September 27, 2003


There's a brilliant New Yorker cartoon of a middle-aged couple in bed, with the woman turning her back on the man. "I can understand a sexless marriage," she says. "But we're having an affair!"


Is it any wonder that droves of midlife women arrive in my office complaining about their lack of libido?


They have time on their hands now. Their kids are generally gone. They can easily fill their days with any of a thousand duties and pursuits -- and they do. Both they and their mates are too busy and too polite to mention that it has been a month -- or two or three.


Their sexual fire is barely an ember.


It was a sitcom that got me thinking about the lies we tell about sexual frequency, the truth we can't bear to share about the lack of sex that comes closer to the truth in the lives of most couples. I'm not referring to the waning of that first flush of heat or lust that has you wanting sex all the time with a new mate. I'm referring to the intervention of life and routine that siphons off our sexual charge until it simply stops.


On the TV comedy I saw, one befuddled character asked his buddy, who had young kids, "Like, how often are you having it now?"


"Oh, not like in the old days," came the reply. "We have to grab it when we can."


His friend persisted. "So how often? Two or three times a week?"


"Yeah, only about that."


Not likely, I thought.


I look after far too many families with new babies and couples who confess to having sex once or twice a year to believe the three-times-a-week routine any more.


One of my patients who recently spent a weekend at camp with other adult women as part of a fundraiser for breast cancer said that as the weekend wore on, a lot of tales about infrequency rolled out as participants skinny-dipped or sat by the campfire.


Others shared descriptions of the gizmos and tools that now ensure equal satisfaction for both partners. These women were in their 40s, and some were just starting their second major life relationship. For them, good sex wasn't just a matter of pride, but of necessity.


I assure my women patients who are past menopause that sex is a 90-10 proposition: 90 per cent is in your head, 10 per cent in your clitoris. I know post-menopausal women who are capable of an ejaculatory experience merely by thinking it through. For most of my patients, arousal is not the issue; time is.


Most midlife women are buried by busy-ness. It began with the babies and carried on as the toddlers climbed out of bed and wandered down the hall. It continued with PTA meetings, soccer practices and god-awful early-morning hockey games. The dwindling sex life wasn't about falling out of love. It was about falling into bed grateful for sleep.


So how to get back to the start-up sensuality that underpinned the affection and passion of the old days?


I have a prescriptive that I give my midlife patients who confess that they can take sex or leave it at this point in their lives.


I advise them to stop and remember the fire. Reigniting that heat isn't difficult, if I can persuade them to devote time and energy to the task. In some of my patients, I've seen the force of this passion rekindled as a result of an affair or a new love, if they find themselves free. And we all can name at least one friend or a mother who has been swept away with a newfound sexual charge that is both wondrous and embarrassing at the same time.


So here is my prescription: It's called Saturday Afternoon Intermezzo.


Remember seduction and the endless time spent fantasizing about where and how and for how long. It pays to slow your thinking about everything else, stop making lists and anticipate the time.


Code phrases such as "weekend away" and "times to ourselves" may not be sufficient for you or your mate's flagging spirit. Directness about wanting a dirty weekend or at least a dirty two hours may make a better point about the plan of action. And it must be single-purpose time. Clothes off. Phones off. Focus on. Believe it or not, one of the hardest temptations is to avoid drifting off into itemizing the weekend chores.


Book the date and the time, just as you would have done on the first date, when the meeting was merely the excuse for the romp. Don't leave it until nighttime (you'll be too tired), or after a big dinner out or any other random distracting event. Event management at this level requires all your attention and wakefulness: 2:30 p.m. is probably more appropriate.


Tell all friends, children and party organizers that you are not available. So please don't call, e-mail, or drop by.


Plan the music, the bath, the food (not a meal) well in advance.


Spend the time it takes to get yourself ready. Most women know by now what it takes to get in the mood, so do it. Some of my male patients confess that they can still muster the charge, but it takes so long they know the erection won't last. For my women patients, it's more an issue of staying aroused for the time it takes the husband to have his ejaculation, and so it becomes a big turnoff for both. This is where couples can spend some quality time in the sex shops looking over the tools and getting comfortable knowing that an entire industry exists for people just like them.


So what do you do when you're lying on the bed with your partner of 20 years? Well, try something shocking: Talk to each other.


Talk about slow arousal, no arousal, lame arousal. The more talk, the more chance there is for closeness, togetherness, craft, suggestion. At the very least, you have a chance of laughing at the folly of it all.


Some of my patients will arouse themselves alone first. Some do it as a part of the Viagra foreplay. Some will need an afternoon of foreplay. Others, a minute and a half of vibrator tune-up. Focus on the task at hand, literally.


Because, at this age, there is no allowance for passivity.

Dr. Jean



Doctor. Writer. Athlete.

Advocate. Adventurer.