Calling in the experts can be critical for relationship and health
Talking to a doctor about their sex life ̶̶ or lack thereof ̶ can be intimidating for women, but it’s something a large number of women should step up and do, says Dr. Asela Russell, who not only treats patients for the problem at the Center for Women’s Health in Englewood, but has experienced it herself. Seeking professional help can improve their relationships and their health, and shouldn’t be ignored, she says.
A failing libido ranks No. 1 for female sex-related problems, Russell says, with surveys suggesting as many as one in three women struggle with the issue. When it comes to defining normal sexual desire? “There’s no one size fits all.” Many factors can lower a woman’s desire, such as hormones, medications, body image, relationship quality and more, says Russell, who learned in her 40s that her testosterone was so low it was undetectable but decided to ignore it. Ten years later, she was “a mess,” gaining weight and losing her “moxie,” as she put it in an article she wrote.
Seek medical help
Not ignoring the issue could have saved Russell a decade of problems, now corrected with subcutaneous testosterone pellets. Talking to a doctor is also crucial for identifying or ruling out medical problems, she says. “A loss in desire that gradually occurs is most likely related to hormones,” she says. “But a lack of desire that occurs abruptly could be a signal that something else is awry.”
Tests can determine hormone levels. Women with low testosterone have fewer sexual thoughts and more trouble having an orgasm, and women with low estrogen experience vaginal dryness. If hormones are imbalanced, not only is sex affected, but risk of cardiovascular and Alzheimer diseases can increase. A doctor might prescribe hormone therapy with creams or pellets and lubricants for dryness. Currently, there is no approved “little pink pill” equivalent to men’s Viagra®, Russell says.
For her and her patients, an exercise regimen is important to lose weight and increase muscle mass, Russell says. She also advises taking supplements, such as zinc, magnesium, and l-arginine, which some studies suggest can help boost desire, she says.
If hormones aren’t the problem, certain medical conditions should also be ruled out, such as depression and pituitary or adrenal problems. Likewise, many medications can sabotage desire, including those for cholesterol, blood pressure, antidepressants, antihistamines, heartburn, and even birth control. For some women, less stress, less alcohol and an extra-hour of sleep might be the answer, Russell says.
Come out of “sexual shell”
A woman concerned about her libido should do an honest self- and relationship-assessment, says Lisa Thomas, certified sex therapist and licensed marriage and family therapist with Online Couch in Denver. Is she comfortable with sex and her body? Can she orgasm by herself or with her partner? Is there conflict in the relationship?
“Sex is the physical connection with another human being,” Thomas says. “When you are not having it, you are disconnected from that part of your life, and it can cause disharmony.” If she is ready to come out of her “sexual shell” and put in the work, she can have better sex, she says.
“Sexual confidence has a high correlation with good sexual desire. If you know your body, and you know what you like, you’re going to be equipped for better sex,” she says. Men are generally hardwired for a higher sex drive, since they have more testosterone, Russell says. And, they are about 10 years ahead of women developmentally. They figure out what makes them feel good as boys. Women, however, don’t usually touch themselves and generally figure sex out later in life, Thomas says.
The “sexual response cycle” includes four components: 1) desire, 2) arousal, 3) orgasm and 4) refraction. Though both women and men experience these phases to varying degrees, Thomas says this particular sequence is more male-oriented, and women generally need arousal before desire. “When women are touched, turned on, or focus on wanting to be sexual, they build desire,” she says.
Another related and common problem is mismatched desires. One partner usually has a high desire and the other low. Practical tools for these couples are sexual scripts. Each person envisions and communicates how they want sex – being very specific as to foreplay, after-play, where it takes place, what times, and frequency.
“These scripts help them have candid conversations about sex,” Thomas says. From there, they can choose how they are going to act out both visions – whether they blend them into a new script, take turns, or do something in between.
People who have good sex over a lifespan have good sexual confidence, a good overall relationship, and flexible sex scripts. They define sex more broadly than just intercourse or orgasm, are comfortable with foreplay-only scripts, and don’t grade sex as pass or fail. They also have sex and/or are intimate at least once a week, so they don’t become desexualized or get out of habit, Thomas says.
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