“I’ve been married a year now and my husband is extremely frustrated because he wants it five times a week and he’s lucky if I can manage two to three, and even then half the time I’m only doing it for him,” writes one reader. “Is this normal or is this just me?”

Jill Smith (name has been changed) is one of many women asking, “What about us?” With so much media attention to Viagra, erectile problems and low testosterone, women with low libido feel left out in the cold.

There are many reasons women find their libido sagging, says Marjorie Rand, Ph.D., a sex therapist and author of Body, Self and Soul: Sustaining Integration.

“Almost every sexual problem concerning women’s libido is a relationship problem of some kind,” says Rand. The crucial relationship may not be with her husband or boyfriend, but her mother (i.e., how she was raised) or her interaction with men as a whole (i.e., her identity as a woman).

When a woman is inhibited from feeling, for any reason, psychological and emotional blocks shut down the body through tight muscles, shallow breathing and other forms of physical armoring.

Medication may also cause low libido. Antidepressants, anti-hypertensives, anti-inflammatories, ulcer medication and birth control pills can affect sexual response. And, post-menopausal women lose testosterone, which can limit sex drive. If either of these scenarios describes you, talk to your medical doctor.

But in the vast majority of cases, says Rand, there is a psychosomatic origin of low libido. “You don’t recognize what’s going on because sex and the body have become split off from your normal states of awareness,” she says.

And so Smith and many like her mistakenly chalk up their lack of sexual intensity to male-female differences. “Men,” says Smith, “can drop everything and do it anywhere at anytime. Women just can’t do that, our minds are still on the laundry that needs to be done.”

There’s more to it, says Rand. Low sex drive is usually a recurring problem and not something that springs up overnight. It is important to consider the entire story of a woman’s life.

A woman may see herself as comfortable with sex and in love with her man, but she doesn’t respond fully. She is frustrated because she wants to have a level of desire that matches his. This stress can accentuate low libido.

Try these ideas to eliminate the pressure and create a secure environment in which to feel sexy:

Eliminate pressure for sex or orgasms:“Sometimes, taking the pressure off of her can improve the problem all by itself,” says Rand. Very often it opens the communication lines and allows him to share his feelings too.

Open up to your man and discuss your low sex drive. Let him know that he is not failing as a sexual “performer” and tell him he needn’t respond by trying harder.

Promote a feeling of security: This means changing the rules, which may be difficult without the guidance of a therapist, but the idea is this: Where he used to just plow forward, he now asks permission.

Rand says a more courteous approach to sex may seem like a loss of spontaneity, but in the long run everyone benefits. “You feel invaded when you think you have to say `yes,’ ” says Rand.

Pursue fitness for mind and body: Most women who lack sexual vitality breathe shallowly, says Rand. She recommends taking several deep breaths (using chest, diaphragm and belly) periodically throughout the day.

Slow deep breaths ease anxiety. Rapid, hard breaths beat back depression by creating “excitation.” Don’t overdo this. Focus on the feeling of breath going in and out of your body. Then notice how you constrict your breathing during sex.

The breathing you do during exercise can be therapeutic, but you want to create overall vitality and do more than build muscles. Take a modern dance or yoga class. Work expressively with music and rhythm.

All deep breathing and expressive movement allows you to connect with the moment and focus on the body. This is indirectly helpful to creating more sexual feeling.

Mix it up: Positions that allow the pelvis to move freely will promote more sexual feeling, says Rand. For this reason, she is not a big fan of the missionary position, which has the woman’s feet flying high in the air. Positions that allow a woman to have her feet on the floor (or on a wall) are very “grounding,” she says. It’s even better if both partners can have something solid under their feet.

Make eye contact: Many women close their eyes during sex. In some cases, a deeply held fear of intimacy may cause this. In her therapy practice, Rand has couples grow accustomed to prolonged eye contact. In true Tantric tradition, eye contact pumps up the energy exchange and enhances emotional interplay.

Learning to look at each other during sex builds comfort and trust. And those qualities help break through the blocks that inhibit desire.


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Our popular culture offers a constant, apocalyptic vision of sexual danger: AIDS, teen pregnancy, date rape, sexual violence and now cyber sexploitation. Add the anxieties of religion, medicine, psychiatry and the law, and it’s easy to understand why many Americans can’t discuss sexual issues rationally.

With our sexuality poisoned by our history, culture and unrealistic expectations, most of us don’t want fantastic orgasms or unending sensual pleasure — we just want to feel less threatened, less inadequate. As a strategy for reducing sexuality deemed abnormal, censorship appears to provide a solution.

Censorship is more than closing a show or jailing a publisher. Its targets include sex education, contraceptive advertising, sex surveys, the Internet, adult bookstores, public nudity and high school libraries.

Censorship has two primary goals: defining what is sexually normal, and announcing which private decisions relating to sex are of public concern. Historically, censorship has been used to control the sexuality of the less powerful: women, youth, and those whose behavior challenges the status quo. No smart feminist would support censorship, not even of pornography.

Those who censor invariably say they can be trusted to judge wisely. This is false as well as illogical. Societies censor because they fear and thus wish to control. There is no limit to what people fear; therefore there is no limit to what they might wish to control.

Don’t be fooled into thinking that as long as your favorite toy, position, book, Web site or store is tolerated, censorship doesn’t affect you. When others have less freedom of responsible self-expression, our own freedom is more fragile. When public policy is based on judgments that demonize others, each of us is vulnerable to being demonized ourselves.

Living in a world that insists certain forms of sexual expression are dangerous, affects us unconsciously. We sense that we are one erotic choice away from being “abnormal,” one song or video away from being a pervert. What’s truly dangerous is when our culture has us mistrusting ourselves.

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Q. What is sex therapy and how do I know if I need it?

Sex therapy is a set of behavioral and psychotherapeutic techniques used with men, women and couples to enhance sexual functioning. You might see a sex therapist if you don’t get erections when you want to; get excited but can’t climax; have pain with intercourse; or notice your sexual enjoyment declining and don’t know why.

Couples go to a sex therapist when they argue about frequency (she wants sex twice a week, he wants it twice a year); preferences (he wants oral sex, she doesn’t); or what’s acceptable (he wants to watch porn and she doesn’t, or she wants monogamy and he doesn’t). Your psychologist or physician might refer you to sex therapy if they can’t provide a solution to (or they aren’t comfortable with) your difficulty.

How can I be sure the sex therapist is credible?

Above all, a good sex therapist is a good psychotherapist, someone who can ask questions you haven’t thought of, and see patterns you haven’t seen. Select a professional with a good reputation, or get a recommendation from a physician or friend.

You want someone who’s comfortable with sex, and with whom you feel you can tell the truth without being judged. If the therapist seems more interested in him- or herself than in you, flirts with you or suggests that you’re abnormal or kinky, run for the door.

What can I expect in sex therapy?

The therapist will evaluate a range of questions. Are sexual difficulties caused or exacerbated by anger, fear or sadness? Is alcohol involved? Is there performance anxiety? Unrealistic expectations? Misinformation about how bodies work?

He or she will help you see sexuality in the larger context of your life, both present and past. The therapist will also comment on how you talk about your sexual experiences, and if you have a partner, how you talk with each other.

Once the therapist understands your problem and has a treatment plan, you will get homework, often weekly. This may include reading, writing or a guided touching exercise. Masturbation is often assigned. Sometimes, a therapist will ask you to refrain from intercourse (not sex, intercourse) to reduce performance pressure or encourage other forms of erotic connection.

In all, sex therapy is usually a pretty eye-opening experience. You may learn things about yourself or your partner with which you’re uncomfortable. But you won’t walk away unchanged, and you’ll probably have new respect for the complex ways you express — or repress — your sexual energy.

You may very well enjoy sex more than you ever have. You’ll almost certainly understand it better.

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