February 23, 2024 • 17 mins
Too many couples are having too little sex, says Dr. Saltz. She tells how to restart your sex life--because it’s good for your physical health, your mental health, and the health of your relationship.
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Speaker 1 (00:05):
Bees are challenging times, but you don't have to navigate
them alone. Welcome to How can I Help? I'm doctor
Gail Saltz. I'm a clinical Associate Professor of psychiatry at
the New York Presbyterian Hospital, the psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight and advice. Why you might ask,
do I need any reasons to have sex? Besides being
responsible for the continuation of our species and the glue
that binds couples together. Sex is youngier than chocolate. It's
(00:49):
more fun than an amusement park ride, it's rewarding, it's relieving,
and it's filled with tenderness and intimacy. One would think
we'd all want want to be having sex night and day,
but we aren't. In fact, according to the Kinsey Institute,
sixty two percent of married women are having sex only
(01:12):
a few times per month or less, compared with thirty
eight percent of married women who are having sex several
times a week. So while most women are having some sex,
not necessarily a whole lot of it. Today I'm answering
a question from a woman about her sex life and
(01:33):
in fact about the health of sex. Some women keep
having sex right on through their mid eighties, though the
frequency drops substantially from seventy three percent of people ages
fifty seven to sixty four down to twenty six percent
of people ages seventy five to eighty five, according to
(01:55):
a new England Journal Medicine study from the University of Chicago.
This study also found that half of women who are
sexually active later in life do struggle with a sexual problem,
the most common problem being low desire at forty three percent,
but also trouble with lubrication thirty nine percent and inability
(02:19):
to have an orgasm thirty four percent. These women actually
rarely discussed their problem with any physician, which is really
a shame because these are all treatable problems. I see
many women who wish they wanted to have more sex.
(02:40):
The reasons they don't want range from being angry with
their partner, being tired and overwhelmed, discomfort with their body,
to just not enjoying it enough. For many women, sex
just falls to the bottom of their priority list. Problem
(03:00):
is that for most couples, when their sex life dies,
the marriage soon follows. It is very easy to get
into a non sexual rut. The less you have it,
the less you want to have it, until you are
part of the fifteen percent of married women who have
(03:20):
sex rarely to never. A sex life can, however, be
jumpstarted with motivation and incentive. In fact, even when you
are not in the mood, sometimes just starting in and
getting the ball rolling often leads to ample arousal and
enjoyment of the love making itself. We are, after all,
(03:43):
hardwired to benefit emotionally and physiologically from sex. There isn't a.
Speaker 2 (03:51):
Specific normal frequency for sexual activity that applies universally to
all women. Sexual frequency can very widely from person to
person and couple to couple due to factors like personal preferences,
their general state of health, relationship dynamics, and life circumstances.
(04:15):
What matters most is that the level of sexual activity
is consensual, is enjoyable, and is satisfying for all parties involved.
Some couples may have sex frequently, while other couples have
a less frequent but still a very satisfying sexual relationship,
(04:35):
all very healthy. Additionally, sexual frequency can change over time
for various reasons, your age, your health, your stress level,
the change in the relationship and other things like having kids.
It's crucial for individuals to communicate openly with their partner
about their desires, about their boundaries and expectations regarding sexual activity.
(05:01):
This can help make sure that both partners are on
the same page and feel comfortable with the level of
intimacy in their relationship. And then issues related to sexual
frequency which do arise, can be openly communicated about, which
is important. Couples benefit by discussing their needs with each other,
(05:23):
exploring new ways to connect intimately, and if necessary, seeking
outside guidance from a counselor or a sex therapist. Ultimately,
what is considered normal varies greatly from person to person,
but it is essential no matter how frequently you are
(05:44):
having sex, to prioritize mutual consent, communication, and emotional connection
in any sexual relationship. So with that, let's get to
my listener's question and ask how how can I help
dear doctor Saltz. I have been in a committed relationship
(06:06):
for four years, and at the start of this relationship,
we used to have sex more days than not, but
certainly most days of the week. As time is worn on,
we now have sex maybe once a week, which I'm
fine with life is busy, I'm tired after work. I
don't feel in need for more often. My boyfriend would
(06:31):
like to have sex more often, and even though I
don't feel the same way, I'm okay with doing it
more often, as clearly it's important to him, and it's
not that I really don't want to, I just am
not as likely to initiate it. One thing he has
said to me is that having more sex is good
(06:52):
for us, that it has health benefits, and that it's
good for our relationship. In truth, this sounds kind of
observed to me, and I think maybe he's making this
up to further support his wish to have more sex.
As I mentioned, I'm not opposed, so he doesn't need
to bolster his argument. But now I am wondering is
(07:14):
there anything really to this idea of better health from
more sex. Actually, it's not a made up story. Sexual
activity is good for you, both for your physical health
in terms of your cardiovascular system and for you in
particular for your pelvic floor strength, something that trusts me
(07:36):
as life moves on, really will matter to you, but
also for the health of your relationship. As he mentioned,
as long as the sex is mutual and not fraught
with stresses, because then it does improve intimacy, and at
the end of the day, a healthy emotional relationship is
(07:58):
good for your overall physical health as well well, because
the reality is our minds take a toll on our bodies,
so your boyfriend is actually not bssing you. However, that
would not in and of itself be good enough reason
to have sex if there were a problem and you
(08:18):
really did not want to be having it, because coerced
sex has enough of a negative emotional impact to rule
out any of these great benefits. If you truly were
miserable having sex and didn't want to, I'd really recommend
seeing a sex therapist to figure out what the issue
might be, whether it's an issue for you to work
(08:41):
on medically or emotionally, or whether it is something to
work on as a couple, because when one person wants
sex and the other rarely, if ever does, it can
harm the relationship overall. Given however, you are satisfied to
have it a little more often than might be what
(09:02):
you would initiate, this may not seem to be a
problem at all, and nice to know this is healthy
for you both in the process. Back in a moment
with some more thoughts on what's healthy about sex? Back
(09:28):
to discuss what's healthy about sex, there are I would
say at least ten healthy and perhaps surprising incentives to
remind you that sex isn't just good, it's good for you.
The first is marital health. Couples who have a satisfying
sex life report being more satisfied with their marital relationship
(09:52):
and more satisfied with their lives as a whole. Marital
happiness and stability is a healthier environ for children to
grow up in and contributes to the mental and physical
well being both of the children and of you the parents.
In fact, children from a happy, stable marriage have lower
(10:14):
rates of alcohol abuse, teen pregnancy, depression, suicide, and divorce.
And there's cardiovascular health. Yes, sex can be quite aerobic
if you work at it. In fact, active love making
burns about four calories a minute. Spend a half hour
(10:35):
in bed and you just burned off a cookie or two.
If you can raise your heart rate for a sustained
period of time, this can serve as your workout for
the day. Does this not beat going to the gym?
If this is your particular aim, then remember, as with
all exercise. The more you sweat and pant, the better
the workout lots of movement as opposed to the just laying.
(10:59):
Their approach not only helps your heart, it helps the
sex next. Sex can better your body. Not only can
you improve your heart health, but you can look more
buff in the process. Love making works key muscle groups
such as abs, buttocks, lower back, and legs. Tightening, strengthening,
(11:21):
and toning. These areas will give your figure a boost
in and out of clothes. Having anxiety about how one's
body looks is often what detracts women from sex in
the first place, so this serves the double benefit of
liking your body and then feeling more comfortable being seen
naked by your partner. Many of these muscle groups get
(11:45):
used during sex, whether you intend to or not, but
you can also make a specific effort to tighten your
abs or buttocks, which will be more effective, and increased
muscle tension will also increase sexuals Arousal. Sex can help
with bladder control. As we age, are pelvic floor muscles loosen,
(12:10):
especially if you have given birth. Weak pelvic floor muscles
lead to urinary incontness. It is really no fun to
pee every time you sneeze or laugh or cough. Sexual
intercourse actually strengthens your pelvic floor muscles if done regularly enough.
(12:30):
This is the same principle as doing kegel exercises, but
it's more fun. Kegels are repeatedly contracting the pubocoigious muscles
of the pelvic floor, which causes them to become tighter.
Contracting those same muscles is often part of sexual intercourse
(12:51):
and can of course be done purposely which your partner
will enjoy, which will tighten them and prevent or reverse
some urineary leakage. Regular sex can prevent painful sex. The
vagina is a muscle too, and the old adage of
use it or lose it holds true. If you don't
(13:15):
have sex much, the vaginal walls atrophy over time, making
them thin, stiff, and dry, which causes intercourse to be painful.
The more you exercise this muscle by having sex, the
more supple and strong it will stay. Actually, vaginal atrophy
(13:35):
is often a cause for vaginal dryness. Having more sex
more often may help you produce more of your natural lubrication,
which comes from the vaginal walls, and lubrication is absolutely
key in having comfortable sex. Sex can be a natural
pain believer. Sexual arousal and orgasm cause the body to
(14:00):
release its own natural endorphins and cordico steroids. These can
be as effective as taking a painkiller, but without side effects.
For some women, the bodies endorphins provide a sort of
natural high, like that described by women runners. Many women
(14:20):
find sex to help relieve migraine headaches as well as
menstrual cramps. So instead of saying please not tonight I
have a headache, you might want to say, I need
it tonight because I've got a headache. Sex can help
regulate your menstrual cycle. It turns out that women who
(14:40):
have regular sexual intercourse also have a more regular menstrual
cycle compared to those who are not having regular sex
and have a more erratic, sometimes short, sometimes long cycle.
The mechanism for this is not entirely clear, but it
is likely that it has to do with hormone release
(15:01):
and regulation. A more regular cycle can make getting pregnant easier.
There is some day to suggest sex might even boost
the immune system. A study of college students found that
frequent sexual activity correlated to a higher level of salivary
immunoglobulin A which helps fight off colds and other viruses. Certainly,
(15:28):
sex often leads to a happier partner. For many men,
sex is a way of showing love and being loved.
When you have more frequent sex with him, he feels
you desire him and want to be close with him.
This increases both his self esteem and the security in
your love. Many husbands report that frequent sex with their
(15:51):
wives makes them want to be kinder, more loving, and
even help out more at home. If you wish you
would pitch in more with the laundry, you might try
increasing your love making. Increased intimacy is another side benefit.
Besides a happier mate, you too will feel closer and
(16:12):
more in tune. When a woman orgasms, she releases a
hormone called oxytocin in the brain. Oxytocin is the same
hormone released when a woman nurses her baby. It is
a hormone of bonding. Oxytocin actually makes you feel closer
to and loving towards whoever happens to be there when
(16:34):
it hits your brain. This is why after good sex
you often do feel especially intimate with your partner. Do
you have a problem I can help with If so
email me at how can I Help at Senecawomen dot com.
All centers remain anonymous and listen every Friday to how
(16:56):
can I Help with Me? Doctor Gails Salt s
Bees are challenging times, but you don't have to navigate
them alone. Welcome to How can I Help? I'm doctor
Gail Saltz. I'm a clinical Associate Professor of psychiatry at
the New York Presbyterian Hospital, the psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight and advice. Why you might ask,
do I need any reasons to have sex? Besides being
responsible for the continuation of our species and the glue
that binds couples together. Sex is youngier than chocolate. It's
(00:49):
more fun than an amusement park ride, it's rewarding, it's relieving,
and it's filled with tenderness and intimacy. One would think
we'd all want want to be having sex night and day,
but we aren't. In fact, according to the Kinsey Institute,
sixty two percent of married women are having sex only
(01:12):
a few times per month or less, compared with thirty
eight percent of married women who are having sex several
times a week. So while most women are having some sex,
not necessarily a whole lot of it. Today I'm answering
a question from a woman about her sex life and
(01:33):
in fact about the health of sex. Some women keep
having sex right on through their mid eighties, though the
frequency drops substantially from seventy three percent of people ages
fifty seven to sixty four down to twenty six percent
of people ages seventy five to eighty five, according to
(01:55):
a new England Journal Medicine study from the University of Chicago.
This study also found that half of women who are
sexually active later in life do struggle with a sexual problem,
the most common problem being low desire at forty three percent,
but also trouble with lubrication thirty nine percent and inability
(02:19):
to have an orgasm thirty four percent. These women actually
rarely discussed their problem with any physician, which is really
a shame because these are all treatable problems. I see
many women who wish they wanted to have more sex.
(02:40):
The reasons they don't want range from being angry with
their partner, being tired and overwhelmed, discomfort with their body,
to just not enjoying it enough. For many women, sex
just falls to the bottom of their priority list. Problem
(03:00):
is that for most couples, when their sex life dies,
the marriage soon follows. It is very easy to get
into a non sexual rut. The less you have it,
the less you want to have it, until you are
part of the fifteen percent of married women who have
(03:20):
sex rarely to never. A sex life can, however, be
jumpstarted with motivation and incentive. In fact, even when you
are not in the mood, sometimes just starting in and
getting the ball rolling often leads to ample arousal and
enjoyment of the love making itself. We are, after all,
(03:43):
hardwired to benefit emotionally and physiologically from sex. There isn't a.
Speaker 2 (03:51):
Specific normal frequency for sexual activity that applies universally to
all women. Sexual frequency can very widely from person to
person and couple to couple due to factors like personal preferences,
their general state of health, relationship dynamics, and life circumstances.
(04:15):
What matters most is that the level of sexual activity
is consensual, is enjoyable, and is satisfying for all parties involved.
Some couples may have sex frequently, while other couples have
a less frequent but still a very satisfying sexual relationship,
(04:35):
all very healthy. Additionally, sexual frequency can change over time
for various reasons, your age, your health, your stress level,
the change in the relationship and other things like having kids.
It's crucial for individuals to communicate openly with their partner
about their desires, about their boundaries and expectations regarding sexual activity.
(05:01):
This can help make sure that both partners are on
the same page and feel comfortable with the level of
intimacy in their relationship. And then issues related to sexual
frequency which do arise, can be openly communicated about, which
is important. Couples benefit by discussing their needs with each other,
(05:23):
exploring new ways to connect intimately, and if necessary, seeking
outside guidance from a counselor or a sex therapist. Ultimately,
what is considered normal varies greatly from person to person,
but it is essential no matter how frequently you are
(05:44):
having sex, to prioritize mutual consent, communication, and emotional connection
in any sexual relationship. So with that, let's get to
my listener's question and ask how how can I help
dear doctor Saltz. I have been in a committed relationship
(06:06):
for four years, and at the start of this relationship,
we used to have sex more days than not, but
certainly most days of the week. As time is worn on,
we now have sex maybe once a week, which I'm
fine with life is busy, I'm tired after work. I
don't feel in need for more often. My boyfriend would
(06:31):
like to have sex more often, and even though I
don't feel the same way, I'm okay with doing it
more often, as clearly it's important to him, and it's
not that I really don't want to, I just am
not as likely to initiate it. One thing he has
said to me is that having more sex is good
(06:52):
for us, that it has health benefits, and that it's
good for our relationship. In truth, this sounds kind of
observed to me, and I think maybe he's making this
up to further support his wish to have more sex.
As I mentioned, I'm not opposed, so he doesn't need
to bolster his argument. But now I am wondering is
(07:14):
there anything really to this idea of better health from
more sex. Actually, it's not a made up story. Sexual
activity is good for you, both for your physical health
in terms of your cardiovascular system and for you in
particular for your pelvic floor strength, something that trusts me
(07:36):
as life moves on, really will matter to you, but
also for the health of your relationship. As he mentioned,
as long as the sex is mutual and not fraught
with stresses, because then it does improve intimacy, and at
the end of the day, a healthy emotional relationship is
(07:58):
good for your overall physical health as well well, because
the reality is our minds take a toll on our bodies,
so your boyfriend is actually not bssing you. However, that
would not in and of itself be good enough reason
to have sex if there were a problem and you
(08:18):
really did not want to be having it, because coerced
sex has enough of a negative emotional impact to rule
out any of these great benefits. If you truly were
miserable having sex and didn't want to, I'd really recommend
seeing a sex therapist to figure out what the issue
might be, whether it's an issue for you to work
(08:41):
on medically or emotionally, or whether it is something to
work on as a couple, because when one person wants
sex and the other rarely, if ever does, it can
harm the relationship overall. Given however, you are satisfied to
have it a little more often than might be what
(09:02):
you would initiate, this may not seem to be a
problem at all, and nice to know this is healthy
for you both in the process. Back in a moment
with some more thoughts on what's healthy about sex? Back
(09:28):
to discuss what's healthy about sex, there are I would
say at least ten healthy and perhaps surprising incentives to
remind you that sex isn't just good, it's good for you.
The first is marital health. Couples who have a satisfying
sex life report being more satisfied with their marital relationship
(09:52):
and more satisfied with their lives as a whole. Marital
happiness and stability is a healthier environ for children to
grow up in and contributes to the mental and physical
well being both of the children and of you the parents.
In fact, children from a happy, stable marriage have lower
(10:14):
rates of alcohol abuse, teen pregnancy, depression, suicide, and divorce.
And there's cardiovascular health. Yes, sex can be quite aerobic
if you work at it. In fact, active love making
burns about four calories a minute. Spend a half hour
(10:35):
in bed and you just burned off a cookie or two.
If you can raise your heart rate for a sustained
period of time, this can serve as your workout for
the day. Does this not beat going to the gym?
If this is your particular aim, then remember, as with
all exercise. The more you sweat and pant, the better
the workout lots of movement as opposed to the just laying.
(10:59):
Their approach not only helps your heart, it helps the
sex next. Sex can better your body. Not only can
you improve your heart health, but you can look more
buff in the process. Love making works key muscle groups
such as abs, buttocks, lower back, and legs. Tightening, strengthening,
(11:21):
and toning. These areas will give your figure a boost
in and out of clothes. Having anxiety about how one's
body looks is often what detracts women from sex in
the first place, so this serves the double benefit of
liking your body and then feeling more comfortable being seen
naked by your partner. Many of these muscle groups get
(11:45):
used during sex, whether you intend to or not, but
you can also make a specific effort to tighten your
abs or buttocks, which will be more effective, and increased
muscle tension will also increase sexuals Arousal. Sex can help
with bladder control. As we age, are pelvic floor muscles loosen,
(12:10):
especially if you have given birth. Weak pelvic floor muscles
lead to urinary incontness. It is really no fun to
pee every time you sneeze or laugh or cough. Sexual
intercourse actually strengthens your pelvic floor muscles if done regularly enough.
(12:30):
This is the same principle as doing kegel exercises, but
it's more fun. Kegels are repeatedly contracting the pubocoigious muscles
of the pelvic floor, which causes them to become tighter.
Contracting those same muscles is often part of sexual intercourse
(12:51):
and can of course be done purposely which your partner
will enjoy, which will tighten them and prevent or reverse
some urineary leakage. Regular sex can prevent painful sex. The
vagina is a muscle too, and the old adage of
use it or lose it holds true. If you don't
(13:15):
have sex much, the vaginal walls atrophy over time, making
them thin, stiff, and dry, which causes intercourse to be painful.
The more you exercise this muscle by having sex, the
more supple and strong it will stay. Actually, vaginal atrophy
(13:35):
is often a cause for vaginal dryness. Having more sex
more often may help you produce more of your natural lubrication,
which comes from the vaginal walls, and lubrication is absolutely
key in having comfortable sex. Sex can be a natural
pain believer. Sexual arousal and orgasm cause the body to
(14:00):
release its own natural endorphins and cordico steroids. These can
be as effective as taking a painkiller, but without side effects.
For some women, the bodies endorphins provide a sort of
natural high, like that described by women runners. Many women
(14:20):
find sex to help relieve migraine headaches as well as
menstrual cramps. So instead of saying please not tonight I
have a headache, you might want to say, I need
it tonight because I've got a headache. Sex can help
regulate your menstrual cycle. It turns out that women who
(14:40):
have regular sexual intercourse also have a more regular menstrual
cycle compared to those who are not having regular sex
and have a more erratic, sometimes short, sometimes long cycle.
The mechanism for this is not entirely clear, but it
is likely that it has to do with hormone release
(15:01):
and regulation. A more regular cycle can make getting pregnant easier.
There is some day to suggest sex might even boost
the immune system. A study of college students found that
frequent sexual activity correlated to a higher level of salivary
immunoglobulin A which helps fight off colds and other viruses. Certainly,
(15:28):
sex often leads to a happier partner. For many men,
sex is a way of showing love and being loved.
When you have more frequent sex with him, he feels
you desire him and want to be close with him.
This increases both his self esteem and the security in
your love. Many husbands report that frequent sex with their
(15:51):
wives makes them want to be kinder, more loving, and
even help out more at home. If you wish you
would pitch in more with the laundry, you might try
increasing your love making. Increased intimacy is another side benefit.
Besides a happier mate, you too will feel closer and
(16:12):
more in tune. When a woman orgasms, she releases a
hormone called oxytocin in the brain. Oxytocin is the same
hormone released when a woman nurses her baby. It is
a hormone of bonding. Oxytocin actually makes you feel closer
to and loving towards whoever happens to be there when
(16:34):
it hits your brain. This is why after good sex
you often do feel especially intimate with your partner. Do
you have a problem I can help with If so
email me at how can I Help at Senecawomen dot com.
All centers remain anonymous and listen every Friday to how
(16:56):
can I Help with Me? Doctor Gails Salt s
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