Sex: Deciding to Just Do It

We are learning more and more about what motivates women to have sex -- enough to know that we still don't know that much.

We do know that our motivations change with our situations. What motivates us when we're young and single is very different from what motivates us when we're older, and in long-standing relationships, or older and single.

So when we suffer from lack of desire -- are we missing the sort of drive we had when we were teenagers? And is it possible we just haven't found a new motivation for sex?

The more we learn from women, the more it seems that for us sex doesn't always begin with lust, but instead starts in our hearts and minds. We engage in our heads first, decide to have sex, and then with enough mental and emotional stimulation, our genitals respond. The older we grow, the more this is true. Age and maturity bring a new game into the bedroom.

For us, having sex is less an urge than a decision. One we can choose to make and then act upon. When we decide to say yes instead of no, decide to schedule sex instead of waiting (perhaps for a very long time…) for our body to spontaneously light on fire, decide to engage with media or methods that will put us in the mood rather than wait for romantic moments to happen along, we're using our heads to keep sex in our relationships.

Deciding to be intimate unlocks the pleasure. And the more sex we decide to have, the more sex we will feel like having. That's the secret to regular bonding.

Why just decide to do it? This much we know:

* Sex leads to a longer life.
* Sex, like all exercise, helps protect us against heart attack and possibly stroke.
* Hormones released during sex may decrease the risk of breast cancer and prostate cancer.
* It bolsters the immune system.
* Sex before bed helps us get to sleep.
* Of course, sex burns calories.
* Sex can help relieve chronic pain, including migraines.
* An active sex life is closely correlated with overall quality of life.
* Good sex can protect us against depression.
* Good sex reduces stress and increases self-esteem.
* Sex with your significant other stimulates feelings of affection, intimacy and closeness.

Making sex a focus in your life as you get older doesn't make you unusual. A study by AARP found that 66% of women age 45-59; 48% of women age 60-74 and 44% of women over the age of 75 believe that a satisfying sexual relationship is important to their quality of their life.

We think those numbers would be higher if women knew they could engage in thoroughly satisfying sex without waiting around for desire. Just by using their heads.

Let's Get Aroused

Hi everybody. My name is Julie. I’m a writer here at MiddlesexMD. My credentials for writing about sex at midlife are… Well… I have reached midlife. And I enjoy sex.

Still.

Despite almost 30 years of togetherness with the same guy. Despite aches and pains, stress and too little time, and all the physical surprises of menopause. Despite all of that, we are nowhere near ready to hang up our sheets.

So when my own friend (we served undergraduate years together) and doctor (my own menopause doctor, because I’m lucky), Dr. Barb, asked me to help her develop her website, I jumped at the chance. I needed to learn about this myself. What better way?

I’ve been writing for years and years, and for many years researching and writing on health  topics. But I have never written about sexual health. Barb is teaching me—you would not believe the size and density of these textbooks.

So, day one, lesson one, Basson’s Model. I had no idea that there is a difference between Sexual Desire and Sexual Arousal. I really always thought they were the same thing, or flip sides of the same impulse, or something. Because that’s the way I’d experienced it for most of my life. Arousal and Desire arrived on my doorstep, it seemed, instantaneously.

But they are considered distinct aspects of the sexual experience. And now that menopause has slowed me down a bit, I understand better.

We can achieve arousal with or without desire. We can have comfortable, enjoyable, emotionally satisfying sex with or without desire. That is, we need arousal for sex. But we don’t need desire. We like it. We want it. We enjoy it. But we don’t need it to engage in sex or get a lot out of our sexual experiences.

The easiest way for me to tease these ideas apart is this way: Desire happens in your head. It’s an idea. Arousal happens all over. It’s physical. Certainly the idea can spark a physical response. But it works the other way more often for women. Sexual stimuli—physical sensations, emotional feelings, sights, sounds, smells—arouse us physically. Our arousal readies our bodies for sex and can breed desire.

So, when we start talking about the kinds of sexual problems women may experience with menopause, the distinction becomes very important. Are we having difficulty with arousal or with desire? Or both?

What used to follow automatically from sexual stimuli—the arousal part—may now take more time and more stimulation. We may have to ask for and give ourselves more help and support to become aroused. This isn’t a lack of desire, but a greater need for stimulation.

We may be receiving all the same sexual stimuli that we always have, that always worked before, but we don’t respond to it as readily. We love our partners just as much or more. But our bodies just don't respond as quickly now. Or we may now have physical or emotional limitations or illness or medications that muffle the effect of sexual stimulation.

This was lesson one for me. A real eye opener. I used to worry that I didn't feel the same desire as I did when I was in my 20s and 30s. Worry isn't the word. It upset me. I am much more relaxed about it now. I'm learning to tune in to stimulation, to appreciate and notice my body's response more. And that helps a lot. Well, I suppose writing about sex every day doesn't hurt either...

There have been and will be many more lessons. Some embarrassingly basic. Some I wish I’d known 30 years ago. I will always be willing to show my ignorance in these matters, followed by Dr. Barb’s patient teachings.

Meantime, I’m gathering up all my favorite stimulants: I’m with Reka, a visitor from the last post, on the potency of Dr. Gregory House. And Dr. Andrew Weil too (his relaxation tapes have an opposite, unadvertised effect on me). I have a thing for David Strathairn. Indian food. Tango/dance movies. And I have this special drawer in my bedroom….  And you? Care to share?

(Anonymous sharing is always welcome. Or make up a name, if you like!)