Take These Tips to BedToo tired? Never in the mood? Turn things around with this expert advice.By Denise Foley,PreventionIsn't it a little unfair that guys can just take a pill when their sex drive is flagging? Even though drugmakers are hotly searching for female versions of Viagra, Cialis, and Levitra, it's pretty clear that there won't be a magic bullet for women at least for a while.
"There's not going to be one panacea—one cream or spray or nasal delivery system—that cures all women of sexual dysfunction," says Laura Berman, PhD, a sex therapist, director of Chicago's Berman Center, and half of cable TV's Sister Act (with Jennifer, a urologist) on the Discovery Health channel.
Until the female Viagra, there's self-help—and plenty of it works. Read on to find the most common sex-life saboteurs, the real reasons behind them, and expert advice on how to handle them.
You're TiredNo matter what causes it—insomnia, working the late shift, a new baby—exhaustion is no
aphrodisiac. All you want to do in your bed is sleep. How do you perk up your love life when you're anything but perky? Try the following:
Make the time"How important is sex and, because they're related, how important is your marriage?" asks Janet Hyde, PhD, a professor of psychology and women's studies at the University of Wisconsin-Madison. "Everyone says they're busy. But my husband and I make time for sex. Things that are important should come first." So, turn off The Amazing Race, and turn each other on. If you have to, says Hyde, make a date that morning so you both can think about it—and each other—all day.
Do it after exerciseFor some people, exercising too close to bedtime makes it hard for them to sleep. Take advantage of that found energy. "After 35 to 40 minutes of moderate exercise, everything in your body is going right," says Hyde. "Your blood is circulating, your nervous system is firing, so scheduling sex right after you exercise makes for good sex."
CompromiseIf your partner comes on to you after a particularly grueling day, you're likely to get angry because he doesn't see how exhausted you are, says Marianne Brandon, PhD, cofounder, with Andrew Goldstein, MD, of the Sexual Wellness Center in Annapolis, MD. "Offer a compromise," recommends Brandon. "There are things you can do for your partner other than intercourse that are less draining but still satisfying, such as oral sex or holding or caressing him while he masturbates."
You're AngryRelationship problems are often the uninvited trois in your ménage. "Some disputes between partners are disguised as sexual problems," says Leonore Tiefer, PhD, a clinical associate professor of psychiatry at New York University School of Medicine and author of Sex Is Not a Natural Act.
"It's easier to say, 'I'm not interested' or 'I have a headache,' when the truth is, 'I'm mad at you.'" Don't try to deal with the anger by shutting down sexually. If you do, you'll both end up suffering.
Use wordsLet your partner know that you want to talk about something important. "If he doesn't have advance warning, he may feel blindsided," says Brandon. "You can say, 'There's something going on. I want to talk about it and get your thoughts. What's a good time?'" Pick a time when you won't be interrupted, i.e., when the kids are asleep.
ListenPay attention to what your partner is saying; don't use the time while he's talking to think up a snappy rebuttal. Remember, you're trying to reach consensus, not win. And don't expect an immediate resolution, says Brandon. "What's important is to stay in touch, so no one feels isolated. You need an ongoing dialogue."
You're Bored"Relationships can settle into patterns that don't support a healthy sex life," Brandon says. "For example, couples can become more like friends than lovers and can lose that sexual spark." A routine repertoire of lovemaking techniques can make you feel ho-hum about sex. Here's how to spice it up"
Resurrect great memoriesMake time every day to fantasize about having great sex with your partner. "When you imagine enjoying sex, it helps you get your body aroused," says Brandon.
Try some risky businessDo something you thought you'd never do. Find a new position—or a new location — that thrills you both.
Slow it downHas sex gotten a little perfunctory? "Quick sex offers next to no pleasure most of the time," says Brandon. "It's like eating ice cream: If you gobble it down, your experience will be much less pleasurable than if you savor every bite. Slow it down until it takes three times longer than it usually takes."
Initiate sex talk"Often couples have different ideas of what sex is for: One feels that it's for romance and bonding; the other feels that's much too serious, and it's just about having an orgasm," says Tiefer. Talk about your feelings in a neutral place (not your bed) with the idea that you're working on a project (your sex life) as colleagues, not negotiating a settlement like two sides in a labor dispute.
Remember, says Tiefer: "Sex is a lot like dancing. There's the same type of cooperating, making mistakes, and correction and praise back and forth before you get it right."
You're in PainRoughly 86% of women have some sexual dysfunction in the first year after they have a child. Fatigue and the delirious love you feel for your new baby play a role in sidetracking your sex life, but much of it is hormonal. "Nursing can affect your libido and your ability to be aroused, and it can even make sex painful," says Goldstein.
Breastfeeding lowers your body's production of the three chemicals you need for a healthy sex life—the hormones estrogen and testosterone and the brain chemical dopamine—as it turns all the body's attention, via the hormone prolactin, to milk production. You lose your desire for sex, and your body isn't able to prepare for it even if you do get the urge. Without enough estrogen, your vaginal walls thin out and don't produce the lubrication you need for intercourse, so sex can hurt. (A similar problem occurs during menopause.)
"Also, women often take a progesterone-only Pill during lactation, and progesterone is one of the main sexual saboteurs," says Goldstein.
Nursing isn't the only thing that can wreak havoc with your hormones. Taking the birth control pill, going through menopause, or having your ovaries removed can disrupt the delicate balance—sometimes dramatically.
Testosterone levels also start declining naturally in women in their late 20s and are significantly decreased by the time a woman is in her 40s. "It's not a menopausal thing," explains Goldstein. What is menopausal: the cessation of ovulation and gradual decline of estrogen from the ovaries. The drop-off of testosterone lowers libido while the lack of estrogen further exacerbates the problem by reducing lubrication and thinning vaginal walls, making sex painful.
Having your ovaries removed, a surgery called oophorectomy, sends you into abrupt menopause because the ovaries are your body's most prolific producer of estrogen. Testosterone also plummets after an oophorectomy.
Some serious medical conditions—endometriosis, ovarian cancer, interstitial cystitis (inflammation of the bladder)—can also cause pain during sex and at other times. By some estimates, as many as 16% of women may have an ailment called vulvar vestibulitis, or vulvodynia, characterized by chronic pain and inflammation at the opening of the vagina. Some women may also have pelvic floor dysfunction, a syndrome that can include painful muscle spasms, often precipitated by childbirth, scoliosis, or lower-back problems that lead to misalignment of the pelvis. Here are your options:
Lubricate, lubricate, lubricateUse lubricants that coat the vagina and are designed to be used just during sex, such as Astroglide and K-Y Warming Liquid. Longer-lasting products such as Replens and K-Y Silk-e Vaginal Moisturizer also relieve other symptoms of vaginal dryness, such as itching and irritation. These over-the-counter products are a good second best to your own natural juices to help prevent painful sex.
The BridgeLie on your back with your knees bent and your feet flat on the floor, hip-width apart. Rest your arms at your sides, palms down. Take a deep breath. Exhale as you contract your abs and slowly curl your hips off the floor, using your buttocks and lower back (not your arms) to lift your torso. Support your upper body on your shoulder blades (not your neck), and use your hands only for balance. Hold for 10 to 15 seconds, relax, and repeat once.
IMPORTANT: If you have neck pain, skip this exercise.
While in the bridge, lift your right foot off the floor. Stretch, throught your toes to keep your body in a straight line. Repeat with your left leg raised. Do the sequence one more time.
Single-Leg CircleLie on your back with your arms at your sides, your knees bent, and your feet flat on the floor. Extend your right leg toward the ceiling, and point your toes. Exhale, and contract your abs.
Slowly circle your right leg counterclockwise, keeping your hips level and motionless. Inhale as you circle your leg out, away from your body. Exhale as you circle it in, toward your body. Do six circles counterclockwise, then do six clockwise. Repeat.
Double-Leg StretchLie on your back with your knees pulled in toward your chest. Rest your hands just below your knees, and exhale as you use your abs to raise your shoulders off the floor. Inhale.
Exhale, and stretch your body long, pressing your arms overhead and your legs straight out in front of you in the air. Make sure you move from your abs, and extend through your fingertips and toes. Hold for a second. Inhale as you bring your knees back in, and sweep your arms toward your knees. Then extend again. Repeat five to eight times.
Forward Spine StretchSit with your legs extended hip-width apart in front of you. Your feet should be flexed and your knees slightly bent. Pull your abs in toward your spine. Extend your arms in front of you at chest level, making sure to keep your shoulders relaxed.
Exhale as you bend forward, pulling your abs back against your spine. Continue curling forward, lowering your head, neck, shoulders and ribs until your spine forms a C. Inhale as you roll back up to the starting position. Repeat three times.
The SawSit with your legs extended shoulder-width apart, feet flexed and arms extended out to your sides, at chest level. Pull your abs toward your spine.
Exhale as you twist and reach your left hand toward your right foot, as if you were trying to "saw off" your foot with your pinkie. As you reach for your toes, contract your abs even more. Inhale as you return to the starting position, then twist to the other side. Continue, alternating sides, repeating the sequence two more times.
creamWhile you're nursing, you may even be able to use a doctor- prescribed vaginal estrogen cream such as Estrace or Premarin; the 3-month vaginal ring, Estring; or the suppository, Vagifem. Very little of the estrogen they contain is absorbed into your body, so it won't pass on to your nursing baby, but it will help thicken your vaginal lining and promote lubrication.
Switch to another contraceptiveIf you want to stay on the Pill, try Yasmin; one study found that it didn't dampen libido. Or look for Pills that contain the progestins levonorgestrel or norgestrel, derived from testosterone, which may also have less impact on your sex life. Otherwise, the copper-containing intrauterine device or a new IUD called Mirena are just as effective as the Pill and don't interfere with libido.
Ask about testosteroneMost doctors currently use compounding pharmacies to mix testosterone creams in dosages for women. But a testosterone patch for women, manufactured by Procter & Gamble, is now through clinical testing and could be on the market soon.
In a recent trial of the patch in women who had their ovaries removed, researchers reported that the women experienced a 56% increase in sex drive and a 74% increase in satisfaction. (Studies of naturally menopausal women are being completed.) "What's interesting is that it didn't just raise sex drive; it improved orgasm and arousal and all the other things that contribute to a satisfying sexual experience," says Goldstein.
Visit a specialistSee your OB/GYN about your pain, and discuss estrogen options. If you think you may have vulvodynia or pelvic floor problems, look for a vulvar-pain specialist or a urogynecologist specializing in pelvic floor disorders.
For vulvodynia, you can get a physician referral after joining the National Vulvodynia Association; to find a urogynecologist, contact the American Urogynecologic Society; for pelvic pain in general, contact the International Pelvic Pain Society. You may be referred for biofeedback or physical therapy.
If your problem is caused by muscle spasms, talk to your doc about Botox. Now used cosmetically to reduce wrinkles, Botox is currently under study as a treatment for chronic pelvic pain (it works by relaxing muscles).
Don't touch that yeast-infection drugUnless you've had recurrent yeast infections—diagnosed by your doctor—don't treat every ache, pain, or itch down there with those handy over-the-counter yeast treatments. "Women have limited ability to self-diagnose vaginal infections," says Goldstein, who cites a study in which researchers asked women about to buy medication at a drugstore to undergo testing—and only 30% had a yeast infection. Using the drugs in the absence of an infection can backfire because they can cause painful irritation.