Sex Drive Mismatch. How much sex should one have? Well, the good news is that there’s no minimum requirement. Some people have sex every day, some have it once a year, some never. There’s no right or wrong answer. Too much or too little sex becomes a problem only when there is a difference in sex drive between partners.
Regardless of your sexual orientation or gender identity, it is estimated that 1 in 3 couples are confronted with a mismatch in sexual desire. When this issue is not addressed, it undermines the intimacy of the couple and can lead to misunderstanding, frustration and even infidelity. Needless to say, this issue can only be resolved if both partners are committed to their relationship and willing to work hard at it. Also, if sex has been absent from your relationship for many months or years, don’t expect the problem to resolve itself in a matter of days to weeks. It will take time, communication, and possibly, physical evaluation.
The first step is to acknowledge that while the person with the lower level of desire holds the power in this struggle, both partners are equally responsible in making an effort towards a more equal and satisfactory sex life. Therefore, there will be no happy sex life unless there is actual conversation about needs, desires and expectations. To save a relationship threatened by lack of sexual intimacy, the issue must be intensively addressed.
Psychological issues (including abuse and trauma) should be considered, evaluated and treated, if appropriate. Dr. Bowers is skilled in sorting out deeply personal issues that can impact sexuality. We partner with mental health specialists but also are available to listen to you. We come from varied personal backgrounds and are both women, parents and partners. We really do empathize with you. Simultaneously, it is important to break free from old patterns involving negative behaviors such as avoidance and nagging. To do so, take the pressure off by removing sex from the table….temporarily. Instead, focus on your partner… and yourself. Eat well, take a walk, pamper yourself, masturbate (if you’re the one with high sexual energy), do nice things for and with your partner such as back rubs, writing a sweet note, etc… The goal is to reconnect at an emotional level. Sexual rejection in a relationship hurts. It ruins self-esteem, it creates a void and sucks joy out of life. Use this time to commit to each other and to being sexual with each other again. A few weeks (not months or years) after the first phase, it is time to re-introduce sex again. Two rules apply here: first, the individual with the lower sex drive does need to somehow “give into” sex. They may not feel the desire to do so but they should, simply put, “just do it”. Particularly when sex was previously present, some concession and attempt to rekindle that “old magic” is essential. Who knows what will happen once things are allowed to flow again? Optimism abounds! Have fun (or at least, pretend you are). The second rule applies to the person with the higher sex drive: accept the fact that whatever is given by the other partner is the absolute best they can do at that time. It may not fit the wildest sexual fantasy, but it’s a start and one can build from there. A third rule that applies to both partners is that it is always ok to say no to sex. But in the spirit of building an equal relationship, this “no” should always be followed by an alternative “yes”: schedule another time and follow through with it, offer another sensual suggestion, a new location, a thought outside the box! Old habits are easy to fall back into. Break out but always make it work for you!
Disorder of Sexual Desire
Beyond a sex drive mismatch, there are important physical conditions, disorders and medications that can interfere with one’s desire to be sexual. For example, common medications such as Prozac and Paxil, medications designed to enhance mood, can take a depressing toll on libido—but not invariably. It is important to consider these or other medications can inhibit one’s overall sexual appetite and performance. Often, a lower dose or an alternative medication can be equally effective without negatively effecting sexual performance.
Similarly, there are physiologic imbalances that can lead to less interest in sex. This can include hypothyroidism (low thyroid), perimenopause (menopausal symptoms in the years prior to menstrual cessation), hypogonadism (ovaries not functioning properly or declining prematurely) and hormone imbalance (even women need testosterone!). These are physical conditions that lend themselves to treatment that can potentially spark libido. Drs. Bowers is a skilled clinician who is experienced in helping to clarify these physical causes of low sexual desire.
Other physical causes of sexual dysfunction can include vulvar abnormalities and pelvic pain. Who wants sex if it hurts? Sex should be fun or at least pleasant. When sex causes physical discomfort—and if mutually acceptable alternatives (such as checkers!) are not enough—physical evaluation is warranted. Both Dr. Bowers specializes in sourcing the causes of these problems. Endometriosis, which can be a cause of deep pelvic pain, particularly with deep intercourse, can be treated. Other physical gynecologic conditions such as fibroids, ovarian cysts and bowel disorders all lend themselves to evaluation, particularly with physical exam and/or ultrasound and/or laparoscopy, etc. Similarly, vulvar disorders such as scar tissue following birth, STD’s, or a history of Genital Cutting (FGM) are important to consider. For example, Dr. Bowers is an internationally sought after expert on surgical reversal of FGM. If there is scar tissue in the area or if the clitoris is obscured following FGM, relief is available. We are here to help and welcome your questions. Let us work with you.