Why Women Have Sex (24 page)

Pregnancy is not the only change in health that can negatively affect sex drive. Most obviously, pelvic cancers, surgeries, or traumas and vaginal and urinary tract infections can directly impair a woman’s sexual desire by causing her pain during sex. But pretty much any type of illness can have a negative effect on desire by causing weakness, pain, lack of energy, or poor body image.

Many prescription drugs also impair sex drive, either by influencing the hormones or brain chemicals that directly play a role in women’s sex drive, or indirectly by impairing a woman’s ability to become sexually aroused and have an orgasm—both of which make sex less rewarding to her. For instance, birth control pills can decrease sex drive if they substantially lower testosterone levels. Oral contraceptives that have the active ingredient desogestrel or norgestimate are especially bad in this regard.

Antidepressants, which are used to treat depression as well as certain anxiety disorders, have long been linked to impairments in sexual functioning. An estimated 96 percent of the women who are taking selective serotonin reuptake inhibitors, or SSRIs—the most commonly prescribed class of antidepressants—experience problems with desire, arousal, orgasm, or all three. Up to one-half of women who experience sexual side effects feel that the problem is significant enough to warrant clinical attention. One woman in our study described how she had struggled with this side effect:

My partner has a higher sex drive than me; therefore, I sometimes feel like I should have sex to meet his needs. He doesn’t make me
feel obligated. I feel that way because I know it is a normal part of healthy relationships. Because I’ve battled some anxiety and am on antidepressants, my drive is very low. I could go months, but that would not be fair.

—heterosexual woman, age 38

Antidepressants work primarily by increasing the brain chemical serotonin, which is diminished in many depressed individuals. Animal studies show, however, that certain receptors in the brain that “read” serotonin are also responsible for sexual behavior. If you give those receptors too much serotonin, they suppress sexual functioning. In the past decade, great gains have been made in developing antidepressants that do not activate the brain receptors that influence sexual behavior. As a result, many of the newer generation of antidepressants such as Serzone (nefazodone), Wellbutrin (bupropion), Celexa (citalopram), and Remeron (mirtazapine) cause fewer deleterious sexual side effects than those developed a decade or so ago (such as Prozac and Paxil). Anti-anxiety medications, such as Valium, Xanax, Ativan, and BuSpar, and antipsychotic medications, such as Haldol, Thorazine, and Mellaril, can also negatively impact a woman’s sex drive by interfering with brain chemicals that play a role in sexual functioning.

Finally, some antihypertensive medications that are used to treat high blood pressure, such as reserpine and clonidine, have been found to inhibit the blood flow to women’s genitals. By doing so, they impair a woman’s ability to become sexually aroused and experience orgasm. Over-the-counter antihistamines that are used to treat allergies, including Benadryl, Atarax, and Periactin, can also negatively impact sex drive by drying out the mucous membranes in the vagina.

Women differ in how they respond sexually to medications. In most cases, if a medication is causing a nasty sexual side effect, there will be other drug options that may not have the same negative effects. Sometimes the side effects go away after a few weeks, and sometimes doctors will suggest taking a two-to-three-day “drug holiday” which may help diminish symptoms.

Most people have strong preferences for what physical types they find sexually attractive. If a partner’s physical appearance changes over the course of a relationship, sexual attractiveness may be diminished in the eyes of the partner. This is just as true for women as for men.

The most common physical change that people experience as they age is weight gain. Sometimes this has no effect on levels of attraction, but for many women a partner’s significant weight gain can be a sexual turnoff. The situation can be complicated, however. Because overweight partners may not feel competitive in the mating market, they may be less likely to leave the relationship or have an affair, which naturally makes the other partner feel more secure in the relationship. The partner who is not overweight may even gain some power in the relationship.

Poor hygiene is another sexual turnoff for many women. If a person is constantly sweaty, dirty, smelly, unshaven, rumpled, smells of cigarette smoke, or has bad breath, who would want to get near enough to have sex? In the “Shattered Dreams” chapter of
Eugenics and Sex Harmony
, first published in 1933, the author described the perils that changes in hygiene can have on a woman’s sex drive:

The wife’s dreams of romance are shattered by the stern realities of the work-a-day world. She finds that her knight in shining armor is merely a man who has to be reminded to shave every morning. And who may not infrequently neglect to take his daily bath, unless he is forcibly reminded of this function. She may discover certain habits in him which he has carefully concealed during his courting days. She may find that he delights in smoking some particularly terrible-smelling pipe, which makes his breath almost unbearable. It may develop that he chews tobacco, and that his feet and arm pits exude a most offensive odor, which he takes little or no pains to eradicate by the proper use of formaldehyde solution, or other simple measures. In a thousand different ways her rosy dream of love may be broken into fragments.

Similarly, status and wealth are sexual attractants for many women, and if a partner’s status and wealth decrease over time, so can a woman’s attraction to her partner.

Less commonly, a woman’s desire for sex with her partner may decrease because she realizes that she is more sexually attracted to members of a different gender than her male partner. Or perhaps she knew from the beginning that her sexual orientation was incompatible with her partner’s, but was too afraid or unwilling to let it be known until well into the relationship:

When I was married and our sex life was unfulfilling to me I felt obligated to have sex with my husband to keep him happy. I was his wife and he felt rejected and was suspicious of me having an affair because I wasn’t interested in sex with him. We got married when I was only nineteen (he was twenty-seven) and I knew I found women sexually appealing and was attracted to them but when I attempted to discuss this with my husband he didn’t want to hear about it. I began to resent him over time because I tried to do what was “expected” of me as his wife, but no thought was given to what I was getting out of our sex life and I don’t think he even noticed that I wasn’t fulfilled or satisfied. That was the beginning of a wedge driven between us and I feel it was the underlying cause of our failed marriage.

—predominantly heterosexual woman, age 35

Being with a partner who lacks sexual skills and is unable or unwilling to learn over time can obviously become frustrating and lower the desire to have sex. Some people think that if they dive right in and start vigorously rubbing a woman’s clitoris they are being the ultimate selfless lover. But for most women foreplay starts long before the actual lovemaking begins. This is humorously—but also honestly—depicted in the book
Porn for Women
. In one of the book’s photo spreads, a handsome man sits at the kitchen table cradling his breakfast coffee and says to his mate, “Ooh, look, the NFL playoffs are today. I bet we’ll
have no trouble parking at the crafts fair.” How a woman’s partner treats her in general, and not just right before it’s time to “do the deed,” can dramatically affect her desire to have sex.

One common complaint among women who have been in long-term relationships is that sex becomes routine, predictable, and thus less enjoyable. Here is how one woman in our study experienced the duty of having sex:

I love my husband, but when you’ve been married for awhile, let’s face it—sex just isn’t that exciting anymore. It’s all so predictable. Even when we try to be “spontaneous” it’s almost comical because I can predict his every move. I have sex because I feel I “owe” it to him as his wife, and also because I love him and want to keep him happy. The truth is, though, most of the time I just lie there and make lists in my head. I grunt once in awhile so he knows I’m awake, and then I tell him how great it was when it’s over. It seems to be working. We’re happily married.

—heterosexual woman, age 48

Because heterosexual women are more likely to marry or enter a long-term relationship with a man older than themselves (compared to the opposite scenario), they often must adapt to the sexual and other health problems of aging mates before they are faced with the same sorts of issues. Changes in a partner’s sexual functioning can decrease a woman’s desire to have sex in many ways. If, for example, a partner develops premature ejaculation, whereby he ejaculates before or shortly after beginning vaginal penetration, the woman may lose interest in sex because it becomes too frustrating for her. Similarly, if a man develops problems getting or maintaining an erection, a woman’s desire to have sex with him may wilt as well.

Psychologist Lorraine Dennerstein of the University of Melbourne in Australia conducted a study among a large group of middle-aged women and found that sex drive decreased with the length of their relationships. The longer the women were in a relationship, the more likely they were to experience low sex drive.

The same study measured women’s sex drive before, during, and
after they passed through the menopausal transition. For some women, menopause had no effect on their sex drive. For others it tended to lower their sex drive. For a small group of the women, however, sex drive increased with menopause. What caused these women’s boost in sex drive? Was it a successful sex therapy they had engaged in? Did their partners change in some positive way? Did they discover new sex tricks? No, the best explanation was that the women who showed an increase in sex drive were most often the ones who had found a new sex partner.

Learning and experimenting with new techniques, watching or reading a sexually arousing story together, having sex spontaneously and at times and locations that are not the usual, or planning a romantic getaway with no demands or distractions are just a few of the techniques that can keep boredom at bay among couples who have been sexually active together for a long time.

At times, having a fight with one’s partner can increase sexual arousal and help couples reconnect. But repeated fighting and squabbling wears down most couples over time, as portrayed in the country and western song by the Notorious Cherry Bombs, “It’s Hard to Kiss the Lips at Night that Chew Your Ass Out All Day Long.”

Often, it is hard to figure out cause versus effect—did the constant fighting cause the decreased sexual interest, or did the decreased sexual interest cause the fighting? Often, it goes both ways. Sometimes the fighting revolves not over sex per se, but over differences in the need for nonsexual intimacy. Many women describe needing to feel good about their partners and close to them in order to want to have sex with them. And feeling close may require intimate conversation or quality alone time, not just sexual foreplay.

Among lesbian couples, there is sometimes so much intimacy in the relationship that psychological “fusion” or “merging” takes place. These couples have such an intense desire to relate to each other that all personal boundaries, individuality, and separateness disappear. While
this may epitomize the ideal of intimacy to some women, it often has a negative impact on women’s sexual desire. Some therapists think avoiding sex becomes a way to achieve some distance that is desperately needed in the relationship. Others think that for some women, having sex is a way to achieve closeness and knock down personal barriers. In couples where there are already no barriers, sex becomes unnecessary.

Often a woman has a hard time pinpointing why she no longer desires to have sex with her partner. The change may have taken place slowly over time, perhaps due to an accumulation of too many misunderstandings, disappointments, and frustrations. One woman in our study told the story of how her lack of sexual attraction to her husband led her to wrongly conclude there was something wrong with her sexually:

About seven years into my marriage, I went out for dinner with a male friend of both myself and my husband. My husband stayed at home with the children. . . . This friend and I decided to attend a party [and] we stayed out really late. I was having fun and feeling reckless and free for the first time in years. On the way home, I leaned over and kissed my friend, which surprised both of us. It surprised him because I gave no previous indicator of attraction to him. And it surprised me because I never enjoyed sex with my husband and believed something was wrong with me because of my disinterest in sex. He pulled over to a secluded spot, and we made out. Although we did not have sex that night, it precipitated the sex we had weeks later, beginning an affair and the eventual dissolution of my marriage. In retrospect, I had wanted to leave an unhappy marriage even though I didn’t realize it at the time. My life revolved around my children and I assumed I was sexually dysfunctional. Suddenly, that night, something awoke in me and I became a sexual being again. I realized that I did like sex . . . just not with my husband.