Getting Pregnant

I once had a friend tell me that baby-making sex was the best sex she'd ever had. I've heard many women say that baby-making sex is the first time in their sex life where they feel like that can take control and really enjoy it.

We took a little while to get pregnant with our first baby so sex became a bit of a roller coaster for us. I finally decided to educate myself a bit more and read Taking Charge of Your Fertility
and I highly recommend it.

Here are some of the things I learned:

1. Most (not all) women ovulate 14 days before their period. It's not after ending your period. Ovulation may vary month to month for the same woman.
2. There are usually many variations in basal body temperature (BBT) throughout the month. A spike of about .4-.6 degrees usually signifies ovulation. Once your temperature has risen it means you have ovulated; it doesn’t mean that you’re about to ovulate. BBT varies between people. Take your temperature at the same time every day. Do it after having 5 hours of sleep so it’s a resting BBT. BBT is affected by stress, sickness etc.
3. Your cervix changes position throughout your cycle. It can be low, raised, open, soft, hard etc. Generally a high, open, soft cervix is indicative that ovulation is about to occur.
4. Your cervical mucus changes throughout your cycle. It can be sticky, thick, wet, flaky, dry, yellow, clear, opaque, nonexistent etc. Generally, mucus about the consistency of egg whites (thin, stretchy, clear) is indicative of ovulation. A woman’s fertile phase only lasts as long as she has fertile cervical mucus.
5. Tracking BBT, cervical position and cervical mucus together can be the most helpful in determining ovulation.
6. Sperm can survive in fertile (egg white consistency) cervical mucus for up to 5 days. This is longer than it will survive at any other time in your cycle.
7. A woman’s egg can only live up to 24 hours.
8. It’s okay to go to your doctor even if you have been trying to get pregnant for less than a year if you’ve been monitoring your body well (BBT, cervical mucus and cervical position) and have some knowledge of what’s going on. It will help the doctors have a better picture of what's going on. If you haven't been monitoring these, it's suggested that you wait until a year before seeking fertility help from a doctor.
   
9. Conception actually occurs in the outer third of the fallopian tubes, not in the uterus. The sperm meets the egg in the fallopian tubes and they start to multiply into many cells and then go and implant on the uterine wall.
10. Both men and women can have problems that cause infertility. About 1/3 of fertility problems are caused by women and another 1/3 by men and the other 1/3 are a combined reaction or unknown. Still, fertility should be thought of as a couple issue. Do not blame one of the partners!

That's a lot to keep track of, but I believe that anticipation can help both you and your partner. Sometimes, planned sex can be nice. Maybe, lay out your lingerie on the bed for your hubby to see so he'll know what he has a lot to look forward to at the end of the day.

Sex has the potential to become a bit stressful if you're taking a while to get pregnant, but remember that whether you make a baby that time or not to still enjoy the experience with your partner!

Hypoactive Sexual Desire Disorder

There have been reports of women stating a low sexual desire from at least 1972.

Here are some stats from recent studies:

Berman et al (2003)
• Sample:4,000 women with sexual dysfunction
• 40% reported not seeking help
• 54% of those would have liked to seek help

National Health & Social Life Survey (1999)
• 43% of American women suffer from sexual dysfunction
• 1/3 say they lack sexual interest
• About ¼ to not experience orgasm
• About 20% report lubrication difficulties
• About 20% find sex not pleasurable

It is also known that women are unlikely to discuss sexual dysfunction or dissatisfaction with their physician.

In 1977, low sexual desire was labeled as a specific disorder. However, only 10% of women ages 18-45 meet the criteria for a desire disorder diagnosis. That means that you are probably one of the many that has only a few hurdles to increasing your libido! And even if you do have HSDD, there are still many forms of treatment.

As a clinician, this is the diagnosis criteria that I would use.

Hypoactive Sexual Desire Disorder (HSDD)

A. Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person's life.

B. The disturbance causes marked distress or interpersonal difficulty.

C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Specify type:
Lifelong Type
Acquired Type
Specify type:
Generalized Type
Situational Type
Specify:
Due to Psychological Factors
Due to Combined Factors

Assessment

Here is a rough outline of what I’d do and ask about:
1. Clarify the problem (e.g. details, history, past attempts at treatment)
2. Determine onset (gradual, acute, lifelong)
3. Determine context for the complaints (generalized or situational)
4. List all sexual symptoms
5. Go over typical sexual response cycle
6. Consider partner reaction to the sexual dysfunction (level of conflict, stress)
7. Assess couple motivation for treatment
8. Medical, psychiatric and surgical history

Each of these would impact how to treat the sexual dysfunction. I like to match the type of treatment with the cause. For example, if you’re taking Paxil or Zoloft I’d explain that about 70% of the patients on those medications have sexual side effects. I’d suggest you look into alternative medications. If you think it’s psychosocial, I’d suggest counseling, talking to partner etc. I almost always suggest Sensate Focus for clients presenting with sexual concerns.

Here are some possible treatments:

Physical

• Adjust or change medications that have sexual side effects. Look up the side effects of current medications.
• Treat thyroid problems or other hormonal conditions. You can usually have your doctor order blood work to test this.
• Optimize treatment for depression or anxiety. Make sure you’re following through on your doctors recommendations. Also, I recommend reading Feeling Good and When Panic Attacks.
• Try strategies recommended by your doctor to help with pelvic pain or other pain problems
• Estrogen, Progesterone or Androgen Therapy
• Tibolone, Provestra, Hersolution or Vigorelle (Not FDA approved). *In a small study, women taking the drug experienced an increase in vaginal lubrication, arousal and sexual desire.
• Strengthen pelvic muscles by doing Kegal Exercises
• Have a healthy lifestyle by eating well, exercising, getting enough rest etc.
• Estrogen vaginal cream
• Switch medications to something less likely to affect hormones (e.g. lots of birth controls impact libido depending on amounts of hormones)

Psychological

• Seek Counseling. Look for somebody that says they have experience working with sexual issues. Even better, look for somebody who has treated sexual issues relationally (with couples as well as individuals). The best sex therapy occurs when both partners are involved. *Cognitive Behavioral Therapy has resulted in 75% of women significantly improving with 65% remaining improved at 1-year follow-up. (Basson et al., 2005)
• Talk to your partner. Let them know how you’re feeling and have intimate, connecting conversations.
• Sensate focus, which is similar to systematic desensitization, often found in therapies that treat anxiety, is shown to have about a 50% success rate following treatment. (Basson et al., 2005) This means that it is still effective even after finishing therapy and sensate focus exercises; it has lasting effects.

Happy Valentine's Day! And a WINNER!

Happy Valentine's Day, Loves! Did you know this is my favorite holiday? Oh really?... How'd you know? I'm so glad we could do a little Valentine's Day Giveaway today and am so pleased to announce the winner. Including the anonymous email entries I received, there were a whopping 132 entries! We may just have to do this again sometime :)

The winner was an anonymous email entry and has asked that I keep her name private. I have contacted her via email so check your inboxes :)

In case you missed it, here's what she's won:

A pretty in pink Siri by Lelo. Babeland.com offers the Siri in pink and purple. Lelo designs high-end toys in discrete packaging. The unoffensive design puts to rest any discomfort or hesitation that a first time toy user may feel. Many of the reviewers on Babeland.com's site have named the Siri as their favorite accessory. It's rechargeable, sleek, quiet, and cute.

Here's what they say about the Siri on Babelands website:

Shake hands with Siri, and you may never need to meet another clit vibe again. A beveled shape for targeted clit vibration, six pulsation and speed options (controlled by an intelligent microprocessor, no less!), intuitive controls, and Lelo's quality construction and materials make for a perfect storm of pleasure. And as with all Lelo vibrators, Siri is rechargeable and nearly silent, so you can enjoy it anytime, anywhere. Cup it easily in the palm of your hand, and the rest will come as easy as Sunday morning. Comes with a one-year warranty against breakage or defects.

I hope you all have a fabulous Valentine's Day! Thank you again for participating in the giveaway and for all of your kind words.

xoxo,

Gwen

Sensate Focus Follow Up

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I'm curious to hear how The Sensate Focus Challenge went.

What went well? What didn't?

Did you and your partner learn anything new?

Were there difficulties? Why do you think?

Did you like it? Did it benefit your relationship?

Any tips or advice you'd give others doing this challenge?

As always, feel free to ask questions or make suggestions for future posts.

Valentine's Day Giveaway!

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Military Marriages

Dear Gwen,

First let me say I ADORE your blog. My question is what is your advice for us military wives? My husband is often gone and it is very hard on the relationship. Even when he comes home it takes a lot of time to slowly get back into the swing of things and get used to eachother again. Any ideas or tips on keeping the romance going for us gals' who's hubby is gone often?

-A Military Wife

{photo credit}

First of all, thank you so much for your kind words. And more importantly, thank you for your family's sacrifice. Military families are my heroes.

I'm not sure what protocol is for the military communication, but here is one solution I thought of for you. I assume you are able to send letters to one another.

Try writing an erotic letter to your husband. Don't hold back. Tell him what turns you on and describe your fantasies in detail. It doesn't have to be wild or crazy, but it certainly can if you'd like. The letter can be as simple as describing a past sexual encounter with him. Encourage him to have an orgasm. Though you are miles or seas apart, you will be connected. Tell him to write you back quickly because you are anxious to enjoy the same experience.

Your focus will remain on each other and you will feel as though you still know each other sexually.

Let me know if you try this, how it works out for you. Was his response positive?