Happy, relaxed, Sexually Empowered middle-aged woman on a bed.

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Emily Jamea, Ph.D., is a sex therapist, USA Today Best-Selling author and podcast host. You can find her here each month to share her latest thoughts about sex.

We all remember that scene in When Harry Met Sally, right? Why do you think women have gotten so good at faking orgasms? Because women’s sexual pleasure has been second to men’s for centuries, if not millenia.

The lack of recognition that women deserve sexual pleasure goes deep: It's hard to believe, but accurate anatomy of the clitoris is only recently being described in medical textbooks. Many female doctors aren’t even equipped to help their vulva-owning patients understand their own bodies.

This lack of knowledge about women’s needs and desires harms women as well as their sexual partners. This was the case for my clients, Luisa and Nathan.

Luisa and Nathan had been married for 10 years. He had two sons from a previous marriage, and they shared a 7-year-old daughter. They had difficulty getting pregnant, and their sex life had never fully recovered. By their own admission, it wasn’t stellar to begin with.

Nathan and Luisa met through their church and dated for five years before tying the knot. They connected over their shared values and mutual love of the outdoors. They didn’t struggle with any regular conflicts aside from the occasional squabble with Nathan’s ex-wife. They were happy in their marriage but had reached a point where Nathan felt dissatisfied with their sex life, which is why they came to see me.

“I deeply love Luisa, and I wouldn’t trade her for the world. But I’m not sure we’re on the same page sexually. It often feels like Luisa is going through the motions. I know she loves me, but she’s so quiet during sex. I beg her to tell me what turns her on, what positions she likes, what kind of touch she wants, but she just says she doesn’t know and that she’s happy with how things are. I sense, however, that we could be better.”

He glanced over at Luisa, gently squeezing her leg, reassuring her that this was coming from a place of love and not criticism.

“Tell me how you see things, Luisa,” I prompted.

“I really am happy with how things are. Nathan asks me all the time what I like, but I like how he does things. I don’t have any complaints. I even have orgasms most of the time.”

Nathan sighed.

I asked Luisa to describe her family of origin dynamics and to tell me about the sex education she got growing up. She described her parents as warm, but not overly affectionate. They were married for 35 years before her mother passed away from breast cancer. Her father never remarried and stayed busy with part-time consulting work and volunteering at the church. They never spoke to her about sex except to say that she needed to wait until she got married. She didn’t get negative messages from the church, but agreed with the church’s teachings that sex was meant for marriage.

She and Nathan spent the first five years making out and exploring each other’s bodies with their hands. They describe their first intercourse as a neutral experience. It was a bit physically uncomfortable for Luisa, and Nathan claims she always seems tense when they make love, despite the fact that she has orgasms.

After more probing, I learned that Nathan was always the one to initiate sex and that Luisa had never explored her own genitalia. She hadn’t looked at herself with a mirror or masturbated.

“I hear that you feel relatively satisfied, Luisa, but I also hear Nathan’s complaint that you seem to just be going through the motions. Did you know that female sexual satisfaction is predicted more by assertiveness than it is about the frequency of orgasms? I also hear that you may not have received negative messages about sex growing up, but it also wasn’t something that was celebrated. I wonder how much this affected the passion you feel about sex.”

“That resonates with me,” Luisa said. “I enjoy sex, but I can’t say I feel passionate about it, at least not the way I see in the movies.”

I asked Nathan to step out so I could ask Luisa some questions alone. “Would you be willing to share your sexual fantasies with me,” I asked, leaning forward. She turned bright red before finally admitting that she did sometimes fantasize about being punished. “I’ve always done the right thing. I’ve never gotten into trouble. I suppose I feel a little turned on by the idea of being naughty for once.” I smiled. “This gives us something to work with.”

I explained that she’d likely experience more passion and hunger for sex if she learned to express her sexual desires and needs. I told her that this didn’t necessarily mean she had to tell Nathan every fantasy she had, but that allowing him to share in some sexual thoughts might improve their intimacy and overall pleasure.

“I sense that you’ve reduced sex down to a function of the body when it has the potential to be so much more than that. Sex is an opportunity for connection and even self-expression. I want you to see what it feels like to tap into your fantasy as you explore your own body without Nathan present.” I told her to use a mirror and learn to identify all of her parts. “Information is power. This is about sexual empowerment for you. Sex can only make us feel alive if we feel like we’re in control of our own pleasure.”

“Nathen says you’re quiet during sex. What’s that about?”

“I’m not sure,” she said. “I just feel silly making lots of noise.”

“I want you to do what feels authentic to you,” I started. “Some people are quieter than others, and that’s OK, but I don’t want you to hold back if a moan or sigh is inside. Being verbal not only communicates what feels good, it also helps you feel more turned on. Try it by yourself before letting it out with Nathan if that feels like a safer first step.”

I checked in with Nathan and Luisa a month later. Luisa was glowing.

“I didn’t realize how shut down I was about sexuality until I wasn’t,” she said “All this time I thought I was having sex the way I was meant to, but there’s so much more to it than I realized. I can’t tell you how freeing it feels to shed the limiting beliefs that I didn’t even know I had. I’ve even started to initiate sex, something I never saw myself doing.”

While learning to become more assertive in bed doesn't happen overnight, it is possible. And once you start having sex in a way that feels totally authentic to who you are, that can be wildly exciting.

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