Agony and ecstasy: sex advice

At www.loving-angles.com you can buy modular sex furniture that will “give you the support you need to enjoy a wide range of challenging and exciting sexual positions”. The advertising blurb leaves a lot to be desired but the product does look as if it might deliver on its promise to provide “fuller and more intimate contact with your lover”.

The furniture, which looks a bit like those wooden architectural blocks that babies play with, is made of something called Super Bultex, which is, apparently, a “super resilient material of orthopaedic quality”. The different shapes are all specifically designed to aid certain sex positions. The Tantric Tilt, £89.95, for example, is a large wedge shape. If your wife lies on her front, face to the floor, the wedge pushes her hips up to create the perfect angle for rear-entry sex. It can be also be used to elevate the hips for better thrust and grind in the missionary position.Loving angles furniture comes in a range of 32 colours and, needless to say, all fabrics are either wipe-clean or machine-washable.

Having looked at these websites (or bought my book) and tried doggy and spoons and butterfly and the seventh posture of the perfumed garden, you and your wife may well find that you still like missionary best. If you fancy a little variation on this theme you might want to try the coital alignment technique (CAT). Devised by the American psychotherapist Edward Eichel in the 1990s, CAT is basically a revised missionary position. It involves rocking rather than thrusting to put rhythmic pressure on your partner’s clitoris during penetration. You get on top, so your pelvis is positioned higher than hers. You penetrate, so the head of your penis is inside her but, because you are positioned farther up her body, your shaft will be outside her vagina, pressing against her pubic bone. You rest your full weight on her, which makes you slide toward her shoulders and head. She wraps her legs around yours and rests her ankles on your calves. She pushes up and forward to force your pelvis backward. You allow your pelvis to move back but it continues to press against hers.

During the upward stroke your penis disappears into her vagina. During the downward stroke, you force her pelvis back and down, and press her clitoris against the base of your penis. During the downward stroke, the shaft of your penis will reappear. Rock backwards and forwards like this, keeping a slow and steady pace until . . . well, you know what happens next.

Dr Thomas Stuttaford

It is always useful to know for how long you have been married. When giving out Kamasutra-type advice, it is also helpful to know both of your ages and your build.

There are five basic positions: face-to-face (missionary); rear entry; woman sitting on man and facing him with the man sitting on a chair; woman sitting on a lying man and either facing his head or feet; and lying side-to-side (spoons).

Obviously some of the more exotic variations of these positions couldn’t be considered if either of you had a physical disability or were restricted by a cardiovascular or lung problem. Weight is also an important consideration. Some standing positions in which a tall man holds a slight, short woman aloft while he clasps her to his body won’t apply if your wife is 14st and 6ft.

Although you are critical of the missionary position and find it boring, it has become commonplace and popular because, ever since humans walked on two legs and stood erect, it has become the most obvious way of copulating. Animals that walk on four legs have rear entry sexual intercourse, as do most apes, because it is easier and hence more natural. But they do not kiss with the same meaning as humans: their lick is not the equivalent.

Human sexual behaviour changed once we evolved into standing on two legs and stopped crawling around on all fours and swinging from trees. As the result of standing, erect breasts have replaced the bottom as the zone of primary erogenous attraction, and face-to-face intercourse became more usual than rear entry.

The advantages of the missionary position are that it enables you to continue to make eye contact with your wife, and you can kiss her and hold her much closer. And you can maintain the position comfortably for almost as long as you like.

If boredom is a problem, I would recommend that you buy a good sex manual that you can follow without being an Olympic athlete. You do not have to buy one from the friendly neighbourhood bookshop, where you might find yourself queuing up at the cash point with your neighbour, but can visit some impersonal multinational bookstore in the nearest city.

It would have been useful to know your age, not only because that would have given us some idea of your likely general physical fitness, but because it could also allow us to make a reasonable guess as to your potency. Most men over a certain age (somewhere between 45 and 55) will not have a spontaneous erection when having sex with their regular partner, but will need manual stimulation before they have one. Men who have problems either in maintaining their erection long enough for the woman to have an orgasm, or are unduly slow themselves, sometimes find that rear-entry positions put greater tension on an erect penis so that erections are maintained more readily and their orgasm is better controlled.

As we don’t know how long you have been married it is not possible to guess just how realistic your sexual ambitions are. Changing sexual positions isn’t going to be a panacea. Many of my patients who enjoyed sex several times a week before or during the early days of their marriage found that its frequency fell away to once or twice a week after a few years and, within 20 years, one in four, although happy, are asexual.