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Sexual Desire: Why It Goes Missing, and How to Get it Back

Why It’s Normal to Lose Sexual Desire

Sexual desire, and how to keep it going in a relationship, can be a bit of a mystery.

But don’t feel bad. It’s a mystery to most sex experts as well. In this article, I’ll show you how sexual desire really works, and why it doesn’t always behave the way you want it to.

I’ll also introduce you to a new way of looking at desire problems—not in terms of what causes them, but in terms of what perpetuates them.

When we’re done, you’ll have a better sense of what to do—and what not to do—when desire goes missing.

I hope you come away from reading this article with some fresh ideas on the subject—and with some new ideas for how to keep sexual inspiration alive in your own relationship.

First though, some background:

 

Sexual Desire Isn’t Simple

For a long time, sex researchers never attempted to study sexual desire.

That may have been good judgment on their part, since it’s a confusing subject. In the 1950’s and ‘60’s, Masters and Johnson limited their field of study to what they called the “sex response cycle,” which was all about getting more blood flow to the genitals and preparing for orgasm.

Desire never really figured into it.

Later, in the 1970’s, Helen Kaplan understood there was something missing from the Masters and Johnson model. Her solution was to tack on something called “desire” at the beginning of Masters and Johnson’s “sex response cycle”.

The idea had a kind of intuitive appeal. After all, you obviously need something to get sex going. But there never was really much science behind it.

Now many years later, sexual desire is still a murky subject. Sex researchers these days even debate whether sexual desire and sexual arousal are really two separate things at all. .

 

The Accelerator and the Brake

Sexual desire has both positive and negative inputs. It has an accelerator and a brake.

Your sexual mind takes account of everything in the moment that might make you want to have sex, and everything that might make you not want to have sex. Then it turns desire on or off, depending on the outcome.

That’s true of both women’s and men’s desire. But ordinarily men’s brakes aren’t as sensitive. For many women, the fact that there are unwashed dishes in the sink can seriously interfere with desire.

For a man, that would be rare.

There are many other reasons a woman’s sexual desire might keep its foot on the sexual brakes. Stress and exhaustion would certainly top most modern women’s list. Then there’s hating your body; feeling angry, depressed, or worried; painful intercourse; too much pressure to have an orgasm; bad sex in general; or any combination of the above.

Trauma from your past can make a woman’s sexual desire plummet—sometimes years or decades later, when you least expect it. So can being abused or mistreated by your partner. Or knowing there’s no future in the relationship, but not being quite ready to leave.

 

A New Category of Things That Ruin Sexual Desire

In my book, Love Worth Making, I discuss a new category of things that can be relevant to sexual desire.

Things in this category don’t necessarily cause low sexual desire. Instead, they tend to perpetuate it.

These things tend to be just ordinary negative reactions to sexual disappointment. But negativity tends to be un-erotic, which obviously creates further impediments to desire.

In my book, I call these phenomena “sex-knots.”  A sex-knot is when your natural reaction to a sex problem ends up making that problem worse. Let me show you some examples:

 

Sex-Knot #1

     You have no desire for sex.
     You think, “There must be something wrong with me.”
     Now you definitely have no desire for sex.   

Now obviously you don’t even need a partner to get caught in the above sex-knot.  It’s one you can tie all by yourself. But the majority of sex-knots require two people.

As in the following example:

 

Sex-Knot #2

      You lose desire.
        Sex begins to feel like an obligation. 
That makes you really lose desire.

“Obligation sex” can be a real desire-killer.  It doesn’t take long for most low-desire people to figure that obligation sex isn’t the answer.  But then there’s still the problem of what to do with a partner who’s still interested.

Under the circumstances, many women start avoiding anything that might turn their partner on. No sexy underwear. No lingering kisses. Nothing that might put them in the uncomfortable position of having to say no. It’s easy to see where this might lead: .

 

Sex-Knot #3

    You have no desire.
    You worry that if your partner gets turned on, they’ll get frustrated and angry.
So you shut yourself down sexually.
    Now you totally have no desire.

You might even start staying up later and later at night, hoping your partner will be asleep by the time you get to bed.

Some couples’ bedtime rituals become an intricate dance around the question of whether they’re going to wind up in bed awake together or not.

Loss of sexual desire can start out quite innocently and understandably, and then turn into something bigger that involves your whole attitude towards lovemaking.

It’s crucially important to identify sex-knots. Unless you accurately identify and correct them, they’re likely to keep perpetuating states of low sexual desire.

The sex-knots above are all from Chapter 10 of my book, which is a chapter entirely devoted to women’s sexual desire issues. Chapter 11, which addresses men’s desire issues, features a whole different set of sex-knots.

Sex-knots are so important for sex therapy that I added a whole separate section at the end of Love Worth Making, with descriptions of the most common ones – and instructions for how to untie them. 

 

Taking Action

Loss of sexual desire can have major repercussions on your relationship with your partner. It doesn’t necessarily mean there’s anything wrong with your relationship.

Desire comes and goes in any relationship. Sometimes you feel it, and sometimes you don’t—as I explain in the following video:.

But loss of desire can be an indicator that you need to take stock of your sexual state of mind.

You’ll want to ask yourself, “Is the sex we’ve been having really worth desiring?  If not, what’s missing? Am I in some way “stepping on the brake”?  If so, why?

Knowing a bit about “sex-knots” (above), you might also want to ask yourself, “Is my reaction to my own lack of desire perpetuating the problem?”

It can be useful to ask such questions. But just knowing the answers won’t always fix the problem. As every sex therapist knows, you can’t resolve a sex problem just by thinking about it, or even by talking about it.

If you’re like most couples I work with, you also need an action plan. Fortunately, there are things a couple can do to have good sex—even in the absence of sexual desire. In my article, Sexless Marriage, and What To Do If It Happens to You, I’ll show you some simple methods for “tuning up” together as an erotic couple—even if one or both of you aren’t feeling much sexual desire at all.

Desire problems are among the most common reasons couples come to sex therapy. Happily, these days there’s a lot we can do to help.

My book, Love Worth Making, goes into much more detail about what we sex therapists actually do in the office. About how sex therapy really works. And about making sure the sex you’re having is really worth desiring in the first place.

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Sex Tips for Married Lovers

Why Most Sex Tips Don’t Work

Sex tips these days tend to be long on technique — but short on feelings.  Maybe that explains why so few couples in my sex therapy practice seem to come in with any idea what good sex is supposed to be all about.

We’re the most sexually over-exposed society in history. Pornography is everywhere. We know the names for sex acts our grandparents never knew existed.  But are couples today any more satisfied in bed?

I doubt it. One study from the Kinsey Institute found that nearly a quarter of adult American women in heterosexual relationships were markedly distressed about their sex lives.

 

Sex Technique vs Sexual Emotions

Emotions are far and away the most important part of sex. But few couples give much thought to their emotions when making love.

As a sex therapist—someone who gives sex tips and relationship advice for a living—I’ve searched for a long time for a book to recommend to my patients that would help them learn about erotic feelings.

Finally, after years of fruitless searching, I finally decided to write it myself.

Over the years, I shared drafts of many of the chapters with hundreds of individuals and couples who consulted me for sexual concerns.

As I developed the book over the years, I noticed patients starting to get better, faster. That’s when I knew I was on to something good.

I was pleased to be able to sell the book at auction to St Martin’s Press, and to work with some of the finest book professionals in the business.

And now it gives me great pleasure to share the book with you:

Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship. 

It’s in many ways a contrarian book, since it contains very little about sex technique, sexual science, or novelties like three-somes and kink.

Instead, the book focuses like a laser beam on sexual emotions: what you actually feel, or don’t, when you’re having sex.

The following video explains in more detail what I’m talking about:

Beyond Hardness and Wetness

Masters and Johnson spent years studying sexual response, but their observations were limited to physical reactions like heart rate, muscle tone, hardness, and wetness.

But you can be perfectly hard or wet and still have very boring sex.

Here’s what I tell patients in my office to look for, if you want to be sure you’re genuinely aroused:

 

1.   You lose a fair number of IQ points.        

If someone gave you an IQ test during peak arousal, you wouldn’t do too well on it. The tester might have a hard time getting you to pay attention to the questions.

Good sex definitely makes you dumber. And great sex can make you downright stupid.

When you’re aroused, sex grabs your attention. You stop thinking about bills, worries, responsibilities—your entire portfolio of ordinary concerns.

Your time sense may get a little messed up. (Sexually aroused people tend to arrive late to meetings).

 

2.   You become somewhat more childish.

Sexual excitement puts you in a more primitive and selfish state of mind.  It makes you less patient, less forgiving.

You don’t tolerate frustration very well. You become somewhat immature.  (OK, sometimes a lot immature!)

If the phone rings during lovemaking, you don’t care who’s calling, or what they want.

You may feel very close to your partner, but it’s a selfish kind of closeness. You’re not really interested in listening to the details of how their day went.

You just want them to give you their complete attention, and to tell you how wonderful you are.    

 

3.  You feel absolutely wonderful about yourself.      

Arousal feels special. Validating.

Good sex makes us feel good about ourselves. That’s how we know it’s good sex.

With good lovemaking, we have a feeling of “Yes, that’s me. Here I am. You found me.”  We feel in touch with our deepest, most authentic selves.

It’s a grateful feeling. ‘Yes, you found me. The me of me. Thank you for finding me. Thank you for bringing me home to where I really live.’

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The Urology / SexTherapy Connection

The Urology / SexTherapy Connection — on SIRIUS XM Doctor Radio

Urology specialists come in all flavors. Some specialize in the prostate, others in the bladder, others in the ureters and kidney. But in Manhattan there are several urologists who specialize in what’s called “sex and infertility.” As a sex therapist in Manhattan, I’ve been fortunate to work closely with several of the best  — and occasionally to be interviewed by them on the radio.

Sirius XM Doctor Radio broadcasts from the lobby of NYU Medical Center on the East Side of Manhattan. The studio is separated from the rest of the lobby only by a floor-to-ceiling glass window, so being a guest on Doctor Radio is a bit like being in a fishbowl.

I’ve been interviewed on this station several times over the last decade or so — either by my urology colleague Joseph Alukal MD, or by my psychiatry and sex therapy colleague Virginia Sadock MD.  Dr Alukal is Assistant Professor of Urology, and Director of Reproductive Health at NYU Urology Associates, and he and I have worked collaboratively with many patients whose problems didn’t fit neatly either into the urology or sex therapy silos.

My urology colleagues joke that they focus on “the little brain” rather than the big brain. But the connections between the little brain and the big brain are profound. As I’m always telling patients in my office, the brain and mind have roughly speaking two kinds of inputs to the genitals: positive and negative.
In men, positive signals, mediated by nitric oxide and the parasympathetic autonomic nervous system, stimulate erections. And negative signals, mediated by the so-called “rho-kinase” system, the sympathetic autonomic nervous system, and no doubt other kinds of inputs too that we haven’t discovered yet, act to make erections go away.

Why would there be a system whose sole purpose was to bring down erections?

Simple: In our natural ecological niche, on the plains of Africa 200,000 years ago, we weren’t at the top of the food chain. Lions were. And when there were lions around, any human who stayed busy having sex would likely be the first to be eaten. So presumably it was an evolutionary advantage to have a circuit between the brain and penis whose function was to make erections go away. Now in the 21st Century, we’re left with the consequences:  arousal that goes away when negative emotions arise.

Unfortunately it’s not easy to get Sirius XM Doctor Radio clips after a show, so the best I can advise is to keep a lookout for future episodes.

Between urology and sex therapy, there’s always plenty to talk about.

 

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Sex Talk and the Sexual Self

Sex Talk Is Easier Than You Think

I can talk about sex with anyone. Which makes sense, since I’m a sex therapist and that’s what I do in the office all day. But I have to remind myself how difficult it can be for some individuals to talk frankly about their sexual feelings.

Bustle’s Maria Yagoda (who in her own words “writes about the two most important topics in the world: food and sex”) convinced me to be interviewed for her March 2015 article, 7 Dos And Don’ts Of Communicating During Sex — Because We’re All Vulnerable In Bed.  I especially liked the second half of the title, which I think may have been inspired by our interview.

As I mentioned in an earlier blog article, On Talking During Sex, getting naked with a new partner can sometimes be a lot easier than speaking frankly to your long-time companion about what you’re really feeling in bed.  Many (if not most) couples take a “vow of silence” once lovemaking begins.

Sometimes keeping quiet during sex can be just the thing to make sure you don’t get distracted. But there are other times when speaking up about what you’re feeling and experiencing can help your partner avoid having to do a lot of guess-work.  Yet it’s remarkable how many couples refuse to do much talking while making love.

An Unexpected Intimacy

No, I’m not talking about dirty talk. Though that’s fine if it’s what you like. What I mean is just plain opening up to each other, as you would while doing anything else.

The first time I suggest to a new couple that they “go oral” in bed — that is, communicate verbally to each other during sex — they often look shocked. Most couples, having lived under the code of silence for so many years, assume that talking to each other while making love will be unromantic — or will spoil the mood.

But if I keep urging them to open up in bed, very often they end up telling me it’s a positive thing. Some couples grow to love it.  Many have told me they now realize much time they wasted doing things in bed that neither really enjoyed very much — because each thought the other wanted them.

There’s been much attention lately to the need for “affirmative consent” in college dating. If both partners have to say “yes” to a verbal request before anything can happen, there’s less misunderstanding later about whether or not both people really wanted to have sex. Just Google #yesmeansyes.

Affirmative Consent and The Antioch Rules

According to legend, the affirmative consent doctrine got started at Antioch University.  Students initially groaned that it would be the death of romance. But in fact the new rules reportedly made hookups more interesting . . . and more intimate.  Partners appreciated the courage it took to speak up and say, “May I unfasten your top now?”

For her article in Bustle, Yagoda wanted information about the best ways to verbalize your wants and needs while sex was actually happening.

I offered the following advice:

1.  Be prepared for it to feel a little weird at first. You’ve spent your whole erotic life obeying an unwritten “code of silence,” and in the beginning it may feel as if you’re learning a new language.

2.  Be kind to each other. The sexual mind needs a lot of praise and reassurance. So at first, limit yourself to positive and encouraging statements, such as “Oh, you feel so good. Can I tell you what would really turn me on right now?” All of us much more vulnerable and sensitive in bed, so avoid making overtly critical comments.

3.  Be prepared for it to feel more intimate than usual. Many couples worry that talking during sex will feel less romantic, but usually it’s the opposite!

.

Our exchange led to item #4 in the article: “Don’t Say ‘Ew!’ or ‘Gross!’.”  (In other words, be at least somewhat positive).  Here it was noted that everyone needs a lot of praise and reassurance during lovemaking, because we’re all especially sensitive to criticism in bed.  An obvious point perhaps, but once worth repeating.

I was also pleased that my distinguished sex colleague Megan Andelloux was quoted in item #2: “DON’T Ask, ‘Did You Come Yet?’”  As Andelloux emphasizes, putting pressure on your partner to have an orgasm is generally a bad idea, since it might make them anxious. As I wrote in an earlier article on PsychologyToday, “Two Roads to Orgasm,” it’s usually best not to make orgasms such a big deal in the first place. Orgasm should be like dessert at the end of a good meal.

It’s fine to ask your partner whether they’ve had enough to eat. But best to leave it at that.

 

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Twilight, and the Art of Foreplay

Foreplay.  Women traditionally complain they don’t get enough of it.

Often this gets interpreted as being due to a woman’s needing more physical stimulation to get fully aroused.  OK, maybe sometimes that’s the issue.   But I don’t see it as the essential thing.  The physical aspects of sex rarely are. The essential thing is this:  Foreplay represents the one time when a woman can get a man’s full and undivided attention.

That is, if it’s good foreplay.  In good foreplay, she is his entire focus.   She feels his desire for her, and his arousal.    She feels his heightened interest in the small details of her body, made more intense by  his anticipation of even greater pleasures ahead.

Having your partner’s complete attention – a very important part of sex.  One of the most important parts.

 

It’s in every romance novel since Jane Austen.   The heroine meets a man who attracts and puzzles her.   She spends the novel trying to figure him out, only to discover that he is crazy in love with her, and that he has spent every second since they first met thinking about her.    And that he can’t stop thinking about her.    Because she’s just that fascinating.

One reason this basic formula is so appealing is that in the average woman’s life it is so rare.    The average heterosexual woman has been sorely disappointed by the fact that she thinks about the men in her life much more than they think about her.   Usually she has more capacity for sustained attention than a man does.    Men tend to be oblivious.

Good foreplay, like a good romance novel, provides a welcome respite from this everyday state of frustration.    In good foreplay, he’s really paying attention.   Who wouldn’t want that to last a little longer?

 

Twilight follows the standard romance novel outline, but with a twist.  Bella, the teen heroine, comes to realize that her extravagantly handsome biology lab partner, Edward, in addition to being a vampire, is absolutely obsessed with her.   That he can’t stop thinking about her.  Being a vampire and unable to sleep, he has spent all night every night since they first met simply watching her sleep.  His eyes and his body are always focused on her.  She finds it uncomfortable, but also sexually intoxicating.

In one of my favorite scenes, he says he’d like to ask her about herself, and she consents.  She’s stunned by the detail of his interest in her.   He wants to know all about her favorite food, color, flower, memory; all the details of her childhood, including friends, teachers, triumphs and disappointments.  The questions go on for days.  She never knew she was so interesting.

The male reader of Twilight will find much to learn about good foreplay from this scene.

 

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NYC Sex Therapist Diary: Dining and Differentiation

What’s the secret to keeping love and sex alive?

There’s no one best answer, and every couple is different.  But many sex therapists, myself included, talk about something called “differentiation” as a key factor.  Differentation means being able to take care of yourself, as a separate person, while you’re in intimate dialog with your mate.

A popular book on the subject of differentiation is David Schnarch’s Passionate Marriage. Schnarch has probably done more than any modern sex therapist to promote the idea of differentiation as a core value in a romantic partnership.

Differentiation is hard. Especially if one hasn’t seen it demonstrated in one’s family of origin.  One of the benefits of a good enough marriage or any other deep partnership is that it provides a holding place in which differentiation can occur.  In which each partner can “become more truly oneself.”

Differentiation is not easy to describe, as an idea and as a feeling.  Many couples tell me, “It sounds nice, but I don’t get what it’s supposed to feel like.”

 

Here’s an analogy

Let’s say you really want to go out for sushi, and your husband really wants pizza. You could (1) go along with his wish, (2) insist he go along with yours, or (3) decide to go to separate restaurants.  All pretty conventional approaches.

None of them, though, are going to help you feel what it’s like to be more differentiated.

But let’s say that instead you decide to (4) stand on the street bickering about it, getting more and more hungry and upset, and wondering if this relationship is really going to work.

Now that’s a good start!  You’re suffering together.  You’re both being real clear about what you want, and advocating for your own needs.

Now let’s say you’re so exhausted that you say to each other, “let’s see if we can find a place that would work for us both.” You walk down the street looking at restaurants. You find an Indian place that looks promising, but you discover that one or both of you don’t really like Indian food.

The next night you go out again, thinking, “there’s got to be SOMETHING that we both like—and damn-it, we’re going to find it together!”

 

Now you’re really on your way . . .

And when at long last, after many weeks of searching, you find a kind of food you both like, and a restaurant that serves it, you are so happy and feel so accomplished, that it becomes “your restaurant.” You find recipes for all their dishes and start learning to make them at home.

Those recipes are YOURS as a couple. You worked hard for them.  They belong to no one but the two of you.  They are your story – of keeping faith with yourself, and with each other.

If you’d never met each other, you’d never have found them.  The relationship (this is important) took you someplace that neither of you ever intended to go.  The relationship expanded you, and changed you.  But it only did so BECAUSE you and your mate both insisted on what you really wanted.  The answer wasn’t clear at first – but you found it.

You’ve differentiated from your respective families as well.  No one in either of your families ever knew anything about that kind of cuisine. Your families think your new dining habits are a little strange.  But they don’t understand about this particular journey you’ve been on together.

Only the two of you understand.  You’ve become a more differentiated couple.  Now you’re more confident that you can each take care of your own wants and needs in the relationship, and make it work.  And you know that the next time you stand together on the street bickering about whatever the next thing is . . .

You’ll figure it out.

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Why Some Men Have Trouble Ejaculating During Intercourse

Trouble Ejaculating and The Orgasmic Double Standard

Men who have trouble ejaculating are a misunderstood bunch.

Women’s and men’s orgasm difficulties are really very similar. As I explained in my article, "Advice for Men Who Have Difficulty Ejaculating," an orgasm is really just a reflex. Male or female, people differ in what’s called their "orgasm thresholds" — how much stimulation they need to climax.

We’ve come a long way in understanding women’s orgasms. People now recognize that some women just need much more stimulation to climax. There’s nothing wrong with her. That’s just how she’s wired.

But our knowledge of men’s orgasm difficulties has lagged a bit. Lots of couples still put pressure on the male partner to orgasm, and they worry there’s something terribly wrong with him if he can’t.

In the previous article, I showed you four rules to follow if you want to make it easier for a man to climax.

Today, let’s go a little further . . .

Ask Him How He Masturbates

As a sex therapist, if you want to be able to help men who have trouble ejaculating, you need to get comfortable asking them how they masturbate.

Men who have trouble ejaculating tend to masturbate in particular ways. The details can vary. But in working with many hundreds of men with trouble ejaculating in sex therapy over the last 30 years, I’ve noticed some consistent patterns.

Here are the most common ones:

1:  “FAST”

Many men who have trouble ejaculating tend to move their hand very rapidly when they masturbate. Especially right before orgasm. To see examples of this, just watch some male porn stars in action.

Many male porn stars have trouble ejaculating. Look carefully, and you’ll see that many of them have to masturbate their own penises at the end in order to climax.  If you look at their hands, you’ll often see a very quick motion — something of a blur.

It’s the same for many women who can orgasm by themselves but not with a partner. They need a very rapid stroke — which is something they can easily do by themselves, but that’s not so easy for a partner to do.

Same thing for a man who has difficulty ejaculating. He often needs to go fast at the end — which is obviously much easier to do with your own hand, since you can feel confident of not hurting yourself in the process.

2:  “FORCEFUL”

The second element of masturbation technique for many men who have trouble ejaculating is that they tend to grip the penis forcefully — more forcefully than a vagina can grip a penis, and more than a partner might dare to grip it.

Men who don’t have any trouble ejaculating tend to masturbate with a much looser grip. They may use a lubricant as well, since the skin of the penis tends to like something moist.

But for most men who have trouble ejaculating, a loose hand won’t do the trick. You need a really tight grip to get to climax.

Most men who do this kind of forceful technique while masturbating will also tell you they get a better grip with a dry, unlubricated hand. That presents an obvious disadvantage when it comes to ejaculating inside your partner’s vagina.

3.  “FRENULUM”

During masturbation, most men tend to focus strongly on a part of the penis called the “frenulum” — which is on the underside, close to the tip. Men who have trouble ejaculating often concentrate especially strongly on this spot.

The underside of a man's penis is basically just “bubble-wrap” to protect the urethra. Nature supplies both men and women with this protective tissue. And for both genders, this bubble-wrap tends to be erotic.

A woman’s urethra — and the bubble-wrap that protects it — is located at the roof of her vagina. That’s the origin of the so-called “G-spot.”

The most sensitive part of a man’s bubble-wrap is usually right under the head of his penis — just a couple of floors down from the top of the Flatiron Building, above. For most men, that’s the magic spot. That’s where most men who have trouble ejaculating tend to focus all that fast, forceful attention during masturbation.

During intercourse, his frenulum is mostly buried deep inside his partner’s vagina where it doesn’t see much action.  So if he’s someone with trouble ejaculating who’s learned to need intense frenulum stimulation, it’s likely he may have trouble ejaculating during penetrative sex.

——–

Once you know these three basic elements — FAST, FORCEFUL, and FRENULUM — it’s easy to see why intercourse might be a problem for a man who has trouble ejaculating.

A woman’s vagina typically can’t move very fast. It can’t exert much force. And for the most part the most sensitive part of his penis, his frenulum, is buried deep inside her vagina where it doesn’t get much stimulation.

So what can be done about this?

Can Trouble Ejaculating Be Overcome By Changing Masturbation Technique?

You might think all a man who has trouble ejaculating would need in order to fix the problem would be to change his masturbation technique. to stroke his penis more slowly, and with less force, and with more attention to the entire shaft rather than just the frenulum.

That’s often worth trying. And sometimes it does help.

But it’s not always so simple. Here’s why:

Many men who end up using some variation of the FAST – FORCEFUL – FRENULUM technique use it to compensate for the fact that they have a high orgasm threshold.  They develop this kind of masturbation technique because they need it — to compensate for their high orgasm threshold.

So in addition to adjusting their masturbation technique, many men find they also need to learn the methods for good partner sex that we discussed in the previous article.

On Being Accepted For Who You Are

But here’s the thing: A man’s high orgasm threshold isn’t usually something he control, or change.

Just like a woman who needs a lot of stimulation to climax. The only way you’re going to enjoy really great sex with her is to accept her as she is. Same with a man.

As I discuss in my book, Love Worth Making, acceptance is “Vitamin A” for good sex. Without enough Vitamin A, you won’t get very far.

In future articles, we’ll discuss even more techniques for managing this condition. But remember, no techniques have much chance of working unless you accept each other in bed for who you are.

That should always come first.

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Sexless Marriage: What To Do If It Happens to You

Sexless Marriage . . .and “Nearly-Sexless” Marriage

There’s sexless marriage. And then there’s “nearly sexless marriage” — where a couple might only have sex a few times a year. Or as one patient of mine, an insurance executive, described it — “on a quarterly basis.”

If sex on a quarterly basis feels like enough for you, that’s fine. But in my experience, most couples with sexless or nearly sexless marriages consider it a problem and wish things were otherwise.

Sexless marriage is one of the commonest reasons couples come in for sex therapy. It’s been said that sex is 20% of a marriage when it’s going well, but 90% when it’s not.

Feelings of inadequacy are common. So are feelings of shame — especially if you assume all the other couples you know are having awesome sex lives.

But the truth is that sexless or nearly-sexless marriage is very common. Conservative estimates put the prevalence at 15% of American couples. So chances are, at least some of your friends and neighbors are in the same boat.

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What Causes Sexless Marriage?

There are as many different stories as there are couples.
But here are a few kinds of stories we sex therapists hear frequently: 

1.  Bad Sex

If for whatever reason one or both of you aren’t enjoying the sex you’re having, then it’s not surprising you wouldn’t want to do it. As I discussed in my article, The One Sex Tip You Need For a Long-Lasting Relationship, some couples lack basic knowledge of how sexual feelings work.

Any of the so-called “sexual dysfunctions” (vaginismus, pain on penetration, erectile dysfunction, premature ejaculation, etc) can make you feel bad about yourselves as a couple. And feeling bad about yourselves is not exactly an aphrodisiac for most people.

2.  Bad Feelings

Sometimes the reason has nothing to do with sex. If you’re like most people, how you feel about yourself as a person has a direct connection to how much you’re able to enjoy yourself in bed. To quote one of my favorite sex writers, Julia Heiman, “Often sex is a nonverbal expression for what is avoided or inaccessible verbally, such as marital unhappiness, a power struggle, emotional emptiness, or existential anxieties or losses.”

You’d be surprised how many couples expect themselves to have sex despite the fact that they hate each other. And many other couples suffer from unresolved grief or trauma, or the other life difficulties that sap their sexual connection. To add another twist, sexless marriage itself can be a potent source of emotional unhappiness.

3.  Loss of Desire

Sometimes one or both partners may lose their libido entirely, even when the sex has been reasonably good. This appears to be more common in women. The causes of loss of desire are endless. Biological, psychological, and social factors commonly come into play.

Loss of desire can be global — where nothing makes you feel sexually interested anymore. But sometimes it’s just loss of desire for your mate. Some wives in sexless marriages continue to masturbate, and some don’t. But almost all husbands in sexless marriages are masturbating in private.

Enter the Westermarck Effect

Regardless of whether your sexless marriage is the result of bad sex, emotional unhappiness,  or loss of desire, there’s something specific that eventually happens in almost every case of sexless or near-sexless marriage that makes the condition much more likely to remain permanent. Psychologists call it “The Westermarck Effect” — for Finnish sociologist Edvard Westermarck, who noted that people raised together as siblings don’t ordinarily regard each other as potential sex partners.

Following Westermarck, most researchers today assume there’s a basic biological mechanism at work here. If you live with someone for a long period of time and don’t have sex together, you begin to feel like siblings to each other.

That’s exactly what happens to people in sexless marriages. They eventually begin to feel like siblings. The incest taboo accidentally kicks in, and once this happens sex can start to feel pretty awkward.

For this reason, as a sex therapist I advise couples in sexless marriages to take action as soon as possible, and not wait months or years to do something about it. And when a couple in a sexless marriage starts taking steps to reverse the process, I tell them to expect that the first few times are going to feel awkward.  That’s normal — The Westermarck Effect in action.

So What’s A Sexless Couple To Do?

For most couples, The Westermarck Effect dictates that you can’t just jump in bed together and expect good sex right off the bat. In addition to knowing beforehand that things might feel awkward at first, I usually recommend couples start by first spending some time getting in tune again.

We sex therapists have a long tradition of recommending “warm-ups” for couples — from Masters and Johnsons’s “sensate focus” to this decade’s “mindfulness.”  My new book Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationshipshows you both of these techniques.

What I usually recommend for sexless marriage couples in my office is something a little different — a technique I developed myself, that I discuss in Chapters 6 and 15 of Love Worth Making.  I call it “The 2-Step.”  Here’s how it works:

Step One

Step One is basically a mindfulness practice. Spend some time in bed doing nothing together. Most couples prefer to be naked, but do whatever makes you feel most comfortable.

If you like, you can talk about whatever is on your mind—good, bad, or indifferent. Anything at all. It doesn’t have to be erotic. But keep it simple. No big discussions.

When you feel you’ve talked as much as you need or want to, see if you can give yourselves permission to just be together quietly, doing nothing.

This might not feel erotic at all at first. That’s fine. Sometimes you may just need time to quiet down a little. But in time that quiet can be the soil from which arousal grows.

The key to Step One is that your only goal at first is to do nothing at all. So often we get so wrapped up in our emotions that we lose sight of the simple elements of experience — our breathing, the sensation of our bodies against the mattress, the temperature in the room.

Step Two

At some point during Step One, you may notice feelings of arousal. Not just hardness or wetness. I mean authentic psychological arousal—that hypnotic, dumb-and-happy feeling that makes you resent if the phone rings.

If that happens, just enjoy it for its own sake. Arousal isn’t all-or-none. Sometimes it can be rather subtle – a private, inward thing.

Take your time. Just focus on your moment-to-moment experience of arousal.
If you’re like most people in sexless couples, this will feel awkard at first.
Just notice the awkward feeling, without getting too involved with it.
Sometimes awkward feelings like this will pass, if you don’t get too emotionally involved.

The key to Step Two is to experience arousal for its own sake, without feeling like you have to do anything about it. Too many couples assume that every time they get aroused, they have to extinguish it with an orgasm — as if arousal was something irritating or unpleasant.

Instead, think of arousal as something warm and nourishing. If you’re like most people in sexless marriages, you’ll want to let that warm feeling sustain a bit, before acting on it fully.

If you both want to have sex, then sure — go ahead.

But here’s the thing:

What ultimately heals a relationship is usually not the sex. More often, it’s the time you spend in bed just being in the moment together, doing nothing at all.

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How Do I Find A Sex Therapist?

What Makes A Sex Therapist Different?

Finding a good sex therapist isn’t easy. If you’re suffering from a sexual problem, it’s crucially important that you see someone who understands the difference between a sex therapist and a “regular therapist.”

Often a “regular therapist” will advertise themselves as a sex therapist, when they’re really not — which can lead to a lot of wasted time and money.

If you have a sex problem, don’t assume just any therapist will be able to help you. As a sex therapist, I see many individuals and couples who’ve spent years in conventional psychotherapy and not gotten any help at all with sex.

Here’s how to tell the difference:

1. A Sex Therapist Wants to Know All the Details

It’s not enough to just hear someone describe their sexual problem. If you’re a woman who has pain during intercourse, it’s crucially important to know whether the pain is on initial penetration, or on deep thrusting. And whether it’s all the time, or only some of the time. If you’re a man with difficulty ejaculating, a sex therapist will want to know the details of how you masturbate.

A sex therapist wants to know everything that goes on in bed – and in your head. Who does what to whom? And how does that feel? Then what happens next, and why?

As a great architect once said, “God is in the details.” The tiniest details can sometimes contain the solutions to a couple’s sexual problem.

2. A Sex Therapist Is Interested in NOW

Your sexuality is clearly influenced by your experience in life – not just your sexual experience, but also your experience of being loved, appreciated, and listened to, going all the way back to childhood.  Those experiences carry a lot of weight.

Unfortunately, most therapists, on hearing that you were abandoned as a child, will want to spend weeks talking with you about it. Sometimes that can be helpful, but often it’s not. And it can be particularly un-helpful if in the meantime you’re struggling with a sexual problem that’s not getting any better as the weeks go by.

A sex therapist appreciates full well the importance of the fact that you were, say, emotionally abandoned as a child. But a sex therapist also knows that if you don’t get help for your sex problem, you’ll soon feel emotionally abandoned in therapy as well.

The solution, as every sex therapist knows, is to deal first with the immediate causes of the sexual problem – then deal with other more “remote” causes later on.

Your sexual mind is very simple. It just wants to feel good. You can’t resolve a sexual problem if you keep having discouraging experiences in bed. The only way to heal a sexual problem is by having good experiences in bed. For most people, that has to come first.

Much of regular therapy, typically, is about pain. The therapy itself is often very hard work. But a couple can stay in pain for years in therapy, and still not resolve their sex problem.

As every sex therapist knows, sex therapy is not about pain. It’s about feeling good. Unless the therapy helps you feel good, nothing productive is going to happen.

Which brings me to the final way a sex therapist differs from a regular therapist . . .

3. A Sex Therapist Wants You to Take Action

Talking with someone in therapy, or with your partner in therapy, can be very important. But talking will only get you so far. If you’re not taking action in the bedroom, then chances are nothing much is going to happen.

After a first consultation session, a sex therapist will typically recommend that an individual or couple do something specific at home – both to get experience doing it a better way, and to gather more data.

After seeing a sex therapist for the first time, you’ll want to come away with a specific action plan – of things you can do right away, to get you on the road to feeling good again.

Sex problems — like loss of desire or sexless marriage — tend to make people feel terrible about themselves. As a sex therapist, I feel it’s crucially important that someone feel better when they leave my office, than when they walked in.

If you’re struggling with a sex problem, there’s never been a better time to get help. Just make sure you see someone who has lots of experience helping people with sex problems.

Make sure you see someone who can give you a sense of hope – and an actionable plan for turning that hope into reality.

OK . . So How Do I Find Someone Like That?

Simple: Both the Society for Sex Therapy and Research (SSTAR) and the American Assocation of Sex Educators, Counselors, and Therapists (AASECT) have search directories where you can search for someone in your area. They hyper-links above will take you there directly.

One you have some names, call each one up and talk with them about the 3 issues I mentioned above. Some therapists will have this information on their websites already, as I do on my Frequently Asked Questions page.  And with some, you’ll need to specifically ask.

Don’t be afraid to ask a potential therapist whether they have particular experience with the specific sex problem you have — including how many patients they’ve seen with this issue.

And if you want to be a really informed consumer, check out my book, Love Worth Making. It’s not a substitute for seeing a sex therapist, but it will give you a fair idea of what goes on behind the office door.

Copyright 2018 Stephen Snyder MD

Love Worth Making launched February 13, 2018, from St Martin’s Press, and was immediately  hailed by New York Times bestelling author Dr Christiane Northrup as “Hands down, the most practical, fun, and empowering book I’ve ever read on how to have a fabulous sex life in a committed relationship.” 

The post How Do I Find A Sex Therapist? appeared first on Stephen Snyder MD.

Women’s Sexual Desire, and Why Men Often Don’t Recognize It

Women’s Sexual Desire Is Different

We’ve learned a lot about women’s sexual desire in the last few decades.

Back when sexologists were mostly male, sexual desire—or “libido” —used to be thought of as like some kind of hydraulic pressure in the body. Like the pressure most young men feel when they need to ejaculate.

But the hydraulic model doesn’t fit the facts of most women’s sexual desire. Most women need a reason to have sex. Otherwise, they might go for a long time without feeling desire.

Men need a reason to have sex, too.  But for most men, the reason can be as simple as your partner taking off their shirt.

Most men’s minds tend readily to say “yes” to sex. Whereas most women’s minds tend to say “maybe,” or “that depends.”

As a sex therapist, when a straight couple comes to see me because they aren’t having sex, the male partner is almost always still regularly masturbating. Often the women has stopped masturbating, or does it only rarely.

In the absence of satisfying sex, it’s as if the woman’s sexual desire has just gone to sleep. Like the screen-saver program on an old-fashioned desktop computer, a woman’s sexual desire system will often stay in “sleep mode” until someone moves the mouse.    

As I discuss in the video below, the most important way to move the mouse is simply to have good sex:

Women’s Sexual Desire and the Definition of Good Sex.

Of course that leaves open the question of just what constitutes good sex, right?  People have widely different opinions, of course.

But having discussed the subject with many hundreds of people over the years, I think most people’s notions of good sex would involve getting authentically aroused– not just hard or wet.

As I discuss in my article, Sex Tips for Married Lovers, authentic arousal requires more than hardness or wetness. By my definition, you’re not really aroused unless you’ve lost a lot of IQ points.

Real authentic arousal should also make you feel good about yourself.  And good about your partner too—in a primal way that just says “YES, that’s the stuff I like!” Otherwise your mind can easily go into screen-saver mode, and sexual desire can turn off completely.

But many couples don’t know how to recognize authentic sexual arousal. They think if they’re hard or wet, they’re ready to have sex. That leads to a lot of bad sex, since hardness and wetness just aren’t sufficient to move the mouse.

You can’t nourish desire with bad sex. Only good sex can nourish desire in a committed relationship. 

Obvious, huh? You’d be surprised.  Many couples I see in my office have never bothered to reflect on those simple facts.

How Women’s Sexual Desire Confuses Men

As a sex therapist, I’ve noticed that heterosexual women’s sexual desire sometimes confuses men. They miss it completely.

Here’s why: Many women don’t just want sex. They want to feel desired first.  

If a woman doesn’t feel desired, then the sex itself may not seem so appealing.

Wait, you say. Doesn’t everyone know how important it is for most women to feel desired?

You’d be surprised. I see many men in my office who have no clue how important this is for women’s sexual desire.

Now here’s something that I find baffles most men: In order to feel desired, a woman may sometimes actually move away from her partner — in the hopes he’ll come running after her.

That’s so foreign to the average male mind that few men understand it at all.

When talking with men in my office, I’ll often cross species lines and illustrate with the following example:

What Men Can Learn from the Sexual Behavior of Female Rats

I once attended a sex therapy convention where researcher Jim Pfaus showed videos of rats having sex. The most interesting part turned out to be the foreplay.

By human standards, male rats are all premature ejaculators — so rat sex is typically very short-lived. But rat foreplay can go on for a long time.

Here’s typical rat foreplay:

The female rat runs in front of the male rat, gets his attention, then darts away. With any luck, he’ll be interested enough to chase after her. He might chase her around the cage for a long time, before she finally lets him have her.

The female rats tend to like to prolong all this running around. And more than one sex researcher has wondered whether the female rats enjoy this strange kind of foreplay more than the actual sex.

Many people have noted that the whole thing looks suspiciously like what sometimes during heterosexual human mating: how women’s sexual desire often seems to be as much for the pleasure of being chased as for what happens afterward.

“Juego” and Women’s Sexual Desire

Now, of course, there are exceptions. Just as there are exceptions to every generalization you might make about sex and gender. There’s a tremendous amount of diversity in human mating. In an article in PsychologyToday, I discussed the fact that some men have an unusually strong yearning to be desired too.

But the fact that many women’s sexual desire can manifest by a wish to run away ordinarily causes a lot of mischief in heterosexual couples. So it’s a crucial thing for a man to understand.

My colleague Esther Perel describes one of her Spanish-speaking clients playing a game she calls “Juego.”  To play this game, the first thing is to make yourself a bit unattainable. If your partner responds by pursuing you, then you’ve won the game.

For many men, the hardest thing about playing “Juego” is to realize there’s a game going on in the first place.

A lot of men will just greet their partner’s unavailability with a shrug of the shoulders and go do something else — which of course defeats the whole purpose. Then they’re surprised that she’s angry or frustrated.

Take home message:  If you’re in a committed relationship, notice when she might be pulling away from you. If that happens, keep in mind the possibility this is a manifestation of her desire — and that like the female rat, she may be hoping to begin a chase.

Just keep that in mind. You can thank me later..

You’ll find more actionable advice on how to make sense of men’s and women’s sexual desire in my book, Love Worth Making.  

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