Even though I talk to women all the time about some of their most sensitive and private health concerns, sex can still be a difficult topic for many women to bring up. I know it’s coming when I ask my patient if there’s anything else she would like to discuss and she begins with some variation of “well, there is one more thing my husband would like me to ask you…”
The Libido Equation
Sex drive, or “libido,” is the interest in and desire for sex. Sometimes referred to in women as “female sexual dysfunction,” low libido can be caused by medical problems, such as Multiple Sclerosis, Parkinson’s disease, chronic renal disease, chronic pain of any kind or cancer. The hormonal fluctuations that are a natural part of our monthly cycle or that occur with age can lead to changes in sexual desire. Pain with intercourse can be an issue for some women. Alcohol and drug abuse are common and frequently undiagnosed players in the libido equation. Other big barriers to a healthy sexual desire include a history of sexual trauma (rape, abuse), history of emotional or physical abuse or infidelity. In these circumstances, a commitment to professional counseling is critical.
Fatigue is the #1 Enemy of Sex
In my experience, however, decreased libido can be blamed much more frequently on the emotional and environmental issues that face women and their partners every day. Many of us have young families, work outside the home and lack a supportive local family network to help alleviate some of the stress. We’re tired and fatigue is the #1 enemy of sex.
Sex and Gender
Women and men also think about sex differently and need different things from their partners as a result. Women need an intimate emotional connection, non-sexual touching, such as holding hands or hugging, and romance. And one of the biggest aphrodisiacs for women is…wait for it...HELP! That’s right; a little help around the house will get you a long way in the bedroom!
In contrast, men need mutual satisfaction – they need to know they are pleasing their partners in bed. They need a sexual connection – some men cannot open up until after they have had sex with a woman. A patient of mine expressed it this way: “women need intimacy to have sex; men need sex to have intimacy.” Men need responsiveness – they need to hear “yes” from us! If the answer is “no,” then it should be followed by a “yes” (“not tonight, but how about tomorrow morning?”). Women need to understand that, when we say “no,” men can feel like we’re saying “no” to all of them, not just their sexual proposition. Finally, many men need their partners to initiate sex at least some of the time.
It is a fact that most men think about sex far more than most women. I bet that women think about food way more than we think about sex. We need to consciously work on thinking about sex more. I suggest to women that they make notes to “TS” (“Think Sex”) in their calendars or wear something sexy under their regular clothes (just for them!). Most of all, we need to plan sex. Like exercise, sex might not “just happen” unless it’s planned. Be sure to have enough “margin” and “boundaries” (see the list of suggested reading) in your days and weeks that you aren’t exasperated at the end of them. I get caught in the trap of over committing to “good things” and having nothing left for my husband. The health and well-being of our relationships should be our first priority, and sex is part of that.
Some time ago I was seeing one of my partner’s patients for a checkup near the end of her pregnancy. When I entered the exam room, the woman greeted me and, pointing to her belly, said “this is a TS baby.” Apparently, she had heard me speak on this topic and put some of my suggestions into action!
If you have concerns about your sexual health, contact an office to make an appointment with one of our providers. Share this post with someone you know who might be struggling with this issue in their own life - it's more common than you think!
Dr. Drea Olmstead is a board-certified OB/GYN physician and surgeon who sees patients at the Tualatin, Oregon Office of Women’s Healthcare Associates, LLC. She attended Occidental College in Los Angeles and went on to medical school at the University of Washington. She completed her obstetrics and gynecology residency at Oregon Health & Science University. Her clinical interests include obstetrics, domestic violence, adolescent gynecology, pelvic surgery and international medical missions, among others. She has been married to her high school sweetheart for 25 years and they have two beautiful children.
For additional reading:
- "Your Sexual Health," ACOG Patient Pamphlet
- Sheet Music: Uncovering the Secrets of Sexual Intimacy in Marriage by Dr. Kevin Leman
- The Language of Love: How to Be Instantly Understood by Those You Love by Gary Smalley and John Trent, PhD
- The 5 Needs of Men & Women by Gary Rosberg, Barbara Rosberg and Ginger Kolbaba
- Margin: Restoring Emotional, Physical, Financial and Time Reserves to Overloaded Lives by Richard A. Swenson, MD
Sources: Image - Health.com