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Medication Isn’t ALWAYS the Answer: Why there’s Nothing Wrong with Your Sex Drive

Medication Isn’t ALWAYS the Answer: Why there’s Nothing Wrong with Your Sex Drive
Sometimes, you may not be in the mood for sex.

Who can blame you?

You might have such a crammed schedule with several projects and to-do lists that sex with your partner is the last thing on your mind.

However, you may feel like it's your fault or that something must be wrong with you and your sex drive to not want to engage in an intimate act with someone you love.

Your doctor may also want to prescribe anti-depressants and other medications that try to "fix" your problem.

But, what if it's not medication that you need, but rather a deeper understanding between you and your partner about desire and arousal?

Dr. Emily Nagoski joins HER Radio to share why a new approach to understanding sex drive is needed in relationships, as well as why there might be nothing wrong at all with your sex drive.
Featured Speaker:
Emily Nagoski, PhD
Nagoski Sex educator, author, researcher and activist Emily Nagoski has a PhD in Health Behavior with a doctoral concentration in human sexuality from Indiana University (IU), and a Master's degree (also from IU) in Counseling, with a clinical internship at the Kinsey Institute Sexual Health Clinic. She also has a BA in Psychology, with minors in cognitive science and philosophy, from the University of Delaware.

While at IU, Emily worked as an educator and docent at the Kinsey Institute for Research in Sex Gender and Reproduction. She also taught graduate and undergraduate classes in human sexuality, relationships and communication, stress management, and sex education.

RadioMD Presents:HER Radio | Original Air Date: April 9, 2015
Host: Michelle King Robson and Pam Peeke, MD

Dr. Pam Peeke, New York Times best-selling author and founder of the Peeke Performance Center, and Michelle King Robson, leading women's advocate, entrepreneur and founder of host the show everyone's talking about. It's time for HER Radio.

PAM: Well, Michelle.


PAM: Medicine isn't always the answer to a funky sex life. You know, popping that little pill and, you know, kind of going to that place.

MICHELLE: We don't even have that little pill to pop.

PAM: Oh, we have to make someone else do it. The whole thing is so complex. It is!

Dr. Emily Nagoski is with us to help us understand why medicine isn't always the answer. Why there's nothing wrong with your sex drive. Her book is, Come As You Are. Hmm. There's an ol' play on words.


PAM: Come As You Are: The Surprising New Science That Will Transform Your Sex Life. Dr. Nagoski is a sex educator, author, researcher and activist. She has a PhD in Health Behavior and is going to help us understand.
What is this all about, Dr. Nagoski?

MICHELLE: Let's go!

PAM: For HER Radio. Alright. Let's do this! So, why don't you need that pill? What's going on with this whole issue of there's nothing wrong with your sex drive?

DR NAGOSKI: So basically, the idea of sex drive in and of itself is essentially flawed. The story we get told about sexual desire is how it's supposed to work. It just appears spontaneously out of the blue where you want sex all of a sudden. So, by the time you get home, you're already interested and ready to go. That is absolutely one of the ways that a lot of people experience desire. It's spontaneous, at least some of the time and there is another way of experiencing desire. The researcher calls it "responsive desire" where it doesn't necessarily appear out of the blue, but if you're in the middle of like flipping channels or reading a magazine and you partner comes over and starts touching your arm or kissing your neck, you weren't thinking about it before, but in this nice context, your brain and body go, "Oh. Right. Sex. That's a really good idea. We should do that." So, responsive desire emerges in response to arousal whereas spontaneous desire emerges in anticipation of arousal and both are equally normal.

MICHELLE: Okay. So, they're both normal and, you know, I know you wrote this article in The New York Times. Both Pam and I found it fascinating and that's why we wanted you to come on the show, but talk to us a little bit about why is there nothing wrong with a woman's sex drive, in your opinion?

DR NAGOSKI: Yes. Responsive desire is probably a little more common in women than in men. I think we've been taught the spontaneous model of sex drive because it is more typical of the way men experience sexual desire. So, we're imposing this like male standard onto women's bodies and surprise! Women are not identical to men. They're different in some ways.

MICHELLE: Every way.

DR NAGOSKI: And have a greater sensitivity to context.

MICHELLE: Every way.

DR NAGOSKI: Both men and women experience desire.

MICHELLE: That's nothing about us that's like men. Let's be clear.

PAM: Oh, my god.

DR NAGOSKI: So, many times...

PAM: Put the timer on and two minutes later. Oh my god. And then, they get right back to their racquetball game. It's just...

PAM: So, we're trying to understand women's sex drive. I think a lot of women just guilt trip themselves, don't they? I mean, you know, "What's wrong with me? If I'm not feeling responsive?" Or, "What's wrong with me because my partner isn't interested?" Or, what is this whole thing with the women's sex drive?

DR NAGOSKI: Yes. We have. A lot of women that I've talked to have spent a long time beating themselves up for not experiencing spontaneous desire and there's this horrible, ironic process that happens where if you're not experiencing spontaneous desire, you do all these things to try to increase your spontaneous desire. You try lingerie and erotica and role play and none of it works. The less it works, the more you beat yourself up and the more you beat yourself up, the less likely you are to experience desire.

MICHELLE: Boy, is that true.

DR NAGOSKI: So, let go of the idea that your desire is supposed to be spontaneous and out of the blue. You let go of that and you recognize that responsive desire is just as normal and healthy and you allow it to be true. You, me and the plaid boxers, Saturday night. We're going to get together and I might not be hot to trot when we get started, but when my skin touches your skin...
AM: The what? The plaid...

MICHELLE: The plaid boxers?

DR NAGOSKI: The plaid boxers.

MICHELLE: I love it.

DR NAGOSKI: You know, it's different for every couple.

PAM: Oh. Who wears boxers in this couple?

MICHELLE: You're wearing them on your head.

DR NAGOSKI: Whatever works, right?

MICHELLE: Whatever works is right.

PAM: Dr. Nagoski, you got that one right down right there. So, I mean...Alright. So, what are the options to be able to help a woman walk through this? We've identified the problem. You said it so beautifully. So, what are the first steps you can take to kind of get yourself out of this funky mindset?

DR NAGOSKI: The first step is to think about...Well, first of all, just knowing that having responsive desire is normal all by itself is a really great start. It's tremendously liberating to know that you are not broken and there is nothing wrong with you just because your desire isn't spontaneous. So then, you start thinking about what aspects of context will create desire? When does desire emerge for you? I use the dual control model of sexual response developed in the Kinsey Institute about 15 years ago which says that there's a sexual accelerator and a sexual brake. Think about what is it in your context and your relationship? What kind of touch do you enjoy that activates your accelerator, turns you on and what are the things that are hitting the brakes and keeping the "off"—the shut down? So, this will often be things like stress or worry about being interrupted or body self-criticism or most challenging of all, when you feel critical of your own sexual functioning, that hits the brakes. So, gather yourself a list of those two things.

MICHELLE: That's a great way to put it. The accelerator and then taking your foot off the pedal, right? Because you have both of those.

PAM: Well, I've got a stick shift.

MICHELLE: You're so bad. You are so bad. Emily, I had a complete hysterectomy and I tanked. One of the things that happened was, you know, with my ovaries removed, of course, there was no production of estradiol and/or testosterone. One of the things that really helped me was, because my libido was shot, I had none, along with all the other symptoms I had. That really helped my sex drive come back and I think that's important for women to know as well because I suffered from that for one year. Trying to figure out what to do and that was so helpful for me.

So, what do you think about women who have hysterectomies, for example?

DR NAGOSKI: The research around women's' sexual desire and response post-hysterectomy is really varied and it's like with hormonal contraception, some women respond with an increase, some with a decrease, some with a flat line and we don't know yet, which women are going to respond in which way. The best advice is to try. If you notice a change, talk to your doctor and try a different hormonal replacement and see if it's effective because we just don't know for which women that's effective and for which it's not.

MICHELLE: That's a great answer because I think it's not a "one-size fits all", right?

DR NAGOSKI: Absolutely.

MICHELLE: I couldn't agree with you more. Thank you so much. That clarifies for women, a lot.

PAM: I just really think that that's a beautiful way to put it because we really need to be able to honor every single woman's uniqueness and I think a lot of the same blame and guilt comes from the fact that one woman compares herself to someone else.

MICHELLE: Exactly.

PAM: And, it just doesn't work that way. Dr. Nagoski, you have just been fabulous in helping us understand this whole issue of women's sex drive and that medication isn't always the answer.

Everyone out there, we've been talking to Dr. Emily Nagoski. She is a sex educator, health educator and has written a wonderful book. Go on out there and grab this one. Come As You Are: The Surprising New Science That Will Transform Your Sex Life.

Thank you so much for being on HER Radio. We so appreciate your insights and wisdom. I'm Dr. Pam Peeke with Michelle King Robson.

MICHELLE: Don't forget to get Emily—Dr. Nagoski's—book.

You're listening to HER Radio on RadioMD. Follow us on Twitter, like us on Facebook. Stay well.