World Sexual Health Month is wrapping up! Let’s celebrate – I am Christene Lozano, Certified Sex Therapist. Here to answer your questions. AMA

How do you compromise when it comes to frequency without the lower libido partner feeling like they're doing something because "they have to"?

Great question, and a very common one when there is a discrepancy in sexual desire, sexual arousal, and interest in the frequency of sex. One thing that I think can be really helpful is to get a very thorough understanding of what "lower libido" means for that partner. Oftentimes, that term used as a blanket statement. Perhaps they aren't super interested in intercourse, but they enjoy certain types of touch and kissing. Perhaps they don't enjoy giving oral sex as much as receiving. There's often a ranking people have of what activities they enjoy over others, even though the ranking may be subtle.

What oftentimes happens for the partner that has less interest in certain sexual activity is that it all gets clumped together under the same umbrella. They may have been interested in certain activities before, but if it was then expected that those activities "should" lead to other activities, then they typically close off to most forms of sexual and sometimes even physical intimacy due to fear of it "having" to lead to more.

For instance, maybe a partner did enjoy caressing parts of the body and kissing, but then it became a pattern that those activities were expected to lead to intercourse. Instead of enjoying the caressing and kissing on their own, now the partner is reluctant/turned off by those activities because they have become tied to intercourse when they want to be able to enjoy caressing and kissing sometimes without leading to other things.

Many of the clients I work with who describe having less interest in sexual activity from their partner typically express a sense of relief when intercourse (or other specific activities) are intentionally off the table for a period of time so that each partner can enjoy other sexual activities without the pressure and expectation that it should lead to intercourse. When there is open dialogue and an agreement that certain activities are off the table for a period of time, it can allow the partner who has less interest in sex to feel more freedom to explore other ways to be sexual and physical.

Hope this helps!

I second this question, but as the partner with the low libido. I'm not a physically affectionate person in the first place and I feel like my "intimacy battery" is already being used up from distracting kisses and whatnot throughout the day?

I've talked about this with my partner (communication is an amazing thing, oh my god) and while we're ok with each other's libido in theory, it's still causing strain.

I'm glad you're both communicating about it - that's so important. It does add an extra layer when it's not only sexual intimacy that is not desired, but physical intimacy as well. "Intimacy battery" is a great term for that - it can get drained. One refection question to ask self: Are there any ways that my "intimacy battery" gets recharged? This can be anything, doesn't need to be physical or sexual in nature (e.g., partner cooking dinner with me, going on a bike ride together, having our own solitude time).

Hope this helps!

I am a 34 year old man who has never had sex. I know this is makes me a somewhat minority, and that fact makes it difficult for me to date and creates a negative feedback loop.

In your experience, are there general suggestions for people in such a predicament to help them overcome this gap in experience and successfully date? I have had counselors in the past but it always seems to be handwaved to some degree for more generalized treatments (i.e. "am I depressed", "am I anxious") but from my POV the reality of being a male virgin at this stage of life is the core issue and nobody offers suggestions which have worked for others in the same scenario.

Thanks!

Thank you for your vulnerable question. Since it's from a throwaway account, I think your question might end up getting deleted once you delete the account, so I'll summarize your question in my response so that future readers have a sense of what is being asked.

Being 34 and never having sex can be challenging for many reasons. I'd be curious if by sex, you mean intercourse specifically or all forms of partnered sex (e.g., giving/receiving oral sex, mutual masturbation, sex toys with/on others, etc). If you have engaged in some of these other behaviors but not intercourse specifically, then technically, you actually have had sex. I know it may feel like other forms of sex arent's as valuable as intercourse, at the same time, they are all sex just manifesting in different activities.

It could be helpful to reflect on constraints that may have gotten in the way of you being more sexual than you have been just to better understand within yourself what may be contributing to that. For instance, is there anxiety being sexual with yourself (e.g, masturbation), or minimal to no anxiety with that but concerns with partnered sex? How we view ourselves sexually and our relationship to our bodies has a huge impact on how we show up sexually with others. Not in a blaming way of yourself, but more so to better understand the context of what has been happening for you. Understandably, the more time goes on, the more anxiety there can be (e.g., the feedback loop you mentioned).

Hope this helps!

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That sounds challenging for both of you. I imagine there's some sadness, frustration, and maybe some confusion for you. I would be curious what may be happening for her, as there's a difference between feeling neutral about sex (e.g. "I can take it or leave it") vs an aversion to it (e.g., "Ew, get sex away from me"). There's also a difference between someone not being interested in certain sexual activities or less interested in partnered sex, but more comfortable with masturbating. Depending on what may be happening for her would help determine how to best go about it. She may or may not be fully aware of what the constraints are for her, which would be natural and understandable if she hasn't reflected on it within herself.

It could also be helpful to better understand what it is about Fridays at noon that work best for her, as that is a very specific day and time. Are her stressors and anxieties typically a bit lower during that time? Factors had her decide that time feels the best for her.

It sounds cliche, but communication is so essential. Similar to what u/LawBird33101 mentioned, it'll be very challenging to make solid movement around this if you both aren't effectively communicating about it.

Hope this helps!

How does one overcome serious negative associations regarding sex that don’t come from trauma, but rather anti-sex teachings, police TV/crime drama, and a mind that works in such a way as to take those things more seriously than the average person?

Great question. So many factors contribute to our views of sex and our sexual selves, including but not limited to: our family upbringing, culture, religion, school, friends, media. Sometimes messages are more overt (e.g., someone saying "sex is a sin"), and sometimes messages are more covert (e.g., parents lack of providing solid sex education to their kids and speaking very little about it or not at all, which for a kid can be perceived as sex is shameful that we aren't allowed to talk about it). While these may not appear to be common sexual traumas (e.g., sexual assault), they can be traumatic in different ways

I think the first step would be to reflect on what are the specific views and messages one has about sex as whole and about one's sexual self. For instance, someone may view that other people having sex is okay, but there may be a lot of shame if they have any sort of sex themselves. That would be different than someone having the mentality that "all sex is bad sex regardless of who you are". Reflecting on if there's a viewpoint where there are exceptions to sex being healthy could be helpful too.

Hope this helps!

My wife is on SSRIs and they have certainly had an effect on our sex life. I can’t make her orgasm anymore and it has really taken the fun out of sex for me. I enjoy getting her there but now it feels like the best part was taken away from me and that makes me sad.

Any advice to make sex fun and interesting again? My best idea was to try pegging to make it more interactive for her in a new way and to change the power dynamics for fun but she isn’t too excited about that idea, which makes me sad because I thought I had a good idea. I want it to be fun for both of us again.

Medication can definitely impact one's hormones and physiology.

Our society highlights orgasms as being one of the main determining factors of whether a sexual experience is “successful”. This can add unnecessary judgment and anxiety for both of you. Shifting the narrative away from orgasm being the goal can be really helpful and liberating. And in case this is a concern for you as it is for many: Her not orgasming is not a reflection on you as a person. This doesn't make you any less of a person (or man, if you identify as male).

Pleasure is in the process of sex: the anticipation, the teasing, the touch, the taste, the visual, the dirty talk, the passion, the eroticism. Hopefully, you both can drop into your body and find what feels pleasurable. Pleasure may or may not end up in orgasm.

When you remove orgasm as the goal, you can tune into the process - the process of play, exploration, and pleasure. Orgasm is just a juicy bonus.

Hope this helps!

I have a fairly niche and quite-harmful kink. I really enjoy doing it, but aside from one person, I never found anyone who would enjoy it with me. On the other hand I'm not very interested in the vanilla kind of sex.

Are fetishes able to be unlearned? Is it possible for one to become more interested in more common and less harmful practices? What reading materials would you recommend on this subject matter?

Great question, and thank you for your vulnerability in sharing a bit about this. Safety is always the #1 concern, so it's important to consider potential safety issues with your kink (e.g., physical safety, legal safety). If there's a safety issue, that can be a signal to take a pause. Wouldn't want you engaging in something that can seriously hurt you or someone else.

One thing that can be helpful to do is reflect on the reasons you're interested in unlearning the kink/fetish. Is it due to it misaligning with your values, due to fear of others judging you?d fetishes are learned somewhere, sometimes from sexual trauma but sometimes not. If it was learned from sexual trauma, one may be engaging in "trauma repetition" and inadvertently retraumatizing themselves. On the other hand, engaging in the kink/fetish in a way in which the trauma survivor feels more empowered and is reclaiming their own sense of control (while not harming another, of course) can be very healing.

One thing that can be helpful to do is reflect on reasons you're interested in unlearning the kink/fetish. Is it due to it misaligning with your values, due to fear of others judging you?

Hope that helps!

How often do you see multiple partner relationships pan out well for the individuals involved?

I get the feeling that a lot of the stories that get posted regarding involving additional people in the bedroom have one major divide: those that are doing it to save a relationship and those who are doing it because their relationship is particularly strong. Naturally there also seems to be a fairly even divide between the results of said relationships.

What makes those types of relationships healthy versus unhealthy, in broader terms than a threesome to save a relationship is more likely to kill it? Have you had clients that maintain healthy poly relationships? This question is less geared towards open relationships, more actual shared partner situations.

Great question. In my experience, the poly relationships that I have seen to be more solid and healthy are the ones in which there is open and clear communication about agreements and boundaries, and these are continuously reassessed over time. Ideally, each partner is practicing introspection, relational self-awareness, and are real with themselves around what they are truly okay with vs what their partner wants.

There's definitely a difference between a couple who decides to have a poly relationship as a "last ditch effort" vs a couple who has a very solid foundation of trust, safety, and communication before they decide to welcome other partners into their dynamic.

Hope this helps!

How to increase libido?

I have an old blog post that can be helpful in better understanding how sexual desire is impacted: https://www.merakicounselingservices.com/blog/lets-talk-about-sex-quick-tips-towards-transforming-your-sex-life

It can be helpful to get a better understanding about oneself with the things that may be getting in the way of accessing sexual desire and arousal. Two common constraints are stress and anxiety. For most people, if they're experiencing stress and/or anxiety, they aren't feeling sexual desire. For some, it's not on their radar when they are feeling stressed or anxiety. So reflecting on the main stressors in ones life (sometimes big stressors but subtle ones can then cause accumulated stress) and addressing those would be one of the first steps.

On the other hand, some may feel stress/anxiety and want to alleviate that by some form of sex. So for these folks, stress/anxiety may not impact their sexual desire as much.

Hope this helps!

At what point should I consider hiring a sex worker? I haven't had any kind of sex in 8 years and don't have friends. I have always had a ton of problems meeting people and, at this point, I'm convinced that whatever it is that is wrong with me, isn't fixable, so I've given up trying. While I'm kind of resigned to never having sex again, I'm wondering if I should hire a sex worker and if it would even be any better than masturbation.

Thank you for your vulnerable question. It's understandable that after not having any kind of sex in 8 years, you would consider what your various options are. While I can't encourage one to hire a sex worker (as many of those services aren't legal), I recommend reflecting on the costs and benefits if you take that route.

Safety is always the number one concern, so consider potential safety issues. Legality is another big thing to consider, as you wouldn't want find yourself in a position with legal issues.

Hope this helps!

My partner refuses to honestly work on their sexual intimacy with me after 5 years of being together our sex life has become almost nonexistent. I’ve been begging her for sensual, more thoughtful sessions to which she is really only interested in getting the job done and moving on. When I complain that I’m not satisfied she feels offended. Im desperately craving a level of flirtation, foreplay she doesn’t seem willing to give any longer. Any suggestions?

My reply to u/That_UK_Guy upvoted above may be helpful for your question here.

I imagine it can be discouraging when you and your partner are having difficulty aligning on this. As u/LawBird33101 mentioned, communicating effectively is essential. It can be tough enough to work through concerns like this with effective communication, so if that isn't present, it can be even harder.

One thing to reflect on would be how sexual intimacy evolved over time and things (individually for each of you and relationally between the both of you) that may have contributed to the evolving (e.g., physiological changes, psychological changes, relational changes).

Hope this helps!

I see that you're a certified sex addition therapist. Can you say what leads you to identify someone as a sex addict and what you typically recommend in that case?

I have an old blog post that can be helpful in better understanding how Certified Sex Addiction Therapists (CSATs) assess for compulsive sexual behaviors: https://www.merakicounselingservices.com/blog/am-i-a-sex-addict

Essentially, there are ten criteria therapists often use to indicate the presence of addiction. In addition to this assessment, CSATs incorporate other assessments as well as meeting with the client to gather a very comprehensive understanding of the onset and complexities of the sexual behaviors.

Depending on what the person's unique struggles are would help better determine the therapist's treatment plan (i.e., game plan).

Hope this helps!

How do you introduce novelty in the bedroom? What recommendations do you have?

Great question, and such a common one. Sex is truly and endless buffet, though if you are with the same person/people over a very long period of time, we can tend to lose sight of this.

One helpful step can be to reflect on this: what activites are you already engaging in? Are there any elements that you (and your partner) can change/add to enhance the experience? Think 5 senses: anything you can do to shift any of your 5 senses during the experience is helpful. When we continue to have the experience that we're having the same "boring" sex over and over without any spice, oftentimes that's partly due to a lack of engaging all the 5 senses in different ways..

Communication is huge when it comes to having a sexually fulfilling life. Ideally, you'd be tag-teaming this brainstorming for novelty with your partner(s) so that it's a team effort and you can both contribute to the elements you're interested in giving a shot.

Hope this helps!

Real question , I’m 49 , single dad , don’t date at all and haven’t in 7 years and keep trying to convince myself I can live out my life like this but feel conflicted as I still crave sex yet it’s been so long that I don’t know if I want it enough to start dating ??? I used to be active all the time but was a coccaine addict for 22 years but 12 years clean and I’ve lost all appetite ?? Am I doomed to never do it again ??

Thank you for your vulnerable question. Dating nowadays can be challenging, especially being a single parent and not having been in the dating world for several years. I feel you.

I think if you're trying to convince yourself, then there's a part of you that imagines you want more for your life than how it has been. It makes sense that a part of you feels doomed. The dating world can be discouraging sometimes. I think if a part of you is wanting to date, have a romantic partner, and/or have sex partner(s), it would take you stretching out of your comfort zone and meeting people, whether on apps, in group meetups, community hang outs, through friends/family/colleagues. You may have already been doing this, so it can feel tiring.

P.S. Kudos on your recovery from cocaine, that drug is no joke.

Hope this helps!

Why are you so fabulous? I need to know.

Takes practice

is it ok to watch porn as a porn addict every once in awhile or is completely abstaining from porn best? i am on 3 week streak and am a little sad i can’t watch hentai anymore because i love the art and excitement it gives me. I wish i could masturbate thinking of my partner that way I do when watching hentai

If someone is struggling with porn addiction, it's typically advised to abstain from porn use which can understandably be very challenging. For many people who struggle with this addiction, attempting to use porn in moderation wasn't working as it typically would increase over time, and then would feel out of control. There's definitely a grieving that happens if/when someone decides to stop their porn use. Kudos on your 3 week streak.

Hope this helps!