Feeds:
Posts
Comments

Posts Tagged ‘sexual intimacy’

Let’s first acknowledge that women—and men, too—come to sex with a host of different backgrounds, value sets, cultural expectations, emotional foundations, and experiences. It’s very difficult, given that variety, to assert that anything is or should be true for every woman.

It is theoretically possible to have a strong physical attraction and enjoy sex with little emotional intimacy involved—whether we are men or women. There are differences between us, though: Research suggests that for women there are six neurotransmitters involved in sexual activity, and that the areas that “light up” in our brains with sex are completely different from men’s responses. Women release oxytocin with sex, a very strong bonding hormone; men don’t.

Cultural stereotypes may exaggerate the differences between men and women when it comes to sex, but the science is there to prove there are differences.

Among the women in my practice and in the rest of life, I observe that women often go into sexual experiences with an expected outcome that includes some emotional connection. Most of the women I see desire emotional intimacy as a cornerstone for their enjoyment of physical intimacy. And the study I recall that went the furthest in qualifying sexual enjoyment (“A Portrait of Great Sex“) implied emotional intimacy as intertwined with physical intimacy.

All of that said, I come back to the fact that women come to sex with enormous variety of experience and expectation. As long as she is caring for her own emotional and physical safety and health, each woman can choose, I hope, the right combination of emotional and physical intimacy.

Read Full Post »

That sounds like a bad riddle, right? Like one I heard on NPR last week: What goes up a hill and down a hill but doesn’t move? The answer to that one is a road. And the answer to what subtracts more than it adds is sex.

Here’s the disturbing—but not, when I think about it, surprising—statistic I ran across this week, courtesy of colleague Sheryl A. Kingsberg, a PhD and chief of the Division of Behavioral Medicine at the University Hospitals Case Medical Center: “When sex is good, it adds 15 to 20 percent additional value to a relationship. When sex is bad or nonexistent, it plays in inordinately powerful role draining the relationship of positive value—about 50 to 70 percent!”

I was so struck by that statistical picture, I’m on the trail of the original research to understand more. But in the meantime, what I know from other studies—and my own experience and conversations with women—suggests that’s about right.

Let me first say that good sex doesn’t automatically make a relationship good. And a good, loving relationship doesn’t automatically mean that the sex will be good. But if I think back to a study done a couple of years ago, “The Components of Optimal Sexuality,” I’m reminded of how many of the characteristics of good sex are also characteristics of good relationships.

I won’t revisit the whole list, because you can read the series of detailed blog posts we did on each of the components. But here are just a few that come to mind in this context:

  • Being present. It’s so easy to take our partners (and, of course, others in our lives) for granted. Truly paying attention to one another—today—is a great gift.
  • Connection. When we feel connected to our partners, intimacy comes naturally (especially when we’re overcoming obstacles together). If you’re feeling “together but alone,” there are steps you can take.
  • Authenticity. At this point in our lives, I find that many of us are more willing than ever to own what we think and feel. Whether we’re in longstanding or new relationships, this helps us to be ourselves—and to be open about what we like and need, in the bedroom and the rest of life.
  • Vulnerability. Having sex is perhaps the ultimate act of making yourselves vulnerable to each other. What a reinforcement of the bond that a couple has with each other!

If those parts of your relationship are important to you, too, you’ve got more reason to understand how to stay healthy and be intentional about nurturing this part of your life.

Read Full Post »

A couple of weeks ago, I talked about an article I’d seen about how sexual intimacy is linked to marital happiness. The research, by Adena M. Galinsky and Linda J. Waite, found that continued healthy sex-lives help couples dealing with physical illness, especially chronic health problems.

Couples who had sex frequently (and sex was defined broadly—it didn’t need to include vaginal intercourse) were more likely to say they had a good relationship.

This is, of course, a chicken and egg: More sex doesn’t automatically make a relationship good. It’s more likely—and perfectly reasonable—that an unsatisfying relationship will include less sex. And the women I meet through my practice as well as the rest of life show me that this is often a time when our relationships get some re-evaluation.

Sometimes it’s the empty nest, and the change in schedules and priorities that comes with it. Sometimes it’s retirement, for one or both partners, which means a lot more together time. Sometimes it’s the stress of caring for aging parents along with everything else. Whatever the prompt, when some of us look at our relationships, we say, “Is this really what I want?”

So it was interesting to me to read the details of the Galinsky Waite study, to see how they measured the quality of relationships. These are the questions they asked:

  • How close do you feel your relationship with your partner is?
  • How often can you open up with your partner if you want to talk about worries?
  • How often can you rely on your partner for help with a problem?
  • How often does your partner make too many demands?
  • How often does your partner criticize you?
  • How happy is your relationship with your partner?
  • Do you like to spend your free time together, separately, or some of both?
  • How emotionally satisfying is your relationship?
  • How often does your partner get on your nerves?

If you’re feeling some vague discontent, those questions might help you with a conversation with your partner—or with a couples therapist if you decide some outside perspective and coaching would be helpful. If you’re feeling angry, or resentful, or isolated in your relationship, it’s no surprise that you’re not feeling sexy.

And you deserve to.

Read Full Post »

The loss of estrogen that comes with menopause results in thinning of urogenital tissues, which include the vagina, vulva, and urethra. Because those tissues are thinner, they can be more fragile and susceptible to “trauma.” We don’t think of sex as “traumatic,” but the activity can cause minor tissue damage.

Sex can also introduce bacteria to the bladder via the urethra, which can lead to bladder infections. And either an infection or the inflammation of damaged tissue can lead to the symptom of urinary urgency.

Using a lubricant during intimacy will minimize the “trauma” to tissues. Emptying the bladder soon after sex may flush out bacteria before they can proliferate and become an infection. (Women with frequent urinary tract infections linked to sex sometimes find it helpful to take a dose of oral antibiotic with sexual activity.) And a therapy like localized estrogen or Osphena may help by restoring proper pH and increasing cell layers.

Read Full Post »

There are many benefits to being sexually active: It releases estrogen and increases oxytocin, serotonin, endorphins, and immunoglobulin A. This chemical and hormonal stew makes us both feel and be healthier. Having sex makes us feel powerful, giving, and connected, all of which feed our relationships with our partners.

I came across a recent study that affirms another benefit I often talk to women about: Sex is good exercise.

The study was conducted by Antony D. Karelis, who teaches exercise science at the University of Quebec at Montreal. Participants in the study wore armbands while having sex, and also jogged on treadmills to produce comparative data. The results? On the “metabolic equivalent of task” scale, on which sitting still ranks a 1-MET, sex ranked 6-MET for men and 5.6-MET for women. That puts it, according to Gretchen Reynolds, author of “Sex as Exercise: What are the Benefits?” as roughly equivalent to playing doubles tennis or walking uphill. To do your own comparisons, it’s categorized as “moderate exercise.”

Good to know, right? And I think we midlife women can use this knowledge to our advantage. Part of my counsel to women experiencing diminishing libido is to be intentional about remaining sexually active. There are two parts to my rationale: First, as our hormones diminish, we’ve got that “use it or lose it” thing going on that I’ve talked about before. Second, having sex begets having sex. That is, we women will want to have sex more often when we—wait for it—have sex.

There’s a line from the study conclusions that made me smile: “Both men and women reported that sexual activity was… highly enjoyable and more appreciated than the 30-minute exercise session on the treadmill.” I’m so glad to hear that!

So I start to wonder: How can we apply to our sex lives the same thinking that gets us religiously to yoga or Pilates several times a week? Neither we nor our partners want us to be thinking about sex as one more chore on the to-do list or an obligation on our calendars. But can we consider it a gift to ourselves and our health, as we do our morning walk or Zumba class? Will that give us the extra incentive to make the time and the commitment?

I’m hoping so.

Read Full Post »

You say that you’re both excited and anxious about being with your partner, but that you’re tense with him and haven’t experienced this before. Let me first say that there’s no magic pill that will solve this problem.

For women, sharing sexual intimacy requires the ultimate in trusting, giving, and sharing. This emotional component is just one part of a complex whole for women, but it’s the place I’d start. I’m curious about whether you’re tense with this partner in situations outside the bedroom, and whether you’ve been able to express your concern. It would be helpful it it’s a problem you’re looking to solve together rather than a “performance anxiety” issue for you alone. Being anxious about being able to experience orgasm only makes it more difficult!

You might consider seeing a therapist with a focus in sexuality to be sure that you’re clear on the emotions and feelings you’re experiencing.

If there is no emotional barrier to address, I’ve recommended Viagra or a very low dose of testosterone for women who have lost orgasm or intensity; both of these drugs are prescribed “off label,” which means they’re FDA-approved for another use.

I wonder whether you’re able to experience orgasm with self-stimulation; if you haven’t tried, I encourage you to. A vibrator used either alone or with your partner may provide the increased sensation you need. And if you’re able to orgasm alone, you may learn some things about your response that you could share with your partner.

Sex is often complicated, with multiple interdependent components; it doesn’t help that our bodies change as we gain years! Please do look to a therapist for any emotional considerations; if physical considerations remain, a health care provider knowledgeable about menopause can help you evaluate options. Most women in my practice are able to reclaim this part of their pleasure!

Read Full Post »

Few things affect quality of life like lack of sleep. Nothing kills the jazz or even dulls the everyday ho-hum routine like that head-in-a-fog, feet-in-the-mud feeling of too little sleep.

And sex? Romance? That delicate dance we do to stay connected with our life partner? Fuggedaboudit. We’re having enough trouble keeping our heads up and off the desk at work. All we want is a good night’s sleep, and that’s the very thing that’s as elusive as a four-leaf clover in an alfalfa field.

If you haven’t discovered already, insomnia is the dark shadow of the menopausal years. (And insomnia can begin years before other menopausal symptoms and can last long after other symptoms subside.) In fact, almost half of women age 40-64 report having sleep problems, according to a 2007 National Sleep Foundation survey. Compared to premenopausal women, those in peri-and post-menopause report sleeping less, sleeping badly, and are twice as likely to use prescription sleep aids.

Yuck. That’s a lot of cranky, sleep-deprived women.

As you might expect, menopausal insomnia can be caused by a lot of things—hormonal changes, for one.  “With impending menopause, most women experience a reduction in progesterone and estrogen,” says David Slamowitz, MD, medical director of the SleepWell Center in Denver, in this article for More magazine. “These hormones help regulate sleep, so declining levels can cause sleeping difficulties.”

Better sleep may be another reason to consider hormone therapy.

But these years are often associated with change in our careers, health, children, parents, and partners. Change is stressful, and stress is the archenemy of sleep. If you’re anxious about your health (or your parents’ or your partner’s), if your children are adjusting to adult life, if you’re having difficulty covering the demands of your job, it’s hard (or impossible) to drop these worries at the bedroom door.

Other causes of sleeplessness can be the physical insults of getting older—arthritis, frequent nighttime urination, sleep apnea, restless leg syndrome. Not to mention the misery of hot flashes and night sweats, which can awaken us several times a night. The only mercy here is that if we can make it to blessedly sound REM sleep, hot flashes tend to lose their power to wake us up.

So, what is a foggy-brained, sleep-deprived, menopausal woman to do?

Well, first, if you snore, feel depressed, or find insomnia to be seriously affecting your ability to function, talk to your doctor. You may need to tease out how other factors may be influencing your sleep. Review the medications you’re taking, which can also interfere with sleep (and sex). Ask him or her to check your thyroid for an endocrine disorder that can disturb sleep.

But you have some control over your sleep (or lack thereof) as well. You can be proactive about getting a good night’s sleep. Plus, good sleep hygiene often ends up being good for your overall health as well. (You knew we were going there.)

Here’s a regimen that may have you sleeping, if not like a baby, perhaps almost like a normal human being.

  • Exercise. Vigorously in the morning with maybe a bit of gentle yoga in the evening. Here’s a nice yoga stretching routine that I use frequently.
  • Get outside when you exercise. Natural light helps establish a good sleep-wake cycle, and we tend to become more housebound as we age.
  • Don’t nap. Yeah, this can be tough when you haven’t slept at night, but we’re moving toward establishing a rhythm here.
  • No stimulants. Obviously, a double latte at 8 p.m. will keep you jittery into the wee hours, but avoid caffeine in any form, including chocolate. Ditto for nicotine and alcohol. Contrary to common (mis)perception, alcohol will relax you at first and wake you up later when your body begins to metabolize it.
  • Don’t eat heavily before bedtime.
  • Establish a soothing bedtime routine that sends “now we’re getting ready to sleep” signals to your brain. And do it at the same time every evening. (That rhythm thing again.) Drink an herbal tea. Read a book. Do your yoga. Don’t watch TV or do computer work if it winds you up. Don’t engage in stressful conversation in the evening.
  • Make the bedroom pleasant and sleep-inducing. It should be dark and cool but not cold. The bed should be comfortable and you should use it only for sleep—and sex. Oh yeah, remember that?

With any luck, you’ll gradually move beyond this tough transition and slowly reestablish more normal sleep patterns as your hormones settle down. But as with many issues during menopause, we may need to adjust to a new normal as well. Some women say they’ve been able to make their peace with and adapt to different sleep patterns.

And whether we’re talking about sex or sleep, adaptation is what it’s all about right now.

Read Full Post »

Ringing the Love Button

Maybe you gathered from last week’s post that the clitoris is command central of the female orgasm. Perched atop the labia minora, its sole purpose and function is sexual pleasure. It has more nerve endings than the penis, and—although affected by conditions that reduce blood supply—it can retain sensitivity as you age.

Most of the clitoris is out of sight, extending deep within and around your vagina and labia. “The most recent anatomical research suggests that the clitoris is perhaps better described as the ‘clitoral complex,’ where the vagina, urethra, and clitoris all function as a unit rather than as individual parts,” says Dr. Debby Herbenick, in this article for Men’s Health.

Unlike the penis, the clitoris can orgasm repeatedly without a refactory (rest) period. Clitoral orgasms also last from between 10 to 30 seconds and involve from 3 to 15 contractions, which can reach from the abdomen to the vagina.

So, rather than creating artificial divisions and hierarchies between whether an orgasm is vaginal or clitoral, why not view the whole area as one big erogenous zone? Clitoral orgasms involve the vagina and vice versa, so neither is “better” or more desirable. Every orgasm is right on the money. Use what works, rather than focusing on the vagina, which as you know, can get a little cranky right about now.

And if you can coach your partner on some clitoral finesse, lovemaking could take on a whole new dimension.

Let’s return to the fact that the clitoris, as we mentioned before, is “homologous” to a penis—it has the same biological features. Thus, it has to be treated gently. Too much or too rough and it’ll either hurt or go numb. So start slow and gentle.

To begin, use lube on your fingers. (Your partner’s tongue is great.) Start a vibrator on low. The glans (head) is usually too sensitive to touch directly, so stroke the hood over the top of the glans, stroke around the labia minora and the vaginal vestibule. Stroke inner thighs, breasts, nipples. Use round and round and over the top motion on the clitoris.

For the partner: Tongue action on and around the clitoris is very erotic. Done well, it can make her “come” all by itself. Don’t jump into action. Get things warmed up with your best foreplay action.

Then, with lubed fingers begin a gentle, playful massage downtown—gently stroke her inner labia, across, over and around her clitoris. As your partner becomes aroused, slide between her legs and begin using your tongue, licking firmly up the tiny shaft of the clitoris, using separate strokes at first. Vary the action with quick darting motions on the exposed glans or by flicking her clitoris with your tongue. Begin using a firmer, continual stroke without breaking contact until she begins to orgasm.

You can then quickly move to penis-in-vagina action until you orgasm, or you can cup her “mound” with the palm of your hand, applying gentle pressure to her clitoris, which feels very comforting.

You don’t have to go crazy with the tongue action (how exhausting that would be!). Set the scene well with foreplay; keep the action gentle and varied, increasing both the frequency and firmness as she becomes aroused. Some handwork on her breast and nipples helps. And remember, practice makes perfect!

Good positions to increase clitoral contact during sex include the faithful missionary but with the partner pressing down to engage the clit. Either partner can reach the clitoris if she’s on top or in the rear entry position. “There’s no need to be overly fancy during sex—the very best positions are the ones that focus on the clitoris,” says author and sexologist Dr. Logan Levkoff.

Finally, the clitoris needs good blood flow to be its best orgasmic self—and orgasms boost the immune system, support a healthy sleep cycle, and help keep your hormones balanced. You can keep clitoral blood flow through:

  • Exercise. “Twenty minutes of moderate exercise increases a woman’s genital engorgement by 168 percent—and the effect persists for hours,” writes Weed. Go for a walk with your partner, she suggests.
  • Sex and masturbation. It’s the whole “use it or lose it” dichotomy. You have to keep the tissues plumped and primed or they atrophy, especially as you age.
  • Clitoral pump. That’s the whole purpose of this handy device—bringing blood and, ergo, sensation and function, to the clitoris. In no way should a pump replace the first two parts.

Clitoral stimulation techniques of your own? Please share.

Read Full Post »

I had never thought of bringing together these two very personal and powerful actions until I read this post by psychotherapist and MiddlesexMD advisor Mary Jo Rapini. She writes, “One method not as well studied but also valid in bringing a couple closer together and improving sex lives is prayer.”

Well, that got my attention! Prayer, however you express it, has always seemed like something you do alone and in private, although we pray with others in certain contexts, such as liturgies and church rituals.

Sex, on the other hand, is an intimate and private act between two people, who may sometimes struggle with the vulnerability such intimacy demands.

But bringing the two together? Doesn’t that seem, um, odd if not downright sacrilegious? After all, one is sacred and one is, um, fairly creaturely.

Actually, prayer and sex are the most natural intertwining of intimate acts in the world.

If you believe in any sort of Higher Power, bringing that Being consciously (through prayer) into your sex life could open a new level of intimacy between you and your partner. It could also sweep away those musty, Victorian notions that sex is somehow “of the flesh” and therefore opposed to things of the spirit. Which may be where that stubborn scent of guilt that clings to sex originates.

Nothing could be further from the truth. There is no such dichotomy, even though we tend to create one. Male and female become “one flesh”—that’s how we were made, to be sexed creatures. We were made this way by the God whom we would prefer to exclude from the bedroom.

“See, sex in not an afterthought, a way to make more babies. Rather, it is an indispensable quality woven in the fabric of each life on this planet. Sex is not first something we do; it is primarily who we are,” writes Dan Hayes in this post about sex and prayer.

Why not invite God in? Consciously. By praying together. You don’t even have to belong to the same religion—you just have to believe. (God is there anyway; it’s just helpful for us to acknowledge it.)

Sex is a sacred act. That concept is the foundation of many Eastern practices, such as the Tantra. Sex is sacramental—the most intimate physical joining that human creatures can attain. Prayer acknowledges this, and it introduces a different kind of intimacy and perspective between partners.

A few of the effects of bringing prayer into sex, according to Mary Jo, are that by acknowledging a higher power, our own ego and self-righteousness dissolve, unspoken barriers between partners are broken down, and the bond between them is strengthened.

Praying together begets acceptance and forgiveness. It softens the sharp edges that creep into a relationship over time.

So, in the midst of using all the other tips and tricks we’ve discussed so much on this site, why not also pray together? You can do it in any way that’s comfortable for you. You don’t have to use words, but it might be helpful for each of you to hear the prayer of the other.

Join hands. Be still. Quiet yourselves.

Then pray. Together. With or without words.

If you don’t know what to say, here’s a starter:

Father, send your Holy Spirit into our hearts. Place within us love that truly gives, tenderness that truly unites, self-offering that tells the truth and does not deceive, forgiveness that truly receives, loving physical union that welcomes.

Open our hearts to you, to each other and to the goodness of your will. Cover our poverty in the richness of your mercy and forgiveness. Clothe us in our true dignity and take to yourself our shared aspirations, for your glory, forever and ever.

(“A Prayer Before Sex” from Patheos.com)

Read Full Post »

Ladies, sometimes we are just too full of ourselves.

Yeah, it’s tough growing older in a society that adulates youth. It’s especially distracting in bed: Does he see the cellulite on my thighs? When I’m on top, my belly sags like a pregnant dog, so let’s stick to the missionary position. While we’re at it, nothing stronger than a candle. One candle.

Of course, our secret vulnerability is that we yearn, in the secret recesses of our still-adolescent souls, to be desired. To have the person we love (or maybe someone who looks like George Clooney) think we are the most beautiful creature he’s ever seen. In such a way that we know it’s true.

And, of course, as we discussed before, everything in our culture, in our psyche, and maybe even from our family of origin rewards youth, beauty, and thinness. And we are not those things any more.

But what about men?

Aren’t they unscathed by cultural expectations about sex and intimacy? They created them, didn’t they? And they don’t have to be in the mood. They don’t have the same, um, unpredictabilities when it comes to getting it off in bed. Things are just more straightforward for guys.

Not really.

I’ve been doing some reading lately, and it’s given me a different perspective on Mars. The cultural messages and expectations they absorb almost from the cradle are equally potent and can be equally unrealistic and even damaging. And part of the message is that they aren’t supposed to talk about it. No whining, no complaints, just be a man. Get it up and get her on.

Consider this observation from a researcher who has interviewed men (and even more women) for many years: “… From the time boys are from eight to ten years old, they learn that initiating sex is their responsibility, and that sexual rejection soon becomes the hallmark of masculine shame.” She heard this from a man she interviewed:

“Even in my own life, when my wife isn’t interested, I still have to battle feelings of shame. It doesn’t matter if I intellectually understand why she’s not in the mood. I’m vulnerable, and it’s very difficult.” (From Daring Greatly by Brené Brown).

I encounter this sentiment repeatedly. Men are vulnerable too. Because they usually initiate, they can be rejected. And they’re “responsible,” not only for their own orgasm, but in some way for ours. After all, if they were slower or faster or lasted longer or were more skilled….

There’s a reason for performance anxiety in men. A lot is riding on that “performance.” They don’t articulate it, not even to themselves, but their self-worth is connected to “performing” well. And if we don’t get off, or, God forbid, if they don’t, the result is shame.

“A guy can’t get through the day without seeing an ad for an erectile stimulant, getting spam about some sort of penis enlargement pill, or hearing sexual tall tales from the guys in the locker-room,” says Ian Kerner, author of She Comes First. “We live in an age where a lot of guys feel like they have to make love like porn stars, and with all the cultural reinforcement, it’s hard to believe otherwise.”

When you think about it, ladies, who are the male role models put before our men and boys? Wouldn’t the Disney Princess counterpart for boys look something like GI Joe or the Terminator? And for men, according this Esquire list, it’s George Clooney (who “eats class for breakfast”) and Liam Neeson. (Actually, the list is incredibly thoughtful and diverse. Check it out.)

But the point is that social pressure on boys to be “men,” and how we define “manly” is every bit as intense and constricting as is the pressure on us to be young, beautiful, and thin. And performance in bed is absolutely integral to the definition of being manly.

“Sexual prowess is the Holy Grail of manhood,” writes Scott Alden. “More than success, more than athleticism, more than witty banter—if we’re not a killer in the sack, we’ve failed as men.”

Ouch.

But what is really sweet, actually, and vulnerable and heartbreaking is that the thing your man wants most—even if it’s buried deep inside under years of habitual behavior in bed and out—the thing your man want most, is to turn you on and to know that he did it.

Truth. Nothing is sexier to a man than to turn on the woman he loves.

“For men, there’s nothing sexier in a woman than awakened desire,” writes Alden. “We also have a deep-seated need to keep our mate committed to us, and pleasing her better than anyone else in the history of sex has ever pleased anyone would be a good way for us to do that.”

All of us—men and women—are stereotyped in unhelpful ways by our time and culture. We’d probably have a lot more fun if we understood the forces that form us and viewed each other with a little more compassion.

Read Full Post »

Older Posts »

Follow

Get every new post delivered to your Inbox.

Join 296 other followers

%d bloggers like this: