Sexuality & fertility

Sexology 101 — ignite your sex life with advice from an expert

by Marcelle Pick, OB/GYN NP and guest author Barbara Carrellas, noted sex educator and facilitator

• Changes in libido
• What is ecstasy?
• It’s OK to masturbate
• Many ways to reach orgasm

Welcome to Sexology 101 — our ongoing article series devoted to sexual health. Our goal is to provide answers to your questions with information about libido, masturbation, partner issues, orgasm, and more. Women to Women celebrates the idea that satisfying sexual activity can be an integral, health-enhancing element of every woman’s life at every age.

SPECIAL NOTE FROM WOMEN TO WOMEN: the following article is an honest discussion about women’s sexual health that includes adult themes and vocabulary. If you would rather choose an alternate topic, please explore our other women's health articles.

When I was a girl moving with my family from Australia to the United States, I fretted about America’s wild and uninhibited reputation with respect to sex. But now, years later as a healthcare practitioner, I spend many hours helping women in this country reclaim and honor their sexual selves.

I see many women struggling to overcome their preconceived, cultural notions about sex, and it seems clear that our society still doesn’t promote the idea that sex is normal and healthy for women and girls. And we certainly aren’t taught that it can be a fun, creative aspect of total wellness!

So I had a conversation with my friend and colleague, Barbara Carrellas, a sex expert and facilitator. Through her workshops, lectures, and coaching, Barbara encourages women to set off on their own “life-changing adventures in the infinite realms of sex and spirit.”

Changes in libido — remind yourself what you love about sex.

Too many patients tell me their sex lives are nonexistent, or that their libidos are long lost. Worse, some say they have no hope — or desire — of rediscovering the joy, satisfaction, and stress relief that sexual activity provides. A woman in perimenopause or menopause may say to me, “I used to be interested in sex. But my libido has gone somewhere.”

Many women say they used to love sex and that for years, it had been a major part of their lives — something they looked forward to, and saved the time and energy for. But now they couldn’t care less if they’re touched at all. They have absolutely no sex drive, and ask me, “Is it my hormones? Is it testosterone or reduced estrogen? What? Something is different — what’s wrong with me?” Let’s hear how Barbara answers that question:

Barbara Carrellas: Marcelle, I’ve started asking (these women) a new question: “Why did you have sex? What did you like about it? What was the big pay-off?”

And their answers tell me what the reward was in sex, what the yum was about it. People say at first, “Oh, well, you know, like everybody.” When I say, “Yeah, what is that?” They answer, “Well... you know.” Finally, they might say, “I do it because I like the intimate connection with the partner.” That’s one answer. Some people thought it brought them home to themselves, and grounded them. Other people did it for the adventurous feeling of it. Some people loved sex because they felt it connected them with God, or “the infinite.” Others liked sex because it made them feel ego-less. So there are all these different answers as to why people had sex.

Barbara’s Best Ideas: Pump up the volume on sensuality

Make a sensual or erotic date with yourself — to help open up to new erotic possibilities. It can be a very powerful way to jumpstart a sensual awakening because as we know, energy follows thought:

• Buy a wonderful, exotic meal for one. Focus totally on the food, savoring each morsel — no reading a book or talking on the phone while you eat.
• Go see an exhibit of erotic photos or buy a great book of erotic stories. Slow down and take your time absorbing the content.
• Take a walk in a beautiful natural location that inspires you and triggers multiple senses.
• Take a long, sensual, scented bath by candlelight. Don’t rush even one moment in your “sensual sanctuary.”

Once I know the reasons why somebody had sex, I can get deeper and say, “Okay, then, if that’s such a big pay-off, why do you think you might not be wanting it now?” And that opens up a whole new avenue of questioning, and you get a lot more information about what else is going on in their lives, about how their bodies feel, about what their relationships are like, about whatever has changed.

Defining ecstasy

For some women I see at the clinic, hormonal fluctuation is partly to blame for their lowered libido. But something else often shifts in menopause, and it’s not just hormones. Women may think, “This is just what menopause is like,” or “Once you’re in your 60’s you never have sex anymore anyway.” Their desire seems to have just vanished. Barbara, how do we guide women who have absolutely no desire for sex?

BC: For some women, I find that I need to give them permission to say “no” because otherwise they feel broken and not normal. But then I ask, “Well, is it a problem for anyone else around you? Is there somebody around you who’s pressuring you for sex?” Because then we have to look at that dynamic in the relationship.

But if a woman says, “I just can’t find a turn-on anywhere — not with a flashlight, not with a magnifying glass — nothing! What do I do?” I say, “Well, let’s put sex and orgasm in the realm of ecstatic experience.” The human body–mind–spirit craves ecstatic experience. Ecstatic doesn’t just mean, “Oh, wow, that feels greeeaaat!” Ecstatic means having a cathartic, earth-shattering, dissolving-the-self kind of big feeling to it, and can be a combination of all sorts of emotional and physical release and expression.

Sometimes I ask, “Well, is there any ecstatic expression somewhere in your life?” And someone might say, “Well, I used to love to dance.” Now we’re getting somewhere; we’re getting to a body-based thing — a way in. “What kind of dance did you like to do? Could you do more of that?”

Rediscovering your “sensual identity”

For the women I see who have lost the connection to their physical and, especially their sexual selves, the trip back to sexual awareness may be very hard to map. I find that they simply don’t know where to start. Here’s what Barbara suggests:

BC: My goal is to bring people back to their bodies in a way that is yummy for them, and start to reconnect. I’m trying to reconnect their ecstatic pathways, specifically physical ones. Some people can get there spiritually. If they can find a place of ecstasy somewhere in their lives, it will often wake up the system, and sex becomes a logical extension of the desire for the ecstatic experience.

Dr. Mona Lisa Schulz (behavioral neuroscientist and medical intuitive) says that in the temporal lobe of the brain, emotions, sexuality, spirituality, and intuition are all connected. So when we light up that area of the brain for one purpose, we frequently turn on one for another. And people say, “Well, I wish I could connect my spirituality with my sexuality with my emotions with my intuition.” But they’re already connected!

It’s really the fact that we have been told by society to keep them all separate. One of the reasons people stop having sex is that is so limiting in our culture. For a married couple, it’s essentially: penis + vagina, with a little oral sex thrown in or a little 1-2-3 erogenous zone warm-up. It’s boring!

In my travels, I often study informally the cultural differences between women in America and those in other countries. I am struck by the obvious sensuality with which women in certain other cultures move through their days, even as they shop or cook or just walk down the street. This sensuality is what I try to awaken in my patients, and although the two aren’t the same, I know it can help spark new interest in sex.

BC: That is so true. My book, Luxurious Loving, is based on the senses for just that reason. Deconstructing sex helps us to see all of its components, and then we can then decide which parts turn us on. For instance, some people really love touch. Other people would rather be surrounded by beautiful aromas — the sense of smell really does it for them. Others are more visual.

To help people connect with their sensual selves I ask, “What sense seems to be the hottest for you?” And once I find that out, we make a list of ways to erotically fulfill that sense. I love the book The Artist’s Way, by Julia Cameron. If you replace the word “artist” in Julia’s book with “erotic” or “sensual,” you have a great manual for the senses.

The erotic impulse does go to sleep if we don’t use it, or if we’re bored. I like waking up both the erotic mind and the erotic body, and the good news is, with little bit of an effort to become more sexual, sensual, or erotic, the body wakes up and responds.

Saying yes to masturbation

In most circumstances, masturbation can be a wonderful — and exceptionally safe — way to reawaken your sexuality, whether you have a partner or not. When I first bring the topic up with some patients — in particular, my older patients — they’re shocked and worried about the whole notion of masturbation. “Is it okay?” “What does it say about me, if I do masturbate...?”

Barbara and I agree that just letting women be shocked by the idea for awhile can actually be helpful. Because just thinking about it helps them get used to the word and the concept itself. So when we talk a little more about masturbation and its health benefits — both emotional and physical — most women will hear me out. Once you understand that masturbation is completely normal, that it allows you to experiment and explore, and that it can be totally private, it sets the stage for developing a new sexuality, one that fits who you are now. Barbara agrees:

BC: I advise people to develop a really strong “self-loving” practice. If having good self-esteem is great, then why isn’t loving yourself physically great? That’s how I find out what a woman’s objection or negative thought is to masturbation. It helps to know that other people your age do it, too, and that sales of vibrators and sex toys to the older population are high. You’re not alone.

The fact that we don’t talk to each other about sex is a big part of the problem. We don’t know how to find out more about sex because we never learned that subject in school. We are like pre-K around sex.

Many people think masturbation is for people who don’t have partners or that it’s “wrong.” But I think self-loving is (a divine) gift to all of us. And if you don’t know how to be sensual or sexual with yourself, how do you expect to be good at it with another person? Masturbation helps you make the connection between your sexuality and your heart — often this link is broken, damaged, or weak. So just try it. I think you’ll like it.

(If you’re curious, take our masturbation survey.)

If you don’t have a partner

When I write about sex or talk about it to my patients, I often hear from women who tell me that their libidos are just fine — it’s the partner that’s missing! Masturbation is part of the answer for these women, but with a few special instructions from Barbara:

BC: For a woman who doesn’t have a partner, I suggest that she master the art of self-loving. I use this wonderful exercise I learned years ago from author and sex expert Margo Woods:

Masturbate almost ‘til you orgasm, but not quite. Bring that energy up to your heart, and then — just be with it. When the energy starts to dissipate, masturbate again almost to orgasm, and just before you’re going to orgasm, bring the energy up to your heart again. Do it again for a third time but this time let yourself orgasm. Now the energy will shoot up to your heart and it is such a lovely feeling of reconnection, it sometimes helps people get over their embarrassment, their reticence, or their judgments about self-loving. It works.

The big “O” — wonderful and thrilling but sometimes elusive

Over the years at Women to Women, we as practitioners have shared all the cultural and personal changes that women have experienced as sexual beings across their lifespan. One of the recurring themes is “orgasm” — how to achieve it and whether it is an essential element to our sexual identities. Barbara shares her unique perspective on orgasm:

BC: I think a lot of women who haven’t had genital orgasms believe on some level that it’s never going to happen, so it never happens. We need to look at orgasm as a much bigger event. It’s not just a release of tension and a feel-good that happens when clitorises or penises are stimulated. For me, an orgasm is an expansion of energy that’s flowing through the entire body, mind, and leading us to spirit.

I believe in “emotion-gasms.” When somebody says she hasn’t had an orgasm, I say, ’Okay, I hear you. You haven’t had a genital orgasm. But have you ever laughed so hard that the laugh was ’doing you’ to the point where you wondered if you were going to get your next breath? You didn’t even remember what you were laughing about, you were just laughing?” And people go, “Yeah! Yeah!” And I say, “Okay, how did you feel after that?” “Oh, well, like, totally wasted and giddy,” and I say, “Well, that’s kind of the feeling you get after an orgasm. So, let’s call that a giggle-gasm. You’ve had one of those.”

If you take orgasm apart as if it were a layer cake, you find out that the ingredients are not just genital stimulation, or even erogenous zone stimulation. It’s breath. It is squeezes of the entire pelvic floor. It’s the brain, and imagination of what’s going on and where the energy is moving. It’s sound. It’s movement. All those things make up an orgasmic experience. You can even have an orgasm without [the] clitoris or penis being involved.

Reinventing your approach to have better sex and much, much more fun

There is a common perception that as you get older, the goal of peak sexual experience becomes less important. Barbara and I have both seen in the women we’ve worked with that intimate encounters during midlife — and beyond — can become the most spectacular chapters of a woman’s sex life. Barbara explains how you can create a new vision for your own sexual experiences:

BC: I subscribe to [the] Jack Morin theory in his book, The Erotic Mind. It’s about finding the right balance of safety and risk — or you can use the word adventure... something a little dangerous. Because if I tell people, “Go home and try sensual massage,” there’s no risk! There’s no danger! It’s not exciting! So part of my goal is to find the edge, find the new risk.

By the time we’re 50 or 60 years old, we’ve seen a lot. It’s hard to find something that’s “whoopee!” or challenging and exciting — especially around sex. That’s because sex also brings up fear: “Oh my, I couldn’t do that. That’s too scary.” Or, “My husband would hate that.” Or, “That’s too weird. My friends might find out.”

That’s not the kind of risk I’m talking about. I’m talking about the kind of risk that’s like, “Oooh! That sounds dangerous!” in a good way, or “Oooh, that’s kind of a turn-on....” For example, you could ask your partner, “Do you have any fantasies that would be fun to try out?” And just see what your partner says. You don’t have to play them all out but just hearing each others’ fantasies can be a big turn-on.

You want progress — not perfect!

Getting in touch with your own sensuality and sexuality can — and should — be a satisfying, joyful set of experiences. It’s a journey, and thank goodness there’s some practice and experimentation involved! Barbara and I are dedicated to helping women learn to first talk comfortably about sex. Then know that it’s safe to explore, and to find out what you like, what fits your style and feels right to you. That’s the very beginning of creating a new sexuality for yourself — one that can light up your body, mind, and spirit!

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Last Modified Date: 04/19/2011
Principal Author: Marcelle Pick, OB/GYN NP