The Libido Codes: How to Keep Passion Alive in Long Term Relationships

An Interview with Dr. Diane Mueller

This article is based on an interview with Dr. Diane Mueller, a board-certified sexologist with dual doctorates in naturopathic medicine and acupuncture & oriental medicine. She is the founder of mylibido.com and hosts the Libido Lounge podcast.

From Pelvic Pain to Pleasure: Dr. Mueller's Journey into Sexology

Dr. Diane Mueller's path into the world of sexology and intimacy began with two profoundly influential experiences. The first struck in her early twenties when she developed inexplicable pelvic pain. She went through all the tests – UTIs, STIs – everything came back negative, leaving her utterly baffled.

Living with a wonderfully open roommate at the time, Dr. Mueller heard her talk about her masturbation practice – something entirely foreign to her due to her religious upbringing. In her world, such topics were taboo, dirty even, meant only for the sanctity of marriage. So, the idea of masturbation was simply not on her radar.

But one night, restless and in pain, her roommate handed her Betty Dodson's book, Sex for One. Curious, Dr. Mueller read it. Lying awake with that nagging pelvic pain, she decided to try it. And miraculously, the pain vanished. The next day, it was back, and again, masturbation provided relief. After several sessions, the pelvic pain completely disappeared, never to return.

This was Dr. Mueller's first profound introduction to reforming beliefs around pleasure. It reshaped her understanding of what pleasure truly is, its health benefits, and its very purpose. It even prompted a reconstruction of her religious beliefs: how could a part of her body, designed in the image of spirit or God, be inherently "bad"? This experience truly opened her up to the vast curiosity surrounding pleasure.

The Physiology of Pleasure: Beyond the "Woo"

When it comes to the physiological mechanisms behind Dr. Mueller's pelvic pain relief, she has a two-fold suspicion. Firstly, during orgasm or heightened pleasure, we release oxytocin, which profoundly relaxes the nervous system. Oxytocin has the remarkable ability to balance our "fight or flight" chemicals like adrenaline and cortisol, shifting our nervous system into a more relaxed, calm state.

Sometimes pain stems from a neurological dysfunction, where the nervous system misinterprets signals. Imagine gently tapping your hand on a table; normally, your brain registers it as touch. But with a dysfunctional nervous system, that same gentle tap could be interpreted as pain. Anything that helps repattern the nervous system, like the experience of orgasm, has the potential to re-regulate these thresholds. This is one of Dr. Mueller's theories for what was happening with her.

Secondly, chronic pain often involves muscle tension. Think about those near-misses in a car – you hold onto that tension long after the event. Dr. Mueller believes similar tension can accumulate in the pelvic area. There's also a concept in holistic medicine, "as above, so below," which suggests imbalances in one part of the body, like the jaw, can manifest as compensation in another, like the pelvis. TMJ, for instance, where people hold immense tension in their jaw, can theoretically throw off pelvic muscles. Even without known pelvic trauma, many people unknowingly hold tension in their jaw. The contraction and relaxation of muscles during orgasm could potentially release some of this underlying tension contributing to pain.

Keeping the Spark Alive: Tackling Low Libido in Long-Term Relationships

In the beginning of a relationship, we experience that "new relationship energy." We're simply high on the other person, captivated by the newness and novelty. This newness triggers a surge in dopamine, a powerful driver of desire. What many don't realize is that dopamine isn't just about happiness; it thrives in that "in-between" space where we want something but haven't quite got it yet. That anticipation fuels dopamine.

However, in long-term relationships, as we merge lives and routines, that space often disappears. We fall into habits. Just like discovering a new walking path near your home after months of the same route, we create scripts in our relationships, including our sex lives. This familiarity, while comfortable, can diminish novelty and curiosity, leading to a decline in that dopamine drive and, subsequently, desire. The sad truth is, often what leads to this decline is boredom.

So, how do we keep monogamy hot when boredom sets in?

First and foremost, talk about it! Studies show that 91% of couples who report being truly happy with their sex lives openly discuss it. If we're not talking and co-creating our sexual experiences, we're likely to get stuck in a rut.

Dr. Mueller views novelty through the lens of "people, places, and things":

• People: In a monogamous relationship, this often translates to role-playing. Maybe it's something cliché like the "sexy secretary," or simply exploring different personas to inject a sense of newness.

• Places: If you always get intimate in the bedroom, try the closet, the shower, or even the floor. Dr. Mueller knows a couple who's found immense joy in "closet sex" – it became their "hot place." Experiment with different positions too. Keeping sex position books by the bed can be a fun way to get inspired. While some positions don't work for every body (like Dr. Mueller's "wheelbarrow" disaster, which felt more like an acrobatic feat than a pleasurable experience!), the key is to approach it with curiosity and playfulness. Laugh off what doesn't work, rather than letting it become another "train wreck" in your intimate history. This playful approach can bring so much joy and reduce the pressure of having to "perform."

Navigating Vulnerable Conversations: The Art of Sexual Communication

Getting to a place of curiosity and playful exploration, especially after negative experiences, is a process. When couples start having these intimate conversations, they often face three threats: a threat to oneself, a threat to the partner, and a threat to the relationship. While most conflict discussions give equal weight to these, with sex and intimacy, the threat to oneself is by far the biggest. This is why people tend to shut down or struggle to truly hear their partner – there's a natural egoic desire for self-protection.

Understanding this innate tendency is the first step. To ease into these sensitive conversations, Dr. Mueller suggests starting with what's going well. Begin by affirming what you love, both sexually and non-sexually. "Wow, I loved the way you just brushed my arm the other day, it really made me feel soft." Or, "I loved the way you kissed me last night." The more specific you are, and the more you share how their actions made you feel, the more you encourage that behavior. While it's important to eventually discuss what you don't like, focusing on the positive first builds trust and reduces the ego's defenses.

As for when to have these conversations, timing is crucial. Avoid bringing up sensitive topics when either partner is stressed or has had a bad day. Dr. Mueller also advises against the dreaded "Honey, we need to talk" opener, as it triggers alarm bells. Instead, try something like, "Babe, I'm really wanting to improve our sex life, and you did something the other day that I absolutely loved. I'd love to tell you about it and explore more things like that. When can we have a conversation?" This approach softens the message and sets a positive tone.

In the beginning, Dr. Mueller usually advises against having these talks in the bedroom or your usual intimate spaces. If the conversation goes poorly, you don't want those negative associations lingering. Once you're both more comfortable and skilled, then you can talk anywhere.

However, don't wait for the "perfect" moment that may never come. While setting yourself up for success is important, sometimes you just have to "rip the bandaid off" and go for it.

Understanding Low Libido: Physical, Personal, and Interpersonal Roots

Dr. Mueller breaks down the root causes of low libido into three main categories:

1. Physical: These are typically medical or physiological factors.
2. Personal: This involves your individual relationship with your body, including issues like numbness, pain, or internal emotional blocks that prevent you from enjoying pleasure and being present.
3. Interpersonal: This focuses on the dynamic within the relationship itself – how you and your partner connect and communicate, both sexually and otherwise.

From a physical standpoint, hormones are often a major player. Many people seek out Dr. Mueller's work after trying hormone replacement therapy (like testosterone) only to find an initial boost in libido that quickly fades. This is a crucial warning sign that hormones aren't the only problem.

To help identify the physical root causes (whether it's hormones, circulation, neurological issues, or pelvic pain), Dr. Mueller has created a useful online quiz at libidoquiz.com. It suggests what tests to ask your doctor for and provides lifestyle recommendations. This tool is incredibly useful because there's a common misconception that low libido can simply be "cured" with a pill.

Learn more about Dr. Diane Mueller at www.mylibidodoc.com

Listen to the Sex Talk Cafe Interview with Dr. Mueller Below: