It’s FINE that you Orgasm That Way

I deal with many common misconceptions every day in my practice but here is one that creates so much stress needlessly:

Many, many women have orgasms while lying on their stomachs rather than on their backs, and they feel like there's something strange about it. But let me tell you, it's totally normal and actually pretty common!

 

I don't have hard statistics, but I'd say around 20% of the women I see prefer the stomach orgasm. And you know what? That's absolutely fine! It all comes down to how our brains get wired and what we learn early on in our experiences. Many women start exploring their bodies and pleasuring themselves when they're young, and for some, the stomach position becomes their go-to method for achieving orgasm. (Think about rubbing against a soft blanket, pillow or toey.) Once that pattern is established, it can be challenging to change.

 

So, why do these women feel like it's some deep, dark secret? Blame it on popular media! We're bombarded with images of sex that usually involve heterosexual intercourse with the woman lying on her back having mind-blowing orgasms. There's not much room for showing variations, and that's why the stomach orgasm isn't portrayed much. It's a shame, really, because many women feel embarrassed about it and even avoid talking to their partners about it.

 

But let me clear something up: there's absolutely nothing bad or problematic about having an orgasm on your stomach! An orgasm is an orgasm, and it's equally pleasurable, intense, and valuable, regardless of the position. Sure, it might be a bit more challenging to have your partner stimulate you that way during sex, but it doesn't make the experience any less enjoyable.

 

Now, the big question is, should you try to change the way you orgasm if the stomach is your preferred posture? Well, it's a personal choice. If you're perfectly happy with the way things are and you and your partner have found what works for you, then keep going! No need to fix something that ain't broke, right?

 

But if you haven't told your partner about your preference, it's time to come clean. Trust me; living with a deep dark secret about your orgasms is no fun and can lead to resentment. Communication is key in any relationship, especially when it comes to sexual satisfaction.

 

Sure, you can try learning to orgasm on your back if you want to explore different options. Practice can help you rewire your brain and expand your pleasure possibilities. But listen, if it becomes stressful or makes you feel bad about yourself, it's not worth it! The most important thing is to enjoy your sex life and have fun with your partner.

 

So, to all you wonderful women who orgasm on your stomachs, embrace your preferences, communicate with your partner, and most importantly, have a blast! Remember, there's no one-size-fits-all approach to pleasure, and what matters most is that you're happy and fulfilled. You go, girl!

 

(And read more in my book: Satisfaction Guaranteed: How to Have The Sex You’ve Always Wanted.)

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Here’s how you can tell if you are sexually compatible with someone

I hear it all the time. How do I “know” if I am sexually compatible with someone? Do I need to have had sex (people usually mean intercourse) in order to “know for sure”?

So, my answer is no. No, you don’t need to have had oral sex, intercourse, or any other kind of sex to know if you are compatible. And honestly, nothing is going to guarantee long-term compatibility anyhow, because we all change. All the time. However, I do think there are some basic indicators that can give you an idea if you will (or are) sexually compatible.

 

So, here are my top 3 things:

 

# 1 - You like the way they smell.

The reality is that sexual attraction is not rational. It’s not well understood, but there is something about body chemistry, be it pheromones, or something as yet undiscovered, which let’s you know pretty quickly whether or not there is a basic attraction to this person. Without it, it is hard to weather the ups and downs of a long-term physical relationship. You’ll never be able to talk yourself into attraction, but when it’s there it’s a good sign that this person might well be for you.

 

# 2 - You like the way they kiss.

You like the way they kiss. I think it’s time we jettisoned the idea that soulmates are determined by communication and non-physical relationship criteria! When did we decide to privilege the verbal over the physical? A good sign that this person is your soulmate, and that the relationship will have staying power may well be that you love the way they kiss. The physical reality and presence of instinctive attraction is at least as good an indicator of soulmate material as loving their sense of humor. Let’s get over our discounting of physical reactions as “unimportant” or “merely temporary.” A strong physical relationship can be a huge determinant of a strong long term prognosis in a relationship.

 

# 3 - You've both talked about it and you both way the same kind of sex.

Let’s face it, if one person’s idea of a good sex life is having sex once a week primarily in the bedroom, and the other person's idea is having sex twice a day, having regular threesomes or steady visits to sex clubs, then I think compatibility may be a question! So, if you're not having sex with the person yet you may want to have a conversation about what a good sex life looks like to them. Or if you are having sex and your expectations are that as the relationship develops it will look different than it does now, you should probably explore that. Because wanting and expecting a certain kind of sex-life needs to be clarified. 

 

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

OH YES. YOUR ANTIDEPRESSANT CAN BE AFFECTING YOUR SEX LIFE.

Could my anti-depressants be affecting my… sexual desire, my arousal, my orgasm??? Yes!
You are not crazy, and you are not imagining things.

The class of anti-depressants called SSRIs (selective serotonin reuptake inhibitors) and their sister group : NSRI’s work extremely well as anti-depressants, and anti-anxiety medication. I love them for that. I really, really do.

 

However, for many, many individuals (some studies show as high as 70%) they can have immediate and dramatic impact on desire, arousal and ability to orgasm. But some of them have a much lower side effect profile. And just because a lot of people react that way, doesn’t mean YOU will.

 

So if you think these drugs would help the bigger problems of anxiety and depression, the best thing to do is discuss this issue with a knowledgeable prescriber. You can see if they can either try you on different SSRIs to see if any have fewer side effects or to see if you can try a different class of anti-depressants. Because there are many. The other possibility is to add another drug that can help.

 

Knowledge is power here. Talk to your health care professional. And if they don’t seem to take this seriously, find another one!

 

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Low Libido after Childbirth

Once upon a time, you were into sex. You remember that was you and not someone else. You can remember thinking that sex was fun and exciting. But it just doesn’t seem to be happening that way anymore.

Okay, you think, “so I had a baby (you fill in the blank: 6 months, 1 year, 2 years, 4 years) ago. Shouldn’t my desire for sex have come back? What’s happening to me?” Fair enough. Let’s see if I can answer that question… although it may well take me two blog posts.

So many women find that their desire for sex drops dramatically after the birth of a child. It can happen after the first or the second child. Some find it drops after number 3 or more. Some have a problem after each of them. They are tired and stressed. They don’t have enough time to take a shower, let alone have a sexual rendezvous with their partner. Traditionally women have been told that it is all in their head. There is definitely much truth to the fact that changes in your life, the stressors, and the craziness does affect your desire. But don’t forget that there are also many powerful physiologic (physical) changes as well. Your body goes through significant physiological changes after a birth of a child, and these can be significant contributing factors to the ‘do not enter’ sign on your door.

So here are some real factors that can be at play. You need to ask yourselves which ones apply to you, and what can you do to resolve some of this, and then get to work! And as motivation, just think about the fact that a strong sex life with your partner will make your relationship so much stronger as you face these stressful child-rearing years together.

 

  • You are, no doubt, tired and stressed. Taking care of children is more work both physical and emotional than we ever anticipate.
  • You are probably “over-touched.” Who wants to have their nipples fondled after they’ve just spent the morning breast feeding?
  • Your self-definition may have unconsciously (or consciously) changed. Hey, you are the mother of three now. Is it really okay for you to also be the babe who comes into your husband’s shower with a bar of soap, two glasses of wine and nothing on? Or to be the wild women who screams dirty things as you have an orgasm?
  • You may be angry at your partner. Perhaps you feel that more responsibility for the house and the kids seems to always fall on you. And then he expects you to do what?? You may not be outwardly angry, but maybe angry enough that it is affecting your desire to make love with your partner.
  • You may feel disconnected from your partner. When was the last time you had time alone without the kids? When was the last time you had a conversation that didn’t revolve around scheduling, carpools, signed notes and babysitters
  • Your hormones likely have shifted significantly during your pregnancy and post-partum. Hormones play a critical role in a women’s sexual life. They affect our desire, our ability to become aroused and orgasm. This is not a condition that a glass of wine or a romantic dinner can fix. In this case, it’s not in your head, but in your body.
  • Labor, and birth may have created subtle (or not so subtle) physical changes that seem to make it harder to get aroused and have an orgasm. Hey, when it’s more work, it’s certainly harder to get started. Similarly, there may be discomfort and pain in your vagina as well. This adds a big obstacle on the road to romance.
  • It may not be the childbirth at all. It may be your age, changing blood flow or irregular hormone levels. I know our kids keep us young, but unfortunately, they don’t freeze us in time!
  • You’re out of practice. Oddly enough, sex seems to feed on itself. The more you have the more you want. The less you have, the less you seem to think about it.
  • Maybe you need a different kind of sex. Your life has changed significantly. Maybe those two- hour love-making sessions are a thing of the past (for right now) and you are having trouble adjusting to a 15 minute “quickie.”

 

Most likely your low libido is a combination of a few of the issues listed above and perhaps some more I haven’t even discussed. Happily, most low libido issues can be resolved if enough of the factors are addressed. I’ve seen some of the toughest cases turn around. I believe you can too.

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Not knowing about sex is nothing to be ashamed of!

Really. Let’s be honest. Most of us got almost no sex education growing up. There were few resources for us to access easily and effectively.

It was hard to differentiate between correct sexual information and misinformation. How could we possibly feel like we “know about sex??”

 

And then, to layer on top of that, so many of us feel a sense of shame that we know so little or feel so incompetent when it come to sex.

 

Here are five things I want you to consider, that may make you feel better:

  1. What you have to understand is that almost everyone feels ignorant about sex. Or, at least not confident. I talk to hundreds of people every year about sex. Almost everyone feels insecure and inadequate. I promise you.
  2. Sex is not rocket science. Basic sexual information is not that complicated, no matter what the media, the experts or your friends may say.
  3. Once you have the “basics”, sex is yours to improvise, enjoy, explore and figure out. Because there really and truly is no “right” way to have sex. Everyone’s sex life and interests are so different from each other. Trust me. You don’t need to know the statistics about everyone else’s sex life to figure out yours.
  4. It’s okay to ask questions. As a matter of fact, it’s GOOD to ask questions. The only bad sex life is the static sex life that is never changing and exploring. So, if you are curious about a particular element of sex, read a book, look it up in a reputable source on line, ask a friend
    or ask a professional. Try not to be embarrassed. See #1.
  5. It’s okay not to know, and ask your partner, if you have one. This may be the most important thing to remember. Being fun in bed does not mean you have to be an expert. It means that you are being responsive to your needs and to your partner’s needs. See #3.

 

So just remember these 5 things as you approach your sex life. And have fun!

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

How a Sex Therapist Misplaced Her Orgasms in Synagogue -Then Found Them There

Let’s face it. We like to blame sexual problems on our relationships.

How do I know this? I’m a sex therapist. And maybe more importantly, I’m a woman. Of the hundreds of women I see in our practice, nearly everyone blames any issues that come up on her relationship.

 

Janie’s husband is not interested in sex with her? I’ll watch her sobbing that “maybe he is having an affair, addicted to porn, or disgusted by the five pounds she has gained.” Okay, Janie. Maybe. But here’s another thought. Perhaps he is just temporarily tired, distracted, or perhaps his hormones are low, and none of this has anything to do with you?

 

Maria has pain with intercourse? She decides that she must not trust her partner or is not sufficiently turned on by said partner, or maybe has abuse in her history that she has blocked out. Well, okay, maybe, Maria. But maybe, just maybe, you just have tight muscles, or need external lubrication or more facts?

 

This is such a crazy trap, and if you want to know how alluring this trap is, you can look no further than me. I know this better than anyone. I fell into the same trap. Twice. And it took services at synagogue to climb out.

 

So let’s talk about the first time I misplaced my orgasm. It was 30 years ago; I’m in my early 30’s and struggling with anxiety, which would come and go at different points in my life. Suddenly I find myself unable to orgasm when I’m having sex with my husband or when I’m by myself, for that matter. What the hell was going on? My sex life, like most people’s, had its ups and downs, but having an orgasm was always a sure thing. And now, it was suddenly gone; disappeared like a bowl of jellybeans at a 5-year-old’s birthday party.

 

Thirty years ago, I was not yet a sex therapist. So I did what any normal woman would do. I panicked. What the hell was going on? I went into what I now term the classic “blame the relationship” game. I assumed that something incredibly problematic was going on in my relationship with my husband, that I was harboring some deep-seated anger, developed trust issues in the relationship, or was so depressed that I couldn’t orgasm.

 

And once I decided that something “must” be wrong in the relationship, I looked for a hook in the relationship to hang it on. Let’s be honest, folks. Who can’t find a hook that’s a bit wobbly in a long-term relationship? I was often tired and irritated at my husband. We were two busy professionals with two little kids and a crazy life. I was always “mistrusting” him, if you count mistrust that the groceries would be picked up, playdates organized, and birthdays remembered. Whatever.

 

Objectively, I was no more irritated, angry, depressed, or distrustful than I had been a month earlier when I was still having lovely orgasms. And, ironically, those orgasms were often the one thing that made me less irritated, angry, and distrustful. Sex as a great escape from the craziness of our day-to-day life and a glue for the relationship.

 

To understand this story, we need to travel back just a few months before the disappearance of the orgasm. I had been talking to a friend in synagogue, let’s call her Sharon, about my anxiety and depression. Here’s what you should understand: as an Orthodox Jew, our Saturday morning services are long. They can easily run for three hours. Sometimes (okay, more than sometimes), I am guilty of talking to friends in between the prayer services. Anyhow, Sharon is a psychiatrist and a couples therapist. She and I often grab a minute during “downtime” in the service to consult on difficult cases. Once, another friend, overhearing us talking about a couple in conflict over his erection issues, leaned over from the next row and said to us: “no one, and I mean no one, would ever believe the conversations I overhear during these services!” But I digress.

 

Anyhow, on this particular Sabbath morning, a few months before the great disappearing orgasm, Sharon is listening to me go on and on about how my anxiety seemed to be getting worse. (In self-defense, I do get some prayer in between all these fascinating conversations). She told me about a new drug called Prozac that seemed to be getting terrific results. I eagerly bought and read “Listening to Prozac,” and it spoke to me. She prescribed me some to try. I know. Having your friends give you curbside consult in synagogue? Not the best idea. But I was a busy working mom of little kids, and the idea of seeing a psychiatrist on top of my weekly therapist appointments was overwhelming. So, this worked well for me.

 

About two weeks after I started the Prozac, I remember feeling, “Oh my God. This must be how ‘normal’ people feel.” The continuing cycle of anxiety in my head that would repeat over and over again had finally quieted down. For the first time in my life, when I had issues that were bothering me, I could think about them rationally and calm them down in a way that psychotherapy, much as I felt it helped, did not do. As delighted as I was on the Prozac, it never occurred to me that the Prozac could have been the reason I wasn’t having orgasms. Before you roll your eyes at me, this was in the early days of Prozac, and that information was not widespread.

 

A few months after starting the Prozac, I’m at synagogue telling Sharon how delighted I was with the Prozac. Then, on a whim, I said to her, “There’s no way that the Prozac could be affecting my orgasm. Right?” She looked at me and laughed. “Well, yeah,” she said, “That is the most common side effect of Prozac.”

 

So, here I am, 30-year-old Bat Sheva. After months of analyzing my relationship, never-ending late-night discussions with my husband to figure out all of the “issues” that weren’t even there, and after months of wasted therapy sessions focusing on The Problems That Must Exist In My Relationship, it was the Prozac.

 

Now let’s fast forward. I was in my early 50s and had worked as a sex therapist for 20 years. It was eight years ago, and I was clumsily wending my way into menopause. Once again, the orgasms seemed to be going on a hiatus. Whereas the last time, they had disappeared overnight, this time, they gradually faded away, and the progression wasn’t linear. Sometimes they were fine. Sometimes weak. I’m writing all this by way of excusing myself for once again falling into a similar trap. I can’t be that thick, can I? I started going through a similar relationship issues rabbit hole. You know that adage: fool me once, shame on you. Fool me twice, shame on me.

 

Except for this time, my husband and I had fewer outside pressures, and our relationship was humming along quite smoothly, thank you very much. And this time, I was a sex therapist and a seasoned one at that. This one hit me over the head faster, but embarrassingly, a second time at synagogue.

 

Esty cornered me to complain about her diminished libido. As a sex therapist, you get cornered at large gatherings. I’ve had informal consults at weddings, bar mitzvahs, and, I kid you not, once at a funeral. And synagogue? Well, that, pre-Covid, almost functioned as an offsite office.

 

Anyhow, as I’m talking about her diminished libido, I hear myself talking about possibly having her testosterone checked. And I stop in my tracks. Well, there you go, Bat Sheva. Physician, heal thyself.

 

What was so striking to me is that I have dedicated my life to debunking the preconceived notions that sexual problems are always a result of relationship issues. And here I was, falling into the same rabbit hole. Maybe it’s good. It keeps me humble.

 

We women are prone to doing this, aren’t we? Blaming ourselves for so many things: our “mishandling” of relationships and communication, our “over-sensitivity,” our assumption that any problem that arises is a result of something we’ve done wrong. Maybe it’s time for us to acknowledge that many problems may be a result of someone else’s decisions, or actions. Or, as in this case, they may be a result of a medical issue.

 

Anyhow, this loss of orgasm turned out to be, once again, chemical, and not the result of some unidentified relationship issue. And I think there are three lessons to be had from my crazy stories: not all sexual problems result from issues in the relationship, sex therapists struggle just like everyone else, and God answers prayers in all kinds of interesting ways.

 

This article first appeared in the Lilith Magazine, Spring 2020.

https://lilith.org/articles/how-a-sex-therapist-misplaced-her-orgasms-in-synagogue-then-found-them-there/

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Botox Injections for Vaginismus?

Using Botox injections to help women who struggle with vaginismus seems radical, but it truly is not!

Once upon a time, maybe 15 years ago, I was working with a patient who was hyperventilating from fear during a dilation session. She sat up on the exam table and said “Bat Sheva, there has to be another way to do this.” And she was right.

 

I started doing research and set out to find a treatment method for women who are overwhelmed, fearful and panicked at the idea of putting something into their vagina. Or for those women who have not been successful using traditional dilator therapy.  And I found a procedure using Botox injections and lidocaine in the vagina.

 

A woman is put under IV sedation for the procedure which takes about 30 minutes. The medical professional injects Botox and  anesthetic in the vaginal walls and massages the introital muscles to break any muscle spasms.  Once the muscles are relaxed,  a large dilator is inserted. The patient wakes up with the dilator in place.

 

This is the first step, but it is only a first step. Once the procedure is over, the patient’s brain and vagina need to learn to be friends, communicate and relax. She needs to learn to insert the dilators herself, feel comfortable with touching her vulva and vagina and to relax with penile penetration.

 

Here are some of my random thoughts if you are interested in finding out more:

      •   For the right patient it works really, really well! What I have discovered is that for a patient whose pain is primarily tight muscles and who have the fear that goes with the pain, the Botox injections can bypass months of scary and overwhelming dilator work.
      •   It’s really not such a big deal. The entire procedure takes 15-25 minutes and seems to have little to no side effects at all.
      •   “Waking up” from the procedure with the large dilator inserted is an exciting and moving experience for women who have, until then, not been able to insert anything into their vagina.
      •   It will not work if your pain is primarily from hormonal imbalances or structural issues.
      •   A supportive partner or friend can make a big difference! It’s important to have someone cheering for you.
      •   If you’re single and avoiding dating because of your fears of sex, this might change your life.

 

I wish more women with vaginismus knew about the possibility of Botox injections. It could change their lives!

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Rethinking the Affair

 

Every once in a while, a client makes me think through an issue in a new way, or helps me clarify something, and that is one of the most interesting and rewarding parts of my job as a sex therapist. Recently, I had that experience with a wonderful, smart, gutsy woman recovering from an affair that her husband had.

 

Like many of my clients whose husbands have strayed, they see it as a harbinger that it is time to take care of their sex lives. In some cases, the affair was truly an outgrowth of a sexual problem the couple was having. In many cases it really wasn’t a direct result, but the women feel that it may finally be time to deal with an issue they have long been trying to avoid.

 

The funny thing we’ve noticed is that often (and counter-intuitively) the fact that the partner has strayed seems to increase the woman’s sex drive. Now there’s a really interesting plot twist, and one we’ve struggled to put into context (and by the way, partners… please don’t see this as a technique to get your beloved back into bed). We’ll often have women saying to us “I hate myself”, or “I am so totally confused, but since I found out about the affair, suddenly my libido is back!”

 

So what’s going on?

 

Life and sex are really complicated and this is no exception. But I think the two issues that jump out at me are:

 

      1. Your sex drive loves competition. The same rev-you-up hormones (norepinephrine and dopamine) that get your heart pumping in a race can be activated by any type of competition, sex being only one. If you’re the kind of person who loves a challenge, a challenge to your sex drive will fall right into the pattern.
      1. You suddenly come face-to-face with the reality that you don’t thoroughly and completely know the person to whom you are committed. Ironically, this not totally knowing or trusting, may be one important key to preserving an erotic life with the person you love.

 

Numerous books and articles posit that trust and intimacy often exist at odds with eroticism. We don’t like to admit that to ourselves. It’s fundamentally scary to live an ongoing existence with someone who we don’t know entirely. In order to stay happy and comfortable in our lives we convince ourselves we really know everything there is to know about our partner; they are an open book. But eroticism needs some shadow. It may grow best is the darker crevices. And that’s an uncomfortable reality for us to face.

 

Enter my patient. She is typical of a woman recovering from her spouse’s affair and trying to work on her sex life. She talks about her struggle to rebuild trust in her relationship. And this dichotomy of trust vs. eroticism is particularly meaningful and poignant for me to watch.

 

On the one hand, she feels like she needs to trust her spouse entirely. On the other hand, I wonder if her new found sexuality is partially due to her finding out, deep down, that her husband is truly a separate individual. She may never know him entirely.

 

This is a painful reality for any of us, this idea that our partner exists in his or her own world, with his or her own thoughts and feelings and insecurities and impulses, some of which we will never ever fully participate in. As a matter of fact it is such a painful idea that most of us would rather live in the fantasy that we can know another individual entirely, even if that might kill our sex life. But the truth is that as much as we may love our partner and as much as they may love us, they are separate individuals living a life and reality apart from us.

 

And the good news? Reality builds eroticism. So as I watch my patient struggle, I want to reassure her that maybe not knowing and not trusting 100% is painful at times, but it has its upside. And she’s found that in the bedroom.

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Let’s Talk About Birth Control — and Sex

Not everyone responds well to the pill

In 1961, the FDA approved the use of female oral contraceptive pills (commonly known as birth control pills) and the world has never been the same. Currently there are well over 60 different birth control pills on the market and an estimated 12 million women in the United States using birth control pills. For most women, birth control pills work very well. They are inexpensive, efficient, effective and take so much of the fear of unwanted pregnancy out of the equation. However, there is a group of women who really don’t do well on oral birth control and often the side effects are overlooked, or women don’t even realize that the side effects they are experiencing are from their birth control!

 

What side effects? It’s clear now that hormonal birth control pills can create low desire, decreased arousal, dryness, and even pain. I have had so many patients tell me they wondered if their birth control pills could be contributing to their sexual problems, but they figured that since they were never told about these potential side effects by their prescribing practitioner then it must be all in their head — and they are angry about that. And who can blame them? “Why wouldn’t my doctor tell me?” or “I would have stopped the pill years ago when this first started if I had known that this could be a problem,” they will say. Sometimes the problem has been going on for years and they are just now realizing the cause.

 

So, ironic as it may seem, the little pills you started because you were having sex, are now what could be the reason you don’t want sex anymore. Birth control pills suppress hormones in your body to prevent you from ovulating and preventing pregnancy. But they also suppress your natural production of androgens, specifically testosterone. They also increase production of SHBG (sex hormone binding globulin), a protein which will bind to testosterone and make it unavailable for your body to use. Testosterone is the hormone most closely linked to driving a woman’s libido. The birth control pills reduce your testosterone levels significantly. (This is also why birth control pills will help clear your skin).

 

Women are starting birth control pills at younger ages, and it is not uncommon for women to be on birth control pills for 10–15 years. While it is perfectly safe for women to stay on birth control pills for many years, it is unclear what kind of effect this long-term use has on a woman’s libido. Some research has shown that even after discontinuing use of birth control pills, women still have not regained their libido.

 

If you’ve been looking for a non-hormonal birth control, there are a few options you can consider:

      • Condoms and diaphragms (yes, they are still making diaphragms although they can be hard to track down.) are good straight-forward options.
      • Some IUDs are completely hormone free. And even the ones that do have hormones, only have “local” hormones, that should not affect you systemically.
      • As of September 2020, the FDA-approved a vaginal gel contraceptive (Phexxi) which is significantly more effective than spermicides. It is a cream that is made of lactic acid (which is naturally produced in the vagina and is found in dairy products like yogurt and kefir) and potassium bitartrate (used in cooking as cream of tartar) It’s inserted into the vagina (with an applicator) an hour before intercourse. It keeps the vaginal pH levels steady and moderately acidic, which effectively kills any viable sperm.

 

So, here are the most important take-aways:

      • Birth control pills work for many women with no side effects.
      • If you are having symptoms of low desire, problems with arousal or pain in your vulva/vagina and it seems to correspond with starting to take birth control pills, you are not crazy. It probably is related to them.
      • If you discontinue the birth control pills it may help the problems but it may not be enough. You may need additional help to “fix the problems.”
      • There are definitely options out there if you want to explore non-hormonal methods of birth control. You just have to keep an open mind.

 

I have so much more information about this in my book Sex Points. You may want to check it out.

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Joint Pain and Sex

If you suffer from arthritis or other joint pain,

have no fear, a fabulous sex life can still be yours for the taking. I know it feels like you will never be able to having great sex, but with a bit of planning, extra pillows and, above all, a sense of humor, you can take back your sex life.

  • Positions will need to vary depending on where the pain is experienced. You need to support the affected area with a minimal amount of movement. Ironically, the classic missionary position will work best if the woman is experiencing pain, and women on top will work best if a male partner is experiencing pain.
  • Pillows and cushions are your best friend, as the real key is keeping the areas that are in pain, supported. There are excellent “wedge” shaped cushions that can help support the back, the legs, the arms or neck if that is necessary.
  • Move slowly. Especially if you are just trying to get back to a sex life, move slowly with your partner and express what is going on. Do not ignore pain!! If something hurts, shift, and try something else. It’s doable. 
  • Get yourself a light vibrator. Note, I didn’t say smaller… or weaker.. As we get older we need higher levels of stimulation to reach orgasm, and for women this often means a stronger vibrator which is chargeable and not battery operated. Check out the weight of the vibrators before purchasing them. There are any number of light weight, chargeable external vibrators that can be your best friend.

Please don’t give up on your sex life because of arthritis, or other joint pain. Do what we all do when you see a bump in the road. Reroute.

 

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Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted