Julia, Your New Sex Therapy Client, Is Distressed That Her

Julia, your new sex therapy client, is distressed that her husband doesn't find her attractive, because he achieves orgasm rather quickly when he masturbates, but hardly ever when he penetrates her. She says that usually during sex she spreads her legs, tells him to go on, and lies there waiting for him to finish, because she's exhausted after a long day. Shouldn't it be enough for him that she's offering her vagina when he's hard? What can you tell her?

A) Often an erection means that the man is somewhat aroused, but not enough to achieve orgasm. Spending some time and attention on increasing arousal before penetration may help.
B) Often an erection means that the man is aroused and ready to penetrate until orgasm. If he is not ejaculating, there must be a physiological cause; e.g., a new drug that he has been taking.
C) Often an erection means that the man is aroused and ready to penetrate until orgasm. If he is not ejaculating, there must be a psychological cause; e.g., he's thinking about work or another sexual partner.
D) Both B and C