There is a growing, rarely spoken-about problem in our society: low sexual desire, which affects many women and also many men. This decline in desire has many causes and can contribute to unhappiness in the relationship. As the frequency of sexual connection diminishes and one or both partners feel unwanted, discord in other areas of the couple’s life can arise. As a sexual health specialist, I discuss with my patients the many ways they can raise sexual concerns with their partners and find solutions to improve their sexual desire and pleasure.

For women, one solution is to focus on sexual thoughts and fantasies, which many shy away from because it feels like cheating or watching pornography. Men are more likely to be comfortable with the use of sexual fantasy. It is essential to let couples know that fantasizing is normal, healthy, and nurturing of one’s sexual drive and pleasure. You don’t have to share your fantasies unless you want to, and you shouldn’t pressure your partner to share their fantasies if they don’t want to. When someone has difficulty visualizing and using fantasy, I recommend websites and erotic literature that help them find something that works for them. When combined with physical stimulation, the imagination is a powerful driving force for sexual arousal and orgasm. Having an orgasm releases feel-good neurotransmitters and hormones, among them oxytocin and endorphins, and enhances the couple’s bond with one another.

In addition to the perfectly acceptable use of fantasy to become aroused, what does it involve to have your partner earnestly desire you? There is excitement, novelty, and the unknown in a new relationship. In a long-term relationship, a strong emotional and psychological connection, deep mutual understanding, humor, love, trust, interest in sex, a willingness to make the time for sex, and to experiment and be spontaneous, and, of course, psychological and physical desirability. Most of us do not look like models or movie stars! But suppose we do not keep ourselves reasonably fit, healthy, well-groomed, psychologically alive, interesting and interested, and kind. In that case, it is not so surprising that desire may be absent. There are many resources to help men and women work their way back to that more desirable version of themselves.

Another common problem is difficulty expressing needs, wishes, or desires with one another. Oftentimes, one partner is shy or even ashamed of communicating their sexual desires and wishes. This reluctance leads to a deterioration in their sexual connection, and other critical areas of their relationship suffer, including their bond of TRUST and ability to forgive one another for slights or transgressions. Sex happens to be a great window to learn about one another and oneself.

Significant issues for men are erectile ability and size, especially since many men are familiar with unrealistic images portrayed in pornography. Endowment is linked to a man’s pride and male ego.  Men put pressure on themselves, have unrealistic expectations, and think that they should always have erections on demand, even multiple times in one session. If they have trouble performing sexually, rather than patiently working it out with their partner, they may give up on the relationship or take performance-enhancing drugs. Many reasons beyond a man’s control might cause performance issues, among them medications and age-related declining testosterone levels. Being stupendous all the time is unrealistic and not healthy. There are other ways to enhance one’s sexual health naturally or non-invasively.

Guiding my patients with the right attitude is the first step toward a new level of functionality and understanding.​​ For example, being creative, flexible, and adjusting expectations allows you to connect even during temporary physical inability. Sometimes, when a temporary physical challenge arises, and the couple cannot adapt, their sexual relationship changes irreparably.

Men and women with sexual problems should discuss their issues with their doctor and receive the appropriate blood tests and other tests. They should look into the medications they are taking because many of them have side effects that impair sexual function. Men and women should work to minimize the burden of chemicals they are exposed to, as many of these are endocrine disruptors and harm sexual function. Discuss your diet and overall health with your physician to reduce causes of low desire driven by nutrient deficiencies and hormonal and vascular problems. More about all these topics in future blog posts. Taking these steps can lead to better health habits, which can reduce or make unnecessary taking medications that cause sexual side effects. Attending to sexual problems can inspire positive diet and lifestyle changes and better overall health.