I'm glad that we've been celebrating orgasms this month, but I'm afraid that some readers may be feeling left out. Many of my patients tell me that they're worried about their sex drive, that they're not as interested in sex as they once were. A lack of desire is pretty common, and almost half of women report experiencing it at some point. A decreased drive may be due to a medical reason, in which case your gyno can help...but your drive may be totally normal.

The old-school thinking about our sex drive is that we get aroused, seek out sex, and then get satisfaction, 1,2,3--just like men. Now, this may be how we respond sometimes, but not all the time (and not for all women). So many things can affect our ability to get aroused: concerns about pregnancy, safety, privacy, timing (it's too hurried, not sexy, or just too late at night). The new thinking? Our sexual response experience is more like a circle, and not a straight line. Great research by Rosemary Basson has shown that we're more likely to experience spontaneous desire in a new relationship, after a long separation, or if it's been awhile since we've had sex. And many women think less frequently of sex when they're in long-term relationships, or feeling stress at work, or for many other reasons.

Sometimes, you may begin a sexual encounter from a position of what Basson calls "sexual neutrality." These are the times when you aren't actively aroused or seeking sex, but you want it for other reasons: to express love, to share physical pleasure, to feel emotionally closer, or to please a partner you care about. (My husband and I call this being "persuadable.") In these situations, your desire develops after sexual activity (foreplay, dirty talk, a little porn) gets your juices flowing. In other words, your body follows your mind's lead. So what if you're not initiating sex as much as you think you "should"? What matters most is that you're having as much sex (and good sex) as you want to have.

Do you ever find that you start out in neutral...and get into gear after you've started playing around?