How to Manage Mismatched Sex Drive in a Relationship

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Frances and her wife have been together for more than 40 years, and early on in their relationship they couldn’t keep their hands off each other. Then came three children and a series of health issues (along with accompanying medications) that slowly eroded her wife’s libido.

“Her interest just went away,” said Frances, 61, who asked not to be identified by her last name out of respect for her wife’s privacy. “What had been maybe once a week went down to maybe once a month, then maybe once a year. Then at some point, it just stopped.”

For 10 years now, the couple has been in a sexual drought. Frances loves her wife and said their marriage was “strong.” But she also longs for the “mutuality” of sex.

“I find myself fantasizing about just about everyone I meet, and I feel guilty for these thoughts,” she said. “I feel like I’m crawling out of my skin.”

Recently, The New York Times asked readers about libido differences, and more than 1,200 wrote in, many sharing deeply personal stories of how they have navigated sexual incompatibilities. We also spoke to sex therapists and researchers who said that discrepancies in sexual desire were common, almost to the point of inevitability in long-term relationships. Research suggests that desire differences are one of the top reasons couples seek out therapy.

“I’m inclined to say that this happens in almost every partnership, either some of the time or more perpetually,” said Lauren Fogel Mersy, a psychologist, sex therapist and co-author of the forthcoming book “Desire: An Inclusive Guide to Navigating Libido Differences in Relationships.”

Many factors can influence libido: interpersonal dynamics, physical and mental health, the social messages around sexuality that people absorb during childhood and adolescence. The list goes on, and there are seldom easy fixes. But Dr. Fogel Mersy and other experts said more communication could help couples bridge gaps in sexual desire.

When she sees clients with libido differences, Dr. Elisabeth Gordon, a psychiatrist and sex therapist, does not focus on lowering one partner’s sex drive or increasing the other’s. Instead, she helps partners understand what is driving those differences — which could be anything from relationship concerns to work stress — and, crucially, how to talk about them.

“I say this again and again, but the most important thing we can do is improve communication,” Dr. Gordon said. “Communication is the bedrock of sexual health.”

Joel, 40, and his wife of 12 years have struggled with sex for much of their marriage. The couple come from backgrounds that were rigid in different ways: His family was religious, and hers tended to avoid emotional topics. He is the partner with higher desire, and often can’t find the words to convey his frustration.

“I don’t want to feel needy ” said Joel, who also asked not to be identified by his last name to protect his family’s privacy. “And yet, at the same time, I want to express how important this is to me.” He said it can be “lonely” and “confusing” to sometimes feel like your partner is just not attracted to you anymore.

Dr. Gordon reminds clients like Joel of the basic tenants of good communication. Set aside a time to talk that isn’t at the end of a long day or when you are attempting to multitask. Consider what setting would help you feel comfortable, Dr. Gordon said, such as over a quiet dinner or during a walk.

Kristen Mark, a professor at the University of Minnesota Medical School’s Institute for Sexual and Gender Health, recommended using “I” statements, which can feel gentler and help curb defensiveness. (For instance, “I am not feeling much sex drive lately, because I am tired” or “I want to feel closer to you, whether we have sex or not.”) Or, she said, try the “sandwich method” — sharing a request or more difficult statement between two compliments.

Sex therapists who work with couples experiencing desire discrepancies may nudge their clients to expand their so-called sexual scripts. These are ideas people sometimes cling to about what sexual intimacy “should” look like and how it “should” unfold.

What matters is that you’re setting aside time for intimacy, whatever that means to you, Dr. Gordon said. For instance, she has seen clients who have compromised by having one partner hold the other while he or she masturbates.

Most people have never thought about what, specifically, they get from sex, Dr. Mark said. Is it all about the physical pleasure? Fun? Emotional release or connection? Ask yourself, then try to brainstorm ways other than sex that you and your partner might fulfill at least some of those needs, she said.

Sex brings Jack, 23, and his boyfriend closer emotionally, he said, but they’re not having it as often as his boyfriend would like. Jack, who asked not to be identified by his last name out of respect for his partner’s privacy, has dealt with mental health issues that have hampered his sex drive. So he and his boyfriend have looked for other ways to foster the kind of intimacy they get from sex.

“Things as innocent as hugging or holding hands or standing next to each other and leaning on each other while we cook are important,” Jack said, “despite it not always being sexual,” he added.

Despite these moments of connection, his partner still struggles with hurt feelings, and Jack often feels like something is wrong with him. But finding ways to be intimate without being sexual has “helped combat some of the frustrations,” he said.

There are generally thought to be two types of sexual desire, Dr. Fogel Mersy said: spontaneous and responsive. Spontaneous desire comes on suddenly, much like what we see in movies or TV. Responsive desire happens in reaction to physical arousal through any of the five senses, like a pleasing touch or visual cue. It can happen quickly, or it can take some time to build up. People tend to overlook the benefits of responsive desire, Dr. Fogel Mersy said.

“Without teaching people that there are different types of sexual desire, many are left feeling broken,” said Jennifer Vencill, a psychologist and sex therapist who wrote the book “Desire” with Dr. Fogel Mersy.

In their book, they suggest partners consider the “willingness model,” a 0 to 10 scale, to answer the question: Am I willing to see if my sexual desire will arise or respond? A 0 means you are not willing to try to create responsive desire — and that is OK. (Consent is crucial.) But if you are at a 5, are you willing to hug or lie with your partner, and see if you feel open to more physical contact from there?

Therapists, particularly sex therapists, can be a valuable, and often underutilized, resource for couples with mismatched libidos. If the desire imbalance is causing fights or distance in your relationship, you might consider couples counseling. Ask prospective therapists whether they have dealt with your issue before, and don’t be afraid to offer feedback after a few sessions. Research shows it can make therapy more effective.

Keep in mind that sex therapists cannot treat underlying health conditions that may be affecting libido, such as pain associated with sex, low desire from certain medications or erectile dysfunction. Anyone with those concerns should see a physician.

Much of the work sex therapists do is focused on adjusting their clients’ expectations and normalizing experiences, Dr. Gordon said.

“We want them to understand,” she said, “that discrepancy in desire is extremely common, really normal, and it can be worked with.”, GO TO SAUBIO DIGITAL FOR MORE ANSWERS AND INFORMATION ON ANY TOPIC

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