When Jasmine enters my office wearing her dark, tightly tailored business suit with hair and makeup done to perfection, she is unable to leave her hard exterior at the door until I asked her why she booked the visit. She reluctantly, and with obvious internal distress, reaches for the Kleenex and lets a tear escape her otherwise controlled demeanor, stating that her husband sent her. They are starting to believe that something is seriously wrong with her. She isn’t interested in having sex with him anymore and he is growing impatient. She wants herself fixed as soon as possible before their marriage deteriorates any further. While he appreciates her for the professional woman she is, her husband brings to the table an intrinsic need to provide for and lead his wife and family. In fact, his leadership defines who he is as a man and when Jasmine does not allow him to do this, he feels like a failure. His ego is bruised. He needs her fixed or he will never feel whole again. This dynamic will result in 2 possible outcomes: They will resolve to live separate lives to avoid how the other makes them feel about themselves, or they will learn to re-model their respective roles and extend greater understanding to each other for their respective contribution.

There are many complicated factors impacting a woman’s sexual desire. That spontaneous, gut-wrenching, pelvic-tingling, impulse for sex that was once commonplace in young or new relationships is only a tiny component in a mature woman’s desire pathways. A more common route into the sexual cycle is a “willingness” to be receptive, to make oneself mentally, emotionally and physically available to be led into a sexual encounter. This is more intellectual than biological, more planned and scheduled than organic. But, with practice and pleasure, the “feel-good-sexy” brain hormones get easier to access, making it more likely that she will want to go back for more. In fact, when a 70 or 80 year old woman enters a new sexual relationship, she often returns to that deeply biological, uncontrollable urge for sex that she felt remotely as a young woman and I have seen many examples of this excitement in my older patients. Fun wow!

For Jasmine, the safest and most permanent, long-term “treatment” for their sexual dysfunction is more difficult than taking a pill or a patch. It involves looking deep into the relationship and figuring out what makes each of them tick. There may need to be a reshuffling of family priorities or a change in work schedules or even a change in career for one of both of them. Are they motivated enough to make those changes? Some couples will have to completely re-negotiate the marital contract to ensure both parties are heard and understood. It means letting down the walls and communicating openly both with your partner and, more importantly, with yourself. It means going outside your comfort zone and into your erogenous zones in new and exciting ways. There are books, videos and workshops to help you on your quest for, not only better intercourse, but a better life. Because sex is the glue that holds marriages together, find what motivates you and your partner and explore how to tap into those needs.

Whenever we embark on a project that will require incredible time, energy and effort, it is important to have a strong, “why?”. This will help maintain momentum through the ups and downs and keep focus on the desired outcome. It’s not all roses with relationship work. Absorbed by career progression and raising children, Jasmine has not spent much time actually “working” on her marriage in several years. What motivates her and her husband to make changes now? Usually it involves a crisis or breaking point in the relationship. They hit rock bottom and the sexual dysfunction, once isolated to the bedroom, now translates to daily rising tension and maybe even extra-marital affairs. If the sex is lacking the relationship is, no doubt, also deficient. It is impossible to separate the relationship from the sex. A woman’s lack of sexual desire has been found to impact her quality of life in a similar magnitude to other chronic conditions such as back pain or heart disease. On the flip side, we know that people in long-term, satisfied relationships report higher overall health and wellness and actually live longer than their single counterparts. Great sex helps women to have better marriages and better marriages help couples to be more open and intimate in the bedroom. It’s a wonderful feedback loop toward deeper connection. Children who grown up in healthy, functioning families, do better in school and tend to emulate the strong communication they have seen at home. On a family and societal level, this makes improvement in sexual function and maintenance of close, bonded relationships even more fundamental! So get to work!

For this step in your relationship homework, plan a weekly date-night and bring a pen and paper. Make 2 columns and write down each of your 2 names across the top. Now make a list of YOUR top 3 marital needs (sexual affection, help with the kids after-school activities, open communication, flowers and gifts, whatever you desire from your marriage) and then your partners top 3 martial needs as you see them. Spend the time you need to create your 2 lists and then compare your answers. The intent is to open dialogue about what YOUR needs are and to improve understanding of your partner’s needs. We speak different love languages and often pour into our partner what we would like them to extend to us. In many cases, this means that the receiving partner’s needs go unmet and he/she cannot understand why their spouse doesn’t care enough to do these things when, in fact, the giving partner has no idea they are so off track. If you want to go deeper with this conversation, try reading these resources WITH your partner:

1.  The Five Love Languages: How to Express Heartfelt Commitment to Your Mate by Gary Chapman

2.  His Needs, Her Needs: Building an Affair-Proof Marriage by Willard F. Harley

On your subsequent date-nights, bring your notes each time and ask 3 questions for each week. First, what went well over the past week, be very positive with each other and emphasize all that was wonderful. Second, identify if any (or all) of your top 3 needs were met and respectfully discuss what may have been missing. Be specific, your partner cannot read your mind. Lastly, if the past week was not a perfect 10/10, what could be done in the upcoming week to make it a perfect 10? While it is important to learn your partner’s needs if you want to make a meaningful contribution to your marriage, your happiness does NOT depend on your partner. Take full responsibility for finding your own peace and happiness day to day and this will likely mean making changes outside of your relationship to fulfill your needs, wants and desires. The two of you can evolve together and by strengthening yourself and finding independence you will have more to bring to the table in your marriage, more to give and more grace with which to receive.