No, not that F word.  I’m talking about fear.  We humans are also mammals, and fear powerfully affects mammals.  Emotionally, fear engenders a “fight, flight or freeze” response.  Physically, fear activates our adrenal glands to pump adrenalin into our blood, which triggers muscle response.  We either fight harder or run faster or freeze and tremble.

Fear also reduces blood flow to our genitals.  Males lose their ability to create or sustain full erections.  Women lose any engorgement in their vaginal area and clitoris and lose their ability to lubricate.  This loss of blood flow and engorgement response is coupled with a loss of libido, i.e., desire, feeling “horny”, wanting sex.  This loss of libido causes relationship problems for many couples.

What are we so afraid of?  Well, we are “communal” – we live in community with other humans as opposed to each of us trying to live far away from others.  Most of us have an inborn fear of being shunned, cast out, alone.  We pair-bond and form families; which has us fear that we will lose our partner, lose our family.  We have ego, pride, individual identity, so we fear humiliation and shaming, as well as feeling powerless over our circumstances – impotence.

To be human is to come face to face with fears and develop coping mechanisms – some conscious, some sub-conscious.  We learn to feel fear but not let it stop us and we learn to avoid situations that make us fearful.  Some fears we face and defeat – fear of the dark or fear of thunder.  Some fears haunt us for a lifetime – fear of being “not enough” or unlovable, fear of death.

In terms of sexuality and physical intimacy, if you are a man, the odds are that sooner or later you will either lose your erection during sex or fail to get an erection – erections require vascular flexibility, which decreases with age.  From then on, your fear of not being able to “perform”, fear that you are no longer fully “male”, will impact your sexuality.  The more fear, the more erection problems.  The more erection problems, the more fear.  The more fear and erection problems a man experiences, the less libidinous feelings.  And one day, there you are, in a sexless relationship.

For women, the odds are that sooner or later you will experience vaginal dryness or clitoral tenderness –mostly commonly as a result of ever-lowering levels of estrogen (and testosterone) in your bloodstream, which happens with age.  Penetration will feel uncomfortable, maybe even painful.  From then on, your fear of that pain or discomfort will compound the dryness and soreness.  The dryness and soreness will compound the fear.  The more discomfort a woman experiences, the less libidinous feelings.  And one day, there you are, in a sexless relationship.

For women undergoing treatment for cancer, that treatment most often includes a chemically induced “menopause”, a turning off of your estrogen production.  Estrogen triggers vaginal and clitoral engorgement, as well as lubrication, all of which supports libido.  No estrogen and soon you will experience vaginal dryness and/or clitoral tenderness.  Penetration will feel uncomfortable, maybe even painful.  The more discomfort a woman, the less libidinous feelings.  And one day, there you are, in a sexless relationship.

I was taking to women’s health expert Dr Jeanne Alexander (MD, Psychiatrist) about what can be done to get healthy sexuality back into a relationship and we agreed that there is no substitute for behavior.  When you want the physical intimacy back in your relationship, when you feel ready to gently begin to bring sexuality back into your connection, because of fear and physical discomfort, you are very likely NOT going feel libido – horniness, desire.   Even in the absence of that desire, schedule time for sexuality with your partner – make a date, then keep that date.  Men, let your desire lead the dance a bit – asking for touch and permission to touch.

Dr. Alexander also talked about the importance of using lubrication.  I meet too many women who feel shame that their genitals don’t self-lubricate anymore.  Sex without lubrication is painful, and as described above, that pain will destroy your natural desire.  Aging, the onset of menopause, cancer treatment, and fear all contribute to vaginal dryness, so please find a personal lubricant that feels good to you.

Women: not all lubes are designed with women’s health in mind, but many are.  Too many best selling lubes contain parabens, glycerin, silicon, and petrochemicals, all of which can actually contribute to long-term dryness!  I’ve done a little research and here are three companies making lubes specifically for women: System JO http://www.systemjo.com/public/products/jo-personal-lubricants/jo-women, Pink Lubricants http://pinklubricants.com/, Good Clean Love http://www.goodcleanlove.com/store/personal-lubricants.  And there are many others.  Men: do you really want petrochemicals on your penis?  I know I don’t.

Following the advice above, a great step towards physical intimacy is agree to “date night”, putting it on your calendar, and not breaking the date when you start to feel hesitancy or fear.  On date night, don’t just jump into bed and start “doing it”.  Romance each other.  Candlelit dinner?  Music? A Fox-trot?  Talk, flirt, laugh.  It’s OK to talk about your fear, your lack of “fire”, but don’t let that stop you.

Make sure the date includes getting naked and holding each other, perhaps massaging or caressing each other from head to toe? If you want to try some manual stimulation, have a bottle of lubricant open, nearby.  Make an agreement that no “performance is required – she doesn’t “need” to “feel sexy” or “ready”, he doesn’t “need” to get hard.  Just let your bodies remember how nice it feels to give and receive loving touch.  If you both agree to manual play, great!  Oral play, great! Intercourse, great!  If all you do is hold each other and caress each other and look into each other eyes and talk about your feelings, GREAT!  How much sweeter than laying lonely and apart in same bed, pining for love!

I know that it’s much easier to think or write about this than it is to actually make it happen.  But, as I said, there is no substitute for behavior, and there’s no time like the present, so go ahead and make that date.