Good Morning America

Good Morning America & the Two Dr. Bermans

Jan. 17 - Nearly half of all American women have problems with sex. But Dr. Jennifer Berman, a urologist, and her sister, Laura Berman, a sex therapist, say it's possible for women to take control and make some changes.

In many cases, female sexual problems have been dismissed as something that was just in their heads. Yet, according to a Journal of the American Medical Association study, 43 percent of American women suffer from some type of sexual dysfunction.

While male sexual concerns have resulted in extensive research and treatment by the medical community, female sexual dysfunction has been virtually ignored.

Dr. Jennifer Berman MD and a urologist, and her sister, Laura Berman, PhD and a sex therapist, have addressed these problems in a new book, For Women Only, in which they discuss the fact that most female sexual problems are rooted in both medical and emotional difficulties.

The sisters frequently appear on Good Morning America to talk about female sexuality, as part of GMA's "Personal Best," series and they will be taking questions to answer on the GMA Web page. They provide insightful and important answers to many of your questions about sex, relationships and the challenges of intimacy.

Dr. Jennifer Berman and Laura Berman are co-directors of the Female Sexual Medicine Center at UCLA Medical Center and of the The Network for Excellence in Women's Sexual Health NewShe.com Jennifer is a urologist with specialized training in Female Sexual Dysfunction; Laura earned her doctorate in Health Education and Therapy - specializing in human sexuality - at New York University. The Berman sisters are the former co-directors of the Women's Sexual Health Clinic at Boston University Medical Center.

Dr. Jennifer Berman, left, and her sister Laura Berman, a sex therapist, answer sex questions.

These two women have been instrumental in educating women as to what is "normal" ...extending our belief that many women feel alone. YOU ARE NOT ALONE! Browse through these sexual health expert's questions from people like you and me.

Discover how to have better, more meaningful sex on Berman & Berman: For W omen Only, each weeknight at 10 p.m. ET on the Discovery Health Channel.

Sex Problems Revealed
Dealing With the Issues

- January 17th

Sex-Hampering Health Problems

Health issues that cause erectile dysfunction in men, such as diabetes, high blood pressure, high cholesterol and various medications, can also lead to sexual dysfunction in women, the Bermans say.

Many women lose interest in sex at the onset of menopause, and many have sexual complaints on the heels of hysterectomy or surgery.

The top hurdle for women is low sex drive, experts say. And the lack of libido stems from an inability to reach orgasm, decreased vaginal and clitoral sensation or a lack of vaginal lubrication.

Emotional issues also have an effect on sex drive. "Often, the women will come in and say, 'You know, I'm having lack of interest, and my partner is extremely frustrated, and he's withdrawn, and I can't go and hold his hand any more because if I hold his hand, he thinks it's an invitation, and then I have to reject him again.' So the couple really pulls apart," says Laura Berman.

Laura Berman says the first step they take in therapy is to get the couple to talk about it. It's up to the person that's feeling uninterested to let their partner know they shouldn't feel badly about it. Instead, they should attempt to address the problem.

The couple should definitely make sure that the lack of desire isn't a signal of a medical problem. If it is medically-based, there are some new methods that may solve some the problem. If it turns out that the source of the problem is not medical, the couple should try to figure out what they could be doing to enhance sexual interest.

Women should never look to alcohol to increase to desire. Although it tends to release your inhibitions, it has a negative effect on arousal. "So you might be feeling more relaxed, but your body won't necessarily respond along the same lines. So we do not encourage, you know, drinking alcohol for issues of anxiety," says Dr. Jennifer Berman.

Finally, women shouldn't feel as if there's a certain amount of sex that people should have or a certain kind of sex that people should have. However, if a lack of desire or other sexual problems should be addressed if it's making the woman unhappy. The Berman sisters say they are solutions out there and women should find and work with a good therapist and medical doctor until they find a solution.

Sex Questions Answered

1. How can "getting your tubes tied" affect your sex life?

Theoretically, any surgery in the pelvic region could potentially affect your sex life because doctors still don't have an adequate understanding of the crucial nerves and blood vessels involved in a woman's sexual function, and the potential to damage them is always present. The Bermans are doing research to further identify these structures in order to create nerve-sparing pelvic surgeries for women, like those they have for men. Emotionally, the impact differs. Some women feel freer because they are less concerned about getting pregnant and can relax more. Other women may have trouble reconceptualizing their sexuality without connecting it to the potential to bear children, Dr. Laura Berman said.

2. What happens when you only feel sexual towards your mate when you've been drinking?

Alcohol often decreases inhibitions and makes it easier for some to relax into a sexual situation and thus respond better. But, ideally, a woman should be capable of responding as naturally and enthusiastically without the influence of alcohol. If she finds it extremely difficult to do this and always needs the help of alcohol in order to respond, she should likely look into what the alcohol is really masking.

3. What should you do when you and your partner disagree on how frequently you should make love?

It's a common, complicated complaint. When one person is suffering with a sexual function complaint, both are affected. A long-standing dissatisfaction with the sexual life of a couple can prompt them to withdraw form one another, and lead to communication and intimacy breakdowns, and a relationship crisis.

For instance, a woman may have low libido and will be avoiding sexual contact. Then, it snowballs.

Her partner feels rejected and angry and starts to withdraw from the relationship. The woman becomes angry and acts angry. She also avoids approaching her partner with any affection at all because she is worried that if she reaches for their hand they will think of it as a sexual invitation and she will have to reject again. So the relationship breaks down and they find themselves emotionally and physically isolated from one another.

We talk in our book a great deal about the couple's life, how to negotiate with your partner for your sexual needs, and at what point and where to get help if needed.

4. What happens when you stop feeling attracted to your mate, but still love and are committed to them?

Many people will talk about the difference between "loving" and "being in love with someone."

There are so many pieces to this. Are these feelings rooted in a long-standing lack of sexual intimacy and romance in the relationship (in which case you would focus on re-igniting the sexual life - from a mind body perspective - and working with the couple to make romance a priority).

Or is it because the couple has stopped communicating and growing together and have thus grown apart (in which case you would want to engage in couples therapy to work on reconnecting with one another). Is it because there is a misconception of what "committed love" really is?

We talk about this and the rest of it in the book. The difference between the infatuation stage of the relationship (when everything is really hot and intense and you can't stop thinking about or touching each other … no one can sustain that level cause we wouldn't get anything done!) and the attachment Stage (this is where every committed relationship goes, to a more stable, calmer, softer and committed place … not as intense as the infatuation stage, but can be much more emotionally and even physically fulfilling).

Some people who don't understand the difference feel like they might be falling out of love when the relationship moves from the infatuation to the attachment stage.

Others either can't emotionally tolerate the deeper intimacy of the attachment stage or they become so attached to the feelings of infatuation that they keep seeking it over and over and can't stay satisfied or connected to their partner once the infatuation stage ends. These are often the folks that move from brief relationship to brief relationship and never really commit.

- ABCNEWS.com

Treatment Methods for Sexual Dysfunctions
It Is Possible to Solve Many Sexual Problems

Dr. Jennifer Berman, a urologist, and her sister, Laura Berman, a sex therapist, are formerly co-directors of the Women's Sexual Health clinic at Boston University Medical Center, one of the first in the country to offer comprehensive treatment for women. They run The Network for Excellence in Women's Sexual Health (also called NEWSHE).Here are some treatment methods that are used for women's sexual dysfunctions.

A device called EROS-CTD, aimed at treating sexual dysfunction, was approved by the FDA last spring and has helped some women re-start their interest in sex. It is about the same size as a thimble, and when placed over the clitoris, it increases vaginal lubrication, clitoral and vaginal sensation, increasing the blood flow to the vaginal area so that women are able to achieve orgasm.

Viagra has been tested on women, but medical studies have been mixed. For a woman with physical or medical problems, such as a hysterectomy, she may benefit from medication alone, Dr. Jennifer Berman says.

Though some antidepressants make libido plummet, one drug, Wellbutrin, can actually increase arousal, researchers at Case Western Reserve University in Cleveland have found. After researchers gave it to 66 women who were not interested in sex, one third saw significant improvement after two months of use.

A combination of L-Arginine, an amino acid available over the counter in health food stores, and yohimbine, a powder made from the inner bark of the yohimbine tree in West Africa, is currently being tested as a treatment for female sexual arousal disorder in postmenopausal women. The initial results look promising, the Bermans say.

In their research, the Bermans found that women were lacking real and detailed information about the physiology of their sexuality: anatomy, the role of physiology in sexual dysfunction. Women are about 20 years behind men not only in terms of being fully acknowledged as sexual beings with sexual rights, but in terms of basic understanding of their sexual anatomy.

- ABCNEWS.com

Getting Your Groove Back
Overcoming Sexual Obstacles

- January 16th

Moderator at 2:00pm ET
Welcome to our chat with the Berman sisters! Dr. Jennifer Berman, a urologist, and her sister Laura Berman, a sex therapist, are co-authors of the new book, For Women Only.

Before we turn to questions from our audience, please tell us how you define "sexual dysfunction," as it applies to women?

Jennifer Berman at 2:01pm ET
Sexual dysfunction is defined in terms of the specific symptoms that the woman is experiencing. Thus, there are a variety of disorders that fall under the global term dysfunction. One is loss of libido, which means lack of interest in sexual activity, loss of sexual thoughts or fantasies, etc.

Another is sexual arousal disorder, which means decreased vaginal lubrication, or decreased genital sensation. There is also orgasmic disorder, which means difficulty or inability achieving orgasm.

And finally, women may experience sexual pain disorders which are related to pain with intercourse or other sexual activity. These include problems such as vestibulitis, in which pain and discomfort are caused by an inflammatory condition of the inner labia.

Moderator at 2:02pm ET
How does a woman's sexual response change during various stages of her life?

Laura Berman at 2:03pm ET
Certainly there are different components of a woman's life that change throughout her life cycle, depending not only on her age but also her social situation.

Adolescent women are facing a certain range of social and psychological struggles or challenges. Women in their childbearing years are dealing with pregnancy, both from a social and physical standpoint. As women age, they are dealing with hormonal changes and shifts, as well as changes in blood flow, along with the social and emotional aspects of aging in our society. For each stage, the symptoms may be similar, but the causes may actually be different.

There is a whole chapter dedicated to sexuality across the lifespan in our book, and lifestage-specific issues are something that we pay great attention to, both in the book and in our clinical work.

Aaron at 2:05pm ET
What percentage of sexual dysfunction in women would fall under the category of a psychological conditions, as opposed to physiological disorders?

Laura Berman at 2:07pm ET
The way that we experience women in our clinical setting - more often than not, there are emotional, relationship and physical factors affecting the problem simultaneously, all interacting with one another. Even if the woman has a medical problem, there are very real emotional or relationship outgrowths to that problem that need to be treated.

In the reverse, even when there are very real emotional components to the problem, there are often medical ones as well. It's very rarely just one or the other. And that's why we focus on treating the whole woman.

Moderator at 2:08pm ET
Katy Wade asks: "Is there any biological relationship between obesity and sexual dysfunction?"

Jennifer Berman at 2:09pm ET
There is a correlation between obesity and estrogen production. Obese people have higher estrogen levels, because estrogen is stored and converted in the fat cells.

There may be a relationship between obesity and sexual function but it is not primarily physiologic. If an obese person has high cholesterol levels, this may impact on blood flow, because cholesterol plaques can clog the pelvic arteries, preventing adequate blood flow to the genitals.

Laura Berman at 2:11pm ET
Just in terms of the emotional standpoint, and also a logistical one, if the woman is uncomfortable with the size and shape of her body, that can create problems in the bedroom, and with her response.

Also, if she has extra fat around her genital area, it can affect the direct stimulation of her genitals during sexual activity. She also may be limited in range of movement and the kind of sexual activity she can engage in.

Jennifer Berman at 2:13pm ET
In obese people there are higher levels of SHBG, which stands for Steroid Hormone Binding Globulin, a protein which binds to testosterone, making it less available to the body. Thus, obese women may experience low libido for this reason.

Sheria from 53.110.54.nwrk.grid.net at 2:13pm ET
I am taking Prozac which has further reduced my already low libido. Is there anything that can be done to counteract the lowered libido that results from the drug?

Laura Berman at 2:15pm ET
There is evidence that SSRIs (Prozac is part of that family of drugs) impact on sexual desire and sexual response. From the desire standpoint, at the moment there is not much that can be done if the woman's testosterone levels are where they should be.

From the standpoint of sexual response, there have been some studies that have been done which indicate that Viagra may counteract the negative sexual side-effects of SSRIs.

It is important to talk to your prescribing physician about these symptoms, because she or he may be able to work with you around either lowering the dosage or switching medications. Certainly, nothing should be done without a physician's supervision.

Lou Saunders at 2:16pm ET
Is Viagra effective for women and is it safe?

Jennifer Berman at 2:17pm ET
Viagra is not yet FDA-approved for use in women. However, there are ongoing studies in the United States evaluating its effects in women with arousal problems. There are smaller pilot studies that suggest at this time that Viagra improves arousal responses and orgasmic ability in post-menopausal women.

Shannon from tigffx.amsinc.com at 2:17pm ET
Can different birth control pills affect your libido (i.e.higher estrogen/ progesterone)?

Jennifer Berman at 2:19pm ET
Yes, combinations of different preparations of birth-control pills can impact on libido. The combinations with lower estrogen and higher progesterone tend to have less deleterious effects.

Dawn from proxy.aol.com at 2:19pm ET
What are some of the physiological reasons that would interfere with achieving an orgasm?

Jennifer Berman at 2:21pm ET
The most common reasons for new-onset orgasmic problems are injury to pelvic nerves during surgery (i.e., hysterectomy), a traumatic injury (i.e., pelvic fracture), or prolonged and difficult childbirth. Other physiologic factors that can influence orgasmic ability include genital blood flow, and hormonal levels. If there are decreases in genital blood flow or estrogen and testosterone levels, a woman may have increasing difficulty achieving orgasm.

Jackie at 2:22pm ET
How do you find the right GYN to help address all of the possible causes of low libido?

Laura Berman at 2:23pm ET
While GYNs are typically the gatekeepers to women's sexuality, they're not necessarily the only ones that can deal with woman's low libido or other sexual complaints. There are urologists, general practitioners, and nurse practitioners, all of whom are focused on women's sexual function complaints.

Jennifer Berman at 2:25pm ET
One of our goals at the Network for Excellence in Women's Sexual Health (www.NewShe.com), an organization that we created, is to provide information not only to women, but also to the health care professionals treating them, and to help women advocate for care with their doctors through supporting them and providing information to them. We are also creating a referral network so that women can find health care providers in their area who are willing and able to treat them.

Vicki from tnt19.chi5.da.uu.net at 2:26pm ET
What is the average number of times, in your practical experience treating people, that married couples engage in intercourse?

Laura Berman at 2:27pm ET
We really hesitate to state any one norm for frequency of sexual activity. In fact, neither an individual nor a couple is considered to have a problem in this area, unless it is something that is causing them personal distress.

There is no one correct number of times per week that a couple should be having sex. It only becomes a problem when one, or both, are dissatisfied with the situation.

Moderator at 2:27pm ET
Many women say they're too embarrassed to talk their doctors about sexual problems. Any advice on how to broach such a sensitive subject?

Laura Berman at 2:29pm ET
First, understand that your doctor is human also, and if they do react in an awkward way, it is only because they, too, are embarrassed, and not necessarily because they are judging you.

Two, admit that this is a hard subject for you to bring up, but that you feel that it's an important part of your life, and you're hoping that this trusted health care professional can assist you. This way, you are letting the doctor know that this is hard for you, and that you are putting your trust in her or him, and they will take your complaints more seriously.

Three, inform yourself as much as possible about the specific complaint. There is nothing wrong with bringing in articles, reports, our book, or any other information that you think is relevant, because this is a new area of study and treatment and some doctors' hesitancy to treat the problems may be rooted in their own lack of information and resources.

Finally, don't take "no" for an answer. If your doctor repeatedly brushes off your complaints, seek help elsewhere, or contact us and we'll do our best to help you.

Moderator at 2:30pm ET
Debbie writes: "I am wondering if you would address the problems of women who were sexually abused as children as they relate to their current sexuality. What advice do you give?"

Laura Berman at 2:33pm ET
First, we make a distinction between unresolved and resolved sexual abuse histories. The degree of the abuse, whom she told, the reactions she got when she told, and whether there was any counseling that took place, or any prosecution, all impact on how much resolution she has with this history.

If she is having any post-traumatic symptoms, (e.g., flashbacks, anxiety, either in general or in sexual situations, lack of arousal or response) then that is one sign that she may not yet have resolved this very painful history. Some women feel that their past really is behind them, and that they've done the work to resolve it.

We certainly don't feel that a sexual abuse history dooms one to sexual dysfunction. However, if a woman has not completely resolved this history, it can impact on her sexual interest, as well as her sexual response, even with a very loving and trusted partner.

Typically, these women report that they're not interested in sex, that they can't become aroused or reach orgasm with a partner, or sometimes even with themselves, or that they can become aroused but feel like they reach a brick wall and can't get past a certain point of arousal to a release. Counseling and therapy are wonderful resources in these situations.

Moderator at 2:35pm ET
Erik writes: "I just read about a treatment called EROS in the article on the Web site. Can you explain how this works?"

Jennifer Berman at 2:35pm ET
The EROS-CTD basically provides gentle vibratory suction to the clitoris and surrounding tissue. The woman controls the intensity and frequency of the suction, and the device gently pulls blood into the clitoris and surrounding tissue which, in turns, creates lubrication and increased sensation.

The woman would use this either prior to sexual activity, or perhaps in the beginning of a sexual encounter, either alone or with her partner.

Laura Berman at 2:37pm ET
There have been some small scale clinical trials which have indicated that this device is effective in enhancing the sexual response of women with sexual arousal complaints.

Soon there will be studies underway to determine if perhaps this device may have a therapeutic effect in that it will promote improved overall genital blood flow over time.

Vicki at 2:37pm ET
Doesn't it stand to reason that a woman's low/nonexistent libido could be at least partly due to her man's lack of stamina? In other words, if she doesn't get anything out of the whole three minutes of love making, why bother and frustrate oneself?

Laura Berman at 2:39pm ET
Absolutely. Sex is always a couples issue, and the partner plays a huge role in the woman's sexual response, not only in terms of that partner's willingness to stimulate her (as well as her willingness to direct him/her) but also in terms of the partner's sexual function.

If a male partner has difficulty achieving and/or maintaining erections, or he reaches ejaculation too soon for her to become adequately aroused, then these are very real issues that should be explored as part of the couple's treatment. They should be discussed within the couple.

Very often medical intervention as well as therapeutic intervention is helpful. If a woman is not having fun during a sexual experience, is not becoming aroused or reaching orgasm, and feels frustrated about this, or has pain during sexual activity, either due to dryness or some other cause, she's not going to be motivated to be sexual.

Lisa Czub from airstreamcomm.net at 2:40pm ET
I have menstrual migraines, three days prior, the day after, and then one week later, most l ikely due to estrogen fluctuations. Would this fluctuation also contribute to sexual dysfunction? I have a loss of orgasmic response to direct clitoral stimulation. It seems more prevalent at certain times of the month.

Jennifer Berman at 2:43pm ET
Fluctuations in hormones, as we mentioned earlier, can impact on sexual function response, as well as libido. You should be aware of these changes, as you obviously are, and consider using sexual aids such as lubricants, vibrators, and erotic videos to help enhance your sexual encounters during these periods.

Melissa from baltimore25.md.pub-ip.psi.net at 2:43pm ET
What treatments are available for women who cannot orgasm or have difficulty achieving orgasms?

Jennifer Berman at 2:44pm ET
There are no specific treatments at this time for orgasmic disorders. What exists are treatments for improving sexual arousal, i.e., Viagra, that help to improve orgasmic ability through enhancing the arousal response. Thus, increased lubrication, sensation in the genital area and engorgement of the genital area with blood usually help to improve orgasmic ability.

Laura Berman at 2:47pm ET
Furthermore, there are lots of things that the woman, or the couple, can do beyond medical treatments to enhance her ability to be orgasmic. First, she should explore her own body through self stimulation, either manually or with a vibrator, so that she can fully understand her own arousal process, and learn to have an orgasm by herself in order to teach her partner. Second, she could educate her partner on ways to stimulate her, particularly in the genital area. And there are also several sexual positions that will provide more direct stimulation to her clitoris and or G-spot. We discuss all of this in our book. Particularly in the "How To" chapter, because it's a very common question for women.

Jayne at 2:48pm ET
Any information for women who have really lost all interest in sex. Where do we go or what do we do to help get that feeling back?

Laura Berman at 2:52pm ET
It's important to ask yourself what you think may be the cause. More often than not, women have a sense of whether they feel like it's something physiological and/or emotional or relationship-based.

Then cover all your bases in seeking out the cause of the problem. Make sure your testosterone levels are where they should be (this can be done through a simple blood test). Make sure your arousal is where you want it to be, and if you have any emotional issues (either present or historical), or any relationship conflicts that may be creating a lack of sexual interest in you, then it is important to seek help.

Prior to seeking help, make sure that you are not putting too much pressure on yourself, or that someone else isn't putting pressure on you. There are a lot of expectations put on women who are balancing career, family, and relationship expectations, and sometimes we're just too exhausted to be sexual!

Regardless, if you do want to seek help, talk to your doctor or your therapist. We have started a clinic at UCLA Medical Center in L.A., the Female Sexual Medicine Center (FSM Center), and the number is 310-825-0025. Women can come to us for comprehensive evaluation and treatment, or they can log on to www.NewShe.com for help and support around seeking help with their own health care providers.

Moderator at 2:52pm ET
Our thanks to the Berman sisters for participating in this live event!

For more information, or to contact the Berman sisters, visit NewShe.com.

- ABCNEWS.com

Hassled by Hormones
Young Woman Stuggles With Menopausal Symptoms

By Jennifer Berman

L O S A N G E L E S, April 25 - In this week's column, sexual-health experts Laura and Jennifer Berman hear from a 32-year-old woman who struggled with menopausal symptoms before discovering her level of estradiol could not be detected.

Question:
For approximately one year, I have struggled with menopausal symptoms. After much lab work, referrals to endocrinologist, and now an OB/GYN, it was discovered that my estradiol level [one of the three estrogens found in the female body] was undetectable.

The GYN took me off of oral contraceptives, and my estradiol level shot from 29 to 166. She has me going another month without oral contraceptives, and will do a recheck. I'm having trouble understanding what's normal for a 32 year-old, and am not sure what to do next. The GYN is stumped as well.

Now, a girlfriend, age 36, has the same problem. Her OB/GYN put her on oral contraceptives with a higher level of estrogen - the opposite treatment as my OB/GYN!

We're confused about what's best. The doctors' opinions conflict. Any advice?

- Confused in Olathe, Kan.

Answer:
Oral contraceptives definitely lower both estrogen and testosterone levels. Normal estrogen levels in premenopausal women, not on birth control pills, fluctuate with the menstrual cycle. Normal estrogen levels can range from 20-200 pg/ml, depending on what phase of the cycle she is in.

If you were experiencing symptoms of low libido or vaginal dryness, it is good that your doctor took you off the pill. It is also reasonable to change the pill to either a lower or higher estrogen concentration, depending upon your symptoms. There is no blanket answer to this. Each case needs to be taken on an individual basis.

- ABCNEWS.com

Dwindling Delight
First-Time Mom Misses Old Orgasms

By Jennifer Berman

L O S A N G E L E S, April 11 - This week's column, sexual-health experts Laura and Jennifer Berman hear from a 30-year-old woman who is having difficulty finding the same satisfaction during sex as she did before giving birth.

Question:
Help! I had just had a baby not too long ago, and I am finding that I am unable to have an orgasm like I used to. Could there be a problem?

- Grieving in Atlanta

Answer:
Depending on how long ago you delivered your baby, there are medical and psychological factors that could be causing your problem. You need to discuss this with your doctor.

The first 6 months following childbirth, and even longer if you are breast-feeding, are a time where sexual changes can arise. If the problem persists for greater than 6 months to 1 year following your delivery, there may be a medical problem.

Nerve damage, hormonal abnormalities, and stretching of your vagina and support structures of vagina (muscles and ligaments) can all impact on sexual function and your ability to achieve orgasm. These things should be evaluated.

Good luck! Let us know if you need resources in your area.

- ABCNEWS.com

Cheating Hearts
Getting Beyond the Broken Bond

By Laura Berman

L O S A N G E L E S, June 15 - In this week's column, sexual-health expert Laura Berman offers advice on infidelity. The question: What do I do if my spouse is cheating?

This is a tough question, mostly because there are so many variables involved.

Is this a suspicion or a fact?
If it is a fact, how did you find out?
Have you confronted your partner yet?

Is your partner committed to working this out and want to stay in the relationship? The main issue is that infidelity typically causes tremendous stress in a relationship, but it does not necessarily doom the relationship to failure. How you move on through this both as an individual and as a part of a couple will determine the outcome.

Infidelity brings up a range of feelings in partners; guilt, anger shame remorse, despair, rejection, anxiety, fear, loss and vulnerability. It is important to remember that if you have just discovered your partner's infidelity it is going to take a while to work through how you are really feeling about it and where you want to go from here.

Take your time, think carefully, and don't make any life decisions until you have had a chance to digest all of this. Meanwhile, most importantly, it is vital to get the support of a trained couple's therapist who can help you work through this, whatever the outcome.

- ABCNEWS.com

Sex Drive Discoveries
Survey Says Couples Try and Overcome Obstacles

The experts say communication is key when it comes to sex drive. Couples need to talk about what they want out of their sex life.

- August 23rd

What if he wants sex all the time and she never wants it? Or what do you do if you both want it but at different times?

Well, you can find some peace in knowing that you're not alone. A study conducted by the Journal of the American Medical Association shows as many as 43 percent of women and 31 percent of men say they feel some type of sexual dissatisfaction.

It's often the result of low sex drive or conflicting desires with their partners. However, the results of Good Morning America's online sex drive ballot shows that couples are still having a lot of sex, even with all that stands in their way.

Sex therapist Dr. Laura Berman and her sister, urologist Dr. Jennifer Berman say the results are not surprising. The co-directors of the Women's Sexual Health Center at Boston University say couples may say they're having sex, even if they're not completely happy with their sex life.

Read the results of our online ballot and read what the Bermans have to say about taking control of our own sex drive.

Online Sex Drive Ballots

Which one of the following factors is most responsible for decreasing sex drive?

Long work hours: 34%
Relationship problems: 32%
Body image problems: 16%
Parenting pressures: 13%
Money problems: 5%

How often do you have sex with your partner?

Two to three times a week: 37%
Once every few weeks: 23%
Once a week: 16%
Daily: 12%
Rarely or never: 12%

Dr. Laura Berman says:
Many women ask their doctors, if there's something wrong with them if they have lowered sex drive. She says that sexuality is a couple's issue. In other words one can't just look at a woman or man as isolated entities. That's why sexual communication and negotiation with a partner is so important, but it should take place away from the "hot potato" location of the bedroom. The conversation shouldn't come up just before one partner wants sex and the other doesn't.

She gives several tips for dealing diminished sex drive. First she suggests couples share the workload at home. That includes getting as much help as you can afford to have. It's important that busy moms know that don't have to be Superwoman. Dr. Laura says that if they attend to their relationships they'll be doing their kids a huge service.

She also stresses taking your own time out while your partner (or a babysitter) watches the kids. You can go for a walk, exercise, read, nap, take a bath. This will make you feel good about yourself, your body, and even your sexual needs. Don't forget to take time as a couple too.

If the sexual desire in your relationship is not equal, let your partner know your desires. Many couples find a way to meet each other half way. In other words you need to talk about your needs, wants and problems with one another to improve your sex life.

Dr. Jennifer Berman says:
There are many reasons why one's libido may be low. They range from physical to emotional. You should first deal with the physical. Check with a doctor to make sure your hormonal levels are where they should be. You shouldn't always assume your problem is one with the relationship.

If the problem does turn out to be a physical one, there are various steps you can take. You may need to switch one of your prescription medications to another. This often occurs with anti-depressants that affect sex drive.

Getting Behind the Wheel

Show your partner support in non-sexual ways. Bring home dinner when they're exhausted for example.
Keep the non-sexual contact going. Cuddles, hugs, kisses, touches, hand holding don't always have to lead to sex but do lead to feelings of intimacy, which almost always inspire sexual feelings.
Surprise your partner in a romantic way Plan a getaway, even a picnic one afternoon. And make a bath for your partner with candles and music.
Have date nights. At least once a week, a night should be etched in stone for just for the two of you. No talk about diapers or homework is allowed.
Make privacy a priority Set boundaries around your private space that the kids and everyone else knows is off limits. Couples with kids often worry they'll be thinking mom and dad are being sexual. But no matter what they think, they'll know their parents make each other a priority and that's great lesson to pass onto them.

- ABCNEWS.com

Sex After the Split
Intimacy Isn't Easy After Divorce

Dr. Laura Berman spoke to Good Morning America, about dating after divorce, pointing out, for example that the rules may have changed since some people's last dating experience.

- October 23rd

After a divorce, the thought of dating again and having a sexual relationship with someone new can be scary and difficult.

For some people, it's like being in high school, starting all over again. But while you may be swept away by a new romance, there are some down-to-earth issues to grapple with.

How do you introduce your children to a new man? And how do you deal with the issue of safe sex, when both you and the person you are seeing have just gotten out of a marriage?

Dr. Laura Berman spoke to Good Morning America about this issue, pointing out, for example that the rules may have changed since some people's last dating experience.

For instance, those who married in their early 20s, and are now in their late 30s and early 40s, did not become sexual in the AIDS era, so they may have some new skills and vocabulary to learn.

"Sex is a risk...it is important to feel safe with that person, to feel a degree of intimacy, " Berman said. If there is any doubt, don't do it, she said.

Emotional Roller Coaster
Experts say that the prospect of new sexual relationships bring emotions related to your break-up to the forefront. Unresolved hurt or anger can affect your sexuality and your ability to get involved in a fulfilling relationship.

If you are not far enough along in the healing process, post-divorce sex can make you feel worse. On the other hand, if you are further along on the healing curve, it can be a loving and satisfying experience. Generally, therapists say it takes about one to two years to heal after a divorce, and to be ready for a relationship again.

Some women avoid sexual contact since rejection has a negative impact on their self-image. If they have been dumped by their spouse, there can be feelings of low self-esteem, or personal failure and abandonment. This can impact how you feel about your sexual attractiveness, and the way you interact with people of the opposite sex.

Some therapists recommend setting goals to help define the new you. Another way to get out of the slump is exercise, such as a brisk, 45-minute walk, to chase away depression and help you feel emotionally grounded.

Wear clothes that give you a lift, perhaps something with a bright color. And dwell on the positive aspects of being single.

Getting Back into a Relationship
For other women, divorce may prompt them to jump into a sexual relationship right away to regain a sense of power. But experts warn that jumping in too soon may provide temporary fulfillment, but could lead to hating yourself the next morning.

For those who have been married, wearing condoms may not have been an issue, but upon re-entering the dating game, the newly divorced need to know about the dangers of unprotected sex.

"Ideally, it should be talked about ahead of time, before you are in the bedroom," Berman said.

A person cannot tell whether someone has a sexually transmitted disease by just looking at them, so remember to practice safe sex. Whatever you do, experts say that there should be a good feeling, and a sense of rightness in a new relationship.

Sex is one of the most intimate acts that can be shared between two people, and divorce can lead to a loss of trust, faith and idealism. In order to get into a positive relationship, you must have a positive sense of self, therapists say.

Relationships and Your Children
After a divorce, children often wish their parents would get back together, and it is difficult to introduce anyone new to them.

Berman recommends not bringing anyone into the children's lives unelss it is someone you are going to have a firm commitment to. If the child becomes attached to the person, it would be difficult for he or she to suffer yet another loss in their lives.

Do not let your children decide whether you see someone or not, but respect their feelings. They may feel frightened or angry at the prospect of you having a new mate, but allow them to talk about these feelings, experts say.

If you get to the point where you are going to remarry, waiting to do so allows children the chance to get used to it. Children should understand that its OK to like the new person, even if they are still angry about the divorce.

- ABCNEWS.com

Too Close for Comfort
When Intimacy Puts Out the Fire

By Laura Berman

L O S A N G E L E S, March 26 - This week's question comes from a 30-year-old woman who can't hold on to her sexual attraction once there is an emotional attachment.

Question:
I seem to have a problem combining sexuality and love. I am extremely attracted to men during brief encounters - for sex only.

When I actually get to know someone and really care about them, I end up not being sexually attracted to them. It's like I am sexually fulfilled by one man - and then by another for emotional fulfillment and companionship. How can I change this?

- Worried in Memphis

Answer:
There is no easy fix for this sort of problem. The key is in finding out the root(s) of the problem, which are likely not to be medical ones. It could potentially be that the novelty of a new relationship compensates for some physiological issue that is causing the low libido, but that is not as common.

Typically, women who complain that their libido drastically decreases once they are in a secure relationship are struggling with many different issues. In other words; the low libido is an expression of a much deeper issue or fear.

For instance, are you struggling with feeling vulnerable to your partner, scared around issues of trust and really diving into the relationship so you are holding a piece back? Are you not attracted now that your partner is so committed to you because part of you feels that if he could be so interested in you there must be something wrong with him? Are you afraid of getting to attached or too dependent? Some of these questions may be striking a chord, but there are many others.

If this really is a recurring problem for which you want help, our advice would be to seek the help of a trained general therapist who can help you work through the potential emotional or relationship bases for your complaints. The good news is that you are aware of the pattern and how it affects the intimacy in your life and clear that you want to change it. The next step is to get help.

- ABCNEWS.com

A Lonely Climax
Intimacy Doesn't Equal Satisfaction

This week's question comes from a 23-year-old woman who can't achieve an orgasm when having sex with her boyfriend.

Question:
I saw your column on the Web and was very interested in your advice. I have not been able to speak with a doctor or any of my friends due to being embarrassed. It concerns sexual intercourse and orgasms. I have been with the same man for over three years now and I have not been able to have an orgasm with him. I know that I can have one because I can do it to myself, but this concerns me. We have tried everything from different positions to toys, etc. Is it mental or physical? I have not ever been able to have one with man. Though, it is no problem for me to do it to myself. Please help!

- Confused in Chicago

Answer:
Thank you for your question. I know it is hard for you to determine if your problem is mental or physical or both, and it is even harder for us, because we know so little about you or your history!

I can say that if you are able to have an orgasm with self-stimulation but not with your partner, it is likely that one of several things are happening. First, it may be possible that there is something going on in your own mind (and heart) in relation to your partner that is impacting on your ability to relax into or enjoy the sexual situation as much as you'd like to. You may be feeling anxious, you may be harboring some anger or resentment toward him or you may not feel completely safe with him.

Those Old Feelings
Also, it may be that there is something from your past that is still in your mind somewhere. When you are in a sexual situation with a partner, those old feelings come up (e.g. history of unresolved abuse/trauma, past pains or sorrow in relation to a past partner, etc.) If you have never had an orgasm with any partner, this latter issue is likely to be an important one to look at in individual therapy. If it is only this partner that you are having difficulty with, you may want to consider a consultation with a couples sex therapist to rule out the need for further education or relationship work.

Now that's the emotional/relationship side, on the physical side, there may be something affecting your genital sensation so that you need the extra stimulation of a vibrator in order to become aroused fully.

Physical Factors
Have you tried using a vibrator with your partner? If that works, then you may want to be evaluated for blood flow, hormone levels, and genital sensation levels to make sure that you are physiologically where you should be. I would also suggest taking the quiz in the back of our book, For Women Only that helps you identify some initial red flags for medical causes (see NewShe.com for more information). If you are still struggling with either finding answers or getting help, please let us know and we will try to help you further. Best of Luck.

- ABCNEWS.com

Don't forget...you can tune in every weeknight...

Discover how to have better, more meaningful sex on Berman & Berman: For Women Only, each weeknight at 10 p.m. ET on the Discovery Health Channel.

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