Greetings!

Spring is a time of change. But really, change is with us always. Even the art on your favorite box of cereal has changed, hasn't it? So why would you expect everything to stay the same in the bedroom, too?

Couples complain of boredom, that's nothing new, either. What many couples may not understand is that as they develop or as they age, their sexual wants and needs may change. How to adapt to change in the bedroom is the topic of this month's feature article. If you have any questions or comment, feel free to contact us.

A final note on change: We've already updated the website at thebuehleri nstitute.com. It has a lighter, brighter look and everything works the way it's supposed to. The blog is undergoing changes, too, but it should be up and running in a week or so.

Things are easy in the beginning, people tell me. But when I ask them to reflect, they agree that they actually put a lot of conscious thought into their love-making. They made plans to do special things that would lead up to sex. They wore clean new clothing, they scented themselves, they bought wine, they popped corks.

Maybe what they mean is that the physicality of the relationship was easy. Every touch was novel, every kiss a new experience. Every moment was filled with tension. Passion and bliss were almost guaranteed. That changes, doesn?t it? Sex becomes an effort. Darn.

Over time, the realization sets in that sex is going to be like every other part of a human relationship. It is going to have to be discussed, negotiated, and adjusted. Change, it seems, is inevitable.

Why is it so difficult to talk about one?s changing needs when it comes to sex? Are we afraid a partner will be hurt? Or won?t listen? Are we not permitted to discuss our needs? Are we afraid we will look a little perverted if we want to bring up a need for sexual change?

Change isn?t all bad. If you communicate your desire, if you let your partner know what you want, it is an opportunity for intimacy. Do you need more stimulation? Do you want a more relaxed approach? Is a different night of the week or time of day better now? Is there an ache or pain somewhere that makes your usual position impossible? Say. Speak. Mention. And ask your partner in turn if there is something else wanted or needed. How wonderful is this, that there is, perhaps, only one person with whom you share your sexual wants and needs.

One of the effects is that women may seek Intrinsa by mail through Canadian pharmacies, because once Europe approves a medication Canada soon follows suit. Another is that women may ask American doctors for testosterone, which has been prescribed ?off label? for years. Finally, if women can?t find a doctor to prescribe it, and is afraid to purchase it from Canada, they may resort to purchasing a supplement like yohimbe, taken from the bark of an African tree and believed to increase desire.

What I also learned?actually, what I already know?is that testosterone and desire are poorly correlated. That is, there are plenty of women who have almost zippo testosterone but have wonderful sex, and plenty of women with high testosterone who have almost zippo desire.

What does that mean? If desire has waned, don?t rule out the possibility that you need a boost from testosterone. But don?t expect it to be a magical cure. It generally isn?t. Desire is very complex. Sometimes it takes 6-10 sessions of therapy just to try to figure out what is holding someone back from wanting sex with a partner whom they love. And it isn?t because I?m a lousy therapist, or the person is resisting figuring it out!

Hormones regulate our bodies and affect our emotional state, but they don?t necessarily rule it. Our minds, our hearts, and our relationships are more complex than anything that can be explained by chemicals, at least at this point in time.

As for the debate, my partner Dr. James Simon, a reproductive endocrinologist from Washington, D.C. and I won. You didn?t think I?d write an article about this if I?d lost, did you?

Dr. Buehler has been quoted on the topic of sexuality in Tango, an online publication, on narcissism in the bedroom; the Erickson Tribune in Maryland on seniors and sex; Military Spouse on relationships between mothers and daughters-in-law when a soldier is deployed; and Kimberly-Clark?s Poise Magazine regarding how to talk to your spouse about delicate medical problems. She will also be quoted online regarding pornography and the workplace--in Danish! When the link arrives, we'll put it in the next newsletter.

Christine Seeberger, M.A. was selected to present a poster session on sexual pain disorders at the upcoming American Psychological Association convention in San Francisco this summer. Ms. Seeberger is a therapist at the institute and a doctoral student at Azusa Pacific University.