Connie A. O'Reilly, Ph.D. Clinical Psychologist Oregon Fibromyalgia Team

What if I just don't feel like it?

Our society puts tremendous pressure on us to be sexual.

Television and movies convince us that unless we have wild passionate rip-your-clothes-off sex in odd or unusual places at least weekly (preferably several times daily), we must have some sexual hang-up. Living with the Madison Avenue image of what is beautiful leaves most of us with some significant insecurity about our bodies. We doubt that anyone could find us desirable because we are not among the "beautiful people." The body changes, pain, and fatigue associated with illness can zap sexual desire further. Anxiety, depression or the medications used to control those conditions can decrease one's libido. Also, antihypertensives, ulcer medications, and others may have similar effects.

What is normal sexual desire?

Daily sex is normal. Sex once a month is normal. So the concept of normal is not very important, or very helpful. The real issue is often a significant difference in basic sexual desire between two partners.

While you may at times choose to accommodate your partner's greater desire out of love and caring, giving in when you really do not want to is likely to lead to increasing resentment which ultimately can sabotage the relationship. Sexual desire changes, from day to day and from year to year (remember the first year of any intimate relationship!). If your desire is lower now than previously, there are things you can do to change that.

So what can I do about it?

  1. Address unresolved power struggles in your relationship. When a lack of communication has left one or both partners with built up resentment, it is very difficult for them to have enough trust and security with one another that they are willing to risk being sexual together. Sex is simply communication, but it is the most intimate and complex form of communication. If the partners are not talking openly, negotiating needs, and resolving conflicts productively, there is no reason to expect that they can have a satisfying intimate relationship. Unexpressed feelings usually get expressed in the bedroom.
  2. When we feel powerless, we will take whatever steps we know to take our control back. While most people see control as being demanding and forceful, the other powerful way of exerting control is to be passive and withholding. One striking way to do that is to withhold your sexuality from your partner. This often leaves the partner feeling inadequate and impotent. If you believe that expressing your anger may threaten your security, you may feel afraid to confront problems, which ultimately leads to increasing resentment. Withholding your sexuality is one powerful way to express your anger, without having to confront issues directly. The problem is that the real issues never get addressed nor resolved, and your partner is left feeling confused and inadequate.
  3. Tend to your pain. Discuss your pain with your medical caretakers. Find out if there are any more effective medical treatments for your symptoms. If your are experiencing sexual side effects from your medications, don't just discontinue them. Discuss the problem with your medical professionals. Don't accept painful sex as normal. There are many potential causes which can be readily treated. If you experience problems with vaginal dryness, try one of the many lubricants on the market, with great names like Astro-Glide, Aqua Lube, Lubrin, or Replens (avoid sticky water-based products or petroleum-based products).
  4. Open the lines of communication with your partner. Be open and direct. State your feelings and ask for what you want. Don't assume you know what your partner is feeling, even if you've been together for years. Listen actively, by paying attention, responding to comments, and asking questions for clarification. The best way to change your sexual relationship is to talk to one another about what you would like to see happen. Good sex takes two, and both of your needs and desires are important. But given that this is such a complex form of communication, you can get in trouble if you try to mind read. Contrary to what the movies lead us to believe, talking during sex is not only ok, it's generally necessary.
  5. Plan ahead for good sex. If you use medications to control your pain, time them so that you are likely to feel better when you have sex. Likewise, time a hot bath or soak in the hot tub to maximize your relaxation, and minimize the level of pain. Make massage a part of your physical closeness. Make it a priority to spend time with your partner. If you don't plan it and schedule it, it is likely to be superseded by any of a dozen different obligations. Spontaneity is exciting, but not necessary for good sex. And if you continue to struggle with the intimate part of your relationship, seek help. Take a class on couples' communication, buy a book or video on relationship issues, or seek the help of a professional marriage counselor or psychologist.
  6. Nurture yourself. It's easier to feel sexy if you feel attractive. Give yourself time and permission to pamper yourself and take care of your appearance. Shower, use lotion or scent, wear attractive clothing. Think of what things your partner does that please you, and try to do those for your partner. You can enhance your body image and your functioning by doing regular exercise to increase your strength, stamina, flexibility, and self-esteem.
  7. Be creative. Sex is not an Olympic event. There are many wonderful ways to be sexual without actual intercourse. Touch and cuddling are a very important part of feeling close. Too often couples develop some conflict leading to difficulties with sex, and then they avoid cuddling for fear it will lead one person to believe it is a prelude to sex. It's important for women to know that a man's erection is a compliment...not a demand. And remember, one person declining sexual contact is not a rejection of their partner; it is a statement of what is going on with them at the time.

There are things that may increase desire levels. Sexual fantasy, or erotic stories, magazines, or movie scenes often trigger increased arousal. Sex in a new setting, a romantic atmosphere, new positions, oral sex, or use of vibrators may decrease boredom and stimulate arousal. Also, pay attention to times and situations when your desire is higher, and don't be afraid to experiment with what you've learned. But remember that good sex in a relationship takes two, and it's counterproductive to try to force someone to do something they just aren't comfortable with.
If you experience muscle pain or stiffness during intercourse, experiment with different positions. The Arthritis Foundation publishes a wonderful free leaflet called Living and Loving: Information About Sexuality and Intimacy which describes alternatives to traditional positions.
Also, let yourself consider alternatives for sexual intercourse. There are many ways to pleasure one another (or yourself) without intercourse. Manual and oral sex can be fulfilling alternatives. And there are times when you feel sexual and there is no partner around, or times when only one of you desires sex. Masturbation is a normal, healthy, and satisfying form of sexual activity. You can learn a lot about your body, what feels good, and what leads you to orgasm. It may increase the pleasure you experience during sex with a partner, and will help you put into words, or actions, what you would like your partner to do. Many people experience pleasure by using a vibrator specifically made for sexual stimulation (available in adult stores or by mail order). It's time to bring masturbation out of the bathroom and the back bedroom, and into healthy sexual relationships, with a partner or by yourself.
In summary: Building a solid relationship, which requires time together, caring, respect, and open communication, will be the most powerful tool to increase your level of sexual desire. Sex is the most intimate and most complex form of communication. Unfortunately, many of us were raised with very rigid and Victorian views of sexuality and what sexual behavior is acceptable. But those views were learned; and they can be unlearned. It takes time, open-mindedness, and a willingness to experiment with new behaviors. Good luck, and enjoy the journey.


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