When the Answer is "Not Tonight"

by Marlene M. Maheu, Ph.D.

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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....

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Sexual desire is made up of both psychological and biological (physical) components.

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 health.

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 and desire.

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 prefer.

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!

1/19/98

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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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