A gynecologist’s two cents about sex….

Sex is complicated! Heterosexual sex is even more complicated…

Male and female genders encounter the same four distinct phases of their sexual cycle (As described by Masters and Johnson) but sadly we do not go through them together – even more concerning is that there is a disconnect between men and women as to which phase is most important. A woman passes from desire (libido), to arousal (excitement), to orgasm (climax) and then resolution ( what I like to call the “aftergame.”) While many will not transcend through each phase in this particular order, most do. Most women will attest to the first and last being most important and most men will assume the arousal and orgasm as their most important phases…so what do we do?

I wish I had a dollar for each woman that asks me about her libido, often experienced as, “hey Doc, my libido is down since I had a child” or “menopause has killed my libido,” or even “my partner always wants it but I just don’t and I don’t know what to do.”

In my experience, one of the first questions I ask these women is do they masturbate? If the answer is yes, there is NOTHING wrong with their libido. The desire is there, but the attunement with their partner isn’t. First children (I have three) are the wet blankets on the fire of sex. The exhaustion, the neediness, the insecurity about altered bodies does not help the situation. How can breasts be a sexual organ after we use them as a tool to feed our young? How can the vagina feel the same after it has been stretched to allow for birth? Factor in stress and hormone changes.

Men often describe women as complicated (and we are.) We may be incredibly turned on but simply not having our new hairstyle noticed will slam the sex window shut. Luckily for women when the window is open, a man simply needs the wind to blow in his direction for his desire stage to move right into arousal.

My advice to women is like the Nike slogan –Just do it!  For when you do, it makes you feel sexier, more desirable and overall younger. If you don’t use it, you lose it sisters!

Where I can help as a medical provider (I am not a sex therapist) is with arousal and orgasm. These stages have “cures” when in trouble. We have all heard of the little blue pill Viagra and Erectile Dysfunction (ED) medications that assist in blood flow to the penis. I administer O-shots and Priapus shots at my Medical Spa, Elite Aesthetics in Needham, Massachusetts, which require a simple blood draw in the office. While numbing the penis or vagina topically, I isolate a patient’s blood products’ platelets or fibrin and inject him or her pain free. This allows for more sensitivity and blood flow to the respective organs and allows for more lubrication, harder erections and better orgasms. It is approximately a 45-minute visit and almost always ends in my receiving messages with water, eggplant and thank you emojis.

One couple in their 60s recently attested “we are literally having sex like teenagers again after 35 years of marriage.”

Different generations describe dating, orgasms and the sexual cycle in a variety of ways. Most men over 40 are reluctant to take Viagra as it is a dig on their masculinity while those in their 20s and 30s are happy to try it to see if it will make sex better. I have a divorced friend in his early 50s who shared with me that once he started dating  again, he realized that beyond some necessary manscaping, he needed to get some ED meds to kick it up a notch, even though he did not have ED issues.

I want to make mention of a woman’s last and final stage “the after game.”  How many men get up and “clean up” after their orgasm? How many women want to kiss, touch and connect post sex? Women are still in a phase of sex. Yes men, even though you have climaxed, women are still having sex. Wouldn’t this make women want it more if she knew her partner would remain to cuddle? Staying present allows a woman to rebuild her lost libido. Maybe the next time the wind blows, she would be more likely to respond.

So that is my two cents about sex and while I do offer modalities to improve orgasm (The O-shot, Priapus Shot) improve lubrication (Viveve Radio Frequency and the O-Shot) and reduce atrophy and tighten the vagina while reducing Stress Urinary Incontinence (Viveve Radio Frequency),  I cannot offer a cure for Men Are from Mars and Women Are from Venus.

All we can do is keep trying to connect.

Dr. Joelle Lieman

Dr. Joelle Lieman is Board Certified in the practice of Obstetrics and Gynecology and has practiced in the greater Boston area for over 15 years. Her unique perspective on the effects of aging on the skin and body led Dr. Lieman to the specialized field of aesthetics a decade ago, and has allowed her to achieve certification by the Academy of Aesthetic Medicine. She has since performed thousands of procedures, utilizing her clinical experience and surgical skills to produce “natural” results that gracefully roll back the hands of time without looking artificial. Her state-of-the-art, non surgical treatments include: skin rejuvenation techniques, injectable solutions to reduce the signs of aging by relaxing muscles and fine lines, CoolSculpting (non-invasive technology to reduce unwanted fat) and Ultherapy for lifting and tightening the face and body. Dr. Lieman’s approach is thorough, meticulous, caring and unintimidating.

In January 2016, Dr. Lieman realized her vision of opening a unique, specialized luxury Medspa — Elite Aesthetics, where she and her staff of highly trained, exacting professionals provide a personalized and reassuring approach to aesthetic medicine by using the most sophisticated, cutting edge technologies and advanced medical grade skin care products and techniques. Through a prescribed customized plan, Dr. Lieman enhances the best version of each patient, helping to bring out their best features and feel their most confident. Our top-rated services include CoolSculpting, Ultherapy and other skin rejuvenation treatments near Boston MA.