Tag Archives: low libido

Embrace Sexual Liberty This July After the Fireworks

We have just celebrated another July 4th which marks this country’s liberty from the restraints of despotism. When the fireworks went off we honored the declaration of independence that promised Americans “with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”  How do these rights influence your sexual life? Many in Washington seem to be challenging the meaning of these ideals in as far as sexual liberty goes, including the right for a woman to choose whether she has an abortion, the right for a transgender student to use a bathroom that aligns with their identity, and the question of whether a business owner’s claims of religious freedom override the discrimination wrought when they refuse to sell their products based on the customers’ sexual orientation.

In this July blog I wanted to focus on the theme of liberty as it relates to a couple’s sexual relationship because as an AASECT Certified Sex Therapist and Director of Center for Love and Sex, the majority of our clients come to us seeking help in identifying and/or expressing their unique erotic “pursuit of happiness”.  According to Merriam Webster’s definition, liberty is alternatively described as

 the quality or state of being free:

a :  the power to do as one pleases

b :  freedom from physical restraint

c :  freedom from arbitrary or despotic control

d :  the positive enjoyment of various social, political, or economic rights and privileges

e :  the power of choice

When a couple first meets and they seem to click or hit it off they may feel hopeful that they finally found the ‘one’ with whom they can be totally authentic; free of restraints, or arbitrary control, and fantasizing about how they will enjoy one another to the fullest including in their sexual connection. Perhaps after that first date where they make out or the morning after they lay next to one another in the nude, the endless imagined erotic freedoms seem to pop like Independence Day firecrackers during passionate daydreams.  couple in loveThe last definition of liberty, namely “the power of choice” is where I find many couples get stuck. What do I mean by this? Once the first couple of years have passed, many couples find that the original sexual fireworks have mellowed to the flickering of candles with an occasional pop of a sparkler or firecracker. At this point, many couples tell us that they have become so close to their partner they feel like they have literally become ‘family’, experiencing the other more like a sibling or best friend. What happened to that erotic thrill they felt when their partner was less known? Why has their erotic connection lost its sizzle?

Once partners become joined, very frequently they may unconsciously regard the other under the same category as a member of their family of origin. What can become triggered are the many restraints one felt growing up in their particular family including restrictions dictated by: religion, community, and their particular culture. Those rules, boundaries and traditions may cause them to erect walls inside their minds leaving them powerless to choose who they want to be in their sex life.

A client at CLS who was engaged to be married was working hard with her sex therapist to recover from the Genito-Pelvic Pain Penetrative Disorder so that she could honestly tell her priest that she would be ready to “perform her wifely duties” once they wed. This priest had not asked about what she looked forward to in her sex life, nor did he ask her fiancé if he was ready to give pleasure to his fiancée once they were wed. The Roman Catholic ideal of wife and husband having intercourse was focused more on procreation than bonding, pleasure and intimacy for both partners.couple marryied by Catholic priestWhen I use the phrase “who they want to be in their sex lives”, I mean what fantasy they want to enact, what sexual acts they may want to try with their partner(s), and/or what kind of erotic power exchange they may have dreamt of playing in the bedroom. Do they want to be consensually taken, ravaged, or overtaken by their lover? Are they hoping to play out a scene from a movie that turns them on? Do they want to dress in particular clothing that heightens their arousal?

Couples can become what David Schnarch in his respected book Passionate Marriage describes as “emotionally fused” when they fall for one another and the idea of a person making the choice to express a desire that might differ from a partner/spouse’s can lead to their partner expressing ridicule, disdain, disgust or abandonment because it is alien, kinky or frightening. The partner who is hearing the request or fantasy may not even have to say a word but the roll of the eye, or raising of an eye brow may be all it takes to indicate surprise scorn. Like a firecracker going off the partner quickly shuts down further requests of new or different sexual interests for fear of losing their partner, not to mention wanting to avoid feeling put down, rejected or just plain weird.

Recently when I asked a married het couple (I’ll call them Chloe and John to protect their identities) who were having trouble infusing their sex life with more passion and excitement, if they had seen, read or heard something recently that turned them on and kept it to themselves. The wife tentatively began telling me how she and her husband loved to watch Showtime’s series Billions together. Billions couple enact a BDSM sex sceneWhen the scene of the lawyer Chuck Rhoades (played by Paul Giamatti) is being tied up by his wife Wendy (Maggie Siff) she quietly said that she noticed some tingling in her genitals. Her husband looked at her in surprise in the session as if seeing a new woman emerging. I asked her what happened next with this awareness and she said: I was turned on by the sensation and the scene but didn’t think I could share this with John, he would think it was weird.

So what happened in your body after you edited yourself, I asked. She looked down and said, the sensation went away and we continued to watch the show. I reflected that she had chosen to let the feeling go because she didn’t feel permitted to include what she considered transgressive turn-ons with John. Then I checked in with him and wondered what was going on in his body and mind when he heard this sitting next to her and he said: I was getting a bit turned on hearing her describe the scene, and felt surprised that she didn’t share it with me since I never knew she was into that. In fact, I was turned on watching the scene myself at the time but chose to keep it to myself to protect Chloe from my dirty mind. Each of these partners has remained behind their wall of excitement and passion for fear of how their partner might judge them negatively.

I helped them to anchor their physical experiences so that they don’t run off into analytic explanations and remain true in the session that is free of judgment and shame, so that they stay present with their authentic selves in the presence of their partner who is equally as vulnerable. In various ways with clients, I ask them these questions:

What aspects of ourselves do we choose to keep hidden or private from our partner?

What could shift in an erotic partnership if we choose to become more vulnerable, playful and curious with ourselves and one another?

These are the questions that have been continually asked by artists, scientists and creative thinkers for generations. My colleague Esther Perel asks in her latest Podcast, Where Should We Begin?, how can you want what you already have? The teacher and writer Alton Wasson offers participants of his Contemplative Dance workshops the metaphor of moving and witnessing the mover as an experience akin to a “chest of drawers”. Similar to partnered sex in which one partner is engaged in and witnessing/experiencing a partner, the choice to open a drawer to experience an aspect of ourselves and our partners happens only when there is “freedom from arbitrary or despotic control” (Declaration of Independence), meaning free of limits set by an external power. In this case it could mean external societal values, misunderstandings/myths of meaning when it comes to one’s fantasies, or limits placed on gender roles.

Myths or misunderstandings about sex, fantasy and erotic desire begins with a child’s learning from their family, religion and schooling about sexuality. Unfortunately, due to limited subjects being allowed in schools due to Abstinence Only education in the US, and heteronormative focus of sex education,  people grow up with the kind of limited information that inhibits them around speaking of their sexual desires with a partner. lesbian couple expressing sexual passion  They may have learned about STIs (formerly known as STDs), or protection like condoms, oral contraceptives and the IUD (why oh why are doctors not telling folks about the female condom, stay tuned for an upcoming blog on this topic!). Many people also believe that their partners should be able to read their mind and automatically know what turns them on. I can say from my clinical experience that it is almost impossible for people to be mind readers and know exactly what turns their partners on sexually without active and open communication.

 According to relationship therapy research conducted over many years by John Gottman, open and continual communications are the building blocks of a satisfying relationship). There is often a misperception that too much communication and frankness about sexuality in a relationship may lead to the end of relationship; however, couples who are emotionally and verbally expressive (whether strongly or even in moderation) tend to have long and satisfying relationships. In other words, it is important that partners in a relationship be comfortable expressing themselves in constructive forms of communication. Since partners don’t get this training early on, nor is it modeled for them, they are lost in the woods and revert to silence and emotional shutdown on this critical aspect of their lives. After the early novelty wears off,  a couple need more nuanced language to describe what they desire. Couples come to us months and sometimes years into a relationship that has been reduced to a tapering spark. 

My mission in creating CLS and the Sex Esteem® model is to provide people the education, the confidence and the curiosity to become more aware of their erotic triggers, their sexual fantasies, and explore the play space of their sexuality with their consciously chosen partners.  My background in modern dance and improvisation taught me from a very young age that exploration is fun, that there are no wrong movements (as long as all around you are safe and consensually there) and that you can create

from nothing an experience that is new, unique and fortifying when you are fully free.

Being able to constructively communicate sexual desires to a partner/spouse is not only freeing and gratifying for oneself and one’s partner(s), but the freeing nature of co-creating an experience serves as a bridge to a more intimate, authentic relationship. The rocket needs to be ignited again and again by each person to produce a sustaining spark of passion. And as the Declaration of Independence states “we mutually pledge to each other our Lives, our Fortunes, and our sacred Honor.”

Be mindful of your erotic liberty and honor your intentional choices this July to enhance your sex life.

 

 

Sex Esteem® Holiday Tips for Feeling Sexy

Multi Generation Family Celebrating ThanksgivingThe holiday season is meant to be joyful and merry, but it often comes with a whole lot of stress and anxiety for Americans. I am lucky in that Thanksgiving is chosen holiday for me given that I was born in Canada and never celebrated any type of Thanksgiving until I moved to the U.S. So that history that others have with their childhood Thanksgivings and both the positive and the negative associations people have with them is not something I have. However, I am keenly aware how this holiday and the holiday season that follows next month stir up many people’s anxiety pot. Over the years I’ve helped clients in my private practice and coaching clients online to prepare before and process after the holiday. Holiday stress ends up affecting people in many ways, including their eating habits, how the food intake then affects their body image, and very frequently impacting their sex lives. Their Sex Esteem® can become impacted by the way they feel inside their body and how they focus on how they are perceived by others.

woman tired of diet restrictions deciding to eat healthy food or sweet cookies When it is time to reunite with family members, people often find themselves sinking back into the family patterns from childhood which may include misunderstanding, resentments and dysfunction they hoped would be left behind years ago. With family members reuniting, quizzing each other on their jobs, significant others, and recent accomplishments, it is far too easy to forget that this time of year is meant to be a time to rejoice and relax.

Eating disorders are more than twice as prevalent as they were 40 years ago, affecting up to 30 million Americans today (20 million women and 10 million men). When people are under stress from the marathon of holiday events they attend, they tend to miss out on much-needed sleep, which may lead to emotional eating. Depositphotos_1022974_s-2015With appetizers, dinners, desserts and wine as center pieces, it is easy to get sucked into a holiday “diet”, leaving you even more stressed and self conscious than before. It is far too common to then feel heavier and weighed down, especially as the temperatures sink outside.

Messages and pictures from the media often influence and perpetuate body dissatisfaction and self-criticism. Americans watch, on average, three hours of television each day with commercials and shows containing subconscious as well as conscious messages that to convey an ideal of beauty and virility Female characters on TV, commercials and in films are unrealistically thin, busty, and curved in the right places, failing to represent what women truly look like. Photographs of models’ and actresses’ bodies are edited to make their breasts look bigger, waists smaller, and skin more flawless. Research has found a link between exposure to the thin ideal and unrealistic body types in the media to body dissatisfaction and disordered eating among women. In other words, the more women are exposed to the unrealistic body and beauty expectations of women through TV, ads, and other media, the worse they feel about themselves and the more likely they are to have unhealthy eating habits. In the end, women are left feeling self conscious and unhappy with their bodies.

Woman looking at self in mirrorIn my practice, I have found that women who are self-conscious about their bodies are also unable to thoroughly enjoy sex with their partner, at times avoiding sexual encounters. The focus is taken away from feeling pleasure in their bodies as they ruminate over what they perceive as faults, or insufficiencies while in the act of sex. Research has shown that low body image and weight concern affect women’s sex drive. When women feel worse about their bodies, they are less sexually active and less able to become sexually aroused.

Cheering upIncreased drinking, combined with an inadequate amount of sleep, can all add up to feeling down, or a euphoric feeling that leads to eating more than one needs to be physically satiated. When one feels over-stuffed one has much less energy for sexual intimacy (which under good circumstances can feel pleasurable). I’m providing a warning to all you holiday revelers to resist the urge to alienate yourself from true holiday pleasure in your body, mind and heart which can result in feeling less sexual and most likely more isolated.

What can you do to feel healthier, sexier, and more active? Want to retain and build on the Sex Esteem® you have been growing through reading my blog? I urge you to be mindful of your relationship with stress and food at this time of year. It is important to be aware of your emotions and how you may be attempting to numb them by throwing a huge pile of stuffing and pumpkin pie on your plate. I invite you to think about your erotic self and how your inner mind wants to keep you feeling vital, passionate and connected. What are my holiday tips this year?

Depositphotos_56552229_s-2015Begin the day by doing some sort of movement to get you in touch with your body, whether it’s some simple stretches, a walk or run outside, or a trip to the gym or a yoga class if that’s your thing.
Cheerful multi generation family playing football in the park Perhaps organizing a family tag football game will give you some running, some playing and some fun time with the extended family or friends before sitting down to the meal.

If you are feeling stressed with particular people at the gather, like your Uncle Tim and Aunt Lisa, focus on others with whom you connect more; like 8 year old cousin Brittany who wants to play house with you. If the tension becomes high for you, excuse yourself to take a little break outside to get some fresh air and breath deeply for 5 minutes. If you are working on goals to eat more healthily fill a smaller plate and resist the urges (your own and others’) to take seconds or thirds to satisfy an emotional need. Instead enjoy the flavors of the food by eating more slowly and mindfully.

In my new webshow Sex Esteem® on Youtube I discuss the power our senses have in our ability to turn ourselves on. For some the smells of pumpkin pie become a trigger for sex while others seek out the texture and flavors of homemade creamed spinach, mashed sweet potatoes, and turkey with a bit of gravy on the side. Think about what aspects of the holiday contain erotic triggers for you. If you aren’t cooking and are trying to keep to a healthier regimen, volunteer to bring along some healthy side like sauteed green beans or roasted asparagus.

christmas dinner table
If you are in a relationship It is important to prepare for the holidays by telling your partner about what concerns you have about the relatives you’ll be visiting, the menu and your personal food and alcohol goals and ask him/her to support you during the celebration. Check in with him/her before the meal and throughout to be in connection with each other. Discuss how much alcohol you plan to drink and how comfortable you feel at the table. If you’re both on the same page, having a buddy sticking to a plan is a great way to enjoy eachother and the holiday even more.

Initiate hugs and touching with your beloved sporadically throughout the day so that you are giving and receiving support, love, and connection. By creating an intimate plan with your partner, you are making sure that you will look after each other and know what to expect throughout the day. BLD055516

Communicate ahead of time to find pockets of time you might have time (and privacy) for some sensual fun. It will keep one another grounded and connected in what may feel like a maelstrom of activity outside the bedroom. If you are single, try to sit next to the person with whom you feel closest. Be of service to those you love by helping out with the preparation of the food and or table. Giving hugs provides closeness to both those you hug and yourself.
Intimate lovers embrace

Do not rush, and take time to savor every positive moment. The holidays are a time to reflect on your company, health, and positive relationships. Remind yourself what you are grateful for and what you love about yourself. Take a deep breathe and appreciate all that you have around you. Avoid overstressing and try to check back into what makes you happy. Remember that your emotional and sensual peace is much more significant than the size of your waist.

Addyi Passed by FDA; Will it Help Low Libido?

This past August, the Food and Drug Administration (FDA) approved the first prescription drug designed to increase women’s sexual drive. Addyi (rhymes with Daddy, don’t ask me how they come up with these names), developed by Sprout Pharmaceuticals, has been dubbed the “Female Viagra.” However, unlike Viagra used primarily by men to help them with their erections and other PDE5 inhibitors which allow more blood flow to a penis, this medication works on the brain. Another important difference is that Viagra (and the medications for a man’s Erectile Dysfunction) is taken as needed and works pretty rapidly whereas Addyi is taken every day, much like an anti-depressant and one may not see improvement until 4 weeks have passed.

Addyi is being hailed as the first of its kind to treat the root of the issue formerly known as Hypo Sexual Desire Disorder (or HSDD), now called Female Sexual Interest/Arousal Disorder (FSIAD) in the new DSM 5 (Diagnostic and Statistical Manual)
in pre-menopausal women. The new DSM 5 merged the experience of not feeling frisky or interested with the experience of not being able to get physically aroused.
sad_woman_420jpg-420x0
HSDD is characterized by low sexual desire that causes marked distress or interpersonal difficulty and is not due to a co-existing medical or psychiatric condition, problems within the relationship, or the effects of a medication or other drug substance. HSDD is acquired when it develops in a patient who previously had no problems with sexual desire. HSDD is generalized when it occurs regardless of the type of sexual activity, the situation or the sexual partner. (www.fda.gov)

Originally developed as an antidepressant, Addyi works on the neurotransmitters in the brain to increase desire. While it is without question that the FDA and pharmaceutical companies often discriminate towards women in drug development and manufacturing, before women across the United States can truly claim victory, there remain strong concerns that this miracle pill (dubbed the little pink pill as a marketing ploy to resonate with the little blue pill that is Viagra) might actually bring more harm than good.
pinkpill One of the biggest concerns surrounding Addyi is whether the drug actually does what it claims. Approval for Addyi (when it was called Flibanserin) was actually previously rejected by the FDA twice – in 2010 and 2013 – for many reasons, including lack of effectiveness.

Even in the most recent studies, women taking Addyi only saw just one more sexually satisfying event (SSE) per month than those participants just taking the placebo. What my clients come in discussing is the loss of their intrinsic desire (or what some would call horniness, a physical tingling that alert them to their desire, an erotic fantasy or awareness that one is turned on) versus receptive desire (prompted by flirting, a fun date, or an intimate connection for example). Some in my field are not clear whether the Addyi study really were able to tell the difference in these types of issues by looking mainly at SSEs.

Moreover, many women do not realize the power their erotic mind has in boosting their drive and they do not understand that intrinsic physiologic triggers wear off naturally over time – which is why many in my field are asking whether we know enough about women’s desire to a) called it a medical pathology in the first place and b) offer them a medication versus educating women on other ways to increase their desire through other means? Considering that there was a high placebo effect in the study confirms my belief that some women need more education on how to enhance their erotic triggers besides intrinsic biological triggers.

In addition to the minimal evidence that the medication provides any substantial benefit to a woman’s sexual desire, I also share others concerns surrounding the side effects of this medication. As I mentioned above, the FDA previously rejected Addyi and another reason for those rejections were due to the high risk of side effects. First, there are the common side effects which including fainting, drowsiness, nausea, dizziness, and low blood pressure. While these are common for many other medications, women taking Addyi are also heavily counselled to abstain entirely from alcohol while on this medication because of the increased risk of severe hypotension and syncope due to the interaction between Addyi and alcohol.

The FDA felt so strongly about these side effects that each Addyi box will contain strong labeling highlighting these risks. Moreover, any doctor wishing to prescribe Addyi and any pharmacist that sells this medication must complete an online training course. It seems unrealistic to ask women – who may use alcohol as a means to relax prior to a sexual encounter – to abstain from alcohol and experience strong side effects from a pill that might only minimally increase their sexual arousal.

Finally, it also remains unclear that insurance companies will even cover Addyi. Some argue it would be equivalent to a monthly dose of traditional Viagra which is approximately $400, not an affordable medication for most folks. This means that even for a patient who does experience increased libido with no side effects, cost might continue to be a barrier. But pharmaceuticals are big business and when Sprout Pharmaceuticals was acquired by Valeant for $1 billion dollars, it was clear they were investing for a huge long-term gain on investment. You have probably heard about Valeant as recently as this past week, since it has reportedly raised the price on its brand name medications an average of 66% this past year.

While I am hopeful now that the FDA are taking women’s medical issues more seriously, and that they are interested in helping women who indeed have HSDD, I think we have to help women strengthen their Sex Esteem® by
a) figuring out if their low desire fits the criteria for the diagnosis of FSIAD
b) continuing to educate women on the many-layered causes for lower desire over long-term relationships
c) help them make an educated decision whether they need a medication.
d) ensure that they aren’t going to use alcohol when on the medication.