The Food Medic - S7 E5: Stop faking orgasms and fix your sex life with Dr Karen Gurney

Episode Date: February 2, 2022

In this episode Dr Hazel is joined by Dr Karen Gurney a clinical psychologist and psychosexologist. Karen is the Lead Psychologist for a busy central London NHS clinic specialising in sexual wellbeing. She is also director of The Havelock Clinic, an independent multidisciplinary sexual problems service. As part of her mission to educate, inform and challenge widely held ideas that harm people’s sex lives she did her first TEDx talk and wrote the bestselling ‘Mind The Gap: the truth about desire and how to futureproof your sex life’ in 2020. She is passionate about translating sex science outside of the therapy room and uses her Instagram platform @thesexdoctor and online workshops to reach a wider audience. This episode covers:- Why is sex still taboo? - How much sex is normal?- Female pleasure and the orgasm gap- Faking orgasms are doing you a disservice- The sex drive myth - Masturbation and sex toys help not hinder sex- Using mindfulness for better sex- The secret sauce to a good sex life in the long termIf you loved this episode make sure to give it a review, rating (hopefully 5 stars) and share it with your friends and family. @thefoodmedic/www.thefoodmedic.co.uk Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hello and welcome back to another episode of the Food Medic podcast. I'm your host Dr Hazel and today we're going to be talking about all things sex and desire. You might be thinking well what does sex have to do with our health or nutrition because you are the food medic aren't you? Well on this podcast we cover all aspects of health and our relationships and sex life are also integral to that. We don't learn much about this at school and as adults we're expected to learn through experience and hearsay but that also means there's loads of myths and misconceptions around sex and I think it still remains a taboo. For this episode I'm joined by Dr Karen Gur, who's a clinical psychologist and psychosexologist. Such a mouthful. Karen is a

lead psychologist for a busy central London NHS clinic specialising in sexual wellbeing. She's also director of the Havelock Clinic, an independent multidisciplinary sexual problem service. As part of her mission to educate, inform and challenge widely held ideas that harm people's sex lives, she did her first TEDx talk and wrote the best-selling Mind the Gap, The Truth About Desire and How to Future-Proof Your Sex Life in 2020. So in this episode, we explore some of the gaps in our knowledge when it comes to sex and desire, including the orgasm gap, which is the fact that heterosexual couples, men are having far more orgasms than women, female sexuality, and how we can have

better sex for life. Lots of the questions in this episode were actually submitted by you guys through Instagram. So listen closely in case your question comes up. I mean I'd love to start by just asking you a little bit more about yourself, who you are, what you do and what you're passionate about. So I'm a clinical psychologist and psychosexologist and I work part-time for the NHS managing sexual problem services and part-time for the Havelock Clinic, which is an independent sexual problem service in London, which essentially means I spend most of my time seeing clients for therapy, and usually about some aspect of their sex life that they're not happy about, or they want to be different. And that might be with individuals or with couples. I also do some research, some training, some supervision, and I am super passionate about taking sex therapy outside of the therapy room, which is partly why I started

my Instagram a couple of years ago and did the TED Talk and wrote my book, Mind the Gap, because to be honest, not as many people need to come and see me for therapy than who come and see me. So actually what I want to do is reduce the number of people who need to see somebody like me. Amazing. And I've read your book and it's amazing, which is why I wanted to get you on and chat to you. And when I did reach out to you, you were like, I don't know if I can advise on food and sex. Yeah, I was like, that's not my specialist area, although it's very interesting. Of course. And even when I was, you know, I shared on stories that you're coming on and we're going to have a chat about this topic. And I got a few comments like, oh's a bit you know a bit left field for

what you're talking about I'm like well I'm a doctor and sex is a huge part of our health and our relationships and so I don't see why we shouldn't be talking about it. Absolutely yeah I think there's been such a move actually in the wellness health and wellness space to considering sexual well-being sexual wellness as part of overall well-being and I think that's correct because I think a lot of the time people think about sex as being a really kind of frivolous pursuit and just something you do with your body and actually it's not it's about relationships it's about your psychological health it's about your connection health. It's about your connection with others. It's about sometimes the strength of your relationships. And so it's really important

to overall well-being. Absolutely. So, I mean, obviously we're having these conversations online, there's more podcasts, there's books coming out, but why do you think sex is still a taboo? Oh, that's a really good question. And of course, it's rooted in history and culture and religion. And it's quite an interesting one, because actually, we know that we've gone through different times in history of sex being more or less taboo. So there used to be a bit of an idea that actually sex has always been taboo but there's been quite a lot of times across cultures of sex being something that wasn't taboo at all and was celebrated and obviously in recent kind of centuries things have become more taboo again

I think things will stay a taboo as long as we don't talk about them and as long as we don't talk openly with young people about them, they'll stay a taboo. And so that's the challenge we have at the moment is that because it's considered a taboo, it's a self replicating prophecy. Yeah, absolutely. And I think it was really insightful for me to see what kind of questions people were asking. And there was a lot of is this normal especially when it comes to how much sex we're having and like a lot of people I mean my audience is primarily female but a lot of women saying you know not having as much sex as my friends or I don't think I am and I would love to know how much sex are we having and what is considered normal because I think there's this like three

times a week myth there absolutely is yeah I'm happy to answer that question but I'd like to preface it first by saying that actually quantity is not a good marker of a good sex life and that it's important to note that having lots of sex that isn't great is generally worse for your sex life than having less sex that is great. So I'd like to preface my answer with that. And also to say that quantity isn't important if the sex you're having is pleasurable, life affirming, connected sex. And so take ideas about quantity with a pinch of salt. But given that, we know from large scale UK research, so the biggest sex survey in the world happens in the UK, which is great. And we know that in a survey of 15,000 adults of all ages from 16 to 74, you know, the whole breadth of adulthood, that people are having sex a little less than once a week in the UK. So that's about

three times a month. And if you're in the, I think it's 34 to 44 age range bracket, it's a little less than that still. It's about twice a month. But it's important to see that even within those numbers, a third of UK adults haven't had sex at all in the last month. So even if people aren't having sex that frequently, so two or three times a month, actually, that's not unusual. There's a large proportion of people who aren't having any sex at all in the last month. So I'd like people to be reassured by that. Because as you say, there's a real common idea that everyone's having sex three times a week. I don't know where it comes from, this myth, but it's so pervasive. And whenever I see people with sex therapy and they're worried about how much sex they're having,

and I say, how often do you think you should be having sex? They always say three times a week. I don't know who's got time to have sex three times a week. I mean, we all do maybe sometimes, but it's very unusual. And hopefully people can be reassured if they're having sex a lot less than that. And know that actually quantity does not matter one bit. Yeah, I think that it will be really reassuring for women. And I guess second to that, like another question that was coming up a lot was you know differences in sex drive or libido between partners and or some people finding that they're going through a bit of a dry spell or

they're having a drop off and in terms of their sexual drive and I'd love to explore that with you first of all what is it and second of all again how do you know if it's too high or too low oh this is this is a good question but it's quite a big question. So let me try and draw on some of the key points here. So the first thing to say is that there is no such thing as sex drive and that we all have an experience of sexual desire, as you mentioned, that can fluctuate ebb and flow across time. And that's very normal.

It's also very normal to have a discrepancy between partners of sex drive, sexual desire. So it's more normal than not to have different ideas of how much sex you want. The challenge though is that we've been socialized to think of sex drive as something we should just have and something which is there and something which is innate and normal when you're in love with someone. And actually that isn't how sexual desire works. So what I would say is that it's really normal to have different ideas of how much sex you want to a partner. It's crucial to learn about how desire works so that you can understand how to have desire feature as much as you like in your

sex life which is really why I wrote the book because there's a huge gap between what we know about desire and what's kind of out there in society and then it's also important to have a conversation with your partners about what needs to sex meet for each of you psychologically and for the relationship. Why does it matter to each of you if you have a difference in the amount of sex that you'd like to be having? And the reason I say this is because when there's a desire discrepancy, which is very normal, it's very rarely about the amount of sex that people are struggling with it's about the meaning of sex so for example the higher desire partner might feel unhappy with the amount of sex that they're having because they would like to be having more of it but why would they like to

be having more of it it can't simply be about the physical act of pleasure and orgasm because you could do that on your own. So what else is it that they're missing out on? And if we start to explore that with each other and find out, well, when we have sex, I feel desired, wanted, close to you, connected, like we've got a strong relationship, X, Y, Z, whatever it might be, we can really start to find ways to help each other meet those needs when there's a desire discrepancy, or perhaps when we're not feeling like sex. Sometimes it can give us a little bit more empathy with the other person's perspective. So we think, okay, well, I'm not feeling like it right now. But I'd also like to feel close. So let's go to bed, talk, have a bit of a kiss and see what happens. Rather than thinking my partner just always wants sex because they just want to meet their own needs. And I'm frustrated with that, which can sometimes be the default.

Does that answer the question, do you think? Yeah, I think so. Absolutely. And I think that's really interesting how you've reframed that in that understanding the why, like why someone wants to have sex. And I guess that also underpins like one of the other questions I had for you, which is, why is sex so important? Because it's not just to reproduce. It's like it bonds you in a relationship. It does. And I think this is one of the great misconceptions of sex. You know, we do have an idea as humans, I think that there is such a thing as a sex drive, which is an urge to physically perform an act with somebody else. We know that, you know, feeling horny, feeling turned on is one of the motivations that humans have for engaging in sex, but there are 236 others. So a kind of really important bit of sex research from some researchers called Meston and Buss found out that there are 237 reasons why humans are motivated to have sex. So reasons why people seek out and express desire. And they can be, as you've mentioned,

reasons other than the physical act, but reasons that are connected to our psychology. So boosting our mood, stopping us feeling lonely, making us feel wanted, attractive, expressing love, out of boredom sometimes, there can be so many reasons and understanding those things about ourselves and others the partners that we have is super important and also really helps us to get a grasp on why sex can be important for a relationship because we know that sexual satisfaction is important to relationship satisfaction for most people. And that sexual satisfaction also guards against challenges in the relationship, guards against people going outside the relationship if it's monogamous for sex elsewhere. But sometimes we can really trivialize it to being

an itch that people are trying to scratch and not thinking about why that is and as you say it can be much deeper than the physical itch it can be that people find that feeling connected sexually is the glue that makes them feel connected to their partner in a way they don't with others yeah absolutely and I think satisfaction and pleasure is often not really discussed as definitely in you know sex ed or in a doctor's office and what I've been really interested in recently is the research around like female pleasure and how heterosexual women are at the kind of bottom end of this scale when it comes to who's the most likely to have an orgasm and I found that research so interesting and I'd love to chat to you about the reasons why that is why there's this huge gap

yes so yeah the orgasm gap that you're referring to is such an important piece of research because I think again there's lots of myths about. I think there used to be a widely held belief that women's orgasms were more elusive and difficult to come by. And that was often used as an explanation for why women didn't orgasm as much as men when they had sex together. What's been so interesting about the data that came out in the mid-2000s and late 2000s around the orgasm gap, which has been replicated several times, is that actually, if you separate men and women, and apologies for the binary language, but sex science is often quite binary in its categories, even though we know gender is not binary. If you separate people in categories of men and women and get them to masturbate,

men and women can usually masturbate in the same amount of minutes, so kind of less than five minutes, 95% of the time. So when it comes to reaching orgasm, we know there's no difference and it's not more tricky physiologically for women to orgasm. And many women listening to this will know that from their own masturbation. It's not a difficult process. Of course, some people have challenges with orgasm, but it's generally speaking, no more than the men do. But when you put men and women together to have sex, men's orgasm rate stays at 95% and women's drops to about 65%. Now, this doesn't happen when women have sex with women. The orgasm gap goes down to about 86% of the time women often or usually orgasm with a partner. And when you put men and women together

in a more casual sexual encounter, the orgasm gap drastically changes. So men continue to come at about 95% of the time. So there's no difference for men, masturbation, regular partner or casual partner, they pretty much always come. When you have casual sex and you put men and women together, women's orgasm rates drop to around 18% or even lower. So what we see is an orgasm gap where men and women have sex together. The reasons for this are societal ideas about what sex should look like, whose pleasure is prioritised and how sex happens. So sex that always ends in penis and vagina sex, for example, is less physiologically pleasurable for women than it is for men. So women generally don't orgasm that way. Some women can, especially with additional clitoral stimulation. But for most women, it's all about the clitoris.

So women prefer types of sex that are people using their hands or fingers to stimulate the clitoris or receiving oral sex or using sex toys. But communicating that in a patriarchal world when our sexual scripts say sex is penis and vagina sex and you shouldn't ask for anything different can be quite difficult and women sometimes don't feel normal because they struggle to orgasm through vaginal penetration which is totally normal so that's the orgasm gap and it's fascinating yeah and I think that understanding is really important because I think a lot of women feel like it's a failure on their part because they're not able to orgasm from penetration alone. When you've just explained quite rightly that, you know, a very, very small percent of women can do that. And it's not way we've been taught and how sex ed is thought and we don't talk about how yeah how to pleasure female or prioritize it because both partners pleasure matters yes and

and it becomes really crucial when you talk about desire because there is no such thing as sex drive what we know desire is is more of a motivation to be sexual than an innate urge to be sexual and we're only motivated to do something if it's rewarding for us. So when you see an orgasm gap, when people have sex together, when one person regularly doesn't get the same amount of pleasure as another, that's a disincentive and it will reduce someone's desire over time. So that's really important. But it really made me think of something you said earlier about how we talk about sex in society, because the idea of the sexual script that ends with penis and vagina sex is so ever present in our language that we even have a word, virginity, which essentially puts that type of sex on a pinnacle, on a pedestal, I meant, over all other types of sex and says, this is the important event in your life. This is you losing your virginity, in inverted commas, and everything

else isn't really sex, which is a way that language kind of keeps perpetuating those ideas of what sex should look like. That's just really not helpful for women's sexuality. No, absolutely. So then in terms of narrowing that gap, obviously, education is a huge part of that. And I think some of the research actually did go back and they did do some form of education and seeing that it did improve orgasm rates or pleasure. That's right. So that's one thing. But I guess, what else? Like communicating with your partner. I think that reflects what you said in that women who are having casual sex

are even more, even less likely to orgasm. But if you're in a comfortable relationship, then I'm sure orgasm rates increase because you feel more comfortable, more vocal to say these are the things that work for me. That's right. Yeah. And I think, you know, before we kind of venture into this, it's important to say that orgasm isn't the be all and end all. And it doesn't, it isn't the singular marker of great sex. There are plenty of other things you might want to get from sex and orgasm might be lower down your list. So that's okay. But it is a marker of gender equality when it comes to sex. It is a very obvious marker of what's happening

there with inequality. So that's why it matters. And I think there are a couple of ingredients to this. The first is, as you mentioned earlier, in terms of education, I think until we start talking about pleasure as a possible outcome of sex for women, which sex education up until recently has really been about all the bad things that can happen when you're not wanting them to from sex. So it's a bit like don't have sex, you'll get an STI. Don't have sex, you might get pregnant. Don't have sex, you might get a bad reputation bad reputation there's lots of or there has been lots of negative messages around women's sexuality that women are socialized into so that's important for desire later on because it affects how we think and feel about sex but it means that women are often starting their kind of

sexual career if you like not really understanding about the clitoris, not understanding about pleasure, not understanding which parts of their body might be the pleasure givers because no one teaches you about the clitoris. And over on my Instagram, whenever I post a picture of like the full structure of the clitoris, It doesn't matter how many times I post it, people's minds are blown because they're like, I'm 30, I'm 40, I'm 50. I never knew that that's what the full structure of the clitoris looked like. I mean, that's not okay, is it? No. So there's something about education and education about pleasure. An important part of it is communication and being able to say, this is the type of sex I like. This is the type of touch I like. This is what I want our sex to look like some of the time or most of the time. But a really important underpinning of that communication is about autonomy, bodily consent and assertiveness and gender politics and that's the more tricky bit because I think we are often raised in a way which congratulates women putting other people's needs first not being too assertive not being too

demanding and we see that happen a lot in sex science those messages come through loud and clear so I think what I hope to do with widening the information on this with things like my Instagram platform is to give people the knowledge that they are normal so that they can then feel confident to assert that. Because I think knowing you're normal allows you to go, well, hold on a minute. It's not just me. Actually, you know, 80% of women can't come from this type of sex so why shouldn't I ask for additional clitoral stimulation why shouldn't I say I don't want all the sex we have to look this way so I think giving people that information about what's normal

is really helpful in allowing them to be a bit more assertive. Yeah absolutely and I guess going back to what you said in that women are often praised for you know thinking of others first and putting their needs for before them typically caregivers and things like that also leads into the whole faking orgasm situation and I think I read the stat in your book and I think it was 50 to 65 percent of women have said that they faked orgasms I actually think that could be higher yeah I think so too um but thinking about everything that you said it's not just doing them a disservice you know there's wider implications for that but then I think if more women were aware that actually it's not on them, why it hasn't happened.

And so you don't have to, you know, appease your partner. So I think this conversation hopefully will help change those stats a little bit. I'd like to think so. so and as you say there's something about knowing your your normal to not have orgasms through vaginal penetration alone which allows you then to communicate that in a way that is matter of fact and say I'd like to come and I'm going to need x y and z or if they ask you did you come you say no but I really enjoyed it I only really come from x y z. You know, if we don't have those types of conversations, no matter the gender of our partners, then we are perpetuating an idea that women's pleasure is easy to come by through those routes that we know communication it's a communication that doesn't really help in the longer term both on a societal level and on an individual level because you don't get to say what you need but it is a communication of something which is often I'd like to finish now I've had enough of

this or I'd like to signal to you that it's time to stop. So I think building communication skills more generally can also help because it's also okay to say, this is great, but I'm not going to come, but I'm happy to stop now if you're okay with that, or I'm happy to do something else. So it is all connected to communication as well. Yeah, absolutely. That's really helpful. And then thinking about, you know know we've been talking about couples and obviously people can have self-pleasure and masturbation and as much as sex holds a lot of stigma and the conversation around that I feel like masturbation and self-pleasure is even more stigmatized and I would love to address that because some of the questions that I got were from women who

are saying you know is it bad that I use sex toys or I'm trying to wean myself off sex toys and and so I just wanted to bring this topic up and would be interested in your thoughts on it that's a really interesting question people do worry a bit about becoming, and I'm doing inverted commas here, dependent on sex toys, and it's just not a thing. So let's start at the beginning with this. So your question was about the stigma. And something I find fascinating about masturbation or solo sex, sometimes might call it around stigma, is I think it's become less stigmatized for women recently. And that's a really positive thing because we know there's a strong association between solo sex and masturbation and good sexual functioning for

women. So generally speaking, we know that people who start masturbating earlier and enjoy masturbation tend to have good's still something which is seen as a little bit negative for men to take their time in enjoying a solo sex session and I think that's interesting and it would be great to see that narrative changing I think for men it's seen as a little bit more something they shouldn't be doing or something yeah that's true I've not thought about that you know it's well I mean obviously I'm biased in what very sensual, self-care, erotic way. And when I talk to men about masturbation, there's an awful lot of kind of, it happens very quickly. It's a kind of get it done with job. There's not much kind of external planning of the environment, thinking about how they might want it to be.

And actually, it can really benefit men also to set some time aside to really touch their body, to think about pleasure, to experiment with new things, to set the scene. And that could benefit men as well. But generally speaking, masturbation is really good for our sex lives. It helps us be more connected to our sexual function and what we want. It's very rare, but it does happen that some people feel out of control with masturbation. That's usually linked. It's not addictive. It's nothing to worry about.

It's usually linked with it's become a way to manage low mood because it does make us feel good. The chemicals that are released when we orgasm, they give us a little mood boost. And so it becomes a very effective way to manage low mood. So some people feel like that, but it's very rare. And that's not about masturbation or sex toys being addictive. It's just because it's a really nice strategy. A bit like going for a run can be a nice strategy if you're feeling a bit low. And we can support people with other ways of managing that. But people worry about becoming dependent on sex toys. It doesn't work like that. So how it does work is if you're using a sex toy, it can be that, for example, your clitoris might be a bit number than usual for a period of like 15 seconds, I think the research shows, after orgasm, which can make it quite difficult to feel much after that. But then it's gone and you're back to normal. So there is a little bit of an effect in the very, very short term of that stimulation taking away sensation after you've come, but not in any harmful way. In actual fact, the more people have

orgasms and have orgasms through different means and different ways, the easier it is for them to have orgasms. So what sex toys basically do is remind our brain and our body that those neural pathways are there and that orgasm is something that we can do and can do quite easily. I think sometimes people worry about getting reliant on them though because they struggle to introduce them with a partner and I think we really need to normalize the idea that sex toys, vibrators, clitoral suction devices, whatever it might be, should come into sex with partners and I think that's something that queer couples find a lot easier than cis het couples who might struggle a little bit to integrate and might worry that their partner sees

that as a as an insult to their sexual skill but actually bringing a vibrator into sex with someone else can increase pleasure for both of you make sex quicker make orgasms come more easily and that has an incentivizing effect on desire over time yeah absolutely and I think like most couples want to provide pleasure to their partner because that's giving them pleasure and typically like having those conversations and how you can support them I'm sure they would be more than supportive to try these things. Yeah, there was some great research on that, actually. I wish I had it in my head to tell you the statistics, but I can't keep all the percentages in my head the whole time. But there was some great research which said that, and again, I'm talking about

women having sex with men here, because that's where we know women struggle most with sexual satisfaction. So that's why I'm often talking about women having sex with men. That women were more worried about telling a partner about wanting to use a sex toy and thought partners would react badly. But when men were interviewed about their female partners introducing sex toys, they were pretty much all open to it. So there is a bit of a discrepancy there in terms of what we expect people will say and what they actually say yeah that's so interesting and and going back to kind of a couple of things that we've brought up like obviously it's a it's a very physical act sex but um what our mind is doing during sex is

super important and it can yes you know it can be the difference between good sex and terrible sex if you're distracted and so how can we best focus our minds to work with us and not against us yes um this is something i'm super interested in especially being a clinical psychologist thinking about the brain and how it interacts with what's happening with our body so it might help if I explain the process to people so they can see where our minds can get in the way. So the first thing that happens when there's a sexual stimulus in front of us, so that means like a naked partner or we're kissing someone or we're listening to audio erotica or whatever it is, is that our brains automatically respond with

physical arousal. And we know that happens for people in research when they're wired up to devices and looking at sexual stimuli. So it's an automatic process. But what happens next in terms of our sexual function, so how turned on we get, the amount of desire we feel, how well our erections work, how close to orgasm we get, etc. is that dependent on how much attention we're able to pay to that sexual stimulus, our bodies respond in different ways. So we know that when people are distracted, they tend to see a decline in their sexual function. So that makes it harder for them to get turned on, it makes it harder for them to maintain erections, it that makes it harder for them to get turned on. It makes it harder

for them to maintain erections. It can make it harder for them to orgasm. And we get distracted by a lot of things because the human brain is a thought generating machine. And so we've got this constant battle in our brain of brains are wanting to just respond to sexual stimulus with physical arousal like many other animals do. But because we've got this human bit of our brain which generates thoughts constantly, if our past learning or memories or associations with sex are quite negative and we're having lots of thoughts like what's going to happen? What will they think of my body? What if I don't orgasm? What if I don't stay hard? What if we get pregnant? What if we don't get pregnant? If I don't stay hard what if we get pregnant what if we don't get

pregnant if we're having those types of thoughts then our attention is distracted away from sex and onto worries and what that does is closes down our sexual function and makes it really difficult for our bodies to respond in the way that we want so that's where in sex science the biggest leap in the last kind of decade or so has been understanding the role of attention and using generic mindfulness skills to train our brain if you like to be able to be more present in the moment and their skills that are essential for sex so focusing on kind of like the senses in terms of like as you would in traditional mindfulness techniques that's right yeah so I usually get people to do six or eight weeks of daily mindfulness first to build up

generic mindfulness skills outside of sex so you know using an app one of the good mindfulness apps for like around eight to ten minutes a day and then getting them to bring that into solo sex masturbation so just bringing their attention back the whole time to sensation and then getting them to bring that into solo sex, masturbation. So just bringing their attention back the whole time to sensation, and then getting them to use similar skills with a partner. And for anyone who's interested, we have an online workshop for this called Train Your Brain for Better Sex. That's kind of a download on demand with me talking people through a program and the science behind it. But we know from sex science that mindfulness has a distinct improvement in sexual function across all elements so it can improve people's

desire it can improve people's orgasms it can improve pain that people experience during sex and that's simply by modifying that attentional focus amazing that's so interesting it really is yeah another kind of common theme that comes up is as a relationship progresses or you've been in a relationship for a very long time the amount of sex tends to drop off and and maybe sexual desire drops off as well and so if there is a couple in that situation and they want to bring back some sexual desire into the relationship, what kind of advice can you give them? Okay, so my first bit of advice to them would be find out how desire works because it's both much more complex and much more simple than you think. And you can have desire feature as much as you want in your relationship. Saying that, it's really normal for there to be a drop in spontaneous desire, particularly for women, regardless of the gender of their partner. So women having sex with women,

women having sex with men, we see a drop in spontaneous desire, which means feeling like it out of the blue, about 18 months to two years into a relationship. It doesn't mean anything. It's just what happens and it's normal. But we don't see a drop in women's responsive desire, which means desire that you trigger by intentionally trying to stimulate it. So you see a sex scene on TV that's quite hot. You read some erotica. You have a long, passionate kiss with your partner, you go to bed naked together to chat for a while. Those types of things tend to trigger women's desire very easily. What can happen though in a long-term relationship is what I call sexual

currency, which means the charge between the two of you that's sexual outside of sex. So, you know, the glances, the passionate kissing, the flirtation, the text, the looks at each other, the bum grabs, whatever it might be. The sexual currency tends to decline and we fall into other ways of relating that are less sexual, like flatmates, like friends, like co-parents. And it can make it harder to see our partner as a sexual being. So we have to work on sexual currency outside of sex to create that context but also to provide stimuli to kickstart our responsive desire and we can also see a decline in novelty when we have sex with the same person again and again and so if monogamous long-term relationships are your thing you have

to be aware that there will be a decline in novelty because it's the same person you're having sex with. And it's really important to find ways to keep novelty. And by novelty, I don't necessarily mean, you know, nipple tassels and swinging from chandeliers, although it's fine if that's what's your bag. By novelty, I mean making sure that sex doesn't always look the same, making sure that you get to express all sides of your sexual personality and sex, not just one type. So the sex isn't always sensual if you're also someone

who likes quite frantic, passionate sex. And finding a way to check in with each other regularly about what you'd like to kind of grow into sexually. So I have an exercise around people understanding their conditions for good sex and that's something that they can do alone and then discuss it with a partner. And it's a little bit of a kind of looking forward exercise and what are the things I'd like more of and what am I interested in and how can we navigate that together because our sexual wants and our sexuality is always changing so if our long-term relationship can't keep adapting to those changes then we risk a reduction in desire does that make sense yeah absolutely so there's so many things but I would say probably

understanding desire is key it doesn't work like you think it does so learn that first increase sexual currency and that will remind you that each other is a sexual being and create lots of opportunities for responsive desire and work on novelty and predictability and pleasure and that's a good starting point. And so is that the secret sauce to a long-term good sex life? Yes and I would like to add that it's really important that people know a decline in sexual satisfaction is not inevitable in a long-term relationship but keeping sexual desire for the same person over decades without any intentional or purposeful effort isn't always realistic either. And so if people want a good sex life

and a long-term relationship, they can have it, but they absolutely need to put some work into that intentionally, just like you do your diet. You know, you need to, you can't just eat what you want and then expect to be healthy. That's a good message. I think that's a good message to end on. But before we finish, I'd love to ask you three questions, which we ask everyone. And the first one is your number one takeaway from this podcast episode. My number one takeaway is learn as much as you can about sex and what's normal because that will change everything. Amazing and the second one's a little bit different if you could go back in time and tell your 18 year old self something what would it be? It would be don't feel that you need to

conform to people's expectations of how you need to be. I love that and finally if you could recommend one book to everyone what would it be and why? It's obviously going to be my book obviously otherwise I wouldn't have written it but I think that that's not entirely fair so firstly my book Mind the Gap after that I would really recommend Emily Nagoski's book, Come As You Are, which I think is a great accompaniment to Mind the Gap and does a lot of good around quashing myths and giving information about sex. Amazing. Well, thank you for your time today.

Thank you. If someone wants to come get more information from you, is social media your main place, Instagram? That's right. So at The Sex Doctor on Instagram. And there's loads of links to free resources and online workshops on things we talked about today and my ted talk etc in my bio so there's tons of stuff for people to access there amazing thank you so much thank you

okay so i know that was a bit of a different podcast topic than usual, but I really hope it was empowering and informative. As a doctor, I feel like we just don't talk about sex enough. And personally, I found it very liberating. So thank you so much again for tuning in. Make sure to subscribe so you're the first to hear about any new episodes. And if you would like to submit a question to the podcast, whether it's on health, fitness, nutrition or mindset, any of the topics that we cover on the Food Medic podcast, please make sure to send your voice recorded questions to ellie at thefoodmedic.co.uk

for your chance to feature on the podcast. Finally, if you are enjoying the show, I would love if you could leave a rating and a review, hopefully five stars, and share the episode with someone you think would enjoy the podcast. That's all from me. See you again next time.