouyoumdjian |title =Introduction to Psychology| publisher = [[Cengage Learning]] | year = 2010 | page = 344|isbn = 978-0-495-90344-4| quote= Inhibited female orgasm refers to a persistent delay or absence of orgasm after becoming aroused and excited. About 10% of women never reach orgasm...}}</ref> and 40% or 40–50% have either complained about sexual dissatisfaction or experienced difficulty becoming sexually aroused at some point in their lives.<ref name="Knoepp">{{cite journal |vauthors=Knoepp LR, Shippey SH, Chen CC, Cundiff GW, Derogatis LR, Handa VL | title = Sexual complaints, pelvic floor symptoms, and sexual distress in women over forty | journal = [[The Journal of Sexual Medicine]] | volume = 7 | issue = 11 | pages = 3675–82 | year = 2010 | pmid = 20704643 | pmc = 3163299 | doi = 10.1111/j.1743-6109.2010.01955.x }}</ref>

[[Vaginismus]] is involuntary tensing of the pelvic floor musculature, making coitus, or any form of penetration of the vagina, distressing, painful and sometimes impossible for women. It is a conditioned reflex of the pubococcygeus muscle, and is sometimes referred to as the ''PC muscle.'' Vaginismus can be hard to overcome because if a woman expects to experience pain during sexual intercourse, this can cause a muscle spasm, which results in painful sexual intercourse.<ref name="Weiner2"/><ref name="Ferri">{{cite book|author=Fred F. Ferri|title=Ferri's Clinical Advisor 2013,5 Books in 1, Expert Consult&nbsp;— Online and Print,1: Ferri's Clinical Advisor 2013|publisher=[[Elsevier Health Sciences]]|isbn=978-0-323-08373-7|year=2012|page=1134|access-date=November 29, 2014|url=https://books.google.com/books?id=OR3VERnvzzEC&pg=PA1134}}</ref> Treatment of vaginismus often includes both psychological and behavioral techniques, including the use of [[vaginal dilators]].<ref name="Goldman">{{cite book |author= Marlene B. Goldman |author2= Rebecca Troisi |author2-link=Rebecca J. Troisi |author3= Kathryn M. Rexrode| title = Women and Health | publisher =[[Academic Press]]|page=351|year = 2012|access-date=December 6, 2014| isbn = 978-0-12-384979-3 |url =https://books.google.com/books?id=mavb4v8w8bsC&pg=PA351}}</ref> Additionally, the use of [[Botox]] as a medical treatment for vaginismus has been tested and administered.<ref name="Comer">{{cite book |author= Ronald J. Comer| title = Fundamentals of Abnormal Psychology | publisher =[[Macmillan Publishers|Macmillan]]|page=338|year = 2010|access-date=December 6, 2014| isbn = 978-1-4292-1633-3 |url =https://books.google.com/books?id=y-FUzkLQ7GsC&pg=PA338}}</ref> Painful or uncomfortable sexual intercourse may also be categorized as [[dyspareunia]].<ref name="Goldman"/>

Approximately 40% of males reportedly have some form of [[erectile dysfunction]] (ED) or impotence, at least occasionally.<ref name="Schouten">{{cite journal |vauthors=Schouten BW, Bohnen AM, Groeneveld FP, Dohle GR, Thomas S, Bosch JL | title = Erectile dysfunction in the community: trends over time in incidence, prevalence, GP consultation and medication use—the Krimpen study: trends in ED | journal = J Sex Med | volume = 7 | issue = 7 | pages = 2547–53 | date = July 2010 | pmid = 20497307 | doi = 10.1111/j.1743-6109.2010.01849.x }}</ref> Premature ejaculation has been reported to be more common than erectile dysfunction, although some estimates suggest otherwise.<ref name="Porst"/><ref name="Emmanuele"/><ref name="Schouten" /> Due to various meanings of the disorder, estimates for the prevalence of premature ejaculation vary significantly more than for erectile dysfunction.<ref name="Porst" /><ref name="Emmanuele" /> For example, the [[Mayo Clinic]] states, "Estimates vary, but as many as 1 out of 3 men may be affected by [premature ejaculation] at some time."<ref name="Premature ejaculation">{{cite web|url=http://www.mayoclinic.com/health/premature-ejaculation/DS00578|title=Premature ejaculation|publisher=[[Mayo Clinic]].com|access-date=March 2, 2007}}</ref> Further, "Masters and Johnson speculated that premature ejaculation is the most common sexual dysfunction, even though more men seek therapy for erectile difficulties" and that this is because "although an estimated 15 percent to 20 percent of men experience difficulty controlling rapid ejaculation, most do not consider it a problem requiring help, and many women have difficulty expressing their sexual needs".<ref name="Reinisch"/> The [[American Urological Association]] (AUA) estimates that premature ejaculation could affect 21 percent of men in the United States.<ref name="auanet.org">{{cite web|title=Guideline on the pharmacologic management of premature ejaculation|publisher=[[American Urological Association]]|year=2004|access-date=October 12, 2013|url=http://www.auanet.org/common/pdf/education/clinical-guidance/Premature-Ejaculation.pdf|url-status=dead|archive-url=https://web.archive.org/web/20160303170443/http://www.auanet.org/common/pdf/education/clinical-guidance/Premature-Ejaculation.pdf|archive-date=March 3, 2016}}</ref>

For those whose impotence is caused by medical conditions, prescription drugs such as [[Viagra]], [[Cialis]], and [[Levitra]] are available. However, doctors caution against the unnecessary use of these drugs because they are accompanied by serious risks such as increased chance of heart attack.<ref name="Greenberg ED">{{cite book |author= Jerrold S Greenberg |author2= Clint E. Bruess |author3=Sara B. Oswalt | title = Exploring the Dimensions of Human Sexuality | publisher =[[Jones & Bartlett Publishers]]|page=633|year = 2010|access-date=December 8, 2014| isbn = 978-0-7637-9740-9 |url = https://books.google.com/books?id=6b36v8JHznIC&pg=PA633}}</ref> The [[selective serotonin reuptake inhibitor]] (SSRI) and antidepressant drug [[dapoxetine]] has been used to treat premature ejaculation.<ref name="Balon">{{cite book |author=Richard Balon |author2=Robert Taylor Segraves| title = Clinical Manual of Sexual Disorders | publisher =[[American Psychiatric Pub]]|page=292|year = 2009|access-date=December 6, 2014| isbn = 978-1-58562-905-3 |url =https://books.google.com/books?id=YuP3Hb0TMLQC&pg=PA292}}</ref> In clinical trials, those with PE who took dapoxetine experienced sexual intercourse three to four times longer before orgasm than without the drug.<ref name="Architectural Press">{{cite book| title = The Architects' Journal |volume=221 |issue=17–21 | publisher =[[Architectural Press]]|page=16|year = 2005|access-date=December 6, 2014|url =https://books.google.com/books?id=7HlNAAAAYAAJ&q=The+Architects%27+Journal,+Volume+221,+Issues+17-21}}</ref> Another ejaculation-related disorder is [[delayed ejaculation]], which can be caused as an unwanted side effect of antidepressant medications such as [[fluvoxamine]]; however, all SSRIs have ejaculation-delaying effects, and fluvoxamine has the least ejaculation-delaying effects.<ref name="Balon2">{{cite book |author= Richard Balon |author2= Robert Taylor Segraves| title = Clinical Manual of Sexual Disorders | publisher =[[American Psychiatric Pub]]|page=281|year = 2009|access-date=December 6, 2014| isbn = 978-1-58562-905-3 |url =https://books.google.com/books?id=YuP3Hb0TMLQC&pg=PA281}}</ref>

Sexual intercourse often remains possible after major medical treatment of the reproductive organs and structures. This is especially true for women. Even after extensive gynecological surgical procedures (such as [[hysterectomy]], [[oophorectomy]], [[salpingectomy]], [[dilation and curettage]], [[hymenotomy]], [[Bartholin gland]] surgery, abscess removal, [[vestibulectomy]], [[labia minora]] reduction, [[cervical conization]], [[surgical]] and radiological cancer treatments and chemotherapy), sexual intercourse can continue. Reconstructive surgery remains an option for women who have experienced benign and malignant conditions.<ref name="Hoffman2012">{{cite book | last = Hoffman | first = Barbara | title = Williams gynecology | edition = 2nd | publisher = McGraw-Hill Medical |page=65 |location = New York | year = 2012 | isbn = 978-0-07-171672-7 }}</ref> Men and women who have undergone extensive surgery should consult their medical team to understand how their treatment or surgery affects sex and how long they should wait before having sexual intercourse after a surgery.<ref>{{Cite web |date=2017-09-22 |title=Sexual Health Issues in Men and Cancer Treatment - Side Effects - NCI |url=https://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-men |access-date=2024-10-21 |website=www.cancer.gov |language=en}}</ref><ref>{{Cite web |title=Sexuality and intimacy |url=https://www.cancer.org.au/cancer-information/cancer-side-effects/sexuality-and-intimacy |access-date=2024-10-21 |website=www.cancer.org.au}}</ref><!--pages 1020-1348-->