I recently agreed to do part of an online course in LGBT studies. I’m doing the “B”: bisexuality. They had a hard time finding someone to do it; no one thought they could fill the time with enough info on the subject! After all, we still live in a world where a lot of people think there is “no such thing” as bisexuality.

The more I dig, the more I feel that understanding bisexuality is the key to understanding a LOT of things about sexual orientation, behavior, attractions, and gender itself. Here are 10 things I’ve learned so far:

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1. There are more bisexual people than gay and lesbian people. That’s right. Not only does bisexuality exist, those who self-label as bi outnumber those who identify as gay or lesbian. A 2011 study in The Journal of Sexual Medicine found that 3.1% of respondents in a national survey said they were bi and only 2.5% lesbian or gay. Other studies have found similar results.
2. Younger people embrace the identity more than older people. Lisa Diamond and Ritch Savin-Williams’ research shows that people under 40, and especially those under 30, think it’s no big deal to acknowledge attractions to both men and women. But then again, young people tend to think marriage equality is a no-brainer, too.
3. Women may be more bisexual than men—or they just accept it more. About 15 years ago, Meredith Chivers did lab research showing that women—regardless of their sexual identity—respond more to bisexual erotica than men. And recent analyses of national youth surveys by Nanette Gartrell show about 15% of adolescent girls have had a same-sex experience, not just attractions.
4. But men may be catching up. Savin-Williams is doing research on “mostly heterosexual” men—those with a little bit of same-sex attraction and behavior. There are a LOT of them. And Diamond, once an advocate of the position that women were more bisexual and fluid than men, recently published a paper called “I Was Wrong—Men Are Pretty Darn Fluid Too.”
5. Bisexuals threaten heterosexuals because they “blur the line.” In case you haven’t noticed, many heterosexuals still fear and reject gay people. They want to distance from same-sex attraction in every way. If the world is divided neatly into two “camps”—those who are 100% heterosexual and those 100% gay—that’s easy. But if there is a third group, people who are attracted to both men and women, it’s harder to draw the line and make that separation.
6. Bisexuals threaten gay people because they represent the ability to hide behind “heterosexual privilege.” Lesbians and gay men often fear they cannot compete with heterosexual privilege in a relationship, and many suspect that anyone who self-labels as “bisexual” will eventually find the lure of a “normal” life too tempting. Some see bisexuals as potential traitors—and heartbreakers.
7. This double “biphobia” leaves bisexuals without a community. The “B” in LGBT is only grudgingly accepted. Bisexuals would normally seek solace from their “queer” tribe—but there is sometimes only marginal acceptance by the tribe.
8. There is a tremendous pressure to “lie” if you are bisexual. Only 23% of self-identified bisexuals tell others. It’s easier to just let people assume that if you are with an opposite-sex partner you are straight and if you are with a same sex partner you are gay.
9. This leads to “bi-invisibility.” “Biphobia” is the irrational fear of bisexuality. “Bi-invisibility” is the denial that bisexuals exist and being blind to the existence of bisexuality. Until recently, this was argued in the scientific literature about bisexuality, and it is the most common public misconception about bisexuality. But bisexuals themselves may unwittingly help to maintain bi-invisibility by not “coming out.” After all, arguably the single most important thing that advanced gay rights in the past 40 years was gays and lesbians becoming more public.
10. Bi-invisibility is also maintained by “bi-erasure.” Bi-erasure is the cultural tendency to refuse to acknowledge bisexuals even when they proclaim their bisexuality. How many people think Rock Hudson gay and Marlon Brando straight? Both talked openly about attractions and sexual experiences with men as well as women. Larry King’s fumbling interview of Anna Paquin is not unusual. For reasons that mystify, many people have such a hard time wrapping their heads around the idea that someone could be attracted to both genders—or that gender might not matter—that they just erase the possibility from their worlds!

[fat_widget_relationships_right]Depending on your therapist and his or her approach to couples therapy, sex may never come up. That, however, is not always the case. Sometimes discussing sex may help the couple strengthen the relationship and the therapist could suggest sex therapy if necessary. If sex is part of your couples therapy, rest assured that the subject will be approached with tact. Here, several therapists explain how sex is discussed in their practices during couples therapy:

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For many couples, the sexual intimacy tends to wax and wane over time. I get countless couples who state they have had sex-starved or sexless marriages for years. They come to sex therapy to rebuild, but then struggle on the path to recovery.

For the purposes of this discussion, a sexless marriage is one in which sex happens 10 times a year or fewer. In these marriages, sex is so infrequent that by the time couples do have sex it can feel awkward, uncomfortable, and even involve sexual dysfunction.

Sexless marriages tend to be cyclical in nature. First, individuals wait for long periods of time between sexual encounters. During that time, pressure or tension builds between the partners. Next, individuals put higher expectations on the sexual experience. When they do have sex, something goes wrong or it just doesn’t meet expectations. This leads to both partners feeling like failures and waiting even longer before trying sex again. It’s a vicious cycle.

Relationships become sexless or sex-starved for a variety of reasons. Sometimes couples don’t intentionally set aside time to themselves as a couple. It is hard to be intimate if you don’t feel connected to your partner. Other times, an individual may develop a sexual dysfunction such as orgasmic disorder, erectile dysfunction, premature ejaculation, or pain during sex. Instead of getting treatment, the person avoids sex.

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Whatever the cause, once couples get into the cycle, it can be difficult to break, especially if the cycle lasts for more than a year. After a year, couples begin to build resentments toward one another. The lack of intimacy can lead to problems in other areas of the relationship.

In sex therapy, couples learn how to rebuild their relationship over time. Couples can expect a sex therapist to assign different intimacy-building tasks to help them gain confidence and comfort within the sexual realm. Typically, sex therapy can last anywhere from six sessions to 15-plus depending on what relationship issues may also need resolution. I strongly encourage couples struggling with this issue to seek help before it is too late.

For couples who would like to prevent sexless marriages, here are a few intimacy-building tips to keep the spark in your relationship long term:

1. Make your relationship a priority. Set aside time together alone at least three times weekly. This can include a date night, going for walks, cuddle time before bed, sharing a hobby, having a coffee together on your porch, sharing a meal, exercising together, or anything else that involves you two being alone together.
2. Create and keep couple rituals. A couple ritual is a habit you and your partner share with one another that is unique to your relationship. A ritual can be simple or great. Examples include brushing your teeth together, watching a game show and competing for who can answer the questions first, kissing before you leave for work and once you get home, an inside joke or special language only the two of you share, etc. Develop a variety of couple rituals and keep these rituals going over the years.
3. Intentionally and regularly put yourself in the mood for sex. People tend to wait until they feel sexy before initiating sex. The issue with this is that during different times in your life, you will have more or less desire for sex. Rather than waiting, learn what turns you on and intentionally do things to put yourself in the mood. I encourage each person in a couple to put themselves in the mood and initiate sex with their partner once every week.
4. Flirt and keep flirting. While dating, couples are great at flirting with one another. They share sexy text messages, speak with innuendo, smile and toss their hair, dress their best, and in general try to attract their partner. Many couples get married and assume flirting is not necessary anymore. Flirting is a key component to keeping that spark flowing.
5. Work at it. Try new things. Talk about likes and dislikes. Practice being more romantic. Be affectionate regularly. Whatever you do, understand that intimacy in long-term relationships takes work from both parties. As long as you are both committed to do that work, you’ll do just fine.

Thank you for your honest question. If anyone were to tell you that you’re “going straight to hell” for this, believe me, you’d have plenty of company on the way down—and an especially good chunk of the male population ages 15-25. My first thought was “he’s in high school or college,” when hormones have pretty much taken over, especially for men.

But the shame you refer to indicates that this is more of a psychological than physical issue; it’s as if you’re violating some strict “rule” by pleasuring yourself, which (again) is natural. It’s sad when I hear of people who can’t enjoy this; nature clearly intended this, or we wouldn’t be so powerfully stimulated by genital contact. I wonder what “commandment” or prohibition you are “breaking” by self-stimulating? Because of the intensity of the feelings here, you might want to seek out a therapist or counselor to sort out why you feel such strong self-loathing after masturbating. I would bet, in fact, that the intensity of the self-loathing creates a need for relief—and thus the compulsion to do it a second time, which then, of course, only stokes the angry “inner critic.”

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I would wonder, if you or someone else were to bring this issue to my office, if the voice of criticism might in fact exist before the act, and thus create a need to feel good in a way that is self-activated. Whose voice is this? A critical parent or caretaker? When did it start? What is the “crime” being committed here? Are you ignoring something else you “should” be doing instead? I would also be curious about the attitudes around sex in your family of origin. Was it seen as something “dirty” or wrong? Or maybe it wasn’t even talked about, creating a kind of unspoken shame around the topic; it could also be you are inheriting shame around sex and pleasure from implicit or explicit family beliefs.

Sometimes such intensely self-hating emotions come when there has been some kind of overt or covert abuse, physical or emotional. I am not suggesting this is the case here, only that sometimes in my clinical work, I find an association of good sexual feelings with shame over an earlier boundary violation, subtle or severe. Of course, any intensive criticism you might have received, about what you are doing in private with your own body, would constitute a boundary violation of its own.

The other thing I’d want to explore is the question of whether masturbation is the only way to bring some kind of embodied, out-of-your-head relief or pleasure to yourself. Sometimes folks with obsessive minds pursue repetitive means of relieving an overburdened or tired mind. If you feel you have no choice but to masturbate, or if it drains you of necessary energy to complete the tasks of living (work, play, socializing), then you might be caught in a compulsive activity which might necessitate a therapeutic intervention. (I could be wrong, but my sense is that yours is not a compulsive or addictive issue, since those with sexual compulsions usually reflect more ambivalence or torn feelings than your letter indicates.)

The danger isn’t so much the “wrongness” of the act itself, in my view; it’s the long-term effects of shame and self-loathing over bringing pleasure to yourself, and possibly sexual activity, which might inhibit intimacy and get in the way of developing satisfying romantic relationships—either concerning sex itself or shame over your habit. (I wonder if shame might also be felt in other areas where you seek personal satisfaction, like career, creativity, etc.) Shame about sex tends to create defenses that can keep others away, with heartbreaking results, when those we care about feel pushed away.

Good for you for having the courage to write in about such a sensitive issue; it’s not only a common pleasurable activity, it’s relatively common to question whether it’s OK to do. You needn’t feel shame about the need to get some guidance on this, especially if balanced, non-shaming guidance was missing in earlier years.

Kindest regards,
Darren

Before I jump straight to the heart of your question—to divorce or to not divorce—I’d like to take a moment and encourage you to consider some intermediate steps.

What I hear you saying is that while you love your husband, have a generally positive relationship, and are companionable, you feel as if there is something missing from your relationship, something you do not want to do without for the rest of your life. I wonder if he feels the same way.

What might it be like to open a dialogue that celebrates the time that you’ve had together and opens up a discussion about what you each want for your remaining years? If you haven’t let your husband know that you aren’t satisfied with the status quo, you have not given him, nor you, an opportunity to see if your relationship can change. That seems unfair, and it does not honor the relationship you have shared these many years. It may be that he also feels unsatisfied and doesn’t know what to do about it. You can’t know unless you begin communicating with each other.

There are couples who work together to reignite the “spark” that has faded. There are some who stay married, yet change the expectations of their relationship so each can get their needs met. There are others who decide that separation or divorce is the best option for them. Figuring out which path is for you should be, at the very least, a conversation rather than a unilateral decision.

These conversations can be challenging, often because we are afraid to hurt those we care about. Imagine, however, the depth of hurt when one is blindsided by a request for a divorce with no indication that one’s partner is unhappy. You both deserve better than that—as does your relationship.

I encourage you to get the support you feel you need in broaching these topics with your husband. He might be hurt to learn that you are not satisfied with your relationship, but he also may be relieved to finally be talking about it. If you are hesitant to open up a dialogue on your own, you can work with a couples counselor to explore these issues. Divorce is a big step to take, with logistical, emotional, and financial ramifications, but if the two of you are open with each other, explore options together, and ultimately come to that decision together, the chances of retaining the positive spirit of your relationship are significantly greater.

Best of luck!
Erika

Today’s world is filled with messages on how to date, but frankly, most of what we hear is creating heartache after heartache for women. After even one heartbreak, a woman might find herself distancing herself emotionally, having problems connecting, or experiencing trust issues.

The examples in pop culture are numerous. On this past season of ABC’s The Bachelor, for example, viewers watched as women became physically involved with the leading man. In the words of one participant, when they kissed, all the issues in her mind “disappeared.” Several women during the season described delving into a fast, physical relationship, while the emotional relationship was missing something.

What we are seeing is that many women are first looking for a physical connection and then asking themselves: Do I really like him? Are we really compatible? Do we really want the same things in life? Unfortunately, once we develop a strong physical or sexual connection and become infatuated, our brains start to convince many of us that the answers to the above questions are yes, when in fact they may be no.

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Why does this happen? According to researcher Helen E. Fisher, individuals who are “falling in love” experience elevated concentrations of central dopamine and norepinephrine along with lower levels of serotonin, which tends to mean they obsessively focus their thoughts and attentions on one another and, more importantly, on their partner’s positive attributes rather than the negative ones (p. 416). Once that “falling” feeling has diminished, as it generally does over the next few months, individuals begin to notice deficits more rapidly than before.

So now we have a situation where a woman is emotionally invested and connected with a man, but experiences confusion about whether they are actually compatible or share the same values or goals. To protect her heart, she tries to convince herself that they are a good match and that they want the same things in life. But she may still hear that “little voice” telling her that something is not right.

Ladies! Consider the following advice to protect your heart, make smart dating decisions, and more easily find the person you may be searching for:

1. Take the physical relationship slowly. Very slowly. Even kissing.
2. Get to know him deeply. Find out if you share the same life goals and values. What kind of lifestyle does he envision? What are his thoughts on marriage and commitment? (Hint: If he tells you he has commitment issues and you are looking for commitment, then back away now.) Do you share the same family values? Do you see eye to eye on religion and spirituality? These are the types of answers you want.
3. Believe that you can know whether you have chemistry with him before you are physical. Many people ask me, “But if we do not have a sexual relationship at first, how do I know if we will have sexual chemistry?” Do you long to kiss him? Do you want to reach out and hug him? Do you stare into each other’s eyes? If the answer to these questions is yes, then you can relax your anxiety because you do, in fact, have sexual chemistry. You can work on whatever sexual issues may arise once you have built a solid relationship.
4. If a little voice inside of you is telling you that it’s not right, pay attention to that voice and try to figure out why it feels that way. What is it saying? What are the red flags you are picking up? Why are you staying in a relationship if your gut is telling you it’s not right? Are you afraid of being alone? Do you wonder if you will ever find Mr. Right?
5. Be OK with being alone for a while. If you have a need to be in a relationship, you may settle or convince yourself that he is what you want out of fear of going without anyone. While you’re with Mr. Wrong, you won’t be emotionally available and open to meeting Mr. Right.

If we take care to protect our hearts and open ourselves up safely and slowly, we will reduce our possibility of getting hurt. Opening yourself up too much, too quickly may create a pattern of distrust or emotional guardedness with others, making it hard for you to find “the one,” even if he is standing right in front of you. Taking the time to open yourself up slowly and protecting your body and feelings will let you lead with your head so that your heart can follow.

Reference:

1. Fisher, H. E., Aron, A., Mashek, D., Li, H., and L. Brown (2002). Archives of Sexual Behavior. Vol. 31, No. 5. Pp. 413-419.

Have you ever experienced pain during sex? If so, you are not alone. According to a Huffington Post report from a National Survey of Sexual Health and Behavior study, 30% of all women ages 18 to 50 experienced painful sexual intercourse during their last sexual encounter.

What Causes Painful Sex?

Painful sex can be attributed to variety of possible reasons. Some women experience pain after giving natural birth due to scar tissue that forms after tearing or cutting of the vaginal walls.

Other women develop a condition of vaginal muscle atrophy or atrophic vaginitis According to Medical News Today, up to 75% of women will experience this problem after menopause. The conditions involves vaginal dryness, irritation, painful sex, and changes to the appearance of the vagina.

If you are experiencing painful sex, there are many other potential causes of pain that can be assessed with proper treatment. Ideally, the best treatment option is a combination of medical treatment, physical therapy, and sex therapy.

Medical Treatment

[fat_widget_sex_right]Initially, it is helpful to get assessed by your primary care physician, gynecologist, or urologist. One challenge women face when seeking medical treatment is working with a doctor who is not familiar with the available options for painful sex.

It is important to seek a medical professional who specializes in the area of sex. Doctors who know about this field are more likely to collaborate with other potential resources and offer more specific medications that are designed to help in this area.

Pelvic Floor Physical Therapy

In addition to medical treatment, many women seek the help of a physical therapist who specializes in pelvic floor work. You can find these specialists at the Women’s Health website.

Physical therapists help women in several ways. First, they spend more time assessing the entire area including potential problems with the hips, groin, and urinary tract. Second, they offer specific exercises women can use to strengthen their vaginal muscles both in and out of sessions. Third, they teach internal stretching exercises that help sex become less painful over time.

Sex Therapy

As a final option, sex therapy can be used to help incorporate partners into treatment. Some women have difficulty transitioning exercises from the physical therapy room to the sexual relationship.

In sex therapy, clients are taught how to make exercises a more fun part of their sexual experience. It also helps women transition treatment from a solo endeavor (she is fixing her sexual problem) to a partnership (the couple is developing a better sex life).

Sex therapists can also help women who are burdened by psychological anxiety as a result of painful sex. Women report feelings of anxiety about potential pain that could happen, even when the pain is not present. If you are experiencing pain during sex, please don’t wait to get help.

Many couples with whom I work continue to return (or call back if they’re in distance therapy). They find it’s helpful to have regular “tune-ups” even after we have repaired and healed their relationships to move past whatever hang-ups or problems inspired them to contact me in the first place.

In these ongoing conversations, I get to learn about many ways that loving couples heighten sexual intimacy and strengthen their relationship by creating fun and pleasure. I continue to notice that couples who have a happy sex life view lovemaking as an expression of intimacy, but they don’t take any differences in their needs or desires personally. They enjoy a relaxed and accepting view of sexual pleasure.

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Fantasy is an important aspect of creative intimacy. Believe me when I tell you that your sex life will be greatly enhanced if you feel safe enough to share your sexual fantasies with your partner—and perhaps even explore them with one another. Does your partner know about what really turns you on? Can you imagine telling him or her about it?

Fantasy is the base of variety, imagination, and adventure for most of us when we experience sexual pleasure, either alone or with a partner. But relatively few couples seem to be able to trust their loved one with their fantasies and then find some way of “acting them out” together. When we share these secret places in our minds, the result can be great romance and excitement that swoops us out of the monotony that can ensue when we are mating in domesticity.

I encourage couples to cultivate the idea that within the safe boundaries of their relationship, all wishes, images, fantasies, and desires are acceptable and welcome. Nothing is intrinsically wrong or disgusting. We can decline a partner’s request, but we don’t judge or disparage him or her for it.

Describing and sharing a fantasy requires a great deal of courage, so receive your partner’s secret longings with tenderness and compassionate curiosity. One couple recently shared about their bedroom “treasure chest” that includes sartorial regalia honoring each of their delights and predilections. The contents include police and nurse uniforms, a cheerleader outfit, and several pirate costumes—sort of a Caribbean theme!

“It’s really a helluva lot of fun,” one person laughed. “I don’t even begin to understand some of my desires or fantasies, and I have no idea why Johnny Depp got me so turned on in Pirates of the Caribbean! But my sweetie doesn’t care—they just consider it play and we have a ball!”

Most of us base our expectations about sex on informal and unreliable sources, usually friends we had as adolescents. And this “information” is usually based on fantasy.

Ignorance often leads to people judging themselves harshly and comparing their performance to the actors who appear in their favorite fantasy. I often hear people lament that they are “just no good in bed.” An obvious example is the guy who believes he always has to be able to produce an erection whenever the situation requires it. When it doesn’t happen, self-doubt and genuine fear often result.

Years ago an author named Nancy Friday interviewed thousands of women about their sexual fantasies—one of her books that I really enjoyed is My Secret Garden: Women’s Sexual Fantasies. Those of us who are female are usually (not always!) less visual and therefore more inclined to enjoy reading erotica, while men tend gravitate toward video/online stimulation. Consider watching with your partner, discussing what’s exciting and what isn’t.

Talk about your fantasies with your partner. He or she might be surprised and/or delighted. I guarantee you will grow in intimacy as you trust one another with your deepest desires. Let go of any attachment you might have to a particular outcome, such as orgasm.

The results can be downright entertaining, and you’ll learn a great deal about one another. Just don’t take things too seriously. You’ll laugh together at the very least, and that’s one of the best aphrodisiacs!

For many women, having a baby is a long-awaited blessing. You have been carrying a baby for nine (or even 10) months; you might have been trying to become pregnant for a while; and your entire world changes from being a couple to being a family. Several weeks after delivering a baby, women can begin to resume sexual intimacy.

However, few women bounce back so quickly. Many women feel that their body has changed and have conflicting feelings about sexual intimacy. Here are some very common postpartum sexual concerns for women, as well as some tips to overcome them:

1. Directly following childbirth, women may be somewhat traumatized by the childbirth itself.

Cheryl Beck, Nursing Professor at the University of Connecticut, conducted a study and found that up to 34% of women experience some sort of trauma during childbirth (Beck 2008). Following childbirth, women may experience posttraumatic stress (PTSD) symptoms such as anxiety, panic, or insomnia.

This traumatic experience could lead to anxious feelings about your vagina in general, and it is not uncommon for women to be anxious about penetration. This type of anxiety may go away on its own once you resume intercourse, but if it doesn’t, it might be helpful to seek support from a therapist who specializes in PTSD.

2. New mothers are often exhausted, sleep-deprived, and fatigued.

Due to the feeding schedule and short sleeping periods of infants, many new parents only get two or three hours of sleep in a row. Fatigue for both mothers and fathers can lead to feelings of depression and relationship conflict. Decreased sleep can lead to increased arguing and feelings of irritability.

More relationship conflict can also make it less likely partners will feel like having sex. After a period of adjustment, many couples find that their amount of sleep increases and that they have adapted to the change. Try talking to a counselor if relationship issues persist.

3. Adjusting to a new role as a parent can make it difficult for partners to have the energy to fulfill each other’s needs as well as the new baby’s.

Many women embrace motherhood and put all their energy into being a loving, caring, fully engaged parent. At the end of the day, it may be somewhat challenging to transition back into the role of romantic partner.

It can help if both partners make it a goal to set aside quality time to spend together doing things that don’t involve your baby. Do a hobby or an activity you used to do together, and try to take advantage of a babysitter when the grandparents come to visit. Keeping up the romantic relationship will be paramount in the success of your growing family.

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4. Postpartum depression can make it even more difficult to adjust to parenthood.

Postpartum depression occurs in approximately 15% of women. Symptoms of postpartum depression include lack of energy, fatigue, insomnia, loss of appetite, thoughts of suicide, or thoughts of harming one’s baby. Depression on any level decreases feelings of desire and interest in intimacy. If you are having these feelings, contact your doctor right away. Medications and therapy can significantly help.

5. After giving birth, you may not feel like being touched.

Having an infant cling to you for most of the day and night can be pleasant and fulfilling. However, many women do not wish to be touched further, especially on their breasts (if breastfeeding), once baby is asleep for the night. Instead, it might be far preferable to shower and have a few minutes to yourself.

In addition, women are receiving oxytocin from cuddling with the infant so they are less likely to need cuddling and intimacy from their partners. This feeling of not wanting to be touched usually improves after a few months when babies nurse less frequently, sleep through the night, and women have started to return to a more regular schedule.

6. A decrease in sexual desire is common, regardless of type of delivery.

Whether they gave birth by vaginal delivery or C-section, most women report a decrease in sexual desire. According to the website Healthline, a woman creates more estrogen in the first months of pregnancy than in the rest of her entire life combined. After giving birth, however, estrogen levels plummet very quickly to pre-pregnancy levels. Estrogen is an important hormone in sexual desire and arousal, and decrease in sexual desire is a common effect of the rapid decrease in these levels.

In addition to estrogen changes, prolactin, a hormone secreted in the brain that causes milk letdown, increases when you are breastfeeding. When prolactin is elevated, testosterone and estrogen is suppressed, causing low libido and vaginal dryness. The vaginal walls may become frail and narrow. Hormonal birth controls can also worsen vaginal dryness, so consider speaking to your doctor about non-hormonal birth controls such as an intrauterine device (IUD) in order to offset these issues.

7. Many women experience difficulty with arousal and orgasm after giving birth.

Due to lowered levels of estrogen, fatigue, possible depression, and constant contact with an infant, many women report lower levels of arousal. Try much more extended foreplay (45 minutes to an hour) to give yourself more time than usual to become aroused. And although lubricant can be good, give your body sufficient time to try to get lubricated on its own. Listen to your body if it is telling you it is not ready for intercourse just yet.

8) For many women, childbirth may involve an episiotomy, stitches, tearing, or C-section. Many women find that they are anxious about resuming sexual activity because of the physical trauma their bodies have been through. Additionally, some women experience urinary incontinence and flatulence as a result of childbirth. These two conditions, and the possible embarrassment related to them, can make some women avoid sex. These two issues usually resolve themselves after six months, so talk to your doctor if these are a concern for you.

9. Vaginal pain may occur with intercourse. 

Whether you give birth vaginally or by C-section, vaginal pain is likely to happen (most likely due to the hormone changes). The good news is that recent research from University of California San Francisco shows that childbirth does not appear to affect a woman’s long-term sexual functioning (Fehniger, J.E.).

As long as your medical provider has given you approval to resume sex, take it slow, make sure you are adequately lubricated, and rest assured that any pain should be significantly improved within a few months. Try using a silicone-based lubricant for vaginal dryness. Some women may benefit from a vaginal moisturizer or an estrogen cream.

In addition, having more sex will likely help. Vaginal atrophy, when the walls of the vagina narrow and thin, can occur after long periods of time without sex. Having more frequent intercourse will help the vagina bounce back into shape. Of course, speak to your medical provider if the discomfort does not improve after a few months.

Having a baby is a wonderful time, but sometimes, sexual problems can be embarrassing or leave women feeling like they are alone in their problem. I hope that this overview was helpful and that you receive the support you need to resume your intimate relationship after adding a new addition to your family.

Resources:

1. Beck, C., Watson, S. (2008). Impact of birth trauma on breast-feeding: A tale of two pathways. Nursing Research, 57(4). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18641491
2. Fehniger, J. E., Brown, J.S., Creasman, J. M., Van Den Eeden, S. K., Thom, D. H., Subak, L. L., & Huang, A. J.  (2013, November 19). Childbirth and female sexual function later in life. Obstetrics and Gynecology, 122(5). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24104776
3. Moore, K., Watson, K. (n.d.). What do you want to know about pregnancy? Healthline. Retrieved from https://www.healthline.com/health/pregnancy

In 1982, sociologists Pepper Schwartz and Philip Blumstein published American Couples: Money, Work, Sex, the first major study of its kind to compare gay male, lesbian, and heterosexual couples on basic issues such as sex, communication, and money. Among many other findings, their research showed that lesbian couples had less frequent sex than anyone else. And thus was born the trope of “lesbian bed death.” A majority of comparative studies in the past 30 years have replicated these results, although a few have found no differences between lesbian and heterosexual couples.

Over the decades, though, those of us who first publicized the American Couples findings have come to doubt them. More specifically, we have questioned whether “sexual frequency” is the most valuable measure of the sexual health of a relationship, whether our views and definitions of sex may be inherently heterocentric, even phallocentric. However, until recently we had nothing but our theories—and the incontrovertible data showing that female couples have less sex. The stereotype of “lesbian sex” became … cuddling, even the stereotypes that lesbians have of themselves. Never mind that the frontiers of BDSM, polyamory, and erotic gender bending were explored by lesbian and bisexual women long before most heterosexual women had a clue. Let’s forget the gay and bisexual female sex radicals, from Virginia Masters to Betty Dodson to Tristan Taormino. Lesbian sex, when not thought of as entertainment for men, has come to be seen as tepid and a little bit boring.

But now, finally, someone has done the research that explores the questions raised by feminist sexologists. At the annual conference of the Society for the Scientific Study of Sex (SSSS), which I attended for the first time in many years, I discovered that an abundance of the smartest young researchers in sexology are women, many of them queer women. One of them, Dr. Karen Blair, presented research that tested several measures of “sexual well-being,” not just frequency. She compared more than 800 men and women in relationships, about equal numbers of lesbians, gay men, heterosexual men, and heterosexual women, and asked questions about sexual frequency, duration of each sexual encounter, types of sexual acts, and orgasms.

Sure enough, as measured by frequency lesbians fell behind the others. Only about 15% of the lesbians had sex more than twice a week, compared to 50% or more of the others, and about 40% said there were weeks when they had no sex at all, compared to less than 20% of the rest of the sample. But if you looked at how long each sexual encounter lasted, women in same-sex relationships were champs. Gay men and especially male and female heterosexuals reported typical sexual encounters of a half hour or less, often much less. Lesbians, on the other hand, described sexual sessions lasting upward of 30 minutes, and nearly 10% reported encounters of two hours or more. This is our first hint that the measure of “sexual frequency” is inadequate. Perhaps lesbians have lower frequency because if each sexual encounter involves extended periods of sensual and sexual activity, it is harder to find time for sex. And if sex is that intense, maybe you don’t need or desire it as frequently. Maybe some of the other needs that genital sex fills—such as the need for intimacy and closeness—CAN be fulfilled by cuddling.

Blair’s other results are also food for thought. Not surprisingly, the most frequent sexual activity engaged in by heterosexual men and women was penile-vaginal intercourse, with the most common among gay men and lesbians being giving and receiving oral sex. More surprising was the finding that heterosexual women were most likely to say they did not always have an orgasm during partner sex—and lesbians, of all four groups, most frequently reported not only orgasms but multiple orgasms most frequently. Perhaps lesbians have sex less frequently because—due to those extended sessions and an abundance of oral sex—they tend to not only climax, but climax repeatedly on a regular basis. Looked at from this perspective, the “lesbian bed death” trope is clearly inappropriate and grossly misleading.

All participants in Blair’s study reported similar levels of sexual satisfaction, regardless of their orientation, and other comparison studies have shown a similar result. This is an interesting finding, considering that heterosexual women report fewer orgasms than lesbians, and that a common complaint of heterosexual women is that their partners do not spend enough time on foreplay. Do heterosexual women trade consistent orgasm for frequency? Do they care? The neuroscientist Sari van Anders, who rocked a plenary at SSSS with her research on hormones and neurotransmitters, provided a clue to the last question. Van Anders included both lesbians and heterosexual women in her research on the relationship of hormones to sexual behavior, and she found that heterosexual women did not expect orgasm during sex, while lesbians took having an orgasm in partnered sex for granted. Perhaps our expectations are shaped by our experiences, and “satisfaction” may have more to do with what we think is realistic than what is ideal.

So what does this mean about “lesbian bed death”? Sexual frequency declines in all long-term relationships, just a bit more drastically for women with women. Is frequency the only measure we should be looking at? Blair’s research suggests not. For lesbians, it seems just as satisfying to have fewer sexual encounters, to spend more time on each one, and to know that both partners will have at least one orgasm when they do choose to have sex. For many women, exchanging quantity for quality may seem an exchange worth making. What’s so bad about that?

To go a little deeper, if we throw out ‘frequency’ as the sole or even most important measure of sexual health, we see differences in sexual style that vary by sexual orientation but also by gender, and contrasting these dimensions gives us new insights. Lesbian sexuality could be thought of as what women do when they construct sexual scripts without male influence, while the sexual styles of women who have sex with men reflect how sex is constructed when there is a need to balance both male and female sexual styles. Lesbians construct sex as less frequent but more prolonged, intense, and orgasmic. Heterosexual women are content with fewer orgasms and more frequent genital encounters. Many heterosexual women dream of what in heterosexual terms is called “foreplay” but for lesbians is a routine part of sex—a lot of touching and oral genital contact. Do lesbians dream of quickies and sexual encounters where you go straight for the crotch?

There is tremendous variety, of course, in women’s sexual preferences, and the stereotypes I’ve created based on Blair’s study are grossly reductionistic. But there is something to be looked at here, something involving gender, the purposes served by genital sexual contact, clues that will help us learn more about human sexuality in gender.

But we will only learn it when we stop using terms such as “lesbian bed death” and start to look at all sexual styles as equal but different, instead of privileging certain types of sex over others. Sex is not a competition; it’s a rich and diverse activity whose mystery we have only begun to comprehend.

A colleague of mine encourages people to consider the first day of every month a “New Year’s Day” of sorts: Instead of one New Year’s resolution, why not mindfully attempt change every month? Imagine what you can do for yourself in only a year.

While popular wisdom has long suggested that habits can be formed in about 30 days, recent research reveals the process is more nuanced, with habit formation typically taking 18 to 254 days, with an average of 66 days. However, the beauty of a 30-day challenge isn’t just about permanent habit formation—it’s about creating momentum, building awareness, and experiencing positive changes that can motivate longer-term growth.

Having challenged myself to new habits 30 days at a time in 2013, I’m challenging you to begin your own changes today.

Accept this invitation to tackle a 30-day challenge to enrich intimacy in your relationship. Start now—don’t wait until the first of the month. Consider which habit(s) would benefit you and your relationship to enrich or enhance intimacy. I’ve drawn up a possible list, pulled from research as well as my professional and personal experience, to help inspire ideas:

Within 30 days, read a book to improve your relationship—people who seek relationship counseling with me are encouraged to read Hold Me Tight by Dr. Sue Johnson. This groundbreaking book on Emotionally Focused Therapy has sold over 1 million copies and continues to help couples strengthen their relationships through evidence-based approaches. Another favorite is The Truth About Love by Dr. Pat Love, which explores the predictable stages of love relationships.

Commit to kissing hello and goodbye. In a fast-paced culture, romantic partners are often like “two ships passing in the night.” We miss simple, everyday opportunities to slow down and reconnect with loved ones. For the next 30 days, make a new rule in your relationship: kiss hello and goodbye—no exceptions! (Already doing this? OK, try this one. Make each kiss last at least five seconds; trust me, it’ll feel longer and more intimate than you assume. Imagine your lips on your loved one’s lips, cheek, or neck for the count of one … two … three … four … five. Now THAT’s a kiss.)

Add the “hug to relax” or “five-minute hug” to your day, every day, for 30 days. Recent research confirms that couples with higher comfort levels around physical affection report significantly better relationship well-being, with private touch being particularly important for relationship satisfaction. Set a time, and in a standing hug enjoy the waves of experiences you have in your partner’s arms. Notice what each of your five senses is sensing. Notice the smell of your partner’s neck, shirt, hair, etc. What do you hear in the hug? A heartbeat, breathing, or sounds of the environment? Notice the touch of your bodies: Where do you touch? Where do you not touch? Notice the sensation of standing on your feet for a period of time in one place.

Reduce your complaints and increase praise of your partner for the next 30 days. Dr. John Gottman’s extensive research has identified a “magic ratio” of 5:1—for every negative interaction during conflict, happy couples have five or more positive interactions. As with good parenting, we need to balance negative feedback and interaction (“Go do your homework!”) with positive feedback and interaction (“Thanks for getting to your chores!”) in our intimate relationships. I often explain to people that we are born to particular caregivers, but when we mature into adults and commit to a relationship, we choose and become “chosen caregivers.” It’s essential that we remember that our spouses are sometimes just “tall kiddos” who need and desire more praise than complaints.

Last but not least, consider sexual, engaged activity every day for 30 days. Now, this doesn’t have to mean intercourse, orgasm, or even nakedness, the goal is to foster closeness, affection, and mutual comfort. There is an array of activities we can indulge in to ignite and nourish our sexual selves. Recent research highlights the strong connection between active, satisfying intimacy and overall relationship wellbeing, with studies showing that couples who engage in regular intimate connection report higher relationship satisfaction. Body rubs, hand massaging, bathing together, undressing your partner, spooning, masturbating solo or beside each other—these are just a few ideas for a 30-day challenge.

This exercise works best for couples who are feeling generally good in their relationship. If you or your partner are navigating sexual pain, past trauma, postpartum changes, big differences in desire, or other challenges, take it slow, and don’t hesitate to check in with a sex therapist before diving in.

Bonus idea straight from a sex therapist’s office: One of my clients’ favorite ideas for being sexual that doesn’t require much of anything is a “walk down memory lane.” This approach draws on the therapeutic power of reminiscence, which research shows can create positive emotional connections and enhance wellbeing. Reminisce together about the hottest sex you’ve had together, fire up your memory by indulging in a description of what your senses experienced, maybe even come up with a title for this memory as if it were its own sexy movie. Perhaps take the memory a little further by embellishing, elaborating, or peppering some components of fantasy by sprinkling in spicy details you would add if you could go back in time.

The “walk down memory lane” exercise is most enjoyable when your shared sexual history feels positive and consensual. If you and your partner have experienced trauma, coercion, or infidelity, revisiting sexual memories might feel upsetting instead of connecting. In that case, it’s perfectly okay to skip this one, or try it with guidance from a therapist.

Find a Therapist

This isn’t necessarily a go-big-or-go-home challenge, mind you. Take on something you can be successful doing. The goal is to form a new habit, enrich intimacy, and add pleasure to your relationship.

Enjoy!

References:

1. Singh, B., Murphy, A., Maher, C., & Smith, A. E. (2024). Time to form a habit: A systematic review and meta-analysis of health behaviour habit formation and its determinants. Healthcare, 12(23), 2488. https://doi.org/10.3390/healthcare12232488
2. Healthline. (2025, October 16). Habit formation: How long it takes and how to start now. Healthline. https://www.healthline.com/health/how-long-does-it-take-to-form-a-habit
3. Psychology Today. (2026, January). One powerful habit that couples should never underestimate. Psychology Today. https://www.psychologytoday.com/us/blog/social-instincts/202601/one-powerful-habit-that-couples-should-never-underestimate
4. Johnson, S. (2008). Hold me tight: Seven conversations for a lifetime of love. Little, Brown and Company.
5. International Centre for Excellence in Emotionally Focused Therapy. (2024). Dr Johnson books. ICEEFT. https://iceeft.com/dr-johnson-books-2/
6. Gottman Institute. (2017). The magic relationship ratio, according to science. The Gottman Institute. https://www.gottman.com/blog/the-magic-relationship-ratio-according-science/
7. Psychology Today. (2022). The Gottman ratio for happy relationships at work. Psychology Today. https://www.psychologytoday.com/us/blog/curating-your-life/202206/the-gottman-ratio-happy-relationships-work
8. Australian Institute of Family Studies. (2023). Relationships and sexual activity: Trends in Australia. https://aifs.gov.au/research/reports/relationships-and-sexual-activity-trends
9. Positive Psychology. (2025). Reminiscence therapy vs. life review therapy: A quick guide. PositivePsychology.com. https://positivepsychology.com/reminiscence-therapy-life-review-therapy/

Why do some things spark sexual excitement for one person while those same things leave another person quite uninterested?

I frequently speak to people who are upset because they’re indulging in sexually compulsive behaviors that cause problems in their lives. (I want to emphasize these are not the same as turn-ons or fetishes that any couple might happily incorporate into love-making or sexual play. No problems there!)

Sometimes sexual feelings and behaviors become a problem because they get in the way of healthy intimacy. For example, one man secretly discovered porn on Dad’s smart phone at an early age. Now he becomes sexually aroused whenever he’s alone and picks up his smart phone. Another grew up in a rural area where he peeked into the outhouse to watch female family members urinate. Now he uses spy cams in restrooms or pays prostitutes to give “golden showers.”

Women also find themselves thinking and participating in sometimes dangerous behaviors that are sparked by early experiences that are exciting, confusing, or, more often, traumatic. For example, if a woman experiences sexual, physical, or emotional abuse as a child she may move into adulthood finding that again and again she is attracted to dangerous, high-risk sexual encounters with volatile or unavailable people.

When sex becomes a problem, it is useful to explore our arousal template, which is a mix of physiology and learning based on relational or sexual experiences. A template is a pattern or blue print of how and why individuals think or behave in habitual ways. Arousal is an automatic knee-jerk sexual reaction that is usually closely related to excitement, fear, or how we’ve been wounded.

Almost anything can become an unconscious trigger that cues us to become sexually excited or aroused. The Internet provides thousands of examples. Numerous websites feature young girls (often fully clothed) smoking cigarettes. These sites cater to men who became obsessed as adolescents with girls who smoke. Objects that are sexualized include shoes, cars, lingerie, or anything made of leather. This last example can be linked with sensation (the feel of leather against the skin) or scent.

Emotions such as rage, fear, shame, pain, loneliness, and sadness trigger some people to sexual arousal, as do physical characteristics. Most of us can relate to feeling attracted to a particular height, weight, hair color, and body shape, as in, “well, s/he is really not my type…” Or perhaps someone is, and we are “hooked”—there’s that arousal template again!

It organizes what we believe about consent, equality, respect, trust, safety, dishonesty, domination, objectification, power, and control. Arousal templates also shape what is valuable, worthwhile, thrilling, or desirable, and just as importantly, what is to be feared and avoided. It is primarily an unconscious map of how we have become wired sexually, built on preferences already determined by basic survival instincts.

Fortunately, most of us are not compelled by violent arousal templates to act out in a violent manner. Fantasy can be a delicious and enjoyable way to spice up sex with a partner or engage in self-pleasuring. Some of us, however, are overwhelmed and debilitated by the vagaries of our arousal template.

Used in conjunction with experience of different types of sexual patterns and courtship developments, the arousal template is an essential tool to help therapists gradually detail components of a client’s sexual history. Each of us possesses a unique model of sexuality, formed at least in part by incoming family messages, childhood abuse or neglect, culture, the media, and, of course, religious influences.

As we explore and better understand our childhood relational experiences and memories we get to deconstruct our arousal template with what I like to call “compassionate curiosity.” As we explore these early messages, we can recognize and gently release old patterns that no longer serve us. This is what sexual healing is all about!