Dear Dr. Jenni,
I am a single woman in my early 40s and have put on a lot of weight in the past 10 years. It incrementally increased over time. Now I find that by Boulder’s standards, I am obese. You can imagine that I am struggling with body image issues. However, when alone, I find myself incredibly horny. I also masturbate daily and orgasm very easily. The odd part is that when I do date men, I find that I am unable to get turned on sufficiently and unable to orgasm. Is this purely psychological, or is there something biological having to do with my weight?
—Worried about Weight
Studies show that obesity in women does not seem to be a major contributor to sexual dysfunction; however, it does psychologically affect different aspects of our sexuality — primarily how we feel as a sexual being. Regrettably, our society doesn’t give permission for women even slightly overweight to feel sexual. Accepting our body, no matter the size or shape, is one of the most difficult endeavors to achieve. However, the more we can learn to love our bodies, the more sexual desire we start to feel for ourselves and our partners.
When larger women lose weight, their androgen and free testosterone levels also drop, which can cause a decrease in sexual desire, arousal and orgasm. Thus, if you flip the coin, weight increases do the opposite, hormonally helping create a higher sexual appetite. This is probably why you are easily turned on and orgasmic when engaging in self-pleasure.
However, hormones are only a piece of the puzzle when considering the human sexual response. The brain is the biggest sexual organ, and our psychological well-being can outsize our hormonal drive. Feeling nervous or self-conscious when out on dates can turn off our ability to be aroused, orgasmic, and generally open to sexual intimacy. Thus, before you can fall in love with another, you need to fall in love with yourself.
I am 36 years old and giving birth to my third child next month. My husband and I are finished having kids, so I am thinking of putting in an IUD after delivery. My only concern is that they have hormones that might affect breast milk. I was also considering the minipill, but again that contains hormones.
What are your suggestions for preventing more pregnancies without hormones?
—Preventing More Pregnancies
Pregnancy prevention is a very personal choice. Yes, the mini-pill (a progestin-only pill) and the Mirena IUD contain small doses of hormone. That said, so does a lot of the food we eat, unless you are consciously eating an organic, all-natural diet.
If you are looking for long-term contraception that does not have any hormones, the Paraguard copper IUD is a great option that lasts 10 years — versus Mirena, which only lasts five. On the downside, Paraguard is known for causing longer periods with more cramping. If you choose an IUD, you will want to do it immediately after delivery, or wait until after your sixweek window.
The other long-term option is a vasectomy. They are easy to do, quick to heal and have a protection rate very similar to IUDs. Though there is more surgical intervention involved, tubal ligation is also an option.
While you may not be having intercourse for the first six weeks post delivery, don’t forget that breastfeeding alone is not a sufficient form of birth control for most women. Some have even gotten pregnant while breastfeeding and taking the mini-pill, so talk to your doctor about the best approach for your body.
Send questions for Jenni Skyler, PhD, to firstname.lastname@example.org. Skyler is a sex therapist and board-certified sexologist who runs The Intimacy Institute in Boulder, www.theintimacyinstitute.org.
Questions Send questions for Jenni Skyler to drjenni@ theintimacyinstitute.org.