Guest Expert:  Dr. Anna Cabeca

Years ago over lunch, a close young female friend of mine who had been married only a short while asked me if having sexual intimacy twice a week was “normal,” or in other words, comparable to the number of times weekly my husband and I made love.  I gathered that she was trying to gain some idea of what frequency of sexual relations other couples had, so that she would have a benchmark by which to measure the health of her own sex life with her husband.  Although I did divulge to her the average frequency of my own sexual activity with my husband (since she was a close and trusted friend), I also explained to her that the best measure of the health of any woman’s sex life is not the comparative frequency she and her partner have sex in relation to other couples, but rather the balance between her sexual desire and that of her partner.  There are two and only two significant participants (at least, one would hope!) in a couple’s life both in and out of the bedroom, and what contributes most to the “normalcy” of their sex life is the amount of satisfaction and fulfillment they are both experiencing with their love-making and sexual union in general.  It takes two satisfied partners to constitute a good sex life, which is built upon the levels of desire and satisfaction which each individual possesses.  I also explained to her what my mother once told me, that men’s brains are wired to be more preoccupied with intercourse than the female brain, and that they need it more on a purely physical level than we as women do.  Thus, the balance of desire may sometimes appear to be skewed, and a woman may begin to feel that she is abnormal simply because her mind is not on sex as much as is her partner’s (and an insensitive husband may sometimes blurt out this opinion in the heat of the moment).  I explained to her that while this discrepancy is really normal rather than abnormal, that we as women needed to work at bridging that gap and finding ways to enter a man’s mental and sexual world while at the same time inviting him to visit ours.  Thus what really matters is coming closer to understanding and accommodating one another’s sexual needs, and finding common ground in order to gain a balance in satisfaction.  It just will not do to have one partner jacked up all the time, feeling short-changed and resentful, with the other partner feeling put-upon and pressured to perform.  That would be like when as a child I sat on a see-saw on the playground, with a much heavier child on the other end.  Try as I might, we couldn’t get the see-saw to balance or to go back and forth, and I usually ended up having to jump off and hit the ground hard!  But as long as a sort of loving compromise can be reached which allows both partners to have their felt needs met, a state of balance has been achieved which is irrelevant to the number of times a week they actually have sex.  In short, I told her that sexual balance superceded sexual frequency in importance!  But I’m also here to tell you that there are lifestyle changes which, when adopted by both partners, can help both you to desire and enjoy sex more frequently and more passionately.

If you are experiencing an almost total loss of sexual desire or have pain during sex, this constitutes a sexual dysfunction.  In order to qualify as a real sexual dysfunction, one or both partners would be dissatisfied with the state of their sex life, and there would be an imbalance in sexual desire and interest, with one partner’s desire far outweighing that of the other, creating intense unhappiness for one or both partners.  Know this, if you have a sexual dysfunction which prevents mutual satisfaction and fulfillment in your relationship, there are definite causes for the dysfunction which, when properly addressed, can restore the sensuality and sizzle to your relationship.  First of all, your psychological history contributes to your sexual functionality.  No matter how we learned about sex, in the process of learning we picked up more than bare facts – we also picked up emotional, moral, and cultural associations to sex.  If your psychological history includes anything with a negative connotation associated with sex, chances are you have retained some of those negative sexual connotations to this day.  The key to changing this is honesty, first with yourself and your partner, and then possibly talking about it with a therapist or close friend.  If you have positive psychic vibes regarding sex but your physical desire is low, the first positive step towards changing this is to transform your diet and lifestyle to follow healthy guidelines.  Improving dietary intake and exercising will improve self-image and help to balance our hormones naturally, which will often improve the libido as well.

If you are eating a healthy diet and exercising regularly and still experiencing low libido, a visit to your gynecologist which includes an honest assessment and a thorough lab work-up is in order.  There are many bio-identical hormone treatments today with a variety of routes of administration available.  Make sure, however, that the gynecologist with whom you consult is knowledgeable and qualified in the area of hormone therapy.  Not just any OB/GYN who claims to specialize in HRT will necessarily be of help for your specific problem, but with some determined research and seeking, you can find the right practitioner to help with your problem.

When a couple’s sexual balance is out of whack, a frequent by-product is resentment, no matter how much they love each other.  One all-important deterrent to the forming of resentment is honest communication.  Men, you need to know that a lower-than-desired libido in your woman is not to be viewed as a defect, but rather the result of very real physical and psychological causes which, although beyond her control in the past, can be remedied in the future.  Ladies, be certain of this, your man is just being a man when he communicates his urgent need for sex, and that with some work on altering psychological attitudes and presuppositions as well as finding medical and non-medical ways to improve your general and sexual health, the two of you can ride that sexual see-saw together (hmm, I just had a vivid mental image of a very kinky sexual encounter involving a see-saw!).  No seriously, by paying heed to these real time-tested truths regarding the complicated but beautiful gift of sex, the “see-saw” may go up and down, but a healthy balance will be achieved!