"We never have sex anymore" - what's going on?

Many couples who have been together for a long time have difficulties in maintaining a healthy sex life. The reasons are many and varied, of course, and can include:-

* changes in body image and sexual confidence due to pregnancy and childbirth

* lack of energy due to the demands of work and parenting

* the challenges of keeping sexual intimacy fresh and exciting with the same person over time

* dissatisfaction in other areas of the relationship that mean one (or both) no longer feel like being intimate, sexually or otherwise.

It's always worth looking at the 'big picture' when sexual problems emerge in a relationship - that is, how satisfied are each of you with the relationship as a whole. Can you answer 'yes' to the following?

* Do you feel that you can trust your partner to always be there for you, and to give you practical as well as emotional support when you need it?

* Do you and your partner respect each other as people? Do you share the same values and sense of what future you want to buid together?

* Are you able to work through differences in a way that each of you feel that your needs matter and are thought about by the other person?

* Do you work as a team - as parents, as householders etc.?

* Do you make time just for the two of you as a couple, to have quality connecting time?

* Do you have fun, are you playful together?

If you are fully satisfied that your relationship is OK in these areas, only then is it helpful to think about "what's not working with our sex life?" It may be useful to regard working on improving these things as 'foreplay' - when both partners feel loved, respected and supported by the other, you're already building intimacy, and it's only a small step from there to physical intimacy.

If you're both feeling that everything else is as you need it to be in your relationship - it's only the sexual desire that seems to elude you, more focussed questions can be asked about what each of you need sexually. The following questions may provide a place to start.

* Are you able to ask your partner to change what she or he is doing to better meet your needs (and remember our sexual needs can and do change over time as our bodies change and age)?

* Are there differences in libido that need to be discussed in order to come up with ways of being intimate that meets both of your needs? (For example, being physically close in non-sexual ways sometimes).

* Are there medical reasons that one partner is unable to enjoy sex? (this would need to be addressed with your GP).

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