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What Gets Talked About In Sex Therapy?

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We Have Mis-Matched Sexual Desires

The most commonly reported problem in sex therapy is called ‘desire discrepancy’: one partner wants sex more often than the other and in a more erotic way. In the beginning of a relationship, the higher desire partner probably kept the erotic energy going in the marriage and it was fun and sexy. After a while, if you’re the lower sex-drive partner, it can feel annoying and even manipulative to have a partner who is constantly looking for sex when you aren’t.  Sometimes it’s just because the sex isn’t that great; working on discovering the kind of sex both partners want can improve the performance and eroticism of their sex life. Or it could be that there’s tension and frustration in the relationship and it’s leaking over into the erotic part of the relationship. If that’s the case, it’s a hard climb over that kind of resentment in bed. But talking about what’s bothering you can actually bring you closer and make you more inclined to want to make love.

I Can’t Orgasm The “REAL WAY”

Women sometimes tell me they wish they could climax the ‘real’ way — through intercourse. The clitoris, however, not the vagina is the centre of sexual and pleasure nerve endings. In fact, only about 15-20 percent of all women can climax during sexual intercourse and even then they require lots of vibration, manual or oral stimulation to get them close. For those who still want to try likely positions, I recommend two with good G-spot-penile contact: Either woman-on-top at a 45 degree angle or woman-lying-on-her back on a relatively firm surface with her hips rocked up (for instance, with her knees hooked around his elbows).

Performance Issues

When a man is in a relationship, the most common performance problems are premature ejaculation (PE) and erectile dysfunction (ED). In both instances,​ ​the men end up with strong​performance anxiety which can cause them to avoid sex and intimacy. Women whose partners are dealing with ED may feel insecure that their partners are no longer attracted to or desirous of them.  To move beyond performance anxiety, men need to focus on their own bodies and pleasure and worry a little less about their partners. Learning to focus on pleasure, relaxing your body and your breath and letting yourself enjoy the experience help tremendously. If you are his partner, it’s essential not to take it personally and to be gentle with him. Supportive partners who do not require that their partners function perfectly all the time have the best chance of resolving these issues.

I Want To Spice Up Our Sex Life But My Partner Isn’t Interested

People frequently tell me they want more variety in the bedroom. As time goes on, partners may express more desire for novelty or feel more comfortable letting their partner know they have certain activities they want to explore. While one partner might enjoy getting a few slaps on the behind or experimenting with anal play, the other may not want to try. A sex therapist’s responsibility is to assess and possibly promote openness to change and reveal the underlying tensions that the couple may not be discussing initially.

Before Baby Sex

Couples seek sex therapy soon after having babies, sometimes because the woman feels too loose and says she can’t feel him inside her.  Kegel exercises with twenty reps three times a day can improve the muscles in the pelvic floor. If she wants quicker results, there are medical devices such as the Apex which inflates to fit and does your Kegel exercises for you through gentle electric stimulation. Of course there is more to satisfying sex than just intercourse, such as mutual masturbation, oral sex and incorporating sex toys into their sexual pleasure

I Have A Lower Sex Drive Than My Wife

I frequently see couples where the man is confused about why he doesn’t want to have sex and the woman is the frustrated one. Without a clear answer, I end up asking a ton of questions trying to decipher why. If it’s because he feels too dependent or too close to his partner, distancing is the goal.  Most commonly, men complain to me about not getting the loving contact they want. He may feel she goes through the motions, treats sex like a chore, or just lies there when he wants more love, contact, emotion and presence. Women sometimes make the mistake of thinking their partners are just trying to satisfy a biological need and treat sex in a perfunctory manner, to ‘please’ the guy. But this shuts men down; they want more passion than that. I remind couples that passion requires engagement, expression, eye contact and trying to really feel. It’s more than touch.

I Have A Lower Sex Drive Than My Husband

Many women tell us that they either have never felt much desire or their desire has dropped considerably over the course of their life or relationship. There can be many underlying reasons why women are experiencing low desire. They might have had a lot of negative learning in their lives telling them that they were not supposed to want sex, they might not have been able to express their main fantasies or changing sexual desires to their partner or they might be feeling emotionally disconnected. This problem can often lead to sexless marriages or relationships. In the case of low desire, women need to get back in touch with their bodies and learn to ask for what they want. It can take time to address and requires patience, understanding and a willingness to learn on the part of their partner

My Partner Is Ill But We Want To Maintain Our Physical Connection

Couples often need help when one of them gets sick. For instance, a cancer patient might feel too broken or undesirable for sex, while their partner feels helpless. I encourage them to do different kinds of touching such as cuddling, massaging with feather light strokes, kissing and even just holding hands regularly. Bathing together can also be a healing experience that helps reduce strain on joints, relax muscles and increase blood flow. For something more sexual, if the person is sick feels self-conscious or insecure, I recommend he or she blindfold their partner and make love to them so they feel less self-conscious.

Stuck In A Sexless Relationship

Oftentimes a low sex or no sex marriage happens when a couple finds themselves in a rut of distraction or avoidance. They are distracted by work, by young kids or the business of everyday life. Whoever was the traditional initiator of sex stops initiating. The non-initiating partner waits, hoping things will get back to ‘normal.’  To get out of a low sex or no sex rut, talk to your partner. Throw out some ideas that you are wondering’ about — for instance, ‘I am wondering if we are both so tired at night that we should try for morning sex?’ Keeping your statements vague and phrasing them as ‘wonderings’ takes the pressure off and makes whatever sexual issue you’re avoiding easier to talk about. The truth is, it’s not your fault or theirs. Your sex life belongs to both of you.

 

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Courtesy of some great USA sex therapists.

Gone were the days of emotional restraint.

Women do want sex

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Women want sex for the sake of sex just as much as men, it’s just that they mostly don’t allow themselves to admit it. When they do, both men and women will be able to be more honest with one another and enjoy sex more!

Women are naturally sexual beings.

Allowing women to give themselves permission to be the fully sexual beings that they naturally are is a large part of the work as a sex therapist that I do.

It arises from the suppressed  nature of our male dominated society and it is one of the most important pieces of work a sex therapist can do with someone who has sexual issues.

In subtle and not so subtle ways our culture still tells us repeatedly  that women are allowed to be “sexy” – that is that they are permitted to evoke sexual desire (usually by looking a certain way which conforms with our society’s idea of idealised youth-centric beauty).

Meanwhile, men are given permission to be “sexual” – that is to act out their sexual impulses and to express them. This is seen so clearly not only in pornography but in the media imagery around women and their bodies.

Women’s internalised beliefs about sex

The sad thing is that men have done such a great job of suppressing female sexuality that most women have internalised the belief themselves. What, you may cry, not I! But ask yourself, do you really allow yourself to access your full desires? Do you dare to admit to yourself what you truly long for?

This denial of female sexuality means that both men and women suffer. When a woman disowns her sexuality it is all too common to project that out onto others. Sexually active women become sluts and men become “only interested in one thing” or labelled as lewd, base, sex obsessed perverts or, at worst, potential abusers.

Giving yourself permission to enjoy sex

One of the reasons for the success of 50 Shades is, I suspect, that it gives women permission to get in touch with some of those long suppressed desires. It is only a relatively recent myth that men want sex more than women. Until 200 years ago, it was believed that women needed to orgasm in order to get pregnant. Sadly modern science in the 19th century disapproved that wonderful idea and with it the importance of female sexual pleasure declined and women’s pleasure assumed a less important role.

My experience is that when a woman truly gets in touch with her desire, it is stronger than in most men. As a man, unless you’re trained in Taoist or tantric practices of retaining your ejaculation (or you’re 20 years old) once guys have ejaculated that’s usually them done for a bit. Women on the other hand, have the potential to have as many orgasms as they can handle.

This high libido caused men to fear the infidelity of their women and hence encourage the suppression of female sexuality. Most women have bought into this by believing that suppressing their desires to fit in a monogamous relationship is a fair trade for the supposed security it offers. Yet studies show that the numbers of women cheating in relationships is roughly the same as men.
The idea that women want emotional connection and men want physical sex is also a myth.

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Female viagra

5 reasons why ‘Female Viagra’ (Flibanserin) is NOT good news for women.

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An excellent expose of the power of lobbying by the pharmaceutical companies to push the so called “Female Viagra”.

The Side Effects of “Female Viagra”:

One in five women in clinical trials experienced central nervous system depression (sedation, fatigue, “sudden unconsciousness”, and extreme sleepiness) equivalent to drinking four alcoholic drinks.

Accidental injuries associated with central nervous system depression occurred more than twice as often in flibanserin-treated women as in the placebo group and 16% suffered from symptomatic low blood pressure.

In addition, flibanserin interactions with drugs commonly used by perimenopausal women, like birth-control pills and anti-fungals, lead to even higher rates of sudden unconsciousness, low blood pressure and dizziness.

 It Doesn’t Work:

It has not demonstrated an increase in sexual desire in any of the research studies. In the 2012 Daisy Study, over 1,000 pre-menopausal women were asked to record their libido levels in an eDiary.  No group showed a significant increase in eDiary desire score vs. the placebo group.

What they did report was a lessening of distress with their low libido. They were asked to rate their sexual encounters as satisfying or not. This drug was passed because women reported 1 more satisfying sexual encounter per month than they had experienced before.

Please consider that before the study they didn’t have any hope of having libido. With the study they were willing to have sex as a homework assignment…boom…libido barrier overcome and now they are having sex and grading the encounters.

This didn’t actually help their libido (as the study points out), it gave them homework… “have sex and tell us how it was for you”.

That in and of itself is one of the most powerful cures for low libido there is…be willing to experience desire after you start getting aroused. No side effects with that intervention and do you recognize the power of the placebo effect here?

It’s Dangerous:

ALL of the studies done on this drug have been paid for by Sprout Pharmaceuticals. Even then, the risks outweighed the benefits.

Taking the recommended dose of 100 mg every night is like drinking 4 alcoholic drinks. When combined with alcohol, oral contraceptive pills, anti-fungal medications, anti-hypertensive medications, and many other medications, this liver effect is potentiated by 7 times.

If Viagra was contra-indicated with alcohol, as Flibanserin is, I question if the uptake would have been so exceptional. (Christina’s insert)

It Does Not Address The Root Cause of Low Libido:

In the HURT Study (Healing Un-Resolved Trauma), 5 root causes were found to be the foundation of low libido in women (Ewers, K. (2014). An integrative medicine approach to the treatment of HSDD: introducing the HURT Model. Sexual and Relationship Therapy, Vol. 29 (1),42-55).

The 5 root causes are physical, emotional, mental, and spiritual—or found in her Libido Story® somewhere in her Libido Map®. For most women, there is a combination of root causes that creates the low libido she experiences.

Believing that a one size fits all pill will permanently alleviate such a complex issue is short sighted and potentially very dangerous.

It Masks The Real Problems

Offering a pill to women for low libido is really focusing on the wrong issue. Are all women engaging sexually for the same reasons? Is their desire limited to only sex? Is passion contained only in the sexual act? I have never met a woman in my clinical practice that would say yes to these questions.

The placebo effect is powerful. If women get a prescription from their medical providers for Flibanserin and rush home thinking that all of their desire and passion issues will be fixed, they will be sorely disappointed.

Self-awareness, self-confrontation, good (if not great) communication, healthy boundaries, proper self-care practices…these are all of the important ingredients for intimacy a one size fits all magic pill theory ignores.

 

And finally one more reason.

This marketing campaign that has been undertaken to target women who are suffering from a very real issue is insulting to women’s intelligence. It’s being marketed as “the pink Viagra”. Viagra is used for male erectile dysfunction, not male libido issues. Erections are about a physiological issue involving the penis. This is interesting to me that a company that sells a medication for female sexual desire would actually be that illogical in their marketing strategy. But the frightening aspect to all of this is that no one is pointing this out from the consumer side of things.

Yes, Viagra works to make a penis erect. The logic is that by pairing the word Viagra, which consumers have an immediate and fairly positive association with, with a drug that has nothing to do with penile erections and is unsafe, it will make female consumers feel safe and even hopeful that they now have their version of Viagra.

No! Stop the train! This is not the same issue. Please do not associate Flibanserin with Viagra. They don’t do the same thing, they are not meant to do the same thing, and they should not be put in the same marketing slogan.

 

Dr. Keesha Ewers, Chief Medical Officer

The Functional Sexology Institute

425-999-4185

http://www.functionalsexology.com

 If you suffer from low libido and would like to discuss with a sex therapist please phone Christina for a

free 10 min consultation on 0435 438 899