Ask the Sexpert: Part Two

Today we continue our two-part “Ask the Sexpert” series with Dr. Erin Ross, a licensed marriage and family therapist who specializes in sex therapy at the Institute for Couple and Family Enhancement in San Antonio.

In today’s post, Erin tackles some of our best advice-related questions. Click here to read our earlier “Ask the Sexpert” post, which focuses on questions with concrete, factual answers.[hr]

Ask the Sexpert

1). My husband’s performance has diminished with age, and it’s starting to become a problem. How can I address the possibility of erectile dysfunction issues without wounding his ego?

Erectile dysfunction (ED) occurs when a man is unable to sustain an erection sufficient for sexual intercourse. ED is also something that can affect any man at any age. In recent studies, researchers have found that it is increasingly being found in younger men (under 40) and at higher severities (Capogrosso, et al., 2013). Therefore, it is not completely uncommon that women our age will need to have this conversation with their partners. There are new techniques that can be used, different positions, and of course, communication about physical health and eating habits that should be addressed.

While you might be worried about his ego, denying a problem or ignoring is much worse. If you have noticed a problem, than he most definitely has too. Being able to communicate about his worries, fears, and concerns in a non-judgmental, safe environment is helpful not only to the ED, but also to your sexual relationship. Take some time out of your day, separate from a sexual experience, and discuss your concerns. When looking to try new positions or add new dimensions to your sex life as a means to increase satisfaction, seeking therapeutic advice is always helpful. However, first and foremost, encourage your husband to make an appointment with his primary care physician and/or a specialist to rule out any significant physical health problems.

2). I want to tell my husband what I want in the bedroom, but whenever the opportunity strikes, I clam up and feel too embarrassed. Any advice for women who are too embarrassed/shy to confront their partner about what they want sexually?

First off, good for you for knowing what you want! You are already ahead of the crowd. Second, think about how you normally communicate with your partner and figure out what type of communication works best for you. Do you talk things out? Are you a more effective communicator via notes or emails? Begin the conversation in a manner that works for you…but finish it in person. This means if you normally discuss uncomfortable topics in writing, shoot him an email or text to let him know you have some things on your mind you would like to discuss that evening after the kids are asleep. If you have a hard time using the necessary language, write it down. Make a list of your needs, desires, and concerns. You can physically hand the list to him and let him know you’ve spent time thinking about it. I always tell clients to vocalize the importance of their lists or notes. For example, “Our sex life is important to me. I love you and want us to enjoy each other. Here is a list of things I have been thinking about lately, and it is extremely important to me that you read it and know these things about me. I am nervous but feel it is important to share them with you.” Obviously that serves as an example, but the key elements are that you: (1) start with a positive comment; (2) describe what you have written; and (3) explain that you are sharing with him because you care about your relationship.

And lastly, don’t do it during sex or when you’ve been drinking. Wine might give you an extra dose of courage at first, but your head will be foggier and you may not communicate as effectively. Treat this conversation as importantly as it deserves.

3). My husband always falls asleep right afterward, while I am sometimes ready for Round Two. Is there a biological reason why sex often energizes women but wears out men?

Not only is this common, it’s not personal! There is an actual physiological reason behind a man nodding off after sex. In most cases, it is a combination of two things: physical exertion during sex and a chemical release of prolactin, oxytocin, and vasopressin (along with several others). The result is a very sleepy and/or relaxed husband. Men who have difficulty performing soon after ejaculation usually have higher levels of prolactin, which can cause drowsiness but is also related to sexual satisfaction. Therefore, your husband may feel less need to continue once his body is satisfied. Oxytocin is related to emotional relaxation and is often known as a “love hormone.” It works to promote a perception of relational connectedness that calms our stress levels. And finally, vasopressin works to constrict blood vessels and relax the brain after sex. Together, they make quite a tranquil potion.

An increase in energy after sex may be your particular experience, but it is not necessarily felt across the board for females. However, paired with a much less intense refractory period, women do seem to place more emphasis on what happens after sex. In fact, women are often offended or hurt by their male partner’s post-coital sleepiness. Cuddling, talking, and emotional engagement are common expectations for women. This goes back to the general stereotypes of women using sex for emotional connectedness and men using it for physical pleasure. Is that always the case? Of course not! However, general stereotypes are just that—not created to classify everyone or every sexual experience. However, they can be formed based on significant research findings that serve to create them.

4). My husband is often too wrapped up in work to think about sex. What do you do when your sex drive is not in-sync with your spouse’s? Does it matter whether it’s the woman wanting it more often than the man?

Sexual desire ebbs and flows for all human beings, regardless of sex, gender, age, or ethnicity. The one thing you can always count on is that your sexual desire is rarely perfectly in-sync with your partner’s. That’s OK; it just makes us work harder at a sexually satisfying relationship. Respecting your and your partner’s desire level is important. You do this through communicating your observations and feelings: “I can tell you’re really involved at work lately. Let me know how I can help. I miss you and your touch.” While that may seem direct, you are observing his work habits, respecting his need for time, and also letting him know how you feel. Even if a spouse is busy or not in the mood, it is always nice to know you are missed and loved.

It makes no difference if it is the man or woman wanting sex more—the fact that you notice a difference is the only factor. Sometimes it is cause for concern (if it has been long enough to be affecting your relational and/or sexual satisfaction OR if you have communicated your concern without any response or respect for your feelings). However, many times it can just be a waiting game. Our jobs, kids, and daily stress can stunt sexual desire very easily. Stay on top of your sexual needs, just like anything else, and recognize a difference is natural. And remember, while you wait, you can always pleasure yourself.

5). Any tips to help survivors of sexual assault, rape, etc. resume a healthy sex life?

Sexual trauma of any kind is incredibly violating and can be damaging to one’s sense of self, safety, and desire. Due to the personal nature of such an experience, treatment varies greatly based on the individual. However, there are many opportunities for survivors to seek help in resuming a healthy sex life. It absolutely CAN happen. Often the first step is recognizing the impairment it might have on your life (e.g., inability to form or maintain close relationships, negative body image, post-traumatic stress, etc.). Recognizing this can help the individual or therapist decide the best route to recovery. This is by far the most difficult area to seek therapy for, due to the private nature of the matter. However, seeking therapeutic help to recover from a sexual trauma is important. There are many specific treatment programs, support groups, and experienced therapists in the San Antonio area who are able and more than willing to help guide this process.

6). How can I get in the mood when I’m really tired, emotionally stressed, etc.? Any tips to help moms feel sexier and/or understand how to make the mental shift to “lover” after being “Mom” all day?

First, let me say that if you are really tired and/or emotionally stressed, take the night off! Allow yourself to just be tired. Wearing the mommy hat all day long makes for a longer night when you feel the pressure of trying to perform sexually in a non-sexual environment. So, before you decide to try to feel sexier and get in the mood, make sure you really want to.

Now, once you’ve established that sex with your husband would be nice, set the stage. Getting into the mood is all about self-care. What makes you feel good? Not sexually, but in general. For me, it’s a warm cup of decaf coffee, a hot shower, and about 15 minutes to slowly get ready for bed (I’d love 30, but who are we kidding?!). It doesn’t happen often, but when it does it transforms me into my best “self” before bed. What makes you your best “self?” This is critical to feeling good. Plus, it’s a great time to transition between putting the kids to sleep and becoming a lover.

Figure out what works for you and practice it. Your favorite face scrub? Putting on some music? Cleaning up the house? (We all know how sexy a clean house can be!) In all honesty, though, self-care, just like a good sexual experience, is all about trial and error. Find out what works for you and DO IT, because regardless of what it is, the most important step is taking time to allow for transition before sex. Many mommies don’t do this simply because of time—but time is of the essence here. Make it work for you.

7). What are some things I can do to spice up my sex life? Is watching pornography with my spouse as a warm-up a positive or negative thing?

Spicing up your sex life always starts with a single question: what is currently missing from your sex life? I have my clients go through what isn’t working long before we start working on adding spice. Many times vanilla sex becomes boring because we get into a sexual rut of doing just what “works” or what is fastest (which often simply means physical satisfaction for both—or maybe just one—of you). But, that may not be working in terms of achieving emotional connection and high levels of sexual satisfaction. If you feel the “spark” is gone, ask yourself what ignited the spark when it was present. More involved foreplay? Music and candles? Significant touch and massage? All of these things tend to take a back seat as parents.

Pornography is a sexual option that is completely personal preference and often a hot topic in therapy. Is it wrong to watch pornography with your partner as a means of foreplay? Absolutely not…if both of you enjoy it and choose to watch it. However, it can be severely damaging to the sexual experience and your connection to your partner if only one partner is into it. Discuss this issue with your partner prior to attempting to add it to your sexual menu. If it is considered, there is also a need to discuss what types of pornography are acceptable. Respecting your partner’s interests and disinterests is the number one sexiest part of a good partner.

8). Our attitude toward sex has changed since we’ve struggled with fertility issues. Any advice on how to overcome the mental barriers we now have with sex?

Fertility is a strange bird because it takes an experience that is supposed to natural, unplanned, and sexual and turns it into a scheduled, planned, and unsexy business meeting. Struggling to maintain a healthy sexual relationship is one of the biggest complaints during this journey. However, it can be done.

One of the greatest gifts you can give your sexual relationship during this time is to remember that being sexual isn’t just about having sex. In fact, at times it can be sexier to not have sex. Instead of trying to make sexual intercourse something it’s not right now, recognize the pressure you both feel and opt for different sexually charging behaviors. Suggest a naked partner massage, a shared bubble bath, or mutual oral stimulation. These things can be enjoyed separate from the pressure of getting pregnant, and you never know…they can always lead to more along the way!

And lastly, this is a hot ticket issue for any relationship—so if you and your partner are struggling with the stress and demands of fertility treatment, get some help! Therapy is an excellent way to work through some of the relational stress of this taxing time.[hr]

Dr. Erin Ross
Dr. Erin Ross

Erin is a licensed Marriage and Family Therapist who, following the completion of her undergraduate and graduate degrees, earned her Doctorate in Philosophy in Marriage and Family Therapy from Texas Tech in 2010. She is a member of the clinical faculty at the Institute for Couple and Family Enhancement here in San Antonio.

In addition to holding board positions with the American Association for Marriage and Family Therapy and the Texas Association for Marriage and Family Therapy as well as serving as an elected officer of the San Antonio Association of Marriage and Family Therapy, she has presented at state and national professional conferences in the areas of sex therapy, gender issues, and relational communication. Erin enjoys working with individuals, couples, and families struggling with communication problems, sex/gender and intimacy issues, premarital counseling, marital conflict, general relationship enhancement, and family adjustment/transitions.

Erin and her husband have been married for five years and have two children who fill their lives (and calendar) with joy. You can learn more about her approach to therapy on her personal website:


Taylor is a San Antonio native and stay-at-home mom to two daughters: eight-year-old Harper and one-year-old Hayes. She and her Okie husband, Jeff, have been married 12 years despite their Texas/OU rivalry. Taylor is a former Clark Cougar, a devout Texas Longhorn, where she studied English, an active MOPS member, and often feels like a professional juggler. She relishes trips to the theater, loves embarking on new adventures with her family, and admittedly spends too much time on Facebook. A former contributor, Taylor’s posts center on parenting her tenacious, strong-willed first-born and the challenges she faced along the way to becoming a mom of two. She now serves as ACMB’s editor and resident proofreader, and as such, cares way too deeply about the use of Oxford commas.