CHINA - A 55-year-old woman with short curls, a pearl coat and dark blue skirt, walks briskly through the crowds in Renmin Square in Shanghai and passes the driveway to a hotel.
In a quiet suite decorated in warm colors, her psychosexual therapist is waiting. It is the woman's fourth session. She wants to have an orgasm, something she has never experienced in the past 30 years.
"I felt shameful in bed, like a 'bad woman' trying new positions or being proactive during the process," she said. "But I heard the word 'orgasm' hundreds of times, from my friends or saw it in books and I wanted to experience it."
Her therapist Ma Li is one of China's few psychosexual therapists with a license from the American College of Sexologists.
Ma said 10 years ago most of her clients were men. "People's attitudes to sex have changed in recent years, though," she said.
An increasing number of women are visiting Ma's clinic, ranging from women in their 20s who want to know how to deal with their "first time", to long-married wives who are unable to achieve orgasm.
A report on the happiness of Chinese sexual life, compiled by the Chinese Medical Association's Society of Andrology, the China Sexology Association and sponsored by US drugmaker Pfizer, was released in Beijing on the weekend.
Based on interviews early this year with 10,520 respondents (59 per cent male and 41 per cent female), the report shows a more proactive attitude toward sex among women. As many as 98 per cent of women have bought sex toys.
However, men felt a less-satisfying performance. About 90 per cent of male respondents were younger than 35, but only 55 per cent could get erection hardness score of four.
"A score of four is described as a fresh cucumber. A score of one is more like bean curd," said Jiang Hui, secretary of the China Sexology Association.
The report found that among the 10 major occupations in the survey, men working for medical institutes ranked top in terms of quality of sexual life.
However, men in the auto industry performed poorly, with 41 per cent only managing an erection score of one or two.
"Men used to absolve themselves from responsibility of poor sex and blame it on women. I think the survey gives a real take on the problem," said Tong Songzhen, a sex therapist from Taiwan, who runs a sexual therapy centre at a hospital in Wuhan, Hubei province.
More than 20 per cent of all female respondents said they never experienced orgasm, according to the report.
In terms of frequency of sex, male civil servants and women working in medical services ranked lowest.
"Apart from working pressure, many couples lack communication," Tong said. "Most see sex as a 'mechanical movement', rather than a skilled, joyful experience. Sex is an emotion-involved communication. To enjoy it, you should talk with your partner more."