When the Answer is "Not Tonight"
by Marlene M. Maheu, Ph.D.
As relationships get older, and as we get older, sexual desire
sometimes decreases. This condition is even more problematic in a
relationship where one partner has a "high" sexual drive and the other
one has a "low" drive. Classically illustrative is the scene in the
movie Annie Hall. Woody Allen's character is in his psychiatrist's
office at the same time his girlfriend is at her psychiatrist's office.
Both are asked about their sexual frequency. "Hardly ever," says a
disappointed Allen, "maybe three times a week." "Constantly" says
Diane Keaton, "I'd say three times a week." Many people are not sure
what to do. Here are a few things to consider if you are finding
yourself preferring to mow the lawn or clean the kitchen....
Sexual desire is made up of both psychological and biological
- Since a psychological intervention won't
help if there is a biological problem, the first place to start is
physically. Although it might not seem like it when we're younger, sex
is a very fragile biological system easily affected by our state of
Possibilities to explore include current medications.
- The most commonly taken prescription medications that can affect sexual
desire are the antidepressants, anxiolytics (anti-anxiety medication),
and the antihypertensives. Different medications affect people
differently and not all people are affected. If you are unsure of a
medication's potential for reducing sexual desire, call a pharmacist
and ask him or her, or call your physician. Better yet, call them both
and ask exactly the same question. Compare answers. Sometimes a
different medication to treat the same problem will have less of a
negative effect on sexual desire. Also be aware that for some people,
alcohol consumption and tobacco use can influence sexual responsiveness
Learn about age and/or gender differences.
- Many people can
have a relatively problem-free sexual response through to very old age.
However, there may be brief periods in your life when bodily changes
decrease sexual appetite. Many women have symptoms of "peri-menopause"
for years before becoming menopausal. One symptom is reduced sexual
desire. Women are now experiencing signs of peri-menopause as early as
35 years old. Men can go through hormonal changes also. Having
testosterone levels checked is a simple blood test that can be
performed by your family doctor. Both men and women may benefit from
hormonal replacement if their hormonal levels are insufficient.
Think about overall health.
- People suffering from chronic
conditions (backache, migraines, lupus, arthritis, etc.) often find it
difficult to work up a sexual appetite to sustain them through vigorous
sexual activity. Sensitivity and good communication about what is, and
isn't possible can go a long way to working out satisfying sexual
contact for both people, even if it isn't as "wild" as one would
Consider psychological conditions.
- Emotions and mood can
have a negative effect on sexual desire. Depression, anxiety, anger,
fear, frustration, stress, and relationship problems can all have an
inhibiting effect. It is difficult to get "in the mood" and feel close
if you have just had an ear splitting argument with your partner, or
another in a long series of highly stressful days. Eating disorders
that lead people to overeat can also make sex difficult. Having sex
with an overfull stomach can be extremely uncomfortable. The
psychological aspect is when people know that sex is in the plan for an
evening, and repeatedly find themselves overeating to the point of not
being able to sustain a complete sexual encounter.
What can you do?
Talk with your partner.
- Try to sit and calmly discuss the
situation with your partner when you are not having a fight. Bringing
up sexual inadequacies in the heat of battle is not going to help the
situation the next time you feel romantic. Pick a time when you won't
be disrupted, and both of you are willing to talk rationally. Make an
appointment if you have to. Make sure you keep it. Plan something fun
afterwards so the topic doesn't get too heavy. Raise the possibilities
described above and decide if you can do anything to help the
situation. Avoid nagging, jabbing, humiliating, or using guilt to get
your partner to accommodate you.
Ask for help.
- If you try and can't find adequate solutions,
be strong enough to seek the help of a psychologist or marriage
counselor trained in sex therapy. Insisting that it "isn't problem" or
"you don't need help" can cost you years of sexual pleasure. Is your
pride worth the cost?
Ask about a psychotherapist's training.
- If you decide to ask
for help, don't assume all therapists are trained to help you with
sexual problems. Interview your potential therapist on the phone,
before you make an appointment. Ask how many couples they have treated
for your type of difficulty. If you aren't getting the sense they're
experienced enough for you to trust, ask around for the name of a few
specialists, or trained sex therapists. Call your local psychological
professional group and ask for specialists.
If you give yourself and your partner the serious consideration
you need, there are a wide variety of options to help you discover ways
to physically improve your sex life.
- Let yourself be embarrassed if
need be, but continue to make attempts to improve the situation. Most
people feel somewhat embarrassed talking about their sex lives, but
find it gets a lot easier once they get started. Good therapists and
physicians are trained to help you find ways to say what you need to
say. You'll probably get over your embarrassment quickly, and certainly
be glad you did!
Author Marlene M. Maheu,
Ph.D. is also a Licensed Psychologist who maintains a private
practice in San Diego. She works with individuals and couples
experiencing a range of sexual difficulties.
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