Successful Relationship with Emma

Libido Differences, Rekindling Desire, and Sexual Satisfaction w/ Deborah Fox (Ep.16)

• Emma Viglucci • Episode 16

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Do you find that one of you wants more sexual intimacy in your relationship? 

Differences in libido and desire levels are common in a relationship because of how penis and vagina owners are wired differently and because of the differences in how their sexual organs work. This is especially true for heterosexual couples, but still true for all couples in that individuals bring their uniqueness to their interactions and sex life…   

Partners come to their intimacy with a rich background of mental, physical, emotional, and energetic conditioning that influence their experience and desires… And that inform what style of sexual beings they are…  

In today’s episode I’m excited to have a very informative and reassuring conversation with Deborah Fox, Sex Therapist, about how conditioning and other factors affect libido and desire, how partners are usually also opposite in sexuality styles and what to do about it, reasons for difficulties with female orgasms and male erectile dysfunction and how to address them, the truth about sexual satisfaction when couples have been together a long time and in older couples, and how to maintain a healthy sexual relationship to ensure a mutually satisfying sex life… This is an episode not to be missed!     

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🌟ABOUT OUR GUEST:

Deborah Fox, MSW, LICSW, is a clinical social worker with over thirty-five years of experience in private practice in Washington, DC. She is a Certified Imago Relationship Therapist and a Certified Sex therapist, providing individual, couples and group psychotherapy, as well as clinical consultation. Deborah lectures on the integration of mind-body strategies into couples therapy, sex therapy, and the treatment of sexual trauma, as well as conducting small group seminars and consultation groups.  You can find her at DebFox.com.

Find her also here: 

LinkedIn | Facebook | Instagram


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🌟MENTIONED INSIDE / RESOURCES: 

Book – Come as You Are

Article – Tuning Into The Body 

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🌟MORE ON THIS EPISODE: 

Watch the YouTube Video! 

More about the podcast on our Podcast Page

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DISCLAIMER: This content is meant to support your Journey and not as a replacement for professional assistance. Additionally, the ideas and resources provides by our guests are their ideas and recommendations alone and not necessarily a reflection of the host’s.



Emma K. Viglucci:

Hello and welcome to another episode. I'm so excited to be here with you, lovelies. I have a very special guest with me today. We're going to be talking with Debra Fox about all things sexuality for couples and partners who want to make their sex life better. So, whether you're having sexual difficulties, whether you want to rekindle your romance and your fun time sexy time or you just are feeling that you don't have enough of it, you know. So we're going to figure out how to get into having a better sex life with your partner. I'm going to pick Debra's brain today and she's going to shed some light for us to improve our intimacy with our partner. Stay tuned, you're in for a treat, so welcome.

Emma K. Viglucci:

I'm so excited to have Deborah Fuchs with us today. I am going to read her bio and then I'll say hello to Deborah. So Deborah Fuchs is a clinical social worker with over 35 years experience in private practice in the Washington DC area. She's a certified mango therapist and a certified sex therapist, providing individual, couple and group psychotherapy as well as clinical consultation. Deborah lectures on the integration of mind-body strategies into couples therapy, sex therapy and the treatment of sexual trauma, as well as conducting small group seminars and consultation groups. Her most recent publication is the integration of somatic-based strategies into couples therapy, published in the Clinical Social Work Journal last year. You're welcome to visit Debra at her website at devfactscom. So happy to have you with me today, debra. How are you?

Deborah Fox:

I'm great. It's my pleasure to be here with me today.

Emma K. Viglucci:

Debra, how are you? I'm great. It's my pleasure to be here. I am so excited for this conversation Very needed. A lot of people have questions and wonderings about intimacy and sexuality, so hopefully we could put a lot of those myths and questions to rest. Of course, yes, okay. So first tell us a little bit about who Debra is and what brings you to this work.

Deborah Fox:

Yes, so I have been practicing a very long time. I think what brought me to this work was really my interest in people, in their stories. What made people tick, what made them who they are and certainly what their life stories happen to them and brings them to this point in life, and what could make them less distressed.

Emma K. Viglucci:

Yes, very nice. And so you work in the Washington DC area and you specialize in working with couples and your old, sex and couples things. Yes, that is true, terrific, very, very good. So let's jump right in. I am thinking why don't we start with? How do people experience themselves, what's going on within themselves that they might be bringing to the relationship that contributes to difficulties with sexuality or really enjoying their sex life?

Deborah Fox:

Yes. So some of it is what we bring just as individuals in our life experience, and then a lot of what really suffers is that we don't have a lot of sexuality education in our culture, in our families, in our relationships. That's terribly useful and our families and our relationships that's terribly useful. And so a lot of couples are really just struggling with not knowing, and one of the big things I'll say about that is there are different sexual styles, for example. This is not common knowledge outside the sex therapy universe, now it is outside the sex therapy universe, now it is. Fortunately, there have been some books published. Finally, so that information. So there's so much life experience, good experiences, bad experiences, as well as information that is sorely needed, absolutely.

Emma K. Viglucci:

So what, aside from the pleasure that the body seeks when we're having intimacy and sex is not just about bodily pleasure, right, so we could maybe get into that a little bit as well but what is happening with the body? That might actually get in the way of starting on a good path to a good sex life.

Deborah Fox:

So people grow up with so many different experiences about their relationship with their own body. Many people don't grow up feeling good about their body, you know, if they receive comments, particularly in their families, that they're too skinny, they're too fat, they're too, you know, short or whatever it might be. Is that information really becomes ingrained? And we hold a lot of information in our body that we don't necessarily even know is there. And, if I can introduce a technical word, word called implicit memory that this is very powerful when it comes to sexuality. And just a simple way to explain what implicit memory is is that, let's say you're five years old and you were hit by a red truck. You survived, you're fine, you recover. Now you're 35.

Deborah Fox:

And you're standing on a street corner just waiting across the street and traffic's going by and a red truck goes by and your body flinches your body, your implicit memory, is remembering that you were hit by a red truck and that that hurt, but consciously you're just watching the traffic go by. So we hold this information. Or just like, you can get on a bicycle you haven't ridden a bicycle in 15 years, but you don't have to think, oh, how do I ride a bicycle? Your body remembers.

Deborah Fox:

Well, our bodies also remember bad experience and hopefully good experience too. But unfortunately, in this case we're talking about bad experience, certainly people who have been made uncomfortable in some way about their body. It can be as simple as, let's say, you're a girl who's just come into puberty and you're somewhat self-conscious and you have an older relative you know who comments in some way you know in my view, of course, inappropriate to comment on her developing body and she is, you know, so embarrassed. Time goes on and she kind of forgets that that happened, but her body remembers that and so she's very self-conscious about her body.

Emma K. Viglucci:

Yeah, I'm actually feeling that because I've heard stories like this and I have similar stories of my own, of course. So, yeah, for sure, just the messaging, the experiences, and not just related to the body and sex per se, but just all kinds of life experiences, like you were talking about the bicycle and the red truck. So anything that might feel like traumatic or not comfortable gets stored right. This is memory, and then it plays a role. You know ability to relax and be comfortable and right. How does it affect us? So I want to tell us more about that.

Deborah Fox:

Yes, so often what happens is that people can be uncomfortable in a sexual interaction, but they don't necessarily know why.

Deborah Fox:

Yeah, and it can be as alarming as don't touch me there you know a really powerful response.

Deborah Fox:

And or it can be I'm just kind of uncomfortable with the lights on and you know I really want to be under the sheets at all times Right, so it can be, you know, really explosive or very subtle, and these things tend to have a lot of lasting ability because we don't know how to solve them except to avoid something that's uncomfortable, like always having sex in the dark, with the lights out. You know the solve them, except to avoid something that's uncomfortable, like always having sex in the dark, with the lights out. You know the shades drawn, so to speak. So, yes, so many things are recorded and I use a pretty minor example but of course, there are many situations of sexual abuse and really overt assaults that have a very powerful effect, that are stored in the body too. Now, in many cases, we do remember them consciously, not always, so we know they're there when that's the case, but it still can affect us. It's not like we, therefore, can just throw it off and get rid of it.

Emma K. Viglucci:

Right. You know it's interesting too because there's I mean, with the work that I do with couples it's very obvious, or part of the work that we do is one partner wants more sex and the other or more intimacy than the other, more touch, more affection. The other one has no interest, or they have a hard time. They want to, of course, but they don't prefer it, or they struggle and just they're not being touched. Even right, like just even basic affection is challenging for some people that might have histories of either some sex situations or just, in general, just receiving weird messages that talk about your body or your selfhood period any any message, right, as we know.

Emma K. Viglucci:

Yeah, very good, so thank you for that. So what do you think are other things, then, that contribute to people not being interested in being touched or not be interested in intimacy sex or have low desire?

Deborah Fox:

yes. So one of the most common things that will bring couples into any therapist's office is really what we call desire discrepancy, where one partner, you know, wants more, usually more frequent sex. Now, sometimes it can also be, you know, different, you know sexual behaviors for sure, but just in terms of the frequency it's so, so common. And here's where some education really is important, because I'll go into other factors, but this one is just not common enough knowledge which is sexual styles. There are two big sexual styles. One is spontaneous, the other is called responsive, and spontaneous sexual style is what we know the most about. You know, this is the person who is just walking down the street and you know, every sixth thought is about something sexual. They just have an internal engine that easily they feel desire. It just pops up, or they have have a thought, or they see a person that they're attracted, or you know they, they see a sign. You know just that some of us might not react to. And spontaneous sexual desire is what we and it's what we see in the media, it's what we see in the movies. This is where people are dropping their clothes and you know, as soon as they walk at the door, and the sex is, you know, hot and passionate. Passionate in five seconds, right, that's what we're familiar with, but that is not representative by everybody. So an equally large group is represented by something we call responsive desire, and this is the one that's not in the movies.

Deborah Fox:

And this responsive desire people are those who don't particularly walk around with that internally charged engine that, just you know, pops up naturally. They are more inclined to where arousal might actually come first, before desire, and what that means is this question of I'm not in the mood is the wrong question. The question is oh, am I open and willing to engage in physical touch? And when I am touched, or I am touching, then some inklings of arousal might show up, and, oh, I am very glad to be here doing this, and so desire shows up. But let me back up a moment, because these are the folks where the context is crucial. So context meaning are they fatigued, are they preoccupied with a work deadline or a project, or they have a family member who's maybe struggling or ill, or, you know, there's a one of their children is, you know, on their mind because of some problem that needs to be addressed? All these are contextual issues and for a spontaneous person, these might be just factors, but for a responsive person these are central, these are decisive.

Deborah Fox:

And so we don't know about responsive sexual style and even the people who fall into that category, they've never known about it because it's not talked about Right, except for books in recent years. Thank goodness you know that are certainly bring this information. So most couples and this can be true in my experience, even with same gender couples usually have one representative from each group. Now Emily Nagoski, in her book Come as you Are, who's a sexuality? Emily's a sexuality researcher. She gives some statistics and which I think are interesting, that there are some nuances to this. But I'll give you the bottom line, which is about 75% of men are in the spontaneous sexual style, which would fit with what I think we commonly know, and about 25% of men would be in the responsive category. And then for women it's flipped where there's nuances, but there's about 85% who would fall into that responsive category.

Deborah Fox:

Now the really goofy thing about this is that in dating, in the early stages of infatuation, this is when most couples tend not everybody, but tend to be the most interested, and so the spontaneous people that's their happy place, and the responsive people they look more spontaneous during that time because we're creatures of novel and new and infatuation, there's all sorts of hormones coursing through our bodies and so in a couple that ends up staying together long-term, that naturally fades.

Deborah Fox:

That's biology. But we very confused by that, the spontaneous person, I think, what happened to my you know my partner, who wanted to have sex with me all the time. You know, suddenly you know it's important that there's food in the refrigerator that didn't used to be, or to work, that's not a problem. Now it's important to not be late to work, to stay home and have sex. So I and the responsive people are also confused because nobody knows what quite happened and they don't know what to do at that point, and so that's where just a lot of unnecessary suffering comes into play. So let me just pause there for a moment and see, does that sort of make sense so far?

Emma K. Viglucci:

Yes, I love the distinction because it makes total sense. I mean, I see it anecdotally and I see it with the stories that I hear from our couples and just the experiences right, that usually one person like we were saying before before we started recording wants more than the other and just the frequency plays out recording once more than the other, just the frequency plays out, and it's probably part of this definition as well. I assume that the spontaneous person probably wants more, or it seems that they will be more interested in sex because they have that engine revving with the other one.

Emma K. Viglucci:

They need to line up all the stars right to be able to be ready right. That's how I joke about it sometimes.

Deborah Fox:

Right, and there's things that couples can do about this. I mean, you know the spontaneous people. They can be helpful, you know, in terms of helping to create that context. Right, and the responsive person also needs to think of, well, what can I do to sort of clear the decks? That's right, so I can be open to touching, you know, and then they can work together as a team.

Deborah Fox:

You know, let's say they have children, and the spontaneous person can say, hey, you know, I'll put the kids to bed and I'll do the dishes, which maybe will give you time to chill out, relax, read your favorite magazine and be more open to engaging in touch. So this is just a huge thing that people know about and they really take seriously. Now, the taking seriously is kind of a point to emphasize here, because when I explain responsive desire to a spontaneous person, their jaws drop. They just cannot imagine that their partner doesn't walk down the street and just have spontaneous sexual desire. They did, it's like it's. They live on a foreign planet, right? And the responsive person when you explain the spontaneous style to them, it's the same jaw dropping experience. You're kidding, they do that.

Deborah Fox:

Right, and the responsive person also has their wide eyed. Look, because that's me. You have just explained my experience. That I never knew was a thing. I just thought something was wrong with me. And so both partners think something's wrong with the responsive person, and which is just such a shame, totally Such a shame.

Emma K. Viglucci:

Yes, yes, for sure, and I love that you said that it doesn't have to be a problem or a thing. Right, they could do something about it and I love the example that you gave that the spontaneous person kind of helps set up the context, right. So what are the things that would help the other person? Whatever are the things that are bothering the person or getting in the way, how can they help with those things so the other person can start to load it with all the things that keep them from being ready and available?

Deborah Fox:

Yes, yes, and everybody talks their own language. So, like this spontaneous person is often saying to their responsive partner well, tell me what turns you on. And they're thinking of sexual behaviors because that's what their frame of reference and they're they had, because they have no idea about how important the context is. And so there's just this constant missing of communication around these kinds of things.

Emma K. Viglucci:

For sure, and that's so interesting that you said it like that, because also the other thing is, not only they're looking for what turns you on sexually, but then they're looking for like okay, and what else can we do, and the whole thing is sexual. Right, it's not just like a position or a thing, but like everything is sexual, is sexual context, when the other person sex is at the bottom of the list. So all the other content right.

Deborah Fox:

Address first yes, exactly, exactly. And couples do need to prioritize their relationship because it, you know, it does fall off the priority list when you know jobs are full time and more than full time and they have children who come along and it just falls off. You know, we put everything else on our calendar but we don't put sex on our calendar. You know, that's kind of odd, but people are people.

Emma K. Viglucci:

That cracks me up, because whenever I bring up scheduled sex, people freak out and I say listen, if you're not having it at least once a week, then you need to schedule it At least that first one. I'm not telling you not to have more than that. Then the rest could be spontaneous.

Deborah Fox:

But at least have that one you know. Very good.

Emma K. Viglucci:

So any thoughts about what might be different for women whose biology is a little bit slower, to rev up and to enjoy the moment? So anything about that one and two, the discrepancy with orgasming or different ways that the woman can orgasm to make it easier, because the typical traditional thing the person who gets off easier might think that the other person will get off just as easily and that's just usually not the case. Right, and I'm trying to use proper language.

Deborah Fox:

Yes, yes, and let me say one thing before that, and then I'll make sure I'll get to that, which is another thing that is so important, is about discomfort and pain, and the reason I want to put this in there.

Deborah Fox:

It's another thing that there are different conditions, physiological conditions, that create pain for women, and the reason I'm mentioning it in the context of your question, which I will answer, is that often women do not know that we're not supposed to have any pain and so because they've always had it, for example, where it's just evolved, and they don't realize that there is a problem and often there's enough physicians are not really properly educated or and don't ask the right questions and don't know what to look for, so that women suffer unnecessarily for pain, vaginal pain, either, internally, the muscles sometimes can be too tight, which create a condition, and therefore that leads to not wanting to engage in sex, of course, because we don't go towards pain right and some of these things can interfere with orgasm.

Deborah Fox:

So it's it's really important that if, if a woman is saying you know, or a couple, you know, it's really important that if a woman is saying, or a couple, it's hard to get to arousal and climbing that arousal ladder to an orgasm. It's super important to be really talking about the physiological things that might be going on. I'll give you just one example, because women don't know this one either typically and sometimes doctors don't, unfortunately is that there can be some scar tissue that develops under the clitoral hood and it can interfere with pleasure. And if a woman isn't saying that the doctor doesn't know what to look for her, then you know she's really not in a position. She can, you know, have the most amazing partner or the most amazing toys or whatever, and her sensations are going to be very muted.

Emma K. Viglucci:

So what a good observation, or share, because and they might not even know that something's wrong, that they have scar tissue there, they just exactly this is their experience. Right? This is like right. How are they? Yes that's amazing. Yes, thank you, yes yes, so super important.

Deborah Fox:

And that's where knowing a sexual medicine physician which not all gynecologists or urologists are is super important.

Deborah Fox:

And so to get to the next part of your question is, yes, often women do have a slower climb on that arousal level than men do, and some of it is about the context.

Deborah Fox:

You know, if there are, you know, some flirty text messages that have gone back and forth or there's some playfulness or they're reading, I don't know some flirty text messages that have gone back and forth or there's some playfulness or they're reading, I don't know, some erotic literature together, you know, beforehand, that's a lot of priming the pump and, as we all know, the largest sexual organ is the one between our ears, and so some of these things are very, very important.

Deborah Fox:

And the other thing is we have lots of erogenous zones that are not the most obvious, you know. So a lot of touching is can be very arousing, and I like to call this a to and fro. So what it means is, you know, if you're rubbing somebody's back and then your hand goes towards erogenous zones and then it goes back down the arms and then comes back to erogenous zones, that these kinds of things, that anticipatory touch, can be very arousing Because so often, especially with a spontaneous person, they might just die for erogenous zones because that's what they would like right, you know the funniest example, and there's many versions of this.

Deborah Fox:

but a woman will say he just comes up behind me while I'm doing the dishes and puts his hands on my breasts, and you know, and I, you know, I'll elbow him in the stomach and and he thinks he's doing something that is, you know, very appealing. And and if he, and if she asked him, he'll say, like if she were to say, well, do you want me to come up and just grab your crotch, he'll say, yeah, that's right. So then, you know, people need to get to know each other. You know we're talking about heterosexual couples here, you know, who are different styles and different genders. They need to get to know each other in ways that we don't, unfortunately. So, yes, so that anticipatory touch of spending time enjoying touches all over our body, you know, not just those erogenous zones is very important. So we're talking about the whole lead up as well as what happens when you're actually engaged in physical touch.

Emma K. Viglucci:

Yes, that's terrific, exactly so. Anticipation build up before you even get to the bedroom or the location where you think you're going to have sex or you want to have sex at, and before you even start touching. So all the pieces, that's priming the pump. I love that. Invest in that for both partners, right. So the partner who is like, okay, geez, I wish I was more ready, then that's your homework. And for the partner who wants their partner to be more ready, you could help them along. Right, so you could invest in that. And getting more ready for more enjoyment Beautiful. Okay. And so we talked about some difficulties for the woman. So what might be some difficulties for the man? So maybe some erectile dysfunction? Are there some other things that happen for them?

Deborah Fox:

Yes. So erectile dysfunction has different causes and I would say for any man who this is happening with some frequency, I would definitely encourage a medical evaluation with somebody, with a physician who specializes or is very knowledgeable, because often they go to a urologist and they give them a testosterone test and they say, oh, your testosterone is fine, have some Viagra, and you know, for some people that can work and it's certainly a very appropriate medication in some contexts. However, there are other things I've learned from a knowledgeable physician that sometimes there's a stenosis of the spine which can cause some erectile dysfunction. So you really want to have that thorough evaluation before you assume it's something that has no physiological basis. So that's an important first step.

Deborah Fox:

Yes, there are some medications that can interfere with sexual functioning, and then a very common one we work through that physiological evaluation and nothing comes up is is looking at anxiety, because anxiety plays a huge role in all for men and for women in terms of sexuality.

Deborah Fox:

It interferes in, basically, the blood flow, let's put it right, then, and there there certainly can be performance anxiety, and that comes from many different sources, emotional as well as specifically sexual. If a man has one, even as few as one situation where his erection goes away or doesn't arrive, and again, that's a very normal circumstance for that to happen on occasion. You know he's fatigued, he's had too much alcohol, he's exhausted, you know the stars just aren't particularly aligned that time. But then what happens is he becomes anxious about it happening again, and so, even though the first time it may have happened would be totally benign, no real issue, he gets into what we call in the sex therapy world, spectatoring, which means watching for his erection. And just as that old adage of a watched pot never boils, well watched erections do not pop up.

Deborah Fox:

Wow, that's awesome. Erections occur in the presence of relaxation and simulation, not anxiety.

Emma K. Viglucci:

Right.

Deborah Fox:

So that's a huge source of problems and you know men can also have a generalized anxiety disorder, not just about sexuality, but they're generally one of those people who worry a lot that can also show up in their sexual functioning and be a concern. And then they back away from sexuality because of course it makes them feel very bad about themselves and so then they withdraw from sex and that kind of makes the anxiety just grow.

Emma K. Viglucci:

Yeah, it's like a runaway train at that point. Yes, yes that makes sense. So is there anything that the woman can do? To in those situations absolutely or the partner who's of you know could be the same gender, of course also like yes, absolutely to help the partner who's having you know could be the same gender, of course also, yes, absolutely.

Deborah Fox:

To help the partner who's having the issue.

Deborah Fox:

Yes, and truth be told, for many women who have an orgasm without any penetration, you know, because the way our physiology is is that most of the nerve endings are really in the clitoral area and just in the outer third of the vagina. So there's this misconception that for women, you know it's very important to you know have penetrative sex, not true? And of course, and of course, men think it's all about penetrative sex, so they even ignore what I just said, even if they've heard it. So for women, or for the partner, it's very important to be reassuring that this is not, you know, the being and all of sexuality for them. And the other thing is is that erections do naturally ebb and flow during a sexual encounter. So it's important for both people to be aware of that, which is often not the case because, you know young men, they're having erections more than they want, right? It's like how do they get them to go away sometimes? And so, in a natural aging process, when their erection isn't there all the time, it's very, very disconcerting to them.

Emma K. Viglucci:

Sure, you know, and that's so pretty, how you said, just to be a reassuring partner. So, regardless of which camp you fall under, if you're the spontaneous or the responsive and you're dealing with a partner, that's usually the opposite. That's Mother Nature's way of messing with us. We usually get the opposite in everything right, Even in sex.

Emma K. Viglucci:

And then okay. So how do we support each other? How do we have each other's back right? So if you're more spontaneous, how can I step up into that? If I'm more of the responsive, how can you help me create that context? If I need more stimulation because my clitoral area is not as responsive or just for whatever of the reasons, then to play with all the erogenous zones and all the touching, if I'm the person who's not having as many erections or whatever, just to have that reassurance that other sex is fine too and just to reduce that anxiety.

Emma K. Viglucci:

Overall beautiful yes yes, yes, yes, excellent. So there was a thing that we kind of touched on this a little bit already, that over time sex and interest kind of gets smaller or falls to the wayside or there's less interest in sex. So any thoughts about long term relationships? What to do about that? How does that place out? And even for elderly couples or older couples couples, how do we play with these things?

Deborah Fox:

so there's. I'll start with the last part, first, in terms of aging, which is that there's a common misconception that couples in their 70s and 80s are not having sex. And not really true. And they true, they certainly are capable and there are natural age-related changes, but it does not mean that sexual satisfaction goes down. Frequency may go down, there's a little bit less desire, but that doesn't necessarily mean that satisfaction goes down. And most people really do want and need to be touched. And so we can also redefine what is sexuality. Is it just having orgasms? And for many people that's not true. Right, you know that they may have some level of arousal, but they don't have enough, whatever it is, to climb up to that orgasm. But that still feels good to them. They would still define that as as sexual. So it's often the case that because and this will be particularly true for penis owners is that that erection, who that used to pop up, you know, all the time, and then most of the time when it stops popping up so easily and in, even under stimulation, that freaks them out and they start to withdraw and they'll withdraw from from sex. So we need to understand that age-related changes does not get in the way of satisfaction. And, on that note, menopause is a really important thing because for many, many, many women, their interest in sex and their ability to get aroused really drops off, starting in perimenopause and then in menopause. And this is another thing that has not been well treated by the medical profession. I think it's only in the last couple of years and that's really new that we've come around again, because in the 1990s, when there was the Women's Health Initiative research which put a kibosh on hormone replacement therapy, and the people I knew at the time in the profession was saying this is wrong, this is flawed reaction to the study. It was flawed for all sorts of reasons which I won't go into that, but just that menopause is something that women have not been served well by the medical profession. So I would encourage women to find somebody who's knowledgeable a doctor who is knowledgeable about sexuality and menopause and is really up to date with the current research, and to make very thoughtful decisions about what they might want to do in terms of hormone replacement. So super important, super important, yes.

Deborah Fox:

Now to get back to your question, which is just other than the aging process. There's relationships that go on for five years, for 10 years, for 20 years, for many more years, and that, uh, that same level of energy. That certainly happens in that early phase of the novel, and the excitement is that there's definitely things that people can do to put some of the pizzazz. And this is where, um, you know you want to create some context. You know what can you do to make that a special evening, if that's kind of what works for somebody, you know, is it lighting the candles?

Deborah Fox:

Is it I don't know eating naked and by the fire? Or scantily clad, attire, you know, and having some appetizers and a glass of wine in front of the fire? Is it going away for the weekend and surprises Not everybody likes a surprise, but many people do or is it leaving sexy notes for your partner? Is it sending sexy texts along the way? So it takes more awareness to sort of put some of the sparks back in and create some of the fun. It can be if people like to role play and have fantasies. I mean, the reason that Victoria's Secret is so popular is because a lot of people really love these visual cues, and I had one woman once say why should I put on a negligee? You take it off in 30 seconds and he goes yeah, that's the point, that's right. It's worth that 30 seconds.

Emma K. Viglucci:

So there's yeah, so it's really putting in more effort and awareness and thought, as opposed to it just doesn't happen between the sheets like it might have when you first met each other yeah, and it doesn't mean that because you've been together for a long time and because you're aging, that you should settle for having mediocre sex life now, a much more modest sex life. You could have whatever sex life you want and just invest in that. Yes, yes, yes, yes, yes. Very good Now. So tell me about chores being playful. What might get in the way from couples getting on the same page about these things, and how can they use that for the good of this sex life?

Deborah Fox:

Right. So this is just trying to, you know, put some humor, some fun, you know, back into relationships. That can. You know. We all have busy lives, you know, whether it's work or we love our kids but we don't necessarily love them 24, seven so we can get drained. We don't have the energy at 45 that we had when we were 23. And so the idea of you know putting some fun back into the thing, you know, maybe if you're washing dishes, you fling a soap bubble at your partner or you take the kitchen towel and do one of those whip things, you know that the kids do all the time.

Emma K. Viglucci:

I appreciate it Right.

Deborah Fox:

So it's trying to put a little fun and humor and lightness even around just everyday things.

Emma K. Viglucci:

I love that, yes, so good. Oh, my goodness, this was so informative, debra. Any other thoughts that come into mind that you think would be very significant for people to know if they're either having some dysfunction and they might not even know they're having dysfunction, if they're struggling having a sexy, satisfying sexy lifestyle or sex life, or they're trying to rekindle. So anything on either one of those areas that you want to just add in here to rekindle.

Deborah Fox:

So anything on either one of those areas that you want to just add in here. Sure, there certainly are books you know that people can use. But I do want to add a note of caution is that if people are, if couples really are struggling, if it's been something that's been a sore point between them for years, it's awkward but it's really important, I think, to seek out some help from a sex therapist. And I just would encourage people not to hesitate, because some of the things I've shared with you today physiological condition they might have is being treated always or frequently get a second opinion, because I have had so many people come into my office and I'm thinking, you know just not sure we've gotten to the bottom of this and I'll refer them to another sexual medicine physician or a sexual medicine physician, because I'm not sure they saw the first time, because I think when it comes to sexuality, people have been grossly underserved. So it's like continuing to look for what you're struggling with until you really get a good answer.

Emma K. Viglucci:

Love it. Now, what kind of physician is this? Because I've never seen them advertised as a medical, sexual medical physician. Is there a specific doctor that? What is their title or their type of medicine?

Deborah Fox:

Yeah, no, it's a good question. It's not an official distinction. So these are going to be your gynecologist or your urologist. However, it's how they define. Interestingly enough, there's a wonderful urologist who's a sexual, who defines herself as a sexual medicine physician, but she wasn't allowed to put it on the sign. That's on the street, you know, and this is not the first person who has been in that situation. So it's also how they present themselves, because these physicians have gotten extra training, they've paid extra attention, they go to these kinds of conferences, so it's really how they define themselves, which you could understand more about looking at their website or asking questions you know when you go to see them or looking at how they present their biographies on the website.

Emma K. Viglucci:

Or their training, their background. Excellent, that's great information Very good. Okay, so any last words of wisdom.

Deborah Fox:

I think we've done pretty well.

Emma K. Viglucci:

I think so too. I really appreciate you. Thank you so much for sharing time with me and all of this wisdom and nuggets so that people can improve and have a much better sex life. Thank you so much. Wonderful, you are welcome. Thank you and, for our listeners, I will see you at the next one. Bye.

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Emma K Viglucci, LMFT

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