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from the book

Anyone who has stood in a supermarket checkout line has seen all the sexy headlines on women's magazines, touting exciting new ways for readers to drive their men wild in bed or to heighten their own sexual pleasure. These are tantalizing promises, to be sure. But they sorely miss the mark.

The fact is, many women aren't interested in more sex or better sex. They aren't interested in sex at all. They used to be, of course. Over months or even years, their sexual desire all but disappeared. And they can't understand why.

Through years of clinical practice, Andrew Goldstein, M.D., and Marianne Brandon, Ph.D., have worked with scores of clients who aren't satisfied with their sex drives. They've seen how women struggle to open up about this very personal and painful problem. And they've seen how it can erode women's self-esteem and strain intimate relationships.

In Reclaiming Desire, Dr. Goldstein and Dr. Brandon present a self-care version of their highly effective holistic approach to treating low libido.

Inside you'll find:

~ An exclusive self-test to assess physical, emotional, intellectual, and spiritual health -- the four cornerstones of a healthy sex drive

~ Essential information on how major life events like pregnancy, menopause, and divorce can affect a woman's sexual health

~ A range of practical measures, from conventional and herbal medicines to mind-body techniques and lifestyle strategies, that can help rekindle sexual desire

~ Personal stories that draw upon the real-life experiences of women who once struggled with low libido -- and emerged with a greater understanding of their sexual selves

Reclaiming Desire also offers a healthy dose of reassurance and encouragement as an antidote to all of the misconceptions about low libido. As you'll learn, a decline in sex drive doesn't automatically happen with age. And while hormones influence sexual desire and response, they don't determine a woman's sexual destiny. Just as important, low libido doesn't necessarily point to a problem in a woman's relationship with her partner. More than likely, she simply has lost touch with her sexual self.

Unlike those magazine headlines, Reclaiming Desire will more than live up to its promise. With this book, you can reclaim your desire -- and make your sex life better than ever.

A woman's sexuality is vital to her self-image and self-esteem. So if her sex drive should falter, the consequences can reach far beyond the bedroom -- to her sense of value as a person, her perception of her relationship with her partner, and her satisfaction with life in general.

Yet many women are reluctant to seek help for low libido, because it's such a deeply personal problem. Those who do may not get effective treatment. Too often doctors attempt to pigeonhole a diminished sex drive as purely physical or psychological. It's much more complicated than that.

Reclaiming Desire is the only book to address low libido by considering the whole woman -- her physical health, her emotional resilience, her intellectual fulfillment, and her spiritual beliefs. At last women can get a complete, accurate picture of their sexuality by exploring the diverse factors that have helped shape it. Using an array of proven self-care techniques, they can determine what could be sabotaging their sex drives -- and what will help bring it back.

About the authors:
Andrew Goldstein, M.D., And Marianne Brandon, Ph.D., are cofounders of the Sexual Wellness Center in Annapolis, Maryland, where they specialize in treating women's sexual health problems. Dr. Goldstein divides his time between Annapolis and New York City; Dr. Brandon resides in Annapolis.

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Interviews

Exploring Womanhood > Interviews

Exploring Womanhood Interviews
Andrew Goldstein, M.D. & Marianne Brandon, Ph.D.
Co-authors of
Reclaiming Desire: 4 Keys to Finding Your Lost Libido


Drs. Goldstein and Brandon, co-authors of Reclaiming Desire, are cofounders of the Sexual Wellness center in Annapolis, Maryland. Reclaiming Desire is the culmination of their years of research and treatment helping women who have lost their sexual desire find their libido through a body and mind approach to sexual health.

They visited StorkNet and Exploring Womanhood to talk about this sensitive and important topic and answered questions from our members. Here are the results of this informative interview . . .


EW Reader: I've lost my sexual desire and I really have no interest in finding it again. Is that wrong?

Marianne Brandon, Ph.D.: You are not alone. About one-third of women report low desire when surveyed. The fact that you aren't interested in changing it isn't a matter of right or wrong. It's a personal preference. Consider the benefits of rekindling your sex drive, versus the benefits of sexual disinterest. Many women find that low desire has a negative impact on the intimacy (physical and emotional) they develop with their partner, on their feelings about themselves as a woman, and on their experience of physical pleasure in general. If this is the case for you, you may want to consider why you hesitate to feel sexual again.

There are "advantages" to being sexually disconnected. For example, you may use your lack of desire to communicate anger with your partner. Some women prefer the safety of celibacy to the vulnerability of sexual intimacy. After all, being open with your partner does involve risk. The more of yourself you share with him, the more power he has to hurt you. This issue is complicated by the fact that you may be consciously unaware of fears like these, while your unconscious mind motivates your lack of desire. Relatedly, a woman may want to avoid any form of dependence on her partner. This can be the case after watching her own mother struggle but stay trapped in a marriage that wasn't healthy, perhaps out of fear of being alone. This relates to sexual desire because, in allowing your partner closer to you, giving him the opportunity to please you sexually, a level of dependence on him can unfold.

I invite you to get curious about your lack of libido. That doesn't mean that you need to change your behavior. Increased insight into your preferences and behavior will only add to your understanding of yourself, which is empowering, regardless of what you do about it.

Note: The following two questions have similar concerns. Dr. Brandon has answered them together.

EW Reader: My DH has an extremely low libido. It wasn't this way when we first got together but has seriously declined the longer we have been married. We are the perfect example of it only takes once to get pregnant. We had sex once last year and it resulted in the conception of our daughter. It has now been 15 months since we last had intercourse. I have tried everything to change that. After awhile, though, you just get tired of being rejected all the time so I give up trying. He has been to the doctor, and he went on antidepressants for a year, and it didn't help that aspect. He is now off those drugs but still has no libido. I range from being really angry, to being really sad to just plain not caring anymore. He is a great father and we love each other very much but I feel such a huge void in our relationship. Sometimes it's hard not to be resentful. He will not consider counseling. I just don't know what to do anymore.

AND:

EW Reader: My husband and I have been married for just over 10 years. Over these years, our sex life has grown, but now I think we are stuck in a "funk". My husband seems to have a low libido (and always has). Not so low, that there is a health reason just lower than I'd like and he'd like at times. I am tired of being the one who initiates, and I think, bored of my methods as well. Any suggestions?

Marianne Brandon, Ph.D.: You are bringing up a great question -- decreased sex drive in men is not uncommon but rarely talked about. My concern is that you are writing this question, not him. By that I mean, if he doesn't want to increase his sex drive, your efforts will probably have little impact. So start by talking with him. Does he know how distressing this is for you? Sometimes women are afraid to bring these more sensitive issues up with their partners, so they communicate with behaviors and subtle comments rather than direct conversation. That tends to only hamper communication and increase misunderstandings, however.

If after this discussion your husband is motivated to change, then the first step will be for him to identify why his libido is low. It is true that some people, including men, just have lower sex drives. Nonetheless, other issues may still be fueling his decreased interest. When a man struggles with low sex drive, unexpressed emotion (such as anger at his partner) may be the culprit. Keep in mind that men in Western cultures, men are in a difficult position at the moment. On one hand, most women are turned on by strong, masculine men who are powerful and confident in the world. Unfortunately, we teach men to develop these traits by shutting down emotionally. This starts at an early age -- male children consistently get the message that boys don't cry. Unfortunately these messages live on in our man's psyche as he matures. The way he copes with these messages will later have a direct result on his sexual expression. As he learns to cut himself off from showing painful emotions, he simultaneously cuts himself off from showing soft and loving feelings as well. His method of sexual expression will probably reflect this. He can become emotionally numb which results in a cold sexual experience for his partner, or perhaps he'll loose his interest in sex altogether.

Other typical libido-killers for men include excessive alcohol consumption, exhaustion due to long work hours, or discomfort with the power of his masculinity. This can result from the societal pressures that he not be "macho" and unemotional. These men may be afraid of the destructive aspects of their powerful masculine energy. In an attempt to be more emotional and responsible in the world, he may pull away from his sex drive, or at least stop bringing his powerful sexual energy to his partner. In this case, she may then loose interest in sex because of a lack of sexual excitement in their union.

These issues generally require more than a quick lifestyle change to resolve. That doesn't mean that you are out of luck, however. If your man isn't interested in sex, there's a lot you can do to get his sexual attention. Taking some sexual risks yourself will help him open up to his own desire. Try dancing sexy for him, read erotic literature to him by candlelight, or masturbate in front of him. Allowing yourself to be more vulnerable with him will likely initiate a more intimate sexual energy between you both.

EW Reader: Hi! Thank you so much for taking the time to answer our questions. Gosh, I just don't know where to start. I have a three year old and a 14 month old. I'm a stay-at-home mom. I have and a truly wonderful, loving, doting husband and father and I just can't seem to find the energy to have sex anymore. Both my children are sleeping through the night, but I just find that I have almost no interest or energy to have sex. Raising little ones is physical and I'm just dog tired by bedtime.

I've tried a glass of wine and a bath, while letting him put the kids to bed, he's great about making sure I get enough 'me' time. Part of it seems to be a desire thing, the other part seems to be an energy thing. I've lost all my pregnancy weight, so it's not that I feel unattractive, (although I'm a bit discouraged by the sad state of my breasts after nursing two babies, lol!) I don't know, I sure wish there was a Viagra for women! Thanks!

Marianne Brandon, Ph.D.: You are bringing up the most common questions we hear from moms of young children. Most mothers find that the energy it takes to raise their families can negatively impact their energy and enthusiasm for sex. If you are perpetually tired, and/or not getting enough time for yourself, your sex life will indeed suffer. It's very hard to be giving and loving toward your partner when you are maxed out from giving all day to your kids. Even if your partner helps out on occasion, one "night off" isn't going to spark your libido into action. Think in terms of any biological system -- energy output depends on energy input. If you are putting out more than you are taking in, you will burn out fast. A lifestyle change, involving more regular time for yourself, is probably necessary for your body to really relax and feel sensual pleasure again.

Next, there are some "tricks" to boosting your desire. Your brain has probably been so focused on mothering that you've lost touch with your sensual side. In my answer to another question in this forum, I addressed how to turn that around. One other approach that can often yield great results involves taking some sexual and emotional risks with your partner. This doesn't mean engaging in unsafe sex practices. The risks I am speaking of result from increased vulnerability with your husband. First, discuss with him some things you've always wanted to try sexually, but were afraid to ask for. Just about everyone can identify something on this list, even if it was a something they thought of years ago. By sharing yourself in this way, you drastically increase intimacy with your partner. For the most part, increases in intimacy will have a beneficial effect on your desire for sex. If you can't think of anything, and even if you can, try buying some books on sexual techniques and read them with your partner. Everybody can stand to learn something. Another step involves changing your sexual patterns. Most couples get in to sexual habits that produce boredom over time. Sex has to be interesting and exciting for you to desire it. Make your sex life worth wanting. Changing your sexual routines, including asking your partner to touch you differently, will help matters. Think about the best sex you've ever had, and determine what made it great. Recreating that experience in some form now will probably help you feel sexually enthusiastic again. Finally, try slowing sex way down. Rushing the experience by limiting foreplay, or attempting to orgasm fast, significantly decreases your opportunities for pleasure in the moment. Try an experiment -- without even telling your partner, slow down the ways you caress him. Make a point of feeling the sensuous nature in what you are doing. It will change your shared sexual experience.

EW Reader: I am very embarrassed to ask this question, but in almost 6 years of marriage I have never really gotten comfortable with touching my husband intimately. I just seem kind of "turned off" by his "parts." I try to play along but am not often in it for myself but for him - meaning I don't get much pleasure out of sex. I feel like a total freak. What can you recommend to help me overcome this? I am 34 and healthy. We do not have children yet, and as far as I know I was never molested as a child or anything like that. Thanks for taking the time to answer our questions!

Marianne Brandon, Ph.D.: This is a great question, and I'm glad you asked. First, you bring up a key component of a healthy sexual relationship -- both partners, including the woman, need to feel that they get something for themselves from making love. If a woman has sex just to please her partner, it will feel cold and mechanical to both participants, and as a result, not enjoyable. I encourage you to start by focusing on yourself, rather than on your partner. Find what is in it for you to make love to him. Many women feel that the closeness and emotional intimacy they feel with their partner is key to their enjoyment. Others like the playful aspects of sex, the pure physical pleasure of making love, and/or the joy of making a partner feel good. If you aren't in it for yourself, it's unlikely that you will open up to enjoying stimulating him.

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Next, I urge you to experiment with your own body for a while. It sounds like you would benefit from exploring your sensual self. Being sexual with your partner first requires comfort and enjoyment with your own sensuality. In other words, you can't give him what you don't have within yourself. Most women with low sex drive have lost touch with themselves as sensual beings. They no longer feel or enjoy sensual expression outside of sex. Reacquainting yourself with your sensual side literally starts with a focus on your five senses -- that is, your use of vision, touch, hearing, smell and taste. Take time to attend to sensual images in the form of artwork or nature. Bring these images into your bedroom and other spaces where you spend your time. Explore different music styles to find those that help awaken your sensuality. Play them while you make dinner, or in your portable CD player while you walk the dog. Use erotic scents, like perfumes or incense. Finally, learn to experience foods sensually. For example, eating a juicy peach can be erotic, as can dining on red meat, or creamy chocolate. Finding the sensual aspects in your daily life will help you open to the sensuality of your body and your sexuality.

The next step in your exploration involves focusing more directly on waking yourself up sexually. Reading erotic literature can help you further define what sparks you sexually. You can incorporate what you learn into sexual fantasies, or, better yet, tell your partner what turns you on. Create a sacred space where you make love -- a bedroom that feels romantic and safe will help you open to your sexual feelings. Further, research shows that women are more sexually responsive after aerobic activity -- another great reason to exercise! Masturbate regularly -- not with the intention of orgasm, but instead to reconnect yourself with the intimate aspects of your body. Finally, use your mind to your advantage. Every day imagine enjoying making love to your partner. Creating pleasurable erotic images in your mind will help you desire your man.

I expect that in this process of connecting with your sexual self, you will find yourself more open to your partner's sexuality. Taking these exercises seriously will likely automatically change your response to him, and your feelings about his genitals.

EW Reader: My daughter was born 19 months ago. While I was pregnant, my libido was pretty good, and I enjoyed sex. Since then, it has gone way, way down. I am still nursing, but somehow I view sex at the end of the day as a chore - one more person wants something from me, wants a part of me. I feel like it is something I have to perform until finally, thankfully, I can sink into my pillows and not have to worry about anyone or anybody. My husband is upset that I don't get more excited about sex- we do it about twice a week, and I have an orgasm maybe every third time. Usually, I just "perform" to please him and meet his needs. Honestly though, I am just as happy to be left alone. He senses that, and is kind of hurt.

Our financial situation has been stressful for what seems like forever- he has been in and out of work, and is now trying to run his own business. He also suffers from clinical depression and ADD, and I feel often like "coach, cheerleader, psychologist, wife" combined- the one to talk him through it, be encouraging, give a little structure, point out all his good points when he is down in the dumps again, etc. He also has two kids from the previous marriage, and there are constant ugly issues to resolve with his "ex" regarding visitation. I often totally feel stressed out and a bit burnt out by all the issues, and just want my peace and quiet at the end of the day. So my question is- how can I stop viewing sex as a chore and a duty? Thanks!

Marianne Brandon, Ph.D.: Well first let's talk about your biology. Specifically, the prolactin you secrete because you are nursing is doing a lot to make you disinterested in sex. So much so, in fact, that you probably won't have much of a sex drive for this reason alone. However, as you identified, the issues with your husband are also clearly impacting your passion. It seems as if, in wearing all those hats for him ("coach, cheerleader, psychologist, wife") you end up giving him more then you get. This set up leaves you feeling depleted, and it's unlikely in such a situation that you are going to want to make love to him. You are in effect mothering him, and of course you won't want to then have sex with your "son." In order for you to stop viewing sex as a chore, you will probably need to feel a change in this dynamic between the two of you. Start by discussing this issue and it's impact on your sex drive. He will need to take some responsibility for getting himself out of his depression so that you are more freed up to love him the way you would like to.

EW Reader: Dear Drs, thank you for coming to StorkNet/Exploring Womanhood. Does your book deal with libido for women over 40 whose children are not young? I may be hitting menopause and I feel a lot of changes going on. One day I'm a tiger, then next I have no interest in sex at all. It's all or nothing. Is this normal? I'm anxious to read Reclaiming Desire. Thank you ahead of time.

Marianne Brandon, Ph.D.: I love this question, because it gives us an opportunity to discuss some cultural stereotypes that are destructive for women. Our book does discuss these issues, but I'd like to make a few points about it here. First, your experience of libido varying over time is normal. This happens all through a woman's life, but particularly at the time of menopause because of hormonal fluctuations. The most common sexual complaint at the menopause is difficulty with vaginal lubrication. This is the result of decreases in estrogen and can easily be accommodated with OTC lubrication. However, it is not the case that women should expect libido to cycle down with age. Cultural myths like this are extremely destructive for women. Another myth is the notion that young women are more sexually responsive than mature women. This simply makes no logical sense when you consider that sexual response involves knowing one's body and being comfortable in it, both of which are more likely for seasoned women as opposed to our younger counterparts. Because our expectations have much to do with how we perceive ourselves and our environment, it is crucial that we dispose of these worn out notions so that women are freed up to experience our feminine essence for the beauty and grace it offers as we age.

EW Reader: I'm the overworked, overstressed mother of two small children, one of whom cosleeps and still nurses. I'm a full-time student, I'm my family's sole support, and (for reasons that should be clear by now!) I'm on fluoxetine (Prozac). All these factors conspire to reduce my libido to NADA. Zip. Zilch. Intellectually, I'd like to have sex, but I have no desire -- it just doesn't seem worth the effort. To make it worse, my husband, a stay-at-home-dad, is stressed from taking care of the kids all day, he has sleep apnea (uses CPAP), and takes a beta-blocker (metropolol) -- so no libido on his part, either. We both know what the problems are, but talking about it just seems to threaten him, and I find I don't care enough anymore to press the issue. I love my husband, and he loves me. The stability of our relationship is not in question. I'm just wondering if we'll ever have sex again... and if I care whether we do or not? Will I care? How can I help us regain some semblance of a sex life? Thanks in advance! signed: frustrated on one level, but not too much on another...

Marianne Brandon, Ph.D.: My goodness you have so much going on. It's easy to imagine why you aren't interested in sex right now. The two of you seem to have developed more of a friendship than a marriage, and most friends don't desire sex with each other. The bad news is that it is unlikely that either of you will spontaneously desire sex again unless you both make an active attempt to work at it. My first concern is that he shrinks from discussing sexual issues with you. As a result, you may find yourself loosing respect for him, which will further decrease your interest in being intimate with him. You are then vulnerable if you meet a man while at work (or in another part of your life) who is willing and able to be more open with you. At that point, you may find yourself contemplating an affair. Obviously, your situation can become more complicated very fast. So, I encourage you not to ignore your dissatisfaction, but instead fight for more for yourself and your marriage.

EW Reader: My husband is definately a "breast" man and I enjoyed that tremendously. But we have a seven month old daughter that I am currently weaning off nursing. How can we both become more comfortable with my breast being sexual again and not for feeding our daughter. It has been a tremendous issue for me, I have mentioned it to him and he understands. Thank you.

Marianne Brandon, Ph.D.: This question comes up frequently for new moms. All the body changes associated with pregnancy require some getting used to. The good news is that time is on your side -- the association you both have made between your breasts and nursing will likely diminish when you are no longer nursing. And don't be alarmed if the act of nursing excites you sexually at times. This feeling is only normal (after all, your breast are being stimulated), but sometimes mothers get upset by it and essentially dissociate themselves from sensations in their breasts as a result.

There are some things you can do to turn this around for yourself. First, remind yourself how sexy your breasts can be. Go braless around the house if you are comfortable. Massage your breasts with oil while thinking sexy thoughts in the bathtub. Wearing clothes that show off your breasts may be fun for both you and your partner. Finally, bring your breasts back into your love play slowly at first, beginning when you are very excited. Either you or he can massage them when your passion rises. Over time you can "relearn" the association between your breasts and sexual excitement.

EW Reader: My husband, (now 45, it's 20 yrs we're married) was raised with the idea that women have NO sexual needs. I'm not very sexual myself, but out of self esteem issues, I'm working on (body image). Well, every time I initiate anything he says something like "oh, a miracle is happening" or similar in an irony tone that cools me down immediately. How can I convince him I have needs too? He was raised in an all-boys environment and his mother is very nice but cold and distant. We have a preschooler son and very busy lives. I don't know how to make time for sex!

Marianne Brandon, Ph.D.: Well my first reaction in reading your question is that I'm not surprised that you don't find time for sex - most women wouldn't be very interested if their partners made hurtful comments as you've described. So, your lack of desire is probably a very normal response to a difficult situation. And kudos to you for taking steps to work on your body image issues! I love that you are putting effort into taking care of yourself.

Your husband's attitude, that "women don't have needs of their own", is an old cultural myth that continues to rear it's ugly head. If he won't take your word for it, try getting some books that discuss these themes and show him that experts say it's unlikely he's going to get you interested in sex if he keeps treating you this way. By the information you gave, I can see that you suspect his relationship with his mother has something to do with how he's treating you. That very well may be the case - specifically, that he's angry with his mom and taking it out on you. That is a common dynamic (as is the reverse, women unconsciously act out issues with their fathers toward their husbands). Bottom line, my dear, please take good care of yourself.

EW Reader: I have just heard that taking a break from sex can be normal. I think perhaps, that is what my husband and I have been doing. But, how long is too long and how does one get "back in the saddle" after a break? I am ready to, but my husband does not seem as interested...

Marianne Brandon, Ph.D.: While it is normal for sexual frequency to vary within a couple over time, "taking a break" may mean something entirely different, such as a couple experiencing increased emotional distance and, as a result, their physical intimacy takes a nosedive. I'm wondering how long it has been since you have made love, and if this break was consciously agreed upon, or whether it is just happening. The latter is more concerning in that if you two haven't planned it, and aren't discussing it, you've got some work to do regarding communication. In addition, the longer you go without sex, the more challenging it will feel to both of you to resume sexual relations. "Getting back in the saddle" will likely require discussion and effort on both of your parts. Be gentle with yourselves, and don't expect it to happen quickly, such as after one well-meaning discussion. Intimacy, physical or emotional, takes time and patience to develop and maintain. (This is as true for a long-term relationship as it is for a young one!)

Some of my answers to other questions here will help you reconnect physically. In addition, easing back into making love can be done slowly by breaking sex down into defined stages, and agreeing to take one stage at a time. Therapists call this "sensate focus." First, spend several sessions just lying naked with each other, for at least 30 minutes. This will allow you to get used to the feeling of being physically intimate again. Then spend several sessions taking turns just touching each other in nonsexual ways (each session involves one partner only touching, the other only receiving per session). When you are ready you can add sexual touching in this same pattern, then sexual touching with orgasm, and then intercourse. This "one step at a time" approach can help you both redefine what feels good, how you like to be touched, and what you need from your partner. Taking the time after sessions to share verbally what you liked and didn't like is essential for your sexual relationship to develop.

Otherwise, if you'd like to spark your husband's fire on your own, try approaching him in a way that he finds exciting. For example, act out one of his sexual fantasies, dance sexy for him, or otherwise create a sexual event that is impossible for him to resist. In this way you may be able to bypass his "no" and help him find his "yes" to sex again. If that doesn't work, read some of my other responses in this interview regarding low sex drive in men. They may give you some insight into what is happening with him.

You would probably also benefit by taking the time now to consider the dynamics of your marriage. This can be challenging to do, because it can be emotionally painful. However, problems that don't get addressed usually just get worse over time. So in the long run, you are probably better off dealing with them sooner rather than later. To do this, assess your relationship for balance in the four quadrants that we explore with couples at the Sexual Wellness Center. Specifically, we examine partnership dynamics as related to physical, emotional, intellectual, and spiritual health. Basically, if your relationship is imbalanced in any of these quadrants, low libido in one or both partners is a likely result. I will describe each of these quadrants briefly, but you may find it helpful to read our book for a more thorough discussion if you are interested.

The physical health of a relationship relates to whether the two of you together experience physical pleasure both outside of sex, as well as sexually. This could mean via mutual nonsexual massage, exercise, or any other way that you might experience enjoyment with your bodies. For your relationship to be emotionally healthy, you would both be free to express and work through a full range of emotions together - from joy and pleasure to the more difficult feelings, such as anger or jealousy. The intellectual health of your relationship speaks to whether you are intellectually stimulated together by conversation and/or activities. Finally, the spiritual health of your connection refers to your finding and sharing deeper meaning in your life and relationship. Usually when couples find their sex life suffering, one or more of these aspects requires attention for mutual desire to return.

Marianne Brandon, Ph.D.: Nancy forwarded me some concerns several members have shared about intimacy and infertility issues, and I'd like to respond. As a sex therapist with a specialized focus in low libido, I can assure you that struggling with libido issues during and after infertility treatments is normal. Please know that you all are not alone with this concern. It is a difficult problem to deal with, and I'd to offer you some things to think about.

First, I cannot stress enough how your relationship with your body impacts your sexual experience. Most women who have participated in infertility treatment have complex feelings about their body, many of which are negative. They can feel as if their bodies are weak, damaged, or otherwise letting them down. They become angry at their bodies. Rather than being gentle and loving with themselves, they (sometimes unconsciously) express anger toward their physical selves. This can occur in a variety of ways. Some examples may be not exercising or eating properly, withholding physical pleasures like massage or swimming, or simply becoming numb to physical sensation in general. The impact of the physically and emotionally uncomfortable treatment procedures only makes matters worse. Ultimately, most women seek to "disconnect" from their bodies rather than "feel" them. As you can imagine, disconnecting from your body all but ensures that you will have a bland, if not uncomfortable, sexual experience. As a result, you certainly won't desire sex.

To counteract this process, I encourage you to first identify how you may be treating yourself unkindly. Step one is to stop these behaviors ASAP. Focus on loving your body instead of sending it negative energy. Explore whether your self-esteem has been impacted by the medical treatments you have received. If you are feeling less of a woman, making love will be less enticing for you. Give yourself the opportunity, in whatever form, to enjoy your femininity. You can do this via the clothes you wear, the perfume you choose, or whatever helps you feel sensual and feminine. And don't limit yourself to just exploring the physical aspects of your self-esteem - make sure to take care of your emotional self as well. Depression, stress, and anxiety all lead to low sex drive. If you aren't getting what you need in your life generally, it will be all but impossible for you to enjoy giving to your partner sexually.

These are just a few ideas to get you started. There are many more issues, such as your sexual history, and your relationship with your partner, that also affect your sex drive now. While our book, Reclaiming Desire: 4 Keys for Finding Your Lost Libido, does not have a chapter focused on infertility and its impact, the issues addressed will likely apply to your struggles in some ways. I encourage you to maintain your dialogue with each other as well, as sharing information, and thus realizing you aren't alone, can be so comforting in difficult times like these. Finding your lost libido will take effort, but the increased connection you will feel with yourself and your partner will make it worth it. Warmly, Marianne Brandon

EW Reader: Dear Dr. Brandon- I'm 37 years old and have been married for 14 years. I have two children and a good husband and marriage. Probably, not much different than many other women my age, I don't feel like I've got a good handle on intimacy. I feel like something is missing, and I'm going to make a guess at what it is. I don't really feel like I know myself. I feel a little inhibited. I grew up with my parents, society, church and pretty much everything I was taught telling me that masturbation is wrong. It was wrong to touch myself. Wrong to get to know my body. So now, as an adult, I have old messages playing in my head, even though I don't agree with them at all. My better sense tells me that it's my body, and I have the right to know it and how it works. And, that there is nothing dirty or wrong about that. After all, I touch other parts of my body, right? I please myself with massage elsewhere, so what's the big deal? If it will help me help my husband learn how to please me, then what is wrong with that? So, where do I begin? Help me know what to do, where to begin, how to learn about my own body and how it works. Thank you very much ahead of time.

Marianne Brandon, Ph.D.: First I want to say that I love how candid you are in your question. That alone is an optimistic sign for you, because it tells me that you are willing to reveal information and uncomfortable feelings about yourself in an effort to grow. It speaks to how motivated you are to move forward. Motivation can take you far on your path of healing. I suspect your instincts are right on - you cannot be intimate with your partner if you can't first be intimate with yourself. So, let's get down to the business of how you can change that.

Our culture, and many of our religions, do teach negative messages about women's sexuality. Unfortunately, these messages take a while for women to overcome. Be gentle with yourself, it's likely that most women growing up with the same influences as you would have the same fears and sensitivities. So go slow, and break down your efforts into discrete, manageable parts.

Step one is to look at your genitals in a mirror. Get to know your body and gain some comfort with it. I suggest that you first buy yourself a rose and keep it next to your bed, or wherever you intend to do this exercise. Roses have many similar characteristics to a woman's genitals - their shades of pink and red, the softness of their petals, the way they unfold, and their pungent scent, for example. So first admire the rose, and then, with your heart open, admire yourself. Go back and forth like this for a while, and do this exercise as often as you need to, to facilitate comfort with your body. Next, touch yourself. Not for sexual pleasure, but instead in an effort to send loving energy into your vulva. Be kind and soft with your body, treat yourself with love and respect. After you do that exercise over a period of time (days or weeks), you can move on to touching yourself sexually. First, do so just to learn what types of strokes you find pleasing. Experiment with touching your G-spot, your clitoris, as well as all around your inner and outer lips. Only after you gain confidence in this exercise would I recommend that you touch yourself with the intent of having an orgasm.

While doing each of these exercises, keep saying soothing statements to yourself, such as "I know it is good for me to know my body intimately", or whatever makes sense to you. Keep using words to calm and relax yourself.

One last word of advice - be aware that your partner may have similar discomforts with genitals - his or yours. Men are not immune to these issues. So, you may not be the only one who has to work through old, hurtful messages. In the end, you may have to teach him a thing or two!

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