I am on vacation for another week. But I've invited Dr. Lori Brotto to handle the Savage Love Letters of the Day. Dr. Lori Brotto is a clinical psychologist and sex researcher at the University of British Columbia in Vancouver. You can follow her on twitter @DrLoriBrotto, take part in her studies here and hear her chat about cultivating sexual satisfaction here. Dr. Brotto will be answering your questions all week.

My husband and I have been together for 15 years. Married for 10. I love him to bits. When we started out our sex was the best in that I felt secure and free to explore. But as with most relationships, I guess, my libido waned over time. This is a problem. Over the years we've tried stuff like porn which worked sometimes but mostly made me feel like taking a shower. Twice we tried an open relationship but the feelings around it got so messy and painful for both of us we dropped it. I tried to enroll in a study for testing on a women's Viagra pill but didn't make the cut because of sexual abuse as a child. Oh yeah, that probably doesn't help my libido. Nor the Carrie-like Catholic upbringing. But anyway, I'm really at a loss for what to do. Suggestions?

Loss of Wow

Dr. Brotto's response after the jump...

Dear LOW,

Yours is the most common complaint sex therapists hear in their offices – from women AND men. As relationships become longer, boredom sets in. What used to be exciting and novel is now about as riveting as doing your taxes. And there have been countless large studies that show about 1/3 of women, across ages, will complain of low or totally zilch desire for sex over the past year. Now it is important to know that only a fraction of those are bothered enough to seek help for their waning libidos. Sex researchers and therapists have been fascinated by this phenomenon of declining desire and many argue that we should not be paying too much attention to waning “out of the blue” horniness, especially for those in longer term relationships. Instead, experts are more intrigued by another kind of sexual desire: the type that responds to triggers, and we know that there is much we can do to cultivate this type of triggered desire. If you think back to the start of your relationship, those triggers were new, so you could feel horny even just thinking about sex with your partner, or smelling his used gym clothes. But like any good thing, novelty dwindles, fantasy drops, his gym clothes start to stink, and if you are not exploring other ways to rekindle your fading flame, then your motivation for sex as you’ve been having it all these years will trail off. You mention not feeling “secure and free to explore”. This is something I hear often in my clinical practice, in that you may fear how your partner will respond if you suggest something new like sex in the dining room or using toys. For some, this anxiety prevents them from ever exploring the vast range and ways to be sexual and feel pleasure. In most cases, I’ve seen a partner relieved when the other person suggests they probe new ways of being probed.

So lets look at some of the ways you’ve tried. You mention trying porn but then needing a shower (and I’m assuming this was not a hot seductive shower, but rather a need to clean away the pornographic toxins). Pornography is a massive enterprise, with a retail value in the USA alone of about $10 billion. The range in pornography is massive, and I might argue that you may not have found the type that lights your erotic fire—yet. Many women (though certainly not all, according to Ogas and Gaddam’s 2011 book “A Billion Wicked Thoughts”) prefer erotica, such as that in the beautiful cinematography of Erika Lust’s erotic films. Research shows that while your genitals may light up like the Fourth of July regardless of the kind of explicit film you watch, your emotional reactions and feelings of sexual arousal are likely to be higher with films in the erotica genre. I sometimes suggest to clients that they watch an erotic film on their own, and then notice carefully how their bodies respond as they get wet and become aroused. Doing this can make you more aware of emerging pleasure as you are with your partner. I also often encourage people to play with vibrators (maybe first alone as a means of tuning into pleasure as it unfolds) and then with a partner. Take a trip to your local sex shop and browse the hardware with your partner. Or, surprise him one day by blindfolding him then turning the vibrator on his neck then slowly moving downwards. The specific type of tool (porn film, vibe, lube, leash, etc.) is less relevant than the novelty, excitement, mystery, and potential danger it elicits, and this is what will flare that dimming erotic flame.

Don't hold your breath for a “female Viagra” to be available anytime soon. Remember that Viagra acts by increasing blood flow to the genitals in someone who already knows how to get mentally turned on. Viagra will not make you crave sex any more than it will leave you with a headache (approximately 10% of Viagra users have headache as a side effect); plus, Viagra is not approved for women by the Food and Drug Administration (FDA). And while there have been countless other medications (and billions of dollars spent) tested for improving women’s sexual desire, none have passed the strict safety standards of the FDA while also showing impressive effectiveness. Newer medications are being tested that affect the brain’s response to sexual triggers, which takes us back to what I’ve already mentioned regarding variety in sexual techniques and props and locations and times of day, et cetera.

I’ll mention a quick word about sexual abuse, only because you seem to raise an eyebrow about whether that may be the root of your sexual woes. Research shows that women with a history of sexual abuse as a child are about 1.7 times more likely to have sexual arousal problems as an adult than women without an abuse history. Research from the University of Vermont shows that a sexual abuse history may distract someone from the present moment, so that you may not be fully experiencing the pleasure of sexual arousal as it is emerging. I spend much of my time with clients teaching them meditation skills, and have shown mindfulness to be a powerful way of fully “being” with sexual sensations, and that these skills can intensify (and even elicit!) sexual desire and arousal. I hear stories of people making their shopping lists, preparing for job interviews, and solving other dilemmas in their minds during sex, rather than riding the pleasure train. Try meditation if you can relate to this.

My bottom line: rather than fretting over why you’ve lost desire for sex, I’d be more curious about why you’ve lost desire for the sex you are having. With novelty, our brains respond differently than when we expect and experience the same “tap-tap-screw-sleep” sequence that entraps many long-term couples.