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Body, Mind -- And More
As a gynecologist and a clinical psychologist who see female clients on a daily basis, we realize that many women want and expect more for themselves sexually. We opened our Sexual Wellness Center in 1999 to respond to women's concerns about a variety of sexual issues, including low libido.
What do we mean by sexual wellness? We interpret it as a holistic concept, with four primary dimensions. Physical, emotional, intellectual, and spiritual. All four must be present and in balance for a person to feel "well" sexually.
We believe that applying this holistic approach is essential to fully and accurately evaluating women who are having problems with their libidos. When a patient tells us that her interest in sex is waning, our first step is to explore the following:
--Her physical health, including underlying medical problems, hormone levels, medications, and lifestyle factors such as nutrition and exercise
--Her emotional well-being -- whether she is depressed, stressed, or anxious, and whether she is satisfied with her life, her marriage, and herself
--Her intellectual fulfillment, both in her private life and in the life she shares with her partner and family
--Her spiritual beliefs and needs, and their impact on her sexuality
By identifying and treating problems in each of these core areas, we help make sex more gratifying for each woman. Oncethis is achieved, sexual desire often takes care of itself.
The majority of our patients come to us because of low libido. Many of them have attempted to get help elsewhere but saw no significant improvement in their sex drives. We suspect that most conventional treatments fail because their focus is exclusively physical (adjusting a woman's hormone levels, for example) or psychological (examiningg a woman's sexual history or current emotional state). They don't take into account the interplay of these and other factors that collectively shape a woman's sexual desire.
From our clinical experience, we've come to understand libido as a function of all that defines a woman -- including her body, her relationships, and her lifestyle. This is why so many cases of low libido have such complex, and surprising, causes. The good news is that most of these causes are completely treatable.
It Isn't Just "Sparks"
More often than not, the women who come to our Sexual Wellness Center are longing, for what might best be described as spontaneous desire. That is, they want to find themselves suddenly and without reason experiencing the sort of intense sensations that indicate they want to have sex. These sensations may take many forms -- warmth or tingling in the genitals, frequent positive thoughts about sex, or perhaps some undefined physical or emotional need.
Unfortunately, spontaneous desire is a misnomer. What our clients remember as spontaneous was anything but. Rather, their feelings of desire locked in with some sort of stimulus -- perhaps an attractive man walking by, a romantic scene in a movie, hot water cascading down their bodies as they showered, or a partner's loving caress. Whatever it was, they were receptive to it at that moment, and they responded by wanting to make love. For most women in mature relationships, this is the nature of desire: Rather than occurring spontaneously, it is a reaction to a stimulus.
Sometimes our clients find this reality disappointing. They would rather experience sexual desire as effortless and dependable, like hunger. In fact, it can be effortless -- if they allow themselves to be open to sexual stimuli, which are all around them.
For most of our clients, the goal of treatment is not to experience spontaneous desire. Rather, it is to relearn how to be open and responsive to a sexual stimulus -- that is, their partners -- long enough for their desire to build. Admittedly, this takes commitment and effort. For a multitude of reasons, which we explore in the following pages, women sometimes shut down sexually. They must work to want sex again.
Reprinted from: Reclaiming Desire: 4 Keys to Finding Your Lost Libido by Andrew Goldstein, M.D., and Marianne Brandon, Ph.D. © 2004 by Andrew Goldstein, M.D., and Marianne Brandon, Ph.D. Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold.