More reasons romance sputters
Lack of sleep
It's ironic that you can't have one without the other, since both sex and sleep are activities that take place in bed but not at the same time. But when a stressed-out life interferes with either partner's ability to get a good night's sleep, sex seems to leave the room.
"Lack of sleep or a disrupted sleep-wake cycle causes mood problems, makes you irritable, makes you less patient -- and it's bound to cause friction in a relationship," says Ken Robbins, a clinical professor of psychiatry at the University of Wisconsin.
Common situations leading to a sex-sleep imbalance: a workaholic partner; someone with chronic insomnia; or a partner who spends nights as well as days caring for a baby, a sick child, or an elderly relative.
Solutions: Temporary sleep disturbances affect every household. But when the situation goes on and on, it's important to find creative ways to protect solid zzz's. (Aim for seven to nine hours a night, says the National Sleep Foundation.) For example, in the case of a live-in relative with a sleep-disruptive ailment (such as Alzheimer's disease), look into respite care such as adult daycare services, which can help make the person more tired by nighttime. There are even night respite programs, or -- if you can afford it -- you may need to hire a night-shift nursing aide.
Don't just write off crummy sleep to lifestyle issues. A sleep disorder specialist or an otolaryngologist (ear, nose, and throat doctor) can evaluate you for physical problems, such as sleep apnea or upper airway resistance syndrome (UARS).
Funky menopausal glitches
"Looks like you have lichen sclerosus," Annie's doctor informed her. Annie panicked. She was expecting him to write off her painful intercourse and swan diving sex life to "the change," not to multiple sclerosis?! In fact, the two diseases have absolutely no connection, although their similar names cause people to mix them up. Lichen sclerosus is a fairly common inflammatory skin disorder of the vulva. For unknown reasons, it often strikes around age 50. And that means it also gets mixed up with menopause.
"Menopause itself is not a bad thing that messes up women's sex lives," says Stewart, who also directs the Harvard-Vanguard Vulvovaginal Specialty Service in greater Boston. "But there are some vulvar problems that peak at this time and that, left untreated, can cause sexual problems."
Lichen sclerosus, for example, often causes itching and, if there are tiny cracks in the skin at the vaginal opening, burning during intercourse. Plain old urinary tract infections can also rise around menopause, thanks to prolapse (a sagging bladder or uterus) or falling estrogen that changes the vagina's acid balance.
Solutions: Don't write off bothersome symptoms as natural consequences of the calendar. If something feels wrong, it probably is wrong -- and it can probably get fixed. (Lichen sclerosus, for example, can be treated with a topical steroid cream.)
Sexologists say there's sexual truth to the adage that you're not just getting older, you're getting better -- at least if you avoid the sand traps.
