Women's sexual health: Talking about your sexual needs

A healthy sex life can help you feel good, both physically and emotionally. But everyone's experience with sex is different. There are many ways people think about and approach sex. Communicating openly and honestly about sex can go a long way toward having a satisfying sex life. Although talking about sex isn't always easy, it's a topic well worth addressing.

It's common to think that wanting sex physically is what starts sexual activity, leading to arousal and orgasm. But some women find that other things are more important for them. Different factors may help women feel aroused and spur them to want sex, and other factors may lessen desire.

For example, sometimes women may not start thinking about sex mainly due to physical desire. Some women might want to have sex to feel close to another person, to share feelings or for other reasons. This approach to sex tends to be more common in women who are in the period of time leading up to menopause, called perimenopause, and those who have gone through menopause.

Sexual satisfaction differs for everyone. Many things can affect how you respond to sex. That may include your health, how you feel about yourself, how you feel about your partner, your religious and cultural upbringing, and any relationship issues you may have.

If you have concerns about your sex life or if you'd like to find ways to make it better, a good first step could be talking with your partner.

It might not be easy to talk about what you want to get out of sex. But sharing your thoughts and expectations with your partner might help you both get more pleasure from sex.

To get started:

• Set a time limit. A long talk about sex, especially the first time you discuss it, can be overwhelming. To get comfortable with the topic, try starting with a 15-minute conversation.
• Talk regularly. Sex isn't a one-and-done topic. Keep the conversation going over time. You may find that the more you talk about sex, the easier it becomes. And your confidence and comfort likely will grow the more you talk.
• Use a book or movie. Invite your partner to read a book about sexual health, or find chapters or sections of a book that cover your questions and concerns. You also might use a movie scene as a starting point for a conversation.

When you're talking about your sexual needs, try to be specific. Here are some topics that you may want to cover:

• Time. Are you setting aside enough time for sex? If not, how might you change things? How can you make sex a priority? Think about how you and your partner can support each other to help create time and energy for sex.
• Romance. What does romance mean to you? Do you feel that you'd like more romance in your life? If so, how can you make that happen? Talk about the role you believe romance has in your sex life.
• Pleasure. What do you like? Knowing what gives you and your partner enjoyment can enhance sex for both of you. If one of you is not comfortable with the other's preferences, try to come up with compromises. But be honest about any sexual activities you don't want to do.
• Routine. Has sex become too predictable? What changes might you make? For example, explore different times to have sex or try new techniques. Cuddling, a sensual massage, self-stimulation, oral sex or using a vibrator may be ways to make sex more fun.
• Emotional intimacy. Sex is more than a physical act. It's also a chance to have an emotional connection, and that can build closeness in a relationship. Try not to pressure each other when it comes to specific sexual acts or reaching orgasm. Enjoy touching, kissing, and feeling physically and emotionally close.
• Physical and emotional changes. Are physical changes, such as an illness, weight gain, changes after surgery or hormonal changes affecting your sex life? Are emotional concerns, such as stress or depression, making sex less appealing? Talk about these changes and think about ways you may be able to manage them.
• Your relationship. Talk about any challenges you may have within your relationship that might be getting in the way of good sex. Discuss ways that you could deal with them.
• Beliefs. Talk about your beliefs and expectations around sex. Think about whether misconceptions, such as the idea that women become less sexual after menopause, are affecting your sex life.

Sexual desire and sexual needs vary. Many things can affect a person's interest in sex, such as stress, illness, aging, family, career and social commitments. Whatever the cause, differences in sexual desire between partners can sometimes lead to feelings of isolation, frustration, rejection or resentment.

It's important to talk about:

• Intimacy needs. Intimacy typically involves more than just what a person wants from sex. Intimacy also may include emotional, spiritual, physical and recreational needs. If those needs aren't being met, you might be less interested in sex. Think about what you and your partner could do to improve intimacy throughout your life. Talk about it openly and honestly. Be willing to listen to each other's point of view.
• Differences in desire. People often have different levels of interest in sex at different times. Talk about those differences. Try to explore options that will satisfy both of you.

If you take medicine that could affect your desire for sex, talk with your healthcare professional. Ask whether there might be a different medicine you could try instead.

If a physical symptom such as vaginal dryness or pain makes it hard to enjoy sex, treatment often is available. Talk with your healthcare professional about your options. For example, a lubricant or medicine may help with vaginal dryness, pain with sex and other symptoms that can happen due to the hormone changes of perimenopause and menopause.

If you have worries about sex that you can't solve on your own, a healthcare professional or therapist who specializes in sex can be a valuable resource to help you work through those concerns.