Sexual frequency is declining in the United States, according to a study by Indiana University researchers.
“Our study adds to a growing body of research that has reported on declines in sex,” said Tsung-chieh “Jane” Fu, a research associate at the IU School of Public Health-Bloomington who co-led the study. “The declines in partnered sexual activity seen in our study are consistent with findings from studies in the U.K., Australia, Germany and Japan.”
Debby Herbenick, a professor of sexual and reproductive health at the School of Public Health who also co-led the study, said the decreases are likely caused by several factors.
“The decreases are not easily explained by a single shift, such as health status, technology, access to pornography or stress,” Herbenick said. “There are likely multiple reasons for these changes in sexual expression, and we need more research to understand how these changes may be related to changes in relationships, happiness and overall well-being.”
The study of sexual frequency is particularly important in light of the COVID-19 pandemic’s impacts on relationships, Herbenick said. Declining sexual activity among adults has consequences for human fertility and health — consequences that have been exacerbated by pandemic-era restrictions.
Published in the Archives of Sexual Behavior, the study is the first to include such a comprehensive assessment of diverse sexual behaviors. The information came from U.S. participants ages 14 to 49 during the 2009 and 2018 waves of the National Survey of Sexual Health and Behavior, a confidential nationally representative survey conducted online. A total of 1,647 adolescents ages 14 to 17 and 7,055 adults ages 18 to 49 were included.
“The National Survey of Sexual Health and Behavior includes detailed data on a variety of sexual behaviors, so we could examine more precisely whether declines in vaginal intercourse might be explained by increases in other sexual behaviors, such as oral sex,” Herbenick said. “However, we found that was not the case. Rather, we found that from 2009 to 2018, fewer adults engaged in a range of partnered sexual activities. We were also surprised to find that, among adolescents, both partnered sex and solo masturbation had declined.”
Compared to adult participants in the 2009 survey, adults in the 2018 group were significantly more likely to report no penile-vaginal intercourse in the prior year, the researchers found. Study participants were also significantly less likely to report engaging in any other sexual behaviors examined in the study, such as oral sex or anal sex. All modes of past-year partnered sex were reported by fewer people in the 2018 cohort.
“More studies are needed to understand if this decline is associated with the emergence of other types of sexual activities in recent years, such as the adverse impact of what some people call aggressive or rough sex,” Fu said.
The study’s findings regarding sexual frequency declines among adolescents are particularly notable, according to Herbenick. The proportion of adolescents reporting neither solo masturbation nor partnered sexual behavior increased from 28% of young men and 49% of young women in 2009 to 43% of young men and 74% of young women in 2018.
“Many studies haven’t included those under age 16 or 18, so our study expands what we know about younger adolescent behavior and how we think about adolescent sexual development,” Herbenick said.
The researchers noted that a number of cultural and social changes may be affecting young people’s sexual behavior, including widespread internet access, decreased alcohol use, increased conversations around sexual consent, and more contemporary young people identifying with non-heterosexual identities, including asexual identities.
While the current findings will help inform the work of sexual health researchers, clinicians and educators, Herbenick said she hopes the study also will open up new investigations into areas such as people’s feelings about their sexual lives and how those feelings may shape subsequent choices about sex.
Schizophrenia, a neuro-mental condition that affects less than one percent of all people, is well-known, yet poorly understood. Contrary to typical pop culture portrayals, it does not create a split personality, or make people violent and dangerous. When it starts to manifest, typically in adolescence or early adulthood, the condition’s effects can be so subtle that both medical experts and the people experiencing them often miss them, or misread them as signs of anxiety or depression.
As it develops, schizophrenia usually causes constant or intermittent hallucinations, disorganized speech and thought, and distorted perceptions of the world, including other people’s actions and motives. People with schizophrenia may struggle to differentiate delusions from reality. Many also find it hard to feel pleasure, express or manage their emotions, or connect with others.
The exact nature and intensity of schizophrenia symptoms and the frequency at which people experience them vary considerably from case to case. So does the extent to which the right combination of medication, therapy, and everyday support for a person’s specific needs can mitigate them. But across cases, schizophrenia usually has a major impact on people’s everyday lives—including their sex lives.
People with schizophrenia are as interested in sex and relationships as anyone. But they often have trouble finding intimacy, sometimes because their symptoms make it hard to manage dating or hookups, and sometimes because of the social stigmas surrounding the condition. Those who do find partners often report that their symptoms can make it hard to think about sex or feel sexy, to concentrate during sex, or to communicate their sexual needs and wants. Some of the medications used to manage symptoms can also lead to issues with libido, sexual sensation, and orgasm.
Conversely, some people with schizophrenia experience episodes of hypersexuality, which may lead them to take risks they otherwise wouldn’t. This, alongside the general vulnerabilities associated with symptomatic schizophrenia, may help to explain why people with the condition seem to experiencemore STIs and unwanted pregnancies, among other issues.
Unfortunately, it can be difficult for folks living with schizophrenia to find support in figuring out how to navigate sex and intimacy. Researchers didn’t pay much attention to the topic until fairly recently, and many clinicians don’t think to bring it up with patients. A few academics and care providers are trying to change this with calls to action in professional groups and academic journals. And in recent years, advocates have sparked public dialogue by speaking openly about sex and schizophrenia on podcasts, social media, and other public forums.
Still, it’s hard to find stories of schizophrenia’s effects on people’s intimate lives. VICE recently spoke to Lauren Kennedy, who runs the popular Living Well with Schizophrenia YouTube channel, and her longtime partner, Rob Lim, about the role schizophrenia plays in their sex lives and how they manage its effects.
This interview has been edited for length and clarity.
Lauren: My schizophrenia started when I was in high school, with mood disturbances. I thought I had depression. That morphed into highs and lows, and mania. (I have schizoaffective disorder, which is like a combination of schizophrenia and bipolar disorder.)
When I was 24, I started to smell terrible things and hear things—like my name, or just chatter—that weren’t coming from anywhere. I had delusional thoughts, like believing my medical care team was trying to harm me.
I was in a long-term relationship when my psychosis symptoms developed. They completely changed the dynamic of that relationship. I was consumed with my symptoms and didn’t have the headspace to pursue intimacy anymore. The relationship ended just before I got diagnosed at 25.
After my diagnosis, my mind didn’t turn to sex very quickly, but I worried right away about intimacy more generally. I worried people wouldn’t accept me because of the stigmas around schizophrenia, and that I wouldn’t be able to be a good partner. On the medications I was on then, I felt like I wasn’t able to fully function, or to be as present and active a partner as I wanted.
Rob and I got together when I was 26. I’d been dating beforehand, but I hadn’t ever told anyone about my schizoaffective disorder, because that didn’t feel safe. I think I decided to tell Rob about my condition on our third date, because I did feel safe. He took it really well.
Rob: I have a degree in psychology, so I’d studied schizophrenia a little. But that was 15 years before we met, so I didn’t know a ton. I hadn’t noticed anything that I’d connected to schizophrenia before Lauren told me she had it.
Lauren: I still don’t think you really knew what schizophrenia was, or how it could affect me—or us—in practice until much later in our relationship.
Rob: No, I probably didn’t fully realize what it meant for you or us until you ended up in the hospital much later on.
Lauren: Do you think I misrepresented it to you when I first told you about it?
Rob: Umm… Not in the worst way?
Lauren: [Laughs]
Rob: There’s a lot to unpack, though, beyond just saying, “I have schizophrenia.” Like, What has your experience with it been like? Disclosing something like that is the start of a conversation.
Lauren: When did you first notice my schizophrenia in our intimate life? [Laughs] I’ve never asked, so I’m curious to know about this!
Rob: There were times when you seemed more tired—like it wasn’t a great time for sex. But the beginning of our relationship felt pretty typical to me, in terms of being in a honeymoon period where we had sex with each other a lot. I didn’t feel like schizophrenia affected that at all.
Lauren: But at that point, we weren’t living together. Our dates were on days when things were going well for me. If I was experiencing a lot of symptoms, I’d stay home in bed. It’s hard to initiate any intimacy when I’m having hallucinations or feeling restless or emotionally flat. And sometimes I’m just too manic to have sex.
Rob: Yeah, I definitely saw more of that as we got closer.
Lauren: I also feel like I was super flat when we started dating. Did you pick up on that?
Rob: When we’ve talked about what we want in sex, you’ve said you’re looking for feelings of ecstasy and connection. And I appreciate that, but sex is a more physical thing for me.
Lauren: So, maybe because sex is more about creating emotional connection for me than it is for you, I notice when I’m having trouble with my affect and connection more than you do?
Rob: Yeah, I think so. To be honest, I don’t really pick up on when Lauren’s having trouble processing or expressing emotion.
Lauren: I don’t think we’ve ever had a discussion like, “Hey, I’m symptomatic now, I don’t want to have sex.” Rob’s always just been good at picking up on when sex might not be on the table for me on any given day or night.
I’m not always symptomatic, so we still have plenty of chances to be intimate with each other. And sometimes when I am symptomatic, sex actually helps ground me. It’s a pretty intense act that occupies my headspace enough that I’m not having hallucinations or anything else when it’s happening. It also reaffirms my connection to the closest person to me in the world. I try to judge if sex will be grounding based on if it feels good and right when we’re cuddling or starting to kiss. If so, then, Yeah, let’s keep going.
Rob: As I learned more about schizophrenia, I did have some doubts about whether we’d be able to have a successful relationship in the long term.
Lauren: In 2019, I went off my medication and tried to hide the fact that I was becoming more symptomatic. I was hospitalized that October. I think Rob felt like I betrayed his trust by hiding that, and that definitely affected our intimacy.
Rob: After that, we started going to couples therapy regularly. We both have our own therapists, as well. We’ve realized that we can navigate a lot together, but there will always be friction—and especially after something like that, we need support in working through things.
Lauren: We made the conscious decision to work on communication, and on getting stability back in our lives. It’s actually dawning on me that maybe the fact that we never discussed and tried to work on schizophrenia specifically in our early relationship was an issue in and of itself. We may not have given as much thought to my condition in our intimate life as we should have.
Rob: We didn’t realize the importance of communication at the beginning of our sex life. It’s something we’re working on. Recently, we’ve had some conversations with our therapists about how we think about consent in relation to schizophrenia. Because we don’t have sex when Lauren’s really symptomatic, but…
Lauren: There are grey areas.
Rob: This actually came up a while back: We were having sex, and I stopped and said, “I don’t know if we should be having sex right now.” Lauren was like, “Oh, no, I totally can,” and I took her at her word. But after, she was like, “I probably couldn’t have given consent then.”
Lauren: Yeah, I wasn’t sure I was totally present, or that I knew what was going on. I mean, I did know, but… It’s really hard to explain what this is like…
Rob: So… what does that mean for our sex life? I don’t feel good about that, you know?
Lauren: But I feel like that’s my fault! [Laughs] If I want to have sex in a given moment, I’m probably not going to tell Rob all the details of where my head is. But that lessens his ability to make an informed decision.
Rob: We haven’t reached a conclusion about this yet. We need to talk about it more. [Laughs]
Lauren: It’s tricky, because those grey areas are just slightly more extreme versions of what I go through all the time. But I think that usually I can consent to sex even when I’m more symptomatic—especially because I always know that Rob is someone I love and trust and want to be intimate with, even when I’m constructing alternate narratives about the rest of reality.
There’ve also been periods in our relationship where we haven’t has as much sex. Like, if I’m on different medications for any reason, my sex drive might just plummet. We also have three kids now, and one of them is seven months old. So that’s changed our sex life, too. [Laughs]
Rob: I’m impressed we’ve been able to maintain our sex life as well as we have, given that we have kids. But there’s still room for us to develop how we navigate sex, for sure.
Lauren: We’re always working on our communication. That’s an ongoing process.
The average vagina is about 9.6 centimeters (3.8 inches) deep but can stretch to twice that amount.
Childbirth and menopause can change the depth of a vagina, which may change how sex feels.
If your vagina feels loose, try Kegel exercises or other exercises to strengthen your pelvic floor.
The average vagina measures seven to ten centimeters (about two to four inches). However, the vaginal canal is impressively flexible and how deep a vagina is at any given time often depends on the person as well as circumstances like sexual arousal, pregnancy, childbirth, and menopause.
How deep is a vagina?
According to a small 2005 study, the average depth of a vagina is 9.6 centimeters (or 3.78 inches). However, it has the ability to stretch when sexually aroused to accommodate a penis.
Additionally, a 2010 study involving more than 500 heterosexual women found that the length of the vagina did not seem to affect how sexually active they were.
How does the vagina change over time?
Age and lifestyle has a big impact on how the vagina changes over time. In particular, giving birth and going through menopause are perhaps the two primary events in a person’s life that will significantly change their vagina.
Childbirth
Childbirth can affect vaginal depth because the pelvic floor muscles, which support the pelvic organs such as the uterus, bladder, and bowels, get stretched out to support the weight of the baby.
In fact, a 2009 study found that the pelvic floor muscles stretch more than three times their normal size during labor.
The vagina can remain lax after childbirth for up to a year, depending on the size of the baby or the number of babies that were born, says Whelihan.
“The main reason for [feeling loose] could be pelvic floor relaxation and tears as a result of pregnancies, and especially vaginal deliveries,” says Harmanli.
During menopause, estrogen levels drop, which makes the vaginal canal shorter and narrower, says Harmanli.
Postmenopausal individuals may feel like there is less room inside the vagina for intercourse if they don’t have penetrative sex for a long time, he adds. However, having regular vaginal sexual activity even after menopause helps maintain the vagina’s length and width and reduces dryness.
What if a vagina feels loose during sex?
When it comes to penetrative sex, there is a pervasive myth that having more sex will make the vagina feel “loose” and lead to less pleasurable sex. However, this is not true and is most likely used to shame people for their sexual activity.
A vagina that is perceived as loose might point to a lack of arousal or be reflective of their partner’s small penis or inability to maintain a firm erection, says Whelihan.
Therefore, if the quality of your sexual experience has diminished, it’s important to communicate with your partner(s) about each other’s wants, needs, and openness to try new things.
Insider’s takeaway
The vaginal canal is usually about seven to ten centimeters deep. But it can stretch and become deeper during sex or childbirth.
The vagina may also get shorter during menopause, but having regular sexual activity helps maintain its length.
Finally, there’s no evidence that having a lot of sex will make the vagina loose. But a vagina may feel loose after childbirth in which case pelvic floor exercises may help restore vaginal lubrication and improve sexual satisfaction.
John in New Jersey talks about hooking up in college, getting a happy-ending massage, and the difference between finding someone hot and being turned on by them.
One of the first times I watched porn, I was over at a buddy’s house, this was probably in fifth grade. His older brother was two years older than us, and he showed a big group of us porn. I remember thinking, “Oh, this is kind of funny.” That was my first reaction to porn. I started watching it myself a few years later, but that was definitely an interesting experience for sure, standing around a computer with a number of other guys. I thought it was funny, but I was definitely, definitely intrigued as well. Soon after that I was at my middle school orientation; it was the first day of middle school and the kids from all the feeder elementary schools were in an assembly and I remember seeing this girl and for the first time I wanted to do something more than just hold her hand or kiss her.
I lost my virginity in college. I was 21 and it was a drunken one night stand. I was living with two other guys and it was one of the first weeks of school. We were living in a co-ed dorm and lived right next to these girls, and I remember one of my friends earlier in the night was talking about how he really wanted to sleep with the girl who lived next door to me. I thought she was cute, but I didn’t think anything of it. I headed back to my room to get something and their door was open and they were drinking and then we started talking and the next thing you know I’m losing my virginity. My friends were very proud of me. They all knew my situation.
Before I lost my virginity, I paid to get a happy ending massage. It was freshman year of college, spring break, and I was waiting for my fantasy baseball draft and I was really bored and horny and so I looked up “happy ending massages” or something like that and the websites made it very clear you weren’t going to have sex with the women. So I found a place at the mall about 10 minutes from my parents house and I went to this hotel next to the mall and I went up to the second floor and a woman who was in her 30s or 40s was there; again, I was 18 at this point. She told me to leave my “donation” on the table so I paid my $100 or $120, which would pay for an hour of her time. She and I both got naked and I got on the bed face down and then she just kind of started rubbing her body over me. After a couple minutes she had me turn over and she started rubbing herself on me again and I shot a load in like two seconds. Again, keep in mind I’m a virgin. She looked at me very seriously and said, “Oh, baby, you busted already?” and I said, “Is that a problem?” and she was like, “You’re only allowed to bust one time.” Keep in mind I’d paid for an hour of time and this was about seven minutes in. By the time I was getting up to leave, she was already on the phone with her next client.
Years later I did a nuru massage in Montreal for a friend’s bachelor party. Three other guys and I went. Basically a naked woman rubs herself all over you for an hour and then it ends with a happy ending. It’s more…professional… though. Like it’s very out in the open. You come in and they let you pick which girl you want to massage you; I chose the girl I did because she looked like Jamie Lynn Sigler. I was in a long-term relationship at that point and so were two of the other guys, but we rationalized it because it wasn’t harmful. None of our girlfriends ever found out. It’s not like we were gonna sleep with these women; it was just a massage.
I recently got out of a three year relationship, the longest relationship I’ve had, and I would consider her to be the best sex of my life. We weren’t crazy or anything. We weren’t like having sex in an elevator or a coat closet or anything, we weren’t really experimenting. I mean I think it was just the bedroom or maybe the shower. There were a couple times when we would travel and be in a hotel or something and we’d be extra frisky because it was a new place. But it was mostly that we cared about each other. I’ve had un-meaningful sex before and I’ve had a decent amount of meaningful sex and I think for me, it’s just always better when there’s a deeper connection. And we had sex frequently; we didn’t live together but pretty much every time we saw each other we had sex.
I’m pretty vanilla when it comes to sex. Trying kinky stuff isn’t really something of interest to me. I consider myself a really sexually-charged person. And if you were to ask my friends, they would probably put me near the top of the list in terms of desire or sexual appetite in general, but I’m not really interested in experimenting. I’ve never really been into sexting or phone sex either. Recently I went on a couple dates with a woman with tattoos and nipple piercings and that was really cool for me to date someone who was not my normal “type.” But she just started unprompted sending me nudes and I was like, “Where did this come from?” It was nice I guess, but getting nudes has never been something that I’ve actively sought out before. Just because I think from a guy’s perspective, it kind of makes you come off as like, creepy or desperate, and it really doesn’t turn me on much. We had a little back and forth about it, but it wasn’t like it was something I was jerking off to. Down the road, if I were to have a partner who wanted to try something more kinky, I might. Never say never. It’s gotta be the right person though. I guess I’ve always wanted to try a threesome with two women, but I don’t know that that’s in the cards for me based on the type of women I date.
My body has kind of got to be into a person, even if I find them hot. About five years ago, before my long-term relationship, there was a woman I was working with who I was really into. We worked in a place where everyone was in their 20s and we all hung out after work and went out drinking and one night I let her know I was interested and we ended up making out and then we had this kind of summer fling. She was just really a mean person, like my friends all hated her. And we were hooking up and spending the night and she was really attractive, but for whatever reason, whenever we tried to have sex, I couldn’t get hard. I think it was my body’s way of saying, “Don’t stick your dick in her!” I also had that happen once in college with a girl I was hooking up with my senior year. We hooked up for a bit and I was super into her—she was exactly my type at that time. And then she broke it off and she started sleeping around for a while and then when we tried to get back together, I couldn’t get hard. It was like, “Something’s not right here.” Even now, it’s not like I’m trying to wait until I’m married or anything, or that I even have to be in a relationship with someone. It’s just that ideally I’d have an emotional connection with somebody beforehand. It just makes it better, you know?
In recent years, my partner and I have grown to have mismatched sex drives. Now, I have a higher libido than my partner, and while I want to be supportive and certainly don’t want them to feel pressured to have sex, I do wonder if there’s anything I can do to help rejuvenate their interest. Regardless of their libido, though, how can I make sure that I’m still satisfied within my confines of my relationship?
Answer
Mainstream society has grown to idealize fiery relationships denoted by passionate partners who can’t keep their hands off each other. The truth is, though, that libido fluctuates every day, and the chances that one’s libido will always match the level of their partner is quite slim. In fact, one of the most common issues couples face in relationships is mismatched libidos. Often, partners adapt to this reality and find a balance that works for them. Other times, though, mismatched libidos can snowball into bigger issues full of frustration, guilt, and resentment.
In particular, people with a higher libido than their partner tend to feel as if their needs are not being met, shame that they want sex more often or rejection when sex is off the table. By contrast, people with lower libido than their partner tend to feel frustrated, pressured, and anxious about their desire not being on par with their partner. Thankfully, though, a mismatched libido is a solvable issue so long as everyone involved is willing to be honest, empathetic, and to prioritize the relationship.
Being on either side of the sex drive seesaw can be frustrating, but let’s consider ways the partner with the higher sex drive can be both supportive and satisfied.
1. Access their stressors
Before you can begin addressing intimacy concerns, take inventory of what is going on in your partner’s life. The partner with the lower sex drive may be contending with a combination of libido-compromising stressors. Some of these lifestyle or health factors may include high stress, medications, chronic health issues, work demands, mental illness, family responsibilities, financial strain, or lack of sleep.
Now, what can you do about it? Well, if you know, for instance, that your partner is stressed, consider how you might be able to help them to feel better. Communicate that your intention is always to help them feel good in order to show that you’re not just trying to address your own sexual desires. Simple acts of support—like offering to cook breakfast for the week, taking a walk together at lunch or allowing them to sleep in on the weekend—can help revitalize their overall mood.
If your partner is going through a change that is more permanent than a period of stress, consider building support into your daily routine. Depending on the severity of the issue, you’ll want to pace yourself and be consistent in your support in a way that feels manageable to you.
2. Rate your sex drives
One easy way to begin healthy sexual communication on this topic is for each person in the relationship to rate their sex drive from one to 10 and explain their ranking. For the partner with the higher drive, make sure you actively listen to why your partner describes the number they share. Regardless of whether your numbers are very different or not too far from each other, use this exercise as an opportunity to empathize with your partner and try to understand their perspective.
3. Expand your definition of sex
Consider this an invitation to unlearn bad sex ed, including unhealthy myths that sex (only) means penetration and that orgasm is always the end goal. Now is a good time to expand your definition and expectations of what diverse pleasure can mean. To do so, have partner write down 10 intimate activities that they enjoy doing with their partner and 10 intimate things they’d like to try. Share the lists with one another and allow it to be the starting ground for an expanded list of acts all parties can enjoy together.
4. Try breathwork together
A few moments before bed, or when you both have downtime together, face one another and take deep breaths together. Unwinding together can help you both feel at ease next to each other. Gently reminding your partner with a lower libido to connect in breath with you allows you both to feel more synced.
5. Don’t forget you-time
While you are working on intimacy in your relationship, do not forget to build intimacy with yourself. Ideas that a partner should “fulfill you” or that they must be your sole source of pleasure aren’t healthy and put too much pressure on one person. You should be a primary part of your pleasure equation and spend time exploring and enjoying your body alone, regardless of your relationship status. Some ideas to bring more pleasure to your life can include full-body massages in the shower, a lunchtime masturbation session or a date night alone in your room with aromatherapy, music, and your favorite toys.
6. Throwback dates
Sometimes, the easiest solution for couples struggling with mismatched libidos is to go back to the basics. Many couples get stuck in a routine and don’t plan out date nights together the way they may have early on in the relationship. There’s no need to reinvent the wheel here, either. Instead, book consistent date nights and hit up old spots you used to enjoy together. Having dedicated time to look forward to helps build desire before the dates; meanwhile, spending quality time together on the dates helps you reconnect more intimately.
7. Work with a professional
It can be scary navigating intimacy concerns with your partner. Whether you are new to the relationship or are in a committed, long-term partnership, working with a professional can be a source of comfort. Sex therapists, sexologists, and intimacy experts are trained to help you talk about difficult topics and guide you on how to reach your goals together. There may also be instances where the best option for the relationship may not be one you have been open to before. Consider working with an expert if you want support navigating mismatched libidos.
A healthy sex life is linked to a number of great benefits: a longer lifespan, improved heart health, and decreased stress, to name a few. That said, at one point or another, it’s likely you’ve simply been too tired to have it. But, having sex when you’re tired still stands to boost your well-being because it makes you feel more connected to your sexual partner and opens you up to all the benefits of experiencing orgasm. (Of course, this doesn’t apply to asexual people, whose relationships are still valid and intimate despite a lack of sexual activity.) And, with the help of some tips, it’s possible to still have great and satisfying sex, even if you’re pretty zonked.
And for the health of your relationship, it may be worth your effort, too. According to experts, using sleepiness as a reason to avoid sex may lead you to not regularly reap the intimacy-boosting benefits of sex. “When you’re maintaining that [sexual] connection, even if you’re going through hard times together, you’re likely to be a little kinder and nicer, and maybe even a little more patient with your partner in the rest of your relationship,” says sexologist and co-founder of GoLove CBD lubricant Sadie Allison, PhD.
That said, if you or your partner is chronically tired and not in the mood, it’s important to first connect about potential underlying issues causing the sex-life-busting exhaustion. “I always encourage couples to first talk about the fatigue,” says sex therapist Shannon Chavez, PsyD. “If there’s not even [sexual] desire, or one partner hasn’t been in the mood, having an open dialogue around that is the first step [to having sex when tired], because you want to figure out what’s getting in the way of sex.” Following this discussion, it’s important to follow up with action. Whether that’s a change in routine, one partner helping the other to minimize sources of stress that may be stoking libido-busting fatigue, or seeking therapy, it’s important to move forward together.
But sometimes, there’s no serious or problematic underlying issue, and you’re just plain old sleepy. Read on for six expert-backed suggestions for having great consensual sex when you’re tired (and why doing so may be worth it).
6 expert-backed tips for having sex when you’re tired (and making it great)
1. Remember that sex goes beyond penetrative intercourse
Dr. Allison says that understanding intercourse as broader than just a penetrative act can ultimately make it easier to to make sure everyone is satisfied, and—considering the factor of tiredness—efficiently so.
For instance, non-penetrative sex acts can be effective for achieving orgasm (the fastest way for vulva-owners to orgasm, after all, is via the clitoris), and having an orgasm releases happiness-boosting chemicals like dopamine and oxytocin in our brains. So, it’s totally possible to reap the well-being benefits of sex without having penetrative intercourse.
2. Try “lazy” positions
In this sense, “lazy” is not meant to convey a negative feeling. It’s more so a way to depict the amount of energy that goes into sex when you’re tired. “Lazy sex is good sex, because all sex leads to feeling more desire for connection,” Dr. Chavez says.
“Lazy sex is good sex, because all sex leads to feeling more desire for connection.” —sex therapist Shannon Chavez, PsyD
Basically, it’s an expert-sanctioned excuse to take it easy on the advanced sex positions when you’re super sleepy. “You want to choose a position that is the least amount of work necessary,” says Dr. Allison. For example, spooning can be a good go-to position for having sex when you’re tired because it doesn’t require much energy or agility—plus, it brings you physically close to your partner.
3. Try to have sex during the afternoon
If you and your partner work remotely, afternoon sex can be a real winner. At this time, we have naturally higher levels of alertness thanks to the hormone cortisol and lower levels of sleep hormone melatonin than at night. So, fitting daytime sex into your schedule may circumvent the feeling of “having to” have sex at the end of a long and draining day.
4. Give yourselves grace
Certain individuals may experience super-busy seasons at work, for example, and this may sometimes impact their bandwidth for sex. For example, if your partner has a presentation coming up they’ve been preparing for months, or you just launched your business, your sex life may lag a bit in light of those energy-absorbing realities. In cases like these, give yourselves a break and stay in communication about how you plan to prioritize your relationship—sexually or otherwise. After all, it’s important to not make sex feel like a chore or another item on an already super-long to-do list.
“During busy seasons, be realistic with the schedule and know that this particular month might be difficult or different. Give yourself some grace,” says Dr. Allison.
5. Prioritize intimacy
Whether it’s a busy season or not, make sex and intimacy a priority; something you want and need to do as opposed to something you have to do. Part of this means not leaving it as the last thing you do in a day, after all your chores and to-dos are finished. Otherwise, sex unfortunately often slips through the cracks because, well, you’re just too tired after doing everything else.
The key here? Both partners should agree that no matter what, even if each is exhausted, they’ll make time for intimate connection. Even if it’s a couple of minutes of eye gazing and not an orgasm-inducing activity, says Dr. Chavez.
6. Try having slower sex
“Slow sex can be some of the best sex,” says Dr. Chavez. And because you’re moving slower, you’re exerting less energy, which can ease anxiety about having sex when you’re just so damn tired.
If you’re lacking confidence in bed, try starting with a simple position like missionary.
Reverse cowgirl and doggy style can be great for people who are self-conscious of their belly area.
For a little more adventure without going too wild, try the leapfrog or the lotus position.
If you feel self-conscious during sex, you’re not alone. Sex can bring up lots of insecurities — about body image, sexual inexperience, and more.
In fact, one survey found that 82% of men and 91% of women don’t always feel confident about their bodies when having sex, and 86% of men and 89% of women don’t always feel confident in their sexual ability.
It’s important to note that while the sex positions listed below are ones that don’t require a ton of sexual prowess and where you can control how much of your body is exposed, learning to have a positive body image can boost your mental health.
Understand that comparing yourself to people you see on social media can lead to unhealthy, debilitating habits like eating disorders. Therefore, if you’re reading this because you’re ashamed of how your body looks, it’s important to take steps to love yourself.
In the meantime, as you are building your confidence and self-respect, you can try out some of the following sex positions for some variety and excitement.
1. Missionary
Missionary is a tried and true sex position. Your bodies will be right up against each other and you’ll be face to face, meaning your partner won’t be seeing too much of your body, says Melinda DeSeta, LMHC, certified sex therapist at Insight Counseling Center Miami.
Plus, this position is super simple, making it a great choice if you’re not confident in your sexual abilities.
To get into missionary, follow these steps:
The partner being penetrated lies flat on their back.
The penetrating partner gets on top, lying directly on top of their partner, and enters.
2. Reverse cowgirl
If you’re the partner being penetrated and you’re self-conscious of your belly or breasts, being on top can feel intimidating. Instead of traditional cowgirl, DeSeta suggests trying reverse cowgirl.
To get into reverse cowgirl, follow these steps:
1. The penetrating partner lies flat on their back.
The partner being penetrated straddles their partner over their pelvis region, facing away from their partner.
3. Doggy style
Doggy is another tried and true position that’s simple and easy to do, even for those who are sexually inexperienced, says Ditza Katz, PT, PhD, clinical sexologist at the Women’s Therapy Center.
Plus, neither partner’s body will be on full display.
To get into doggy style, follow these steps:
The partner being penetrated gets on all fours. If it’s more comfortable, they can then lower down onto their elbows.
The penetrating partner kneels behind their partner and enters.
4. Leapfrog
The leapfrog is a doggy style variation that may allow you to focus more on pleasure, rather than stewing about how your body looks to your partner.
The altered shape of leapfrog can feel a bit more sexually adventurous than doggy (while still being simple), so you can boost your sexual self-esteem.
To get into leapfrog, follow these steps:
The partner being penetrated gets on all fours and then stretches their arms out in front of them, so their chest is down towards the bed and they are resting their head down on the bed or a pillow.
The penetrating partner kneels behind their partner and enters.
5. Spooning
For another position where neither partner’s body is too exposed, Katz recommends a side by side spooning position.
To get in this position, follow these steps:
Both partners lie on the same side so they are spooning, flush against each other.
The penetrating partner enters from behind (they may need to slide down a bit or adjust their positioning so the pelvises will be aligned for penetration).
6. Lotus
The lotus is another position where your partner won’t see too much of your body (and vice versa), says DeSeta.
It’s also simple to do, but since you’ll be sitting upright, you might feel a little bit more adventurous than you would in a position like missionary, which can help improve your sexual confidence. To get in this position, follow these steps:
The penetrating partner sits down with their legs crossed.
The partner being penetrated straddles and sits on their partner’s lap, wrapping their legs around them.
Maneuver your bodies so you’re aligned for penetration.
Insider’s takeaway
Don’t let your lack of confidence hold you back from having, and more importantly, enjoying sex. You deserve to feel pleasure and have fun in bed.
Try out these positions and see what works best for you and makes you feel the most confident.
When Rebecca, 31, was diagnosed with breast cancer in early 2019, her sex life with her partner was a welcome distraction. “We were like teenagers again. There’s nothing like being faced with your own mortality to make you want to feel alive and nothing makes you feel more alive than having sex,” she said. “With cancer I felt let down by my body and sex became a way of reconciling myself with it. It became a psychological thing I needed to do,” she added.
However, when Rebecca started chemo, the treatment affected her sex life. Specifically, she suffered from vaginal dryness and then vaginismus, a condition where the vaginal muscles tighten up, preventing penetration. “When I asked my doctor about whether it was a side effect of chemo, she didn’t know how common it was because no one talks about it.”
Although one in two people in Canada will be diagnosed with some form of cancer during their lifetime, its impact on sex and intimacy is rarely talked about in the medical field, let alone wider society. Naturally, going through cancer treatment impacts your sexual life in myriad ways. “The most common difficulties for women I see are loss of sexual desire, difficulties becoming sexually aroused or vaginal changes such as pain,” explained Isabel White, a COSRT senior accredited psychosexual therapist who specializes in working with people who have or have had cancer.
Issues stem from both the physical and the mental repercussions of treatment. “It can be a physical origin such as treatment-induced menopause that’s very common after hormonal breast cancers, or mental health issues. Low mood and anxiety are two conditions found more commonly in cancer patients versus the general population and these have a significant adverse effect on sexual wellbeing.” Body changes can have a huge effect too. “Hair loss, weight change or loss of body parts associated with eroticism can adversely affect body confidence and the ability to connect with people when being sexually intimate,” Isabel added.
For Bronte, who was diagnosed with leukaemia aged 21, the physical toll of her illness made continuing her sex life with her boyfriend of two years really hard. “I was often exhausted when I was able to see my partner, or just really ill, and the last thing on my mind was taking my clothes off. With so many changes happening to my body I experienced a lot of body image and identity issues which made me hate myself a lot of the time and feel completely disconnected from what I saw in the mirror. This really impacted our intimacy because I simply didn’t feel comfortable in my skin, let alone feel sexy.”
The practical elements of being ill were tricky to navigate, too. “We were both at uni so when I was diagnosed I went back to my parents’ for treatment, which meant we were a three-hour journey away from each other,” Bronte explained. Rediscovering her sex life has been a long process. “Three years later I’m still slowly rebuilding and discovering new interests and desires. As I discovered myself again and recognized my reflection I became more confident and the intimacy naturally followed. It did take an extremely long time for my libido to build back up and I’m so lucky to have a super supportive partner who stuck with me through it all.”
Some cancer patients are advised to avoid sex altogether. Maria, who was diagnosed with leukaemia aged 17, was told to completely refrain from any sexual activity due to the risk of infection. “It was like a hypothetical chastity belt,” she said. Single at the time, she found her libido had also completely diminished. “Previously I would think about romance and sexual activity a lot but that completely disappeared,” she added. During this time she also worried about how she would date again. “I started to get depressed thinking about it and thought I wouldn’t be good enough for anyone again since I didn’t think I could ‘perform’ or live up to a guy’s expectations.”
Kimia, now 30, also struggled with dating after suffering from non-Hodgkin lymphoma aged 21. “At first I was worried about dating again but as my confidence increased after coming out as bi, I thought, This is me, and if prospective partners act weird about my cancer history, then whatever. As soon as people see my scars, I tell them the full story,” she explained. “Luckily, I’m now in a loving relationship with someone who doesn’t treat me differently,” she added.
For some women, reconnecting with their sexuality after cancer is made harder by the drugs they are prescribed to prevent cancer from returning. Joon, who was diagnosed with breast cancer aged 37, has to take tamoxifen for up to 10 years. This very commonly prescribed drug induces early menopause. “It feels like your most intimate life – your skin, sexuality and intimacy with your partner – go out the window. You feel like an old woman,” she told us. “I had a healthy sex life before but suddenly I didn’t want to have sex anymore. Vaginal dryness is also a real bummer.”
Unlike male treatments (for example, Viagra), there are fewer options for women in terms of drugs that can improve sex life. Like so many areas of female health, the gap here is significant. “It’s harder to get funding for research into sexual difficulties in women versus men as a lot of money comes from pharmaceutical companies,” Isabel points out.
In 2010, Isabel was appointed by the Royal Marsden in London (the UK’s top cancer hospital) as its first in-house psychosexual therapist – a position created in response to patient demand. Therapists like Isabel are available in some NHS hospitals but not everywhere or for everyone going through cancer. With cuts to NHS funding, these sorts of services are often the first to go. Alongside the need for greater sexual health resources, Isabel highlights the importance of more research into this area, especially from a female perspective.
The lack of knowledge in this field comes up again and again when I speak to women who have had cancer. Twenty-four-year-old Lynsey was surprised by how little information about contraception was provided when she was diagnosed with breast cancer at the beginning of 2021. As her cancer was hormonal she had to stop taking the contraceptive pill. “They make it really clear you can’t get pregnant during your cancer treatment but no one gave me much advice on alternatives. In the end I phoned the sexual health services, who suggested the non-hormonal coil,” she explained. When Lynsey started chemo, she also struggled to find information about safe sex practices. “It’s suggested you use condoms because of the drugs going around your body but no one seems to really know whether that’s just straight after chemo or up to a week after,” she said. “It’s concerning that there is not more research or information on this,” she added.
Finding support can be life-changing. During her treatment for leukaemia, Maria had access to a women’s health clinic run by a nurse with whom she felt comfortable discussing her sexuality. “Although the information was catered to older female patients, it still gave me some confidence. If it wasn’t for that nurse’s advice I don’t think I would have the confidence to dive back into masturbation or dating.”
Thanks to some women, the narrative around sex and cancer is hopefully set to change. “We need to talk about it so women don’t feel embarrassed and the medical community knows it’s an important issue,” Rebecca explained. As a producer at ethical adult filmmaker Erika Lust, Rebecca decided to use her position to change the current conversation.
“I wanted to make a film about cancer without death. Culturally we are 30 years behind where we are with cancer medically. We still see cancer as a death sentence and it’s just not the case,” she said. After all, there’s an 87% survival rate for young people experiencing cancer. “Sex in society is one taboo, female sexuality is another taboo, put on top of that sexuality when [you have cancer] and it’s a triple taboo,” she said. Inspired by her own experience, Wash Me is an intimate and hopeful portrait of a woman rediscovering her body and desire after cancer. The film aims to raise awareness of the intimacy struggles faced by people with serious illnesses while inspiring others who are going through cancer treatment not to give up on their sexuality but claim it back.
Joon also aims to shift the narrative with her platform sexwithcancer.com. Created with friend, fellow artist and former cancer patient Brian Lobel, it’s a sex shop, a resource for peer-led advice, a platform for artist work and a place to explore journeys around cancer that are harder to dive into. “We need to start thinking about cancer as a chronic condition like mental health or diabetes. We need to think beyond survival about how we live more fully as whole human beings,” she explained. “Pleasure and intimacy are so much about life and what is the point in living if you are just surviving?”
Sex can be more than just the physical aspect. Emotions, hopes, and fears may also be involved.
Sometimes, personal challenges and insecurities can make you apprehensive about your sexual performance.
Though sexual performance anxiety isn’t a formal diagnosis, it can still be a valid reality for you. But there are a few ways you can learn to manage sexual performance anxiety.
What is performance anxiety?
Performance anxiety refers to significant worry and fear about your ability to execute a specific task. It may also involve concern about how others perceive you.
Performance anxiety is what some people call “stage fright.”
Performance anxiety isn’t a formal mental health diagnosis, but it’s part of social anxiety disorder. This disorder is characterized by fear of social situations in which an individual feels they’ll be exposed to possible scrutiny from others.
You can experience social anxiety:
being around strangers
having conversations
during public speaking
Performance anxiety can manifest in many ways. Not everyone will feel and behave the same when having anxiety about performance situations, so you may not relate to every symptom listed here.
Some common symptoms may include:
negative thoughts about oneself
blushing and rapid heart rate
nausea and vomiting
excessive sweating
difficulty speaking
dizziness
intense worry
situation avoidance
Feeling anxiety from time to time is expected. But if you live with any anxiety disorder, you might have persistent symptoms that occur during different situations.
If you live with social anxiety, you might constantly worry about how others perceive you and how you navigate social situations.
Sexual performance and anxiety
Sexual performance anxiety refers to the fear of not being able to perform adequately during a sexual encounter. “Adequately” can mean different things to different people. What matters, though, is what you think that involves.
You may feel you won’t be able to meet your partner’s sexual preferences or experiences, which may cause you to have anxiety, for example.
On many occasions, particularly for men, sexual performance anxiety could impact becoming aroused and physically responding to sexual stimulation. This could confirm in your mind that you might not be able to perform well.
Sexual performance anxiety could manifest in many ways, including:
Men and women can experience sexual performance anxiety, and some may experience orgasm anxiety as well.
Literature reviews from 2000 to 2018 found that 9% to 25% of men experience anxiety associated with their sexual performance. In many cases, this anxiety was linked to symptoms of erectile dysfunction and premature ejaculation.
The same reviews found that women with sexual performance anxiety account for an estimated 6% to 16% of the female population, and anxiety often manifests as a low sex drive. Anxiety can also prevent females from experiencing orgasm.
Causes of sexual performance anxiety
You may experience sexual performance anxiety for many reasons, including:
Learn more about defining boundaries in your relationships, practicing consistency, and living with intention with our limited series.
How to manage sexual performance anxiety
A mental health professional can help you explore the whys behind your symptoms of sexual performance anxiety and structure a treatment plan that works for you.
If your symptoms are linked to a specific situation, such as a new partnership, you may find that performance anxiety subsides as you become more comfortable with them.
If you’ve ever wondered this to yourself while in a relationship, you certainly wouldn’t be alone. Oftentimes the question comes up when there’s a feeling of disconnection in the relationship—a lack of excitement or “spark” between you—and a lack of sex may float to mind as a potential explanation.
But other times, people might feel pretty satisfied and content in their relationships, but outside influences—like hearing other people talk about how much or how little sex they’re having in their relationships—can make you start to question your own.
So we asked Jessa Zimmerman, M.A., an AASECT-certified sex therapist and marriage counselor, what she tells couples wondering about the amount of sex they are or aren’t having.
How much sex is “enough” for a healthy relationship?
First things first: Enough for who?
Zimmerman recommends thinking about how you’re defining the word “enough.” Is it based on comparisons with other people’s sex lives and trying to see if you’re “normal”?
“There is no normal. There is no ‘right’ amount of sex,” she says.
There’s no one magic number that will work for every single pair of people, and how often couples should be having sex will always vary depending on the specific needs of the specific people involved. Some people feel perfectly satisfied with sex once every few months, whereas others would consider that basically a sexless relationship. And of course, some people like having a sexless relationship, whether because they’re on the asexual spectrum or just prefer it that way. It all depends on the individual, and all preferences are valid.
Sometimes people might feel like they’re not having enough sex because they’re comparing their relationship to how it’s been in the past, Zimmerman adds, but even a decline in frequency doesn’t necessarily mean there’s a problem. “It’s normal for our sexual interest to change over time and to feel less intense desire,” she explains. Sometimes you’re just in a period of time when you don’t feel like having sex, and that’s perfectly OK.
The real question, she notes, is whether each partner individually feels like they’re having a satisfying amount of sex—whatever that looks like to them personally. Do you feel satisfied with your sex life as it is right now? Does your partner?
A helpful check-in.
One issue with the question of “how much sex is enough sex” is that it places the focus on the wrong thing, according to Zimmerman.
“I mean, what counts as sex anyway? If you’re focused on ‘the act’ (whatever that is for you) and the frequency of such, then you’re focused on the wrong thing,” she says. “It’s not just about ‘getting it done’ or checking the box. The point of sex, from my point of view, is to share pleasure with your partner and to feel connected in the process, no matter what you do with your body parts and what the end result is.”
It’s less about whether you and your partner are engaging in a certain act a certain number of times. It’s about how connected the two of you feel and how much pleasure you’re getting to enjoy in your relationship.
So with that in mind, Zimmerman recommends asking yourself a more important question: Am I (and is my partner) having enough pleasure and connection?
“Consider whether you’d like more pleasure and whether you feel enough connection in your relationship. And ask your partner about whether they’d like more of those things,” she explains. “If so, prioritize that.”
That might mean having more sex more often, or any other number of ways to creatively bridge the gap. The point, as it always is when it comes to sex: Just focus on doing what actually makes you and your partner feel good.
Treatment can rob women of their breasts, libidos, and self-confidence — here’s how they’re reclaiming their sex lives in the face of it all.
By Jessica Zucker
Carmen Risi, 40, knew there was a good chance she’d one day sit across from a doctor and hear that she had cancer. Her grandmother died from breast cancer, her mother and aunt were both diagnosed with ovarian cancer, and in 2019 she found out she was positive for the BRCA1 gene — an inherited variant that puts people at a much higher risk of developing certain cancers. As a result, Risi spent two years undergoing routine cancer monitoring — every six months, she’d receive an MRI or a mammogram.
In April of 2021, one such MRI found what Risi would later learn was breast cancer.
In addition to six grueling rounds of chemotherapy, Risi decided to take a hormone therapy shot, in order to preserve her fertility in the hopes of soon growing her family — she started IVF before treatment began and has plans for an embryo transfer once she’s done.
One major side effect of the drug? The loss of her sex life as she knew it.
“Lupron has put me into a temporary menopause — complete with hot flashes and a vagina that has completely atrophied,” Risi explains. She wasn’t exactly given a heads up, either. “I have pages of notes about the side effects these various drugs will have on me that I was handed by my doctor,” Risi says. “But there were no notes on how it would affect my sex life. None.”
Shari Goldfarb, M.D., an oncologist specializing in breast cancer at Memorial Sloan Kettering Cancer Center, says many women simply don’t realize the sexual side effects that come along with various breast cancer treatments. That’s why she makes sure to discuss with her patients, upfront, the possibility of menopausal symptoms and sexual challenges, such as vaginal dryness and decreased libido. She also encourages her patients to be proactive by using non-hormonal moisturizers, lube, vaginal dilators, and vibrators to make them feel more comfortable about having penetrative sex when they’re ready.
But the emotional side effects can be just as jarring. The temporary menopause combined with the loss of libido thrust Risi into a deep depression that she says left her thinking, “‘What’s wrong with me?'”
Madeline Cooper, LCSW, a psychotherapist and certified sex therapist, says it’s common for cancer patients to experience depression — as well as other mental health struggles — as a result of receiving a cancer diagnosis. “The first thing I tell my clients is that it is normal to go through a grief and mourning period,” Cooper tells InStyle. Being slapped with a breast cancer diagnosis that, for some, is intimately wrapped up in one’s identity as a woman, can affect so many parts of her life: a change in her body, expression of sensuality, sexual desire, pleasure, body image, the list goes on. “You might need to adapt to a new sexual style with your partner, and this might feel like a loss.”
Of course, not everyone already has a committed romantic partner in their life when they receive their cancer diagnosis and undergo treatment. Chiara Riga was a single 27-year-old when she was told last year that she had stage 4, metastatic breast cancer. While her healthcare providers believe she has between 10 to 15 years to live, her diagnosis is terminal, which, needless to say, makes dating — and sex — particularly fraught.
“I’m casually using dating apps, but there are so many different layers to what makes it a struggle for me,” Riga tells InStyle. “There’s the first layer, which is zero libido. Kids are off the table for me, too — certainly biological kids, but there’s also the ethics of adopting a child knowing that my disease is terminal. Then there’s the issue of ‘when do you disclose?’ and ‘how do I disclose?’ I want to date in order to be able to escape this dark reality I’m living in.”
Part of Riga’s treatment, which she will undergo until the end of her life, suppresses her ovaries and estrogen, because her cancer is hormone-fed. This means she is in full-blown menopause, which has essentially eradicated her desire to have sex. And while Riga says she actually doesn’t miss it, the want and ability to have sex would make her dating life much simpler and a hell of a lot more fun. Breast cancer, in a sense, has eliminated frivolous sexual encounters, by shifting the focus from sexual pleasure to long-term support through partnership.
“Who in their late twenties or early thirties is looking for ‘just a partner’? I think [wanting to have sex] would make dating much easier for me,” she explains. “And I do think for the right person, the right relationship really, I’d try to figure something out. I just haven’t found the right person for that yet.”
Even for those who do have a long-term partner — and a libido — to navigate the process with, redefining what sex looks like after breast cancer takes effort. For Risi, that meant finding other ways to experience orgasm (ahem, clitoral stimulation) with her partner once penetrative sex became too painful during chemotherapy. And after her forthcoming double mastectomy, Risi knows she’ll have to contend with not just the loss of her breasts, but the sexual pleasure they bring her. “I don’t want to lose my breasts. I don’t want to lose feeling. My breasts [stimulate me sexually], so to lose that forever is incredibly daunting,” she says, despite knowing it’s the best decision based on her risk factors.
According to Cooper, this reaction is common. Cancer treatments can often be associated with many types of “loss” — be it loss of libido, breasts, hair, a sense of sexiness, comfort in one’s body, identity even — and that loss, even if some are temporary, can be overwhelming at best.
“Breasts and hair can [contribute to] a woman feeling sexy and confident about her body, and this might shift with the loss of either,” she explains. “These changes could cause one’s body image to become a source of feeling turned off rather than turning herself on, and this can reduce sexual desire overall.”
Learning to love her body and reconnect with her sexual desire is something that Mary Purdie, 38, was already contending with when she was hit with the whiplash of breast cancer in January of 2018. In fact, it was during a new morning ritual — looking at her naked body in the mirror — that she first noticed a lump in her breast. “I was trying to appreciate my body, even though it was causing me so much pain,” Purdie tells InStyle.
After she was diagnosed with stage 1A invasive ductal carcinoma, she underwent a lumpectomy, radiation, and multiple rounds of chemotherapy. She was also put on a long-term hormone-blocking treatment called tamoxifen — a daily oral medication she has to take for at least five years. And while she was able to keep her breasts, and therefore felt more physically “whole” — her libido went out the window.
“Our sex life was already kind of on shaky ground after the last miscarriage, because my body had gone through so much and most of the sex that we were having in the past year or two was strictly for the sake of conceiving and not really for pleasure in any sort of organic way — it was scheduled,” Purdie explains. “So going from that to cancer treatment, it was like, ‘Well, how do we even get back to the honeymoon phase?'”
For Purdie, it was by allowing her husband (of three and a half years at the time) to take care of her. “I was generally the person who was cooking and cleaning. I took care of our house. But that all changed when I was going through chemo — he did everything all of a sudden,” she says. “And those acts of service helped to build intimacy. I could just lay there and be miserable and I knew he was going to take care of me, and that was such a huge showing of his love.”
According to Dr. Goldfarb, experiencing this kind of non-sexual, emotional support from a partner tends to increase the amount of intimacy a patient feels during and after treatment — and can indirectly benefit their sex life too. “Assurances like ‘I love you unconditionally’ and ‘I’m in this with you — I am here to support you through this’ are really important, because patients often worry that a cancer diagnosis will [damage] their relationships,” Dr. Goldfarb adds. “I have seen relationships get closer in times of turmoil and illness when significant others are supportive.”
She says that in addition to simply being there — reminding her to take her medications, sitting with her through chemotherapy treatments, cooking, cleaning — her husband’s patience and attention to the little things also helped, not just in making her feel closer to him but making her feel more comfortable in her body and, eventually, being sexual. He deferred to her in bed — he let her take the lead.
“In the evenings it would often turn into a moment together that, even if it was brief, was a chance for us to be physically intimate,” she adds. “It felt good to tap into that sense of normalcy that we had before cancer and before miscarriages.”
Risi is also determined to maintain her sex life — no matter what changes to her body breast cancer may bring. She grew up in what she describes as a conservative Christian community where women were “taught to be modest” and that “sexuality wasn’t something you should even think about until you’re married.” Risi got married at 28, and says that, as a result, she spent years muting her own sexuality.
“I’m so mad that I lost a part of my sexuality to religion in my youth, and I’m losing sexual function and desire to cancer. It’s maddening,” she adds. “But I know my husband will still want to love and touch on whatever my new breasts are, even if I don’t have a specific feeling there. And I think I will enjoy that, because there’s intimacy there, even if there isn’t sensation.”
I remember a Tumblr post that changed my view of vaginas forever, as Tumblr posts are wont to do when you’re 16 years old and on the family computer late at night. The user was analysing the semantics of how we talk about sex. Why, they wanted to know, is sex always considered to be a penis penetrating a vagina? Why are penises always dominant but vaginas always submissive? What if we flip the narrative? What if the vagina envelops or engulfs the phallus? What if the penis is the submissive one of the pair?
This heteronormative example can be easily applied to queer relationships, too. The one who receives is the ‘bottom’, the one who gives is the ‘top’. The language lends itself to the stereotypes that the former is the submissive and the latter is the dominant. Indeed, the labels ‘top’ and ‘bottom’ are often used interchangeably with the labels ‘dom’ and ‘sub’ – but is this always true? And is it a fair assumption?
In 2018 an Autostraddle survey discovered that 47.4% of lesbian bottoms prefer not to be actively ‘in control’ during intercourse and only 41% of bottoms identified themselves as kinky.
Nate, a trans man who identifies as a switch, contributed to the survey with an important clarification: “Bottoming definitely doesn’t automatically mean anything kinky (same for topping), while submissive (and dominant) mean something more specifically related to kink and power play.”
I think what tops do – give rather than receive – can definitely be more submissive than bottoming.
Bethan, 26
Fran, 25, a submissive queer woman from London, believes this distinction is incredibly important not just for shagging purposes but also on a queer liberation front. “Top and bottom are umbrella terms for giving and receiving,” she tells me. “But I feel these terms stem from attempts of fitting WLW (women-loving-women) relationships into a heteronormative stereotype. I strongly oppose this so I prefer to call myself submissive instead of a bottom.”
Once again the stereotype is that receiving is a traditionally female act in heterosexual relationships and, in turn, being the ‘woman’ of the relationship is an inherently submissive role. This conflation stinks of sexism of a bygone era where woman is seen as lesser than man and so to receive is to be weaker, too.
Lucy Rowett, a UK clinical sexologist working with sexual wellness brand Pleasy Play, asks us to reconsider the act of bottoming and submissiveness in general as a rebellion against outdated gender roles. “Remember that if you are in a lesbian relationship or you are a queer woman, you are already defying gender roles and expectations. What if you could embrace being a bottom as another form of defiance against this and being true to yourself?” she enthuses.
“Regardless of sexuality or gender, of whether kink such as BDSM is involved, the more bottoms or submissives you speak to, you’ll find a commonality: they share a feeling of freedom,” she adds.
In short, she says, by embracing acts that only bring us pleasure, that bring us freedom, we can find a subversive kind of liberation and power in being a submissive or a bottom.
However it isn’t always true that a woman is the ‘receiver’ in a heteronormative relationship. It is possible for two cis straight or bisexual people to be in a relationship where the man prefers to receive and the woman prefers to give (see: pegging).
So what to do? The problem with dismissing these labels as ‘heterosexual’ reminds me of the 1970s lesbian feminists who rallied against ‘butch’ and ‘femme’ monickers, arguing that they mimicked straight relationship roles. That’s a discourse that remains controversial today but is an outdated way of looking at queerness. The identities of femme and butch remain important to our community, our history and our identities. Dismissing the labels ‘top’ and ‘bottom’ from queer language altogether feels, to me, like a repetition of these past mistakes.
“I think the act of giving is more submissive,” says 26-year-old Bethan, a submissive bisexual based in London. “What tops do – give, rather than receive – can definitely be more submissive… Like if a woman is sitting on your face and using you for her pleasure, that feels like a dominant act.”
Again, the language we use to describe our sexual gratification plays an important role. Does a bottom ‘receive’ or do they ‘take’? To push this idea further, the submissive in a kink relationship has the ultimate power over the sexual play taking place. They are the one setting boundaries, expressing what they want and having a safe word. When all is said and done, they are the decision-maker in the bedroom. The fun comes from pretending that they are not in charge at all.
You’ll find this idea in the pop culture that is developing around pegging, too. Pegging memes suggest that there are a lot more men who adore penetration than our limited secondary school sex education allowed us to imagine. Traditionally, there has been a lot of stigma surrounding pegging too. The same problem that lesbians describe with the ‘top’ and ‘bottom’ dynamic is repeated here: assuming that being penetrated equals submission implies that taking on the ‘female’ role is automatically a submissive act. This not only couches submissiveness as a negative but implies that being female is a negative, too. The reality is that submission and being a woman do not necessarily go hand in hand; otherwise, as Fran puts it, “you would never see female doms.”
Jessica*, a 28-year-old submissive woman from Manchester who also likes to don strap-ons, explains that pegging does not have to be a part of power play at all. “I have always been submissive in bed, to the point where being dominant makes me feel extremely uncomfortable,” she tells me. “That said, I really loved pegging my ex-boyfriend – who was also my dom – and it didn’t take away from my submissiveness at all.”
“As our relationship dynamic was already firmly set, it felt natural and even submissive in a certain sense to be the one giving him pleasure in such an intimate way,” she continues. “Although many people who want to be pegged may be submissive, I think it is important to recognise that it is possible to peg without giving up those subby feelings.”
Ness Cooper, a sexologist who works as a sex and relationship coach at The Sex Consultant, confirms that decisions about who tops, who bottoms, who doms and who subs can only be made by those within the relationship. “If you’re both into power play consensually then sure, use the terms ‘top’ and ‘bottom’ freely if you prefer them to ‘dom’ and ‘sub’,” she says.
Ness continues to highlight the importance of looking within your relationship and deciding what works for you. “Remember we are influenced greatly by what we see and read outside in the world when it comes to sexuality,” she continues, “but taking time to learn about yourself can be helpful as no one else knows fully about your world when it comes to how you see sexuality and sex.”
What’s more, the only people who need to know how you describe your sexuality and how you interact with sex are the ones you are being intimate with. A label is far from a cause to force yourself into participating in a dynamic you might not be enjoying or even comfortable with. As long as the sex you’re having is consensual and pleasurable, titles can mean whatever you want them to mean.
As Jessica and Ness lay out, the dynamic between a couple – be that top and bottom, dom and sub or any other kind of role you like to take on – is as unique as the relationship. Lumping labels together only diminishes the highly personal nature of each connection and can lead to invalidating those who don’t fit in with strict definitions of sex and kink roles.
*Name changed to protect identity Complete Article ↪HERE↩!
Feel like your relationship is in a rut, sex-wise?
You’re certainly not alone.
When you’ve been in a relationship for a while, it’s natural for your sex life to go through ups and downs.
But when you’re in a low point, things can feel a bit dismal.
A recent survey from Burton Constable Holiday Park (don’t ask us why they’re doing this bit of research, we’re not sure either) found that 22% of respondents said their relationship spark had disappeared.
The number one cause given for this? A lack of physical affection. Perhaps PDA is worth giving a go… or just more physical intimacy at home, if you’re not keen on putting on a display.
Other reasons confessed for a lull included not going on enough dates with their partner, a shortage of communication, and not having enough one-on-one time.
Relationship expert Hayley Quinn suggested that to remedy this issue, couples should go on regular holidays together.*
*Okay, now we understand why a holiday park commissioned this research.
‘I don’t think many couples put the time and effort into reigniting romance, which isn’t a criticism; it’s difficult when you have to deal with life admin,’ says Hayley. ‘Spending time to create romance easily falls to the bottom of the pile.’
While a romantic getaway does sound nice, it’s not your only option for escaping a sexual dry spell.
We chatted with relationship expert and author Lucy Beresford for her wisdom.
Try not to take a dry spell personally
There are so, so many reasons why sex might not be happening as frequently as it used to. Don’t jump to conclusions.
Lucy tells Metro.co.uk: ‘Recognise that sex is complex and may be about stress or lack of confidence on the part of your partner, so less to do with you and how desirable you are.
‘Focus on adoring yourself and treating yourself with love and respect, so that you are not reliant on how your partner feels about you.’
Have an honest conversation
It’s tough when you feel like you’re the only one struggling with your relationship’s lack of sexual passion.
The first step to sorting this out is acknowledging that there’s an issue.
‘The right amount of sex is different for every couple, so start by having conversations about the current situation to find out how your partner feels and to state your own needs gently,’ Lucy says.
‘Make sure you have these conversations when you both have time to give each other space to state your needs and listen to each other, and keep the focus positive and with no judgement or blame.
‘Explore whether your partner feels the lack of sex is because of a non-sexual relationship issue. For example if they feel you’re distracted, not making time for them, or not supporting them emotionally, you both need to work together on that issue first.’
Ditch guilt, blame, and shame
Stop beating yourself up for not having an allnight sex session every other day.
‘Remember that we often make the mistake of believing everyone else – particularly people we see on social media – have the perfect relationship with tons of sex,’ says Lucy. ‘But in truth, many couples haven’t had sex in weeks, months, or even since the pandemic started.
‘Studies show that as many as 15% of couples are suffering from a sexless relationship. So have compassion for all that you and your partner have gone through this past 18 months, and recognise that you are doing the right thing to address this now.’
Check your language
Related to the above, make sure that when you’re chatting with your partner about your sex life, you’re not assigning blame.
Lucy advises: ‘Use ‘I’ phrases (“I have loved it when…”) rather than “you” phrases (‘you never/always…’). This can help avoid your partner feeling attacked or blamed.’
Come up with some action points
Sounds formal, we know, but make a concrete plan of how you’re going to bring back the sexual spark.
Lucy suggests: ‘Examples include making a promise to always kiss before one of you leaves the house or gets back home, or take an evening to just focus on gazing at each other, or stroke each other, to take the pressure of feeling like you have to have full-on penetrative sex.’
Take small steps to get more physical
When you’re going through a dry spell, just initiating sex can feel like an impossible hurdle – especially if you’ve always relied on your partner to get things started.
Get rid of the pressure by focusing on smaller acts of physical intimacy.
‘Skin-on-skin contact, whether it’s kissing, hand-holding, a massage, or stroking, has a hugely beneficial effect on strengthening the bond of affection, without ramping up the expectation that it has to be about sex,’ notes Lucy.
‘Baby steps as you both get back into the rhythm of sexual activity is more important than going straight for full-on intimacy.’
Check in with your own confidence levels
‘Focus on your own body confidence, which may have slipped during the lack of sex,’ Lucy tells us.
Make sure you’re feeling comfortable getting naked, and perhaps have some self-love time to get your self-image back to a healthy place.
Focus on fun
If you’re stressing out about having the ‘right’ amount of mindblowing sex, you’re on the wrong track.
Get rid of the pressure to orgasm – or to even have penetrative sex, if that feels a bit much for you right now.
Instead, challenge yourself and your partner to have some fun, get intimate, and see what feels good – no pressure, no rush.
Have you ever headed back to your date’s place after a sultry night out, ready to have a good time — only to struggle getting there physically? The connection is there, but you just cannot get yourself aroused no matter how much you want to. You might be left feeling embarrassed at this momentary impotence, kicking yourself for potentially signaling to the other party that you just aren’t that into them when it couldn’t be further from the truth. The technical term for this feeling is arousal non-concordance, which is essentially the disconnect between the mental or emotional response and the body’s response to sexual stimuli. In addition to the aforementioned scenario, arousal non-concordance can also refer to the opposite effect — when the body is responding physically to sexual activity or touches (vaginal lubrication, for example) but the desire is not there or the mind is saying no.
Sexual wellness educator Catriona Lygate explains that while people often tend to use the words “desire” and “arousal” interchangeably, there is a marked difference between the two. By her definition, sexual arousal is a physical state of being, and something one can sometimes not have conscious control over. Desire on the other hand, is psychological. We can desire a second scoop of ice cream after dinner, less work hours, or the neighbor three doors down. This is a conscious want individuals do have control over.
Learning and understanding the desire-arousal distinction are crucial in troubleshooting any issues in communication. Culturally, many are socialized to believe that talking about sexual likes and dislikes is awkward, embarrassing, and unnecessary; that if sexual chemistry is present, the people involved will naturally know how to please each other. In practice, this is not always the case. Arousal actually involves a tricky combination of many contextual factors such as your mood, headspace, your emotions about the relationship with the other person(s), and distinct turn-ons that play on your senses like smell, taste, and touch.
Researcher and author Emily Nagoski popularized the term arousal non-concordance in 2015 when she first published Come As You Are; however this phenomenon has existed for as long as humans have been getting busy. To describe how sexual response works, in her book, Nagoski goes into the dual control model which involves a gas pedal and a brake. Any time your brain receives information that’s even slightly sex-related (like right now), it sends a signal varying in intensity to “hit the gas” and feel arousal. Simultaneously, your brain is also hitting the brakes based on all the external factors in the moment that may indicate it’s a bad idea to be turned on right now. She explains that being turned on relies on so much subjective messaging from our environment.
Many have been in situations where they might not be in the mood for any sexual activity, but a caress or knowing touch in the right spot can elicit an instant response from their body. You might not want to become intimate, but physical changes can be interpreted otherwise. After understanding arousal non-concordance (the disconnect between mind and body reactions), however, it is evident that bodily arousal is not always an indicator as to whether someone wants to initiate or continue sexual acts.
Nagoski actually digs into this further in a blogpost subsequent to her 2015 book, stating that genital response is, again, not primarily about desire or pleasure but sexual “relevance” (meaning presence of sexual stimuli). The stimulation that gets our bodies going in any given moment might be unwanted, but it has no true bearing on one’s sexual fantasies. If bodily arousal appears to be a false “green light” as previously mentioned, then arousal non-concordance is the yellow, signaling that it’s time to slow down and have a conversation. “It is crucial to know and remind yourself that you are not broken, damaged, or flawed if you experience arousal non-concordance,” shares psychologist and certified sex therapist Dr. Kate Balestrieri.
What if the roles are reversed and it’s your partner who is aroused but verbally communicates they do not want to proceed? Listen and respect their limits. Dr. Balestrieri says, “Make note of the context in which you experience non-concordance, so you can be more readily prepared to discuss with a partner, set boundaries that align with your mental and emotional desire, and remain convicted of your own truth about non-consensual experiences.” And if your partner is not aroused but verbally communicates they do want to proceed? Focus on their pleasure. Use this time to ask them what they desire and focus on their erogenous zones during foreplay.
For any instances of arousal non-concordance, the lesson here is to always communicate. If you are experiencing this issue in any form, confiding that information is important to establish understanding between you and your partner. It doesn’t have to ruin the vibe — this is the perfect opportunity to learn something new about each other by offering an alternative. Perhaps this moment helps you realize some sexual trauma ignored early on is resurfacing, and thus preventing you from feeling comfortable enough to take that next step of intimacy. “It can be helpful to work with a sex therapist or to seek assistance from an OB/GYN or urologist if you experience arousal non-concordance frequently, or if you feel distress as a result, especially if you have a history of trauma and feel confused by your body’s reaction,” Balestrieri recommends.
At a time where sex seems on everyone’s minds after months of isolation and anxiety, talking about arousal non-concordance may ease any apprehension one might have about sexual satisfaction and can create realistic expectations when meeting someone new. Remember that genital response does not always equal sexual desire, and you should be looking for clear, verbal consent before getting down to business. Any temporary awkwardness is better than misconstruing what your sexual partner wants at that moment, and communication is key to making your partner feel safe and comfortable. Context is crucial when getting in the right frame of mind to set the mood, so don’t be shy — ask what your partner wants! When both pleasure and desire are present for all parties, it’s a guaranteed great time.
I can’t remember a time I wasn’t interested in sex. As a child, I felt a sort of morbid curiosity towards it and I recognised it as the ‘ultimate sin’. The thing that would get me a ticket straight to hell. As time passed, my curiosity shifted. I was no longer scared, just intrigued and excited.
As a queer Nigerian woman, I know firsthand the level of defiance it takes to explore sexuality. Not only because of the misogyny I have to deal with but also because finding opportunities and people to explore with is an entire battle. I revelled in my defiance though and sex soon became one of my favourite things to do. Rough sex, slow sex, edging, bondage – I tried it all.
Then the pandemic happened and like so many others I had to adjust to a different reality that involved nosy and demanding family members. It wasn’t one I liked or wanted. It made me feel like life was being sucked out of my vagina. I didn’t think it was going to be so bad. Yes, I couldn’t be with any of my sexual partners but I had my fingers and I did a good job taking care of myself. But I soon realised that masturbating wasn’t going to be entirely possible.
I am a bit of a perfectionist with my orgasms. There were a couple of details that I needed to get right if I hoped to get one. The most important was noise; I cannot orgasm if I can hear people talking. But with a family of five quarantining together, it was impossible to find personal time. I didn’t realise when I went a month without an orgasm. It was so unlike me but I brushed it off because by then I had a bigger problem.
My mother had started going back into the office because we needed the money and every time she came home, she spent almost 30 minutes disinfecting. Her paranoia was contagious and I couldn’t help but mirror her anxiety. I was helping her to wipe down our doorknobs, restocking the hand sanitiser and pinching my brother’s ears every time he tried to play with the neighbour’s kid.
In between all this, I simply did not have the energy to touch myself. This was made worse by the fact that despite my family’s best efforts, we caught COVID. The entire experience was demoralising. We had tried to do everything right yet here I was, faced with the possibility that these could be the last moments I spent with my high-risk parents. I doubled my efforts at cleaning. My attitude towards hygiene became obsessive, unnecessary and draining.
COVID-19 led to a massive change in everyone’s lifestyle and our active avoidance of germs throughout the pandemic, though necessary, has undoubtedly left many of us feeling even more anxious about germs and contamination. Among those who are predisposed to anxiety, there’s been a recorded increase in obsessions and associated compulsions.
My libido, which had been very active before the pandemic, had disintegrated and I was desperate to have it back. I wanted to feel like I had some control over this bizarre situation so I forced myself to masturbate. My first orgasm in four months was toe-curling and I had a huge smile on my face as I came down from my high.
It felt good, really good, so my tears came as a surprise to me. Why was I crying? This was something I wanted, something I’d been praying for. But this terrible voice in my head kept asking if I’d washed my hands before I began. I knew I had but the thought had been planted and I struggled to uproot it. The shortness of breath came and in my panicked state I imagined my vagina rotting because I didn’t care enough not to get germs in her. I calmed down a few minutes later but the panic attack really scared me so I decided that I wouldn’t touch myself for a while. Of course that decision didn’t make me feel better.
“When we rely on avoidance to reduce our anxiety, we do not give ourselves a chance to learn that we can tolerate our anxiety. We also continue to believe that the things we are avoiding are unsafe in some way,” says Alissa Jerud, licensed clinical psychologist and host of the Anxiety Savvy Podcast. “Our habit of avoiding gets stronger each time we avoid. Over time, we may find ourselves avoiding more and more, thus fuelling our anxiety in the long run and causing our worlds to continue to shrink.”
It’s been a year since I made that decision not to touch myself and I’ve gone on to have numerous orgasms since then. They’ve all been self-inflicted and not nearly as satisfying. Things are still not the way they were and I doubt they ever will be. I haven’t had sex in approximately six months and I haven’t had good sex for even longer. The last time I tried, I bawled in my partner’s bathroom for an hour nonstop because: What if his penis was dirty? It was irrational, partly because we’d had a bath together, but it was enough to put me off sex. There’s nothing like a panic attack and a terrified man to kill your libido.
I’ve realised that I shouldn’t have an identity crisis because I couldn’t have sex for a while. Why did I feel like I needed to jump back into having sex right after lockdown eased? The obsession with ‘going back to normal’ wasn’t healthy and I needed to address that. I felt like a child again, taking baby steps and trying to relearn intimacy.
My hypersexuality told me that I needed to be the wild, sexual person I was before the pandemic. But I don’t have to be her anymore. I can be the girl who doesn’t remember how to kiss people or touch herself. The girl who’s trying to figure out if she still likes the stuff she used to like. I can have fun rediscovering myself – and I have been.
Sexual chemistry used to be (and still is) such an important part of my attraction to a person but I’ve realised that there are other forms of intimacy and I am focused on building those first. It was easy to forget that I exist outside of the virus and that all the decisions I make don’t need to revolve around it. As long as I’m being safe, I can kiss people without feeling like I’m betraying myself.
It’s impossible to tell how this will play out for me in the future but Alissa says that fear of germs has the potential to negatively impact the mental health and wellbeing of our society. “The avoidance that this fear pulls for could easily lead to an unravelling of the social connections that we are wired to create. The more we – as a society – allow these fears to shape our post-pandemic lives, the wider their ripples will be.”
It’s a little bit hard finding my groove and going back to having sex but I’m having fun while I relearn it. I’m not the same person I was pre-pandemic, and that’s fine.
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