Posts Tagged ‘sex drive’

Musings on Where Desire Comes From

Tuesday, August 23rd, 2011 by Bat Sheva Marcus LMSW MPH PhD

I have been struggling mightily recently with a spate of Ultra-Orthodox women who are completely desireless… I mean totally, completely. Almost asexual. I told my husband the other night that I am embarrassed to admit it but I sometimes despair when I’m working with these patients. We help, but it’s such a struggle. Sometimes I feel like I’m clawing my way up a canyon with nowhere to catch an initial holding. It’s almost like some of these women grew up in an emotional vacuum and they don’t even know what they are looking for. It’s crazy. And I feel so powerless. They look at me and say “I want to want sex. Make me want to have sex.” But then they don’t want to be touched, kissed, stroked… nothing.

But it all gets back to the big question of where desire comes from. Can it be totally shut down? Is it partially learned??? It’s definitely party physical because it does seem that the really problematic ones are all really, really thin. So maybe if you have some normal hormones, you can overcome a completely sensate-free existence… but then maybe you still need to be EXPOSED in some way to romance or sexuality to be able to know what you are aiming for.

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What Drugs Might be Causing a problem in Your Sex Life?

Thursday, June 23rd, 2011 by Bat Sheva Marcus LMSW MPH PhD

Let’s see. What drugs might be causing a problem in your sex life? There’s Prozac, Effexor, Lexapro, Celexa, all the rest of the SSRI’s, the NSRI’s, all birth control pills, the neuroplant, anti anxiety medications like Atavan, Valium,  and the list goes on and on and on and on.

 Here’s the deal. Many drugs can have a negative impact on your sex life. We are only now beginning to understand the complexity of drugs and how they affect a woman’s libido and functioning. That’s mostly because, quite frankly, most investigators didn’t really care much about how sex was affected by a drug. They certainly were not concerned with a woman’s sex life.

 But thankfully that is changing and we are beginning to understand more and more about how drugs impact us.

 We are very clear that any drugs that affect your brain functioning or your body chemistry can affect your sexual functioning. That doesn’t mean it will. It just means that you need to keep an eye on it. In the end, you are by far the best judge of what is happening in your body. If you feel like something is off, it probably is. Trust your judgment. Discuss it with your practitioner and make sure they are listening.

 Drugs can and do affect your sex life. Only you can be the best monitor!

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Testosterone: The Most Misunderstood Hormone

Friday, June 17th, 2011 by Barbara Gross, LMSW

I have spent a lot of time in the last few months analyzing testosterone research.  The bottom line is we all need it for healthy sexual functioning.  Men and women both make it and men and women both need it to have healthy sexual functioning.  If either group does not have enough testosterone, his or her libido will probably decline. So we have found replacement Testosterone is one of the best ways to treat low desire.  Obviously men and women needs different amounts but ultimately they both need to have it circulating in their bodies for optimal health. Women always ask if they will start to see masculinizing side effects. Though there are some slight side effects, we do not generally see that.  In fact, what we see is improved sex drive and an improved sense of overall well being.  The research supports our experience that using Testosterone improves desire. I have seen plenty of published research and a lot of women we have treated report its efficacy in improving low desire.

The question is whether or not there is a risk to taking it. In the past estrogen has been linked to breast cancer. And testosterone and estrogen have a similar molecular structure.   After many months of reviewing the most recent literature I would say that we cannot definitively say there is no risk. However we can say that there does not seem to be a strong risk. All medications have a risk. All pharmaceutical companies must print warnings on the bottle or package because every individual’s body is unique and medications affect everyone differently. Every individual brings a different background to the decision and history and genetics all play a part that I think is important in the decision making process. What i would say is if you are suffering from low desire, there are lots of things that can be done to help improve it, and Testosterone is one of them.

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Does Long Term Monogamy kill Eroticism?

Tuesday, February 8th, 2011 by Barbara Gross, LMSW

Does Long Term Monogamy kill Eroticism?

Esther Perel, in her book, Mating In Captivity, seems to believe that it often does. She writes that in our quest for security and stability we become too close to our partners and we get too comfortable.  In that process, she feels that individuals in a couple often  stop viewing one another as exciting. She posits that with all that intimacy, people in long-term monogamous relationships get sucked into a vortex of familiarity where no mystery or passion can thrive.

She does a great job of describing how and why this particular dynamic gets created in couples.  However, I think if we look at a wide variety of couples, we see that in some long term, monogamous relationships, people feel their sex lives get better over time. These individuals say that as the relationship grows, it allows them to feel more comfortable and so their sex lives improve.  The question becomes: how do they do it?

Long term relationships in which the sex is not fulfilling can be subject to a common pitfall: the individuals get disengaged and disconnected from each other. This emotional and physical distance can be the very thing that creates tension, loneliness or anger in the relationship and, subsequently, things wither in the bedroom.  Great communication and closeness do not always lead to great sex. But without those elements in a relationship, a couple’s sex life is vulnerable to the natural changes and challenges that happen to a partnership over time.

When we spend a little time exploring what is going on in a couple, a good clinician can help a couple regroup emotionally and physically, and find a path back to the closeness and intimacy that may be key to a sexually satisfying, long-term relationship.

For some people,  newness and risk may be exciting, for others safety and familiarity may be the secret. The goal is to discover what creates sexual compatibility and fulfillment for you.

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Dr. Bat Sheva Marcus interviewed by CBS News on female sexual desire

Wednesday, May 26th, 2010 by Ilene Rosenthal, Marketing

Last week, Dr. Bat Sheva Marcus, who has been the clinical director of the Medical Center for Female Sexuality for 10 years, was interviewed by CBS Channel 2 News in New York regarding the expected upcoming approval of a treatment for low sexual desire in women.  Flibanserin, manufactured by the pharmaceutical company Boehringer Ingelheim, is expected to gain FDA approval in the coming weeks for the treatment of hyposexual sexual desire disorder, or HSDD.

The treatment works by increasing the production of dopamine, a chemical in the brain that contributes to sexual desire.

Experts acknowledge that female sexual desire stems from a combination of hormone levels, chemicals in the brain, blood flow and, of course, the quality of the intimate relationship between two people.

Dr. Marcus applauded the addition of Flibanserin in her “toolbox” of possible treatments for her patients, but cautioned that female sexuality is complex and no one treatment is a panacea for all women with low desire.

MCFS patient Gail Marien was also interviewed on CBS and spoke honestly about her journey from the virtual desmise of her libido following a hysterectomy to her satisfying sex life with her husband today.

View the video here

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desire and depression

Friday, March 19th, 2010 by Shannon Bertha, ACS, PhD

Sometimes, when women come into the center with low desire we talk to them about anti=depressants.  The reaction isn’t always good:   “You think I’m depressed? I’mhere to talk about my lack of sex drive!”

Life situations and hormones can play a role in depression.  Serotonin, the hormone normally associated with depression, isn’t the only culprit.  Testosterone may also have an effect on mood.  As an essential hormone needed for desire, low Testosterone levels may contribute to mild feelings of depression as well as low desire for sex.

 So it would make sense that if a women is experiencing low desire, she may also have low testosterone levels and that may be affected her moods. 

If your relationship is unstable lately, or if life is stressful and you haven’t had appropriate time to give to yourself and your partner, you may feel ‘down’ and exhausted from dealing with this.    You may miss the comfort of a loving connection, you may feel lonely and estranged. You may wonder when you’ll have the chance to focus on sex in your life without the myriad interruptions we experience.  Who wouldn’t be a little depressed!

When we prescribe treatment for low desire, after conducting significant blood work and a physical exam,  we investigate levels of testosterone along with other hormones.  Depending upon the patient, treatment will be individualized; but the message is same:  your depression may or may not be the ‘I can’t get out of bed’ kind of depression, but mild or low grade depression can go hand in hand with low interest in sex .  Although people may have a negative association with depression and anti-depressants, it is completely normal to experience some depression with a lack of desire. 

So, don’t be afraid to bring up the issue of low desire with your practitioner.  You may find yourself solving more than one problem when you when you do.

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And the Survey Says……Sex!

Friday, October 2nd, 2009 by Ilene Rosenthal, Marketing

Why is it that we need a survey to prove that women are interested in sex?  And when we get the data, why is everyone so surprised at the results??

 A new online survey asked 500 women aged 35 to 49 about their interest in sex, and whaddaya know, 76% of women are “interested in maintaining a healthy sex life” and about 50% declare they “initiate sex with their partner.”

 Among respondants, 35% say sex improves with age and experience, and half of the women surveyed said that they have sex once a week or more.

 It’s not entirely surprising that this study is getting press.  The ‘middle aged’ woman who’s the CEO of a fragmented and unpredictable corporation called her family may be perceived as too busy, exhausted, or just generally distracted to be interested in intimacy.

There’s no arguing: the business of feeding, clothing and educating her children while cooking, cleaning and holding down a job is unimaginable sometimes.  But we also know from the women who come to the Center that a robust sex life can be an antidote to all that work; it can help let a little air out of the balloon of our full life and, like a sigh, allow us to enjoy ourselves, and the partners we love.

 In fact, the longer we are with our partners, the more comfortable we may feel, and the more we may be ok with asking for some sexual attention when we need it.

 Of course, we see many women who are not part of the 50% that have sex once a week, and who do not initiate sex, either because they don’t feel the desire, or because it hurts to have sex.  Well, that’s our work.  Data like this is an inspiration, even if it’s not a surprise.

 The survey was sponsored by Teva Women’s Health, the manufacturer of the ParaGard Intrauterine Copper Contraceptive.

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Bioidentical Hormones

Tuesday, September 29th, 2009 by Bat Sheva Marcus LMSW MPH PhD

There is so much confusion and misinformation when it comes to “bioidentical hormones.” Let me see if I can set the record straight.

• “Bioidentical hormones” does not mean that the hormones are “organic.”
• “Bioidentical hormones” does not mean that the hormones are “natural.”
• “Bioidentical hormones” does not mean that the hormones are “not really hormones.”

“Bioidentical hormones” means that the chemical makeup of the hormones exactly matches the chemical makeup in the same hormones in your body. It can be man-made but the molecular components are exactly the same as that same hormone in your body. For example, if you look at bioidentical estrogen under a microscope it would look exactly the same as the estrogen your body makes. It could have been created all chemically, in a laboratory, but the components of the compound match your body.

“Hmmmm…” you ask, why would anyone make non-bioidentical hormones to replace those in your body. Well, for one thing bioidentical hormones can’t be patented. The same way you can’t patent water, unless you add some flavorings to it, you can’t patent estrogen unless there is something different about your estrogen. So drug companies are incented to change the chemical compound. Sometimes makers of specific hormones suggest that the difference they have made is a “good” difference and thus justify the changes. We haven’t found that to be the case. In general we find that women seem to respond better to bioidentical hormones.

But don’t worry about the drug companies. Now that many realize that women prefer the bioidentical compounds they have found ways to patent their product by developing better or unique delivery systems: a specific cream to hold the compound, a patch, a pellet.

So, if a practitioner wants to prescribe a hormone, you can ask if it’s bioidentical…and now you’ll even know what that means.

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