Does it seem like everyone’s enjoying sex except you? Well, you aren’t alone: 43% of women experience some type of sexual disorder, according to the 1992 U.S. National Health and Social Life Survey, considered by experts to be one of the most comprehensive reviews of sexual behavior in the U.S.
Whether your sex life has been derailed because of menopause, inhibition, anger or a physical problem, here are some ways to get the zing back:
1. Lack of Desire
He’s revved and raring to go, but you can’t even get in gear for a night of romping.
Not being in the mood is a common complaint among women and their partners, says sex researcher Beverly Whipple, Ph.D., R.N., professor emerita at Rutgers University.
“Men think their partner isn’t attracted to them anymore,” she says, but other reasons may be to blame.
Why it happens: Stress, exhaustion and spreading yourself too thin can wreck your sex life, says Stephanie Buehler, psychologist and director of the Buehler Institute for sex therapy in Irvine, Calif.
So can a strict religious upbringing, fear of pregnancy and negative messages about sex in your head. A bad sexual experience and no emotional satisfaction in your relationship can also make you feel like a wet blanket in the bedroom.
“Lack of desire is probably the most complex sexual problem,” Buehler says. “And the causes are very individual.”
Even if your head and heart are in sync, physical conditions such as diabetes, fibromyalgia and hormonal imbalance (perhaps from thyroid disorders or menopause) can also throw your sex and love life for a loop.
That’s what derailed Leslie (identified by her first name only for privacy), 52, of Austin, Texas. She had a “super low libido” and vaginal dryness when she entered perimenopause.
“It literally felt like I was drying up like an old woman,” she says. “And that was not OK because I actually enjoyed sex and wanted to have as active a sex life as possible.”
Still, as her sex life declined, so did her 10-year marriage. It ended in divorce.
Finally, with hormone replacement therapy, Leslie got her sex life back on track. After a two-year break, she and her husband rekindled their relationship and remarried last February.
Sex Rx: So what’s the best way to ramp up your libido? It depends on the cause.
Once you ID the cause, try these steps to put heat back between the sheets:
- Reduce stress and increase energy level. Maintaining a healthy diet, exercise and balance in your life can help ignite the fire within.
- Make time for sleepy sex. Try this suggestion from Seven Weeks to Better Sex (Westcom Press) by Domeena Renshaw, M.D., director of the Loyola University Health System Sex Clinic in Chicago.Pick a rendezvous night with your mate and set your alarm clock to ring 90 minutes after you go to bed, which takes advantage of the body’s first sleep cycle, when you should be at peak arousal. When the alarm goes off, take a shower together to refresh you, and then have sex, which will relax you and help you get back to sleep again.“You may be skeptical, but try it anyway and see what happens,” Renshaw says.
- Get the bad thoughts out. Cognitive behavioral therapy, in which patients address negative beliefs and feelings, can help you examine your attitude about sex.
- Expand your options. Sex isn’t just about inserting part A into part B. A woman may want a back rub or cuddling instead, Whipple says. “I encourage people to learn about different parts of the body and be aware of what they like – and to communicate to their partner what they find sensual.”
2. Lack of Arousal
“People associate arousal with vaginal lubrication,” Whipple says, but it’s more complicated than that.
When women are aroused, more blood flows to the clitoris and its surrounding flesh, which stimulates fluids to seep through blood vessels into the vagina. It also causes the upper part of the vagina, uterus, cervix and clitoris to expand and swells the lower vagina and labia (the flesh at the opening of the vagina) so the vaginal opening shrinks. In other words, your body gets ready to receive a penis.
When a woman isn’t aroused, the blood doesn’t flow and the process shuts down. “Women describe it as just being dead down there,” Houser says.
Why it happens: Many of the same things that inhibit desire also tamp down arousal. “If your vagina is dry and uncomfortable, it isn’t going to feel any stimulation,” Whipple says.
Often, it’s because a woman can’t let go of her worries and to-do list.
“She can’t relax,” Houser says. “Or she really doesn’t like her husband. Or she is thinking about their kid’s soccer tournament.”
Sex Rx: Water-based vaginal lubricants can help. Don’t use oil-based products, which can dissolve latex condoms and diaphragms, compromising your protection from a pregnancy and sexually transmitted diseases.
If the vaginal dryness stems from a decrease in estrogen levels, hormone replacement therapy may help keep the vaginal lining plump and improve lubrication.
Your doctor can prescribe estrogen in several forms, including cream, skin patch or an estrogen-dispensing ring or tablets, which are inserted into the vagina.
Don’t use estrogen cream as a lubricant, Whipple cautions, because the body absorbs a small amount with each use and too much estrogen could be dangerous.
And skip antihistamines. If they dry out your nose, they probably dry you out down under.
Whipple also suggests ArginMax, a tested over-the-counter oral supplement (it contains the amino acid L-arginine) that may increase lubrication and satisfaction.
This is the inability for either sex to experience an orgasm, but the condition is far more common in women. In fact, only about 30% of women have orgasms from sexual intercourse, Whipple says.
Why it happens: Medical problems such as diabetes, multiple sclerosis and gynecological cancers can interfere. So can antidepressants: 70-80% of women taking selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, have a hard time peaking, Whipple says.
Sex Rx: It’s time to explore your nether regions. “You’d be amazed at how many women don’t know what they look like,” Buehler says.
First, get out a hand mirror out and examine yourself.
Now let your fingers do the walking. Get used to touching your body in a non-sexual but pleasurable way. Give yourself a massage or take a warm bath or shower and explore your entire body to find out what feels good. When you’re comfortable, move your hands to your genitals.
Stimulating your clitoris, G-spot and even the cervix can bring on an orgasm. The trick is finding what works for you, Whipple says. For more tips, check out How to Find Your G-spot.
As you learn your sexual responses, have a show-and-tell with your partner so he can recreate the sensation.
“A lot of people give up too easily,” Buehler says. Because of socialization or fear, the ability to have an orgasm is shut down. “You have to reawaken the wiring.”
Having an orgasm is a skill. And practice makes perfect.
This condition causes the pelvic floor muscles to spasm, essentially blocking a penis from entering the vagina.
How common is the disorder? That’s debatable, because many women don’t seek treatment or are misdiagnosed. At the Sexual Dysfunction Clinic at Loyola University in Chicago, the vaginismus incidence rate is 7%, Renshaw says.
Untreated, vaginismus can be long-term: Renshaw says she treated a woman who had the disorder for 23 years before she sought help.
Why it happens: Repeated yeast infections or urinary tract infections can cause the reflexive muscle reaction, but so can fear of sex, pregnancy or emotional trauma from past sexual abuse.
Sex Rx: If the condition has a physical cause, at-home exercises may reverse it. In Seven Weeks to Better Sex, Renshaw suggests the following exercises:
- Without your partner, lie down and get comfortable. Breathe slowly, opening your mouth when you exhale.
- Lubricate your finger with water-based lubricant or saliva and insert it into your vagina. Continue to breathe deeply. As you explore your vagina, you’ll feel it start to loosen.
- As if you’re trying to stop the flow of urine, contract the muscles in the lower third of your vagina tightly around your finger. Relax and repeat to learn how to control the muscles.
- Repeat the exercises for five minutes, twice a day. Use one finger on the first two days. For the next two days, insert two fingers while breathing slowly and contracting your muscles.
- On the next two days, ask your partner to place one lubricated finger inside your vagina. Guide his finger and keep your mind focused on your sexual response.
- On the following two days, spend as much time on foreplay as you need to get aroused and then ask your partner to lie passively next to you.
- Straddle him and place his non-erect penis into your vagina. Contract and relax your muscles. You should feel your partner becoming erect without experiencing pain. If he is already aroused, you can insert his erect penis or slow things down until his erection subsides and try again. Allow yourself as much time as you need to feel comfortable at any stage of these exercises.
A physical therapist who specializes in pelvic floor biofeedback – a kind of training program that can help people regulate body functions – can teach a woman how to consciously relax her muscles.
A doctor also can prescribe vaginal dilators – a set of plastic or silicone dildos, graduated in size, that are inserted into the vagina by the woman or her partner for 10 minutes a few times a week leading up to intercourse. The dilators gradually stretch the vaginal skin.
Pain during and after intercourse makes sex unpleasant. Unfortunately, many women are too embarrassed to discuss the subject with their doctor and avoid the act altogether, Buehler says.
“There are couples who don’t consummate their marriage for years. If they’d come in sooner, they’d have a smaller problem to solve,” she says.
Sex is an important part of a long-term relationship or marriage, and its absence can threaten it.
Why it happens: Endometriosis (the growth of the uterine lining outside the uterus), vaginismus, urinary tract infections, a dry vagina or any combination of physical or psychological factors can cause dyspareunia.
Sex Rx: First, head to your doctor for a physical exam, blood work and a check of hormone levels. Once a physical problem is ruled out, physical and sex therapy can help.
After all, sexual disorders don’t involve only the genitals, Whipple says. “I view sexual disorders holistically. It’s really important to evaluate the total person and not just one part.”
Remember, intercourse isn’t the only way to get sexual pleasure. Try alternatives, such as oral, manual and anal sex. Anything that feels good can provide satisfaction minus the pain.
An extra tip: If you suffer from unexplained pain, your doctor may prescribe the antidepressant amitriptyline (Elavil). In very low doses — one-tenth of the amount you would take for depression — it can ease pelvic pain.