Brunilda Nazario, MD
Q: My husband and I have a discrepancy in desire. How do we make it match?
A: Many people wait a long time before they try to do anything about sexual-frequency discrepancies -- sometimes 15 or more years.
When this happens, couples settle into a pattern-they get used to turning in each night and staying on their own sides of the bed. How do you overcome this pattern? Here are some ideas:
One prime issue is scheduling. Some people find that if they routinely schedule time together during which sex is a possibility (but not a requirement), they realize what they are missing and get back into it. It may sound too easy, but for some couples this is the answer.
Other people have a difficult time getting things started. They feel anxiety when they go from a nonsexual state to a sexual one. Once they do, they're fine and they wonder, "Why was this so difficult? Why don't we do this more often?"
If that's the problem, then take a look at how the sex you do have gets started. Is it always predictable? Does the same person always initiate it?
Does sex always happen in the same place? For things to change, both people need to agree that they want more sex and must be willing to consider other ways of doing things.
This is particularly true if one person does most of the initiating.
Make sure you rule out a medical problem. For some men, it may be low sex hormones (testosterone) or erectile dysfunction. Performance anxiety can also affect a man's erection and decrease libido.
For women, the solution to a low sex drive is more complex. While a woman's sex hormones may be to blame, she can have high, normal, or low free testosterone levels-which do not necessarily reflect the nature of her sex drive.
Some women have tried testosterone therapy, which does work for many but not all. Ask your doctor about options, including hormonal treatments that may increase your drive, medications such as pills or topical gels that increase blood flow to the genitals, or devices that help enhance libido.
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