Language of Love with Dr. Laura Berman - Mismatched Libidos

Episode Date: April 14, 2021

This episode of "The Language of Love" is all about mismatched libidos and what to do when you and your partner don't have the same level of desire. Mismatched libidos are one of the most common issues that couples face and it often leads to the end of relationships, so this very special episode can be invaluable in helping to preserve your marriage and your sexual pleasure.  First, a woman asks for help restoring her lost libido, as her sex drive tanked after she began anti-depressants. Anti-depressants are notorious for sexual side effects, yet they are invaluable in treating depression and anxiety. Luckily, it is possible to continue taking your medications without sacrificing passion and pleasure. Dr. Berman offers advice for how to sex-proof your relationship even when you are taking SSRIs and other psychiatric medications, as well as how to talk to your partner about your decreased libido and help them to still feel loved and desired even when you are not in the mood. Then, a caller reaches out because her husband is rarely interested in sex, and when they do have intimacy, he seems distracted and stressed out. She is eager to have more sex, but not if he is doing so out of duress and his heart isn’t really in it. But could it be that his history of ED is making him scared to have sex? Dr. Berman discusses how erectile dysfunction can make men afraid to engage in intimacy, even if they actually desire sex because they fear appearing less masculine or displeasing their partner. Over time, this becomes problematic because the less sex you have, the more accustomed you will be to not having it, decreasing your libido and harming your sexual response.  So how can this couple get their sex life back on track and help to decrease his fear of performance issues?  Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey, I'm Dr. Laura Berman, a sex and relationship therapist. And for the past three decades, I've been helping people learn how to love and be loved better. That's just what I'm doing here on The Language of Love, where I get to answer your calls and emails and your most important questions. Because my goal here is to help you discover more meaningful emotional and physical intimacy and to also help you build more awareness of how precious and sacred your sexual life really is. So be sure to email or reach out with your very own love, sex, and relationship questions.

And I might just answer them live on the air. Whether you're single, married, gay, straight, cis, transgender, I am here for you. And this is a safe space to ask all the questions you've always wanted to ask your doctor or your friends, but maybe have just been too embarrassed to bring up. It's time we all become fluent in the language of love. Welcome to the show. I'm excited to be with you and talk about one of the most common complaints when people say, what's the most common sexual issue you hear from people about that they're struggling with in their relationships?

And my answer is always the same, uneven or mismatched libidos. When one partner wants it more than the other. And certainly when sex is working in a relationship, then it's just one small part of the larger working relationships, one cog in the wheels, so to speak. But when it's not working, it really starts to take on a life of its own and starts to fray the fiber of your connection, your emotional connection, your sense of satisfaction in the relationship. The threshold for arguments gets much lower and it can really take on a life of its own. So we are going to tackle mismatched libidos in this episode of A Language of Love, starting with a voicemail from Marissa. Hi, Dr. Berman. I'm a 30-year-old female from Canada. My question is, I am in a three-year-long relationship with my partner.

And the past two years, I have noticed that my sex life or my sexual desire has been very, very low. I don't really have any desire whatsoever. I am on antidepressants, which I've been switching around and playing around to see if it would help. And every time I start a new one, it does not help. Starting to cause a little bit of friction in our relationship. He is not pushy or forceful at all. It just makes him feel really upset and sad and disappointment and unloved. And I feel absolutely horrible for making him feel this way. I used to have a very high libido and just in the past two years, it's just gone to nothing. I know it could be a side effect of my medication, but the amount that I have changed and everything, it's not looking like that way.

So if you can offer any advice or wisdom, that would be great. Thank you. Oh, I'm sorry, Marissa. Yeah, it's really common for people on antidepressants, especially SSRIs like Prozac and Zoloft to experience a loss of desire. Now it's really important for you to get clear on if it's a loss of desire alone or if it's also a loss of arousal because both can happen and impact one another right so obviously if you don't have desire it may be difficult to get aroused but at the same time if it's not as much fun to have sex and it's harder to get aroused and you're not really feeling it physically, then your desire goes down. And so they're obviously interrelated, but they are also, it's important to separate them out

and see whether the chicken or the egg is coming first, because that will determine what can be done about it. And we'll get to that in a second. So I know you said that you're on a very small dose. The main thing is like depression itself will do a number on your sex life and your desire, and I don't want you to be depressed. So if the antidepressants are helping, I don't want you to get off those. You can certainly talk to your doctor and make sure that you are taking or trying, if it will work, to take something that is not an SSRI because even a very small dose of SSRIs can diminish desire and sexual response. I also would say to you that But other things that allow you, adding in things that allow you to really get into your body while on the antidepressants, ideally not an SSRI, like yoga, meditation, and mindfulness practices, I have found really help women connect more with their sensations and their sensuality, help them be in body.

I'm a big fan of antidepressants. I've been on antidepressants. I mean, not like I prescribe them, but I've been on antidepressants many times in my life. And I have a history of depression. And I think depression absolutely can be a chemical thing that we need antidepressants for. However, I also know as not only a therapist, but someone who has struggled off and on through the years with depression, that those of us who have depression or a history of depression are not in the practice of really being in our bodies, right? We like to leave our bodies because it hurts in there. And if you're

someone who doesn't tend to be in her body, then it's going to be even harder to get sexually aroused when there is something in the way of arousal, like an antidepressant or any other medical condition or situation. So that is why the mindfulness, yoga, meditation, getting back in body is so important, maybe in body for the first time, not only will it help with the depression, but it will also help with everything else in your life, including sexual arousal. I also really want you to explore, in addition to whatever else you're doing, somatic experiencing. So if you go to traumahealing.org, that's a great place. I think they have internationally as well, but if not, maybe there's a place in Canada that's similar

where you can incorporate that into everything else you're doing, because that is a beautiful way to not only heal the core sources of depression so you actually can get off the antidepressants, but also, once again, getting you into body, which will only help with the arousal and desire. Now, with regard to your partner, one thing you can do in your relationship is to, and I think every woman needs to do this once she hits her 40s or if she's on medication or if she's really stressed out. We can't expect desire to have sex.

You want to source your desire for sex. It's not going to necessarily, certainly not if you're on antidepressants, come from spontaneous horniness. And for most women over 35, it doesn't come from spontaneous horniness. It comes from a conscious decision, a desire to love your partner

in a way that really lands with them, to connect, to show your love, to give and receive love. So if you can source your desire, even if you're not really feeling it, even if you're not really in the mood, what you will find is that once you do it, you say, hey, this was really fun. I should do this more often. It's just getting started. So it might mean scheduling it so you know once a week and you can get yourself going and kind of geared up and in the mood, so to speak. It may be just a decision you make, but I would really try to have sex. I mean, assuming you're not feeling really repulsed by it, you know, but you're just not in the mood, I would have sex, even if you're not really in the mood when you get started, because chances are you'll enjoy it once you

continue it. The other thing is that if this is an arousal problem that is impacting your desire, then there are specific things that you can do to increase the arousal, the low arousal side effects of the antidepressants. One is that there have been some studies that medications like Viagra, Cialis, Levitra do help to address the arousal issues that come from SSRIs in women. And there have been some studies on this. So when women who take SSRIs struggle with lubrication, sensation, orgasm, that Viagra and the other drugs like it can really help. Vibrators also really help, okay? Now, as far as the desire piece, if the desire is low, secondary to arousal, then the desire

will get better. If it's not, then it's about the mindfulness and the intention and working toward finding other healing modalities that will augment, add to the antidepressants, and eventually, hopefully replace the antidepressants and address any other underlying issues that are getting in the way of your desire. I hope that helps. You let us know how that goes. We also have, with regard to mismatched libidos, an email from Sandra who says, I'm 57 years old and two years ago I had a total hysterectomy and now I have no desire for sex. It's very painful when I do. I feel so bad for my husband.

He's very loving and tries to understand, but it has taken a toll on our relationship. What can I do to get my libido back that is safe and natural? Thank you for your time. Oh, I'm sorry, Sandra. And you know, it makes me so mad. I don't know why you had a total hysterectomy, but I can't tell you how many thousands of times I've heard this story. And here's what we know is that, first of all, the research in the anatomy and physiology

of men's sexual sexual response and sexual anatomy is at least two decades still ahead of women they haven't even adequately mapped the nerves and blood vessels that go into sexual response in a woman's pelvis when a man has a prostate surgery or any pelvic surgery they go in there with a robot that's how specifically they have mapped the nerves they can go in there with a robot and do quote-unquote nerve-sparing surgeries. The closest I have found to that in the gynecological world is what they call a supra-cervical hysterectomy, where they leave your cervix in place because they say, oh yeah, the cervix is just where the nerves are. I disagree, okay? I don't think they even know. They just go in there and take it out. And the women who seem to do really well after

hysterectomy sexually are the women who had extreme pain and discomfort. They had medical conditions like endometriosis or other issues fibroids chronic fibroids that couldn't be treated another way where that you know and that was really impeding on their quality of life and their sex life for those women post-hysterectomy they get better the rest of the women it doesn't seem to happen that way and i can't tell you what pisses me off is how few women are prepared for that and how many doctors just like oh you're menopausal let's just take it out i mean i even had a doctor say that to me. He's like, well, you know, you're not going to use it anymore. Just take it out. I'm like, you are not taking my uterus or my ovaries. Thank you very much. I'm

keeping them. They are organs of mine and you may not have them. But also because I know and I've seen way too many times how it does a number on your sexual response. Now, if you had a total hysterectomy, that means you had your uterus removed and your ovaries removed and your ovaries play a huge role in estrogen and testosterone. Now, I know you're 57, so you were 55 when this happened. You were probably starting or in menopause, so it wasn't like you had bukus of hormones anyway, but you had some.

Now, what a hysterectomy with an oophorectomy, which is removing the ovaries does, is it totally just shuts down your hormones completely. So of course you're gonna have no desire and it's gonna be painful, but there are things you can do. I've already talked about it this time and in other podcasts about the glory of the vibrator, embrace the vibrator. For you, it's going to be really important to also embrace lubricants.

And there are lots of lubricants out there. You want one that is totally natural and organic. And you can also even use one of my favorites if you're not allergic to coconuts and you're not using condoms because it's an oil. Organic coconut oil that you would cook with is one of the best lubricants I know for women, especially women who don't have a lot of hormones and, you know, have tender skin there. So those two things just to start with will help a lot. The other thing is to explore bioidentical hormones. So those are made, they're still synthesized in the lab, but they're made from natural sources

and they are given in a customized way. So you want to find a specialist in bioidentical hormones and they'll test your saliva and maybe your urine and your blood and they'll do a comprehensive assessment and they'll slowly work with you to replace what's missing enough so that you aren't having the difficulties and the negative symptoms that you're having right now. the good news is that all of us can enjoy sex for our entire lives. It just means that we need to sometimes have a little better loving with the help of chemistry because we're living to 100 now. We need the help. All right. Here is a voicemail question from Anonymous. Let's see what it is. Hi, Dr. Berman. My husband and I have been married many years, over 25, and we have only ever been with each other. Before we got married, we were sexually active and it was okay. It wasn't mind-blowing. My husband always has issues with erectile dysfunction now and I tend to want to

have sex more than he does. He's fine maybe with doing it once or twice a year, if that. And it's usually me suggesting that we do something it's just really not enough for me and sometimes he will say he will do something to please me but his heart isn't really in it he's usually his mind is wandering or he's talking about something that has to be done that day or handled and it's just not anything that really turns me on when you know he's not into it so do you have any advice for us. I'm sorry you're going through that. Yeah. I mean, first of all, what is a little concerning is that, you know, I'd be a lot more excited about the prospects, not that we don't have good prospects here, but if you had an amazing sex life before, right? But it sounds

like it's never been great. And that to me means that, you know, some sex therapy would be really good to fold into whatever else I'm going to recommend here. So if you want to find a good sex therapist, you can go to a website called ASECT, A-A-S-E-C-T. It stands for the American Association of Sex Educators, Counselors, and Therapists, A-A-S-E-C-T.org. And then you can go there and find a clinician in your area. You're looking for a sex therapist, not a sex educator who works with couples and maybe even who works with erectile dysfunction. But I have a feeling it's more than that now here's what you need to know about men and erectile dysfunction which is really kind of a bummer you know because what I have found is that once they start to get concerned

about their penis working and all the performance issues performance anxiety kicks in it's like so for women, sex is one thing and emotional intimacy, cuddling, kissing, connecting is another thing. And even I would say for many women, I mean, it's not that we don't want to be aroused and have orgasms, but that's not necessarily required for us to be willing and wanting to have sex. Now, when a man starts to worry about his ability to have erections, just the fear about it, not even the erectile dysfunction itself, just the fear of it will make him not want to try because he's embarrassed, he's self-conscious, he's frustrated. So he just avoids it altogether. And so often in men, I find that when they have low desire,

which is what you're kind of describing here, it's not so much that they have low desire, it's that they have erectile dysfunction and that's making them shut off from wanting to try. because they don't want to fail and because everything is in the same bucket for them not only are they not trying to have you know not wanting to have sex and not initiating and not open to that because they're afraid to fail but they also aren't holding your hand kissing cuddling being romantic because all of that is equal to set you know it's all part of the same thing for them so when they're shut off from sex they often are shut off from all of that which makes it even harder because if he's in a relationship with a woman she really needs and

wants that. So to me, I think what is probably happening with your husband, especially since it seems like his withdrawal from sex, you know, has been in more recent years, even though it was never amazing, is that he has low testosterone. And that's what's causing the erectile dysfunction. And what you need to do is get him into a specialist, a urologist, U-R-O-L-O-G-I-S-T, urologist. That's a doctor that specializes in the urinary tract and urethra and penis in men. They specialize in women too, but you want a male urologist or a doctor who specializes in male urology. Could be a woman, right? But you want a urologist who specializes in sexual medicine and you want to take your husband for an evaluation. They will measure blood flow to

the penis. They will measure hormones. They will measure sensation. And here's the good news for men, not the great news for women who have these kinds of issues, but for men, there are like 20 FDA approved treatments for this. They can help him with his erections. They can help him with his desire, especially if it's hormonally based, which I think it is. So that's the direction I would go. And I would help him find a doctor. I would tell him about it. I would make the appointment. I would make it easy for him. I would go with him. Those are the kinds of things that give the best prognosis to guys with this because they're not likely, because of their own embarrassment and self-consciousness, to take care of this themselves. But there is so much help available,

especially in the urology world or the sexual medicine world for men, that there's no reason he can't enjoy erections and sex. Now, with regard to the amazingness, that's where the sex therapy comes in. And there's no reason. I mean, I've worked with couples who have been together 40 years and revamped their sex life for the first time with me then. So it's never too late to create the sex life that you most desire. And you both deserve that. We all do. Hope that helps. You give me a call or shoot me an email. If you have a question about anything to do with love, life, relationships, dating, mating, ovulating, sex, whatever it is, I'm here for you. Just reach out to me via email or voicemail. You can find both links at drlauraberman.com and make sure

to follow me on all social media platforms at Dr. Laura Berman. I'll see you next time on the Language of Love.