Don’t give up on what used to be a good thing.
By Ashley Welch & Kara Leigh Smythe, MD. Listen to the Podcast at How To Sex.
There was once a time when your relationship had magic. That spark of romance, anticipation, and bonding. You’ve invested so much, until things somehow went south. It might have been a major incident, or a slow drifting away from each other.
It might be a personal health issue, or a forced new environment for the two of you.
We’ll look at home treatments and try to reverse bad habits, But we’ll also discuss your options with a caring and competent professional therapist who specializes in identifying and reversing obstacles in your lives, in a gentle manner.
Let’s first look at the easier solutions you can do in the privacy of your home.
9 Natural Libido Therapies
Want more excitement? Stimulation? Satisfaction? There are several drug-free ways to spice up your sex life.
By Ashley Welch & Kara Leigh Smythe, MD
Exercise, say experts, is one of many natural tools you can use to improve sex.
If fooling around with your partner isn't all you'd like it to be, it might be time to think up new ways to make your sex life sizzle.
Having a date night with your partner — to remind yourself of all the reasons you adore each other — can be a great way to stimulate your libido, says Anita Sadaty, MD, a holistic gynecologist in Roslyn, New York.
This is one of many natural ways that experts say you can improve your sex life.
1. Make Getting in the Mood for Sex a Priority
Sometimes, having more and better sex simply requires clearing your schedule. “It's hard to be in the mood when you have a million things on your to-do list and not much time to do it,” Dr. Sadaty says.
Scheduling sex might sound unromantic, but you put most of your important plans in your calendar, so why not sex? It’s best to schedule enough time to do something relaxing first rather than hopping straight into bed, since women, especially, need to be relaxed before their libido kicks in, Sadaty says.
2. Avoid Negative Thoughts
If your brain is running a feedback loop of reasons you’ve picked up along the way — about how you should feel guilty about sex or maybe that your body is too fat or ugly or, well, whatever — it’s time to stop it in its tracks. Recognize the thought when it appears and change it to a more helpful one.
Practicing sex positivity — the idea that all consensual sexual activities are healthy and positive — can lead to improvements in sexual enjoyment, researchers say.
This means accepting that sex is an essential part of overall health and that you have the right to enjoy sexual activity free from judgment. Examples can include telling your partner what excites you, setting healthy sexual boundaries, and exploring sexual fantasies, which has been shown to improve sexual function and satisfaction.
3. Don’t Forget to Use Lubricants
Vaginal dryness can be common among women, affecting as many as 17 percent of females 18 to 50, according to the Cleveland Clinic.
A number of factors can contribute to vaginal dryness, including a drop in hormone levels due to menopause, breastfeeding, and certain medications. Sex can be more pleasurable if you add a lubricant, which cuts down on friction and irritation and, therefore, discomfort, gynecologists say. You can buy lubricant from the drugstore or use a household oil like coconut oil. (Be sure to use a non-latex condom if you DIY, because these oils can damage latex.)
Don’t try to hide your need for a lubricant from your partner. Make it part of your sexual routine and have fun with it.
4. Move Your Body
You may not think that the exercise you do for your heart and muscles is important for sex, but remember that blood flows to your genitals as much as to your heart.
Men with erectile dysfunction, for example, can often see improvements in this condition with healthy lifestyle changes such as exercise. A review of 10 studies concluded that 40 minutes of aerobic activity of moderate to vigorous intensity four times per week is associated with reducing erectile problems in men with ED.
In women, research shows that physical activity can also improve sexual function, and even a little can go a long way. One study found that women who engage in regular physical activity (one to six hours per week) have higher levels of sexual desire, arousal, and lubrication than women who are sedentary.
5. Get Enough Sleep
Not getting enough sleep can have negative impact on your sex drive. One reason is that hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones related to sex.
For both men and women, feeling tired when you get into bed zaps whatever libido you may have had even moments earlier.
Plus, for women, research has found that sleeping longer is associated with greater next-day sexual desire, and an increase of one hour in sleep led to a 14 percent higher likelihood of engaging in sex with a partner.
6. Practice Mindfulness
It may seem like sex is the ultimate practice of mindfulness. And while orgasm pretty much is — likely no one has made their grocery list or planned a work report in that moment — you may become distracted by random thoughts in the time leading up to that orgasm.
Keeping your attention on what you’re doing and feeling is a powerful way to enhance your pleasure. Research has shown that women who practice meditation at any level experience improved sexual function associated with better overall mental health compared with those who never meditate.
Similarly, the mind-body practice of yoga can aid your libido. When a group of 40 women were instructed to practice an hour of yoga each day, their average scores on a sexual function questionnaire for desire, arousal, lubrication, orgasm, lower pain, and overall satisfaction increased, according to another study.
The yoga postures they did were basic poses believed to improve pelvic muscle tone, release tight hip joints, and boost mood, followed by breathing exercises and relaxation techniques.
7. Consider Acupuncture Treatments
The ancient Chinese practice of acupuncture, in which a practitioner strategically places needles in the body, can also enhance your sex life. Balancing and relaxing the body with acupuncture has long been used to boost libido, says Baljit Khamba, ND, a naturopathic doctor and an assistant professor of naturopathic medicine at Bastyr University California in San Diego.
Dr. Khamba coauthored a study in which 35 men and women with sexual dysfunction, likely caused by antidepressants they were taking, were treated with nine acupuncture sessions. At the end, libido had improved in women, while erection, timing of ejaculation, and ability to orgasm were enhanced in men.
In another study, a six-week course of acupuncture treatments with 18 sessions led to significant improvements in erectile dysfunction in men.
8. See What Some Herbs, Supplements, & Aphrodisiacs, Can Do for You
Some herbs are used by cultures around the world as aphrodisiacs. Some are believed to stimulate nerves in your genitals; others increase levels of nitric oxide, which increases blood flow to the genitals, and the feel-good chemicals in your brain.
Some of these herbs include Chinese ginseng, cordyceps, ginkgo, and muira puama.
Not many scientific studies have been done on these supplements, though some evidence suggests L-arginine, an amino acid, may be tied to increased sexual function. One study of 120 men with erectile dysfunction found that taking a combination of supplemental L-arginine (5 grams) and tadalafil (5 milligrams), a medication to treat erectile dysfunction, for six weeks led to more significant improvements in the condition than taking either the supplement or drug alone.
In another study that included 77 women, researchers found that taking ArginMax for Women, a supplement containing ginseng, ginkgo biloba, damiana, vitamins, minerals, and L-arginine, for four weeks was associated with increased sexual desire and overall satisfaction in women.
9. Masturbate or Self-Stimulate for Better Sex
By experimenting on yourself, you can come to better know what satisfies you sexually — information you can then convey to your partner.
For women, masturbation may have other benefits as well. Vaginal dryness and pain may be reduced when you spend time stimulating yourself, notes the Cleveland Clinic.
That’s why sex therapists often recommend masturbation as a tool for women having trouble reaching orgasm. You might want to add a vibrator for enhanced stimulation.
Medical Reasons May Be Behind Sexual Problems or Disinterest
Of course, there may be a medical reason why your sex life is flagging. Diabetes, thyroid issues, cancer treatments, and cardiac problems can lower sexual desire. Nerve issues, endometriosis, or other problems can cause sex to be painful for women. And certain medications — like some for blood pressure, depression, anxiety, and even birth control — may inhibit desire.
That’s why it’s important to get a medical checkup if you are experiencing symptoms that affect your sex life and get your condition properly treated. You can also ask your doctor if it’s possible to switch your medication to something without a sexual side effect.
But even if you have a medical cause, it doesn’t have to stop you from having satisfying sex.
Sex Therapy: What Men and Women Should Know
By Beth Levine & Allison Young, MD
Sex therapy can help both individuals and couples improve their sexual issues and their relationships.
Let’s talk about sex. Sexual health is an essential part of overall emotional and physical well-being. But if you’re experiencing a sexual problem, the last thing you probably want to do is talk about it. If shame is keeping you from seeking help, know this: 43 percent of women and 31 percent of men report some degree of sexual dysfunction. Sex therapy is designed to get to the bottom of sexual issues and reverse them.
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Working With a Therapist to Address Libido Problems and Other Sexual Health Issues
Whether you work with a psychiatrist, psychologist, or marriage or sex counselor, sex therapy can help with a variety of physical and emotional issues that can interfere with sexual satisfaction, such as erectile dysfunction, low libido, a history of abuse, and others. And it can help you and your partner work through these issues in a supportive and educational environment.
So what does sex therapy really entail? And who qualifies as a sex therapist? Read on to discover the truth about this type of therapy.
What Is Sex Therapy and How Can It Help?
Contrary to what some believe, there’s nothing strange, deviant, or kinky going on behind the door to a sex therapist’s office. Indeed, sex therapy is not very different from other forms of psychological counseling. “Sex therapy is a type of psychotherapy that also takes into account possible physical problems. When a couple comes in with a sexual problem, we try to figure out how each of them could be contributing to the issue. We examine behavior, gradually interpret that for them, and come up with solutions,” says Barbara Bartlik, MD, a psychiatrist and sex therapist at Weill Cornell Medicine in New York City.
What Happens in a Sex Therapy Session?
Your therapist will help you work through emotional issues that may be contributing to sexual issues, such as erectile dysfunction, according to Drogo Montague, MD, a urologist at the Cleveland Clinic in Ohio. If performance anxiety is an issue, sex therapy would typically begin with learning about performance anxiety, then move on to teaching a couple how to establish open lines of communication to discuss sexual wants and needs, Dr. Montague explains. The couple may also explore issues causing relationship stress, he adds.
When May Sex Therapy Be Recommended?
Sex therapy may be recommended in a variety of scenarios, says Michael Krychman, MD, executive director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach and coauthor of The Sexual Spark. Here are some of the most common scenarios:
Personal Conflict Issues Related to Sexuality This includes, for example, sexual trauma or assault. Dr. Krychman recommends seeking individual therapy first to cope with these issues, then gradually including your partner as needed.
Conflict About the Relationship A common example here would be a partner experiencing sexual boredom. In this case, it’s better to seek therapy alone first so that you can better understand yourself and your own sexual concerns, then incorporate your partner, says Krychman.
Compulsive Sexual Behavior (CSB) Once again, in this scenario it’s better for the person with the compulsive behavior or the partner to see a therapist alone first, then bring in the partner. “Sometimes, personal emotions of betrayal, guilt, or fear may need to be explored before incorporating your partner,” explains Krychman. “The one suffering from CSB may also experience a wide range of emotions, such as fear, shame, and anxiety. Addressing your personal emotional experience is important prior to bringing and dealing with your partner — this may enhance communication.”
Couple, Marital, and Sexual Problems For instance, with the infidelity of one partner, Krychman typically recommends that the couple tackle the concern or problem together from the start and address the roles they may have played with respect to the issue. “No one is blameless in a dysfunctional relationship, and couples can jointly work together to improve the quality of their experience,” he says.
Personal Coping Difficulties Related to Sexuality This area might include if you’ve just been diagnosed with a sexually transmitted infection and want to learn how to disclose your status to your partner or partners.
You’ll Learn to Be Mindful and More Aware
In mindfulness training, you learn to be present and focused on the here and now, rather than letting yourself get distracted by grocery lists and carpool plans. When using this concept in sex therapy, you learn to block out extraneous thoughts as well as negative thoughts you might have about your body or your performance. Instead, you are guided in thinking only about how your body is reacting to sexual stimulation.
Lori A. Brotto, PhD, executive director of the Women's Health Research Institute and Canada research chair in women's sexual health at the University of British Columbia in Canada, has done research on this topic, including a study published in November 2016 in Archives of Sexual Behavior. She has found that there's significant improvement in responsiveness in women suffering from anxiety-related sexual dysfunction. Dr. Brotto, also author of Better Sex Through Mindfulness, says that the hypothesis behind the results is that the mindfulness skills that the women acquired benefited their sexual motivation and response both directly, “by allowing them to nonjudgmentally focus on sexual sensations in their bodies before and during sexual encounters, and indirectly, by improving mood and decreasing stress and anxiety.”
Physical Issues Won’t Be Ignored in Sex Therapy
If there is a physical issue, such as vulvodynia or impotence due to radiation for prostate cancer, the therapist will refer you to a medical specialist who will work in tandem with the sex therapist.
Expect Some Sex Therapy Homework
While nothing sexual in nature will happen at the office, the therapist may offer some ideas to try out at home. “The therapist may suggest you try something called sensate focus exercises, which are designed to help you attune more to your partner,” says Montague. The exercises are typically done in stages, starting with touching or stroking anywhere on the body, except the breasts and genital areas. The goal is to experience the sensation of touching rather reach an orgasm. Eventually, the exercises can lead to intercourse.
Sex Therapy as an Individual vs. as a Couple
“Sex therapists can be very helpful in helping to guide one person to help themselves or their partner to overcome self-defeating behaviors. Or we can work one-on-one and then work with the couple together as a unit as well,” says Dr. Bartlik, coauthor of Integrative Sexual Health.
Traditionally, it’s better for people who are experiencing individual sexual issues to seek therapy alone, then gradually incorporate their partner (if they have a partner), says Krychman.
“If you are treating individuals, you are only seeing one side of the discussion,” he explains. “Partners who are counseled together will often interact and the counselor or therapist can assess communication styles in real time. If they are screaming at each other or using abusive language, interrupting, or disrespecting each other, the counselor can discern the communication style and what is happening in their intimate life.” In addition, during couples sex therapy, the therapist can assess the body language of the partners as they both disclose and discuss intimate sexual details, Krychman adds. “For example, if a couple seems angry or hostile, there might underlying reasons for this,” he says.
How Can Sex Therapy Help My Relationship?
Sex therapy can improve a couple’s relationship in a number of ways, Krychman says:
- Enhancing emotional and sexual communication
- Enhancing sensuality and sexuality through sexual exercises that may help eliminate sexual boredom
- Enhancing the understanding of each other’s sexual needs, wants, and desires
- Enhancing fantasy exploration (a neutral third party could make it easier for an individual to disclose their sexual fantasies)
You Keep Your Clothes On When You Work With a Sex Therapist
One thing is certain: Under no circumstances should you have to take off your clothes in a sex therapist’s office or should the therapist be touching you. “Sex therapists don’t touch their patients unless they are gynecologists or urologists and a physical exam is involved,” explains Bartlik.
Do My Partner and I Need Sex Therapy?
Individuals and couples seek sex therapy for many different reasons. According to Krychman, these are some of the most common reasons:
- Mismatched libidos (one partner wants sex all the time; one partner wants it rarely)
- Sexual boredom (one or both partners are bored by their sexual relationship)
- A desire to change the paradigm (e.g., discussions about polyamory, or opening up the relationship to other partners)
- Low libido (one or both partners are uninterested in sexual activity)
- Coping with infidelity
- The impact of compulsive sexual behaviors on the relationship and resulting in personal distress
“If you are troubled by your sexual relationship, [or] feel that there are barriers that may include physical, sensual, or sexual intimacy connections with your partner, you may need counseling or sex therapy,” he explains.
Be Picky When Shopping for a Sex Therapist
This person will help you with your most intimate secrets, so it has to be someone you trust. You will need to feel safe being vulnerable and taking risks. First, start by considering the gender of the therapist you and your partner feel most comfortable with. Environmental issues, such as the confidentiality of the therapy setting, were a factor, too.
“Usually, there will be some indication on the therapist’s website that they have experience in this area. I put on mine that I am inclusive so patients know that I am paying attention and know what to do,” says Bartlik.
Where to Find the Right Sex Therapist for You
Ask to see accreditation. A sex coach is not a sex therapist. Sex coaches may do more physical touching and demonstrating body parts. “They don’t have the same licensure that sex therapists do. Anyone can hang up a sex coach shingle,” says Bartlik. Compared with sex therapy, sex coaching is less stringent and not regulated, according to Bartlik.
Sex therapists often hold degrees in marriage and family therapy, social work, theology, psychology, or medicine. You can find licensed sex therapists in your area from the American Association of Sexuality Educators, Counselors, and Therapists.
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