Solutions for Libido Loss: Arousal

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Before attempting intercourse, it's important to feel comfortable and relaxed, and then aroused. Some therapists suggest that couples learn to concentrate on comfort and foreplay, and delay having intercourse for some later time. In this way, they can establish a successful pattern of foreplay—particularly genital foreplay—as part of their sexual repertoire.

Foreplay is an essential factor for a woman in becoming aroused, particularly for women who find sex painful. The vagina produces natural lubricants, and the vaginal wall relaxes, widens, and lengthens, allowing less painful, more satisfying penetration. A woman is ready for sex after these changes, just as a man is ready when he has an erection.

Viagra may be of some benefit to women who have difficulty becoming sexually aroused. Strictly speaking, Viagra is not an aphrodisiac, but it may help with the female equivalent of a man's erection, sending blood to the clitoris, vulva, and vagina. This in turn may make sex more comfortable and more enjoyable. (If you are already having orgasms, it is unlikely to make them more intense.) Within a few years we should have the results of several studies looking at Viagra's value for women.

Researchers also are studying whether a testosterone patch known as Intrinsa can increase women's sexual desire. Preliminary research has shown some success, but more research is needed to make sure that the higher testosterone levels produced by the patch are not linked to a higher risk of breast cancer.

If low libido is a problem for you, talk to your doctor. Together you can decide if medication is right for you.

If you aren't feeling particularly attractive or sexy, your ability to become aroused may be inhibited, or you may want to get sex over with as soon as possible. One way to overcome this problem is to imagine yourself as you would like to be, perhaps as some glamorous movie star or romance-novel heroine. Mental turn-ons can be as useful as physical ones.

Arousal can also be started and amplified by movies, erotica, and sex gadgets. Some pretty conservative couples get positive charging from these sources. Besides the magazines on the hard-to-reach racks, there are how-to sex manuals—very respectable. Lonnie Barbach has a video, Cabin Fever, especially designed for these needs: romantic, loving, feminine. Her book Erotic Interlude has helped many patients.

What's on your mind

It's important that you take a close look at what's happening in your head when you have sex. Are you calling on an erotic fantasy to get you in the mood, or are you worrying about pain or the bills you have to pay? Switch the channels in your head; get off "This Old House" and onto "Passion on the Waves."

Keep a journal of your moods through the day. When do you feel the most energized? When do you fade and get cranky? When do you think about sex? Can you detect a pattern, predict when you'd be most likely to consider a little time between the sheets? What about a cocktail hour escape? Or an early-morning dalliance? If daylight inhibits you, close the curtains.

Don't count on an exotic vacation to restart your sex life. "I can't think of a faster way to ruin a vacation," says Dr. Leslie Schover. Take the pressure off and take it slow. According to Dr. Schover, it's better to think in terms of mini-vacations, short breaks in your normal routine, "like closing the bedroom door a couple of hours earlier than usual, with a Do Not Disturb sign hanging from the doorknob."

If you don't feel aroused, your partner is going to feel at least somewhat responsible, and that is going to affect his or her performance. Partners can be more disturbed by a woman's diminished responsiveness than by the absence or alteration of a breast.

Books that might help:

For sexual aids try:

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