Our interviewee is sexologist Maarif Mammadov. We talk about sexual dysfunctions that concern both women and men and what causes them.
Denial is the most common reaction to articles and posts on sex-related issues, be it in the media or on social networks, and the authors are accused of promoting immorality and undermining national mental values. So, before we start, one question I would like you to clarify, to establish the facts, as they say: do Azerbaijanis have sex or not?
Azerbaijanis do have sex, but they don’t know that what they do is sex.
So why is it so difficult for our society to accept the presence of sex in our lives, that it is a natural need?
When I start sex therapy, I first establish certain things about the patient. The language we will speak, our common vocabulary… I prefer to speak the patient’s language when talking to them. For example, some don’t know parts of their body, some don’t know the scientific names for the parts of their body, and use other words to describe them. You say penis, they ask, what is penis? You say erection, they say, what is an erection? With those who know scientific names, we use proper terms. It is very important to find a common language in sex therapy. This is important both for the comfort of the person seeking therapy and for us to be on the same page.
I think that the problem here is in the word “sex”, or rather, in the meaning we attach to it. Many people think of sex as something done for money or a pornographic lifestyle. For example, if I ask a person, “How is your sexual relationship with your spouse?”, they will be confused. But phrased as “How is your intimate relationship?” or “How are the relations between you?”, the question makes them feel more comfortable, as if it is easier to talk about it when one doesn’t use the word “sex”. As for why it is so alien to us or why we don’t want to talk about it…
It seems to me that there our education and moral system programs us to see sexuality as something shameful or sinful, or defective. When I ask an older person, they say that they would not hug their children in front of their parents. I think that when we use the words “sex”, “sexuality”, “intimacy”, we think of specific sexual objects—penis, vagina, that is, these words symbolize something, and we immediately want to close that door. I think that we also judge the relationship between men and women accordingly. The moment we see a man and a woman talking, we think, “I wonder…”: “Hmm, they are talking and laughing together, I wonder…” And if we are prone to this thinking, for example, dating can be very difficult, because the period after the acquaintance comes with the “I have to marry this one now” condition.
Have to marry, because…
Because people will talk. Because I can’t be in another kind of intimate relationship, or it should be only this one. I provide premarital counseling to couples. There is something that catches my attention a lot. Some couples say that shortly after they met, they exchanged messages on an intimate topic and immediately went on to talk about it. But they may not be ready to talk about it yet, and it would be better if they didn’t. It is difficult to take a step back from this topic at the next stage, if they have already entered into each other’s private space, if they shared something intimate, exchanged private photos. They don’t know each other and each other’s boundaries.
Could it be because there is nothing else to talk about? I mean, they don’t have common topics to discuss, they don’t let themselves to get to know each other.
Maybe. Ultimately, the biggest issue here is our “selves.” For example, the biggest problem in families is the lack of communication: we cannot talk to each other, we cannot listen to the other person, we tend to interpret the feelings and thoughts of the other person the way we want. When something happens, we don’t think about what happened in the other person’s world, but how we will respond to it. That’s why we can’t find anything to talk about when we date. Normally there are so many things in life that… affect me, affect you, affect other people. We can discuss them for hours. If our discussion is aimed at convincing the other person of something after learning their point of view, it limits the conversation. But if we aim to express ourselves, the conversation can go on and on.
We have so many topics to understand and make ourselves understood! In a relationship, we program ourselves to respond to what the other person is saying. We don’t listen, or rather we don’t understand. What is the most common problem we face in a relationship? Partners say, “He/she doesn’t understand me.” Why? Because there is a very serious difference between what one side says and what the other side understands. They may think they are talking about the same thing, but they are not. Here is an example. Suppose a couple went to a party. When they get back, one of the partners says, “I saw a beautiful bracelet on my friend’s wrist.” The other partner can interpret it as “you don’t buy me bracelets”, or as “that man pays good attention to his partner, but you don’t pay attention to me”, or “I too have a bracelet, but you never told me it was good”, or “when we got engaged your mother promised me she would get me one, but she still hasn’t.” We don’t know what will happen. The partner will respond according to their interpretation. Depending on the context of each topic, we are given a message, the other person tries to make us understand something. But we get that message in the way we interpret it, rather than what the other person wants to convey. So, communication stops after a while, and we say that we don’t understand each other.
The same is true of sex-related topics. For example, I ask partners if they voice their sexual desires to each other, or if they tell each other what they like during sex, if they say, “I want this, I like this pose”? Some will say, “If I say I want this or that, the other person will say, ‘Where did you learn that? Why do you want this? You probably did it before with someone else and you liked it, and now you want that again.” Meaning, I don’t think about the desires and feelings of the other person, I talk to find answers to questions that concern me. That is why our most basic need is being able to communicate. It’s not just about sex. It also applies to market relations, driver-passenger relations, and so on. I will listen to the end without shouting, without interrupting the other person, then I will make sure that I understand what I have heard, and then I will voice my opinion on the subject.
Do more of our people come to see a sexologist now compared to previous years?
Before coming to Azerbaijan, I studied in Turkey. I came here two years ago. When I first arrived, I was told that in Azerbaijan, in general, the attitude towards psychological help is ambiguous, and there are few people who use this service. The difference between two years ago and today is striking. I see that people who want to get psychological help are more courageous. I think they are getting more comfortable talking about sex. The number of people who consult specialists in sexuality is growing. It is true that they come to sex therapy with slightly different motives, which, as a sexologist, I don’t think is right. The goal of the vast majority of those who seek sex therapy in our country is to have children. Of course, the problem is that some people are ignorant, unaware that sexuality is a natural need and should be enjoyed.
It seems to me that when it comes to sex, couples should think about themselves first, it’s not right to have sex just to make a baby. Couples who have good sex by giving each other pleasure don’t experience it as just a penis-vagina union. Otherwise, as a result of physiological changes in one or both partners in later life, there may be a shift to another partner, which creates serious problems for the family. The most common problem of those who seek sex therapy are vaginismus, premature ejaculation, erection problems, and inability to reach orgasm. It has been my observation that the most increasingly common sexual dysfunction in recent years is lack of sexual desire.
Are most of your patients women or men? Which gender is more courageous when talking about these things?
It seems to me that women are more inclined and eager to receive psychological help, not only when it concerns sexual relations, but in general, they are more courageous in these issues. There may be several reasons. One of the main reasons is that it is natural for a woman to ask for help, it is female behavior. The man doesn’t want to get help at all, because that reveals his deficiency. Another reason is that in our society it’s women who most often strive to protect the family and the relationship. It is both the role imposed on women by society and their biological makeup. It’s their ability to give birth, to care for a child, and the ability to immediately sense and analyze anything that happens in their home is stronger in women too. I have seen that many times. If there is something wrong with the male partner, the female partner senses it very quickly. For example, she says, “There is something off about my partner, it looks like he’s cheating on me.” It is impossible for a man to cheat without his woman not feeling it. But this is not part of man’s biological makeup. Our women are more vocal when it comes to speaking their mind. It is more difficult for men to talk about these things, to say, “I have this problem.” A man does not want to feel his shortcomings. In general, men basically don’t want to look inadequate.
While we are on this subject… In our society, the image of a brutal man is emphasized and promoted. But when there is a problem in the family, in the relationship, the woman is always the one to get the blame, while the man not only keeps silent about the accusation but sometimes even supports it. How does this cowardice fit in with the image of a brutal man?
The formation of a man is a difficult process. It’s hard to be a man. A mother—a woman—gives birth to us. A newborn baby doesn’t know that the person in front of it is the mother, and after the person who looks into its eyes satisfies his basic needs, such as food, physical contact and play, the mother figure begins to take shape in the baby’s mind. We are born into this world so helpless that the loss of that woman-mother is the greatest trauma for us. As months go by, it seems to us that we are like that woman, we are part of her, because when she laughs, we laugh, when she is sad, we start to cry, mother is our source of life. Without her, we will die. It’s a little selfish, but we have to protect ourselves.
After two or three years, another figure appears in the baby’s life. Two or three years is the age when we become aware of our gender, and during this period, the father figure appears next to the mother figure. Until that age, we don’t have the image of a father, because our perception of our gender—the formation of the “I’m not like my mother” realization—begins after two or three years, when we say “I’m not part of her, I’m different.” Girls are more comfortable with this process, because they are the same gender as their mother, just like her. But a boy sees that he is different from his mother and tries to be like his father. Men seeing themselves as incomplete and deficient stems from here. This is true of many societies. When men feel inadequate, unsuccessful, or think they look like that from the outside, it becomes a serious trauma for them.
That’s why if a woman uses a language that puts a man down or makes him feel inadequate, be it ordinary or sexual relations, it is very difficult to bring that man round. He either stops communicating, or he doesn’t come home, stays out for hours, has problems with erection, or gets a divorce. His trauma manifests itself in one form or another. There is a deficiency in us and we try to steer clear of anything that will reveal it. For example, if a woman says something, we try to silence her, we want to stop her when she says something has gone wrong. Why? Because it offends us. It wounds a man’s masculinity and he feels lacking. Thus, a language that is judgmental and makes a man feel deficient and incompetent seriously undermines a relationship. I think it’s actually true of all societies. There are studies conducted in different societies, and they show that the experience is more or less similar everywhere. In these studies, therapists reveal many nuances about men, about men seeing themselves as deficient. We are not good enough in certain things, and it is difficult to accept. And, unfortunately, this can lead to objectionable behavior, such as physical, sexual or verbal violence.
Why is this more typical of our society, that is, Eastern society? For example, men don’t allow women to divorce them. Not only do they not let them go, they try to keep them by force, even kill them as a last resort. We read that in the news almost every day. This is more common in Eastern societies. Not to mention that a man has more opportunities to find a partner than a woman. In addition to his wife, he has relationships outside of marriage. And yet when a woman wants a divorce, a man responds harshly.
I think that we don’t know how to be “I”. I mean, we personally feel deficient and incomplete. It is necessary to separate it, perhaps, from the concept of Eastern/Western society, and to look at it from a more socio-psychological point of view. Our parenting styles can play a part here. Our socio-sexual approach can have an impact: the different meanings, values, privileges etc. we attach to/ascribe boys and girls. Maybe if we know this, we can analyze it better. But here is what I think. If a man supplements his personal qualities with something—a car, a job, brand-name clothes, a smartphone—then his formation is conditional. That is, it is subject to conditions: if I have this, I’m fine, if I have that, I’m complete. Looking at a problem in family life not only from the point of view of human relations, but also from the point of view of things and conditions, if we live with the thought “it is mine, it can’t not be mine”, it is still an attempt to suppress the pain of deficiency. In fact, we as human beings are complete individually. And we’re good when we are together, we don’t have to be the same. Being the same means that I will expect you to look like me, to think what I want you to think. This means appropriating the other person. However, if the other person remains their own self, we will be richer for it.
But why don’t we know how to be “I”?
I think this stems from our family upbringing. I have looked at a lot of literature to understand the philosophy of child-rearing in Azerbaijan. What kind of prism do we look through, what kind of philosophical point of view do we take when raising a child? We make up our tales according to it, we write our school textbooks according to it, I don’t know, the messages we put into our music come from it too. When we look at the way we raise our children, we see a lot of confusion. We have a comparison-based structure: those who study well and those who study poorly, those who earn a lot of money and those who earn little, those who have a car or not and those who don’t, those who are skilled and those who are incompetent. We give our children conditional love in the family and teach them conditional love: if you do this or that, I will love you very much, if you do something, you will get something. In fact, it’s not them we love but the “I” we have formed. This also affects the relationship with the opposite sex. If you do this or that, I will love you, you didn’t buy me flowers, so you are a bad person. If you don’t have sex with me, I will punish you.
Even when there is a problem in the family, sexual relations, the woman get blamed, and when she is active in bed, a woman is questioned: where did you learn that, how do you know this, and so on. Or, for example, men who do not accept homosexuals rape them as punishment. What a bundle of contradictions manhood is…
It seems to me that we think we have made up for the deficiency shaped by the separation from our mother, while we have not. We think we’re fine, while we’re not. What does it mean? For example, not being able to have a child or having a girl. Physiologically, both women and men contribute to this process. But why won’t a man question himself? Because if he does, he will be found deficient. That’s why he blames the woman. In sex, a man only wants to hear praise. When his partner voices her desire, the man says to himself, “Oh, so she thinks I’m not good enough, she is rubbing my nose in my shortcomings.” Why does he silence the woman? Because he does not want be hurt by her. A man will always want to see himself as enough, he may think he is enough, but he will feel inadequate inside. It never ends.
After the interview with Vasif Ismayil, I felt sorry for men, but now I feel ever worse.
It’s hard to be a man. But when do we feel complete? When do we have a healthy psychological makeup? “I am a whole person who has his strengths and weaknesses. Yes, I can’t do some things.” Then this man will sign up for therapy, then he will call for help when his tire blows out on the road, then he will calmly accept criticism from a female boss. When his wife says that the groceries he bought are spoiled, it will not remind him of his weaknesses, and he will say to himself that it happened because he was careless or distracted at that moment. Or he can say, yes, I can mess something up, but I can make it right. I may fail at something, but that doesn’t mean I’m lacking, it just means I can’t do this particular thing. If we are not whole, if we are not complete, something will always offend us. It works differently in women and men.
I mentioned Vasif, and you have probably read that interview. One of the things that surprised me and, I think, most people was that mothers bring their young children to him for penis enlargement. What are the psychological factors behind this tendency?
I think that in order to speak on such topics, one should get informed first, read various studies and refer to them. What class, what age group are the people who want this, what socio-economic and socio-cultural values do they hold? I may have a lot of experience, or I may find some things wrong or true, but my opinion must be based on science. So, I want to be careful when talking about whether this applies to all of Azerbaijan, or to Eastern society, or this region.
There are men who are unhappy with their penis or are concerned about the size of their penis. This is a sexual dysfunction. There are men who cannot lead sexual life because their penis is small. Why does this happen? Sexual organs are one of the most basic tools that help us show our performance in sexual intercourse and to satisfy our partner. We, on the other hand, receive false information about the functions and abilities of our sexual organs and try to comply with that information and “correct” the organ accordingly, for example, with various plants, syrups, herbal medicines, etc. There are many remedies, penis enlargement drugs and so on. A man thinks, “If my penis is big, it means I’m strong, enough and good”, and information about sexuality is mostly obtained from porn, so this also informs the attitude to the penis. He thinks that the bigger the penis, the better his sexual skills: I will give my partner more pleasure, and she will choose me.
Studies show that men always want to stand out. It’s common in adolescence, and it’s common in prisons. They masturbate and it’s a competition: who has more ejaculate, who ejaculates prematurely, whose genitals are bigger. It is a way for them to assert themselves—their strength, their excellence. But unfortunately, a large sexual organ not only does not give pleasure to the partner, but also creates a problem. The average penis size is 13-14 cm. The vagina length is 8-9-10 cm. If the penis is 20 cm long, it will only hurt the vagina. And another thing: not all of those 8-9 cm are sensitive to stimulation. The erogenous zone, the so-called G-spot, is the 3-4 cm near the entrance of the vagina. In other words, even if the penis is 5 cm long, a woman can enjoy it, and extending it to 25 cm will not improve the quality of sexual intercourse. Large penis size is only good for a man to feel good about himself, but it does nothing for sexuality. Why mothers? This is an interesting question. Looking at it analytically, does a mother, as a woman, need this? Since women don’t have a penis, mother is considered deficient to begin with. Maybe she is trying to compensate for it: I don’t have one, but my son should have the biggest one! These are psychoanalytical and subconscious issues. Or there is something missing in her sexual life. In situations like this, I always ask whether the child was conceived normally or by artificial insemination. How is her relationship with her partner? What does the penis mean to him? Maybe I’m veering off the topic, but one can’t take everything one sees in porn as a usable template.
Therefore, as a sexologist, it is important to me what characters and images in porn excite the patient. Both men and women. In whose place do they want to be? What do they enjoy the most in that video? Probably one of the main reasons mothers or fathers resort to such measures is their own feeling of deficiency which they try to make up for. But here is something anyone who has sex might find useful: both men and women have Kegel muscles, these are the muscles that contract and relax the genital area. We use them in different activities, such as bodily functions or sexual intercourse. Normally, the vagina has a contracting-relaxing and elongating structure. If the penis inside the vagina is “normal”—in quotation marks, because it is different for everyone—then it essentially contracts and relaxes the muscle and can make sex enjoyable for both partners. So, there is no need to say, “My vagina is big, so your penis has to be big to satisfy me.” Large size plays no useful part in sexual intercourse.
Too big penises shown in porn don’t look aesthetically pleasing at all. I wonder whose idea it was that porn should feature big penises.
I think that the porn industry has a negative effect on our sexuality. Why? First of all, in pornography, we see female models being handled like objects, humiliated, debased, subjected to oral sex to the point of suffocation, ejaculate on the face, used as a tool. Sex is normal, sexual intercourse is a normal experience, but what we see in porn videos is not normal. The same can be said about men. What do men do? They want more ejaculate, they want a bigger penis, they make it too long or impossible to control. And the reason is ignorance. There is also a strongly suggested approach there. It seems to me that we need for some kind of regulation of pornography. Not every porn video is good for you.
One of the most common female dysfunctions these days is vaginismus. Is it more of a psychological problem or a physiological one?
Vaginismus is perhaps one of the leading female sexual dysfunctions in our society. So is lack of sexual desire. We also see more cases of lack of sexual desire and premature ejaculation in men. What is vaginismus? It is the inability of a woman to have sex even though she wants her partner and wants to have sex. That is, she loves her partner, has sexual desire, wants to have sex, and wants to get pregnant, but during sexual intercourse, the muscles of her vagina contract involuntarily and prevent the penis from entering.
The main cause of vaginismus is fear and anxiety. It may be a fear related to a sexual disorder that may arise in the future. Physiological vaginismus is very rare, perhaps one in a million, one in a hundred thousand, and requires a surgery. But in 99 percent cases, this sexual dysfunction has psychological causes, such as the woman being misinformed about the vagina, the penis, sexual intercourse, incorrect upbringing.
Vaginismus is essentially a protective reflex. When do we tense up? When do we curl up like an embryo in the mother’s womb? When there is a danger from the outside. Vaginismus is a similar reaction, a woman’s reflex to protect herself from a certain situation. The protective reflex is actually natural and normal, just misdirected, caused sometimes by misinformation, and sometimes by an abnormal sexual intercourse. It can happen on the wedding night or during the first sexual intercourse. “A girl I know bled so much, and that other girl I knew was in so much pain” and the like. The reaction is natural, but caused by misinformation. Because our brain cannot distinguish between the real and the unreal, it reacts in the same way in both cases. For example, we get scared watching a horror movie. We have a remote control, we can turn it off any moment. It’s only a movie, but we’re scared. Why? Because to our brain, it doesn’t matter whether what happens on the screen is real or not. The brain says, something dangerous is happening there and I have to protect you. It is something like that with vaginismus as well. But vaginismus is a sexual dysfunction that has a 100% solution. It doesn’t matter if you are from the country, from a big city, a university graduate or illiterate.
Does childbirth help get rid of vaginismus?
Unfortunately, childbirth, medical intervention, anesthesia, and medication do not have long-term benefits, because you are trying to approach a natural process artificially, by force. That can lead to a second and even a third dysfunction. This is as much a natural activity as eating and drinking tea, so the problem must be resolved in a natural way. Using the genitals is as natural a process as using eyes and hands. Dysfunction occurs when something violates this naturalness. There is a solution! One of the main causes of vaginismus is childhood trauma. For example, if a woman was unable to protect herself as a child and was traumatized in this way, she may think that she will not be able to protect her child, she will not want to have a baby, and so she shuts down. In general, vaginismus is a dysfunction that requires an individual approach. Not every vaginismus is the same, and we prepare a treatment plan accordingly. Sexuality is not a mechanical process. It involves feelings and emotions. Most importantly, there is a social aspect to it. Everything—the room where we have sex, its design, the female relative outside urging the newlyweds on—can affect it.
You said that lack of sexual desire both in women and in men was becoming an increasingly common dysfunction. When you say lack of sexual desire, do you mean asexuality? And why is it becoming so common?
I think we are actually disrupting our natural way of living with things such as work life stress, with all the goals like “we have an apartment, we should have a country house too”, “we should buy a new car”. We put our natural life in a stressful situation because of desires that we perhaps don’t really need. When we are not content with what we have, we try to complete ourselves with something. I have to have more, I have to have better things! But is it really a need, or is it a way for me to assert myself? Is it really a need, or do I only perceive it that way? In this case, we essentially speed up our normal life, working, say, ten hours a day instead of seven. Inevitably, our activity in other areas changes as well. We can’t spend time with our children, we can’t spend time with our partner, we can’t take a walk. For example, one of the reasons for spreading lack of sexual desire is the loss of contact with nature, too much time in the office environment, negative ion energy we carry on ourselves, and insufficient sports activities.
At the same time, as I said earlier, we are running a race that stems from our commitments. That’s how we approach sexuality as well—we try to get it over with. A woman needs more time to get ready for sexual intercourse. She needs to be touched, she needs words, a nice smell, she needs to be comfortable. It works differently for men. In this fast-paced process, when we focus our energy not on spending time with each other, not on understanding each other, not on caring about each other’s feelings, but on other things, sexuality becomes a burden for us and loses its meaning. Because our priorities are changing. Our priority is not ourselves, but other things. When we are our own priority, the food we eat and the tea we drink are delicious to us, because we are experiencing the moment and all that moment contains. Otherwise, we just fill our stomachs and quench our thirst, without even realizing what we are eating or drinking. Sexual intercourse too becomes a burden for us, and we say to ourselves that we can do without it. Unfortunately, there are married couples who masturbate. Because masturbation is fast, there is no need to understand the partner, I already know myself. There is also a place and opportunity to do it quickly. I programmed my brain for years, I know when I will come. I know that the pleasure of ejaculation relaxes me and reduces my stress. Why do I have to deal with someone for half an hour when there is an easy way? Now partners choose to live fast, instead of making an effort to satisfy the other person, instead of actually living with the other person.
That was my last question. Thank you.
Interview by Aygun Aslanli
Aze.Media
